Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.
Kim, Yun-Young;Yoo, Jong-Hyang;Lee, Su-Kyung;Lee, Si-Woo
Journal of Physiology & Pathology in Korean Medicine
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v.25
no.5
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pp.927-933
/
2011
This study aimed to evaluate the quality of herbal medicine-related RCT (Randomized controlled clinical trial) papers. 79 papers were searched from the domestic Hakjin paper list, and 16 papers of them were evaluated in terms of the Jadad Quality Assessment Scale and the adequacy of allocation concealment, and ethical validity. The evaluation results from Jadad Quality Assessment Scale showed that 15 papers showed high quality with the Jadad score of 3 points or higher, and none of the papers had a problem with randomization and double-blinding. The evaluation results from adequacy of allocation concealment showed that 3 of the papers were executed proper allocation concealment, and all of them had 5 points of Jadad score. IRB (Institutional Review Board) approval and written consent was investigated for the evaluation of ethical validity, and 12 papers had the IRB approval, and 14 papers had written consent. The papers published before 2005 were absent of IRB approval and written consent, and none of the papers had IRB approval number. From the above results, it is concluded that rigorous clinical research led high quality of research papers, and the ethical aspect of clinical researches are getting more important to protect the rights of research participants.
Purpose: The purpose of this study is to assess the effectiveness of short-wave therapy (SWT) for treatment of knee osteoarthritis (OA) as compared to placebo and control, and to assess the question of whether the effects are related to the mode, dosage, and application method. Methods: We searched randomized, placebo-controlled trials using electronic databases. We also manually reviewed sources in order to identify additional relevant studies. Results: Eight studies (597 participants) with OA were included in the meta-analysis. Pulse SWT had a significant effect on pain relief compared with control treatment, while did not favour compared with the placebo group. Pulse SWT had a significant effect on functional improvement compared with control and placebo treatment. Continuous SWT had no effect on pain relief and functional improvement. Capacitive SWT a significant effect on pain relief, functional improvement, and muscle strength. Continuous and capacitive SWT had increased muscle strength significantly. We found no clinical significance of all outcomes except pain and functional improvement in pulsed SWT with low dose. There was no difference in adverse events. None of the participants experienced any serious adverse events. Conclusion: Low dose pulsed SWT provided a short-term clinical benefit for pain relief and functional improvement. Pulsed SWD with low and high dose had effects on pain and function. There seems to be a placebo effect. We found significant effects on pain and function in capacitive SWT. Despite some positive findings, this analysis lacked data on how effectiveness is affected by mode, dosage, and application method of SWT. Further well-designed clinical studies are required in order to confirm the effectiveness of SWT.
Park, Sul Gi;Park, So Hyun;Lee, Sun Haeng;Lee, Jin Yong
The Journal of Pediatrics of Korean Medicine
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v.34
no.2
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pp.57-74
/
2020
Objectives The purpose of this study is to analyze clinical studies on the efficacy and safety of herbal medicine in vitiligo by analyzing randomized controlled trials (RCTs). Methods Three electronic databases including the PubMed, EMBASE, and Cochrane library were used to search for randomized controlled trials, by using specific key words and criteria up to January 4th, 2020. Data in regards to years of publication, nation, demographic information, disease characteristics, duration of diseases, treatment methods, treatment period, outcome measures, results and adverse events were collected for this study. Results A total of 11 randomized controlled trials were selected and analyzed. The total effective rate of the treatment group treated with herbal medicine was significantly higher than that of the control group. In the other outcome measures, the treatment group also showed statistically significant differences in improving the outcome measures compared to the control group, or showed similar treatment effects to the control group. The most commonly used herbal medicines were Carthami Flos (紅花), Angelicae Gigantis Radix (當歸), Angelica dahurica Bentham et Hooker f. (白芷), Astragali Radix (黃芪), Glycyrrhizae Radix et Rhizoma (甘草), Salviae Miltiorrhizae Radix (丹參), Persicae Semen (桃仁), Araliae Continentalis Radix (獨活), Tribuli Fructus (白蒺藜), Psoraleae Semen (補骨脂) etc. Hardly any severe adverse events were reported from the trials selected. Conclusions Based on the results of the clinical studies, herbal medicine treatment could be an effective and safe option for vitiligo treatment and symptom improvement.
