• Title/Summary/Keyword: Randomized Clinical Trials

Search Result 951, Processing Time 0.028 seconds

Clinical Efficacy of Coptidis Rhizoma for Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis (비알콜성 지방간 환자에 대한 베르베린 투여 치료의 임상적 효능 연구: 체계적 문헌 고찰과 메타분석)

  • SongWon Park;MinJee Kim;Seong-Woo Lim
    • Journal of Korean Medicine for Obesity Research
    • /
    • v.22 no.2
    • /
    • pp.158-166
    • /
    • 2022
  • Objectives: The purpose of this meta-analysis was to evaluate the effects of berberine on non-alcoholic fatty liver disease (NAFLD) through a systematic review and meta-analysis. Methods: We searched seven electronic databases for studies through October 2022. All randomized controlled trials (RTCs) of berberine were included. Data extraction and risk of bias assessments were performed by two independent reviewers. The RevMan 5.4.1 program was used for meta-analysis. Results: A total of 279 relevant studies were identified, and 6 eligible RCTs were included to study the efficacy berberine on NAFLD. The six selected trials are studies on the effect between berberine and conventional treatment combined treatment versus conventional treatment. Liver function tests, blood lipid levels, and blood glucose levels were assessed. Combination treatment with berberine, ursodeoxycholate acid, metformin, and monascus purpureus showed statistically significant improvements in liver function levels, blood lipid levels, and blood glucose levels compared to conventional treatment alone. However, there was no significant efficacy of berberine combination dietary, exercise than control group on NAFLD. The meta-analysis results of examining 4 RCTs comparing the therapeutic efficacy of berberine showed statistically significant improvement in the liver function test, blood lipids levels, blood glucose levels. Conclusions: This study suggests that berberine has positive efficacy on blood lipids, blood glucose liver function, fatty liver condition of NAFLD. However, the level of evidence is low because of small effect size,so further investigation is needed.

The feasibility of needleless jet injection versus conventional needle local anesthesia during dental procedures: a systematic review

  • Alreem Ahmed, Alameeri;Hessa AlFandi, AlShamsi;Amel, Murad;Mariam Mahmoud, Alhammadi;Meznah Hamad, Alketbi;Arwa, AlHamwi;Natheer Hashim Al, Rawi;Sausan Al, Kawas;Marwan Mansoor, Mohammed;Shishir Ram, Shetty
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.48 no.6
    • /
    • pp.331-341
    • /
    • 2022
  • This systematic review evaluates current evidence regarding the feasibility of using needleless jet injection instead of a conventional local anesthetic needle. EBSCO, ProQuest, PubMed, and Scopus databases were used to identify relevant literature published in English from 2005 to 2020. Ten studies were selected. Five of them were randomized clinical trials, 3 case-control studies, and 2 equivalence trials. Using the Critical Appraisal Skills Program checklist, 6 studies scored between 67% and 100%, and 4 studies scored between 34% and 66%. According to Jadad's scale, 2 studies were considered strong, and 8 studies were considered moderate in quality. The results of the 10 studies showed differences in patient preference for needleless jet injection. Needleless injection technique has been found to be particularly useful in uncooperative patients with anxiety and needle phobia. Needleless jet injection is not technique sensitive. However, with needleless jet anesthesia, most treatments require additional anesthesia. Conventional needle anesthesia is less costly, has a longer duration of action, and has better pain control during dental extraction. Needleless jet anesthesia has been shown to be moderately accepted by patients with a fear of needles, has a faster onset of action, and is an efficient alternative to conventional infiltration anesthesia technique.

Anesthetic efficacy in vital asymptomatic teeth using different local anesthetics: a systematic review with network meta-analysis

  • Amy Kia Cheen Liew;Yi-Chun Yeh ;Dalia Abdullah ;Yu-Kang Tu
    • Restorative Dentistry and Endodontics
    • /
    • v.46 no.3
    • /
    • pp.41.1-41.23
    • /
    • 2021
  • Objectives: This study aimed to evaluate the efficacy of various local anesthesia (LA) in vital asymptomatic teeth. Materials and Methods: Randomized controlled trials comparing pulpal anesthesia of various LA on vital asymptomatic teeth were included in this review. Searches were conducted in the Cochrane CENTRAL, MEDLINE (via PubMed), EMBASE, ClinicalTrials.gov, Google Scholar and 3 field-specific journals from inception to May 3, 2019. Study selection, data extraction, and risk of bias assessment using Cochrane Risk of Bias Tool were done by 2 independent reviewers in duplicate. Network meta-analysis (NMA) was performed within the frequentist setting using STATA 15.0. The LA was ranked, and the surface under the cumulative ranking (SUCRA) line was plotted. The confidence of the NMA estimates was assessed using the CINeMA web application. Results: The literature search yielded 1,678 potentially eligible reports, but only 42 were included in this review. For maxillary buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than lidocaine 2% with epinephrine 1:100,000 (odds ratio, 2.11; 95% confidence interval, 1.14-3.89). For mandibular buccal infiltration, articaine 4% with epinephrine 1:100,000 was more efficacious than various lidocaine solutions. The SUCRA ranking was highest for articaine 4% with epinephrine when used as maxillary and mandibular buccal infiltrations, and lidocaine 2% with epinephrine 1:80,000 when used as inferior alveolar nerve block. Inconsistency and imprecision were detected in some of the NMA estimates. Conclusions: Articaine 4% with epinephrine is superior when maxillary or mandibular infiltration is required in vital asymptomatic teeth.

