Showing papers by "Sukanta Saha published in 2022"

The effects of prenatal dietary supplements on blood glucose and lipid metabolism in gestational diabetes mellitus patients: A systematic review and network meta-analysis protocol of randomized controlled trials

Abstract: Background Several randomized controlled trials (RCT) investigated antenatal dietary supplements’ effect on gestational diabetes mellitus patients’ fasting plasma glucose levels, glycated hemoglobin levels, homeostasis model assessment of- insulin resistance and β-cell function, quantitative insulin sensitivity check index for glucose, high-, low-, and very-low-density lipoprotein cholesterol levels, total cholesterol levels, triglyceride levels, and triglyceride to high-density lipoprotein ratio. However, an efficacy comparison across various dietary supplements and their co-supplements are unavailable for these outcomes. Therefore, a systematic review protocol is proposed here to make a network meta-analysis (NMA)-based juxtaposition across the following dietary supplements- vitamins, Myo-inositol, choline, minerals, probiotics, prebiotics, synbiotics, and omega-3 fatty acids. Materials and methods A database search will ensue in the PubMed, Embase, and Scopus databases for RCTs testing the above, irrespective of their geographical origin. Data on population characteristics, compared interventions, and outcomes of interest will get abstracted from the studies included in the proposed review. Each of the reviewed studies will get appraised using the revised Cochrane tool. For each outcome, the comparative efficacy across interventions will be estimated in weighted or standardized mean difference using the frequentist method NMA and presented with their 95% confidence interval using league tables. By constructing network maps and comparison-adjusted funnel plots, a visual assessment of the inter-interventional relation and publication bias in each NMA model will happen, respectively. The best-ranked intervention prediction for respective outcomes will transpire using the surface under the cumulative ranking curve values. The Stata statistical software (version 16) will be used for analysis, and statistical significance will be determined at p<0.05 and 95% confidence interval. Trial registration PROSPERO registration number: CRD42020214378.

Comparative effectiveness of adjunct non-pharmacological interventions on maternal and neonatal outcomes in gestational diabetes mellitus patients: A systematic review and network meta-analysis protocol of randomized controlled trials

Abstract: Background Gestational diabetes mellitus (GDM) in pregnancy leads to a range of perinatal complications. Although several randomized controlled trials (RCT) have tested the effect of non-pharmacological standard GDM care adjuncts on these outcomes, there is no agglomerated statistical evidence on how their occurrence risk varies across interventions and with placebo. Therefore, a systematic review and network meta-analysis (NMA) protocol is proposed here to address this evidence gap. Materials and methods A search for above RCTs published in the English language will transpire in PubMed, Embase, and Scopus databases irrespective of date and geographic boundary. The RCTs must test nutritional supplementation, digital intervention, structured exercise program, educational program, counseling service, or a combination of these prenatally in GDM patients. These should report ≥1 of the following outcomes- cesarean section, pre-eclampsia, polyhydramnios, preterm birth, macrosomia, prolonged labor, gestational hypertension, premature rupture of membranes, congenital anomaly, Apgar scores, birth weight, birth length, gestational age at birth, neonatal hypoglycemia, neonatal hyperbilirubinemia, and neonatal Corpulence Index. The risk of bias assessment of the recruited trials will transpire using the Revised Cochrane risk-of-bias tool. Determination of the comparative effectiveness between interventions will occur by the frequentist method NMA for respective outcomes. The categorical and continuous outcomes effect size will get calculated in risk ratio and weighted or standardized mean difference, respectively. For each NMA model, network maps and league tables will show the connections between interventions and effect sizes with their 95% confidence intervals for each intervention pair compared, respectively. The publication bias assessment will occur using comparison-adjusted funnel plots. Best intervention prediction for NMA models with statistically significant intervention effect will happen by determining the surface under the cumulative ranking curve values. Statistical analysis will ensue using Stata software (v16). The statistical significance estimation will happen at p<0.05 and 95% confidence interval. Trial registration PROSPERO registration no: CRD42021271199; https://clinicaltrials.gov/.

Death and invasive mechanical ventilation risk in hospitalized COVID-19 patients treated with anti-SARS-CoV-2 monoclonal antibodies and/or antiviral agents: A systematic review and network meta-analysis protocol

Abstract: Background The ongoing COVID-19 pandemic has claimed >4 million lives globally, and these deaths often occurred in hospitalized patients with comorbidities. Therefore, the proposed review aims to distinguish the inpatient mortality and invasive mechanical ventilation risk in COVID-19 patients treated with the anti-SARS-CoV-2 monoclonal antibodies and/or the antiviral agents. Methods A search in PubMed, Embase, and Scopus will ensue for the publications on randomized controlled trials testing the above, irrespective of the publication date or geographic boundary. Risk of bias assessment of the studies included in the review will occur using the Cochrane risk of bias tool for randomized trials (RoB 2). Frequentist method network meta-analyses (NMA) will compare each outcome’s risk across both types of anti-SARS-CoV-2 agents in one model and each in separate models. Additional NMA models will compare these in COVID-19 patients who were severely or critically ill, immunocompromised, admitted to the intensive care unit, diagnosed by nucleic acid amplification test, not treated with steroids, <18 years old, and at risk of infection due to variants of concern. The plan of excluding non-hospitalized patients from the proposed review is to minimize intransitivity risk. The acceptance of the network consistency assumption will transpire if the local and overall inconsistency assessment indicates no inconsistency. For each NMA model, the effect sizes (risk ratio) and their 95% confidence intervals will get reported in league tables. The best intervention prediction and quality of evidence grading will happen using the surface under the cumulative ranking curve values and the Grading of Recommendations Assessment, Development and Evaluation-based Confidence in Network Meta-Analysis approach, respectively. Sensitivity analysis will repeat the preliminary NMA while excluding the trials at high risk of bias. The Stata statistical software (v16) will be used for analysis. The statistical significance will get determined at p<0.05 and 95% confidence interval. Trial registration PROSPERO Registration No: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021277663.

