• Title/Summary/Keyword: Randomized controlled trials

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Efficacy and Safety of Laser Surgery and Transurethral Resection of the Prostate for Treating Benign Prostate Hyperplasia: a Network Meta-analysis

  • Wang, Li;Yu, Qiu-Yan;Liu, Yan;Zhu, Zhen-Li;Huang, Yuan-Wei;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4281-4288
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    • 2016
  • Background: Traditional meta-analyses or systematic reviews of randomized controlled trials (RCTs) have been used to compare laser surgeries and transurethral resection of the prostate (TURP) for benign prostate hyperplasia (BHP), but they cannot provide a hierarchy regarding efficacy and safety of treatment. Objective: We therefore performed a network meta-analysis (NMA) to compare and create hierarchies for efficacy and safety of TUPR and laser surgeries for BPH. Materials and Methods: We searched for reports of RCTs published up to April 25, 2015. After methodological quality assessment and data extraction, we performed an NMA to compare TURP and laser surgeries for BPH. Results: We ranked the treatments of TURP and laser surgeries for BPH. For IPSS at 6 months, holmium laser resection of the prostate (HoLRP) ranked the first-best and at 12 months, holmium laser enucleation of the prostate (HoLEP). For Qmax at 6 and 12 months, HoLEP ranked the first-best; for operative time it was TURP; for cathedral removal time, diode laser enucleation of the prostate (DiLEP) ranked the first-best. Conclusions: Although TURP is considered the gold standard for treating BPH, it is not better in terms of efficacy and safety compared with the laser surgery. Our NMA created hierarchies for the 9 types of surgery in terms of efficacy and safety, which should help clinicians choose the best approach for the individual patient.

Effects of task-oriented training for Gross Motor Function Measure, balance and gait function in persons with cerebral palsy

  • Han, Hyun-Kyung;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.5 no.1
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    • pp.9-14
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    • 2016
  • Objective: This study was to investigate the effects of Task-oriented training for Gross Motor Function Measure (GMFM), gait and balance function in cerebral palsy. Design: Randomized controlled trials. Methods: Twenty four subjects were recruited by means of a convenience sampling from Kangseo-Gu G rehabilitation center. Subjects were 24 inpatients and were randomly divided into a task-oriented training group and a conventional group. Twelve patients were experimental group who executed the task-oriented training (5 times/wk) for 4 weeks. The task-oriented program mainly focused on the capabilities of independent walking, with the angle of inclination set at 0 degrees and walking at a self-selected comfortable speed. In addition, balance training included the one-legged standing with weight-shifting and task-oriented training. Twelve patients were control group who executed only general conventional therapy (5 times/wk) for 4 weeks. All subjects were evaluated about the motor function, gait and balance function. Subjects have conducted the measured variables, GMFM, GAITRite, PDM Multifunction Force Measuring Plate after treatment. Results: There was statistically significant increase of Gross Motor Function Measure scores of the experimental group and control group after 4 weeks (p<.05). There was statistically significant increase of gait and balance function of the experimental group after 4 weeks of task-oriented training (p<.05). The experimental group showed a significantly improvement in GMFM, gait, and balance compared to the control group (p<0.05). Conclusions: This study proved that task-oriented training after stroke can improve Gross Motor Function Measure, gait and balance. Thus this study can suggest that task-oriented training for gross motor function, gait and balance be effective on the cerebral palsy.

Effects of Korean Medicine Therapies on Oral Pain in Patients with Burning Mouth Syndrome: a Before and After Study (구강작열감 증후군 환자의 구강내 통증에 대한 한방치료의 효과: 전.후 비교 연구)

