Neonatal mortality and topical application of chlorhexidine on umbilical cord stump: a meta-analysis of randomized control trials

Public Health ◽  
2016 ◽  
Vol 139 ◽  
pp. 27-35 ◽  
Author(s):  
J.A. Shariff ◽  
K.C. Lee ◽  
A. Leyton ◽  
S. Abdalal
Keyword(s):  
Neonatal Mortality ◽  
Umbilical Cord ◽  
Topical Application ◽  
Meta Analysis ◽  
Randomized Control Trials ◽  
Randomized Control

scholarly journals RETRACTED ARTICLE: Application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries: a systematic review and meta-analysis

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Aklilu Abrham Roba ◽  
Maleda Tefera ◽  
Teshager Worku ◽  
Tamirat Tesfaye Dasa ◽  
Abiy Seifu Estifanos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neonatal Mortality ◽  
Umbilical Cord ◽  
Topical Application ◽  
Meta Analysis ◽  
Newborn Infants ◽  
Lower Income ◽  
Cord Care ◽  
Separation Time ◽  
Lower Income Countries

Abstract There are conflicting results from large randomized controlled trials in different populations regarding the effectiveness of topical application of 4% chlorhexidine to the umbilical stump of newborn infants at reducing neonatal mortality. Meta-analysis and systematic review of trials performed in South Asia and Europe support 4% chlorhexidine application to reduce neonatal mortality, whereas trials performed in Sub-Saharan Africa do not. The aim of this review is to determine the effectiveness of 4% chlorhexidine application to the umbilical stump of newborn infants born in lower income countries in order to reduce neonatal mortality when compared with usual cord care. Our search strategy included randomized trials published between January1st 2000 and September 4th, 2018, that compared 4% chlorhexidine with usual cord care (“dry cord care”). The outcome variable of interest was neonatal mortality. Pooled relative risks (RR) with 95% confidence intervals (CIs) using a random-effects model were calculated. Nine trials were included, from six countries: Zambia, Tanzania, Bangladesh, Nepal, India and Pakistan, with a total of 257,153 participants. Five studies (N = 119,833) reported neonatal mortality. There was a 21% reduction in neonatal mortality among with 4% chlorhexidine application: pooled RR (95% CI) 0.79 (0.69–0.90), P = 0.0005. The incidence of omphalitis was decreased by 35% with 4% chlorhexidine (6 studies, N = 108,263): pooled RR (95% CI) 0.65 (0.56–0.75), P = 0.00001. Chlorhexidine application delayed the umbilical cord separation time (4 studies, N = 28,917): mean difference (95% CI) 2.71 (2.63–2.78) days. In conclusion, this systematic review found that topical application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries significantly reduces the incidence of neonatal mortality. Chlorhexidine also reduces the incidence of omphalitis, but prolongs umbilical cord separation time. Trial registration Systematic Review Registration: CRD42018109280.

EXPRESS: Comparison of Mothership versus Drip-and-Ship Models in treating patients with Acute Ischemic Stroke: A systematic review and meta-analysis

2021 ◽  
pp. 174749302110132
Author(s):  
Ahmed Mohamed ◽  
Nida Fatima ◽  
Ashfaq Shuaib ◽  
Maher Saqqur
Keyword(s):  
Functional Outcome ◽  
Meta Analysis ◽  
Critical Time ◽  
Functional Independence ◽  
Models Of Care ◽  
Randomized Control Trials ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Significant Difference ◽  
The Mean ◽  
Randomized Control

