Paracetamol/acetaminophen (single administration) for perineal pain in the early postpartum period.

The coronavirus disease 2019 (COVID-19) continues to spread worldwide. Integrated Chinese and Western medicine have had some successes in treating COVID-19.
This study aims to evaluate the efficacy and safety of three traditional Chinese medicine drugs and three herbal formulas (3-drugs-3-formulas) in patients with COVID-19.
Relevant studies were identified from 12 electronic databases searched from their establishment to April 7, 2022.
Randomized controlled trials (RCTs), non-RCTs and cohort studies that evaluated the effects of 3-drugs-3-formulas for COVID-19. The treatment group was treated with one of the 3-drugs-3-formulas plus conventional treatment. The control group was treated with conventional treatment.
Two evaluators screened and selected literature independently, then extracted basic information and assessed risk of bias. The treatment outcome measures were duration of main symptoms, hospitalization time, aggravation rate and mortality. RevMan 5.4 was used to analyze the pooled results reported as mean difference (MD) with 95% confidence interval (CI) for continuous data and risk ratio (RR) with 95% CI for dichotomous data.
Forty-one studies with a total of 13,260 participants were identified. Our analysis suggests that compared with conventional treatment, the combination of 3-drugs-3-formulas might shorten duration of fever (MD = -1.39; 95% CI: -2.19 to -0.59; P < 0.05), cough (MD = -1.57; 95% CI: -2.16 to -0.98; P < 0.05) and fatigue (MD = -1.36; 95% CI: -2.21 to -0.51; P < 0.05), decrease length of hospital stay (MD = -2.62; 95% CI -3.52 to -1.72; P < 0.05), the time for nucleic acid conversion (MD = -2.92; 95% CI: -4.26 to -1.59; P < 0.05), aggravation rate (RR = 0.49; 95% CI: 0.38 to 0.64; P < 0.05) and mortality (RR = 0.34; 95% CI: 0.19 to 0.62; P < 0.05), and increase the recovery rate of chest computerized tomography manifestations (RR = 1.22; 95% CI: 1.14 to 1.3; P < 0.05) and total effectiveness (RR = 1.24; 95% CI: 1.09 to 1.42; P < 0.05).
The 3-drugs-3-formulas can play an active role in treating all stages of COVID-19. No severe adverse events related to 3-drugs-3-formulas were observed. Hence, 3-drugs-3-formulas combined with conventional therapies have effective therapeutic value for COVID-19 patients. Further long-term high-quality studies are essential to demonstrate the clinical benefits of each formula. Please cite this article as: You LZ, Dai QQ, Zhong XY, Yu DD, Cui HR, Kong YF, Zhao MZ, Zhang XY, Xu QQ, Guan ZY, Wei XX, Zhang XC, Han SJ, Liu WJ, Chen Z, Zhang XY, Zhao C, Jin YH, Shang HC. Clinical evidence of three traditional Chinese medicine drugs and three herbal formulas for COVID-19: A systematic review and meta-analysis of the Chinese population. J Integr Med. 2023; 21(5): 441-454.

Clinical evidence of three traditional Chinese medicine drugs and three herbal formulas for COVID-19: A systematic review and meta-analysis of the Chinese population.

Blood transfusions are frequently administered in cardiac surgery. Despite a large number of published studies comparing a "restrictive" strategy with a "liberal" strategy, no clear consensus has emerged to guide blood transfusion practice in cardiac surgery patients. The purpose of this study was to identify, critically appraise, and summarize the evidence on the overall effect of restrictive transfusion strategies compared with liberal transfusion strategies on mortality, other clinical outcomes, and transfusion-related outcomes in adult patients undergoing cardiac surgery.
We searched MEDLINE (OvidSP), EMBASE (OvidSP) and Cochrane CENTRAL (Wiley) from inception to 1 December 2017 and queried clinical trial registries and conference proceedings for randomized-controlled trials of liberal vs restrictive transfusion strategies in cardiac surgery.
From 7,908 citations, we included ten trials (9,101 patients) and eight companion publications. Overall, we found no significant difference in mortality between restrictive and liberal transfusion strategies (risk ratio [RR], 1.08; 95% confidence interval [CI], 0.76 to 1.54; I
In adult patients undergoing cardiac surgery, a restrictive transfusion strategy reduces RBC transfusion without impacting mortality rate or the incidence of other perioperative complications. Nevertheless, further large trials in subgroups of patients, potentially of differing age, are needed to establish firm evidence to guide transfusion in cardiac surgery.
PROSPERO (CRD42017071440); registered 20 April, 2018.
RéSUMé: OBJECTIF: Les transfusions sanguines sont fréquentes après une chirurgie cardiaque. Malgré le nombre important d’études publiées comparant une stratégie « restrictive » à une stratégie « libérale », aucun consensus clair n’est apparu pour guider la pratique de la transfusion sanguine chez les patients de chirurgie cardiaque. L’objectif de cette étude était d’identifier, d’évaluer de façon critique et de résumer les données probantes sur l’effet global des stratégies de transfusion restrictives comparativement aux stratégies libérales sur la mortalité, les autres devenirs cliniques, et les devenirs liés à la transfusion chez des patients adultes subissant une chirurgie cardiaque.
Nous avons réalisé des recherches dans les bases de données MEDLINE (OvidSP), EMBASE (OvidSP) et Cochrane CENTRAL (Wiley) de leur création jusqu’au 1
Sur 7908 citations, nous avons inclus dix études (9101 patients) et huit publications connexes. Globalement, nous n’avons observé aucune différence significative en matière de mortalité entre les stratégies transfusionnelles restrictives et libérales (risque relatif [RR], 1,08; intervalle de confiance [IC] 95 %, 0,76 à 1,54; I
Dans une population de patients adultes subissant une chirurgie cardiaque, une stratégie transfusionnelle restrictive réduit la transfusion d’érythrocytes sans avoir d’impact sur le taux de mortalité ou sur l’incidence d’autres complications périopératoires. D’autres grandes études sur différents sous-groupes de patients, peut-être d’âges différents, sont toutefois nécessaires afin d’établir des données probantes concluantes pour guider les transfusions en chirurgie cardiaque. ENREGISTREMENT DE L’éTUDE: PROSPERO (CRD42017071440); enregistrée le 20 avril 2018.

