Alif Hasan Pranto

Background: Hematopoietic stem cell transplantation (HSCT) is a procedure used in different malignant and non-malignant diseases. Although post-transplant lymphoproliferative disorder (PTLD) is infrequently observed in patients with HSCT, no study on the overall global incidence rate is available to date. Methodology: In this study, we selected 39 studies from 941 studies from three databases (i.e., PubMed, ScienceDirect, and Google Scholar) to identify the global incidence rate of PTLD in HSCT. Results: The pooled incidence was determined to be 5.6% (95% CI: 5.0 to 6.3) and rose further to 12.4% (95% CI: 10.2 to 14.7) after excluding outlier studies. The quality of the studies was high as well. PTLD was prevalent the most in allogenic HSCT (i.e., 5.6% (95% CI: 4.9 to 6.3)) and within the European region (i.e., 27.1% (95% CI: 21.4 to 32.8)). Among risk factors, human leukocyte antigen (HLA) mismatch was reported in most of the studies. Conclusions: This study assessed and discussed the overall global incidence of PTLD in HSCT patients, continent-based incidence, and risk factors that can be helpful in finding the possible prevention mechanism of PTLD and implementing individualized treatment approaches based on the treatment availability during HSCT.

Background: Chronic kidney disease (CKD) represents an escalating global health burden, fundamentally altering morbidity and mortality trajectories across the world, particularly as it advances into end-stage renal disease (ESRD). Beyond the primary decline in renal filtration and excretion, a wide spectrum of endocrine and metabolic derangements frequently accompanies kidney failure, with thyroid dysfunction emerging as a critical complication. Methods: The current study was designed to rigorously evaluate the nuanced association between thyroid hormone dynamics—specifically thyrotropin (TSH), triiodothyronine (T3), and thyroxine (T4)—and renal status in three distinct cohorts: individuals with suspected thyroid issues but normal renal function (NPs), non-dialysis kidney disease patients (NDKPs), and patients undergoing maintenance hemodialysis (DPs). Data were collected from a clinical setting in Bangladesh, involving 161 subjects. Results: The results demonstrated that patients in the DP cohort exhibited slightly elevated thyroid hormone levels relative to those in the NDKP cohort. Specifically, within the subgroups of patients exhibiting normal or sub-reference hormonal levels, dialysis patients maintained higher concentrations than their non-dialysis counterparts. Demographic stratification further revealed that males, females, and individuals younger than 45 years were more likely to demonstrate restorative hormonal profiles in the DP group than in the NDKP group. Conclusions: These collective outcomes suggest that renal replacement therapy, specifically hemodialysis, may serve to stabilize or improve thyroid function in ESRD patients by potentially mitigating the suppressive effects of uremic toxins and normalizing homeostatic feedback loops.

Hepatitis B infection is a global threat caused by the Hepatitis B virus (HBV), which can be transmitted through blood transfusions. Again, dialysis is a mechanical process that is used to filter the blood of patients with chronic kidney disease (CKD). In this study, we aimed to evaluate the worldwide prevalence of HBV infection using primary published data on hepatitis B virus surface antigen (HBsAg) and HBV-DNA prevalence among dialysis patients. To obtain the data, we searched three different online databases, and from 479 studies, 79 articles were selected for this study. Besides prevalence analysis, study outliers, quality, and characteristics were identified as well. We found the pooled prevalence of HBsAg and HBV-DNA to be 7.0% (95%CI: 6.1-8.0) and 1.5% (95%CI: 1.0-1.9), respectively, although, excluding the outliers, the prevalence of HBsAg became 6.3%, but HBV-DNA remained the same. Besides, we determined that 49.2% (95%CI: 30.2-68.1) of dialysis patients took the HBV vaccine, and 40.0% (95%CI: 31.1-48.8) of patients developed natural immunity (anti-HBV antibody). Among continent-based analyses, Australia was determined to have the highest prevalence of HBsAg (8.7%), and Asia and Africa were found to have the same and highest prevalence of HBV-DNA (4.1%). Among risk factors, blood transfusion was the highest, followed by duration of dialysis, HCV/other infections, renal diseases, and so on. This study indicates the importance of careful and contamination risk-free dialysis among patients, vaccination, and early diagnosis of HBV to avoid and prevent the risk of HBV infection.

