scholarly journals Carica papaya L. Leaf: A Systematic Scoping Review on Biological Safety and Herb-Drug Interactions

2021 ◽  
Vol 2021 ◽  
pp. 1-21
Author(s):  
X. Y. Lim ◽  
J. S. W. Chan ◽  
N. Japri ◽  
J. C. Lee ◽  
T. Y. C. Tan
Keyword(s):  
Drug Interactions ◽  
Aqueous Extract ◽  
Carica Papaya ◽  
Controlled Trial ◽  
Grey Literature ◽  
Reporting Quality ◽  
Cochrane Library ◽  
Oral Hypoglycaemic Agents ◽  
Leaf Consumption ◽  
Randomised Controlled

Introduction. The Carica papaya L. leaf is gaining interest as a potential therapeutic agent for alleviating dengue- and non-dengue-associated thrombocytopaenia. In that regard, safety considerations are as important as efficacy potential. The safety evaluation of botanical products for human use is complicated by variable formulations, complex phytochemical composition, and extrinsic toxicants. This review aimed to systematically collate related safety clinical and preclinical data, as well as reports on herb-drug interactions of C. papaya leaf consumption. Methods. A systematic search using predetermined keywords on electronic databases (MEDLINE, Cochrane Library Central, LILACS, and Web of Science) and grey literature was conducted. Relevant clinical and preclinical studies were identified, screened, and analysed to present an overall safety profile of C. papaya leaf consumption. Results. A total of 41 articles were included (23 clinical, 5 ongoing trials, and 13 preclinical) for descriptive analysis on study characteristics, adverse reactions, toxicity findings, and herb-drug interactions, from which 13 randomised controlled and quasiexperimental trials were further assessed for risk of bias and reporting quality. Overall, C. papaya leaf consumption (in the form of juice and standardised aqueous extract) was well tolerated by adult humans for short durations (<five days) while one randomised controlled trial reported safe consumption of C. papaya leaf standardised aqueous extract in children (aged 1–12 years). Minor gastrointestinal side effects were most commonly reported. There are concerns about hepatotoxicity and reproductive toxicity in long-term use, supported by animal studies. Unfavourable herb-drug interactions with metformin, glimepiride, digoxin, ciprofloxacin, and artemisinin were accounted. Conclusion. C. papaya leaf consumption in adults is generally safe for short-term use though cautioned in pregnancy and people with liver impairment. It has potential herb-drug interactions with oral hypoglycaemic agents, p-glycoprotein substrates, and antibiotics with cation chelating properties.

scholarly journals Effectiveness and safety of Er-xian Decoction (traditional Chinese medicine) for women with Primary ovarian insufficiency

2021 ◽  
Author(s):  
Zhefen Mai ◽  
◽  
Chunli Lu ◽  
Zixun Zhuang ◽  
Hongxia Ma
Keyword(s):  
Controlled Trial ◽  
Hormone Replacement ◽  
Grey Literature ◽  
Ovarian Failure ◽  
Primary Ovarian Insufficiency ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Clinical Trial Registry ◽  
Ovarian Insufficiency ◽  
Review Question

Review question / Objective: To assess the effectiveness and safety of Er-xian Decoction in the treatment of primary ovarian insufficiency. Information sources: We will search the following electronic databases, including 3 English databases (PubMed, EMBASE, Cochrane Library) and 4 Chinese databases (China national knowledge infrastructure database, Wanfang database, Sinomed Database, and VIP database). The filters were English and Chinese language. The following key words in Title/Abstract or MeSH search headings are used: “Er-xian” and “Hormone replacement therapy” or “Femoston” or “Climen” and “Primary ovarian insufficiency” or “Ovarian failure” or “Premature ovarian failure” or “POI” and “random*” or “Randomized controlled trial”. In addition, we also search the grey literature such as conference proceedings and dissertations in CNKI and Wanfang database, and relevant trials will be searched in ClinicalTrial.gov database [20] and Chinese Clinical Trial Registry for unpublished trials and protocols. References of all included studies will be hand searched for additional eligible studies.

