The Effect of ShotBlocker Application on Intramuscular Injection Pain in Adults: A Meta-Analysis

2021 ◽  
pp. 105477382110212
Author(s):  
Seda Şahan ◽  
Ayşegül Yildiz
Keyword(s):  
Literature Review ◽  
Intramuscular Injection ◽  
Meta Analysis ◽  
Adult Patients ◽  
Injection Pain ◽  
Control Group ◽  
Evidence Based ◽  
High Quality ◽  
Key Phrases ◽  
Effective Result

This meta-analysis study was conducted to determine the effects of ShotBlocker application during administration of intramuscular injections to adult patients for providing an evidence-based practice. The PubMed, Scopus, Science Direct, Ovid and Google Scholar databases were used for the literature review. The literature review was conducted by two researchers using the key phrases intramuscular injection AND ShotBlocker AND pain AND adults. According to the result of the meta-analysis, the pain levels in the experiment group in which ShotBlocker was used during IM injection to adult patients was found to be significantly different in comparison to the control group (SMD = −0.769, 95% CI = −1.449 to −0.090, p = .027). As a result of the meta-analysis, it was found that ShotBlocker application in IM injection in adult patients reduced patients’ pain intensity. High-quality studies conducted with appropriate research methods are required for achieving a more comprehensive and effective result.

scholarly journals Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine—a meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039358
Author(s):  
Suhairul Sazali ◽  
Salziyan Badrin ◽  
Mohd Noor Norhayati ◽  
Nur Suhaila Idris
Keyword(s):  
Random Effects ◽  
Coenzyme Q10 ◽  
Migraine Headache ◽  
Meta Analysis ◽  
Adult Patients ◽  
Control Group ◽  
Cochrane Central Register ◽  
Statistical Heterogeneity ◽  
Coq10 Supplementation ◽  
The Impact

ObjectiveTo determine the effects of coenzyme Q10 (CoQ10) for reduction in the severity, frequency of migraine attacks and duration of headache in adult patients with migraine.DesignSystematic review and meta-analysis.Data sourcesCochrane Central Register of Controlled Trials, CENTRAL, MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Psychological Information Database (PsycINFO) from inception till December 2019.Study selectionAll randomised control trials comparing CoQ10 with placebo or used as an adjunct treatment included in this meta-analysis. Cross-over designs and controlled clinical trials were excluded.Data synthesisHeterogeneity at face value by comparing populations, settings, interventions and outcomes were measured and statistical heterogeneity was assessed by means of the I2 statistic. The treatment effect for dichotomous outcomes were using risk ratios and risk difference, and for continuous outcomes, mean differences (MDs) or standardised mean difference; both with 95% CIs were used. Subgroup analyses were carried out for dosage of CoQ10 and if CoQ10 combined with another supplementation. Sensitivity analysis was used to investigate the impact risk of bias for sequence generation and allocation concealment of included studies.ResultsSix studies with a total of 371 participants were included in the meta-analysis. There is no statistically significant reduction in severity of migraine headache with CoQ10 supplementation. CoQ10 supplementation reduced the duration of headache attacks compared with the control group (MD: −0.19; 95% CI: −0.27 to −0.11; random effects; I2 statistic=0%; p<0.00001). CoQ10 usage reduced the frequency of migraine headache compared with the control group (MD: −1.52; 95% CI: −2.40 to −0.65; random effects; I2 statistic=0%; p<0.001).ConclusionCoQ10 appears to have beneficial effects in reducing duration and frequency of migraine attack.PROSPERO registration numberCRD42019126127.

Evidence-based approaches to psychiatry

2017 ◽  
pp. 119-134
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Patient Experience ◽  
Meta Analysis ◽  
Psychiatric Research ◽  
Evidence Based ◽  
High Quality ◽  
Qualitative Methodologies ◽  
Meta Analyses ◽  
Based Medicine ◽  
Quality Evidence

‘Evidence-based approaches to psychiatry’ describes the application of evidence-based medicine (EBM) to psychiatric practice. The chapter covers the key processes in EBM, including the formulation of a clinically relevant question, the systematic search for high-quality evidence and the meta-analytic synthesis of data. It demonstrates how evidence-based approaches to psychiatry have led to important developments showing quantitative effects of different treatments through advanced meta-analysis of data from randomized trials. This has underpinned the development of clinical guidelines that have the aim of improving the reliability and quality of treatments that patients receive. The chapter also describes how meta-analyses should be critically reviewed, as well as their problems and limitations. Not all relevant questions in psychiatric research are susceptible to the quantitative approach offered by EBM, and the chapter also outlines how qualitative methodologies can play a key role in answering important questions related, for example, to the patient experience.

scholarly journals Nootropic drugs for correction of cognitive functions through the focus of evidence-based medicine (literature review)

2021 ◽  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Literature Review ◽  
Cognitive Functions ◽  
Evidence Based Medicine ◽  
Randomized Trials ◽  
Evidence Based ◽  
Nootropic Drugs ◽  
High Quality ◽  
Based Medicine

