of CC or LC [4]. Diagnosis of MC is made through multiple steps. A complete medical and family history, including habits, diet, and previous medications, is required. A physical examination, blood tests, and stool analysis may also help exclude other diseases causing watery diarrhea. However, colonoscopy or flexible sigmoidoscopy is required to examine the colonic mucosa, which typically appears normal in the majority of cases of MC [1][2][3][4]. Therefore, microscopic examination of biopsy tissue is the gold-standard for diagnosing MC [5][6][7].The American Society for Gastrointestinal Endoscopy (ASGE) guidelines recommend collecting two or more biopsies from the right colon, transverse colon, descending colon (DC), and sigmoid colon [5]. However, the recommendation was based on expert opinion and low-quality evidence. The optimal number biopsies and sites for collecting biopsies are uncertain, and no single site in the colon is positive in all MC cases. Therefore, we aim to determine the optimal sites and mean number of biopsies needed to diagnose MC with a high level of certainty from published studies.
MethodsWe conducted this systematic review guided by the Cochrane handbook for systematic reviews [6] and reported the results according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA statement) [7].
Literature searchWe searched PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials from inception to October 2020 using the following search strategy: (biopsy OR biopsies) AND [(microscopic OR lymphocytic OR collagenous) AND colitis].
Introduction: Nonalcoholic fatty liver disease (NAFLD) comprises a wide range of related liver disorders affecting mainly people who drink no or very little alcohol. Aramchol is a new synthetic molecule that has been shown to reduce liver fat content. There is little evidence supporting its efficacy in humans.Aim: To evaluate the efficacy of Aramchol in patients with NAFLD according to different randomized clinical trials.Material and methods: We searched PubMed, SCOPUS, Web of Science, and Cochrane Library for relevant clinical trials assessing the use of Aramchol in patients with NAFLD. Risk of bias assessment was performed using Cochrane's risk of bias tool. We included the following outcomes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AP), glycated haemoglobin (HbA 1c ), total cholesterol (TC), triglyceride (TG), HOMA-IR, and insulin level.Results: We included 3 clinical trials. We found that the Aramchol group did not show any significant difference from the control group regarding ALT (
AimsINTRODUCTION: The term ‘psychosis’ is used in NICE guidelines to refer to the group of psychotic disorders that includes schizophrenia, schizoaffective disorder, schizophreniform disorder, and delusional disorder as identified by the International Classification of Diseases – 10th revision (ICD 10; World Health Organization, 1992).BACKGROUND: Children and young people with psychosis and schizophrenia have poorer physical health than the general population as get older. Life expectancy is reduced by 16 to 25 years (Brown et al., 2010; Parks et al 2006).AIMS & OBJECTIVES: To compare the west-midlands child psychiatrist practice with the standard NICE clinical guidelines on baseline physical and metabolic investigations before prescribing antipsychotics in children and adolescents. To compare if fulfilling criteria. Early detection and intervention in order to delay or possibly prevent the onset of psychosis and schizophrenia. To improve the services.Methods•The sample was collected via ‘WEST MIDLANDS CAMHS CONSULTANT SURVEY’.•Information collection through the questionnaire.•Nine members of the west midlands CAMHS Consultant CLENT group participated in 2019.Results•Indications to use antipsychotics, Record keeping and Assessment of nutritional status & level of physical activity: 100%.•Pulse and B.P check: 88.9% yes, 11% not always.•Weight and Height plotted on growth chart: 77.8% yes, 22% not always.•Antipsychotics (must be initiated by suitably qualified health care professional with expertise in prescribing: 33% consultant, 55% doctor, 11.1% doctor or nurse.•Assessment of movement disorders was done by 44.4%always, 11.1% never and 44.4% sometimes.•Lipid Profile was checked by 44.4% always, 11.1% never and 44.4% sometimes.•Fasting blood Glucose and Hb1ac check: 33.3% yes, 66.7% never and 33.3% sometimes.ConclusionData collected suggest meeting the set standards for indications of antipsychotics, record keeping and physical activity checks but not in other domains.Recommendations:
•To create a checklist Performa for physical / metabolic Health Checks for children and adolescent initiated on antipsychotic medications under the care of CAMHS.•Clinicians to stay up to date with NICE guidelines.•To regularly monitor physical health and blood test before prescribing antipsychotics.•To re-audit after introducing Performa in our CAMHS centre, if effective to introduce it in other local CAMHS centres after negotiation with them.
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