scholarly journals An overview of systematic reviews of complementary and alternative therapies for infantile colic

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Rachel Perry ◽  
Verity Leach ◽  
Chris Penfold ◽  
Philippa Davies
Keyword(s):  
Systematic Reviews ◽  
Data Extraction ◽  
Grey Literature ◽  
Research Literature ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Infantile Colic ◽  
Breastfed Infants ◽  
Randomised Controlled ◽  
Complementary And Alternative

Abstract Background Infantile colic is a distressing condition characterised by excessive crying in the first few months of life. The aim of this research was to update the synthesis of evidence of complementary and alternative medicine (CAM) research literature on infantile colic and establish what evidence is currently available. Methods Medline, Embase and AMED (via Ovid), Web of Science and Central via Cochrane library were searched from their inception to September 2018. Google Scholar and OpenGrey were searched for grey literature and PROSPERO for ongoing reviews. Published systematic reviews that included randomised controlled trials (RCTs) of infants aged up to 1 year, diagnosed with infantile colic using standard diagnostic criteria, were eligible. Reviews of RCTs that assessed the effectiveness of any individual CAM therapy were included. Three reviewers were involved in data extraction and quality assessment using the AMSTAR-2 scale and risk of bias using the ROBIS tool. Results Sixteen systematic reviews were identified. Probiotics, fennel extract and spinal manipulation show promise to alleviate symptoms of colic, although some concerns remain. Acupuncture and soy are currently not recommended. The majority of the reviews were assessed as having high or unclear risk of bias and low confidence in the findings. Conclusion There is clearly a need for larger and more methodologically sound RCTs to be conducted on the effectiveness of some CAM therapies for IC. Particular focus on probiotics in non-breastfed infants is pertinent. Systematic review registration PROSPERO: CRD42018092966.

scholarly journals Education as a strategy for managing occupational-related musculoskeletal pain: a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032668 ◽  
Author(s):  
Thorvaldur Skuli Palsson ◽  
Shellie Boudreau ◽  
Morten Høgh ◽  
Pablo Herrero ◽  
Pablo Bellosta-Lopez ◽  
...  
Keyword(s):  
Scoping Review ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Cochrane Library ◽  
Free Text ◽  
Work Related ◽  
Education Material ◽  
Occupational Setting ◽  
Free Text Search ◽  
Randomised Controlled

BackgroundMusculoskeletal (MSK) pain is the primary contributor to disability worldwide. There is a growing consensus that MSK pain is a recurrent multifactorial condition underpinned by health and lifestyle factors. Studies suggest that education on work-related pain and individualised advice could be essential and effective for managing persistent MSK pain.ObjectiveThe objective of this scoping review was to map the existing educational resources for work-related MSK (WRMSK) pain, and the effects of implementing educational strategies in the workplace on managing WRMSK pain.MethodsThis scoping review assessed original studies that implemented and assessed education as a strategy to manage WMSK pain. Literature search strategies were developed using thesaurus headings (ie, MeSH and CINAHL headings) and free-text search including words related to MSK in an occupational setting. The search was carried out in PubMed, CINAHL, Cochrane Library and Web of Science in the period 12–14 February 2019.ResultsA total of 19 peer-reviewed articles were included and the study design, aim and outcomes were summarised. Of the 19 peer-reviewed articles, 10 randomised controlled trial (RCT) studies assessed the influence of education on work-related MSK pain. Many studies provided a limited description of the education material and assessed/used different methods of delivery. A majority of studies concluded education positively influences work-related MSK pain. Further, some studies reported additive effects of physical activity or ergonomic adjustments.ConclusionsThere is a gap in knowledge regarding the best content and delivery of education of material in the workplace. Although beneficial outcomes were reported, more RCT studies are required to determine the effects of education material as compared with other interventions, such as exercise or behavioural therapy.

scholarly journals Has the reporting quality of published randomised controlled trial protocols improved since the SPIRIT statement? A methodological study

