This document outlines the process for conducting a systematic review. It begins by defining a systematic review as a review of research on a clearly formulated question that uses explicit and reproducible methods. It notes systematic reviews aim to identify, appraise, and synthesize all high-quality research evidence relevant to that question. The document then discusses why systematic reviews are important for summarizing evidence, limiting bias, and avoiding errors. It provides examples of how systematic reviews can help establish evidence-based practices. Finally, it describes the typical steps involved in conducting a systematic review, from developing a question to interpreting results.
This workshop is meant to be an introduction to the systematic review process. Further information about systematic reviews was available through a research guide. http://libguides.ucalgary.ca/content.php?pid=593664
An introduction to conducting a systematic literature review for social scien...rosie.dunne
An introduction to conducting a systematic literature review for social scientists and health researchers presented by Luke van Rhoon Health Behaviour Change Research Group, School of Psychology, NUI Galway November 2020
INCLUSION AND EXCLUSION CRITERIA session ACRM.pptxACSRM
Outline:
1. What is a Systematic Review?
2. Hierarchy of Evidence in Research
3. Inclusion and Exclusion Criteria [IC/EC]
4. Rationale for IC/EC in a Systematic Review [SR]
5. Models/Frameworks used in Formulating IC/EC for a SR
6. Examples of Models/Frameworks for
7. Qualitative and Quantitative SR
8. Other Considerations for IC/EC
This workshop is meant to be an introduction to the systematic review process. Further information about systematic reviews was available through a research guide. http://libguides.ucalgary.ca/content.php?pid=593664
An introduction to conducting a systematic literature review for social scien...rosie.dunne
An introduction to conducting a systematic literature review for social scientists and health researchers presented by Luke van Rhoon Health Behaviour Change Research Group, School of Psychology, NUI Galway November 2020
INCLUSION AND EXCLUSION CRITERIA session ACRM.pptxACSRM
Outline:
1. What is a Systematic Review?
2. Hierarchy of Evidence in Research
3. Inclusion and Exclusion Criteria [IC/EC]
4. Rationale for IC/EC in a Systematic Review [SR]
5. Models/Frameworks used in Formulating IC/EC for a SR
6. Examples of Models/Frameworks for
7. Qualitative and Quantitative SR
8. Other Considerations for IC/EC
University of Liverpool Library Researcher KnowHow session 2 of 3 presented by Michelle Maden PhD MAFHEA Postdoc research associate in evidence synthesis at the University of Liverpool on 22nd November 2021.
Summary slides for "Systematic Review and Meta-Analysis Course for Healthcare Professionals", January 8-9, 2013, King Abdullah Medical City, Makkah, Saudi Arabia
http://KAMCResearch.org
University of Liverpool Library Researcher KnowHow session 2 of 3 presented by Michelle Maden PhD MAFHEA Postdoc research associate in evidence synthesis at the University of Liverpool on 22nd November 2021.
Summary slides for "Systematic Review and Meta-Analysis Course for Healthcare Professionals", January 8-9, 2013, King Abdullah Medical City, Makkah, Saudi Arabia
http://KAMCResearch.org
Systematic reviews at the peak of research designsNemencio Jr
This lecture explains why systematic reviews were catapulted to the peak of the study designs. Its advantages and limitations are discussed. The measures to overcome the limitations are also discussed.
A document that provides an unbiased and comprehensive synthesis
of relevant studies and research.
Characteristics of a Systematic Review
Purposes of a systematic review
A well recognised form of research is called systematic reviews on specific point. Why do we need them and How they can be done?? this talk is trying to answer these questions in a simple way
Systematic review and meta analysis is considered as the highest body of evidence in research evidence hierarchy. Often misunderstood or skipped over, this powerful tool can broaden our understanding on a specific topic and form basis of practicing evidence based medicine for us.
I presented systematic review and meta analysis as part of my PG seminar and got a good feedback. Now I wanted to share the presentation for a broader audience.
Any kind of constructive feedback is welcome.
Dr. Anik Chakraborty
JR3, Dept. Of Community Medicine
Pt. B. D. Sharma PGIMS, Rohtak
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Outline
I. What is systematic review
II. Why to do systematic review
III. When to do systematic review
IV. Model of a Cochrane systematic
review
V. Steps to do a systematic review
VI. Challenges of systematic reviews
ABOUBAKR ELNASHAR
3. I. What is a systematic
review?
A review of a clearly formulated
question that
uses systematic and explicit methods to
1. identify, select and critically appraise
relevant research
2. collect and analyse data from the
studies that are included in the review
(Cochrane Reviewers’ Handbook 4.1.5)
ABOUBAKR ELNASHAR
5. QUESTION Broad Focused
SOURCES/ Usually unspecified Comprehensive;
SEARCH Possibly biased explicit
SELECTION Unspecified; biased? Criterion-based;
uniformly applied
APPRAISAL Variable Rigorous
SYNTHESIS Usually qualitative Quantitative
INFERENCE Sometimes Evidence-based
evidence-based
NARRATIVE SYSTEMATIC
Cook, D. J. et. al. Ann Intern Med 1997;126:376-380ABOUBAKR ELNASHAR
6. Level of evidence
• I–1 Systematic reviews.
