JBI Critical Appraisal Research Articles

Misuse, Abuse and Medication Errors' Adverse Events Associated with Opioids-A Systematic Review.

Opioids are the strongest analgesics available and are crucial in the treatment of acute and chronic pain. The line between these critical medications and how they are used beyond standard therapeutics in cases such as abuse, misuse, and medication errors needs to be understood, as it affects their safety, efficacy, and manner of use. The aim of this systematic review was to identify what is known about the adverse events resulting from the abuse, misuse, and medication errors associated with opioid use. A systematic search was conducted in the PubMed®, Scopus® and, EBSCO® databases to retrieve studies from the inception to December 2023 reporting abuse, misuse, and medication errors associated with medicinal opioid use. Two authors independently screened titles and abstracts and full text according to eligibility using Covidence® software. Full articles were examined by two independent reviewers, and disagreements were resolved by a third reviewer. The risk of bias was assessed by the JBI's critical appraisal tools. A total of 934 articles were screened by their title and abstract. Then, 151 articles were selected for full text screening. Of these, 34 studies were eligible for inclusion in this review. The included studies varied significantly in their population sizes, ranging from 9 individuals to 298,433 patients, and encompassed a diverse demographic, including all ages and both sexes. The studies consistently reported a range of adverse events associated with opioid use. Fentanyl, morphine, oxycodone, tramadol, and hydrocodone were frequently implicated. The data heterogeneity in this field resulted in challenges in drawing conclusions. The review highlights that some opioids, particularly fentanyl, morphine, and oxycodone, are frequently associated with preventable adverse drug reactions, abuse, and medication errors, underscoring the need for robust preventative measures and ongoing research to mitigate opioid-related harm.

Examining the quality of life among pregnant women diagnosed with gestational diabetes mellitus: A systematic review and meta-analysis for women's health promotion.

Quality of life (QoL) of women with gestational diabetes mellitus (GDM) is one of the fundamental issues and public health challenges. This study examines the QoL among pregnant women with GDM through a systematic review and meta-analysis. A search was conducted in Scopus, PubMed, and the Web of Science databases for articles published until Jan 30, 2024. Manual searches of gray literature, Google Scholar, reference checks, and citation checks were conducted. The JBI's Critical Appraisal Checklist for Analytical Cross-Sectional Studies was utilized to assess the quality of the articles' reporting. The random model implemented in Stata software (version 16; Stata Corp.) was utilized to conduct the meta-analysis. Among the 516 studies obtained from the literature, only 15 were deemed suitable for inclusion. Most studies (73.3%) were conducted in nations with high-income levels. Additionally, general QoL was assessed in most studies (11 studies). The SF-36 and WHOQOLBREF questionnaires were the most often utilized. Based on the SF-36 measure, there was no statistically significant difference in the QoL of patients with GDM compared to the control group in most of dimensions. The WHOQOL-BREF instrument was utilized to estimate the QoL score at 49.69. The EQ-5D-5L tool revealed a difference in QoL scores between the GDM and control groups (MD=-7.40). The research findings were highly heterogeneous. The median evaluation score for the reporting quality of the articles was calculated to be 5, with a mean of 4.8 out of 7. The results of the present study showed that GDM reduces the QoL of pregnant women, especially in terms of mental and social health. Therefore, interventions and support programs should be designed and implemented to improve these women's QoL.

Pengaruh Seks Edukasi terhadap Kekerasan Seksual pada Anak Usia Dini: Literature Review

Sexual violence is a serious threat that often makes children victims, especially young children. Children are included in a vulnerable group, so children must receive special protection for their physical and mental needs. One of them is protection from the threat of sexual violence. Based on the data obtained, the number of incidents of sexual violence against children in Indonesia continues to increase, even though various efforts have been made by the government. One effort that can be made by parents and educators is by providing sex education. The aim of the research is to analyze and examine journals related to the influence of sex education on sexual violence in early childhood. This research is a quantitative research with a literature review method using the Google Scholar and PubMed databases, study year 2018-2022 using JBI critical appraisal with a Quasi- experimental study based on PRISMA and the number of articles accepted was (n=8). The results of the research show that various sexual education methods such as modified engklek games, picture stories, audio visuals, picture books, songs, snakes and ladders media, busy books, and role play methods can influence and increase children's knowledge of preventing sexual violence.

