Diagnostic value of platelet to lymphocyte ratio in preeclampsia: a systematic review and meta-analysis

Using straightforward and accessible haematological parameters platelet/lymphocyte ratio (PLR) to diagnose preeclampsia (PE) early and precisely remains a challenge. Although several clinical studies suggested that PLR is able to diagnose PE, there has been no systematic evaluation of the diagnostic utility. To examine the diagnostic accuracy and potential applicability of PLR in the detection of PE. Seven databases were searched using a combination of PLR and PE terms, and all potentially pertinent studies were systematically searched up to March 2023. All potentially relevant studies both prospective and retrospective were reviewed. To assess the diagnostic value of PLR for PE, pooled sensitivity (Sen), specificity (Spe), diagnostic odds ratio (DOR) and area under the summary receiver operating characteristic curve (SROC-AUC) were calculated. Thirteen studies were enrolled in the meta-analysis. In the second and third trimesters, the PLR suggested a diagnostic value for PE with a pooled Sen of 54.7% [95% confidence interval (CI) (51.7, 57.6)], Spe of 77.8% [95% CI (75.5, 80.0)], + LR of 2.457 [95% CI (1.897, 3.182)], -LR of 0.584 [95% CI (0.491, 0.695)], DOR of 4.434 [95% CI (3.071, 6.402)], the SROC-AUC of 0.7296 and the standard error (SE) of 0.0370. For the diagnosis of PE, PLR has a limited sensitivity but an acceptable specificity, and showed moderate accuracy. Further using complete blood count (CBC) indicators such as PLR alone or in combination to diagnose and predict PE could reduce healthcare costs and improve maternal and child prognosis.</p

Pattern of medication selling and self-medication practices: A study from Punjab, Pakistan

<div><p>Background</p><p>Access to medicines without prescription is a major contributing factor for self-medication practices. This study was designed to examine the ratio of non-prescribed medicines sales and self-medication practices in Punjab, Pakistan. This study also evaluates the reasons for self-medication within its communities.</p><p>Methods</p><p>An observational study was conducted in 272 systemically selected pharmacies to analyze medicines-related sales, with or without prescription. A cross-sectional survey was performed between June 2015 and November 2016. Consumers were interviewed about their self-medication practices.</p><p>Results</p><p>Of the pharmacies surveyed, 65.3% participated in the study. A total of 4348 medicines were purchased for self-medication by 3037 consumers (15.2% of all study participants), of which 873 (28.7%) participated in an interview. Majority (81.2%) medicine purchaser, (90.9%) interview participants, and (59.4%) drug users were male. On average, each community pharmacy sold 7.9 medicines without prescription each day, to an average of 5.5 customers. Many participants (28.9%) had matriculation in their formal education. The medicines most often sold for self-medication were analgesics and antipyretics(39.4%). More than 25% of participants reported fever symptoms and 47.8% assumed their illness was too trivial to consult a doctor. Media advertisements were the most common source of information for participants (46.7%).</p><p>Conclusion</p><p>Many types of medicines were often sold without prescription from community pharmacies. Self-medication was common practice for a wide range of illnesses. Pakistan also needs effective implementation of policies to monitor medication sales. Public education about rational medication and limits to advertising medicine are very necessary.</p></div

An outline of study.

<p>An outline of study.</p

Sale of non-prescribed medicines.

<p>Sale of non-prescribed medicines.</p

Type of requests to acquire medicines (n = 3037).

<p>Type of requests to acquire medicines (n = 3037).</p

Reason of self-medication (n = 873).

<p>Reason of self-medication (n = 873).</p

Socio-demographic characteristics of participants (n = 873).

<p>Socio-demographic characteristics of participants (n = 873).</p

Perception of participants about their disease.

<p>Perception of participants about their disease.</p

DG treatment (10 mg/kg/day, i.p. for 14 days) attenuated learning and memory impairment in Aβ_1–42-induced AD mice.

<p>(A) Escape latency for escape to a submerged platform in the training trials. (B) Searching distance for escape to a submerged platform in the training trials. * <i>P</i><0.05 and ** <i>P</i><0.01 for two-way ANOVA with repeated measures followed by Bonferroni <i>post hoc</i> test compared with Aβ_1–42-treated, respectively. (C) 24 h after the training trials platform crossing times were recorded. * <i>P</i><0.05 for one-way ANOVA followed by Tukey <i>post hoc</i> test compared with control; # <i>P</i><0.05 for one-way ANOVA followed by Tukey <i>post hoc</i> test compared with Aβ_1–42-treated. (D) Swimming speed in the training trials. con: normal mice; DG: normal mice with DG (10 mg/kg/day, i.p. for 14 days); Aβ: Aβ_1–42-induced AD mice; Aβ+DG: Aβ_1–42-induced AD mice with DG (10 mg/kg/day, i.p. for 14 days). n = 10 mice per group.</p

Inhibition of PGC-1α could partially block the neuroprotective effects of DG.

<p>Five shRNAs targeted to PGC-1α were constructed and the efficacy was confirmed by RT-PCR (A) and western blotting (B) in primary cortical neurons. (C) Quantitative analysis of the relative RNA levels of PGC-1α. (D) Quantitative analysis of the relative protein levels of PGC-1α. (E) Neuronal cells were transfected by shP3 or shP5, 6 h after which cells were treated with 2 µM Aβ_1–42 and 0.001 µg/µl DG for another 24 h. Cell viability was estimated by the MTT assay. ** <i>P</i><0.01 for one-way ANOVA followed by Tukey <i>post hoc</i> test compared with control; # <i>P</i><0.05 for one-way ANOVA followed by Tukey <i>post hoc</i> test compared with Aβ_1–42; & <i>P</i><0.05 for one-way ANOVA followed by Tukey <i>post hoc</i> test compared with Aβ_1–42+DG.</p