| Rajesh Kumar | 2 Articles |
Objectives
Patients receiving hemodialysis (HD) are at increased risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) due to repeated blood exposure, vascular access procedures, and blood transfusions. The study aimed to determine the seroconversion rates of HBV and HCV among patients undergoing dialysis and to identify associated risk factors. Methods A total of 220 adult patients receiving dialysis who were seronegative for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies at baseline were enrolled. Serologic testing was repeated at 6 months. Results Sixteen patients (7.3%) seroconverted to HBsAg positivity, and 23 (10.5%) seroconverted to anti-HCV positivity. HBV seroconversion was significantly associated with multiple dialysis center visits. HCV seroconversion was significantly associated with dialyzer reuse, multiple dialysis center visits, and dialysis duration ≥2 years. Elevated liver enzyme levels were strongly correlated with seroconversion for both viruses. Conclusion HBV and HCV seroconversion remain concerns in HD units. Standardized infection control practices, minimization of patient transfers, and strict adherence to national guidelines are essential to reducing risk.
Objectives
The objectives of this review and meta-analysis were twofold: first, to critically evaluate the effectiveness of cognitive behavioral therapy (CBT)-based interventions relative to standard care or control conditions in promoting smoking abstinence at the end of treatment, and second, to determine abstinence rates at 3 and 6 months of follow-up. Methods A comprehensive search of electronic databases, including PubMed, Cochrane Library, PsycINFO, Embase, and ClinicalTrials.gov, was conducted for randomized controlled trials published from 2001 to September 2024. Studies evaluating the effect of CBT on abstinence rates among healthy smokers (aged ≥12 years) were included and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results Out of 1,514 study records screened, 7 studies (comprising 17 arms and 1,438 participants) met eligibility criteria for inclusion in the final analysis. The pooled analysis revealed that CBT significantly improved smoking abstinence rates, demonstrating a fourfold increase in effectiveness compared to controls (odds ratio [OR], 4.04; 95% confidence interval [CI], 2.73–5.99; I2=19%; p<0.00001). Additionally, CBT significantly impacted smoking cessation at 3-month follow-up (OR, 1.62; 95% CI, 1.11–2.38; I2=0%; p=0.01) and 6-month follow-up (OR, 2.19; 95% CI, 1.59–3.00; I2=0%; p<0.00001). Conclusion CBT has demonstrated efficacy in facilitating smoking abstinence, particularly immediately after treatment, with sustained but diminished effects over time. However, robust conclusions on the efficacy of CBT require further studies involving larger sample sizes, diverse geographical regions, and longer follow-up periods. Citations
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