A Review on Clinical Research Trend in Treatment of Chai-Hu-Shu-Gan-San (Sihosogan-San) for Insomnia (불면증에 대한 시호소간산 치료의 임상연구 동향)

  • Lee, Jae-Eun;Kim, Sang-Ho;Kim, Bo-Kyung;Lim, Jung-Hwa
    • Journal of Oriental Neuropsychiatry
    • /
    • v.31 no.1
    • /
    • pp.25-38
    • /
    • 2020
  • Objectives: This review aimed to investigate the effectiveness of Chai-Hu-Shu-Gan-San (CHSGS) for treatment of insomnia. Methods: 9 databases were comprehensively searched from their inception dates until Jan 2020 using keywords like Insomnia, Chai-Hu-Shu-Gan-San and Sihosogan-san. We included randomized controlled trials (RCTs) using CHSGS as the main intervention for insomnia patients. We assessed the quality of RCTs using the Cochrane risk of bias tool and Jadad scale. Results: 5 RCTs were included. The Chinese classification of mental disorders -3 (CCMD-3) was the most frequently used diagnostic criteria. The effective rate was the most frequently used as outcome. All the 5 RCTs that reported CHSGS and CHSGS adjunctive therapy on insomnia were more effective compared to western medication. Only one study reported adverse effects. The methodological quality of the included RCTs were generally poor. Conclusions: This review found that CHSGS may be effective to treating insomnia. However, because of the small number, heterogeneity and very low methodological quality of included studies, we could not draw any definitive conclusions. Therefore, more rigorous randomized control studies are warranted.

Onion peel extract reduces the percentage of body fat in overweight and obese subjects: a 12-week, randomized, double-blind, placebo-controlled study

  • Lee, Ji-Sook;Cha, Yong-Jun;Lee, Kyung-Hea;Yim, Jung-Eun
    • Nutrition Research and Practice
    • /
    • v.10 no.2
    • /
    • pp.175-181
    • /
    • 2016
  • BACKGROUND/OBJECTIVES: The anti-obesity effect of quercetin-rich onion peel extract (OPE) was suggested in rats, but information from human studies is limited. This study aimed to investigate the effects of OPE on the body composition of overweight and obese subjects. MATERIALS/METHODS: In this 12-week, randomized, double-blind, placebo-controlled study, parallel clinical trials were performed in overweight and obese Korean subjects. Randomly assigned subjects were instructed to take daily either the placebo (male, 6 and female, 30) or OPE capsules containing 100 mg of quercetin (male, 5 and female, 31). Body composition was measured by using bioimpedance and dual-energy X-ray absorptiometry (DXA). Resting energy expenditure (REE) and respiratory quotient (RQ) were evaluated by using indirect calorie measurement methods. Fasting blood levels of glucose, insulin, lipids, and leptin were determined. RESULTS: Quercetin-rich OPE supplementation significantly reduced the weight and percentage of body fat as measured by DXA (P = 0.02). These effects were not shown in the control group. Levels of blood glucose (P = 0.04) and leptin (P = 0.001 for placebo, P = 0.002 for OPE) decreased in both groups. Significant increases in REE and RQ were observed in both groups (P = 0.003 for placebo, P = 0.006 for OPE) and in the OPE group alone (P = 0.02), respectively. CONCLUSIONS: Quercetin-rich OPE supplementation changed the body composition of the overweight and obese subjects. This result suggests a beneficial role of the anti-obesity effect of OPE human subjects.

Systematic Review of External Qigong Therapy for Joint Pain (관절 통증에 대한 외기 방사 기공 요법의 체계적 문헌고찰)

  • Lee, Hyeon-Yeop;Hwang, Man-Suk;Heo, In;Shin, Byung-Cheul;Heo, Kwang-Ho;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.24 no.4
    • /
    • pp.187-193
    • /
    • 2014
  • Objectives The aim of this study is to analyze the therapeutic effect of external Qigong therapy for treatment of other people's disease on joint pain. Methods We searched articles from Pubmed, Chinese Academic Journals (CAJ) and Oasis online databases. Searching keywords were 'external qigong', 'external qi gong', 'qi therapy', '外气', '关节' and '기공'. After searching the articles, we performed quality assessment using Cochrane risk of bias (RoB) tool and risk of bias assessment tool for non-randomized study (RoBANS). Results Among the 117 articles were searched, 2 randomized controlled clinical trials (RCTs) and 2 single-group before and after studies were finally selected. All of 4 studies showed that external Qigong therapy has significant effect on joint pain. Conclusions Although external Qigong therapy has therapeutic effect on joint pain, it is not common therapy yet. However, external Qigong therapy requires more interests and studies in the future, because it is faithful therapy for Korean medicine theory.