Prevalence and incidence of oral cancer and pre-cancerous lesions in indigenous populations: a systematic review protocol.

This review will determine the prevalence and incidence of oral cancer and pre-cancerous lesions in indigenous populations. There are approximately 476 million indigenous individuals worldwide. Oral cancer affected over 350,000 people globally in 2018, with approximately 80% of cases occurring in the indigenous population. Moreover, the incidence of pre-cancerous lesions is high in this population, accounting for 48.3%. Limited evidence exists regarding the burden of oral cancer among indigenous populations despite research on oral health disparities in this group. Studies on the burden of oral cancer and pre-cancerous lesions in indigenous groups, considering rates, ratios (prevalence or mortality), or survival proportions, will be considered for inclusion. There will be no limitations on study design, language, age, gender, or geography. We will exclude studies that only identify, diagnose, or screen oral cancer and pre-cancerous lesions without mentioning prevalence and incidence. This review will follow the JBI methodology for systematic reviews of prevalence and incidence. Databases to be searched will include MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Central Register of Controlled Trials, Scopus, and Dentistry and Oral Sciences Source (EBSCOhost). ProQuest Dissertations and Theses, OAIster, International Association for Dental Research conference abstracts, Google Scholar, government reports, and cancer registry reports will also be screened for unpublished studies. Two reviewers will independently screen articles, and data will be extracted using a customized form. Narrative data synthesis will be conducted and, where appropriate, meta-analysis will be performed. Methodological quality will be assessed using JBI's critical appraisal tool for prevalence studies. PROSPERO CRD42023402858.

SYSTEMATIC REVIEW: COMPARISON OF CUCUMBER JUICE WITH TOMATO JUICE IN THE EFFECTIVENESS OF BLOOD PRESSURE REDUCTION IN PATIENTS WITH HYPERTENSION

Hypertension is a disease characterized by elevated systolic and diastolic blood pressure, or the use of antihypertensive drugs. Hypertension has complications in the form of diseases that target organs including the brain, kidneys, peripheral blood vessels, and heart. This requires effective management by considering effective management in the long term. Pharmacological management of hypertension has side effects of drug-related problems (DRPs) that have an undesirable impact. This makes non-pharmacological interventions recommended for effectiveness. The utilization of fruits is part of non-pharmacological interventions, one of them is with cucumber and tomato which are processed into juice. This research aims to identify further studies through systematic review research on the comparison of the effectiveness of cucumber juice with tomato juice on blood pressure in patients with hypertension. The method used was a systematic review by identification and evaluation of literature with a quasi-experiment research design in according to predetermined eligibility criteria. Databases used included Cochrane Library, DOAJ, Google Scholar, PubMed, Science Direct, and Semantic Scholar. All relevant articles were quality assessed using JBI Critical appraisal. The results of the study resulted in 11 articles that were relevant to the criteria that had been set. The articles retrieved had a low risk of bias after quality assessment. 11 articles resulted in the finding that cucumber juice and tomato juice have ingredients that have an impact on blood pressure in hypertensive patients. Both therapies have effectiveness as hypertension management

Impact of Mobile and Web Health Apps on Pediatric Chronic Disease Management and Quality of Life: An Update Systematic Review

Mobile and web health applications have gained widespread usage worldwide for pediatric patients with chronic diseases, yet comprehensive research evaluating their impact remains limited. This research aims to determine the comprehensive impact of mobile and web health apps on pediatric chronic disease management and quality of life. Searches were performed on seven primary databases (Emerald Insight, Scopus, ScienceDirect, PubMed, ProQuest, Ebsco, and SpringerLink) from 2003 to 2023. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement guidelines. The quality study was conducted using JBI's critical appraisal tools. Descriptive and narrative analysis methods were used, and the findings were presented in text and tabular formats. Out of 1,840 articles reviewed, only 28 met the inclusion and exclusion criteria. The most identified outcomes in the study of mobile and web health apps on pediatric chronic disease management are psychological, cognitive, and behavioural outcomes and quality of life. However, biological markers seem to be the least evaluated outcome. Mobile and web health applications play a positive role in managing chronic diseases and enhancing the quality of life for pediatric patients. These applications offer a range of features, including symptom assessment, information dissemination, educational resources, caregiver communication, social support, and calendar reminders. Healthcare providers and caregivers should consider integrating these technologies into caring for children with chronic diseases. It can lead to improved outcomes and overall well-being.