Objectives : The aim of this study is to assess the quantity and quality of randomized controlled clinical trials(RCTs) published in the journal of oriental rehabilitation medicine(JORM). Methods : After searching RCTs from all the articles published in the JORM from the inception(1991) to Oct, 2012, quantity assessment were made on the study design, sample size, main intervention, intervention versus control design and medical condition. Quality assessment were made on the cochrane risk of bias(RoB) check list. Assessment was performed by 2 independent reviewers and disagreement was discussed based on concensus of all authors. Results : Among the 1013 articles, total 59 RCTs were published. First RCT was published in 1994. 49 RCTs were parallel 2-arm designed. Average sample size was 35.1 per study and 16.3 per arm. The most common medical condition is musculoskeletal disease(30.5%). Quality from cochrane RoB was generally low. Conclusions : Though RCTs published in JORM were increasing, the quality remains low. Researchers should make a effort to follow the RoB checklists and improve the quantity and quality of studies.
Objective: To investigate outcomes of stimulated IVF cycles in which GnRH antagonist was omitted on the ovulation triggering day. Methods: A total of 86 women who underwent controlled ovarian hyperstimulation with recombinant FSH and GnRH antagonist flexible multiple-dose protocols were recruited and prospectively randomized into the conventional group (group A) or cessation group (group B). The GnRH antagonist, 0.25 mg/day of cetrorelix, was started when the leading follicle reached 14 mm in diameter and was continuously administered until the hCG triggering day (group A, 43 cycles) or until the day before hCG administration (group B, 43 cycles). The maturity of oocytes, fertilization rate, embryo quality, and implantation and clinical pregnancy rates were evaluated. Results: The duration of ovarian stimulation, total dose of gonadotropins, serum estradiol levels on hCG administration day, and number of oocytes retrieved were not significantly different between the two groups. The total dose of GnRH antagonist was significantly lower in group B than group A ($2.5{\pm}0.9$ vs. $3.2{\pm}0.8$ ampoules, p<0.05). There was no premature luteinization in any of the subjects. The proportion of mature oocytes and fertilization rate were not significantly different in group B than group A (70.7% vs. 66.7%; 71.1% vs. 66.4%, respectively). There were no significant differences in the implantation or clinical pregnancy rates. Conclusion: Our prospective randomized study suggested that cessation of GnRH antagonist on the hCG administration day during a flexible multiple-dose protocol could reduce the total dose of GnRH antagonist without compromising its effects on pregnancy rates.
Objectives: The purpose of this review was to overview and evaluate the efficacy of electroacupunture for women with polycystic ovarian syndrome (PCOS) Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in PubMED, EMBASE, OASIS, and Google scholar, up to May 2018. Data were extracted regarding hyperandrogenism, obesity and hyperinsulinemia indices. The risk of bias was assessed. Results: Five RCTs were included for analysis. In one RCT, electroacupuncture group had significantly lower free testosterone and testosterone, compared to no treatment group. However, The other RCTs showed no significant difference between two groups. For LH/FSH, Ferriman Gallway score, anti-mullerian hormone, body mass index, weight and waist, and insulin, electroacupuncture group showed no significant difference, compared to physical exercise, no treatment, and sham acupuncture group. Conclusions: Only a limited number of RCTs have been reported. At present, there is insufficient evidence to support the use of electroacupuncture for treatment of PCOS.
Objectives: This study aims to systematically evaluate the effectiveness of Eastern-Western integrative medicine for musculoskeletal disorders compared with Eastern or Western Medicine. Methods: Systematic sea-mes of 9 major Korean databases were conducted for articles published up to July 2011. Searching keyword was "Integrative Medicine". Prospective studies dealt with musculoskeletal disorders by Eastern-Western integrative medicine were included. Quality assessment of included studies was evaluated by Cochrane risk of bias tool. Results: 470 studies in total were seamed, Amalg them 7 studies met our inclusion criteria(3 randomized controlled clinical trials, 2 non-randomized controlled trials and 2 uncontrolled clinical trials). Included studies dealt with lumbar pan(3), shoulder pain(2), pain after traffic injury(1), spinal compression fracture(1). Eastern-Western integrative medicine showed better or equal effect for the treatment of various muscloskeletal disorders compared with Eastern or Western medicine alone. Conclusions: There is very weak evidence for the effectiveness of Eastern-Western integrative medicine for musculoskeletal disorders compared with Eastern or Western medicine alone. Well designed randomized controlled trials with rigorous methodology are needed to evaluate the effectiveness of Eastern-Western integrative medicine objectively in the future.
