scholarly journals Comparison of the Colonies Number of the Germs Formed Post Operation between the Utilization of Single, Double, and Orthopedic Gloves in Closed Fracture Operations More Than 2 Hours

2021 ◽  
Vol 17 (2) ◽  
pp. 151
Author(s):  
Deni Maulana ◽  
Yoyos Dias Ismiarto ◽  
Widya Arsa
Keyword(s):  
Colony Growth ◽  
P Value ◽  
Closed Fracture ◽  
Bacterial Colony ◽  
Surgical Gloves ◽  
Glove Perforation ◽  
Fracture Management ◽  
Significant Difference ◽  
Post Operation

Abstract: Post-operative infection is still one of the most common nosocomial diseases that can cause great losses because it will increase the length of stay, use of drugs, and reduce the quality of life of the patients. The risk will increase if the number of colonies is> 105 bacteria per gram of tissue. Various ways have been done to reduce the number of bacteria in the operation area, including the use of surgical gloves. This study analyzed the comparison of the level of bacterial colonies that grew on the surface of single, double, and orthopedic surgical gloves in closed fracture management for more than 2 hours at Hasan Sadikin Hospital. The statistical analysis was done with p-value = 0.011 (<0.05), which means a significant difference in the number of germ colonies that grow between single, double, and orthopedic gloves. Double gloves and orthopedic gloves have a better ability to reduce bacterial colony growth. Meanwhile, there was no significant difference in the number of bacterial colonies formed between double gloves and orthopedics. Perforation is a factor affecting the number of germ colonies that formed. The use of double gloves and orthopedic gloves in closed fracture surgery for more than 2 hours shows the number of bacterial colonies formed is less than single gloves. There was a significant difference in the rate of perforation between standard surgical gloves and orthopedic gloves. Keywords: Bacteria colony, Single glove, Double glove, Orthopaedic glove, Perforation

PERAN WARGA PEDULI AIDS CAHAYA CARE TUREN DALAM MENINGKATKAN KUALITAS HIDUP ODHA

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Tri Nurhudi Sasono
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Drugs ◽  
P Value ◽  
People Living With Hiv ◽  
Purposive Sampling ◽  
Significant Difference ◽  
Development Goals ◽  
Living With Hiv ◽  
Hiv Aids

