The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform

Zulfiqar A Bhutta - One of the best experts on this subject based on the ideXlab platform.

  • The Cochrane Library - Effect of administration of Antihelminthics for soil transmitted helminths during pregnancy
    The Cochrane database of systematic reviews, 2015
    Co-Authors: Rehana A Salam, Batool A. Haider, Quratulain Humayun, Zulfiqar A Bhutta
    Abstract:

    BACKGROUND: Helminthiasis is infestation of the human body with parasitic worms and it is estimated to affect 44 million pregnancies globally each year. Intestinal helminthiasis (hook worm) is associated with blood loss and decreased supply of nutrients for erythropoiesis resulting in iron-deficiency anaemia. Over 50% of the pregnant women in low- and middle-income countries suffer from iron-deficiency anaemia. Though iron-deficiency anaemia is multifactorial hook worm infestation is a major contributory cause in women of reproductive age in endemic areas. Antihelminthics are highly efficacious in treating hook worm but evidence of their beneficial effect and safety when given during pregnancy has not been established. OBJECTIVES: To determine the effects of administration of Antihelminthics for soil-transmitted helminths during the second or third trimester of pregnancy on maternal anaemia and pregnancy outcomes. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Groups Trials Register (31 January 2015) and reference lists of retrieved studies. SELECTION CRITERIA: All prospective randomised controlled trials evaluating the effect of administration of Antihelminthics during the second or third trimester of pregnancy. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and risk of bias extracted data and checked them for accuracy. MAIN RESULTS: A total of four trials including 4265 participants were included in this review. Two of the included trials were of high quality while two were of relatively low quality with limitations and biases in design and conduct.Analysis showed that administration of a single dose of Antihelminthic in the second trimester of pregnancy is not associated with any impact on maternal anaemia in the third trimester (risk ratio (RR) 0.94; 95% confidence interval (CI) 0.81 to 1.10; 3266 participants; four trials; low quality evidence). Subgroup analysis on the basis of co-interventions other than Antihelminthic which included iron supplementation given to both groups was also not associated with any impact on maternal anaemia (RR 0.76; 95% CI 0.47 to 1.23; 1290 participants; three trials; moderate quality evidence). No impact was found for the outcomes of low birthweight (RR 1.00; 95% CI 0.79 to 1.27; 3255 participants; three trials; moderate quality evidence) preterm birth (RR 0.88; 95% CI 0.43 to 1.78; 1318 participants; two trials moderate quality evidence) and perinatal mortality (RR 1.09; 95% CI 0.71 to 1.67; 3385 participants; two trials; moderate quality evidence). None of the included studies reported impact on infant survival at six months of age. AUTHORS CONCLUSIONS: The evidence to date is insufficient to recommend use of Antihelminthic for pregnant women after the first trimester of pregnancy. More well-designed large scale randomised controlled trials are needed to establish the benefit of Antihelminthic treatment during pregnancy.

  • Effect of administration of Antihelminthics for soil transmitted helminths during pregnancy.
    The Cochrane database of systematic reviews, 2009
    Co-Authors: Batool A. Haider, Quratulain Humayun, Zulfiqar A Bhutta
    Abstract:

    Helminthiasis is infestation of the human body with parasitic worms and it is estimated to affect 44 million pregnancies, globally, each year. Intestinal helminthiasis is associated with blood loss and decreased supply of nutrients for erythropoiesis, resulting in iron deficiency anaemia. Over 50% of the pregnant women in low- and middle-income countries suffer from iron deficiency anaemia. Though iron deficiency anaemia is multifactorial, hook worm infestation is a major contributory cause in women of reproductive age in endemic areas. Antihelminthics are highly efficacious in treating hook worm but evidence of their beneficial effect and safety, when given during pregnancy, has not been established. To determine the effects of administration of Antihelminthics for soil transmitted helminths during the second or third trimester of pregnancy on maternal anaemia and pregnancy outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2008). All prospective randomised controlled trials evaluating the effect of administration of Antihelminthics during the second or third trimester of pregnancy. Two review authors independently assessed trial quality and extracted the data. Three studies (1329 women) were included in this review. Analysis showed that administration of a single dose of antihelminth in the second trimester of pregnancy is not associated with any impact on maternal anaemia in the third trimester (risk ratio (RR) 0.90; 95% confidence interval (CI) 0.68 to 1.19, random effects (2 studies, n = 1075)). Subgroup analysis on the basis of co-interventions other than Antihelminthics which included iron supplementation given to both groups in the study by Larocque et al, and a subset of the study by Torlesse et al, showed that a single dose of antihelminth along with iron supplementation throughout the second and third trimester of pregnancy was not associated with any impact on maternal anaemia in the third trimester as compared to iron supplementation alone (RR 0.76; 95% CI 0.39 to 1.45, random-effects (2 studies, n = 1017)). No impact was found for the outcomes of low birthweight (RR 0.94; 95% CI 0.61 to 1.42 (1study; n = 950)), perinatal mortality (RR 1.10; 95% CI 0.55 to 2.22 (2 studies, n = 1089)) and preterm birth (RR 0.85; 95% CI 0.38 to 1.87 (1 study, n = 984)). Impact on infant survival at six months of age could not be evaluated because no data were available. The evidence to date is insufficient to recommend use of Antihelminthics for pregnant women after the first trimester of pregnancy. More well-designed, large scale randomised controlled trials are needed to establish the benefit of Antihelminthic treatment during pregnancy.

