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Hashan MR, Elhusseiny KM, Huu-Hoai L, Tieu TM, Low SK, Minh LHN, Nghia TLB, Loc LQ, Y MN, Eid PS, Abed M, Elkolaly SS, Tawfik GM, Huy NT. Effect of nitazoxanide on diarrhea: A systematic review and network meta-analysis of randomized controlled trials. Acta Trop 2020; 210:105603. [PMID: 32598920 DOI: 10.1016/j.actatropica.2020.105603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 01/30/2023]
Abstract
We aimed to systematically review evidence pertaining to the safety and efficacy of nitazoxanide in treating infectious diarrhea. On September 21, 2017, we identified relevant studies using 12 databases. The estimates of the included studies were pooled as a risk ratio (RR). We conducted a network and pairwise random-effects meta-analysis for both direct and indirect comparisons of different organisms that are known to cause diarrhea. The primary and secondary analysis outcomes were clinical response until cessation of illness, parasitological response and adverse events. We included 18 studies in our analysis. In cryptosporidiosis, the overall estimate favored nitazoxanide in its clinical response in comparison with placebo RR 1.46 [95% CI 1.22-1.74; P-value <0.0001]. Network meta-analysis among patients with Giardia intestinalis showed an increase in the probability of diarrheal cessation and parasitological responses in comparison with placebo, RR 1.69 [95% CI 1.08-2.64, P-score 0.27] and RR 2.91 [95% CI 1.72-4.91, P-score 0.55] respectively. In Clostridium difficile infection, the network meta-analysis revealed a non-significantly superior clinical response effect of nitazoxanide to metronidazole 31 days after treatment RR 1.21 [95% CI 0.87-1.69, P-score 0.26]. In Entamoeba histolytica, the overall estimate significantly favored nitazoxanide in parasitological response with placebo RR 1.80 [95% CI 1.35-2.40, P-value < 0.001]. We highlighted the effectiveness of nitazoxanide in the cessation of diarrhea caused by Cryptosporidium, Giardia intestinalis and Entamoeba histolytica infection. We also found significant superiority of NTZ to metronidazole in improving the clinical response to G. intestinalis, thus it may be a suitable candidate for treating infection-induced diarrhea. To prove the superiority of NTZ during a C. difficile infection may warrant a larger-scale clinical trial since its superiority was deemed insignificant. We recommend nitazoxanide as an appropriate option for treating infectious diarrhea.
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Sherif NA, Morra ME, Thanh LV, Elsayed GG, Elkady AH, Elshafay A, Kien ND, Al-Habbaa A, Minh LHN, Y MN, Nghia TLB, Mohammed AT, Eid PS, Turk T, Hirayama K, Huy NT. Torasemide versus furosemide in treatment of heart failure: A systematic review and meta-analysis of randomized controlled trials. J Eval Clin Pract 2020; 26:842-851. [PMID: 31436024 DOI: 10.1111/jep.13261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/27/2019] [Indexed: 12/30/2022]
Abstract
AIM Diuretics are a cornerstone in treatment of heart failure (HF). Torasemide is a loop diuretic with a potential advantage over other diuretics. We aim to meta-analyse and compare the effect of torasemide with furosemide in HF patients. METHODS A comprehensive literature search using 12 databases including PubMed, Scopus, and Web of Science was performed. All randomized controlled trials (RCTs) comparing furosemide and torasemide in HF patients were included and meta-analysed. We assessed the risk of bias using Cochrane Collaboration's tool. The protocol was registered in PROSPERO (CRD42016046112). RESULTS Eighteen RCTs with 1598 patients were included. There was a significant difference between torasemide 20 mg and furosemide 40 mg in increasing the urine volume (standard difference of the mean (SDM) [95% confidence interval] = -0.78 [-1.52 to -0.053], P = .036). Torasemide 10 mg and 10 to 20 mg have a significant effect on potassium excretion in comparison with furosemide 25 to 40 mg (P = .018 and .023, respectively). In general, torasemide and furosemide have no significant difference in mortality, edema improvement, weight loss, heart rate, and reducing systolic/diastolic blood pressure. However, oral torasemide has a significant lower hospital stay P < .001 and superior effect in improving ejection fraction P = .029. CONCLUSION Although not all results are statistically significant, torasemide has potential advantages on multiple aspects of HF management when compared with furosemide. More studies are needed to clarify these effects.