Introduction There is controversy if direct to comprehensive center “mothership” (MS) or stopping at primary center for thrombolysis before transfer to comprehensive center “drip-and- ship” (DS) are best models of treatment of acute stroke. In this study, we compare MS and DS models to evaluate the best option of functional outcome. Methods Studies between 1990 and 2020 were extracted from online electronic databases. We compared the clinical outcomes, critical time measurements, functional independence and mortality were then compared. Results A total of 7,824 patients’ data were retrieved from 13 publications (3 randomized control trials and 10 retrospective ones). 4,639 (59.3%) patients were treated under MS model and 3,185 (40.7%) followed the DS model with mean age of 70.01±3.58 vs. 69.03±3.36; p< 0 .001, respectively. The National Institute Health Stroke Scale was 15.57±3.83 for the MS and 15.72±2.99 for the DS model (p=<0.001). The mean symptoms onset-to-puncture time was significantly shorter in the MS group compared to the DS (159.69 min vs. 223.89 min; p=<0.001, respectively). Moreover, the collected data indicated no significant difference between symptom’s onset to intravenous (IV) thrombolysis time and stroke onset-to-successful recanalization time (p=0.205 and p=<0.001, respectively). Patients had significantly worse functional outcome [modified rankin score (mRS)] (3-6) at 90-days in the DS model [Odds Ratio (OR): 1.47, 95% Confidence Interval (CI): 1.13-1.92, p<0.004] and 1.49-folds higher likelihood of symptomatic intracerebral hemorrhage (OR: 1.49, 95%CI: 1.22-1.81, p<0.0001) compared to MS. However, there were no statistically significant difference in terms of mortality (OR: 1.16, 95%CI: 0.87-1.55, p=0.32) and successful recanalization (OR: 1.12, 95%CI: 0.76-1.65, p=0.56) between the two models of care. Conclusion Patients in the MS model have significantly improved functional independence and recovery. Further studies are needed as the data from prospectively randomized studies is not of sufficient quality to make definite recommendations.

Quality assessment and meta-analysis of randomized control trials of ibuprofen

Pain ◽  
1987 ◽  
Vol 30 ◽  
pp. S51 ◽  
Author(s):  
A. AntczakBouckoms ◽  
F. Tung ◽  
T. C. Chalmers ◽  
A. Bouckoms
Keyword(s):  
Quality Assessment ◽  
Meta Analysis ◽  
Randomized Control Trials ◽  
Randomized Control

Trauma-Sensitive Yoga Interventions and Posttraumatic Stress and Depression Outcomes Among Women: A Systematic Review and Analysis of Randomized Control Trials

2021 ◽  
Author(s):  
Ashleigh Kysar-Moon ◽  
Matthew Vasquez ◽  
Tierra Luppen
Keyword(s):  
Systematic Review ◽  
Posttraumatic Stress ◽  
Traumatic Event ◽  
Meta Analysis ◽  
Depression Symptoms ◽  
Randomized Control Trials ◽  
Methodological Rigor ◽  
History Of ◽  
Randomized Control ◽  
Analysis Models

Abstract Research shows that most people experience at least one traumatic event in their lifetimes, and between 6% and 8% of those with a history of trauma will develop posttraumatic stress disorder (PTSD) and/or related mental health conditions. Women face a greater threat of trauma exposure and have a higher risk of PTSD and depression than men. Trauma-Sensitive Yoga (TSY), a body-based adjunctive therapy, has shown potential in several studies as an effective method for reducing PTSD and depression symptoms. However, existing research and systematic reviews vary widely in their methodological rigor and comparison samples. Thus, in this systematic review we examined the effectiveness of TSY among women with a history of trauma and depression who had participated in randomized control trials with clear control and experimental groups. Findings in fixed- and mixed-effects meta-analysis models suggest marginally significant to no effects of TSY on PTSD and depression outcomes. Our systematic review highlights critical questions and significant gaps in the existing literature about the rationale and best practices of TSY intervention duration.

scholarly journals Effectiveness and safety of heat-sensitive moxibustion on bronchial asthma: a Meta-analysis of randomized control trials

2014 ◽  
Vol 34 (4) ◽  
pp. 392-400 ◽  
Author(s):  
Jun Xiong ◽  
Zhongyong Liu ◽  
Rixin Chen ◽  
Dingyi Xie ◽  
Zhenhai Chi ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Meta Analysis ◽  
Randomized Control Trials ◽  
Randomized Control
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