Abstract : Indicator of the health welfare through Sustanable Development Goals (SDGs) is to reduce the incidence of HIV-AIDS, decrease the rate of the epidemic and maintain the quality of life of people living with HIV-AIDS (PLWHA). Trend cases of HIV-AIDS is the most recent spread among people, especially housewives. In Malang until 2015 found 278 Housewife of 409 cases of AIDS. The prevalence of HIV-AIDS in Malang Regency is ranked second after Surabaya city in East Java. For the importance of public participation and citizen care AIDS Cahaya Care Turen take responsibility for the condition. Determination Rule Goverment number 2 2015 year on the Participation of the community response to HIV-AIDS in Malang as a legal rule. Concerned Citizens activities AIDS (WPA). WPA Cahaya Care Turen is increases HIV risk and quality of life PLWHA. The purpose of this study was to determine the role of Citizens AIDS Cahaya Care Quality of Care Turen against people living with HIV in Puskesmas Turen Malang. The study design using a quasi-experimental, with purposive sampling using a sampling technique. Total number of research subjects 23. Based on test results obtained with the Wilcoxon p value <0.005, which means that there is a significant difference before and after PLWHA joining participated in the WPA Cahaya Care Turen. The conclusion of this study is WPA activities involving people living with HIV and at risk groups can optimize compliance with antiretroviral drugs that have an impact on improving the quality of life of PLHIV. Suggestions in this research is done WPA Program activities are structured and ongoing cross-sector in order to improve the quality of life and empower PLWHA.Keywords : WPA Cahaya Care Turen, Quality of life, PLWHA Abstrak : Salah satu indikator kesejahteraan kesehatan melalui Sustanable Development Goals (SDGs) adalah menekan angka kejadian HIV-AIDS, menurunkan laju epidemik dan mempertahankan kualitas hidup Orang dengan HIV-AIDS (ODHA). Trend kasus HIV-AIDS terkini terbanyak adalah menjangkit dikalangan masyarakat khususnya pada ibu rumah tangga. Kabupaten Malang sampai dengan tahun 2015 ditemukan 278 Ibu Rumah Tangga dari 409 kasus AIDS. Prevalensi HIV-AIDS di Kabupaten Malang ini merupakan peringkat kedua di Jawa Timur setelah Kota Surabaya. Untuk itu pentingnya peran serta masyarakat dan warga peduli AIDS Cahaya Care Turen ikut bertanggung jawab terhadap kondisi tersebut. Penetapan Peraturan Bupati Malang no.2 th.2015 tentang Peran serta masyarakat penanggulangan HIV-AIDS di Kabupaten Malang diharapkan dapat mengurangi risiko penularan HIV dan meningkatkan kualitas hidup ODHA. Tujuan dari penelitian ini adalah untuk mengetahui Peran Warga Peduli AIDS Cahaya Care Turen terhadap Kualitas ODHA Di Wilayah Kerja Puskesmas Turen Kabupaten Malang. Desain penelitian menggunakan quasi eksperimen, dengan teknik sampling menggunakan purposive sampling. Jumlah subyek penelitian sejumlah 23. Berdasarkan hasil uji dengan Wilcoxon didapatkan nilai p value < 0.005 yang berarti bahwa terdapat perbedaan bermakna sebelum dan sesudah ODHA bergabung mengikuti kegiatan WPA Cahaya Care Turen. Kesimpulan dalam penelitian ini adalah kegiatan WPA dengan melibatkan ODHA dan kelompok beresiko dapat mengoptimalkan kepatuhan obat ART sehingga berdampak terhadap peningkatan kualitas hidup ODHA. Saran dalam penelitian ini adalah dilakukannya Program kegiatan WPA yang terstruktur dan berkesinambungan lintas sektor guna meningkatkan kualitas hidup dan memberdayakan ODHA.     Kata kunci : WPA Cahaya Care Turen, kualitas hidup, ODHA

Sleeve gastrectomy is the most common cause of Gastro-esophageal Reflux Disease in comparison with other bariatric operations

2021 ◽  
Author(s):  
majdi abu sneineh ◽  
malek abu sneineh ◽  
Monther Abu Sneineh ◽  
mustafa abu sneineh ◽  
muneer abu snineh ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Medical Center ◽  
Bariatric Procedure ◽  
P Value ◽  
Significant Difference ◽  
Symptomatic Gerd ◽  
Swallow Study ◽  
Contrast Swallow ◽  
Gerd Symptoms

Abstract Introduction GERD is one of the complications of bariatric operations that might affect the quality of life. We aim to perform a retrospective cohort study to determine the incidence of symptomatic GERD following different types of bariatric surgery and which operations are considered a contraindication of GERD. Besides, we are attempting to identify the risk factors of GERD after bariatric surgery. Methods Medical records of 729 patients undergone bariatric operations between January 2010 and June 2019 at Shamir (Assaf Harofeh) Medical Center were reviewed. Results There was a significant difference between the type of bariatric procedure and the incidence of GERD symptoms after the operation. The incidence of symptomatic GERD in patients who underwent SG was 39.9% (p =0.0131). This was significantly higher compared to 16.4% following roux en y gastric bypass, 23.4% following LAGB, and 11% following OAGB. 113 patients out of 718 had a positive swallow test and of these patient 71 developed GERD symptoms post-operatively without correlation to the degree of reflux at the swallow test but with statistically significant correlation to the type of operation especially for SG (P-value <0.001) and to our knowledge this was never reported in the literature. Conclusion SG is a good bariatric procedure option but should be contraindicated in asymptomatic reflux contrast swallow study and symptomatic GERD patients preoperatively because of high levels of symptomatic GERD post-operatively. Asymptomatic reflux at contrast swallow study pre-operatively should be considered a risk factor for GERD after the operation.

