Vitamin C is a vital nutrient that functions as an antioxidant and is important as a co-factor and regulator of several immune system pathways. The role of vitamin C in the treatment of COVID-19 is largely debatable. We conducted this meta-analysis to evaluate the efficacy and safety of vitamin C in the treatment of COVID-19. We searched several electronic databases from inception to March 2023 to retrieve randomized controlled trials on the use of Vitamin C for COVID-19. RevMan 5.4 was used to calculate risk ratios (RRs) and Mean Differences (MDs) along with confidence intervals (95% CI) using a random-effects model. We included 9 randomized controlled trials in our meta-analysis. Vitamin C did not reduce the all-cause mortality in patients with COVID-19 compared to the standard treatment [RR 0.86, 95% CI: 0.65-1.14; I 2=66%]. Vitamin C was found to be associated with an increased incidence of ventilation in COVID-19 patients when compared to standard treatment [RR 1.37, 95% CI: 1.18-1.59; I 2=58%]. There were no significant differences between both groups regarding the incidence of hospitalization [RR 1.00, 95% CI: 0.98-1.02; I 2=0%], incidence of recovery [RR 1.57, 95% CI: 0.45-5.50; I 2=52%], hospital mortality [RR 0.68, 95% CI: 0.44-1.06; I 2=0%] and length of hospital stay [MD -0.63, 95% CI: -3.04 to 1.78; I 2=81%]. Vitamin C administration did not reduce all-cause mortality in COVID-19 patients. Additional studies are required to evaluate the role of Vitamin C in the prevention and treatment of COVID-19 especially in ICU patients.

Background: Glutamine is essential for various metabolic processes and is a fundamental component in mechanisms involved in cellular resistance against injury and mortality. However, the specific impact of enteral glutamine administration on burn patients remains uncertain. We performed this meta-analysis to establish glutamine’s role in managing burn injury patients. Methods: We conducted a comprehensive search across multiple electronic databases, including MEDLINE (via PubMed), Embase, and various trial registries, to identify randomized controlled trials that evaluated the effectiveness of enteral glutamine in burn patients. To analyze the data, we employed a random-effects model and presented dichotomous outcomes and continuous outcomes as relative risk and mean difference, along with corresponding 95% confidence intervals, respectively. Results: Our meta-analysis included 6 RCTs involving 1413 patients. Our primary outcome, all-cause mortality, was reported by 5 studies and was found to be comparable between the glutamine and control groups (RR=0.66, 95% CI=0.22-1.94). There was no significant difference between the glutamine and control group regarding the incidence of infection (RR=0.93, 95% CI=0.67-1.30) and length of hospital stay (MD -4.76 days, 95% CI=-10.63 to 1.11 days). Conclusion: The enteral administration of glutamine does not decrease mortality in burn patients. Further high-quality, large-scale randomized controlled trials are needed to provide conclusive evidence.

Aim: This systematic review aims to assess the safety profile of oxcarbazepine during pregnancy. Methods: Observational studies that included women who took oxcarbazepine anytime during pregnancy were included in our systematic review. The review did not include non-English articles, reviews, meta-analyses, case reports, and animal studies. Different online sources such as MEDLINE, Cochrane library, Virtual Health Library, etc. were searched for published and unpublished literature. Assessment of the risk of bias in observational studies was done using the Newcastle-Ottawa Scale. The meta-analyses were performed using a random-effect model. GRADE was used for the evaluation of the quality of evidence for the primary outcomes. Results: We included 19 cohort studies with a total number of 5,071,137 patients, of which 2,450 were exposed to oxcarbazepine either as monotherapy or polytherapy. The summary odds ratio (OR) was 1.69 (95% CI, 0.95-2.98) for congenital malformations following in-utero exposure to oxcarbazepine as compared to the control group of unexposed patients [seven studies (n=625)], and was 1.19 (95% CI, 0.67-2.12) when compared to those following lamotrigine (LTG) exposure during pregnancy [3 studies (n=591)]. In total, three studies (n=770) reported the association between in-utero oxcarbazepine exposure and fetal/perinatal deaths. The meta-analysis yielded a summary OR of 3.33 (95% CI, 1.70-6.51). Significance: Our systematic review will help healthcare providers and guideline developers regarding the treatment of epilepsy and other neurological disorders during pregnancy. More cohort studies with a higher sample size concerning oxcarbazepine use in pregnant patients are required to truly assess the in-utero safety profile of the drug.