Importance Of Meta-analysis In Medical research

Writing articles related to medical research today has to follow certain well-accepted forms of research in order to be accepted. Of the various types of medical research articles, studies based on metadata analysis is one of the most well-accepted forms.

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The concept of meta-analysis stems from the field of statistics. Meta-analysis is a process of combining the results of multiple scientific research related to the same field. Statistically, if there are multiple experiments on the same lines, the results of each are prone to certain degrees of error (for example, the most commonly occurring errors are Type 1 errors related to false-positives or Type 2 errors of false-negatives). However, if all those studies are pooled together, the net derivative result is less likely to have any of such errors and will yield a more definitive result. The key to the aggregation of data is higher statistical power and thereby more robust point estimates than any individual scientific research.

Meta-analysis based medical research started in the 70s and has gained immense popularity ever since. In fact, statistics suggest that meta-analysis based medical articles are the most cited articles in the field.

While meta-analysis generally refers to quantitative studies, there exists another form of studies called statistical meta-synthesis pertaining to integrating results from multiple but related qualitative studies. The approach to statistical meta-synthesis is more interpretive than aggregative and thereby have a different approach altogether. Before embarking on your work, you need to first determine whether you want to go for meta-analysis or statistical meta-synthesis, based on the type of field you are working on.

How to Approach Writing a meta-analysis medical research paper?

Meta-analysis is conducted to assess the strength of evidence, usually on the efficacy of any specific disease or particular treatment. Meta-analysis seeks to collate multiple pieces of evidence to arrive at a conclusion; whether any direct or indirect effect exists, and/or whether such effect is positive or negative (particularly pertaining to a specific type of treatment). This assumes importance as heterogeneity is vital for the development of any new hypothesis.

Key to such study is developing the metadata pool, based on a thorough filing and coding system, proper categorization of data, and thereby identifying the key analytical data- crunching exercise that is expected to yield the best results.

The key to a good meta-analysis exercise is proper identification of the different methods adopted in each exercise and thereby identifying how they may have affected the findings of those exercises. Identifying and mapping methods is also critical given not all methods are comparable and therefore all data may not be compatible.

Tools for meta-analysis

Needless to say, the main tools for such analysis are hardcore statistical tools, mostly software like SAS, STRATA, R. The data is usually pooled from recognized medical research sources like PubMed, Embase, or CENTRAL.

Reporting of results is usually done via the form of Preferred Reporting Items for Systemic Reviews and Meta-analysis or PRISMA.

All About Medical Case Report

Medical practitioners come across a large number of patients with variations in disease expression and subsequent prognosis. Sometimes a unique non reported disease phenotype or may notice the significant outcome of any innovative combinative treatment. These surgical table details are crucial and need to be recorded to provide direction to both doctors and researchers. However, with the hustling profession of being a medical practitioner, it seems an overwhelming task to report “insights of new and unique observations” in form of full-length paper. Does this mean publishing is all about lengthy research article or review writing? The answer is No, the alternative is a MEDICAL CASE REPORT.

What do we mean by Medical Case reports (MCR)?

It is written communication of previously unknown or a rare disease presentation. Also, MCR can be reporting of de novo treatment strategy of utmost medical significance. Since, its frontline of evidence, therefore, can pave the way towards the development of medical sciences bringing better diagnosis and prognostic strategies.

Components of MCR and their relevance

Similar to any scientific text, MCR too has a specific format to provide clarity and keeping the readers engaged until the end.

  • Title
  • Abstract: Short and crisp conveying the gist of the article in a structured manner.
  • Background: Origin of study with highlights’ of what’s known to date.
  • Case Presentation: Physical examination of the apposite prognosis of the subject in chronological order.
  • Discussion: Illustration of the uniqueness of case and future significance.
  • Conclusion: Take home message of MCR.
  • References
  • List of Abbreviation
  • Consent
  • Author information
  • Acknowledgment
  • Cover Letter 

Conclusion: MCR can be the first step to revolutionize the field of medical sciences with heart-throbbing findings of life significance.

                                      

Modulation of life expectancy by weight statistics in young adulthood

Ideal weight not only impacts the overall personality of a person but at the same time, is also the hallmark of good health. Weight management is often goggled in view of its various implications, mostly in the form of grave lifestyle associated disorders.

Obesity implication in early lives:

The obesity statistics in India are alarming, thereby expected to be tripled by 2040, as suggested by the latest research. Narrowing the studies to the early adolescent population worldwide, the figures are a bit scarier.

