Objective: The objective of this study was to investigate the burden of disease associated with lower limb spasticity (LLS) and its complications in adults. Methods: A systematic search of MEDLINE and EMBASE identified 9 studies published between November 2012 and July 2019 that assessed the epidemiological burden associated with LLS. Results: LLS was found to occur in one-third of adults after neuromyelitis optica spectrum disorder (NMOSD), one quarter to one third with multiple sclerosis, one quarter to half with Parkinson’s disease and roughly half with stroke. LLS reduces mobility and diminishes the quality of life. LLS complications, especially injuries following falls are a common occurrence. Conclusion: Given the high prevalence among adults with common disorders, such as stroke; the evidence on the burden of LLS is somewhat finite. Further research is needed to explore the trends over time and across different geographical regions in the incidence and prevalence of LLS. The dearth of high-quality evidence for LLS suggests a lack of awareness of the problem and interest in it, and hence, the unmet need among patients and their carers.
Objective: To evaluate the effectiveness and safety of omeprazole compared to lansoprazole in Gastroesophageal reflux disease patients (GERD). Methods: A systematic search of MEDLINE, EMBASE (inception to December 2019) and CENTRAL (January 2011 to December 2019) was conducted to identify the relevant articles. A detailed inclusion-exclusion criterion was developed and implemented to screen the abstracts. Full texts of the selected abstracts were then assessed to establish their inclusion or exclusion in our review. Cochrane risk of bias criterion was used to assess the methodological quality of the included studies. All relevant data were extracted and the results were summarised narratively. Results: 9 studies met our inclusion-exclusion criteria and were included in this review. In all three trials reporting on heartburn and regurgitation, both omeprazole and lansoprazole were found to be effective in relieving the symptoms of heartburn and regurgitation; however, there was no evidence that one is better than the other. Five out of six studies reporting on intragastric pH provided the evidence of omeprazole’s superiority over lansoprazole in controlling gastric pH. Omeprazole lowered intragastric pH faster and the results lasted longer compared to lansoprazole. The results were statistically significant. Conclusion: There is no significant difference in the clinical effectiveness of omeprazole and lansoprazole in relieving symptoms of heartburn and regurgitation. However, omeprazole is more effective in reducing gastric acidity than lansoprazole.
Objectives: To review the effectiveness of current clinical interventions and integrated care program, and the cost-effectiveness of currently available pharmaceutical interventions in the management of Type 2 Diabetes Mellitus in Saudi Arabia. Data Sources and Methods: A systematic search of MEDLINE, EMBASE, ScienceDirect, CENTRAL, and Google Scholar was conducted to identify the relevant articles. A detailed inclusion–exclusion criterion was developed and implemented to screen the abstracts and full-texts. We extracted study data from eligible studies into a data extraction form and categorized into various themes to answer our research question. Study Selection and Themes: Seventeen studies categorized into three themes were included in this review. The evidence was compiled to report the effectiveness of current clinical interventions, integrated care program, and cost-effectiveness of pharmaceutical interventions. Conclusions: There is strong evidence of safety and efficacy of BIAsp 30 in T2DM patients. In addition, BIAsp 30 with or without OADs is more cost-effective compared with other pharmaceutical interventions. The integrated care program is more effective in reducing HbA1c in diabetic patients compared with usual care programs; however, the evidence is small and more studies are required. Recommendations: Most of the available studies are small cross-sectional studies. There is a dire need to conduct extensive and high-quality studies, with the sample size representative of Saudi T2DM populations, to generate larger data with high-quality evidence to provide more robust evidence in the future.
Objective To identify the causes and treatments of nasal obstruction in the paediatric population. Methods A systematic search of Medline and Embase was conducted to identify the relevant articles. A detailed inclusion and exclusion criterion was developed and implemented to screen the abstracts. Full texts of the selected studies were then assessed to establish their inclusion or exclusion in our review. All relevant data were extracted, and the results were summarised narratively. Results Fifty-nine studies met out inclusion-exclusion criteria and were included in this systematic review. All of these primary research studies were categorised into causes and treatments. Cleft lip and palate was the most reported cause of nasal obstruction among congenital causes. However, among the acquired causes, allergic rhinitis was the most reported. Twenty-one of 39 studies described treatments for allergic rhinitis, including perennial rhinitis, 9 for adenoid hypertrophy, 2 for the common cold, 5 for septal deviation, and 2 for chronic rhinosinusitis. Conclusion This systematic review provides good evidence regarding the causes and treatments of nasal obstruction. Allergic rhinitis is the most common cause of acquired nasal obstruction, and cetirizine, fexofenadine, fluticasone furoate nasal spray, and mometasone furoate monohydrate nasal are the commonly used treatments to alleviate the symptoms.
Objective: To analyze the capability of cone-beam computed tomography (CBCT) to accurately identify low bone mass density in women.Methods: A systematic search of Medline, Embase, Scopus, Google Scholar, Cochrane Library, and Science Direct was conducted to identify the relevant articles. A detailed inclusion and exclusion criterion was developed and implemented to screen the abstracts. Full texts of the selected studies were then evaluated to establish their inclusion or exclusion in our review. Cochrane risk of bias criterion was used to determine the methodological quality of the included studies. All relevant data were extracted, and the results were summarized narratively.Results: Ten studies met out inclusion-exclusion criteria and were included in this systematic review. All of the included studies assessed primary research on the capacity of CBCT to accurately diagnose insufficient bone mineral density. The results indicated that CBCT has good sensitivity and specificity, and high accuracy in predicting osteoporosis. Four of the included studies measured qualitative values while others concentrated on quantitative values and found lower values in osteoporosis patients compared to osteopenic and healthy patients. All of these studies compared CBCT grayscale values with DEXA scores which strengthened our confidence in the accuracy of CBCT diagnostic capability.Conclusion: Given the common use of CBCT in dental practices and the high prevalence of osteoporosis in postmenopausal women, the evidence on the capacity of CBCT to predict osteoporosis is somewhat finite. Although this systematic review provides good evidence regarding the ability of CBCT for predicting osteoporosis, further research is needed to confirm the evidence and enhance its generalisability.
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