Alternative treatment horizon for polycystic ovarian syndrome through Homoeopathy

2021 ◽  
Vol 20 (4) ◽  
pp. 43-59
Author(s):  
Deepti Dewan ◽  
Rashmi Sharma Sharma ◽  
Priyanka Nim Nim ◽  
Shweta Singh Singh
Keyword(s):  
Observational Studies ◽  
Literature Search ◽  
Randomized Trials ◽  
Polycystic Ovarian Syndrome ◽  
Case Reports ◽  
Alternative Therapy ◽  
Case Series ◽  
Holistic Healing ◽  
Evidence Based ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is a complex hormonal and metabolic disorder characterized by oligomenorrhea or amenorrhea, hyperandrogenism and infertility. Global prevalence of PCOS is estimated to be between 06% and 26%. Homoeopathy, being a system of holistic healing can be accepted as one of the alternative treatments for PCOS. Aim & Objective: The aim of the study is to review clinical data, where the intervention was aimed to treat PCOS through Homoeopathy. The objective of the study is to identify the therapeutic approach, assessment criteria, treatment outcomes through an alternative therapy i.e., Homoeopathy in cases of PCOS. Methods: A systematic literature search was conducted in the month of June2021 following International/National search databases for all clinical studies published in the period from 2000 to 2021. This search was aimed to target the entire literature of randomized trials or controlled trials, observational studies case studies/reports on PCOS in homoeopathy. Result:28 articles related to Homoeopathy on PCOS were identified. Out of these 28studies, 22 studies (01 RCT, 02 NRCT,06 observational studies,04 case series and 09 case reports) were included in this review. All studies were published in peer reviewed journals. Conclusions: To establish the evidence based efficacy of the homoeopathic treatment in cases of RCT more pragmatic studies need to be planned in the future based on proper diagnostic criteria.

Clonidine as a strategy for discontinuing dexmedetomidine sedation in critically ill patients: A narrative review

2020 ◽  
Vol 77 (7) ◽  
pp. 515-522
Author(s):  
Shelley S Glaess ◽  
Rebecca L Attridge ◽  
G Christina Gutierrez
Keyword(s):  
Observational Studies ◽  
Literature Search ◽  
Case Reports ◽  
Research Articles ◽  
Original Research ◽  
Loading Dose ◽  
Efficacy And Safety ◽  
Limited Data ◽  
Icu Patients ◽  
Dexmedetomidine Infusion

Abstract Purpose To review the efficacy and safety of transitioning from dexmedetomidine to clonidine to facilitate weaning of patients from sedation with dexmedetomidine. There is a paucity of data describing dexmedetomidine withdrawal syndrome (DWS) as well as clonidine’s place in therapy for DWS. This review will describe and analyze current literature to provide clinical recommendations. Summary A MEDLINE literature search was performed to identify original research articles describing DWS and/or transitioning from dexmedetomidine to clonidine for the purpose of weaning patients from sedation with dexmedetomidine. Four case reports describing DWS, 3 case reports describing the use of clonidine to treat DWS, and 3 observational studies describing the use of clonidine to facilitate dexmedetomidine weaning were identified. The incidence of and risk factors for DWS are unknown; factors including patient age and dexmedetomidine infusion rate, loading dose, and discontinuation strategy have inconsistent associations with DWS. All cases of DWS have been associated with infusion durations greater than 72 hours. While there are limited data describing clonidine use for the treatment of dexmedetomidine withdrawal, clonidine appears to be beneficial for dexmedetomidine weaning and its use for that purpose has been well described. Clonidine dosages that have been assessed for discontinuing dexmedetomidine vary from 0.1 to 0.3 mg orally or enterally every 6 to 8 hours; one study assessed use of transdermal clonidine (100 µg/24 h patch). Patients with extensive cardiac comorbidities may be more susceptible to adverse effects of clonidine, which may limit the drug’s use for DWS intervention. Conclusion Despite limited supportive data, clonidine provides a promising option for sedation management in adult ICU patients, with successful transitions from dexmedetomidine reported within 24 hours after clonidine initiation.

scholarly journals Scoping review: occupational therapy interventions in primary care

2019 ◽  
Vol 20 ◽  
Author(s):  
Marije Bolt ◽  
Tiska Ikking ◽  
Rosa Baaijen ◽  
Stephanie Saenger
Keyword(s):  
Primary Care ◽  
Occupational Therapy ◽  
Randomized Control Trial ◽  
Literature Search ◽  
Relevant Literature ◽  
Case Series ◽  
Evidence Based ◽  
Randomized Control ◽  
Therapy Interventions ◽  
Occupational Therapy Interventions

