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Medicina (Kaunas, Lithuania) May 2021Cardiovascular disease (CVD) is the leading cause of death globally and hypercholesterolemia is one of the major risk factors associated with CVD. Due to a growing body... (Meta-Analysis)
Meta-Analysis Review
Cardiovascular disease (CVD) is the leading cause of death globally and hypercholesterolemia is one of the major risk factors associated with CVD. Due to a growing body of research on side effects and long-term impacts of conventional CVD treatments, focus is shifting towards exploring alternative treatment approaches such as Ayurveda. However, because of a lack of strong scientific evidence, the safety and efficacy profiles of such interventions have not been well established. The current study aims to conduct a systematic review and meta-analyses to explore the strength of evidence on efficacy and safety of Ayurvedic herbs for hypercholesterolemia. : Literature searches were conducted using databases including Medline, Cochrane Database, AMED, Embase, AYUSH research portal, and many others. All randomized controlled trials on individuals with hypercholesterolemia using Ayurvedic herbs (alone or in combination) with an exposure period of ≥ 3 weeks were included, with primary outcomes being total cholesterol levels, adverse events, and other cardiovascular events. The search strategy was determined with the help of the Cochrane Metabolic and Endocrine Disorders Group. Two researchers assessed the risk of each study individually and discrepancies were resolved by consensus or consultation with a third researcher. Meta-analysis was conducted using the inverse variance method and results are presented as forest plots and data summary tables using Revman v5.3. A systematic review of 32 studies with 1386 participants found randomized controlled trials of three Ayurvedic herbs, (garlic), (guggulu), and (black cumin) on hypercholesterolemia that met inclusion criteria. The average duration of intervention was 12 weeks. Meta-analysis of the trials showed that guggulu reduced total cholesterol and low-density lipoprotein levels by 16.78 mg/dL (95% C.I. 13.96 to 2.61; -value = 0.02) and 18.78 mg/dL (95% C.I. 34.07 to 3.48; = 0.02), respectively. Garlic reduced LDL-C by 10.37 mg/dL (95% C.I. -17.58 to -3.16; -value = 0.005). Black cumin lowered total cholesterol by 9.28 mg/dL (95% C.I. -17.36, to -1.19, -value = 0.02). Reported adverse side effects were minimal. There is moderate to high level of evidence from randomized controlled trials that the Ayurvedic herbs guggulu, garlic, and black cumin are moderately effective for reducing hypercholesterolemia. In addition, minimal evidence was found for any side effects associated with these herbs, positioning them as safe adjuvants to conventional treatments.
Topics: Cardiovascular Diseases; Garlic; Humans; Hypercholesterolemia; Hyperlipidemias; Medicine, Ayurvedic
PubMed: 34071454
DOI: 10.3390/medicina57060546 -
PloS One 2018Design and provision of good quality maternity care should incorporate what matters to childbearing women. This qualitative systematic review was undertaken to inform... (Review)
Review
INTRODUCTION
Design and provision of good quality maternity care should incorporate what matters to childbearing women. This qualitative systematic review was undertaken to inform WHO intrapartum guidelines.
METHODS
Using a pre-determined search strategy, we searched Medline, CINAHL, PsycINFO, AMED, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996-August 2016 (updated to January 2018), reporting qualitative data on womens' childbirth beliefs, expectations, and values. Studies including specific interventions or health conditions were excluded. PRISMA guidelines were followed.
DATA COLLECTION AND ANALYSIS
Authors' findings were extracted, logged on a study-specific data form, and synthesised using meta-ethnographic techniques. Confidence in the quality, coherence, relevance and adequacy of data underpinning the resulting themes was assessed using GRADE-CERQual. A line of argument synthesis was developed.