Do-It-Yourself Microsuture from Human Hair for Basic Microsurgical Training

2018 ◽  
Vol 35 (05) ◽  
pp. 315-321
Author(s):  
Pobe Luangjarmekorn ◽  
Pravit Kitidumrongsook ◽  
Sittisak Honsawek
Keyword(s):  
Human Hair ◽  
Statistical Difference ◽  
Smooth Curve ◽  
P Value ◽  
Excellent Quality ◽  
Likert Score ◽  
Significant Difference ◽  
Do It Yourself ◽  
Knot Security

Background Microsuture is an essential material for basic microsurgical training. However, it is consumable, expensive, and sometimes unavailable in the microsurgical laboratory. To solve this problem, we developed a microsuture made from human hair and needle gauge. Methods Do-It-Yourself (DIY) microsuture is made from human hair and needle gauge 32G (BD Ultra-Fine Pen Needles 4 mm × 32G). Methods are explained step by step. This DIY microsuture (labeled as “test microsuture”) and nylon 8–0 (Ethilon suture 8–0, labeled as “standard microsuture”) were used for teaching orthopaedic residents to perform arterial anastomosis in chicken thighs. All residents practiced without knowing that “test microsuture” was made from the DIY method. After completing the training, quality of both microsutures was evaluated by questionnaire in topics of (1) thread quality (size, strength, elasticity, handing, knot perform, and knot security), (2) needle quality (size, curve, shape, sharpness, handling, and strength), (3) needle–thread interface (size, strength, and smoothness), and (4) overall quality of microsuture. Each category was evaluated by Likert score (5 = excellent, 4 = good, 3 = fair, 2 = poor, and 1 = very poor). Results The DIY microsuture was performed in three steps: (1) insert human hair into needle gauge by microforceps, (2) bend needle into smooth curve, and (3) disconnect needle and create needle–hair interface. The questionnaire was completed by 30 orthopaedic residents and showed that thread quality of DIY and standard microsuture had “good” and “good-to-excellent” quality (mean Likert score: 3.77–4.23 and 3.80–4.27, respectively, with no statistical difference). Thread–needle interface quality of DIY and standard microsuture also had “good” and “good-to-excellent” quality (Likert score: 3.73–4.20 and 4.07–4.33, respectively, with no statistical difference). Needle part of DIY microsuture had lower quality than standard suture (fair-to-good compared with good-to-excellence quality, score 3.30–3.67 vs. 4.20–4.27, respectively, with a statistically significant difference, p-value < 0.05). However, overall quality of DIY suture and standard microsuture had “good” and “good-to-excellent” (mean Likert score: 3.73 and 4.00, respectively, with no statistical difference). Conclusion The DIY microsuture from human hair and needle gauge could be an alternative for basic microsurgical training with lower cost, easy production, and more availability for use in practice with acceptable quality compared with that of standard microsuture.

scholarly journals A Comparison of the Quality of Sleep between Pre and Post-Surgery Cervical Herniated Nucleus Pulposus Patients Utilizing the Anterior Discectomy Method

2017 ◽  
Vol 5 (7) ◽  
pp. 948-954
Author(s):  
Ridha Dharmajaya ◽  
Dina Keumala Sari ◽  
Ratna Akbari Ganie
Keyword(s):  
Sleep Quality ◽  
Nucleus Pulposus ◽  
Intervertebral Disk ◽  
Quality Of Sleep ◽  
Post Surgery ◽  
Anterior Discectomy ◽  
Significant Difference ◽  
Post Operation ◽  
Herniated Nucleus Pulposus

BACKGROUND: Herniated Nucleus Pulposus (HNP) is the prolapse of the intervertebral disk through a tear in the annulus fibrosus. This causes nerve root compression with clinical pain manifestation and affects the quality of sleep.AIM: The aim of this study was find out the comparison in the quality of sleep between before (pre) and after (post) surgery cervical HNP patients.METHODS: This study was a retrospective cohort study. Ninety patients were asked to complete the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All data which has been computed were analysed with the McNemar test.RESULT: The outcome reveals that from 90 patient`s cervical HNP, 81 (90%) were 40 years old age group and 66 (73.3%) of them were women. The result showed that 66 (73.3%) patients have a bad sleep quality before surgery. Surgery has increased the quality of sleep after surgery 66 (73.3%) patients had good sleep quality. There was a significant difference in the quality of sleep pre and post operation (p = 0.001).CONCLUSION: There was a significant difference in the quality of sleep between pre and post operation cervical HNP patient utilising anterior discectomy methods.