Contrary, to the age-old, believes that childhood is the “time of liberty” in terms of food choices we make, and cautiousness towards ingredients in the serving plate is applicable only with old age is a misnomer. Junk food, high sugar diet with loads of trans fats, lack of workout, irregular and unhealthy eating habits are making the adolescent population predisposed towards obesity. Primary or secondary obesity prevalence at a younger age has immersed as a deadly threat, closing the survival bracket to just mid-age. Researches have shown that around 12.4% of premature death can be linked to early adulthood associated with obesity.

The timeline of weight management:

A retrospective survey using the BMI (Basal metabolic index) corresponding to the early ages of the participants has shown that the negative implication of obesity on life expectancy remains unaltered. The tough part is that the damage caused due to being obese at a young age can’t be countered by weight reduction in later years. Also, premature death probability remains unchanged in both “presently overweight but previously obese” and “currently overweight” participants. This signifies the irreversible damage incorporated on the cellular dynamics due to early-onset obesity. Subsequently, paving ways to other comorbidities such as cardiovascular disease, diabetes in later lives.

Conclusion:

Weight management awareness at the right age is warranted to make a healthy population with survival fitness. Inculcation of proper lifestyle habits and realization of gross detrimental effects of obesity at the beginning of early adulthood shall help to build future generations with a superior quality of life.

The double catastrophe of cardiovascular-pulmonary disorders

Darkness crippled in the lives of family members, with the sudden demise of the only son of the family, aged 38, years undergoing treatment for an interstitial lung disorder. The death report stated cardiac arrest not a pulmonary failure as the cause of untimely demise. This incidence like many more, hints the fine-tuning at the cellular-functional axis, amongst The MOST VITAL organs “Lungs & Heart” to support life.

Pulmonary cardiovascular disease

Both cardiovascular and pulmonary disease is the leading cause of deaths worldwide. Cardiovascular diseases developed in respiratory patients have a high mortality rate apart from affecting day to day lives. For instance, patients with lung fibrosis or COPD are more likely to die due to heart failure as compared to those with a pulmonary issue but no cardiac involvement”. The irony of the story is that the patient with lung disease is less likely to receive coronary revascularization or coronary artery bypass graft.  It is due to similar symptoms in both condition and complex management in the pretext of existing lung complications.

The dynamics of Heart Lung Reciprocity

Lungs and heart not only share the thoracic cavity in common but also are functionally interdependent. A load of transporting oxygen laden pure blood is a composite effort of both the organs. This is evident in heart diseases having breathlessness as a hallmark.

Pulmonary disease conditions such as ILD can exert backpressure to heart known as pulmonary arterial hypertension causing right-sided heart failure. Also, conditions like left-sided heart failure, mitral stenosis, myocardial infarction can cause pulmonary edema or waterlog in the lungs due to venous hypertension. Fluid accumulation in air sacs or obstruction in blood flow due to fibrosis leads to a build-up of arterial pressure resulting in morbidity due to heart collapse.

Conclusion

Advancement in medical and surgical intervention has undoubtedly increased life expectancy and strengthened emergency care. However, the major lacuna to date is the prognosis mystery regarding the unrevealing of complex lung disorders. The situation is highly alarming with the involvement of pumping organs, eventually leading to untimely catastrophe, known as DEATH.

Diabetic Mice Improve With Retrievable Millimetre-thick Cell-laden Hydro-gel Fiber

There has been a recent advancement in the treatment of Type 1 Diabetes as the researchers at the Institute of Industrial Science, The University of Tokyo) found out that the diameter of hydrogels carrying cells can establish its longevity after transplantation, making the cell therapy for Type 1Diabetes Mellitus efficient. In short, researchers have come up with a fiber shaped hydrogel transplant that can be successful at treating T1DM.

Type 1 Diabetes, also known as insulin-dependent diabetes, is becoming an increasingly common disease among young and adults alike. A 2017 report revealed that about 425 million adults in the age group of 20-79 were living with diabetes around the world. The cause of Type 1Diabetes Mellitus is autoimmune destruction of -βcells that are responsible for producing insulin which is an important hormone that facilitates sugar flow in the cells to produce energy.