RESULTS
35 studies (19 countries) were included in the primary search, and 2 in the update. Confidence in most results was moderate to high. What mattered to most women was a positive experience that fulfilled or exceeded their prior personal and socio-cultural beliefs and expectations. This included giving birth to a healthy baby in a clinically and psychologically safe environment with practical and emotional support from birth companions, and competent, reassuring, kind clinical staff. Most wanted a physiological labour and birth, while acknowledging that birth can be unpredictable and frightening, and that they may need to 'go with the flow'. If intervention was needed or wanted, women wanted to retain a sense of personal achievement and control through active decision-making. These values and expectations were mediated through womens' embodied (physical and psychosocial) experience of pregnancy and birth; local familial and sociocultural norms; and encounters with local maternity services and staff.
CONCLUSIONS
Most healthy childbearing women want a positive birth experience. Safety and psychosocial wellbeing are equally valued. Maternity care should be designed to fulfil or exceed womens' personal and socio-cultural beliefs and expectations.
Topics: Attitude; Culture; Delivery, Obstetric; Female; Humans; Maternal-Child Health Services; Parturition; Perception; Pregnancy; Social Values; Socioeconomic Factors
PubMed: 29664907
DOI: 10.1371/journal.pone.0194906 -
Revista Paulista de Pediatria : Orgao... 2021This study aims to analyze the effects of social isolation on children's and teenagers' development, with emphasis on the possible impacts over their physical and mental...
OBJECTIVE
This study aims to analyze the effects of social isolation on children's and teenagers' development, with emphasis on the possible impacts over their physical and mental health.
DATA SOURCE
Review of the literature following the standards of PRISMA using the SciELO, LILACS and PubMed databases. The following key-words were used: "social isolation" and "child development", "quarantine" and "adolescent development" according to the Medical Subject Headings (MESH) and their translation to the Portuguese. Studies in English, Portuguese and Spanish from inception were included.
DATA SYNTHESIS
519 studies were screened and 12 were included in the systematic review. Five of those focused the psychology and social issues, two of them the effects of pandemics on these issues; four studies reported on impacts on general health and two consequences over the hypothalamus- hypophysis - adrenal axis and the cognitive and social development.
CONCLUSIONS
The review shows a strong association between social isolation and anxiety and depression in children and adolescents. Social isolation leads to higher levels of cortisol and worse cognitive development. Therefore, the mental and physical health of children and adolescents need a careful follow up by health professionals during and after the COVID-19 pandemic.
Topics: Adolescent; Adolescent Behavior; Adolescent Development; COVID-19; Child; Child Behavior; Child Development; Humans; Mental Health; Social Change; Social Isolation
PubMed: 34614137
DOI: 10.1590/1984-0462/2022/40/2020385 -
Daru : Journal of Faculty of Pharmacy,... Dec 2019This review aims to evaluate the efficacy and safety of complementary and alternative medicine methods for constipation in the pediatric population. (Review)
Review
OBJECTIVES
This review aims to evaluate the efficacy and safety of complementary and alternative medicine methods for constipation in the pediatric population.
EVIDENCE ACQUISITION
Medical literature search was performed in several databases for a variety of Traditional, Complementary and Alternative Medicine in childhood constipation. Databases included Web of Science, Scopus, Embase, Cochrane Library, PubMed, ScienceDirect, Google scholar and a number of Persian databases including IranDoc, Magiran and SID. No time limitation was determined. Clinical trials or case series that had evaluated the effectiveness of CAM therapies in functional constipation of 1-18 year old children were included. Papers not in English or Persian language were excluded. Related articles were screened independently by two reviewers according to their titles and abstracts. A data extraction form was filled in for each eligible paper. Quality assessment of eligible documents was also performed.
RESULTS
30 studies were included, comprising 27 clinical trials and 3 case series. Ten documents were on herbal medicine, nine on traditional medicine, ten on manual therapies and one on homeopathy. Except for two herbal and one reflexology interventions, all studies reported positive effects on childhood constipation, with the majority being statistically significant. As the number of studies in each method was limited, we could not perform a meta-analysis.
CONCLUSION
The scarcity of research on the efficacy and safety of different types of complementary and alternative medicine methods in children with constipation necessitates conducting more studies in each field. Graphical abstract.