Adherence to newer second-line oral antidiabetic drugs among people with type 2 diabetes-A systematic review.

The adherence to oral antidiabetic drugs (OADs) among people with type 2 diabetes (T2D) is suboptimal. However, new OADs have been marketed within the last 10 years. As these new drugs differ in mechanism of action, treatment complexity, and side effects, they may influence adherence. Thus, the aim of this study was to assess the adherence to newer second-line OADs, defined as drugs marketed in 2012-2022, among people with T2D. A systematic review was performed in CINAHL, Cochrane Trials, Embase, PubMed, PsycINFO, and Scopus. Articles were included if they were original research of adherence to newer second-line OADs and reported objective adherence quantification. The quality of the articles was assessed using JBI's critical appraisal tools. The overall findings were reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and summarized in a narrative synthesis. All seven included articles were European retrospective cohort studies investigating alogliptin, canagliflozin, dapagliflozin, empagliflozin, and unspecified types of SGLT2i. Treatment discontinuation and medication possession ratio (MPR) were the most frequently reported adherence quantification measures. Within the first 12 months of treatment, 29%-44% of subjects on SGLT2i discontinued the treatment. In terms of MPR, 61.7%-94.9% of subjects on either alogliptin, canagliflozin, dapagliflozin, empagliflozin or an unspecified SGLT2i were adherent. The two investigated adherence quantification measures, treatment discontinuation and MPR, suggest that adherence to the newer second-line OADs may be better than that of older OADs. However, a study directly comparing older and newer OADs should be done to verify this.

The effectiveness of chronic disease management planning on self-management among patients with diabetes at general practice settings in Australia: a scoping review

BackgroundMedicare provides significant funding to improve, encourage and coordinate better practices in primary care. Medicare-rebated Chronic Disease Management (CDM) plans are a structured approach to managing chronic diseases in Australia. These chronic disease care plans are intended to be a vehicle to deliver guideline-based / evidence-based care.. However, recommended care is not always provided, and health outcomes are often not achieved. This scoping review aimed to identify the specific components of CDM plans that are most effective in promoting self-management, as well as the factors that may hinder or facilitate the implementation of these plans in general practice settings in Australia.MethodA comprehensive search was conducted using multiple electronic databases, considering inclusion and exclusion criteria. Two reviewers independently screened the titles and abstracts of the identified studies via Covidence, and the full texts of eligible studies were reviewed for inclusion. A data extraction template was developed based on the Cochrane Effective Practice and Organization of Care Group (EPOC) to classify the intervention methods and study outcomes. A narrative synthesis approach was used to summarize the findings of the included studies. The quality of the included studies was assessed using the JBI Critical Appraisal Checklist.ResultsSeventeen articles were included in the review for analysis and highlighted the effectiveness of CDM plans on improving patient self-management. The findings demonstrated that the implementation of CDM plans can have a positive impact on patient self-management. However, the current approach is geared towards providing care to patients, but there are limited opportunities for patients to engage in their care actively. Furthermore, the focus is often on achieving the outcomes outlined in the CDM plans, which may not necessarily align with the patient’s needs and preferences. The findings highlighted the significance of mutual obligations and responsibilities of team care for patients and healthcare professionals, interprofessional collaborative practice in primary care settings, and regular CDM plan reviews.ConclusionSelf-management support remains more aligned with a patient-centred collaboration approach and shared decision-making and is yet to be common practice. Identifying influential factors at different levels of patients, healthcare professionals, and services affecting patients’ self-management via CDM plans can be crucial to developing the plans.