At the moment, the treatment for T1DM involves timed exogenous insulin administration and continuous blood glucose measurements. This creates an unnecessary burden not only on the patient but also on the health system. The aim of the new cell therapy is to eliminate the need for insulin replacement as it focuses on substituting lost pancreaticβ-cells. Although cell replacement therapy appears to be an interesting option, its clinical success is quite limited. It is often compared to an organ transplant that depends highly on the transplant -acceptance. Foreign body reactions are common factors behind transplant rejection. The idea behind cell therapy is to make use of hydrogels to provide long-term protection for transplanted cells.

This is not the only research that focuses on the replacement of damaged cells to cure this auto-immune disorder, the whole pancreas transplant has already been successful at many clinics. It was noted that even though blood sugar levels were immediately restored following the transplant, the survival rate of the transplanted pancreas was as low as six months. This improved over the years with the advancement of technology but even at present, the transplant doesn’t survive for more than three years.

Interestingly, the study conducted by the researchers at the University of Tokyo revealed that the diameter of these hydrogel fibers can be detrimental in anticipating foreign body reactions. The tests were conducted on diabetic mice. Barium alginate (Ba-Alg) hydrogels with different fiber diameters were implanted into normal mice. This was done to demonstrate that immune reactions seemed quite low at 1.0 mm. In order to further concretize the claim, researchers compared these findings with the foreign body reactions at 0.35 mm. The results revealed that covering hydrogel in 1.0mm-thick fibers resulted in long-term immune-protection for islets of Langerhans and also helped maintain glycemic control in diabetic mice. These fibers also facilitated the easy flow of small molecules of glucose, insulin, and oxygen to pass through the membrane, which is crucial for better functioning of the cells.

The findings definitely give hope, and more clinical trials could be helpful in repairing all possible loopholes.

Raw milk may do more harm than good

There is a popular belief that consuming raw milk or raw milk products is a healthier option, in contrast to consuming pasteurized milk or milk products. There exists a lot of misconceptions about pasteurization, with some suggesting it leads to loss of essential nutrients while others accuse pasteurization as an artificial or ‘unnatural’ processing of milk that risks spoiling the product.

However, scientific studies have found all such allegations to be unfounded. But what is more disconcerting is that scientific evidences suggest consuming raw milk or raw milk products poses definite health threats for us and that pasteurization of milk is critical before it is consumed.

Some critical scientific evidences from across the world suggest:

It is true that the heating process during pasteurization affects some nutrients in raw milk; viz thiamine, vitamin B6 and folic acid within the B-complex, and vitamin C. However, our present diet ensures these nutrients are received from other sources and hence missing them in milk products does not affect us much.

In contrast, raw milk or raw milk products have a higher content probability for harmful germs like Brucella, Campylobacter, Cryptosporidium, E. coli, Listeria, and Salmonella. Between 1993 till 2012, the Centers for Disease Control and Prevention (CDC) in the USA reported 127 outbreaks of diseases due to raw milk, which includes 1,909 illnesses and 144 hospitalizations.

Scientists at UC Davis have discovered that unrefrigerated milk, often done intentionally to allow it to ferment to produce clabber actually leads to these bacteria developing anti-microbial resistance genes which then makes them immune to antibiotic medicines.

The gastrointestinal tract in humans in modern times are often not able to digest certain components which we could earlier; or resist certain types of bacterial infections. A major factor in this development has been the advances made in medicines and how the human digestive system has evolved with these advances. Thus, the gastrointestinal tracts of infants and young children, older adults, pregnant women, and people with weakened immune systems such as people with cancer, an organ transplant, are unable to face the challenges of the different types of bacteria present in raw milk. While most healthy people can recover from an illness caused by harmful bacteria in raw milk products, there always exists the risk that some may develop symptoms that are chronic, severe, or even life-threatening.

A big form of risk stems from raw milk products like cheese, with a new-found customer preference for hand-made cheese or what is known as artisan cheese. Often these are part of ‘back to nature’ products, where the milk and cheese are produced in ‘organic farms’ with pasteurization. While handmade cheese from pasteurized milk is not a concern, such products from unpasteurized milk risk contamination (animal feces, dirt), cow diseases (mastitis, bovine tuberculosis), cross-contamination from dairy workers, etc that raises the risk of harmful elements in the raw milk thus produced.

It is therefore always advisable to consume only pasteurized milk and milk products.

AI making its way to improve results and efficiency in Cardiovascular Imaging

Artificial intelligence is showing reassuring results in cardiology, especially in the area of cardiovascular imaging. Ever wondered how it works? 

Machine learning algorithms (a subdivision of AI) are making it possible for cardiologists to find out new opportunities and delve into new discoveries difficult to be noticed using conventional techniques. This offers newer gateways helpful in medical decision-making.