Topics: Adolescent; Child; Child, Preschool; Clinical Trials as Topic; Complementary Therapies; Constipation; Humans; Infant; Medicine, Traditional; Phytotherapy; Treatment Outcome
PubMed: 31734825
DOI: 10.1007/s40199-019-00297-w -
Traditional Chinese medicine for neck pain and low back pain: a systematic review and meta-analysis.PloS One 2015Neck pain (NP) and low back pain (LBP) are common symptoms bothering people in daily life. Traditional Chinese medicine (TCM) has been used to treat various symptoms and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Neck pain (NP) and low back pain (LBP) are common symptoms bothering people in daily life. Traditional Chinese medicine (TCM) has been used to treat various symptoms and diseases in China and has been demonstrated to be effective. The objective of the present study was to review and analyze the existing data about pain and disability in TCM treatments for NP and LBP.
METHODS
Studies were identified by a comprehensive search of databases, such as MEDLINE, EMBASE, and Cochrane Library, up to September 1, 2013. A meta-analysis was performed to evaluate the efficacy and safety of TCM in managing NP and LBP.
RESULTS
Seventy five randomized controlled trials (n = 11077) were included. Almost all of the studies investigated individuals experiencing chronic NP (CNP) or chronic LBP (CLBP). We found moderate evidence that acupuncture was more effective than sham-acupuncture in reducing pain immediately post-treatment for CNP (visual analogue scale (VAS) 10 cm, mean difference (MD) = -0.58 (-0.94, -0.22), 95% confidence interval, p = 0.01), CLBP (standardized mean difference = -0.47 (-0.77, -0.17), p = 0.003), and acute LBP (VAS 10 cm, MD = -0.99 (-1.24, -0.73), p< 0.001). Cupping could be more effective than waitlist in VAS (100 mm) (MD = -19.10 (-27.61, -10.58), p < 0. 001) for CNP or medications (e.g. NSAID) for CLBP (MD = -5.4 (-8.9, -0.19), p = 0.003). No serious or life-threatening adverse effects were found.
CONCLUSIONS
Acupuncture, acupressure, and cupping could be efficacious in treating the pain and disability associated with CNP or CLBP in the immediate term. Gua sha, tai chi, qigong, and Chinese manipulation showed fair effects, but we were unable to draw any definite conclusions, and further research is still needed. The efficacy of tuina and moxibustion is unknown because no direct evidence was obtained. These TCM modalities are relatively safe.
Topics: Acupuncture Therapy; China; Databases, Factual; Humans; Low Back Pain; Medicine, Chinese Traditional; Neck Pain; Pain Measurement
PubMed: 25710765
DOI: 10.1371/journal.pone.0117146 -
Journal of Alternative and... Dec 2014To assess existing reported human trials of Withania somnifera (WS; common name, ashwagandha) for the treatment of anxiety. (Review)
Review
OBJECTIVE
To assess existing reported human trials of Withania somnifera (WS; common name, ashwagandha) for the treatment of anxiety.
DESIGN
Systematic review of the literature, with searches conducted in PubMed, SCOPUS, CINAHL, and Google Scholar by a medical librarian. Additionally, the reference lists of studies identified in these databases were searched by a research assistant, and queries were conducted in the AYUSH Research Portal. Search terms included "ashwagandha," "Withania somnifera," and terms related to anxiety and stress. Inclusion criteria were human randomized controlled trials with a treatment arm that included WS as a remedy for anxiety or stress. The study team members applied inclusion criteria while screening the records by abstract review.
INTERVENTION
Treatment with any regimen of WS.
OUTCOME MEASURES
Number and results of studies identified in the review.
RESULTS
Sixty-two abstracts were screened; five human trials met inclusion criteria. Three studies compared several dosage levels of WS extract with placebos using versions of the Hamilton Anxiety Scale, with two demonstrating significant benefit of WS versus placebo, and the third demonstrating beneficial effects that approached but did not achieve significance (p=0.05). A fourth study compared naturopathic care with WS versus psychotherapy by using Beck Anxiety Inventory (BAI) scores as an outcome; BAI scores decreased by 56.5% in the WS group and decreased 30.5% for psychotherapy (p<0.0001). A fifth study measured changes in Perceived Stress Scale (PSS) scores in WS group versus placebo; there was a 44.0% reduction in PSS scores in the WS group and a 5.5% reduction in the placebo group (p<0.0001). All studies exhibited unclear or high risk of bias, and heterogenous design and reporting prevented the possibility of meta-analysis.