The effect of restrictive versus liberal transfusion strategies on longer-term outcomes after cardiac surgery: a systematic review and meta-analysis with trial sequential analysis.

Around the world, the use of modern contraceptives has risen significantly, but the quality and reach of sexual and reproductive health services remains weak in the poorest countries. To address the high unmet need, an opportunity arises for mobile health technology (mHealth) to empower both clients and providers. However, evidence that mHealth is effective in increasing modern contraceptive use is limited and mixed, and we set out to assess its impact.
A systematic literature search from seven electronic databases was conducted using key search terms. Individually randomised controlled trials that compared modern contraceptive use in women and men using phone message interventions and those without the intervention were included. Stata was used to calculate pooled estimates of effect under the random-effects model, as well as produce the risk of bias using the Egger's regression method. GRADEpro GDT was used to assess the quality of individual studies.
A pooled estimate of all of the studies showed a positive association between phone messages and contraception use, but no clear evidence of benefit (OR 1.12; 95% CI 0.97-1.29). Notably, pooled results of studies that reported modern contraceptive use as the primary outcome showed that mobile phone messaging was associated with an increase in the use of modern contraception (OR 1.22; 95% CI 1.01-1.47).
The finding of this systematic review suggests that mobile phone message interventions utilising a behavioural change technique are an effective method of increasing modern contraceptive use among men and women of reproductive age in low- and middle-income countries though the effect is small.
Partout dans le monde, l'utilisation de contraceptifs modernes a considérablement augmenté, mais la qualité et la portée des services de santé sexuelle et reproductive restent faibles dans les pays les plus pauvres. Pour répondre à cet important besoin non satisfait, une opportunité se présente avec la technologie de la santé mobile (mHealth) permettant d'autonomiser à la fois les patients et les prestataires. Cependant, les preuves que mHealth est efficace pour augmenter l'utilisation de la contraception moderne sont limitées et mitigées, et nous avons entrepris d'évaluer son impact. MÉTHODES: Une recherche systématique de la littérature dans 7 bases de données électroniques a été menée à l'aide de termes de recherche clés. Des essais contrôlés randomisés individuels comparant l'utilisation de la contraception moderne chez les femmes et les hommes utilisant des interventions via des messages téléphoniques et ceux sans intervention ont été inclus. Stata a été utilisé pour calculer des estimations d'effet poolées selon le modèle à effets aléatoires, ainsi que pour produire le risque de biais à l'aide de la méthode de régression d'Egger. GRADEpro GDT a été utilisé pour évaluer la qualité des études individuelles. RÉSULTATS: Une estimation poolée de toutes les études a montré une association positive entre les messages téléphoniques et l'utilisation de la contraception, mais aucune preuve claire de bénéfice (OR 1,12; IC95%: 0,97–1,29). Notamment, les résultats poolés des études qui rapportaient sur l'utilisation de la contraception moderne comme critère principal ont montré que la messagerie par téléphone mobile était associée à une augmentation de l'utilisation de la contraception moderne (OR 1,22; IC95%: 1,01–1,47).
Les résultats de cette revue systématique suggèrent que les interventions de messagerie par téléphone mobile utilisant une technique de changement de comportement sont une méthode efficace pour augmenter l'utilisation de la contraception moderne chez les hommes et les femmes en âge de procréer dans les pays à revenu faible ou intermédiaire, bien que l'effet soit faible.

Impact of mHealth on contraceptive use among women and men of reproductive age in low- and middle-income countries: a systematic review and meta-analysis.

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