  • Son, Ji-Young;Kim, Ju-Yeon;Kang, Kyung;Baek, Seung-Hwan;Choi, Jane;Jang, Seung-Won;Ryu, Bong-Ha;Kim, Jin-Sung
    • The Journal of Internal Korean Medicine
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    • v.34 no.2
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    • pp.122-133
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    • 2013
  • Objectives : Burning mouth syndrome (BMS) is characterized by chronic pain or a burning sensation in the mouth. There is limited evidence available to provide clear guidelines for treating BMS patients and a variety of different treatments have been used. This study was designed to investigate the Effects of Korean medicine therapies on oral pain in patients with BMS. Methods : We surveyed 30 BMS patients who newly visited the Oral Diseases Clinic in the Kyung Hee University Korean Medicine Hospital from February 2012 to March 2013. When the patients visited the clinic for the first time, they were evaluated on sociodemographic characteristics, BMS questionnaire, severity of pain using visual analogue scale (VAS) and pressure pain threshold (PPT) of the acupuncture point CV17. After 3 weeks of Korean medicine therapies (acupuncture, electroacupuncture, pharmacopuncture and herbal medicine), they were re-evaluated with the VAS and the PPT. Results : After 3 weeks of Korean medicine therapies, 30 patients' oral pain improved and the PPT score on CV17 rose, which means decrease of qi-stagnation score. Conclusions : Korean medicine therapies were effective on oral pain in patients with BMS. To confirm the additional curative effect and evaluate the efficacy of each treatment, well-designed randomized controlled trials will be needed in the future.

A Review of Recent Clinical Research about Banhasasim-tang Combined with Conventional Therapy on Atrophic Gastritis (위축성 위염에 대한 반하사심탕과 표준치료 병용요법의 최신 연구 동향)

  • Lee, Ga-young;Ahn, Su-bin;Jeong, Min-jeong;Jang, In-soo
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1169-1178
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    • 2019
  • Objective: The purpose of this study was to investigate the effect of combined therapy with Banhasasim-tang and conventional treatment for atrophic Gastritis. Methods: The study collected data of clinical studies of combined therapy with Banhasasim-tang and conventional treatment for atrophic gastritis. Electronic databases were used, including PubMed, Cochrane, CNKI, Wanfang, CINII, J-stage, NDSL, and OASIS. The main search terms included such as "Atrophic Gastritis", "Banhasasim-tang", "BanXia Xiexin Tang". This study only included randomized controlled trials (RCTs) that adopted combined therapy with Banhasasim-tang and conventional treatment for atrophic gastritis. Results: A total of 18 RCTs were selected. They all adopted combined therapy with Banhasasim-tang and conventional treatment for atrophic gastritis. In all the studies, the intervention group significantly improved the score of effective rate, and in the 8 studies, Hp negative conversion rate was significantly improved when Banhasasim-tang was taken. Conclusion: Through the analysis of 18 RCTs, we found Banhasasim-tang combined with conventional therapy were more effective in the positive performance of atrophic gastritis than conventional therapy single contribution. However, due to the low quality of the selected studies and the lack of endoscopy, biopsy, follow-up observation, so there is a slight insufficient to prove its conclusion. Therefore, we hope that more systematic and diverse clinical studies will be conducted.

Pharmacopuncture for Stroke: An Overview of Meta-Analyses (뇌졸중의 약침 치료에 대한 메타분석의 통합적 고찰)

  • Kim, Mikyung;Han, Chang-ho
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1081-1100
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    • 2019
  • Objectives: This study is an overview of the meta-analysis and systematic review of randomized controlled trials investigating the clinical effectiveness and safety of pharmacopuncture for patients with stroke. Methods: Core electronic databases were searched from their inception to 21 May 2019. A measurement tool to assess systematic reviews (AMSTAR 2) was applied to screen high-quality studies. The results of these studies were summarized, and additional meta-analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of evidence. Results: Sixteen studies met eligibility criteria. Four were excluded owing to insufficiency of AMSTAR 2 or low data reliability. The finally selected 12 studies were about pharmacopuncture using either a single herb extract, such as Dengzhan xixin, Sanch, Ginkgo biloba, or Acanthopanax, or a mixture of herbs, such as Compound danshen, Shenxiong, Xingnaojing, or Mailuoning. Most of the patients were from China, with acute ischemic stroke. All the studies using a pharmacopuncture versus a non-pharmacopuncture design reported the significant superiority of pharmacopuncture on every outcome measure. On the other hand, in a few studies, pharmacopuncture was inferior to active control in improving neurological deficit. Few studies reported adverse events. Conclusions: It is difficult to apply the results of this study directly to Korea, because the level of evidence is generally low and the clinical settings and social acceptance of pharmacopuncture therapy differ in Korea and China. Further studies are warranted to confirm the domestic applicability of evidence generated in China and to create evidence that supports the domestic situation.