Relevance. In today's world, the first cause of death is pathology of the cardiovascular system. Vascular disease is influenced by many factors: lack of sleep, physical inertia, poorly balanced diet, obesity, heart disease. The fast pace of life forces a person to be in permanent stress, so as not to miss anything and have time for all the goals. This is why there is a demand for excipients and substances that could improve the peak of human cognitive abilities, maintain psychological stability. Today, the pharmaceutical market offers drugs that, according to pharmaceutical marketers, have solutions to the problems outlined above. These substances are classified to group of nootropic drugs (racetams). Objective. Review of high quality research on the effectiveness of nootropic drugs. Materials and methods. The literature review was performed using such scientometric databases as: PubMed, Cochrane Library, Scopus, BMJ Evidence-Based Medicine, Ingecta, Web of Science, UpToDate. The review included studies of randomized trials, placebo-controlled randomized trials, meta-analyzes, and systematic reviews. Data meet criteria A and B of evidence-based medicine. In the absence of high quality studies, studies with a lower level of evidence were selected. The search was made by topics: improving of cognitive functions, improving ability to work, improving sleep, improving mood, treatment of mental and psychiatric pathologies (Alzheimer's disease, dementia with various etiologies, depression), application in pediatrics. Results. The literature review included more than 40 high quality studies, but no conclusive evidence was found on the effectiveness of any drug. Conclusions. Data on the undeniable efficacy in relation to the cognitive functions of any of these nootropic drugs were not found in any study. In the treatment of Alzheimer's disease, some (Cerebrolysin, Nicergoline) drugs show controversial results of efficacy and safety. They require continued clinical research and they need to be approved by the FDA.

scholarly journals The Efficacy and Tolerability of Ubrogepant for Acute Migraine: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Yun Diao ◽  
Hang Yang ◽  
Yang Chun Zhou ◽  
Biao Du
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Acute Attack ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Acute Migraine ◽  
High Quality ◽  
Randomized Controlled

Abstract Objective: The aim of this review was to evaluate the efficacy and tolerability of ubrogepant in patients with acute migraine. Methods: We systematically searched PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov from inception to JULY, 2019. Randomized controlled trials of the efficacy and/or tolerability of ubrogepant for migraine were included. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 4 RCTs involving 4 163 patients were included. The meta-analysis showed that:compared to the control group, the percentage of participants with PF, the percentage of participants with PR, the percentage of participants with SPF, the percentage of participants with SPR,the absence of phonophobia in sound，the absence of phonophobia in light and the absence of nausea (RR=1.31,95%CI:1.18~1.45，P<0.00001, RR=1.63,95%CI:1.46~1.82，P<0.00001, RR=1.22,95%CI:1.15~1.29，P<0.00001, RR=1.32,95%CI:1.22~1.42，P<0.00001, RR=1.16,95%CI:1.05~1.27，P=0.002), all the differences were statistically significant. Conclusions: For adult patients with acute migraine, ubrogepant could effectively abort the acute attack. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and tolerability of ubrogepant for acute migraine.

scholarly journals Clinical efficacy of 5-hydroxytryptamine 3 receptor antagonists in reducing propofol injection pain, postoperative nausea/vomiting and shivering: A meta-analysis

Pteridines ◽  
2020 ◽  
Vol 31 (1) ◽  
pp. 18-27
Author(s):  
Wenjie Zhou ◽  
Jie Zhou
Keyword(s):  
Clinical Efficacy ◽  
Postoperative Nausea ◽  
Statistical Difference ◽  
Meta Analysis ◽  
Injection Pain ◽  
Control Group ◽  
Published Data ◽  
Cochrane Central Register ◽  
Control Groups ◽  
Receptor Antagonists

AbstractObjective To investigate the clinical efficacy of 5-hydroxytryptamine 3 (5-HT3) receptor antagonists in reducing propofol injection pain, postoperative nausea/ vomiting, and shivering through pooling the available published data.Methods Prospective randomized clinical studies relevant to 5-HT3 receptor antagonists in reducing propofol injection pain published before June 2019 were identified from four electronic databases, Pubmed, the Cochrane central register of controlled trials, EMBASE and Wanfang. The incidence of propofol injection pain, postoperative nausea/vomiting, and shivering in patients after 5-HT3 receptor antagonists were compared to relevant control groups by pooling the individual data through random or fixed-effect models. The publication bias was assessed by funnel plot and Egger’s line regression test.Results After screening, a total of 19 publications relevant to 5-HT3 receptor antagonists in reducing propofol injection pain and prevention of postoperative nausea/vomiting or shivering were included for analysis. The pooled results demonstrated that 5-HT3 receptor antagonists could significantly reduce the total propofol injection pain compared to placebo (RR=0.49, 95%CI:0.45-0.54, P<0.05). For mild propofol injection pain, there was no statistical difference between 5-HT3 receptor antagonists and control groups (RR=1.07,95%CI:0.89-1.29, P>0.05). However, for moderate (RR=0.37, 95%CI: 0.31-0.46, P<0.05) and severe (RR=0.19, 95%CI:0.14-0.27, P<0.05) propofol injection pain, the incidence in 5-HT3 receptor antagonists was significantly lower than that of control groups. The pooled results also indicated that incidence of postoperative nausea/vomiting (RR=0.28, 95%CI:0.17-0.44, P<0.05) and postoperative shivering (RR=0.33, 95%CI:0.23-0.48, P<0.05) were significantly reduced in 5-HT3 receptor antagonists group compared to control group with a statistical difference.Conclusion: In this meta-analysis, 5-HT3 receptor antagonists effectively reduced propofol injection pain, postoperative nausea/vomiting, and shivering.