OVERVIEW OF FACTORS INFLUENCING DRUG MANAGEMENT AT PRIMARY HEALTH CENTERS IN INDONESIA: A SYSTEMATIC REVIEW

Drug management is part of pharmaceutical service activities, which includes interrelated stages: selection, planning, requesting, receiving, storage, distribution, controlling, recording, reporting, monitoring and evaluation, which play an essential role in ensuring the availability of drugs at PHCs. The systematic review aims to identify indicators of drug management at PHCs in Indonesia and analyze factors that influenced it. This systematic review used the PRISMA methods. Google Scholar is an electronic database to identify related studies. This study is limited publications from 2013 to 2023. The quality of the articles was assessed using JBI Critical Appraisal. The electronics database search earned 570 articles, while only nine articles met the criteria for analysis. Several indicators are different from the standards used due to several factors. Based on the result, factors influencing drug management at PHCs include human resources, financing, information management, facilities, and technology. For most of them, human resources are a determining factor that significantly influences the quality of pharmaceutical services at PHC’s in Indonesia. The implementation of pharmaceutical services at the PHCs must be carried out by at least one pharmacist, the person in charge, who can be assisted by pharmaceutical technical staff as needed. Resources humans influence indicators of planning accuracy; suitability of requests; storage; distribution; control; recording, reporting, and archiving. This study's results are to make improvement strategies, including interventions to improve the quality of pharmaceutical services that impact community satisfaction and stakeholders.

Systematic review and meta-analysis: Foods, drinks and diets and their effect on chronic constipation in adults.

Dietary approaches are recommended for the management of chronic constipation. Until now, there has been no systematic review and meta-analysis on foods, drinks and diets in constipation. To investigate the effect of foods, drinks and diets on response to treatment, stool output, gut transit time, symptoms, quality of life, adverse events and compliance in adults with chronic constipation via a systematic review and meta-analysis. Studies were identified using electronic databases (12th July 2023). Intervention trials (randomised controlled trials [RCTs], non-randomised, uncontrolled) were included. Risk of bias was assessed using Cochrane 2.0 (RCTs) or JBI Critical Appraisal (uncontrolled trials). Data from RCTs only were synthesised using risk ratios (RRs), mean differences (MDs), standardised mean differences (95% CI) using random-effects. We included 23 studies (17 RCTs, 6 uncontrolled; 1714 participants): kiwifruit (n = 7), high-mineral water (n = 4), prunes (n = 2), rye bread (n = 2), mango, fig, cereal, oat bran, yoghurt, water supplementation, prune juice, high-fibre diet, no-fibre diet (n = 1). Fruits resulted in higher stool frequency than psyllium (MD: +0.36 bowel movements [BM]/week, [0.25-0.48], n = 232), kiwifruits in particular (MD: +0.36 BM/week, [0.24-0.48], n = 192); there was no difference for prunes compared with psyllium. Rye bread resulted in higher stool frequency than white bread (MD: +0.43 BM/week, [0.03-0.83], n = 48). High-mineral water resulted in higher response to treatment than low-mineral water (RR: 1.47, [1.20-1.81], n = 539). Fruits and rye bread may improve certain constipation-related outcomes. There is a scarcity of evidence on foods, drinks and diets in constipation and further RCTs are needed.

Consequences of a cesarean section on the neonatal gut microbiome and future outcomes: a qualitative analysis of the literature

Objective This study aims to evaluate the impact of cesarean section delivery on the neonatal intestinal microflora compared to vaginal deliveries. Design A mini-review. Methods A comprehensive search strategy was implemented, primarily using PubMed, to identify relevant studies published in English within the past 10 years. Selected studies were appraised by three independent reviewers using JBI critical appraisal and data extraction forms. Four articles were included in the analysis, encompassing systematic reviews and a retrospective cohort study. Primary and secondary outcome data were combined across these studies. Results Selected studies revealed consistent trends in bacterial colonization differences between cesarean and vaginal deliveries. Vaginally delivered infants exhibited higher populations of beneficial bacteria such as Bifidobacterium, Lactobacillus, and Bacteroides. Cesarean-delivered infants, on the other hand, showed greater colonization of Enterococcus, Klebsiella, Clostridium, Staphylococcus, Streptococcus, and Corynebacterium. Statistically significant differences were observed in two studies. All articles explored the potential health implications of these microbiome differences, with associations found between cesarean deliveries and various health outcomes. Conclusion This review demonstrates that cesarean section delivery influences the composition of the neonatal gut microbiota. The presence of certain bacterial species more prevalent in vaginally delivered infants, such as Bifidobacterium, is associated with improved infant health, while species found in cesarean-delivered infants, such as Clostridium, increase the risk of certain infections. Recognizing the increased health risks for cesarean-born infants enables clinicians to implement early screening, treatment, or prevention strategies, potentially reducing future morbidity and mortality.

