Although recent studies have investigated the analgesic activity of Damask rose using aromatherapy in different painful conditions, the results are inconclusive. Hence, this systematic review and meta-analysis aimed to clarify the effect of aromatherapy with Damask rose on adults' acute pain.
The online databases of MEDLINE/PubMed, Scopus, ISI web of science, Embase, ProQuest, CENTRAL, CINAHL, SID, and MagIran were searched up to August 10, 2020. The aim of this study was to find randomized controlled trials on the effect of aromatherapy with Damask rose in any form of administration (inhalation, vapor diffusion, and massage) on different types of acute pain in adults. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. Moreover, the quality of the evidence was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects model was applied to pool data using Stata.
A total of 16 studies met the inclusion criteria, of which only one was not included in the meta-analysis. Pooled analysis revealed that aromatherapy with Damask rose reduced the pain severity significantly (WMD: -2.12; 95% CI [-2.85, -1.40]; P < 0.001). Inhalation aromatherapy (WMD: -2.39; 95% CI [-3.31, -1.48]; P < 0.001) and aromatherapy massage (WMD: -1.16; 95% CI [-1.57, -0.75]; P < 0.001) also had significant effects on pain reduction. The quality of evidence was low.
Aromatherapy with Damask rose had a favourable effect on reducing the severity of acute pain in adults. However, there is insufﬁcient evidence for the clinical beneﬁts of aromatherapy with Damask rose due to the low-quality evidence. Accordingly, more high quality randomized clinical trials are needed to make an evidence-based conclusion.

Effect of aromatherapy with Damask rose on alleviating adults' acute pain severity: A systematic review and meta-analysis of randomized controlled trials.

(1) Background: vitamin A deficiency (VAD) is highly prevalent in children living in poor conditions. It has been suggested that vitamin A supplementation (VAS) may reduce the risk of acute respiratory tract infections (ARTI). Our study provides updates on the effects of oral VAS (alone) in children on ARTI and further explores the effect on interesting subgroups. (2) Methods: eight databases were systematically searched from their inception until 5 July 2021. The assessments of inclusion criteria, extraction of data, and data synthesis were carried out independently by two reviewers. (3) Results: a total of 26 randomized trials involving 50,944 participants fulfilled the inclusion criteria. There was no significant association of VAS with the incidence of ARTI compared with the placebo (RR 1.03, 95% CI 0.92 to 1.15). Subgroup analyses showed that VAS higher than WHO recommendations increased the incidence of ARTI by 13% (RR 1.13, 95% CI 1.07 to 1.20), and in the high-dose intervention group, the incidence rate among well-nourished children rose by 66% (RR 1.66, 95% CI 1.30 to 2.11). (4) Conclusions: no more beneficial effects were seen with VAS in children in the prevention or recovery of acute respiratory infections. Excessive VAS may increase the incidence of ARTI in children with normal nutritional status.

Excessive Vitamin A Supplementation Increased the Incidence of Acute Respiratory Tract Infections: A Systematic Review and Meta-Analysis.

Cervical cancer (CC) is the fourth most frequent cancer worldwide. Cigarette smoking has been shown to influence CC risk in conjunction with human papillomavirus (HPV) infection. The aim of this study is to provide the most accurate and updated estimate of this association and its dose-response relationship.
Using an innovative approach for the identification of original publications, we conducted a systematic review and meta-analysis of studies published up to January 2021. Random effects models were used to provide pooled relative risks (RRs) of CC for smoking status. Dose-response relationships were evaluated using one-stage random effects models with linear or restricted cubic splines models.
We included 109 studies providing a pooled RR of invasive CC and preinvasive lesions, respectively, of 1.70 [95% confidence interval (CI), 1.53-1.88] and 2.11 (95% CI, 1.85-2.39) for current versus never smokers, and, respectively, 1.13 (95% CI, 1.02-1.24) and 1.29 (95% CI, 1.15-1.46) for former versus never smokers. Considering HPV does not alter the positive association or its magnitude. Risks of CC sharply increased with few cigarettes (for 10 cigarettes/day, RR = 1.72; 95% CI, 1.34-2.20 for invasive CC and RR = 2.13; 95% CI, 1.86-2.44 for precancerous lesions). The risk of CC increased with pack-years and smoking duration and decreased linearly with time since quitting, reaching that of never smokers about 15 years after quitting.
This comprehensive review and meta-analysis confirmed the association of smoking with CC, independently from HPV infection. Such association rose sharply with smoking intensity and decreased after smoking cessation.

Dose-risk relationships between cigarette smoking and cervical cancer: a systematic review and meta-analysis.

Preoperative anxiety is very common in adults awaiting all types of surgical procedures, which can interfere with the start and completion of surgery and increase the risk of postoperative complications. In this context, many researchers and clinical practitioners have attempted to use aromatherapy to help adults reduce preoperative anxiety.
To investigate systematically the efficacy of aromatherapy on preoperative anxiety in adults.
A systematic review and meta-analysis of randomized controlled trials was undertaken.
PubMed, Embase, Cochrane Library, Web of Science, PsycINFO and CINAHL were comprehensively searched from their inception to June 2020.
Studies on the use of aromatherapy for treating preoperative anxiety in adults were included. Two reviewers assessed the risk of bias of the included studies independently using the Cochrane Collaboration 'Risk of Bias' tool. Overall meta-analysis and five subgroup analyses regarding the type of control, the type of aroma preparations, delivery mode, session length and surgery type were performed using RevMan 5.3. The Higgins' I
Twenty studies comprising 1717 participants were included. The meta-analysis indicated that aromatherapy could significantly ameliorate preoperative anxiety (standard mean difference=-0.57, 95% confidence interval [-0.75, -0.39], p<0.00001) for adults awaiting surgical procedures, compared to placebo control, conventional care and no intervention. The subgroup analysis based on the surgery type showed that aromatherapy had a great improvement on preoperative anxiety for patients awaiting cardiac surgery and relatively low-risk surgery. Lavender oil, citrus species preparations and rose oil were the three most commonly used aroma preparations that could significantly improve preoperative anxiety. Most delivery modes of aromatherapy, including inhalation, massage, and oral administration, were effective. Moreover, short length (≤20 min per session) aromatherapy showed a better effect on preoperative anxiety (mean difference=-5.84, 95% confidence interval [-8.09, -3.59], p<0.00001) than aromatherapy lasting more than 20-minutes per session (mean difference=-2.15, 95% confidence interval [-3.81, -0.49], p = 0.01).
Aromatherapy is an effective intervention for reducing preoperative anxiety in adults. Short-length aromatherapy inhalation seems to be more worthy of being recommended in clinical settings. More well-designed randomized controlled trials containing a wider range of surgical types and participants from more countries are needed to verify our findings before we can make strong recommendations.

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