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Affiliation(s)
- Nourin Ali Sherif
- Faculty of Medicine, Mansoura University, Mansoura, Egypt.,Online Research Club, Nagasaki, Japan
| | | | - Le Van Thanh
- Online Research Club, Nagasaki, Japan.,Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ghadeer Gamal Elsayed
- Online Research Club, Nagasaki, Japan.,Faculty of Medicine, Benha University, Benha, Egypt
| | - Aya Hesham Elkady
- Online Research Club, Nagasaki, Japan.,Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Abdelrahman Elshafay
- Online Research Club, Nagasaki, Japan.,Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Nguyen Dang Kien
- Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Ahmed Al-Habbaa
- Cardiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Le Huu Nhat Minh
- Online Research Club, Nagasaki, Japan.,Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Mai Nhu Y
- Online Research Club, Nagasaki, Japan.,Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Thai Le Ba Nghia
- Online Research Club, Nagasaki, Japan.,Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | | | - Peter Samuel Eid
- Online Research Club, Nagasaki, Japan.,Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tarek Turk
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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Tran L, Nhu Y M, Le Ba Nghia T, Hendam A, Vuong NL, Alzalal E, Sayed AM, Hussain MM, Sharma A, Tieu T, Mathenge PG, Hirayama K, Alexander N, Huy NT. Frequent inappropriate use of unweighted summary statistics in systematic reviews of pathogen genotypes or genogroups. J Clin Epidemiol 2019; 119:26-35. [PMID: 31740320 DOI: 10.1016/j.jclinepi.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/11/2019] [Accepted: 11/12/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Our study aimed to systematically assess and report the methodological quality used in epidemiological systematic reviews (SRs) and meta-analysis (MA) of pathogen genotypes/genogroups. STUDY DESIGN AND SETTING Nine electronic databases and manual search of reference lists were used to identify relevant studies. The method types were divided into three groups: 1) with weighted pooling analysis (which we call MA), (2) unweighted analysis of the study-level measures (which we call summary statistics), and (3) without any data pooling (which we call SR only). Characteristics were evaluated using Assessment of Multiple Systematic Reviews (AMSTAR), Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Risk Of Bias In Systematic reviews (ROBIS) tools. The protocol was registered in PROSPERO with CRD42017078146. RESULTS Among 36 included articles, 5 (14%) studies conducted SR only, 16 (44%) performed MA, and 15 (42%) used summary statistics. The univariable and multivariable linear regression of AMSTAR and PRISMA scores showed that MA had higher quality compared with those with summary statistics. The SR only and summary statistics groups had approximately equal scores among three scales of AMSTAR, PRISMA, and ROBIS. The methodological quality of epidemiological studies has improved from 1999 to 2017. CONCLUSION Despite the frequent use of unweighted summary statistics, MA remains the most suitable method for reaching rational conclusions in epidemiological studies of pathogen genotypes/genogroups.
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Affiliation(s)
- Linh Tran
- Institute of Research and Development, Duy Tan University, Danang 550000, Vietnam
| | - Mai Nhu Y
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Thai Le Ba Nghia
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Abdulrahman Hendam
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nguyen Lam Vuong
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ebrahim Alzalal
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Menofia University, Shebin Elkom, Egypt
| | - Ahmed M Sayed
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Mustafa Mushtaq Hussain
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Akash Sharma
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Thuan Tieu
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Peterson Gitonga Mathenge
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Neal Alexander
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan.