CONCLUSIONS
All five studies concluded that WS intervention resulted in greater score improvements (significantly in most cases) than placebo in outcomes on anxiety or stress scales. Current evidence should be received with caution because of an assortment of study methods and cases of potential bias.
Topics: Anxiety; Anxiety Disorders; Humans; Medicine, Ayurvedic; Phytotherapy; Plant Extracts; Psychotherapy
PubMed: 25405876
DOI: 10.1089/acm.2014.0177 -
PloS One 2018Forensic odontology (FO) is regarded in the literature as one of the most reliable and economical scientific methods for victim identification in mass disasters (MDs)....
BACKGROUND
Forensic odontology (FO) is regarded in the literature as one of the most reliable and economical scientific methods for victim identification in mass disasters (MDs). The present paper systematically reviews the role of forensic odontologists in various global MDs.
METHOD
A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar), along with cross-referencing published peer-reviewed articles, was conducted. The search included full texts, abstracts or titles, had no inclusion year limit (searched until September 2017) and was limited to the English language. Keywords included a combination of 'Forensic odontology', 'Dental records', 'Victim identification', 'Natural mass disaster', 'Criminal mass disaster', 'Accidental mass disaster' and 'Victim disaster'.
RESULTS
Of the included disasters (20), 12 (57.14%) were accidental, 5 (23.80%) natural and 3 (19.04%) were criminal. The maximum number of victims was associated with the Japan tsunami (15892), followed by the Thailand tsunami (4280) and the Estonia ferry disaster (852). A total of 23654 victims were reported, of which 20569 (86.96%) were positively identified. Reports from 17 MDs included the use of FO in victim identification [3025 (14.70%) cases]. In addition, 1094 victims (5.31%; from 7 papers) were identified using FO in combination with other methodologies. The highest percentage of victims was identified using FO following the Kentucky air crash (47; 100%), followed by the Newark air crash (38; 76%), the Nepal air crash (10; 71.42%), the France air crash (56; 65.88%), the Australian bushfire (14; 63.63%), and the Estonia ferry disaster (57; 60.63%).
CONCLUSION
FO has played a significant role in victim identification in several MDs around the world. The success of FO-based identification is heavily dependent on the availability of ante-mortem records from general dental practitioners. Hence, adequate knowledge about FO and appropriate dental record keeping among general dental practitioners are critical.
Topics: Databases, Bibliographic; Disaster Victims; Forensic Anthropology; Forensic Dentistry; Humans
PubMed: 29953497
DOI: 10.1371/journal.pone.0199791 -
Frontiers of Medicine Jun 2017In traditional Chinese medicine, Lonicerae Japonicae Flos is commonly used as anti-inflammatory, antiviral, and antipyretic herbal medicine, and geo-authentic herbs are... (Review)
Review
In traditional Chinese medicine, Lonicerae Japonicae Flos is commonly used as anti-inflammatory, antiviral, and antipyretic herbal medicine, and geo-authentic herbs are believed to present the highest quality among all samples from different regions. To discuss the current situation and trend of geo-authentic Lonicerae Japonicae Flos, we searched Chinese Biomedicine Literature Database, Chinese Journal Full-text Database, Chinese Scientific Journal Full-text Database, Cochrane Central Register of Controlled Trials, Wanfang, and PubMed. We investigated all studies up to November 2015 pertaining to quality assessment, discrimination, pharmacological effects, planting or processing, or ecological system of geo-authentic Lonicerae Japonicae Flos. Sixty-five studies mainly discussing about chemical fingerprint, component analysis, planting and processing, discrimination between varieties, ecological system, pharmacological effects, and safety were systematically reviewed. By analyzing these studies, we found that the key points of geo-authentic Lonicerae Japonicae Flos research were quality and application. Further studies should focus on improving the quality by selecting the more superior of all varieties and evaluating clinical effectiveness.