AbstractThis is the second article in a series of two about occupational therapy and primary care. The first article (see PH&RD….) described the position of the profession in primary care across Europe and the scope of the profession. In this article the broad scope of the profession is illustrated with various examples of occupational therapy interventions. The interventions are identified by means of a literature search. A questionnaire (the questionnaire is available by mailing the author) was sent out to experts across Europe which resulted in both relevant literature and evidence-based examples. The evidence level of these examples differs from expert opinion (5), case series (4), case–controlled studies (3), cohort studies (2) and randomized-control trial (1). The article ends with recommendations in four areas how to develop, establish or strengthen the profession in primary care.

scholarly journals Methodological quality and synthesis of case series and case reports

2018 ◽  
Vol 23 (2) ◽  
pp. 60-63 ◽  
Author(s):  
Mohammad Hassan Murad ◽  
Shahnaz Sultan ◽  
Samir Haffar ◽  
Fateh Bazerbachi
Keyword(s):  
Methodological Quality ◽  
Medical Literature ◽  
Case Reports ◽  
Case Series ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Study Designs ◽  
Inform Decision Making

Case reports and case series are uncontrolled study designs known for increased risk of bias but have profoundly influenced the medical literature and continue to advance our knowledge. In this guide, we present a framework for appraisal, synthesis and application of evidence derived from case reports and case series. We propose a tool to evaluate the methodological quality of case reports and case series based on the domains of selection, ascertainment, causality and reporting and provide signalling questions to aid evidence-based practitioners and systematic reviewers in their assessment. We suggest using evidence derived from case reports and case series to inform decision-making when no other higher level of evidence is available.

So Much Writing, So Little Science: A Review of 37 Years of Literature on Edetate Sodium Chelation Therapy

1993 ◽  
Vol 27 (12) ◽  
pp. 1504-1509 ◽  
Author(s):  
Michael T. Grier ◽  
David G. Meyers
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Literature Search ◽  
Chelation Therapy ◽  
Case Reports ◽  
Scientific Evidence ◽  
Case Series ◽  
Mechanisms Of Action ◽  
Tetraacetic Acid ◽  
Safety And Efficacy

OBJECTIVE: To determine the safety and efficacy of edetate sodium (ethylenediamine tetraacetic acid; EDTA) chelation therapy for atherosclerosis. METHODS: Literature search using MEDLINE, encompassing 1966 through May 1993. Further references were obtained from articles and books, and from citations obtained from the American Academy of Medical Preventics. RESULTS: 16 case reports or case series, 2 longitudinal studies, and 3 clinical trials were reviewed, along with testimonials cited in 19 books. CONCLUSIONS: Little valid scientific evidence is available. Although the postulated mechanisms of action for EDTA are biologically plausible and EDTA appears to be safe, it has not been proven effective. Indeed, the best evidence shows it to be ineffective. Therefore, EDTA chelation therapy should not be used in clinical practice to treat atherosclerosis.

scholarly journals The Treatment and Prognosis of Refractory and Super-Refractory Status Epilepticus

2017 ◽  
Vol 01 (03) ◽  
pp. E204-E210
Author(s):  
Stephanie Gollwitzer ◽  
Hajo Hamer
Keyword(s):  
Status Epilepticus ◽  
Electroconvulsive Therapy ◽  
Case Reports ◽  
Case Series ◽  
Refractory Status Epilepticus ◽  
Evidence Based ◽  
New Approach ◽  
Refractory Status ◽  
First Choice ◽  
Evidence Based Guidelines

AbstractRefractory status epilepticus (RSE) is defined as status epilepticus (SE) persisting over 60 min and resistant to treatment with benzodiazepines and non-sedating antiepileptic drugs. The term super-refractory status epilepticus (SRSE) refers to a refractory episode continuing under general anesthesia for more than 24 h. RSE is treated with a combination of non-sedating AED and i. v. anesthetics; first choice drugs are midazolam, propofol and thiopental. The management of super-refractory status epilepticus (SRSE) is challenging as clear evidence-based guidelines are lacking. Recommendations are mainly based on case reports and small case series. Therapeutic options include ketamine, inhalational anesthetics, steroids and immunoglobulins. Ketogenic diet, electroconvulsive therapy and epilepsy surgery are also considered as potentially effective. A promising new approach is the neurosteroid allopregnanolone. Mortality of RSE and SRSE is largely influenced by the etiology and is markedly higher as compared to non-refractory status epilepticus. It was reported to be about 30% and 50%, respectively.

scholarly journals Viewpoint: The New Zealand Centre for Adverse Reactions Monitoring: a source of practice-based evidence

2013 ◽  
Vol 5 (2) ◽  
pp. 170 ◽  
Author(s):  
Ruth Savage
Keyword(s):  
New Zealand ◽  
Observational Studies ◽  
Adverse Reactions ◽  
Case Reports ◽  
Case Series ◽  
Sufficient Evidence ◽  
Drug Reactions ◽  
Prescribing Practices ◽  
Valuable Contribution ◽  
Primary Health