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4
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Hieu TH, Dibas M, Surya Dila KA, Sherif NA, Hashmi MU, Mahmoud M, Trang NTT, Abdullah L, Nghia TLB, Y MN, Hirayama K, Huy NT. Therapeutic efficacy and safety of chamomile for state anxiety, generalized anxiety disorder, insomnia, and sleep quality: A systematic review and meta‐analysis of randomized trials and quasi‐randomized trials. Phytother Res 2019; 33:1604-1615. [DOI: 10.1002/ptr.6349] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 01/29/2019] [Accepted: 02/23/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Truong Hong Hieu
- Faculty of MedicineUniversity of Medicine of Pharmacy at Ho Chi Minh City Ho Chi Minh City Vietnam
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
| | - Mahmoud Dibas
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
- Sulaiman Al Rajhi Colleges, College of Medicine Qassim Saudi Arabia
| | - Kadek Agus Surya Dila
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
- Kubutambahan II Public Health Center Singaraja 81172 Indonesia
| | - Nourin Ali Sherif
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
- Faculty of MedicineMansoura University Mansoura Egypt
| | - Muhammad Usman Hashmi
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
- Department of General MedicineNishtar Medical University Multan Punjab Pakistan
| | - Mostafa Mahmoud
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
- Faculty of MedicineAlexandria University Alexandria Egypt
| | - Nguyen Thi Thuy Trang
- Faculty of MedicineUniversity of Medicine of Pharmacy at Ho Chi Minh City Ho Chi Minh City Vietnam
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
| | - Lava Abdullah
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
- Faculty of MedicineDamascus University Damascus Syria
| | - Thai Le Ba Nghia
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
- Faculty of MedicineVo Truong Toan University Hau Giang Vietnam
| | - Mai Nhu Y
- Online Research Club (http://www.onlineresearchclub.org) Nagasaki Japan
- Faculty of MedicineVo Truong Toan University Hau Giang Vietnam
| | - Kenji Hirayama
- Department of ImmunogeneticsInstitute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University Nagasaki 852–8523 Japan
| | - Nguyen Tien Huy
- Evidence Based Medicine Research GroupTon Duc Thang University Ho Chi Minh City 70000 Vietnam
- Faculty of Applied SciencesTon Duc Thang University Ho Chi Minh City 70000 Vietnam
- Department of Clinical Product DevelopmentInstitute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University Nagasaki 852–8523 Japan
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5
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Radwan I, Magdy Khattab M, Mahmoud AR, Nghia TLB, Y MN, Trung DT, Hirayama K, Huy NT. Systematic review of spontaneous splenic rupture in dengue-infected patients. Rev Med Virol 2019; 29:e2029. [PMID: 30609179 DOI: 10.1002/rmv.2029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 11/06/2022]
Abstract
Dengue infection varies from a mild febrile form to more severe disease with plasma leakage, shock, and multiorgan failure. Several serious complications such as cardiomyopathy, encephalopathy, encephalitis, hepatic damage, and neural manifestations cause organ damage in dengue infection. Splenic rupture, a less well known but life-threatening complication, can occur in dengue. The mechanism of splenic rupture in dengue is still unclear. Optimal therapeutic management is required to save the lives of patients with this complication. The objective of this study was to conduct a systematic review of studies documenting the development of spontaneous nontraumatic splenic rupture in patients with dengue infection. In March 2018, a search was conducted systematically in nine electronic databases, in addition to hand- searching. A total of 127 references were exported to Endnote; 47 references remained after removing duplicates. Finally, 16 reports met the inclusion criteria and represented 17 cases. All articles were evaluated and data extracted according to predefined criteria: number of cases, age, sex, severity of dengue disease, days of illness before admission, methods of definitive diagnosis, timing of the event, and management and outcome. A total of 17 individual patients including 13 males and four females were found. Most of the patients were young adults (ranging from 20 to 52 years) and diagnosed with computed tomography scan and managed with splenectomy. Four cases were fatal. Pathological splenic rupture in dengue is a rare, life-threatening condition where timely management can achieve a favorable outcome.
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Affiliation(s)
- Ibrahim Radwan
- Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org
| | - Mohamed Magdy Khattab
- Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org.,Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Abdalla Reda Mahmoud
- Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org.,Faculty of Medicine, Minia University, Minia, Egypt
| | - Thai Le Ba Nghia
- Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org.,Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Mai Nhu Y
- Online Research Club, Nagasaki, Japan, http://www.onlineresearchclub.org.,Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Dinh The Trung
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.,Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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6
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Nghia TLB, Y MN, Morra ME, Vuong NL, Tin NM, Karam D, Refaey MA, Shahin K, Soliman AL, Huy NT. P05.63 The best treatment for Vestibular Schwannoma: Systematic Review of Clinical Trials and Case Series. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T L B Nghia
- Faculty of Medicine, Vo Truong Toan University, Hau Giang, Viet Nam
- Online Research Club, Nagasaki, Japan
| | - M N Y
- Faculty of Medicine, Vo Truong Toan University, Hau Giang, Viet Nam
- Online Research Club, Nagasaki, Japan
| | - M E Morra
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Online Research Club, Nagasaki, Japan
| | - N L Vuong
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
- Online Research Club, Nagasaki, Japan
| | - N M Tin
- Faculty of Medicine, Vo Truong Toan University, Hau Giang, Viet Nam
- Online Research Club, Nagasaki, Japan
| | - D Karam
- Online Research Club, Nagasaki, Japan
| | - M A Refaey
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Online Research Club, Nagasaki, Japan
| | - K Shahin
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Online Research Club, Nagasaki, Japan
| | - A L Soliman
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Online Research Club, Nagasaki, Japan
| | - N T Huy
- Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Online Research Club, Nagasaki, Japan
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