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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Prevalence and associated factors for non-alcoholic fatty liver disease among adults in the South Asian Region: a meta-analysis(Elsevier, 2023) Niriella, M.A.; Ediriweera, D.S.; Withanage, M.Y.; Darshika, S.; de Silva, S.T.; de Silva, H.J.BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease worldwide. We estimated the prevalence and predefined associated factors for NAFLD among South-Asian adults. METHODS: We searched PubMed and included descriptive, epidemiological studies with satisfactory methodology, reporting the prevalence of NAFLD with ultrasound. Two authors screened and extracted data independently. Gender, urban/rural settings, general population and individuals with metabolic diseases (MetD) stratified the analysis. In addition, a random-effects meta-analysis of the prevalence and effect sizes of associations of NAFLD was performed. FINDINGS: Twenty-two publications were included after the quality assurance process. The difference in the NAFLD prevalence between the general population and people with MetD was found to be statistically significant (Q = 15.8, DF = 1, P < 0.001). The pooled overall prevalence of NAFLD in the general population was 26.9% (95% CI: 18.9-35.8%) with high heterogeneity. The prevalence was similar among men and women (Q = 0.06, DF = 1, P = 0.806). The NAFLD prevalence in the rural communities was 22.6% (95% CI: 13.6-33.1%), and the prevalence in urban communities was 32.9% (95% CI: 22.8-43.8%) and the difference was not statistically significant (Q = 1.92, DF = 1, P = 0.166). The pooled overall prevalence of NAFLD in patients with MetD was 54.1% (95% CI: 44.1-63.9%) with high heterogeneity. The pooled overall prevalence of NAFLD in the non-obese population was 11.7% (95% CI: 7.0-17.3%). The pooled prevalence of non-obese NAFLD in the NAFLD population was 43.4% (95% CI: 28.1-59.4%). Meta-analysis of binary variables showed that NAFLD in the South Asian population was associated with diabetes mellitus, hypertension, dyslipidaemia, general obesity, central obesity and metabolic syndrome. Gender was not associated with NAFLD. INTERPRETATION: The overall prevalence of NAFLD among adults in South Asia is high, especially in those with MetD, and a considerable proportion is non-obese. In the South Asian population, NAFLD was associated with diabetes mellitus, hypertension, dyslipidaemia, general obesity, central obesity, and metabolic syndrome.