Efficacy of corticosteroids for postoperative endodontic pain: A systematic review and meta-analysis

  • Nath, Ranjivendra;Daneshmand, Ali;Sizemore, Dan;Guo, Jing;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.4
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    • pp.205-221
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    • 2018
  • This systematic review aimed to analyze the efficacy of corticosteroid premedication compared to placebo or no treatment to reduce postoperative pain in endodontic patients. Randomized controlled trials (RCTs) assessing corticosteroids via oral, intramuscular, subperiosteal, intraligamentary or intracanal route compared to passive or active placebo, or no treatment were included. Four databases were searched: PubMed, Web of Science, Cochrane Library and Embase up to 2/21/2018. Risk of bias was assessed with Cochrane Risk of bias tool. Fourteen RCTs with 1,462 generally healthy adults in need of endodontic treatment were included. 50% of the studies were at unclear risk and 50% at high risk of bias. Meta-analysis showed Visual Analog Scale (VAS) pain at 4-6 hours after Inferior Alveolar Nerve Block (IANB) was significantly lower by 21 points (0-100 scale) in the corticosteroid group compared to the control group (95% CI -35 to -7; P = 0.003), however this difference was not statistically significant after 24 hours (P = 0.116). The route of administration was oral and intraligament injection. Patients who received corticosteroids prior to IANB were 70.7% more likely to have none or mild pain 4-8 hours after treatment (P = 0.001) and 13.5% more likely 24 hours after IANB (P = 0.013) than patients in the control group. In conclusion, corticosteroid administration (oral or intraligamental) may clinically reduce the level of postoperative pain at 4-8 hours after IANB, however the quality of the evidence was low/moderate due to risk of bias and heterogeneity. Further studies are recommended.

Effect of traditional dry cupping therapy on heavy menstrual bleeding in menorrhagia: A preliminary study

  • Sultana, Arshiya;Rahman, Khaleeq Ur
    • CELLMED
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    • v.2 no.4
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    • pp.33.1-33.3
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    • 2012
  • Menorrhagia (kasrate tams) is the most common gynecologic complaint in contemporary gynecology, affecting 10 to 15% of the adult female population. It can occur at any age. In the Unani system of medicine, since antiquity, dry cupping therapy (hijamat bila shurt) has been used to treat menorrhagia. An effort was made to evaluate the usefulness of dry cupping on excessive menstrual blood loss in menorrhagia with a well validated menstrual pictogram. This study was conducted on 15 patients at the National Institute of Unani Medicine, Hospital Bangalore, from January 2010 and July 2010. Unmarried or married patients aged 17 - 47 year with a history of excessive or prolonged bleeding per vaginum were included. Two large cups (with 5.7 cm internal diameter) were applied below each breast for 15 min, only once during the menstrual period when the patient reported to the outpatient department. If the menstrual flow was not reduced, the next day again dry cupping was repeated. The outcome was to assess the efficacy of dry cupping on the reduction in the amount of menstrual blood loss. The data was analyzed by the Wilcoxon matched test. The mean scores of menstrual blood loss before and after the treatment was 400.26 (277.95) and 48.4 (32.082) ml respectively, p = 0.002, considered statistically significant. A dry cupping therapy is a useful treatment modality in decreasing the amount of menstrual blood flow in menorrhagia. Further randomized controlled clinical trials and validation are needed in a large population.

The Domestic Trends of Traditional Korean Medicine Treatments on Degenerative Knee Arthritis (퇴행성 슬관절염의 한의학적 치료에 대한 국내 연구 동향)

