Meta-Analysis Based on Clinical RCTs: The Effect of Molecular Epimerism on the Safety of Glycyrrhizic Acid

Objective. To carry out the meta-analysis on the clinical safety of glycyrrhizic acid and the influencing factors between 18α-glycyrrhizinate (18α-GL) and 18β-glycyrrhizinate (18β-GL). Methods. Magnesium isoglycyrrhizinate injection was used as the representative preparation of 18α-GL, and compound glycyrrhizin injection was used as the representative preparation of 18β-GL. The clinical control trial of magnesium isoglycyrrhizinate injection and compound glycyrrhizin injection was searched in a computer, which was published from January 2006 to December 2019 on the databases such as PubMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (CSTJ), and Wanfang Medical Network (Wanfang Data). The data associated with adverse drug reactions (ADRs) were extracted. RevMan5.3 was used for statistical analysis. Results. Finally, 24 studies were included, and 2757 patients were involved, of which the experimental group was mainly treated with magnesium isoglycyrrhizinate, while the control group was mainly treated with compound glycyrrhizin. The results showed that the occurrence of ADRs was significantly lower in the experimental group than that in the control group, and the difference between two groups was statistically significant (RR = 0.26, 95% CI = (0.18, 0.38), P < 0.00001 ). There was no heterogeneity among the studies (I2 = 0%, P = 1.00 ). Conclusion. Compared with 18β-GL, 18α-GL had a lower incidence of adverse reactions and better clinical safety.

Evaluation of the efficacy of Latakaranja as Antispasmodic Drug in Kastaartava - A Randomised Clinical Control Trial

Kastaartava (Dysmenorrohea) is a greek word, describes about painful menstruation which the Pratyatmaka Lakhshans of various Yonivyapad that are Vatala Yonivyapad, Udavartini Yonivyapad, Paripluta Yonivyapad, Mahayoni and Vataja Artava Dusti that affects 75% of adolscents, 25-50% of adult women and 5-20% having dysmenorrhea. It is a common reason for losing time at school or work or visiting family doctor. Morbid Vatadosha especially Apanavata is a causative factor of Kastaartava. Vatahara properties are beneficial considering the morbidity and complications that are caused by Kastaaratava, mentioned above herbal preparation has been tried here. This research work is randomized control clinical study with Pre-test and Post-test design. 40 patients suffering from Kastaaratava (Dysmenorrohoea) were selected randomly for study. The selected patients were divided into 2 groups, 20 patients each. The selected 20 patients in Group A (Trial group) were administered Latakaranja Beeja Churna orally. The selected 20 patients in Group B (Controlled group) were administered Rajapravartini Vati. The duration of treatment was for 03 days of menstruation for 2 menstrual cycles and followup for the next menstrual cycle. After the completion of the clinical trial, it was found that in Rajapravartini Vati, there was highly significant result in Cramping pain in abdomen, Irritability, Tenderness in Breast, Back pain and Headache, where as Latakaranja Beeja Choorna there is also significant result in Cramping pain in Abdomen, Irritability, Tenderness in Breast, Back Pain, Headache and Vomiting but statistically considering average mean Latakaranja Choorna shows comparatively lesser effective than Rajapravartini Vati. By the statistical results it can be concluded that Rajapravartini Vati has better result when compared to Latakaranja Choorna in the present study.

Surgical management of vesicovaginal fistula repair: Our experience.

Objectives: The results of our study would generate useful baseline database which would help the surgeons to manage these fistulae and their related complications properly. Study Design: Non-randomized Clinical Control Trial study. Setting: Department of Urology, Bahawal Victoria Hospital, Bahawalpur and Shahida Islam Medical College, Lodhran. Period: From July 2015 to June 2016. Material & Methods: Total 150 women with vesico-vaginal fistula (VVF) on cystoscopy of either age were selected. Patients with history of recurrence of fistula, multiple fistulae, radiation and severe vaginal scarring were excluded. The transvaginal management was approached in cases of simple fistula, VVF located at trigone of bladder while transabdominal route was preferred when the fistula site could not be easily accessed per vagina, when VVF was above trigone or when the VVF was complex. These patients were followed for 6 weeks at 2 week time interval. Results: Age range in this study was from 20 to 60 years with mean age of 38.18 ± 10.64 years. Majority of patients were (41.72%) with medium sized fistula. In 92 patients, abdominal repair was done while in 52 patients vaginal repair was done. Unsuccessful repair was seen in 14 (9.33%), infection in 25 (16.67%) and recurrent fistula formation in 21 (14.0%) patients. Conclusion: This study concluded that the frequency of unsuccessful repair and recurrent fistula is more after vaginal repair compared to abdominal repair while infection rate was more after abdominal repair.