Dekang Nie - One of the best experts on this subject based on the ideXlab platform.

  • Teaching NeuroImages: Giant cystic echinococcosis with unusual imaging manifestations.
    Neurology, 2017
    Co-Authors: Dekang Nie, Liang Xia, Jian Chen, Wei Shi, Guan Sun, Guo Jun
    Abstract:

    A 6-year-old girl presented with a 3-month history of progressive left-eye strabismus and vision loss. MRI scan of the brain showed a single hypointense lesion in the left cerebral hemisphere with no perilesional edema or contrast enhancement (figure 1, A–C). At surgery, the lesion was shown to be a single large parasitic cyst measuring approximately 7.0 × 6.5 × 6.0 cm (figure 2, A–C). The patient underwent a complete resection and then was given Antihelminthic therapy. This resulted in an uneventful recovery. Pathology confirmed a diagnosis of brain cyst with scolex. This imaging feature of giant cystic echinococcosis is very unusual.1 In the event of neurologic dysfunction or elevated intracranial pressure, emergent operative intervention should precede the administration of Antihelminthic medications as the latter may weaken the cyst membrane and complicate resection. Gross total resection has advantages compared with nonsurgical treatment with Antihelminthics.2 The authors thank staff of the Department of Neurosurgery of the Affiliated Hospital of Nantong University for technical assistance and equipment support.

  • teaching neuroimages giant neurocysticercosis with unusual imaging manifestations
    Neurology, 2016
    Co-Authors: Dekang Nie, Liang Xia, Jian Chen, Wei Shi, Guan Sun, Jun Guo
    Abstract:

    A 6-year-old girl presented with a 3-month history of progressive left-eye strabismus and vision loss. MRI scan of the brain showed a single hypointense lesion in the left cerebral hemisphere with no perilesional edema or contrast enhancement (figure 1, A–C). At surgery, the lesion was shown to be a single large parasitic cyst measuring approximately 7.0 × 6.5 × 6.0 cm (figure 2, A–C). The patient underwent a complete resection and then was given Antihelminthic therapy. This resulted in an uneventful recovery. Pathology confirmed a diagnosis of cysticercus cyst with scolex. This imaging feature of giant neurocysticercosis is very unusual.1 In the event of neurologic dysfunction or elevated intracranial pressure, emergent operative intervention should precede the administration of Antihelminthic medications as the latter may weaken the cyst membrane and complicate resection. Gross total resection has advantages compared with nonsurgical treatment with Antihelminthics.2

Jun Guo - One of the best experts on this subject based on the ideXlab platform.

  • teaching neuroimages giant neurocysticercosis with unusual imaging manifestations
    Neurology, 2016
    Co-Authors: Dekang Nie, Liang Xia, Jian Chen, Wei Shi, Guan Sun, Jun Guo
    Abstract:

    A 6-year-old girl presented with a 3-month history of progressive left-eye strabismus and vision loss. MRI scan of the brain showed a single hypointense lesion in the left cerebral hemisphere with no perilesional edema or contrast enhancement (figure 1, A–C). At surgery, the lesion was shown to be a single large parasitic cyst measuring approximately 7.0 × 6.5 × 6.0 cm (figure 2, A–C). The patient underwent a complete resection and then was given Antihelminthic therapy. This resulted in an uneventful recovery. Pathology confirmed a diagnosis of cysticercus cyst with scolex. This imaging feature of giant neurocysticercosis is very unusual.1 In the event of neurologic dysfunction or elevated intracranial pressure, emergent operative intervention should precede the administration of Antihelminthic medications as the latter may weaken the cyst membrane and complicate resection. Gross total resection has advantages compared with nonsurgical treatment with Antihelminthics.2

Guan Sun - One of the best experts on this subject based on the ideXlab platform.