The database of the New Zealand Centre for Adverse Reactions Monitoring (CARM) is an example of the practice-based evidence discussed in the June issue of the Journal of Primary Health Care. Databases of reported adverse drug reactions (ADRs) were established to generate hypotheses to be tested about previously unrecognised adverse reactions and interactions. Occasionally they are sufficient evidence in themselves. They can also identify prescribing practices that might increase the potential for ADRs to occur and provide feedback into guidelines in terms of the consequences of their use or non-use. Well-documented ADR reports can also highlight risk factors, thus providing a valuable contribution to risk benefit assessments in individual patients. Examples are discussed that support the use of ADRs as practice-based evidence in a non-hierarchical system in which case reports and case series, observational studies and randomised clinical trials contribute in a flexible relationship depending on the issue under investigation.

scholarly journals Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence

2020 ◽  
Author(s):  
Jacques L Tamuzi ◽  
Ayele T Birhanu ◽  
Constance S Shumba ◽  
Olatunji Adetokunboh ◽  
Jeannine Uwimana-Nico ◽  
...  
Keyword(s):  
Clinical Management ◽  
Observational Studies ◽  
Case Reports ◽  
Case Series ◽  
People Living With Hiv ◽  
Related Field ◽  
High Burden ◽  
Screening Algorithm ◽  
Clinical Trials Registry ◽  
Living With Hiv

Abstract Background The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the 21 st century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field and play an important role in the present and future management of the co-infections. However, several gaps are remaining in the knowledge of the burden of COVID-19 on patients with TB and HIV, the diagnosis, and management of these patients. Objectives The study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB and to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management. Methods We conducted electronic search of potential eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and March, 2020 in which SARS-CoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB were managed in adult patients. We screened titles, abstracts and full articles for eligibility. As we anticipated heterogeneity in the literature, results were reported narratively. Main results After removing 69 duplicates, 24 out of 246 articles were assessed for eligibility, of which 9 studies were included for qualitative analysis. Among them, we included two case reports, four case series, one case-control and two retrospective observational studies. The studies have shown that TB may occur during or after SARS-CoV. In terms of severity, the proportion of severe/critical SARS, MERS and COVID cases with TB co-infection was higher than in patients with mild/moderate stages (P= 0.0008). Conclusion SARS/MERS-CoV/COVID-19 associated to HIV/TB or TB subjects had a higher risk of developing severe/critical than mild/moderate SARS/MERS-CoV/COVID-19. Diagnostic algorithms and clinical management were suggested for efficiently improving COVID-19/HIV/TB co-infections outcomes.

scholarly journals Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 4: Observational Studies

2009 ◽  
Vol 1;12 (1;1) ◽  
pp. 73-108 ◽  
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Cohort Studies ◽  
Medical Research ◽  
Evidence Based Medicine ◽  
Observational Studies ◽  
Randomized Trials ◽  
Evidence Based ◽  
Cross Sectional ◽  
Cross Sectional Studies ◽  
Based Medicine ◽  
Strobe Statement

Evidence-based medicine (EBM) stresses the examination of evidence from clinical research and describes it as a shift in medical paradigms, in contrast to intuition, unsystematic clinical experience, and pathophysiologic rationale. While the importance of randomized trials has been created by the concept of the hierarchy of evidence in guiding therapy, much of the medical research is observational. There is competition, contrast, and a feeling of inferiority and uselessness for observational studies, created by a lack of understanding of medical research. However, observational studies and randomized clinical trials (RCTs) can be viewed as the steps of observation and experimentation that form the basis of the scientific methodology. Further, rational healthcare practices require knowledge about the etiology and pathogenesis, diagnosis, prognosis, and treatment of disorders. The reporting of observational research is often not detailed and clear enough with insufficient quality and poor reporting, which hampers the assessment of strengths and weaknesses of the study and the generalizability of the mixed results. Thus, design, implementation, and reporting of observational studies is crucial. The biased interpretation of results from observational studies, either in favor of or opposed to a treatment, and lack of proper understanding of observational studies, leads to a poor appraisal of the quality. Similar to the Consolidated Standards of Reporting Trials (CONSORT) statement for the reporting of randomized trials, the Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE) statement was developed with recommendations to improve the quality of reporting observational studies. The STROBE statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Multiple types of observational studies are conducted; however, 3 types have been highlighted in the STROBE document and also in the present review, which include cohort studies, case-controlled studies, and cross-sectional studies. This comprehensive review provides an introduction and rationale, types, design, and reporting of observational studies; outcomes assessment and data presentation and analysis; statistical analysis, results, and a discussion of observational studies. Key words: Observational studies, cohort studies, case control studies, cross-sectional studies, allocation bias, sample size, Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE)

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