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Objective: The purpose of this study was assess the time trend of the prevalence of prediabetes and diabetes and risk factors associated with diabetes in Pakistan by using a systematic review and meta–analysis. Methods: A systematic literature search of Embase, PubMed, and the Cochrane library was carried out between January 1, 1995 and August 30, 2018. Diabetes and prediabetes prevalence estimates were combined by the random–effects model. The existence of publication bias was tested by Egger regression. This systematic review was reported following the PRISMA guidelines. Results: The search conceded a total of 635 studies, only 14 studies were considered for meta-analysis. The prevalence of diabetes in Pakistan was revealed 14.62% (10.651%–19.094%; 14 studies) based on 49,418 people using the inverse–variance random–effects model. The prevalence of prediabetes was 11.43% (8.26%–15.03%; 10 studies) based on a total sample of 26,999 people. The risk factors associated with diabetes were mean age (β = 0.48%, 95% CI: 0.21–0.78, p<0.001), the proportion of participants with a family history of diabetes (β = 0. 45%, 95% CI: 0.08–0.82, p =0.018, p<0.001), hypertension (β = 0.40%, 95% CI: 0.06–0.75, p = 0.022), weight (BMI) (β = 0.21%, 95% CI: 0.02–0.4, p=0.030). Conclusions: There has been a continuous increase in the prevalence of prediabetes and diabetes in Pakistan. All parts of the country have been affected, with the highest in Sindh and lowest in Khyber Pakhtunkhwa. The main factors include growing age, family history, hypertension and obesity. A nationwide diabetes care survey on risk factors and prevention policy is highly recommended. doi: https://doi.org/10.12669/pjms.35.4.194 How to cite this:Akhtar S, Nasir JA, Abbas T, Sarwar A. Diabetes in Pakistan: A systematic review and meta-analysis. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.194 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Aim:Our goal was to improve treatment outcomes for visceral leishmaniasis by designing nanocarriers that improve drug biodistribution and half-life. Thus, long-acting mannose-anchored thiolated chitosan amphotericin B nanocarrier complexes (MTC AmB) were developed and characterized.Materials & methods:A mannose-anchored thiolated chitosan nanocarrier was manufactured and characterized. MTC AmB was examined for cytotoxicity, biocompatibility, uptake and antimicrobial activities.Results:MTC AmB was rod shaped with a size of 362 nm. MTC AmB elicited 90% macrophage viability and 71-fold enhancement in drug uptake compared with native drug. The antileishmanial IC50 for MTC AmB was 0.02 μg/ml compared with 0.26 μg/ml for native drug.Conclusion:These studies show that MTC can serve as a platform for clearance of Leishmania in macrophages.

These results provide evidence that the use of INH following renal transplantation should be considered mandatory in geographical areas where the prevalence of TB is high. Furthermore, these results have important implication in patients from such areas who are immunosuppressed following other kinds of transplantation and for those who are immunocompromised for any other reason.