Topics: Chromatography, High Pressure Liquid; Drugs, Chinese Herbal; Ecosystem; Lonicera; Medicine, Chinese Traditional; Plant Extracts; Plants, Medicinal; Randomized Controlled Trials as Topic
PubMed: 28425044
DOI: 10.1007/s11684-017-0504-0 -
Medicine Jun 2023Cupping therapy is a common practice in Korean medicine. Despite developments in this clinical and research area, the current knowledge is insufficient to identify the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cupping therapy is a common practice in Korean medicine. Despite developments in this clinical and research area, the current knowledge is insufficient to identify the effects of cupping therapy on obesity. We aimed to assess the effects and safety of cupping therapy on obesity by performing a systematic review and meta-analysis of the effects of cupping therapy.
METHODS
A systematic search of databases was conducted, including MEDLINE/PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Citation Information by the National Institute of Informatics, KoreaMed, Oriental Medicine Advanced Searching Integrated System, and ScienceON, for full-text randomized controlled trials (RCTs) published through January 14, 2023, with no language restrictions. The experimental groups received cupping therapy combined with traditional Chinese medicine (TCM) and conventional therapy. The control groups received no treatment, conventional therapy, or TCM treatments alone. The experimental and control groups were compared in terms of body weight (BW), body mass index (BMI), hip circumference (HC), waist circumference (WC), waist-hip ratio (WHR), and body fat percentage (BFP). We evaluated the risk of bias using the 7 domains stipulated by the Cochrane Collaboration Group and performed a meta-analysis using Cochrane Collaboration software (Review Manager Software Version 5.3).
RESULTS
A total of 21 RCTs were included in this systematic review and meta-analysis. The analysis revealed improvements in BW (P < .001), BMI (P < .001), HC (P = .03), and WC (P < .001). However, there were no clinically significant changes in WHR (P = .65) or BFP (P = .90), both of which had very low certainty of evidence. No adverse events were reported.
CONCLUSION
Overall, our results show that cupping therapy can be used to treat obesity in terms of BW, BMI, HC, and WC and is a safe intervention for the treatment of obesity. However, the conclusions of this review should be interpreted with caution in clinical practice because of the uncertain quality of the included studies.
Topics: Humans; Cupping Therapy; Medicine, Chinese Traditional; Obesity
PubMed: 37327262
DOI: 10.1097/MD.0000000000034039 -
Women and Birth : Journal of the... Sep 2023When midwives offer birth assistance at home birth and free-standing birth centres, they must adapt their skill set. Currently, there are no comprehensive insights on... (Review)
Review
PROBLEM
When midwives offer birth assistance at home birth and free-standing birth centres, they must adapt their skill set. Currently, there are no comprehensive insights on the skills and knowledge that midwives need to work in those settings.
BACKGROUND
Midwifery care at home birth and in free-standing birth centres requires context specific skills, including the ability to offer low-intervention care for women who choose physiological birth in these settings.
AIM
To synthesise existing qualitative research that describes the skills and knowledge of certified midwives at home births and free-standing birth centres.
STUDY DESIGN
We conducted a systematic review that included searches on 5 databases, author runs, citation tracking, journal searches, and reference checking. Meta-ethnographic techniques of reciprocal translation were used to interpret the data set, and a line of argument synthesis was developed.
RESULTS
The search identified 13 papers, twelve papers from seven countries, and one paper that included five Nordic countries. Three overarching themes and seven sub-themes were developed: 'Building trustworthy connections,' 'Midwife as instrument,' and 'Creating an environment conducive to birth.'
CONCLUSION
The findings highlight that midwives integrated their sensorial experiences with their clinical knowledge of anatomy and physiology to care for women at home birth and in free-standing birth centres. The interactive relationship between midwives and women is at the core of creating an environment that supports physiological birth while integrating the lived experience of labouring women. Further research is needed to elicit how midwives develop these proficiencies.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Midwifery; Home Childbirth; Birthing Centers; Parturition; Anthropology, Cultural; Qualitative Research
PubMed: 37037696
DOI: 10.1016/j.wombi.2023.03.010