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Purpose: To conduct a systematic review and meta-analysis for estimating the prevalence of pediatric cataracts across Asia. Methods: A detailed literature search of PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases, from 1990 to July 2021, was performed to include all studies reporting the prevalence of cataracts among children. Two researchers performed the literature search and screening of articles independently, and a third researcher critically reviewed the overall search and screening process to ensure the consistency. The JBI Critical Appraisal Checklist for studies reporting prevalence data was used to assess the methodological quality of the included studies. Results: Of the 496 identified articles, 35 studies with a sample size of 1,168,814 from 12 Asian countries were included in this analysis. The estimated pooled prevalence of pediatric cataracts in Asian children is 3.78 (95% confidence interval: 2.54–5.26)/10,000 individuals with high heterogeneity (I [2] = 89.5%). The pooled prevalence by each country per 10,000 was 0.60 in Indonesia, 0.92 in Bangladesh, 1.47 in Iran, 2.01 in Bhutan, 3.45 in Laos, 3.68 in China, 4.27 in Thailand, 4.47 in India, 5.33 in Malaysia, 5.42 in Nepal, 9.34 in Vietnam, and 10.86 in Cambodia. Conclusions: This study utilizes existing literature to identify the prevalence of cataracts in Asian children. Moreover, it highlights the need for more epidemiological studies with large sample sizes from other countries in Asia to accurately estimate the burden of disease.

Objective This study aims to compare the outcomes of volar locking plating (VLP) versus percutaneous Kirschner wires (K-wire) fixation for surgical management of unstable distal radius fractures. Methods We systematically searched multiple databases, including MEDLINE, EMBASE, Cochrane Central till January 2022 for randomized controlled trials (RCTs) that met eligibility criteria. Following outcomes were evaluated at 6-week, 3-, 6-, and 12-month follow-up period: Disabilities of the Arm, Shoulder, and Hand (DASH) score, Patient Rated Wrist Evaluation (PRWE) score, grip strength, range of motion, and complication incidence. Meta-analysis was performed using random effects models and results presented as risk ratios (RRs) or mean differences (MDs) with 95% confidence interval. Results Fourteen RCTs with 1,450 participants met the inclusion criteria. DASH scores were significantly better for VLP fixation at 6th week (MD = 19.02; p < 0.001), 3rd (MD = 10.79; p < 0.001), 6th (MD= 7.78; p < 0.001), and 12th month (MD = 2.94; p < 0.001) postoperation. At 3-month follow-up period, VLP treatment exhibited better grip strength (MD = − 10.32; p < 0.001) and PRWE scores (MD = 8.78; p < 0.001). There was a statistically significant early advantage in flexion, extension, pronation, supination, radial deviation, and ulnar deviation in the VLP group at 6-week follow-up, but at 1-year follow-up only significantly better extension was observed. At 1 year, radiographic outcomes were similar except for volar tilt favoring VLP fixation (p < 0.001). Superficial infections were more common in patients treated with K-wire (RR = 2.89; p = 0.001), but there was no difference in total complications or reoperation rates (p > 0.05). Conclusion This meta-analysis suggests that VLP fixation and K-wire fixation are both effective procedures, but existing literature does not provide sufficient evidence to demonstrate the superiority of either method. Although VLP fixation improves DASH score, extension and volar tilt at 12-month follow-up, the difference is small and unlikely to be noticeable to the patients.

Sepsis continues to be leading cause of mortality among patients admitted to intensive care unit (ICU), with about 48.9 million cases of sepsis diagnosed and 11 million deaths worldwide in 2017 [1]. Despite significant advances in the understanding of the pathophysiology of sepsis, the mainstay management still relies on active fluid resuscitation for hemodynamic support, early administration of antibiotics, and identification of source and infection control [2]. Vitamin C has been suggested as a possible therapy that attenuates the pathophysiology of sepsis [2]. Multiple randomized controlled trials (RCTs) addressing effectiveness and safety of vitamin C have reported varied conclusions [3]. Previously, published meta-analysis were limited by the sample size and highlighted the need of further studies with a larger number of patients to provide further evidence [3]. The recent publication of results from LOVIT (Lessening Organ Dysfunction with Vitamin C), the largest trial to date addressing this question, justifies re-examination of the evidence [4].PubMed and Scopus databases were searched for relevant studies by two investigators (MAT, UA) using the following keywords: "ascorbic, " "Vitamin C, " "ascorbic acid, " "sepsis, " "septic shock. " Studies were included if they were: (1) RCT (2) comprised of adult patients with Sepsis or septic shock (3) treatment arm: high-dose intravenous (IV) vitamin C (≥1.5 g every 6 hours or 25 mg/kg every 6 hours) either as monotherapy or combination therapy with thiamine and hydrocortisone, (4) control arm: placebo or standard regiment. Outcomes of interest were ICU mortality, 30-day and 90-day mortality, change in Sequential Organ Failure Assessment score (delta SOFA) within 72 hours. Subgroup analyses were conducted for vitamin C as monotherapy versus combination therapy. Review articles, non-randomized studies, conference abstracts and studies published prior to 2010 were excluded. Odds ratios (ORs) or weighted mean difference (WMD) with 95% confidence intervals (CI) were calculated using random effects model. Statistical heterogeneity in studies was assessed by I 2 statistics. A P<0.05 was considered significant.The initial literature search identified 854 unique studies, 14 trials with 2,793 patients met the eligibility criteria [3][4][5]. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) flowchart of the study selection is shown in Supplementary Figure 1. Baseline study characteristics are shown in Supplementary Table 1. IV vitamin C in combination with thiamine and hydrocortisone significantly reduced SOFA score at 72 hours (7 RCTs, 1,318 patients; WMD: -0.52, 95% CI: -1.01 to -0.03, P=0.037, I 2 =53%) (Figure 1D). For