Morbidity and quality of life in patients with vulvar cancer after inguinal sentinel lymphadenectomy compared to radical inguinofemoral lymphadenectomy

2021 ◽  
Author(s):  
Fabinshy Thangarajah ◽  
Kristina Rogeé ◽  
Caroline Pahmeyer ◽  
Kathrin Kuhr ◽  
Matthias Schmidt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Vulvar Cancer ◽  
Lymph Node Status ◽  
P Value ◽  
Sentinel Lymphadenectomy ◽  
Significant Difference ◽  
Inguinofemoral Lymphadenectomy

Abstract Aim Probability of survival of patients with vulvar cancer directly depends on the lymph node status. Surgery of lymph nodes can be performed as radical inguinofemoral lymphadenectomy or in cases with certain conditions as sentinel lymph node surgery. The aim of this study is to obtain an overview of the intervention-related morbidity and quality of life in patients with vulvar carcinoma after lymphadenectomy. Methods Quality of life and morbidity was compared between patients who underwent radical inguinofemoral lymphadenectomy with those who underwent sentinel lymph node surgery. Results All recorded postoperative complications occur more frequently in the non-sentinel group, Significant difference was shown for the occurrence of lymphedema (p-value = 0.024) and sensitivity loss (p-value = 0.024). Recurrence of disease was more frequent in the non-sentinel group (38 % vs. 20 %, p = 0.621, n.s.) and satisfaction with groin surgery is slightly higher in the sentinel group (94 % vs. 89 %, p = 1.000, n.s.). Conclusion We could demonstrate a significantly lower morbidity of sentinel lymphadenectomy compared to conventional inguinofemoral lymphadenectomy while maintaining the same oncological safety. The low morbidity of sentinel- lymphadenectomy does not seem to influence the postoperative quality of life significantly. However, recording of the individual burden of lymphadenectomy by questionnaires should be optimized.

scholarly journals Quality of Life in Children with Asthma versus Healthy Children

2018 ◽  
Vol 6 (8) ◽  
pp. 1413-1418 ◽  
Author(s):  
Samaneh Kouzegaran ◽  
Parisa Samimi ◽  
Hamid Ahanchian ◽  
Maryam Khoshkhui ◽  
Fatemeh Behmanesh
Keyword(s):  
Quality Of Life ◽  
Physical Performance ◽  
Control Group ◽  
P Value ◽  
Healthy Children ◽  
Significant Difference ◽  
Children With Asthma ◽  
And Performance ◽  
Asthma Group

BACKGROUND: Asthma is the most prevalent chronic disease in the pediatric age group. The disease affects different aspects of the children's lives, such as physical, emotional, social and educational aspects. Thus, more focus has been on the quality of life in these patients rather than the duration of their illness in recent years.AIM: This study examined the different aspects of quality of life in asthmatic children for the first time in this geographic area.METHODS: The study was cross-sectional conducted in 2015-2016. The asthmatic group was 100 patients aged 8 to 12 admitted to the Asthma and Allergy Clinic of Ghaem Hospital (as) in Mashhad with the control group composed of 100 healthy children of the same age and gender. The standard questionnaire pedsQLTM was used for comparing the quality of life of children in the two groups. Statistical analysis was SPSS23 with P-value less than 0.05, which was statistically significant.RESULTS: In each group, 58 patients were boys, and 42 were girls. In a comparison of the quality of life of children, the asthma group with a mean total score of Peds QL 20.99 ± 12.54 compared to the healthy children with a mean total score of Peds QL of 8.8 ± 5.41 had a lower quality of life (P < 0.001). Moreover, regarding various aspects of quality of life asthma group had a lower quality of life in physical performance, emotional performance and performance in school (P < 0.001). Nonetheless, there was no significant difference between the two groups considering social function (P = 0.267). Examining the relationship between Peds QL score of patients with asthma with various variables was indicative of the fact that Peds QL scores were significantly correlated with the gender of the patients, showing better quality of life in the girls (P = 0.001).CONCLUSION: The results indicated that children with asthma have a significantly lower quality of life compared with healthy children of the same age. Also, in examining the different aspects of quality of life, these children had a lower quality of life in physical performance, emotional performance, and performance at school, and were at the level as that of healthy children only in social performance.