  • Kim, Tae-Yoon;Kim, Jung-Hyun;Park, Jong-Hoon;Lee, Je-Kyun;Han, Chang;Kum, Chang-Jun;Oh, Jae-Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.9 no.2
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    • pp.69-79
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    • 2014
  • Objectives : The purpose of this review is to investigate the trends of Traditional Korean Medicine treatments on degenerative knee arthritis. Methods : We investigated the studies on traditional Traditional Korean Medicine (TKM) treatments for degenerative knee arthritis via searching 5 Korean web databases. Results : 31 research papers were found to be analyzed according to their published year, the titles of journals, published institution, the types of study, the number of cases, the types of treatments. 31 papers were published since 1992. The studies on TKM treatments about degenerative knee arthritis were mainly published in The journal of korean acupuncture & moxibustion medicine. 13 Randomized Controlled Trials, 10 Case series, 4 Reviews, 3 Non RCTs, and 1 Case Report had been under research. In 22 cases of the studies, one method was used to treat the symptoms. Whereas in 5 cases of the studies, various TKM treatments were used to treat the symptoms. Visual analogue score(VAS) and patient's subjective complaints were used as primary assessments. Conclusion : In this study, we analyzed the trends of TKM treatments on degenerative knee arthritis. Reviewing the domestic trends of studies on Traditional Korean Medicine treatments on degenerative knee arthritis and examining the strong and weak points of those treatments are essential for the further studies.

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Ten Year Literature on Psychological and Behavioral Interventions Against Cancer: a Terms Analysis

  • Feng, Rui;Chai, Jing;Wang, De-Bin;Xia, Yi;Cheng, Peng-Lai;Dai, Zhao-Yang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5171-5176
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    • 2012
  • We here performed a systematic review of PBIC literature using terms analysis in a hope of both identifying potential trends and patterns and exploring methods leveraging traditional literature reviews in this specific area. Articles meeting inclusion criteria were retrieved from PUBMED and translated into dichotomized article records representing presence or non-presence of MeSH terms and a metric consisting of numbers of times of co-occurrence between all pairs of terms identified using a self-designed program. The occurrence of and relations among the terms were calculated and visualized using Excel2007 and UCINET respectively. A total of 1,742 terms were identified from 997 articles retrieved. Put in a descending order, the lines representing the times of term occurrence formed a typical hyperbolic curve; when plotted along the x-axis of whole MESH terms, the lines clustered within four specific regions. Comparison of term occurrence between 2002 and 2011 revealed priority changes in population and subjects (from general groups to priority groups), intervention approaches (from medicine to exercise and psychotherapy), methodology and techniques (from cohort studies to randomized controlled trials) and outcomes (from health and mental health to quality of life, depression etc.). Networks of the terms featured a number of closely linked groups of topics including method and questionnaires, therapy and outcomes, survival management, psychological assessment and intervention, behavioral intervention (individual and community oriented). Terms analysis revealed interesting trends and patterns about PBIC publications and both the analysis methods and findings have implications for future research and literature reviews.

Review of Korean Clinical Studies on Treatment for Childhood Obesity (소아비만의 치료에 대한 국내 임상연구 동향)

  • Kim, Kyoung Ri;Han, Jae Kyoung;Kim, Yun Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.30 no.3
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    • pp.108-120
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    • 2016
  • Objectives The purpose of this study is to investigate Korean clinical studies on treatment of childhood obesity and to propose for better treatment options for childhood obesity. Methods Based on RISS, KISS, OASIS, KMbase with the keyword 'childhood obesity', 'child obesity', 'obese child', 'overweight child', total of 21 randomized controlled trials (RCTs), 11 single clinical studies, 3 chart reviews and 3 case reports have been found, and were analyzed. Results and Conclusion 1. Some study subjects were classified based on their sex - only men or women in a group or sometimes both. Another way of classify the study subjects were based on their age - preschooler, primary school students, middle school students, and high school students. The diagnostic criteria of the subjects were BMI (body mass index), Body fat percentage, Obesity index, Weight and unknown criteria. 2. The treatments used in 38 studies were exercise alone, education alone, both exercise and education or herbal therapy. The 7 studies that used herbal therapy as part of their study intervention had a study group with herbal intervention only and the other 2 study group with herbal treatment in addition to exercise and education. 3. 9 studies included herb medicines, electroacupuncture, auricular acupuncture, cupping, aroma massage, infrared light, and abdomen pad. Herb medications used in 5 studies included Chegameuiin-tang 2 kinds, Sobieum, Biman-tnag, and I-razin. 4. The methods of assessment used in 38 studies were classified by 7 categories and anthropometry parameters which is the basic methods are used in all studies 5. Almost studies (29 studies in all 38 studies) were using anthropometric parameters results on significantly effectiveness of childhood obesity. 6. More studies are needed to prove true effectives from various treatments, especially herbal therapy for childhood obesity.