Risk Factors Analysis in Recurrent Stroke Events: Literature Review

After the first stroke, according to epidemiological data, there is a 30% risk of recurrent stroke. That events are the population who had suffered stroke and the recurrence rate is 9 times compared to the normal population. Results of research from the Stroke Association stated that the possibility of recurrence stroke was 3.1% in 30 days, 11.1% within one year, 26.4% within five years, and 39.2% within 10 years. This literature review is intended to analyze the risk factors of recurrent stroke events. The literature review was carried out by searching for articles in 2011-2021 in Indonesian and English. There were four databases for providing electronic journal articles, namely Garuda, Google Scholar, Science Direct, and PubMed. The quality of the articles carried out using JBI's Critical Appraisal Tools. Narrative synthesized was used to analyze the data of the review. There were 6 articles synthesized in this review. The review result showed that diabetes mellitus, hypertension, cardiovascular disorders, anemia, obesity, lack of physical activity, high serum of LDL/HDL, non-adherence to treatment, lack of confidence in treatment, lack of knowledge about the disease, and gender can encourage the occurrence of recurrent stroke. Many factors cause recurrent stroke events but diabetes mellitus, hypertension and non-adherence to treatment are most widely discussed in the six articles.

Prevalence of depressive disorder in the adult population of Latin America: a systematic review and meta-analysis

Depressive disorder is one of the leading causes of disability worldwide; however its prevalence and association with inequality and crime is poorly characterised in Latin America. This study aimed to: i. systematically review population-based studies of prevalence of ICD/DSM depressive disorder in Latin America, ii. report pooled regional, country, and sex-specific prevalence estimates, and iii. test its association with four country-level development indicators: human development (HDI), income (Gini) and gender inequality (GII), and intentional homicide rate (IHR). We conducted a systematic review and meta-analysis of population-based studies reporting primary data on the prevalence of ICD/DSM depressive disorder in Latin America from 1990 to 2023, irrespective of language. We searched PubMed, PsycINFO, Cochrane Library, SciELO (regional database), LILAC (regional database), and available grey literature. Study quality was assessed using JBI's critical appraisal tools. We generated pooled estimates using random-effects meta-analysis; heterogeneity was assessed using the I2 statistic. Meta-regression analyses were used to test associations of depression prevalence with indicators of inequality and human development. The study was registered with PROSPERO (CRD42019143054). Using data from 40 studies in Latin America, lifetime, 12-month, and current prevalence of ICD/DSM depressive disorder were calculated at 12.58% (95% CI 11.00%-14.16%); 5.30% (4.55-6.06%), and 3.12% (2.22-4.03), respectively. Heterogeneity was high across lifetime, 12-month, and current prevalence, sex, and countries. 12-month and current prevalence was associated with higher Gini and GII, 12-month prevalence with lower HDI, and current prevalence with higher IHR. We found a high prevalence of ICD/DSM depressive disorders in Latin America, and a statistically significant association with inequality and development indicators. The high heterogeneity found across prevalence periods and the major gaps in country representation underscore the need to escalate efforts to improve mental health access and research capabilities in Latin America. Systematic, comparable prevalence estimates would inform more effective decision-making in the region. Pfizer Independent Medical Education Grant.

Prevalence and risk of new-onset diabetes mellitus after COVID-19: a systematic review and meta-analysis.

After the acute phase of SARS-CoV-2 infection, the onset of glycemic impairment and diabetes have been reported. Nevertheless, the exact burden of glycemic impairment and diabetes after COVID-19 has not been clearly described. Electronic search was run in Pubmed (MEDLINE), Web of Science, Scopus, and ClinicalTrial.org for reports published from database inception to September 2022. We included observational studies reporting quantitative data on diabetes prevalence or its onset in subjects with a history of SARS-CoV-2 infection from at least 60 days. Risk of bias was assessed by the JBI's critical appraisal checklist. Random effect model was used to calculate pooled data. The review protocol was registered on PROSPERO (CRD42022310722). Among 1,630 records screened, 20 studies were included in the analysis. The mean or median age of participants ranged from ~ 35 to 64 years, with a percentage of males ranging from 28% to 80%. Only two studies were considered at low risk of bias. The estimate of diabetes prevalence, calculated on a total of 320,948 participants pooled with 38,731 cases, was 16% (95%CI: 11-22%). The estimate of proportion of incident cases of diabetes was 1.6% (95%CI: 0.8-2.7%). Subgroup analysis showed that previous hospitalization increased the prevalence of diabetes and the proportion of incident cases. Diabetes is common in individuals who have experienced SARS-CoV-2 infection, especially if they required hospitalization. This data may be helpful to screen for diabetes and manage its complications in individuals who experienced COVID-19. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022310722, identifier CRD42022310722.