Background: Hematopoietic stem cell transplantation (HSCT) is a widely utilized subtype of transplantation employed in various malignant and non-malignant diseases, particularly when conventional treatments or therapeutics prove ineffective. Despite the frequent occurrence of post-transplantation lymphoproliferative disease (PTLD) in patients undergoing HSCT, no comprehensive global prevalence rate has been established to date. Methodology: In this study, we selected 39 studies from 941 studies from three databases (i.e., PubMed, ScienceDirect, and Google Scholar) to identify the global prevalence rate of PTLD in HSCT patients. Results: The pooled prevalence was determined as 5.6% (95% CI: 5.0 to 6.3) and increased to 12.4% (95% CI: 10.2 to 14.7) after excluding outlier studies. The quality of the studies was also high. The prevalence of death cases among HSCT patients was determined as 0.6% (95% CI: 0.4 to 0.9). PTLD was most prevalent in allogenic HSCT (i.e., 5.6% (95% CI: 4.9 to 6.3)) and within the European region (i.e., 27.1% (95% CI: 21.4 to 32.8)). Among risk factors, HLA mismatch was reported in most of the studies. Conclusion: This study assessed and discussed the overall global prevalence of PTLD in HSCT patients, continent-based prevalence, and risk factors that can be helpful in finding the possible prevention mechanism of PTLD and implementing individualized treatment approaches based on the treatment availability during HSCT.

Chronic kidney disease (CKD) represents an escalating global health burden, fundamentally altering morbidity and mortality trajectories across the world, particularly as it advances into end-stage renal disease (ESRD). Beyond the primary decline in renal filtration and excretion, a wide spectrum of endocrine and metabolic derangements frequently accompanies kidney failure, with thyroid dysfunction emerging as a critical complication. The current study was designed to rigorously evaluate the nuanced association between thyroid hormone dynamics—specifically thyrotropin (TSH), triiodothyronine (T3), and thyroxine (T4)—and renal status in three distinct cohorts: individuals with suspected thyroid issues but normal renal function (NP), non-dialysis kidney patients (NDKP), and patients undergoing maintenance hemodialysis (DP). Data were collected from a clinical setting in Bangladesh, involving 161 subjects. The results demonstrated that patients in the DP cohort exhibited slightly elevated thyroid hormone levels relative to those in the NDKP cohort. Specifically, within the subgroups of patients exhibiting normal or sub-reference hormonal levels, dialysis patients maintained higher concentrations than their non-dialysis counterparts. Demographic stratification further revealed that males, females, and individuals younger than 45 years were more likely to demonstrate restorative hormonal profiles in the DP group than in the NDKP group. These collective outcomes suggest that renal replacement therapy, specifically hemodialysis, may serve to stabilize or improve thyroid function in ESRD patients by potentially mitigating the suppressive effects of uremic toxins and normalizing homeostatic feedback loops.

Hematopoietic stem cell transplantation (HSCT) is a widely used transplant method for different cancerous and non-cancerous conditions, particularly when conventional treatments fail. Again, Epstein-Barr Virus (EBV), one of the major contributors to gastric carcinoma can cause post-transplantation lymphoproliferative disease (PTLD) after transplantations. However, the global prevalence of EBV-associated PTLD in HSCT recipients is yet to be determined. This research examined 33 studies selected from 941 articles across three databases (i.e. ScienceDirect, PubMed, and Google Scholar) to investigate the global epidemiology of EBV-associated PTLD in HSCT patients. The overall prevalence was calculated at 27.0%; 95% CI: 24.5-29.5, increasing to 23.7%; 95% CI: 19.3-28.3 after removing outlier studies. The analyzed studies were of high quality. Among different continents, North America was determined to have the highest prevalence rate (33.3%; 95%CI: 12.5-54.1) followed by Europe (27.8%; 95%CI: 23.3-32.2), and Asia (20.7%; 95%CI: 17.4-23.9). This investigation highlights the need for early detection of EBV-associated PTLD, personalized treatment strategies, and continued research into the condition's underlying mechanisms. Addressing these aspects can enhance outcomes for HSCT patients and contribute to advancements in transplant medicine. PROSPERO (CRD420250583221).