  • Teaching NeuroImages: Giant cystic echinococcosis with unusual imaging manifestations.
    Neurology, 2017
    Co-Authors: Dekang Nie, Liang Xia, Jian Chen, Wei Shi, Guan Sun, Guo Jun
    Abstract:

    A 6-year-old girl presented with a 3-month history of progressive left-eye strabismus and vision loss. MRI scan of the brain showed a single hypointense lesion in the left cerebral hemisphere with no perilesional edema or contrast enhancement (figure 1, A–C). At surgery, the lesion was shown to be a single large parasitic cyst measuring approximately 7.0 × 6.5 × 6.0 cm (figure 2, A–C). The patient underwent a complete resection and then was given Antihelminthic therapy. This resulted in an uneventful recovery. Pathology confirmed a diagnosis of brain cyst with scolex. This imaging feature of giant cystic echinococcosis is very unusual.1 In the event of neurologic dysfunction or elevated intracranial pressure, emergent operative intervention should precede the administration of Antihelminthic medications as the latter may weaken the cyst membrane and complicate resection. Gross total resection has advantages compared with nonsurgical treatment with Antihelminthics.2 The authors thank staff of the Department of Neurosurgery of the Affiliated Hospital of Nantong University for technical assistance and equipment support.

  • teaching neuroimages giant neurocysticercosis with unusual imaging manifestations
    Neurology, 2016
    Co-Authors: Dekang Nie, Liang Xia, Jian Chen, Wei Shi, Guan Sun, Jun Guo
    Abstract:

    A 6-year-old girl presented with a 3-month history of progressive left-eye strabismus and vision loss. MRI scan of the brain showed a single hypointense lesion in the left cerebral hemisphere with no perilesional edema or contrast enhancement (figure 1, A–C). At surgery, the lesion was shown to be a single large parasitic cyst measuring approximately 7.0 × 6.5 × 6.0 cm (figure 2, A–C). The patient underwent a complete resection and then was given Antihelminthic therapy. This resulted in an uneventful recovery. Pathology confirmed a diagnosis of cysticercus cyst with scolex. This imaging feature of giant neurocysticercosis is very unusual.1 In the event of neurologic dysfunction or elevated intracranial pressure, emergent operative intervention should precede the administration of Antihelminthic medications as the latter may weaken the cyst membrane and complicate resection. Gross total resection has advantages compared with nonsurgical treatment with Antihelminthics.2

Wei Shi - One of the best experts on this subject based on the ideXlab platform.

  • Teaching NeuroImages: Giant cystic echinococcosis with unusual imaging manifestations.
    Neurology, 2017
    Co-Authors: Dekang Nie, Liang Xia, Jian Chen, Wei Shi, Guan Sun, Guo Jun
    Abstract:

    A 6-year-old girl presented with a 3-month history of progressive left-eye strabismus and vision loss. MRI scan of the brain showed a single hypointense lesion in the left cerebral hemisphere with no perilesional edema or contrast enhancement (figure 1, A–C). At surgery, the lesion was shown to be a single large parasitic cyst measuring approximately 7.0 × 6.5 × 6.0 cm (figure 2, A–C). The patient underwent a complete resection and then was given Antihelminthic therapy. This resulted in an uneventful recovery. Pathology confirmed a diagnosis of brain cyst with scolex. This imaging feature of giant cystic echinococcosis is very unusual.1 In the event of neurologic dysfunction or elevated intracranial pressure, emergent operative intervention should precede the administration of Antihelminthic medications as the latter may weaken the cyst membrane and complicate resection. Gross total resection has advantages compared with nonsurgical treatment with Antihelminthics.2 The authors thank staff of the Department of Neurosurgery of the Affiliated Hospital of Nantong University for technical assistance and equipment support.

  • teaching neuroimages giant neurocysticercosis with unusual imaging manifestations
    Neurology, 2016
    Co-Authors: Dekang Nie, Liang Xia, Jian Chen, Wei Shi, Guan Sun, Jun Guo
    Abstract:

    A 6-year-old girl presented with a 3-month history of progressive left-eye strabismus and vision loss. MRI scan of the brain showed a single hypointense lesion in the left cerebral hemisphere with no perilesional edema or contrast enhancement (figure 1, A–C). At surgery, the lesion was shown to be a single large parasitic cyst measuring approximately 7.0 × 6.5 × 6.0 cm (figure 2, A–C). The patient underwent a complete resection and then was given Antihelminthic therapy. This resulted in an uneventful recovery. Pathology confirmed a diagnosis of cysticercus cyst with scolex. This imaging feature of giant neurocysticercosis is very unusual.1 In the event of neurologic dysfunction or elevated intracranial pressure, emergent operative intervention should precede the administration of Antihelminthic medications as the latter may weaken the cyst membrane and complicate resection. Gross total resection has advantages compared with nonsurgical treatment with Antihelminthics.2