Human bocavirus-1 infections in Australian children aged < 2 years: a birth cohort study

Abstract: To determine human bocavirus-1 (HBoV1) infection characteristics in young Australian children. Data were from the Observational Research in Childhood Infectious Diseases (ORChID) study, a Brisbane, Australia–based birth cohort of healthy, term, newborns followed prospectively for 2 years. Parents recorded daily symptoms, maintained an illness-burden diary, and collected weekly nasal swabs, which were tested for 17 respiratory viruses, including HBoV1, by real-time polymerase chain reaction (PCR) assays. Main outcomes measured were infection incidence, risk factors, symptoms, and healthcare use. One hundred fifty-eight children in the ORChID cohort provided 11,126 weekly swabs, of which 157 swabs were HBoV1 positive involving 107 incident episodes. Co-detections were observed in 65/157 (41.4%) HBoV1-positive swabs (or 41/107 [38.3%] infection episodes), principally with rhinovirus. Shedding duration was 1 week in 64.5% of episodes. The incidence of HBoV1 infections in the first 2 years of life was 0.58 episodes per child-year (95% confidence interval [CI] 0.47–0.71), including 0.38 episodes per child-year (95% CI 0.30–0.49) associated with respiratory symptoms. Recurrent episodes occurred in 18/87 (20.7%) children following their primary infection. In the first 2 years of life, incidence of HBoV1 episodes increased with age, during winter and with childcare attendance. Overall, 64.2% of HBoV1 episodes were symptomatic, with 26.4% having healthcare contact. Viral load estimates were higher when children were symptomatic than when asymptomatic (mean difference = 3.4; 95% CI 1.0–5.7 PCR cycle threshold units). After age 6 months, HBoV1 is detected frequently in the first 2 years of life, especially during winter. Symptoms are usually mild and associated with higher viral loads.

Participant attrition and perinatal outcomes in prenatal vitamin D-supplemented gestational diabetes mellitus patients in Asia: A meta-analysis

Abstract: BACKGROUND The role of vitamin D supplementation in gestational diabetes mellitus (GDM) patients is unclear. AIM To determine the burden and risk of post-randomization GDM patient attrition from vitamin D-supplemented arms of randomized controlled trials (RCTs). The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes. METHODS RCTs were searched in the PubMed, Embase, and Scopus databases. Random-effect prevalence and pairwise meta-analysis were performed for the primary objective. The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes. Fixed-effect network meta-analyses were undertaken for the secondary goals. All analyses were performed using Stata software, and statistical significance was determined at P < 0.05. RESULTS Thirteen RCTs from Iran and China were reviewed. The participant attrition burden in vitamin D recipients was 6% [95% confidence interval (CI): 0.03, 0.10], and its risk did not vary from non-recipients. Vitamin D and calcium co-supplementation reduced the cesarean section incidence in GDM patients [risk ratio (RR): 0.37; 95%CI: 0.18, 0.74]. The hyperbilirubinemia or hospitalization risk in their newborns decreased with vitamin D supplementation (RR: 0.47; 95%CI: 0.27, 0.83) and co-supplementation with calcium (RR: 0.35; 95%CI: 0.16, 0.77) or omega-3 fatty acids (RR: 0.25; 95%CI: 0.08, 0.77). Vitamin D and probiotics co-supplementation decreased newborn hyperbilirubinemia risk (RR: 0.28; 95%CI: 0.09, 0.91). FPG levels and macrosomia risk did not vary across interventions. CONCLUSION In RCTs, vitamin D supplementation or co-supplementation in GDM patients showed a low participant attrition burden and low risk of cesarean section, newborn hyperbilirubinemia, and newborn hospitalization.

Self-monitoring of blood glucose in gestational diabetes mellitus patients during the COVID-19 pandemic in low- and middle-income countries

Abstract: Self-monitoring of blood glucose (SMBG) is critical for gestational diabetes mellitus (GDM) care. However, there are several hurdles to its practice during the coronavirus disease 2019 (COVID-19) pandemic in GDM patients in lowand middle-income countries when GDM care recommendations emphasize telemedicine-based care. Based on available knowledge, this letter proposes the following barriers to SMBG in these GDM patients during the ongoing COVID-19 pandemic: Poor internet connectivity, affordability of SMBG and digital applications to connect with healthcare providers, government-imposed social mobility restriction, psychological stress, and mental health conditions. Nevertheless, definitive evidence will only be acquired from rigorous research.