Kim, Da-Hee;Choi, Gwang-Ho;Hwang, Eui-Hyoung;Heo, Kwang-Ho;Kim, Yong-Deok;Shin, Byung-Cheul
Journal of Society of Preventive Korean Medicine
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v.18
no.3
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pp.23-39
/
2014
Objective : This review aims at analyzing Complementary and Alternative Medicine (CAM) therapies, using for oral health to know current use of CAM in dental area by analyzing randomized controlled clinical trials (RCTs). Method : We searched the following 6 electronic databases until 1 July 2014. : Pubmed, Medline, Embase, Allied and Complementary Medicine Database(AMED), Cumulative Index to Nursing and Allied Health Literature(CINAHL), the Cochrane Library. We included parallel RCTs and cross-over RCTs that assessed the efficacy of CAM regardless of blinding and language. Results : A total of 154 RCT articles were included. There were 2-arm parallel study design(69.5%), 3-arm parallel study design(20.8%), 4-arm parallel study design(4.5%) and Cross-over design(5.2%). Complementary and alternative medicine RCTs in oral health tend to increase in the early-2000s and in the mid-2010s. In addition, 154 citations were classified according to diseases and interventions that categorized Natural Products studies(68.2%), Mind and Body Practices studies(31.8%). We classified in detail that vitamin and mineral therapies(29.9%), dietary supplements(24.7%), acupuncture(23.3%), Herbal medicine(13.6%), homeopathy (2.6%), energy therapies(2.6%), Massage(1.9%), biofeedback(0.6%), traditional medicine(0.6%). Conclusion : Increasing publications and diverse interventions regarding CAM for oral health is observed by analyzing RCTs from the literature review. Further studies are needed to be performed as systematic reviews to verify their effectiveness and the research to inquire into side effect.
Park, Yong Seok;Kim, Jae Hyun;Lee, Jihong;Chang, Gyu Tae
The Journal of Pediatrics of Korean Medicine
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v.34
no.4
/
pp.77-100
/
2020
Objectives The purpose of this study is to investigate recent clinical studies on the effect of herbal medicine for pediatric tonsillitis in China, and to seek better methods to treat and study for pediatric tonsillitis in Republic of Korea. Methods We searched clinical studies from the China National Knowledge Infrastructure (CNKI) by search formula (SU='扁桃体炎'+'扁桃炎'+'扁桃腺炎'+'乳蛾'+'喉蛾'+'蚕蛾'+'石蛾'+'珠蛾'+'肉蛾'+'乳蛾風'+爛乳風'+'tonsillitis') and (SU='中樂'+'中医樂'+'本草'+'湯'+'丸'+'散'+'方'+'顆粒'+'膠囊'+'自擬'+'herb'+'herbal'+'decoction'+'remedy'+'Chinese medicine'+'Korean medicine'+'kampo'+'formula'+'herbal drug'+'Chinese drug'+'plant'+'Chinese prescription'+'traditional medicine'+'Medicine, East Asian Traditional'+'Herbal Medicine') in professional search from January 2016 to August 2020. We analyzed the literature focusing on the treatment methods and results. Results Among 1464 searched studies, 35 randomized controlled trials were selected and analyzed. In most studies, the effectiveness of oral administration of herbal medicine on pediatric tonsillitis was significant. Most commonly used herbs were Fructus Forsythiae (連翹), Radix Glycyrrhizae (甘草), Radix Scutellariae (黃芩), Herba Menthae (薄荷), Fructus Arctii (牛蒡子), Radix Scrophulariae (玄蔘), Radix Platycodi (桔梗), Flos Lonicerae (金銀花), Radix Isatidis (板藍根), Radix Bupleuri (柴胡), Fructus Gardeniae (梔子), Rhizoma Belamcandae (射干), Radix et Rhizoma Rhei (大黃), Gypsum Fibrosum (石膏). Conclusions By analyzing the improvement of indicators such as total effective rate, cured rate, symptom disappearance time and symptom score, we found that herbal medicine treatment can help improve pediatric tonsillitis. However, additional studies are needed to solidify these findings.
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