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Reliability of neutrophil gelatinase-associated lipocalin in detecting acute tubular necrosis in decompensated cirrhosis:Systematic review and meta-analysis

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World Journal of Hepatology 2024年第11期16卷 1331-1338页

作者： nirav agrawal Scarlet Louis-Jean Zoya Ladiwala Harsha Adnani Ayesha Kamal Mitchell Karpman Albert Steven Fleisher Sanmeet Singh Department of Internal Medicine Anne Arundel Medical CenterAnnapolisMD 21401United States Department of Biostatistics Anne Arundel Medical CenterAnnapolisMD 21401United States Department of Gastroenterology Anne Arundel Medical CenterAnnapolisMD 21401United States

BACKGROUND Acute kidney injury(AKI)in cirrhosis is *** diagnosis of AKI in cirrhosis patients depends on clinical presentation and laboratory tests like serum ***,urine biomarkers could also be used to assess the type of AKI and the severity of the *** performed a systematic review with metaanalysis to evaluate the association with urine neutrophil gelatinase-associated lipocalin(NGAL)marker in identifying acute tubular necrosis(ATN)in patients with *** To assess the reliability of urine NGAL in the detection of ATN in patients with *** We systematically searched MEDLINE and PubMed using keywords including“urine biomarkers”,“NGAL”,“kidney dysfunction”,and“cirrhosis”to identify relevant *** was screened and *** studies assessed hospitalized cirrhosis patients with AKI using the urine NGAL *** synthesized the data using diagnostic odds ratio(DOR),comparative and descriptive analyses,and Cochran Mantel-Haenszel(CMH)statistics to evaluate *** Three thousand seven hundred and one patients with cirrhosis were analyzed from a total of 21 cohort *** DOR of 14 of those studies[pooled DOR:22.150,(95%CI:17.58-27.89),P<0.0001]demonstrated a significant association between urine NGAL levels and its identification of *** stratification by cirrhosis status,heterogeneity was analyzed and showed a significant non-zero correlation between NGAL and AKI(CMH statistic=702.19,P<0.0001).CONCLUSION In patients with cirrhosis,the use of urine NGAL is a reliable biomarker for detecting ATN and identifying the etiology of AKI.

关键词： Neutrophil gelatinase-associated lipocalin Acute tubular necrosis Acute kidney injury Cirrhosis Biomarker Severe liver dysfunction

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COVID-19 pandemic effects on the distribution of healthcare services in India: A systematic review

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World Journal of Virology 2022年第4期11卷 186-197页

作者： nirav Nimavat Mohammad Mehedi Hasan Sundip Charmode Gowthamm Mandala Ghanshyam R Parmar Ranvir Bhangu Israr Khan Shruti Singh Amit agrawal Ashish Shah Vishi Sachdeva Department of Community Medicine Dr.Kiran C Patel Medical College and Research InstituteBharuch 392001India Department of Biochemistry and Molecular Biology Mawlana Bhashani Science and Technology UniversityTangail 1902Bangladesh Department of Anatomy All India Institute of Medical SciencesRajkot 360006GujaratIndia Independent Researcher Centre Groove High SchoolGreenwoodIN 46143United States Department of Pharmacy Sumandeep VidyapeethVadodara 391760India Department of Medical Caribbean Medical UniversityDes PlainesIL 60018United States Shifa International Hospital Islamabad 999010Pakistan Department of Pharmacology All India Institute of Medical SciencesPatna 801507India Department of Paediatrics Gandhi Medical CollegeBhopal 462001India Department of Medical Adesh Institute of Medical Sciences and ResearchBathinda 151009India

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has brought fundamental changes to our problems and priorities,especially those related to the healthcare *** was one of the countries severely affected by the harsh consequences of the COVID-19 *** To understand the challenges faced by the healthcare system during a *** The literature search for this review was conducted using PubMed,EMBASE,Scopus,Web of Science,and Google *** also used Reference Citation Analysis(RCA)to search and improve the *** focused on the published scientific articles concerned with two major vital areas:(1)The Indian healthcare system;and(2)COVID-19 pandemic effects on the Indian healthcare *** The Indian healthcare system was suffering even before the *** pandemic has further stretched the healthcare services in *** main obstacle in the healthcare system was to combat the rising number of communicable as well as noncommunicable *** the pandemic measures,there was a diversion of focus of the already established healthcare services away from the chronic conditions and *** disruption of the vaccination services may have more severe short and long-term consequences than the pandemic’s adverse *** Severely restricted resources limited the interaction of the Indian healthcare system with the COVID-19 ***-establishment of primary healthcare services,maternal and child health services,noncommunicable diseases programs,National Tuberculosis Elimination Program,*** important to prevent serious long-term consequences of this pandemic.

关键词： COVID-19 Healthcare system Pandemic India Healthcare services

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