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      • Pharmaceutical Medicine

        ( Md Azharuddin ),( Mohammad Adil ),( Prem Kapur ),( Pinaki Ghosh ),( Manju Sharma ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

        Aims: Surgical site infection (SSI) is a common and postoperative complication in patients who underwent solid organ transplant and it makes extensive healthcare burden. So far, the pooled prevalence and microorganisms causing SSI among liver transplantation has not been reported well. This evidence-based systematic literature review and meta-analysis aimed to find the pooled prevalence of SSI. Methods: A systematic literature search on PubMed/Medline, Embase was conducted to identify the study determining the prevalence of SSI among patients who underwent liver transplantation, published from inception to May 2020. We calculated pooled prevalence (%) with 95% confidence interval (CI) with a random-effect model. A meta-analysis was performed using “meta” package through R 3.5.0. software. Results: A total of fifteen studies with 5,952 study subjects were included in this analysis. The rate of SSI was ranged between 9.0% and 96.4%. The pooled prevalence of SSI was 27.0% (95% CI: 16.09 to 40.01%) with high degree of heterogeneity (I2 = 99%, heterogeneity-P<0.01). The included studies reported a higher percentage of organ-space SSI (70.2%), followed by incisional, superficial, and deep SSI. The incidence rate of SSI was ranged from 0.34-10.3 episodes per 100 transplantation. Staphylococcus aureus (76.5%) was the most common pathogen identified, followed by Coagulase-negative staphylococci (35.0%) and Escherichia coli (21.25%). Conclusions: The current result suggests the overall prevalence of SSI infection was high. However, due to a high degree of heterogeneity, resulting a considerable amount of clinical uncertainty regarding the prevalence of SSI among patients who underwent liver transplantation. Therefore, studies are required to confirm the present findings.

      • Burden of Healthcare Utilization Associated with Diabetes Mellitus in COVID-19 Infected Patients

        ( Md Azharuddin ),( Mohammad Adil ),( Upasna Gaba ),( Manju Sharma ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

        Purpose There available evidences of increased incidence and severity of COVID-19 in patients with diabetes mellitus (DM) reported with higher risk for intensive care unit (ICU) admission and substantial mortality. We carried out a systematic literature review and meta-analytic synthesis to find out the association between diabetes mellitus (DM) and related healthcare utilization burden in patients with COVID-19 infection. Methods We systematically searched MEDLINE, and Web of Science to identify studies investigating resource utilization of diabetic patients exposed to COVID-19. Meta-analysis was carried out using Review Manager 5.3. The random effects model was used to compute the pooled estimates of odds ratio/mean difference (OR)/(MD) and 95% confidence intervals (CI). Results Results from the pooled meta-analysis found that significant association was found between mortality and DM vs. nondiabetic [OR (95% CI): 2.46 (1.68, 3.58)]. ICU admission and use of mechanical ventilation were significantly associated with DM and COVID-19 vs. non-diabetic [OR (95% CI): 2.79 (1.79,4.34) and 3.33 (2.05, 5.42)], respectively. However, LOS, hospitalization, and ICU admission were not significantly different between patients with DM vs. non-DM. Conclusion The Results showed a significant association between mortality and DM exposed with COVID-19. Other co-morbidities especially CVD/hypertension could be a serious threat for DM COVID-19 infected patients for the higher mortality.

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        Systematic evidence of health economic evaluation of drugs for postmenopausal osteoporosis: A quality appraisal

        Md Azharuddin,Mohammad Adil,Rashid Ali Khan,Pinaki Ghosh,Prem Kapur,Manju Sharma 대한골다공증학회 2020 Osteoporosis and Sarcopenia Vol.6 No.2

        This paper systematically and critically reviewed all published economic evaluations of drugs for the treatment postmenopausal osteoporosis. A systematic search was conducted using relevant databases for economic evaluations to include all relevant English articles published between January 2008 to January 2020. After extracting the key study characteristics, methods and outcomes, we evaluated each article using the Quality of Health Economic Studies (QHES) and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) instruments. A total of 49 studies met the inclusion criteria. Majority of studies were funded by the industry and reported favorable cost-effectiveness. Based on the QHES total scores, studies (n = 35) were found to be industry-funded with higher QHES mean 82.44 ± 8.69 as compared with nonindustry funding studies (n = 11) with mean 72.22 ± 17.67. The overall mean QHES scores were found to be higher 79.06 ± 11.84, representing high quality (75-100) compared to CHEERS scores (%) 75.03 ± 11.21. The statistical pairwise comparison between CHEERS mean (75.03 ± 11.21) and QHES mean (79.06 ± 11.84) were not statistically significant (P ¼ 0.10) whereas, QHES score showed higher means as compared to CHEERS. This study suggests the overall quality of the published literatures was relatively few high-quality health economic evaluation demonstrating the cost-effectiveness of drugs for postmenopausal osteoporosis, and the majority of the literature highlights that methodological shortcoming.

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