scholarly journals A Study on the Efficacy of Saline Nasal Irrigation in Chronic Rhinosinusitis

2021 ◽  
Vol 10 (30) ◽  
pp. 2266-2270
Author(s):  
Rachana Ramachandran ◽  
Santhi Thankappan Pillai
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Post Treatment ◽  
Oral Drug ◽  
P Value ◽  
Saline Irrigation ◽  
Nasal Irrigation ◽  
Significant Difference ◽  
Chronic Rhino Sinusitis

BACKGROUND The objective of this study was to test as to whether daily saline nasal irrigation improved sinus symptoms in adult subjects with chronic rhino sinusitis, and also study the safety of saline irrigation, incidence of any complication and improvement in quality of life in these patients. METHODS This was a prospective observational study conducted between two groups of patients at Government TD Medical College, Alappuzha. Patients who satisfied the criteria for diagnosing chronic rhino sinusitis were included in the study. The first group was given saline nasal irrigation with oral drug therapy while the second group was put on oral drugs alone. Each subject was given a pretested, structured questionnaire. Along with socio-demographic information, the questionnaire also contained queries of quality of life measure, compliance of nasal irrigation and adverse effects following its use. RESULTS The pre-treatment scores and post treatment scores were analysed and the results were statistically significant with P values of < 0.001 in all. 77 % of the patients in the saline irrigation group were strictly using saline nasal irrigation which meant a satisfactory compliance and the improvement in post treatment scores was statistically highly significant with a P value of < 0.001. Also there was a statistically significant difference between the mean pre-test and post test scores of the two groups with P value of < 0.001 and t value of 51.942 using the paired t test. CONCLUSIONS Chronic rhinosinusitis has a major negative impact on the healthcare and economy of not only the patients but also of the society. Saline nasal irrigation is an effective yet easy method of therapy in alleviating the symptoms of chronic rhinosinusitis and improving the quality of life in these chronic sufferers. KEY WORDS Chronic Rhinosinusitis, Saline Nasal Irrigation, Quality of Life, Economic Burden

scholarly journals Quality of Life for Children with Cystic Fibrosis in Gaza Strip

2020 ◽  
pp. 1-13
Author(s):  
Yaser Hamdouna ◽  
Keyword(s):  
Quality Of Life ◽  
School Performance ◽  
Emotional Health ◽  
Clinical Severity ◽  
P Value ◽  
Common Disease ◽  
Organ Systems ◽  
Significant Difference ◽  
Study Population