Key features of AI in Cardiovascular Imaging:

  • AI can help improve performance at low cost thereby facilitating decision making, interpretation, and precise image acquisition of anatomical structures as well as diagnosis.
  • The big data obtained using imaging will be helpful in personalizing medical treatments and keeping an electronic record of patient data, health records, and outcome data.
  • It is believed that this will help physicians work more efficiently on core issues while computers will handle the technical part.

 

Different kinds of imagining possibilities using AI

Echocardiography – This is the most commonly used imaging technique in cardiology, but it is highly user-dependent. It is also important to undergo serious training in order to interpret the results accurately. AI can be a low-cost alternative to provide a standardized analysis of echocardiographic images. It has already shown great success in this area.

Computed Tomography – AI has been greatly appreciated in the field of cardiac CT as it has helped in noise reduction, and image optimization thereby preventing invasive coronary angiography (ICA) in the identification of severe stenosis.

Magnetic Resonance Imaging – This includes anatomical images of various aspects of the heart including flow imaging, contractile function, perfusion imaging, and myocardial characterization. As is the case with Echocardiography, MRI is also highly user-dependent. Reports have shown that implementing computer-aided detection in the clinical setup can increase accuracy and simplify the analysis.

Nuclear Imaging of the heart – This is performed to assess any perfusion defects within the myocardial lining. AI-based models can improve the clinical value of the results obtained. AI-based models have been highly successful at detecting abnormal myocardium in CAD, and their efficiency is at par with manual analysis images received.

Conclusion  

Technology is not new to humans. We’re getting more and more comfortable with the idea of relying on machines for safer and more accurate conduct of our day to day lives. In the case of cardiovascular imaging, AI has proved itself promising in various ways. Here are the reasons why the medical industry is ready to adopt computer-aided detection and diagnosis in Cardiology:

  • Detection and diagnosis of disease
  • Interpretation of data
  • Collection and comparison of data for future studies
  • Clinical decision making
  • Accurate image acquisition of images
  • Reducing health care expenditure
  • Reducing the workload for physicians

 

AI seems to have a lot of pros for the medical industry, but it needs to be made perfect with more testing and re-testing. It will definitely be a great tool for cardiologists as it is capable of recognizing patterns that are otherwise difficult to assess for the human brain.

What are clinical trials?

Scientists follow different methods to test their findings. While it involves observing the subjects in a normal setting, sometimes these can be achieved through questionnaires, medical exams, tests, etc. When scientists come up with a new drug, medication, or therapy, and it is required that a study is performed directly on people who are targeted for the product – it is known as a clinical trial. It is performed to evaluate the efficacy of the treatment at an early stage, and also helps find out if there are any possible dangers or side-effects.

Sometimes, clinical trials are also performed to detect early symptoms of a disease. Every medication approved by the FDA (United States Food and Drug Association) must have performed clinical trials before it can be marketed.

Importance of clinical trials

 Clinal trials help find the best-suited medical procedure or drug to cure a disease. The results of these trials help with feedbacks on the research front in order to improve the intervention.

For any new therapies to be suggested to the patients, it’s important to conduct clinical trials. They form an integral part of medical research because it not only helps find newer ways to cure but also provides ways to reduce the chances of developing the disease.

How are these trials performed?

Clinical trials are well planned and conducted by a group of scientists or researchers. The person-in-charge of these trials is called a principal investigator, and he/she is the one who manages the team of researchers.

The trials are conducted using a protocol that includes details about the objective of the research, a number of subjects required, eligibility criteria, age (if applicable), information required (blood, stool, urine, etc.), and the treatment plan. It might involve a single test or a set of tests at different intervals or all at once. These steps are taken by the medical practitioners in order to avoid any kind of bias that is irrelevant to the protocol.

Here is what happens in a trial:

  • Details about the subjects are gathered by one of the study staff, and information about the trial is given.
  • The subjects can ask questions related to the study.
  • A consent form is then signed by the subjects giving permission to proceed.
  • Screening is done to find out the eligibility, and a first visit, also known as the baseline visit) is scheduled.
  • The subjects are assigned to a treatment, a therapy, or a control group and the family members can followup to report any concerns or issues.
  • More visits are scheduled to evaluate the impact of the intervention.
  • The subjects can visit their physician for usual health concerns regarding ongoing therapies or drug intake even during the period of the study.