The risk of postoperative hemorrhage and efficacy of heparin for preventing deep vein thrombosis and pulmonary embolism in adult patients undergoing neurosurgery: a systematic review and meta-analysis

2017 ◽  
Vol 65 (8) ◽  
pp. 1136-1146 ◽  
Author(s):  
Xuan Wang ◽  
Ying-Chun Zhou ◽  
Wen-De Zhu ◽  
Yun Sun ◽  
Peng Fu ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Postoperative Hemorrhage ◽  
Adult Patients ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Heparin Prophylaxis

The aim of this meta-analysis was to examine the risk of postoperative bleeding and efficacy of heparin for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) in adult patients undergoing neurosurgery. MEDLINE, Cochrane, and EMBASE databases were searched until October 31, 2016, for randomized controlled trials (RCTs) and non-randomized comparative studies that assessed the rates of postoperative hemorrhage, DVT, PE, and mortality in adult patients undergoing neurosurgery. Nine eligible studies (five RCTs, four retrospective studies) including 874 patients treated with either unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) and 1033 patients in control group (placebo with or without compression device) were analyzed. The overall analysis revealed that there was an increase in the risk of postoperative hemorrhage in patients who received heparin (pooled OR 1.66, 95% CI 1.01 to 2.72, p=0.046) compared with no treatment group. The risk of postoperative hemorrhage was more significant if only RCTs were included in analysis. Heparin prophylaxis was associated with a decrease in the risk of DVT (pooled OR 0.48, 95% CI 0.36 to 0.65, p<0.001) and PE (pooled OR 0.25, 95% CI 0.09 to 0.73, p=0.011) but it did not affect the rate of mortality. In conclusion, heparin increased the rate of postoperative bleeding, decreased the risk of DVT, PE and venous thromboembolic event (VTE) but it did not affect the mortality of patients undergoing neurosurgery. For the heparin prophylaxis, the trade-off between the risk of postoperative bleeding and benefit of prophylaxis against VTEs requires further investigation.

scholarly journals Effect of psychosocial interventions on social functioning in depression and schizophrenia: meta-analysis

2013 ◽  
Vol 202 (4) ◽  
pp. 253-260 ◽  
Author(s):  
Mary J. De Silva ◽  
Sara Cooper ◽  
Henry Lishi Li ◽  
Crick Lund ◽  
Vikram Patel
Keyword(s):  
Social Functioning ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Scale Up ◽  
Intervention Group ◽  
Psychosocial Interventions ◽  
Good Evidence ◽  
Control Group ◽  
High Quality ◽  
Positive Effect

BackgroundPsychosocial interventions may contribute to reducing the burden of mental disorders in low- and middle-income (LAMI) countries by improving social functioning, but the evidence has not been systematically reviewed.AimsSystematic review and meta-analysis of the effect of psychosocial interventions on social functioning in people with depression and schizophrenia in LAMI countries.MethodStudies were identified through database searching up to March 2011. Randomised controlled trials were included if they compared the intervention group with a control group receiving placebo or treatment as usual. Random effects meta-analyses were performed separately for depressive disorders and schizophrenia and for each intervention type.ResultsOf the studies that met the inclusion criteria (n=24), 21 had sufficient data to include in the meta-analysis. Eleven depression trials showed good evidence for a moderate positive effect of psychosocial interventions on social functioning (standardised mean difference (SMD)=0.46, 95% CI 0.24-0.69, n=4009) and ten schizophrenia trials showed a large positive effect on social functioning (SMD = 0.84, 95% CI 0.49-1.19, n=1671), although seven of these trials were of low quality. Excluding these did not substantially affect the size or direction of effect, although the precision of the estimate was substantially reduced (SMD = 0.89, 95% CI 0.05-1.72, n=863).ConclusionsPsychosocial interventions delivered in out-patient and primary care settings are effective at improving social functioning in people with depression and should be incorporated into efforts to scale up services. For schizophrenia there is an absence of evidence from high-quality trials and the generalisabilty of the findings is limited by the over-representation of trials conducted in populations of hospital patients in China. More high-quality trials of psychosocial interventions for schizophrenia delivered in out-patient settings are needed.

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