Background: CF is a chronic, multisystem genetic disease with a wide variability in clinical severity. CF is a disease of exocrine gland function that involves multiple organ systems but chiefly results in chronic respiratory infections, pancreatic enzyme insufficiency, and associated complications in untreated patients. Many studies explained the lower QOL among adults with CF. in GS there is no previous studies concerned with measuring QOL among CF children Aim of the Study: The aim of this study was to assess the QOL among children with CF. Methodology: The study was descriptive, analytical and cross sectional studies. The study involves all 36 children with CF (less than 12 years old) who attained CF friends center; community based center in Gaza. The researchers uses the questionnaire which included demographic & illness related variables and Quality of life domains (physical, emotional, social and school). Reliability coefficient for the questionnaire was good (Cronbach alpha =0.833). Results and Conclusion: About 61% of the study population were males and 39% were females. Approximately 47% of them were less than 9 years and 53% were more than 9 years. About 41.7% of the study population from Gaza, 25.0% from middle zone, 13.9% from Rafah, 11.1% from Khanyounis and 8.3% from North of Gaza. Housing classification was 38.9%, 33.3% and 27.8 % for property house, renting house and family house respectively. Most of their parents had low educational levels and the majority of them were unemployed and have a monthly income less than 1200 NIS. About 61% of them have another sibling with CF. the majority of them receive Creon at a regular basis. The most common disease associated with them was Respiratory problem with 43.2%, 38.3% had gastrointestinal disease, 14.8% had heart disease and 3.7% had Diabetes Mellitus. The overall perception of the children regarding QOL was low (55%). The social functions was the highest (61.6%), physical functions (55.2%), school function (50.6%), and emotional function (48.8%). The result presented below show that no significant difference in QOL between socio-demographic data (p-value > 0.05) except the difference for QOL between age groups) p-value =0.001). Children older than 9 years old (2.95±0.3) have QOL more than children under nine years of age (2.53±0.4) and this difference was statistically significant as (P value = 0.02 < 0.05). It is also clear that QOL in males are more than female but this difference was not statistically significant. There is a positive correlation with a highly significant difference between QOL and the 4 domains and between domains with each other. Social performance was high correlated with school performance (r = 0.706) while the lowest correlation was between physical and school performance with no significant (p-value =0.065). Recommendations: The study recommend the importance of initiating a program to enhance the QOL for children with CF and focusing on the emotional health for those children as it was the least one perceived.

scholarly journals THE INCIDENCE & PATTERN OF MICRO PERFORATION OF SURGICAL GLOVES AFTER SINGLE USE

2020 ◽  
Vol 6 (1) ◽  
pp. 06-09 ◽  
Author(s):  
Parveen Akhter Lone ◽  
Mubashar Akram ◽  
Azhar Malik ◽  
Vishal Loona ◽  
Arif Rashid
Keyword(s):  
Surgical Procedures ◽  
Occupational Safety ◽  
Surgical Instruments ◽  
P Value ◽  
Health Administration ◽  
Perforation Rate ◽  
Chi Square ◽  
Surgical Gloves ◽  
Glove Perforation ◽  
Single Use

Aim & Objectives: Concern about the transmission of infection from patients to healthcare workers & vice versa is increasing. According to occupational safety & health administration, USA guidelines, gloves must be worn whenever there is a reasonable likelihood of contact of body fluids of patients to health personnel's in order to prevent contamination. The aim of this study is to report the pattern & incidence perforation of surgical gloves after single-use during different dental &maxillofacial surgical procedures & also to compare the perforation rate in single & double gloving methods during different elective& emergency oral & surgical procedures.Material & Methods: This prospective study was done for six months in the department of oral &maxillofacialsurgery. All the gloves used during elective & emergency, minor & major surgical procedures were collected. Both visual & hydro insufflations techniques were used to check the gloves for perforation & parameters were recorded.Results: A total of 1000 gloves were recorded, used in emergency& elective procedures. The percentage of operating doctor, assistant nurses was recorded. 34.54% gloves used in IMF were perforated.22.14% gloves used in Trans alveolar extraction with burs and 13.33% sharp surgical instruments perforated gloves.Suture needles perforated 18% gloves and needle pricks during extraction perforated 12% gloves. The overall perforation rate in all surgical procedures mentioned above was 18.62%.The chi square value: 114.129 and p value < 0.001.Conclusions: Double gloving method reduces the risk of contamination from patient to operating staff & vice versa by reducing the inner glove perforation

scholarly journals Reduced Intensity Conditioning for Allogeneic Hematopoietic Stem Cell Transplantation of AML in CR and MDS-a Systematic Review and Meta-Analysis of Randomized Controlled Trials

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 14-15
Author(s):  
Yanzhi Song ◽  
Zhichao Yin ◽  
Erhui Yuan ◽  
Yajing Wang ◽  
Tong Wu
Keyword(s):  
P Value ◽  
Random Effects Model ◽  
Reduced Intensity Conditioning ◽  
Hematopoietic Stem ◽  
Quality Of Evidence ◽  
Graft Versus Host ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Reduced Intensity