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e038283
Author(s):  
Zet Wei Tan ◽  
Aidan Christopher Tan ◽  
Tom Li ◽  
Ian Harris ◽  
Justine M Naylor ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
English Language ◽  
Controlled Trial ◽  
Reporting Quality ◽  
Methodological Study ◽  
Eligibility Criteria ◽  
Significant Deterioration ◽  
Before And After ◽  
Randomised Controlled

ObjectivesTo determine the reporting quality of published randomised controlled trial (RCT) protocols before and after the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement (2013), and any association with author, trial or journal factors.DesignMethodological study.Data sourcesMEDLINE, Embase and CENTRAL were electronically searched using optimised search strategies.Eligibility criteriaProtocols written for an RCT of living humans, published in full text in a peer-reviewed journal and published in the English language.Main outcomePrimary outcome was the overall proportion of checklist items which were adequately reported in RCT protocols published before and after the SPIRIT statement.Results300 RCT protocols were retrieved; 150 from the period immediately before the SPIRIT statement (9 July 2012 to 28 December 2012) and 150 from a recent period after the SPIRIT statement (25 January 2019 to 20 March 2019). 47.9% (95% CI, 46.5% to 49.3%) of checklist items were adequately reported in RCT protocols before the SPIRIT statement and 56.7% (95% CI, 54.9% to 58.5%) after the SPIRIT statement. This represents an 8.8% (95% CI, 6.6% to 11.1%; p<0.0001) mean improvement in the overall proportion of checklist items adequately reported since the SPIRIT statement. While 40% of individual checklist items had a significant improvement in adequate reporting after the SPIRIT statement, 11.3% had a significant deterioration and there were no RCT protocols in which all individual checklist items were complete. The factors associated with higher reporting quality of RCT protocols in multiple regression analysis were author expertise or experience in epidemiology or statistics, multicentre trials, longer protocol word length and publicly reported journal policy of compliance with the SPIRIT statement.ConclusionThe overall reporting quality of RCT protocols has significantly improved since the SPIRIT statement, although a substantial proportion of individual checklist items remain poorly reported. Continued and concerted efforts are required by journals, editors, reviewers and investigators to improve the completeness and transparency of RCT protocols.

scholarly journals 1379Has the reporting quality of published randomised controlled trial protocols improved since the SPIRIT statement?

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Aidan Tan ◽  
Zet Tan ◽  
Tom Li ◽  
Ian Harris ◽  
Justine Naylor ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
English Language ◽  
Controlled Trial ◽  
Reporting Quality ◽  
Recent Period ◽  
Before And After ◽  
Trial Protocols ◽  
Randomised Controlled ◽  
The Impact

Abstract Background The impact of the SPIRIT statement on the reporting quality of RCT protocols in health research is unknown. This methodological study aimed to determine the reporting quality of published randomised controlled trial (RCT) protocols before and after the SPIRIT statement, and any association with author, trial or journal factors. Methods RCT protocols were identified by searching MEDLINE, Embase and CENTRAL, included if published in full-text, English language and a peer-reviewed journal, and assessed with the SPIRIT statement checklist items. Results 300 RCT protocols were retrieved; 150 from the period immediately before the SPIRIT statement and 150 from a recent period after the SPIRIT statement. 47.9% (95% CI, 46.5% to 49.3%) of checklist items were adequately reported in RCT protocols before the SPIRIT statement and 56.7% (95% CI, 54.9% to 58.5%) after the SPIRIT statement. This represents an 8.8% (95% CI, 6.6% to 11.1%; p &lt; 0.0001) mean improvement in the overall proportion of checklist items adequately reported since the SPIRIT statement. The factors associated with higher reporting quality of RCT protocols in multiple regression analysis were author expertise or experience in epidemiology or statistics, multicentre trials, longer protocol word length and publicly reported journal policy of compliance with the SPIRIT statement. Conclusions The overall reporting quality of RCT protocols has significantly improved since the SPIRIT statement, although a substantial proportion of individual checklist items remain poorly reported. Key messages Continued, concerted and coordinated efforts are required by journals, editors, reviewers and investigators to improve the completeness and transparency of RCT protocols.

scholarly journals A systematic review of pharmacists’ interventions to support medicines optimisation in patients with visual impairment