Effects of Dignity Interventions on Psychosocial and Existential Distress in Terminally ill Patients: A Meta-analysis (존엄중재가 말기 환자의 심리적.실존적 디스트레스에 미친 효과: 메타분석)

  • Oh, Pok Ja;Shin, Sung-Rae
    • Journal of Korean Academy of Nursing
    • /
    • v.44 no.5
    • /
    • pp.471-483
    • /
    • 2014
  • Purpose: This study was done to evaluate the effects of dignity interventions on depression, anxiety and meaning of life in terminally ill patients. Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms indicating dignity intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.2.11 program of Cochrane Library. Results: Twelve clinical trials met the inclusion criteria with a total of 878 participants. Dignity intervention was conducted for a mean of 2.2 weeks, 2.8 sessions and an average of 48.7 minutes per session. Effect sizes were heterogeneous and subgroup analysis was done. Dignity interventions had a significant effect on depression (ES= -1.05, p<.001, $I^2$=15%) and anxiety (ES= -1.01, p<.001, $I^2$=0). For meaning of life, dignity interventions were effective (ES= -1.64, p=.005) and effect sizes were still heterogeneous. Conclusion: Results support findings that dignity interventions can assist terminal ill patients in reducing emotional distress and improving meaning of life. Further well-designed dignity studies will lead to better understanding of the effects of treatments on spiritual well-being.

Daoyin Exercise Therapy for Stroke : A Systematic Review (뇌졸중에 대한 도인 운동요법의 효과: 체계적 문헌 고찰)

  • Lee, Sang-Hyun;Shin, Byung-Cheul;Hwang, Eui-Hyoung;Heo, In;Park, Sun-Young;Hwang, Man-Suk
    • The Journal of Churna Manual Medicine for Spine and Nerves
    • /
    • v.14 no.2
    • /
    • pp.29-42
    • /
    • 2019
  • Objectives : This study aimed to review the effects of Daoyin exercise on stroke patients in clinical studies. Methods : In this study, we reviewed 11 electronic databases (CAJ, EMBASE, Cochrane Library, Web of Science, Pubmed, RISS, Dbpia, NDSL, KISTI, KISS, KMBASE) on October 27, 2019. We included only randomized controlled trials (RCTs) which evaluated the effect of Daoyin exercise on stroke patients. The methodological quality of the included studies was checked using the Cochrane risk of bias tool. Results : After screening the papers, eleven RCTs fulfilled the inclusion criteria. The results of the meta-analysis showed that Daoyin exercise improves the measurement value on the Fugl-Meyer Assessment, Modified Barthel Index and National Institutes of Health Stroke Scale in stroke patients. Conclusions : We concluded that Daoyin exercise has therapeutic effects in functional recovery and in enhancing the independence of daily living activities for stroke patients. However, the quality of the original articles was low and the number of papers included were few. Thus, to confirm these results, further well-designed RCTs should be conducted.

Effects of Non-pharmacological Interventions on Primary Insomnia in Adults Aged 55 and Above: A Meta-analysis (수면장애가 있는 중장년 환자에게 적용한 비약물적 중재의 효과: 메타분석)

  • Kim, Ji Hyun;Oh, Pok Ja
    • Korean Journal of Adult Nursing
    • /
    • v.28 no.1
    • /
    • pp.13-29
    • /
    • 2016
  • Purpose: This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above. Methods: PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Results: Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant. Conclusion: The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

Effects of garlic intake on cancer: a systematic review of randomized clinical trials and cohort studies

  • Lee, Jounghee;Zhao, Naisi;Fu, Zhuxuan;Choi, Jihee;Lee, Hae-Jeung;Chung, Mei
    • Nutrition Research and Practice
    • /
    • v.15 no.6
    • /
    • pp.773-788
    • /
    • 2021
  • BACKGROUND/OBJECTIVES: Due to the rapid increase of global cancer incidence and mortality and a high level of interest in cancer prevention, a systematic review of garlic intake and cancer risk is needed. SUBJECTS/METHODS: We implemented a systematic review to examine the effects of varying levels of garlic intake on cancer. We conducted comprehensive literature searches in three electronic databases (MEDLINE, Embase, and Web of Science) for studies published between database inception and July or September of 2018. Two investigators independently screened abstracts and full-texts, extracted data, and assessed risk of bias (RoB). A total of one medium-quality randomized controlled trial (RCT) and 13 cohort studies graded as high RoB were included. RESULTS: The 1-year follow-up results from a RCT showed that a significant decrease in the number and size of colorectal adenomas among participants with colorectal adenomas who received high-dose aged garlic extract (AGE) compared with those who received low-dose AGE (P < 0.05). The results of prospective observational studies provided inconsistent associations of colorectal cancer risk with garlic supplements and garlic intake as food. CONCLUSIONS: In summary, the AGE was effective in reducing the number and magnitude of colorectal adenomas in one RCT, but there were inconsistent associations between garlic intake and colorectal cancer in cohort studies. Therefore, we could not draw a firm conclusion regarding the effects of garlic on cancer, because the current strength of evidence is inadequate due to a lack of number of high-quality RCTs.