OBJECTIVE: To evaluate the efficacy of L-ornithine-L-aspartate (LOLA) in improving minimal hepatic encephalopathy in adult patients with liver cirrhosis.

METHODS: A search in PubMed, Cochrane Library, Google Scholar, and Medline was made obtaining four qualified randomized controlled trials. Studies included adult cirrhotic patients with minimal hepatic encephalopathy measured by the number connection test (NCT-A, B), figure connection test (FCT-A, B), picture completion, block design test, and critical flicker frequency (CFF) testing with a cut-off score of

RESULTS: Of the 29 studies identified, 4 fulfilled the inclusion criteria, which entailed analysis of 238 participants (LOLA: 116, Control: 122). Three out of the four studies were used in meta-analysis and one study was analyzed separately due to a difference in the neuropsychometric measure. The meta-analysis favored the experimental group (LOLA), with a mean difference of 2.29 (95% CI 0.72 - 3.86), p-value = 0.004, and an I2 of 18%.

CONCLUSION: LOLA provided great potential in managing encephalopathy since treating earlier related to better survival and prevention of disease progression. The results of our study supported such evidence and its use may be encouraged.

Human ; Fibrosis ; Hepatic Encephalopathy

BACKGROUND: Kidney transplantation (KT) remains to be the preferred mode of renal replacement therapy as it offers the best clinical outcomes, a better quality of life, and lesser complications compared to dialysis. However, KT still carries a number of complications, one of which is graft thrombosis. Despite advancements in treatment, graft thrombosis is still an important cause of early graft loss. Prevention therefore, is of significance. A growing number of evidence suggests that low-dose aspirin has a role in the primary prevention of allograft thrombosis. RESEARCH QUESTION: Among renal transplant recipients, does postoperative aspirin prevent early renal allograft thrombosis? OBJECTIVE: To conduct a meta-analysis to determine the effect of postoperative aspirin on preventing renal allograft thrombosis. METHODS: A systematic search of PubMed, Google Scholar, CENTRAL, and clinicaltrials.gov was done by two independent authors. All randomized and non-randomized studies determining the effect of postoperative aspirin on renal vein/allograft thrombosis were reviewed for eligibility and quality assessment. Studies on both adult and pediatric kidney transplant recipients were included. RESULTS: Five non-randomized cohort studies (3 in adults, 2 in children) with a total of 2,393 patients were included. Using the Newcastle-Ottawa scale, two studies were found to have good quality, while three had poor quality. In a fixed-effects meta-analysis, aspirin was associated with a reduced risk for renal allograft thrombosis in adults (RR 0.13; 95% CI 0.06, 0.28;I2 22%) and children (RR 0.11; 95% CI 0.03, 0.40; I2 0%). CONCLUSION: Post-operative aspirin was associated with reduced risk for renal allograft thrombosis in both adults and children. However, the best available evidence is limited to observational studies. A well-designed randomized controlled trial is needed to confirm this finding.
Aspirin ; Kidney Transplantation ; Renal Veins ; Venous Thrombosis ; Transplantation, Homologous ; Kidney Diseases ; ; Veins ; Allografts

OBJECTIVE: This study aimed to determine the knowledge, attitudes and practices (KAP) of a selected population of patients on herbal dietary supplements (HDS).
METHOD: Methodological triangulation was used to generate a conceptual framework on HDS KAP. A survey of 175 patients was performed to measure knowledge and attitudes regarding HDS and SPSS was used for data analysis. Inverviews and focus group discussions (FGDs) were conducted to further explore the attitudes and practices, and constant comparison method was used for analysis of responses.
RESULTS: Respondents were generally aware of HDS. Majority of survey respondents believed that HDS are different from conventional drugs (52.0%, p<0.05). However, knowledge on the role of the Food and Drug Administration (FDA) in regulating HDS and understanding of "No Approved Therapeutic Claims" were poor.
The attitude toward HDS was generally positive. Majority (64.0%, p<0.05) were positive toward their perceived health benefits as claimed for the prevention of diseases, while a smaller percentage (46.9%, p<0.05) believed in their benefit for the treatment of diseases. A favorable attitude regardings HDS safety was observed due to the idea of their being "herbal" and "natural".
Among the survey respondents, only 22% were HDS users. Family was shown to promote use while cost deterred their use.
CONCLUSION: Individual knowledge and attitudes on HDS exert significant influence toward HDS practices. Factors that promote use are poor knowledge and positive attitudes toward HDS. Good knowledge seems to lead to judicious use or non-use.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Focus Groups ; United States Food And Drug Administration ; Awareness ; Perception ; Safety ; Attitude ; Dietary Supplements