Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Herbal treatments for non-alcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials(Elsevier Ltd, 2024) Rathnayake, D.W.; Sooriyaarachchi, P.; Niriella, M.A.; Ediriweera, D.; Perera, J.BACKGROUND With the rising prevalence of non-alcoholic fatty liver disease (NAFLD), there is a growing need to explore alternative therapeutic interventions. This study aimed to comprehensively evaluate the available evidence from randomized controlled trials (RCTs) for the use of herbal medications in NAFLD.METHODS A literature search was conducted in PubMed, Web of Science and Scopus databases using appropriate keywords for studies published before the 6th of July 2023. RCTs involving humans, with confirmed NAFLD, the intervention group (IG) receiving herbal treatment, the control group (CG) given a placebo, participants aged ≥18 years, published in English, and a Jadad score ≥6 were included. Coffee and green tea as interventions were excluded. A meta-analysis of studies examining the effects of herbal supplementation on clinical and biochemical parameters in patients with NAFLD was performed. Analysis was done with the “meta” package in R programming language version 4.3.RESULTS In this analysis encompassing 48 articles, study durations varied from 6 weeks to 12 months, with sample sizes ranging between 36 and 226 patients. The study included a total of 3741 patients, (IG=2013, CG=1728). Predominant single herbal medicines identified were Phyllanthus niruri, Beta vulgaris, Allium sativum L., Silymarin (Silybum marianum), Portulaca oleracea L., Nigella sativa, and Cynara cardunculus L. Meanwhile, Cynara cardunculus and curcumin were the most common ingredients in polyherbal compounds. Meta-analysis outcomes revealed a higher reduction in alanine aminotransferase (ALT), aspartate aminotransferase (AST), liver stiffness, waist circumference (WC), weight, body mass index (BMI), triglycerides (TG), and fasting blood glucose (FBG) in the IG compared to the CG. Notably, the reductions in ALT and weight were more pronounced in single herb compounds compared to polyherbal compounds. No differences were observed between the two groups regarding HbA1c levels.CONCLUSION These findings highlight the potential benefits of herbal interventions with regard to improvements in anthropometry, metabolic profiles, and liver enzymes in study participants.Item Non-alcoholic fatty liver disease in the South Asian Region: A systematic review and meta-analysis(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Withanage, M.Y; Niriella, M.A.; Ediriweera, D.; de Silva, S.T.; de Silva, A.P.; de Silva, H.J.Introduction: Non-alcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease worldwide. Objectives: We estimated the overall prevalence and effect sizes of associations for NAFLD among adults in South Asia. Methods: We searched for search terms “Prevalence of NAFLD (Non-Alcoholic Fatty Liver Disease)” AND “South Asia” AND individual South Asian countries from January 2004-May 2021 in PubMed database. Strict eligibility criteria were applied. Gender, urban or rural setting, general population and individuals with metabolic diseases stratified analysis. A random-effects meta-analysis was performed. Results: Out of 158 studies, selected 25 studies from five countries (Bangladesh, India, Nepal, Pakistan and Sri Lanka) were included with 15,758 participants, of whom 4703 had NAFLD. The pooled NAFLD prevalence was 40.5% [95% CI 33.7-47.5] in overall, 26.2% [95% CI 18.7-4.4] in general population, 21.9% [95% CI 14.4-30.5] in rural communities, 32.9% [95% CI 22.8-43.8] in urban communities, 54% [95% CI 46.4-61.5] in individuals with one or more metabolic abnormalities and 11.1% [95% CI 7.1-16] among non-obese population. 41.4% of NAFLD patients were non-obese. Gender specific prevalence was similar. Prevalence of NAFLD among individuals with metabolic disease was significantly higher than the general population (p<0.0001). A significant association with NAFLD was found for metabolic syndrome, general obesity, central obesity, diabetes mellitus, dysglycemia, dyslipidemia and hypertension. Conclusions: The overall prevalence of NAFLD among adults in South Asia is high, especially in urban populations and those with metabolic abnormalities. Targeted health¬strategies should be implemented in the region to address this.