2019 ◽  
Vol 41 (6) ◽  
pp. 1400-1407 ◽  
Author(s):  
Basma Y. Kentab ◽  
Heather E. Barry ◽  
Sinaa A. Al-Aqeel ◽  
Carmel M. Hughes
Keyword(s):  
Systematic Review ◽  
Visual Impairment ◽  
Randomised Controlled Trials ◽  
Grey Literature ◽  
Cochrane Library ◽  
Future Research ◽  
Controlled Trials ◽  
Medicines Optimisation ◽  
Randomised Controlled ◽  
The Impact

Abstract Background People with visual impairment often report poorer health and encounter many challenges when using medicines. Pharmacists can play a significant role in optimising medicines use for these patients. However, little is known about pharmacists’ current practices when providing services to this population nor the impact of such services, if any, on medicines optimisation-related outcomes. Aim of the review This systematic review aims to identify the types, and assess the effectiveness of, interventions provided by pharmacists on medicines optimisation-related outcomes. Method Systematic searches of the following electronic databases were carried out from date of inception to March 2018: Cochrane Library; MEDLINE; EMBASE; International Pharmaceutical Abstracts; Scopus; and Cumulative Index to Nursing and Allied Health Literature. Several trial registries and grey literature resources were also searched. Any randomised controlled trials, non-randomised controlled trials, controlled before-and-after studies, or interrupted time series analyses reporting on interventions provided by pharmacists to adult visually impaired patients and/or their caregivers in order to improve medicines optimisation-related outcomes of medicine safety, adherence, patient satisfaction, shared decision making, or quality of life were included. Results A total of 1877 titles/abstracts were screened, and 27 full text articles were assessed for eligibility. On examination of full texts, no studies met the inclusion criteria for this review. Conclusion This review highlights the need for future research that would be vital for promoting the safe and effective use of medicines and the delivery of pharmaceutical care services to people with visual impairment.

scholarly journals Effectiveness of personal letters to healthcare professionals in changing professional behaviours: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Aikaterini Grimani ◽  
Louis Goffe ◽  
Mei Yee Tang ◽  
Fiona Beyer ◽  
Falko F. Sniehotta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Healthcare Professionals ◽  
Grey Literature ◽  
Behavioural Change ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Behaviour Change Techniques ◽  
Randomised Controlled

Abstract Background Letters are regularly sent by healthcare organisations to healthcare professionals to encourage them to take action, change practice or implement guidance. However, whether letters are an effective tool in delivering a change in healthcare professional behaviour is currently uncertain. In addition, there are currently no evidence-based guidelines to support health providers and authorities with advice on how to formulate the communication, what information and behaviour change techniques to include in order to optimise the potential effect on the behaviour of the receivers. To address this research gap, we seek to inform such guidance through this systematic review, which aims to provide comprehensive evidence of the effectiveness of personal letters to healthcare professionals in changing their professional behaviours. Methods/design A comprehensive literature search of published and unpublished studies (the grey literature) in electronic databases will be conducted to identify randomised controlled trials (RCTs) that meet our inclusion criteria. We will include RCTs evaluating the effectiveness of personal letters to healthcare professionals in changing professional behaviours. The primary outcome will be behavioural change. The search will be conducted in five electronic databases (from their inception onwards): MEDLINE, Embase, PsycINFO, the Cochrane Library and CINAHL. We will also conduct supplementary searches in Google Scholar, hand search relevant journals, and conduct backward and forward citation searching for included studies and relevant reviews. A systematic approach to searching, screening, reviewing and data extraction will be applied in accordance with the process recommended by the Cochrane Collaboration. Two researchers will examine titles, abstracts, full-texts for eligibility independently. Risk of bias will be assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for randomised controlled trials. Disagreements will be resolved by a consensus procedure. Discussion Health policy makers across government are expected to benefit from being able to increase compliance in clinical settings by applying theories of behaviour to design of policy communications. The synthesised findings will be disseminated through peer-reviewed publication. Systematic review registration PROSPERO CRD42020167674

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