Browsing by Author "Riazi, Kiarash"

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    Immunoglobulin utilization in Canada: a comparative analysis of provincial guidelines and a scoping review of the literature
    (2023-09-16) Harmon, Megan; Riazi, Kiarash; Callum, Jeannie; Arnold, Donald M.; Barty, Rebecca; Sidhu, Davinder; Heddle, Nancy M.; MacLeod, Laurie; Li, Na
    Abstract Background Canada has high immunoglobulin (IG) product utilization, raising concerns about appropriate utilization, cost and risk of shortages. Currently, there is no national set of standardized IG guidelines, and considerable variations exist among the existing provincial guidelines. The aims of this study were: (1) to compare the existing Canadian provincial guidelines on the use of IG products to identify their consistencies and differences and (2) to examine the existing research in Canada on IG supply and utilization following the establishment of IG guidelines to understand the scope of research and pinpoint the gaps. Methods A comparative analysis accounted for the differences across provincial IG guidelines. We highlighted similarities and differences in recommendations for medical conditions. A scoping review of citations from MEDLINE, PubMed, Scopus and Embase databases was conducted for studies published from January 01, 2014, to April 12, 2023. Results While provincial guidelines represented a considerable overlap in the medical conditions delineated and relatively uniform dose calculations, numerous differences were observed, including in recommendation categories, provision of pediatric dosing, and divergent recommendations for identical conditions based on patient demographics. The scoping review identified 29 studies that focused on the use of IG in Canada. The themes of the studies included: IVIG utilization and audits, the switch from IVIG to SCIG, patient satisfaction with IVIG and/or SCIG, the economic impact of self-administered SCIG versus clinically administered IVIG therapy, and the efficacy and cost-effectiveness of alternative medications to IG treatment. Conclusion The differences in guidelines across provinces and the factors influencing IVIG/SCIG use, patient satisfaction, and cost savings are highlighted. Future research may focus on clarifying costs and comparative effectiveness, exploring factors influencing guideline adherence, and evaluating the impact of updated guidelines on IG use and patient outcomes.
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    Worldwide Prevalence and Incidence of Non-Alcoholic Fatty Liver Disease (NAFLD) in the 21st Century: A Systematic Review and Meta-Analysis
    (2021-09-10) Riazi, Kiarash; Kaplan, Gilaad G; Shaheen, Abdel Aziz; Swain, Mark G; Congly, Stephen E
    Non-alcoholic fatty liver disease (NAFLD) is defined as the presence of lipid deposition in more than 5% of hepatocytes, also known as fatty liver, in the absence of any history of excessive alcohol use or secondary causes of fatty liver. NAFLD is the most common liver disorder worldwide and the leading cause of liver-related morbidity and mortality, mainly because of cirrhosis, end-stage liver disease, liver transplant, and an increased incidence of hepatocellular carcinoma.The prevalence of NAFLD is constantly rising. Due to a silent presentation, high prevalence, and the detrimental outcomes associated with it, NAFLD is a major global health problem. Since there are currently no approved treatments for NAFLD, disease prevention is the only available option for reducing the disease burden. Since primary epidemiological data are the crucial cornerstones for every public health and preventive medicine attempt, updated and accurate epidemiological data are of utmost importance. There are currently a few existing research publications on the prevalence and incidence of NAFLD worldwide, which are either outdated, methodologically imperfect, or geographically restricted. Therefore, there is a need to update current data and accurately estimate NAFLD's worldwide prevalence and incidence.We performed a systematic review to identify all the studies reporting on the prevalence or incidence of NAFLD among the general adult population of different world regions over the past two decades. We used a random-effects meta-analysis method to calculate overall or sex-specific pooled prevalence or incidence rates. We also created static and interactive choropleth maps of pooled data to highlight the geographic differences in NAFLD prevalence/incidence.We estimated that the overall prevalence of NAFLD is appreciably higher than what had previously been assessed and is growing at an alarming rate. Furthermore, our findings show that the epidemiological reports regarding NAFLD from many parts of the world are missing. A dramatic rise in prevalence should drive enhanced awareness of NAFLD among primary care physicians, public health specialists, and health policymakers to encourage the development of more effective preventive policies.