Background: As a major maternal health concern, the prevalence of human immunodeficiency virus (HIV) among pregnant women was previously investigated in European, African, and Latin American regions other than the North American region. This study analyzed the prevalence of HIV among pregnant women in the North American region including 3 major countries: the USA, Canada, and Mexico. Methods: Relevant studies were screened from 3 online databases: Google Scholar, PubMed, and ScienceDirect using specific search keywords. Ultimately, 10 studies of the North American region were included with a total of 339,831 pregnant women residing in the USA, Canada, and Mexico. Results: The overall pooled prevalence was 0.6% (95% confidence interval [CI]: 0.4–0.8) with a high degree of heterogeneity (I ² = 97%). Pooled prevalence rates of HIV among pregnant women in Canada, Mexico, and the USA were 0.3% (95% CI: 0.1–0.5), 0.5% (95% CI: 0.2–0.8), and 2.3% (95% CI: 0.0–5.7), respectively with high degrees of heterogeneity. Conclusion: The overall prevalence rate of HIV among pregnant women in the USA, Canada, and Mexico was minimal as compared with the countries of Eastern Europe, sub-Saharan Africa, or Latin America. Awareness, adequate testing and healthcare facilities, better socioeconomic, and geopolitical conditions might be crucial to lowering the prevalence of HIV among pregnant women.

Thalassemia is one of the most prevalent genetic disorders worldwide and has previously been found to have an association with several physiological and organ complications. Several studies have found both its positive and inverse correlation with the glomerular filtration rate (GFR). Therefore, in this meta-analysis, we tried to assess the accurate correlation of β-thalassemia major (β-TM) with GFR. We searched in Google Scholar, PubMed, and ScienceDirect, and from the initial 96 articles, we finally included 12 studies. The quality and publication bias assessment confirmed that all the studies were of high to moderate quality with no publication bias. The main outcome of the mean difference (MD) was −6.94, 95%CI: −20.69, 6.80 (p < 0.00001), which indicated a negative correlation of the GFR with β-TM. The sensitivity analyses found one study to be a slight outlier, and reanalyzing the data excluding that study, an MD was achieved of −16.46, 95%CI: −26.81, −6.11 (p < 0.00001), which provides even stronger support for our main outcome. Our result determined that the GFR is generally higher in healthy people as compared to β-TM patients.

Thalassemia is one of the most prevalent genetic disorders worldwide which has been previously found to have an association with several physiological and organ complications. Several studies found both its positive and inverse correlation with glomerular filtration rate (GFR). Therefore, in this meta-analysis, we tried to assess the accurate correlation of thalassemia with GFR. We searched in Google Scholar, PubMed, and ScienceDirect, and from the initial 96 articles we finally could include 15 studies. The quality and publication bias assessment confirmed that all the studies were of high to moderate quality with no publication bias. The main outcome of the mean difference (MD) was -6.45, 95%CI: -18.50, 5.60 (P<0.00001), which indicated a negative correlation of GFR with thalassemia. The sensitivity analyses found one study as a slight outlier and reanalyzing the data excluding that study MD was achieved as -13.90, 95%CI: -24.22, -3.59 (P<0.00001) which even strongly supports our main outcome. Our result determined that the GFR is generally higher in healthy people as compared to thalassemia patients.