Introduction Animal derived surfactants are considered to be the standard treatment for neonatal respiratory distress syndrome (NRDS). However, their comparative effectiveness remains inconclusive given the multiple prior studies with inconsistent results. Therefore, we conducted a systematic review and meta analysis to compare the effectiveness of two animal extract surfactants (calfactant and beractant) for the management of NRDS. Methods We searched Pubmed, Scopus, and Google Scholar for studies comparing efficacy of calfactant and beractant for the treatment of NRDS. Mean differences (MD) and risk ratios (RR) with a 95% confidence interval (CI) were calculated using Review Manager. Result We found no significant difference between calfactnat and beractant groups in the primary outcomes: neonatal mortality before the age of 28 days (RR = 1.19, 95% CI = 0.97–1.46, p = 0.09), mortality before the hospital release (RR = 1.12, 95% Cl = 0.94–1.33, p = 0.22), oxygen requirement at 28 days of age (RR = 0.97, 95% CI = 0.90–1.05, p = 0.52), and death or oxygen need at 36 weeks postmenstrual age (RR = 0.99, 95% CI = 0.91–1.08, p = 0.81). The duration of supplementary oxygen was significantly lower in calfactant users (MD = −4.95, 95% CI = −7.60–−2.30, p = 0.0002). Calfactant significantly lowered the duration of hospital stay, risk of pneumothorax and air leak syndrome whereas beractant users had lower risk of intraventricular hemorrhage (Grades 3 and 4). Conclusion There is no substantial difference in the efficacy of both surfactants in the prophylaxis and treatment of NRDS.
To the Editor, Hydrochlorothiazide (HCTZ) is the most commonly prescribed antihypertensive drug that belongs to a diuretic class.1 It mainly works by increasing the removal of excess water and salts from the body into the urine and by this function it is most widely used alone or in combination with other medications to treat patients with uncontrolled blood pressure and edema that results from numerous medical conditions like heart, Liver and kidney diseases. It also helps treat other ailments like diabetes insipidus, renal tubular acidosis and reduce the risk of kidney stones in patients with high calcium levels in urine. Despite its various uses and benefits, HCTZ comes with a heavy price of undesirable side effects like fatigue, lethargy, gastrointestinal discomfort and is known to cause hyperuricemia and hypokalemia associated with increased blood glucose.2 Furthermore, HCTZ increases the skin sensitivity to sunlight. However, recent research has revealed a more worrisome side effect of HCTZ that needs to be highlighted. In 2017, a nationwide study conducted in Denmark involving more than 70,000 patients with Basal cell carcinoma and 8000 patients with squamous cell carcinoma found a considerably increased risk of developing Non melanoma skin cancer, particularly among the users of HCTZ.3 A recent study also substantiated that a total of 135 squamous cell carcinoma events per 100,000 person years were reported in new users of HCTZ.4 These alarming figures raise a question mark on the safety of HCTZ use. Moreover, HCTZ is now classified as a carcinogenic agent for humans by the International Agency for Research on Cancer and the U.S. Food and Drug Administration has also permitted changes to the HCTZ drug label to warn the health care workers and patients of the risk of non-melanoma skin cancer. 5, 6 Unfortunately in Pakistan, HCTZ is still heavily used as a diuretic and people are not much aware of this new fact. In view of these findings and the fact that HCTZ is among the most generally prescribed drugs in Pakistan, its potential indication of causing skin cancer would impose a serious public health concern so the responsibility lies on the cardiologists, nephrologists and other medical physicians to be aware of this possible hazardous outcome of HCTZ use and should be cautious while prescribing it to patients who are at risk of developing skin cancer or who have had a history of skin cancer.
Background: Blood group and intelligence are both highly heritable traits unique to each individual. For the past several years, a possible correlation between these two traits has been suggested but existing studies report contrasting results in different geographical populations. Objective: To investigate a potential relationship between blood group and intelligence among consenting medical and dental students of Dow University of Health Sciences, Karachi. Materials & Methods: This study is a cross-sectional study involving the MBBS and BDS students of Dow University of Health Sciences within age group of 18-21 years. The study was conducted in the department of Physiology, Dow Medical College (DUHS) from 15th February 2021 to 1st July 2021. After the Institutional Review Board’s approval, we determined the ABO and Rh blood group of the participants through test tube method (forward grouping) during the physiology practical sessions. Intelligence levels were assessed using the Stanford Binet IQ Test. SPSS 21 was used to analyze the data collected. Results: Out of 353 participants, 67 (18.98%) were male and 286 (81.01%) were female with a mean age of 20 years. We found highest IQ scores in blood group A negative (25.80±8.25) with no statistical significance (p=0.162). Moreover, there was no statistically significant difference between the intelligence of male and female participants (p=0.257). Conclusion: Blood group and intelligence of an individual are two heritable traits that are not linked with each other. There is no difference in the IQ of males and females. This finding has important implications in the educational field as it shows that male and female students of different blood groups have similar cognitive capabilities and consequently, similar educational needs.
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