IntroductionDysphagia affects several children in USA and around the globe. Videofluoroscopic Swallow Study (VFSS) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) are the most objective studies to define swallowing function. The presence of tracheal aspiration during VFSS or FEES in children with dysphagia is associated with an increased risk of aspiration pneumonia. However, the association of laryngeal penetration with aspiration pneumonia remains unclear. This systematic review aims to assess the risk of aspiration pneumonia in children with dysphagia with laryngeal penetration on VFSS/FEES and compare it with children with tracheal aspiration and children with neither tracheal aspiration nor laryngeal penetration.Methods and analysisThis study will be a systematic review and meta-analysis. Systematic electronic searches will be conducted on PubMed, EMBASE, Web of Science, CINHAL, Scopus, Cochrane CENTRAL, LILACS and WHO Global Index Medicus. We will include studies published through 6 October 2021. Primary outcome will be the incidence of aspiration pneumonia. Secondary outcomes will be incidence of hospitalisation, paediatric intensive care unit admission, enteral tube requirement, growth, symptoms improvement and mortality. The Cochrane Risk of Bias In Non-Randomised Studies of Interventions tool will be used to assess the risk of bias. Meta-analysis will be used to pool the studies. We will pool dichotomous outcomes to obtain an odd ratio (OR) and report with 95% CI. Continuous outcomes will be pooled to obtain mean difference and reported with 95% CI. Overall grade of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and findings will be presented in a summary of findings table.Ethics and disseminationThis study is a systematic review without contact with patients. Therefore, IRB approval is not required. Authors consent to publishing this review. Data will be kept for review by editors and peer reviewers. Data will be available to general public on request.PROSPERO registration numberCRD42020222145.
Background: Corneal blindness may be curable by keratoplasty but the demand for eye donation is however, unmet due to a variety of factors including knowledge gap. The purpose of this study was to assess the awareness of the medical undergraduate students towards eye donation and to assess the effectiveness of an orientation program in bridging the knowledge gap. Methods: This was a cross-sectional study done on MBBS students of 2nd and 3rd professional years. A pretested questionnaire was used to assess the knowledge of medical students. Knowledge regarding the contraindications to eye donation, the procedure involved and common misconceptions were assessed. This was followed by a session on orientation regarding eye donation. A second assessment using the same questionnaire was done after the session to assess the effectiveness of the same. The data was analysed using EPIINFO version 3.5.4 using chi square test. Results: Less than 50% students were aware of contraindications and less than 10% students knew ideal cornea harvesting time and nearest eye bank to their homes. Less than one-fourth students knew common causes of corneal blindness. However, most (77%) students were aware that hospital staff must motivate deceased’s family for eye donation. Significant increase in awareness was observed post orientation regarding most issues.Conclusions: This study shows that there is a knowledge gap amongst undergraduate medical students regarding eye donation. It also suggests that orientation sessions may be helpful in bridging this gap.
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