Brachial plexopathy as a result of anatomical prone position in COVID-19 patients-Systematic review.

In patients with COVID-19 different methods improving therapy have been used, including one of the anatomical position-prone position, to support ventilation. The aim of this review was to summarize the cases of brachial plexopathy as a consequence of the prone position in COVID-19 patients, and thus bring closer the issue of the brachial plexus in the face of clinical aspects of its function, palsy, and consequences. The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed, inclusion criteria were created according to Patients, Interventions, Comparisons, Outcomes (PICO). PubMed and Scopus were searched until April 1, 2023 by entering the key term with Boolean terms. The risk of bias was assessed using JBI's critical appraisal tools. Fifteen papers with 30 patients were included in the review. This study showed that brachial plexopathy after the prone position occurs more often among males, who are at least 50 years old with comorbidities like hypertension, overweight, and diabetes mellitus. The most common symptoms were weakness, pain, and motion deficits. Duration of the prone position session and the number of episodes were different as well as the modification of positioning. Brachial plexopathy is a significant problem during prone position, especially when hospitalization is prolonged, patients are males, have comorbidities, and changes in body weight. Attention should be drawn to understand the anatomy of the brachial plexus, correct positioning, avoiding factors worsening the prognosis, and proper nutrition of the patients.

Spatiotemporal Gait Changes During Pregnancy: A Literature Review

Background: Pregnant women experience several changes that can be seen from a spatiotemporal perspective and the parameters are stride length, stride width, walking speed, walking cadence, cycle time, step time. The importance of knowing changes in gait patterns in pregnant women in order to reduce the risk of falling and improve the quality of life of pregnant women. Purpose: The purposes of the study were to know the measurement or instrument used as a spatiotemporal parameter, the results of the changes and the factors that influence changes in gait patterns in pregnant women from a spatiotemporal point of view. Method: The study using the literature review method by assessing articles with critical appraisal on six articles using JBI's Critical Appraisal. The databases were Google Scholar, National Center for Biotechnology Information (NCBI), PubMed, Science Direct, Garuda Portal, InaBJ with keywords, “pregnancy” OR “pregnant women” OR “pregnant” AND “gait” OR “biomechanics” OR “spatiotemporal”. All articles would be organized, remove duplicate articles using EndNote, appraisal, and quality assessment for the risk of bias. Results: based on the finding the result from databases, there were 6 articles used for assessment and appraisal. Conclusion: increased lumbar lordosis, decreased stride length, decreased walking rhythm, decreased duration of single support, increased duration of double support, increased COP/COG angle were the determinant factors of the spatiotemporal gait changes during pregnancy. Keywords: pregnancy, spatiotemporal, gait

Effectiveness of Vitamin C Administration on Outcome in COVID-19 Patients: A Systematic Review and Meta-Analysis

Background: Numerous studies on the effectiveness of vitamin C against the COVID-19 infection have been widely carried out recently. However, the differences in dosage ranges and therapeutic efficacy in previous studies have prompted a systematic literature review on the effectiveness of vitamin C on outcomes in COVID-19 patients. In addition, this study aimed to determine the appropriate therapeutic dose of vitamin C for COVID-19 patients, either alone or in combination with other supplements, and to determine the side effects.Methods: Gleaned from the search on Pubmed, Science Direct, and Google Scholar databases up to April 25, 2022, fourteen studies were relevant, namely five studies using vitamin C orally and nine studies administered intravenously. We assessed multiple outcomes, including mortality, hospitalization, and symptoms. The quality and risk of bias analyses were performed using JBI critical appraisal tools.Results: The oral administration of vitamin C resulted in a significant difference in the mortality of COVID-19 patients (OR=0.66; 95% CI=0.45–0.97; P=0.04; I2=0%) and a non-significant difference in the outcome. Duration of hospitalization (OR = -0.21; 95% CI = -2.70-2.28; P=0.87; I2=94%). Regarding the cost-effectiveness and side effects manifested in digestive disorders such as nausea, diarrhea, stomach cramps, and vomiting, vitamin C with a dose of 500-1000 mg could be given orally.Conclusion: Oral administration of vitamin C showed a reduction in the mortality of asymptomatic COVID-19 patients with moderate symptoms.