 

How to find a clinical trial?

 Those who wish to participate in a clinical trial can find out more information online by simply running a keyword search. You can also consult your general physician to help you connect to an association or support group in your area.

Can L-Serine supplements restore memories?

The brain is the major energy consumer of our body; for proper functioning of the brain, neurons, and the surrounding cells mostly the astrocytes must cooperate. Insufficient supply of energy due to whichever reason leads to drop in memory.

What is Alzheimer’s disease?

Alzheimer’s disease or AD is a neurological disorder marked by progressive memory decline and cognitive impairment. Basically, in AD the brain cells are caused to degenerate and die and mostly due to lesser nerve cell connections.

Amino acids essential for brain function

Amino acids such as D-Serine are vital to activate a type of neurotransmitter receptor in the brain called as N-methylate-D-aspartate receptor or NMDA receptor. L-Serine is a precursor for D-Serine; therefore a synthesis of L-Serine is pre-requirement for the making of D-Serine.

Enough glucose is essential for the biosynthesis of L-Serine

Synthesis of L-Serine is further dependent on glycolytic intermediates; therefore availability of glucose is a requirement for the proper functioning of the brain. Shortage in the concentration of glucose in the body may directly hamper the availability of ATP required to produce a proper amount of D and L-Serine.

Job of L-Serine in the brain

L-serine is a vital knot for the biosynthesis of molecules such phospholipids and sphingolipids. It provides carbon to the one-carbon pool that is concerned in folate (vitamin B9) metabolism, contributing to the synthesis of purine. This metabolic pathway is mainly necessary for the nervous system. In the brain, L-serine is the compulsory precursor of D-serine, a physiological ligand of the co-agonist spot of synaptic NMDARs present in the hippocampus, which is needed to maintain synaptic transmission. Therefore, failure in producing enough amount of L-serine would lead to disruption of these pathways.

L-Serine provided as a nutritional supplement can probably restore memories

Nutritional supplementation of L-serine may set off medical treatment, to fight early symptoms of disease metabolic discrepancy such as Parkinson’s, Huntington’s, or Alzheimer’s disease. As L-serine is obtainable as a nutritional supplement, this amino acid should be thoroughly tested in humans, from end to end restricted clinical trials.

CT Scans Offers the Best Diagnosis for COVID-19 Disease

COVID-19 is a contagious infection caused by the coronavirus family, the most recently revealed disease. This newly discovered virus has been provisionally termed “2019 novel Coronavirus” (2019-nCoV), which is a novel infection outbreak with possibly extensive public health complications, therefore on the edge of spreading throughout the world.

Signs associated with novel Coronavirus:

The indications associated with thisCOVID-19, include high temperature, drowsiness, and dry cough. A number of sufferers might possess pains and aches, sore throat, nasal jamming, runny nose or diarrhea. All of these mentioned symptoms are generally minor and initiate progressively.

For the above-mentioned reasons, vaccines for this virus cannot be rapidly prepared for at least a year to the public. Therefore, the best thing is to check symptomatic patients to avoid or slow the virus spread.

Screening methods:

Presently, polymerase chain reaction (PCR), a molecular technique necessitating distinct laboratory machines, is used to diagnose maximum pandemic-prone diseases, including coronavirus. The diagnosis of Coronavirus is taking a new turn as the current nucleic acid testing protocols are turning up a high amount of false negative. For better disease treatment and control, early identification of the virus COVID-19 is crucial.

Computed tomography:

Computed tomography(CT), a routine imaging tool, is fast and comparatively stress-free to perform. CT usage distinct x-ray equipment to inspect irregularities found in other imaging tests and to aid diagnoses the reason of unexplained cough, breathing shortness, chest pain, and fever. The advantages of CT scanning are accuracy; speed, simple, as well as noninvasive.

Compared to RT-PCR, chest CT imaging is considered for better stable, applied, and fast method to diagnose and assess COVID-19, especially in the epidemic area. In numerous studies, the sensitivity of chest CT was found to be greater (98 percent) than that of RT-PCR.

A number of researches trust the usage of chest CT for COVD-19 diagnosis for patients with medical and epidemiologic symptoms well-matched with COVID-19 contagion principally when RT-PCR test is negative. Hence, now the focus of the scientific world should be on testing the suspected patients at the initial stage and quarantine the infected as soon as possible. This action will not only help to reduce the current Covid-19 epidemic greatly but also will generate a system for emerging comparable tools to end upcoming pandemics.