I–2 One or more large double-
blind RCT.
• II–1 One or more well-
conducted cohort studies.
II–2 One or more well-
conducted case-control
studies.
II–3 uncontrolled experiment.
• III Expert opinion.
• IV Personal experienceABOUBAKR ELNASHAR
7. Why on the Top
• Rigorous methodology
• Peer reviewed
• Relatively large sample size
• Ensures the highest quality evidence
ABOUBAKR ELNASHAR
8. II. Why do we need it?
• Too much trials
25000 biomedical journals in print
8000 articles published per day
• All studies not equally well designed or interpreted
So, we need a study of studies
• To summarize evidence from studies that address a
specific clinical question.
• To explain differences among studies on the same
question
• To limit bias (rigorous methodology & clear reporting)
ABOUBAKR ELNASHAR
9. Example
• Protocols in neurology units - 80% still
recommend bed rest after LP
• Systematic review of 10 trials of bed rest after
spinal puncture
– no change in headache with bed rest
– Increase in back pain
Serpell M, BMJ 1998;316:1709–10
ABOUBAKR ELNASHAR
10. • Many single trials had relatively low power
• Avoid Type II error: Investigators did not detect a
difference when a difference actually exists
• This is not surprising as the power to detect a
difference will have been increased by the increase
in the sample size
• Systematic reviews help us to avoid the personal
bias inherent in traditional reviews and expert
opinion
• Results from systematic reviews are the
cornerstone for developing practice guidelinesABOUBAKR ELNASHAR
11. III. When can you do meta-
analysis?
• When more than one study has
estimated an effect
• When there are no differences in the
study characteristics that are likely to
substantially affect outcome
• When the outcome and treatment effect
have been measured in similar ways
• When the data are available
ABOUBAKR ELNASHAR
12. When not to do a meta-analysis?
• ‘garbage in – garbage out’
– a meta-analysis is only as good as the studies in
it
– meta-analysis in presence of serious publication
and/or reporting biases may produce an
inappropriate summary
ABOUBAKR ELNASHAR
14. Cochrane: Prof. Archie Cochrane
CBE, FRCP, FFCM (1909-1988)
1960-74: Director, MRC Epidemiology
Research Unit
1972: Publication by Nuffield Provincial
Hospital Trust of his book
“Effectiveness and Efficiency :
Random Reflections on Health
Services”
“It is surely a great criticism of our
profession that we have not organised a
critical summary, by specialty or
subspecialty, adapted periodically, of all
relevant randomised controlled trials.”
ABOUBAKR ELNASHAR
15. The Cochrane Collaboration
• International collaboration
• Prepares, maintains, and disseminates
systematic reviews
• Diverse internal structure (Review Groups,
Centres, Fields, Methods Groups, the
Consumer Network)
Cochrane Library
• The current resource with the highest methodological
rigor
• $235/year or abstracts only
• www.cochrane.org
ABOUBAKR ELNASHAR
17. The logo
represents meta-analysis of 7 trials of IM
corticosteroids given to mothers for
foetal maturation in preterm infants
[Chalmers et al].
ABOUBAKR ELNASHAR
18. Abstract
Background
Objectives
Criteria for considering studies for this review
Types of participants
Types of intervention
Types of outcome measures
Types of studies
Search strategy for identification of studies
Methods of the review
Description of the studies
Methodological qualities of included studies
Results
Discussion
Conclusions
Implications for practice
Implications for research
Internal sources of support to the review
External sources of support to the review
Potential conflict of interest
Acknowledgements
Contribution of Reviewer(s)
Synopsis
Characteristics of included studies
Table 01 results
References to studies included in this review
Additional references
Typical Systematic Review “Skeleton”
ABOUBAKR ELNASHAR
19. V. Steps to do a systematic review
• Well-Formulated Question
• Efficient Search Strategies
• Review Abstracts to Determine Eligibility
• Apply Strict Inclusion/Exclusion Criteria
• Extract the Data
• Perform the Required Analyses (Meta-
analysis)
• Interpret the Results
• Determine Implications for Health Care Policy
and Practice
ABOUBAKR ELNASHAR
20. Methodology
• At least 3 reviewers
• Detailed description of :
Trial design characteristics
Why included / excluded
Quality of included studies in details
Source of articles
• Electronic databases
• Bibliography of selected articles
• Hand searching Journals
• “Gray” Literature
• Key Informants
• Web Searching ABOUBAKR ELNASHAR
21. VI. Challenges for systematic
reviews
• Evidence into practice
• Many interventions reviewed cannot be
implemented in resource-poor situations
• Most interventions reviewed so far don’t
reflect developing world priorities
• Very few studies that have been conducted in
a developing country
• Most developing country research that is
found is excluded on quality grounds
ABOUBAKR ELNASHAR