Fathers’ Role in Bulimia Nervosa: A Systematic Review

IntroductionBulimia Nervosa (BN) is a highly prevalent eating disorder related to multiple risk factors. In this regard, familial variables can play a critical role in the development and maintenance of BN.ObjectivesThe existing studies frequently explored mothers and maternal factors, while fathers and paternal variables have been less extensively investigated in this field. Therefore, we aimed to systematically review the studies on the role of paternal factors in BN.MethodsThis systematic review process was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. As a result of the literature search on PubMed, Web of Science TM, and APA PsycINFO, 419 candidate papers were determined and evaluated based on the eligibility criteria. The quality assessment of the final 59 studies was conducted using the JBI Critical Appraisal Tools.ResultsThen, we thematically arranged and narratively reported the qualitative and quantitative research findings. Paternal attitudes (e.g., critical, abusive, aggressive, uncaring, and unaffectionate), family dynamics (e.g., chaotic, rigid, less communicative, and emotionally involved), and father-specific features (e.g., personality traits, eating psychopathology features) were found as three main groups that could be directly or indirectly associated with the development and maintenance of BN symptoms. The eligible qualitative studies also indicated that fathers could positively influence the recovery process of their daughters with BN (e.g., by helping them develop healthy adaptive body image, self-adequacy, and self-esteem).ConclusionsThe contradictory outcomes were discussed for further research and clinical implications.Disclosure of InterestNone Declared

Influecing Factors Reccurence of Adult Asthma

Asthma is not contagious but this disease includes high morbidity and mortality in severe cases. Asthma can relapse with severe asthma exacerbations associated with loss of asthma control. So it is important to know the influencing factors in order to control the recurrence. The purpose of this study is to find out what factors affect recurrence in adult asthma sufferers, through researching literature on the phenomenon of adult asthma recurrence. The research method using literature search is carried out through google scholar and PubMed. The keywords used in adult asthma and recurrence factor. The search was carried out from 2017-2022, and 4 journals were reviewed which had been selected using PRISMA diagrams and were tested for feasibility using JBI critical appraisal. The results of 4 journals that have been analyzed show that the factors that affect recurrence in adult asthma patients are influenced by dust, airway infestation, weather changes, cigarette smoke, exercise, stress, anxiety and pregnancy. It is hoped that the results of this study for patients can be used as supporting information in controlling recurrences, and for nurses, it can be used as a reference for health education in asthma sufferers to prevent asthma recurrences.

Applications, benefits and challenges of telehealth in India during COVID-19 pandemic and beyond: a systematic review

BackgroundIndia, the seventh-largest country in the world and the second-most populated faces enormous challenges when it comes to healthcare. The country’s healthcare system was close to collapse due to the detrimental effects of the COVID-19 pandemic. Telehealth, which enables treating patients remotely, played a critical role during these challenging times. This systematic review investigates in detail the role of telehealth during COVID-19 and its application beyond the pandemic.MethodsDatabase searches on PubMed, Scopus, Science Direct and Web of Science were carried out for studies published on telehealth, and articles were included if they focused on any audio or video telehealth consultation during the pandemic in India. Findings were synthesised into three main themes: applications, benefits and challenges of telehealth services. Methodological quality was assessed using JBI critical appraisal tools.ResultsThe initial search on databases yielded 1143 articles. Of those, 19 met the eligibility criteria. Findings highlight the effective utilisation of telehealth across multiple medical specialities. Although insufficient technological infrastructure and other barriers due to the virtual consultation challenge the successful implementation of telehealth in India, it has the potential to bridge the rural-urban healthcare divide with cost-effective and easily accessible services.ConclusionHigh patient/provider satisfaction underscores the need to integrate telehealth into routine healthcare practices in the country. However, the review urges the government and healthcare practitioners to address the telehealth challenges with prime importance to ensure quality healthcare throughout the nation even after the pandemic.