Background Allogeneic hematopoietic stem cell transplantation is the most effective treatment that can cure acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). However, myeloablative conditioning (MAC) regimens cause high non-relapse mortality (NRM). Reduced intensity conditioning (RIC) regimens can reduce NRM but increase relapse incidence (RI) and as a result of it, has the similar overall survival (OS) to the MAC regimen according to the results of published clinical trials. Nevertheless, most of these clinical trials aren't high quality studies and the results of different studies are not consistent. To clarify whether RIC is as effective as MAC but safer than it for AML in CR and MDS we write the systematic review (SR). Methods Two reviewers independently comprehensively searched the related databases and websites and hand searched the reference lists. They also independently screened and evaluated the retrieved studies and then extracted data of included studies with the Cochrane Collaboration recommended tools. Only randomized controlled trials (RCTs) were included. Hazard ratio (HR) was used to compare the OS, RI, leakemia free survival (LFS), non-relapse mortality (NRM), the incidence of acute graft versus host disease (aGVHD) and chronic graft versus host disease (cGVHD) with the generic inverse variance method. The III-IV aGVHD and graft failure (GF) were compared with the Mantel-Haenszel method pooled risk ratio (RR). A two-sided P value of less than 0·05 was considered as significant difference. Heterogeneity was significant when the P value of the Chi-square test was less than 0·1 and/or the I2 value was more than 50%. Additionally we used the GRADE principles to evaluate the quality of evidence. The SR was registered on PROSPERO with ID of CRD42020185436. Results 7770 records were retrieved. We included 6 RCTs with 1413 participants comparing RIC with MAC. Our results showed there wasn't significant difference in OS (HR=0·95 95% confidence interval (CI, 0·64, 1·4), P=0·80) and RI (HR=1·18, CI (0·88, 1·59), P=0·28). Six RCTs and 1413 pariticipants were included of the two outcomes. The result of LFS was (HR=1·09, CI (0·69, 1·74), P=0·71) between RIC and MAC, three studies and 596 participants were included. The heterogeneity was significant in the OS, RI and LFS outcomes so we combined the three outcomes with the random effects model. RIC significantly reduced NRM than TBI/Bu based MAC (HR=0·53, CI (0·36, 0·80), P=0·002), four RCTs and 633 participants were included. On the other hand, RIC didn't reduce NRM than treosulfan based MAC with the results of (HR=1·67, CI (1·02, 2·02), P=0·04) compared with treosulfan 10 g/m2*3 days regimen and (HR=0·76, CI (0·45, 1·3), P=0·32) compared with treosulfan 14 g/m2*3 days regimen, both included only 1 RCT and 460 and 320 participants were included respectively. RIC had a trend to reduce the incidence of aGVHD compared to TBI/Bu based MAC (HR=0·79, CI (0·60, 1·03), P=0·08) and III-IV aGVHD (HR=0·61, CI (0·36, 1·04), P=0·07). RIC didn't show significant difference to treosulfan based MAC regimen on the two outcomes. The heterogeneity of the NRM, aGVHD, III-IV aGVHD was non-significant and we combined the three outcomes with the fixed effect model. The cGVHD was similar between RIC and MAC (HR=1·01, CI (0·79, 1·28), P=0·96), results of included results had significant heterogeneity and random effects model was used. GF was rare in both RIC (2·6%) and MAC (1·1%) arms. The quality of evidence on OS, RI and LFS was moderate and on NRM, aGVHD, cGVHD was high. Conclusions For AML in CR and MDS paitents, RIC don't increase OS and RI compared with MAC. RIC regimens reduce NRM than the TBI/Bu based MAC regimens. RIC regimens are also good choice of preparative regimens before HSCT for AML in CR and MDS. The treosulfan based MAC has a promising result in one RCT and even causes less NRM than RIC. Nevertheless, studies are scarce and more studies are needed to confirm the result. Disclosures No relevant conflicts of interest to declare.

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