Objective: To assess the effectiveness and tolerability of the 23 mg tablet donepezil in patients with Alzheimer’s disease (AD) using meta-analysis of randomized controlled trials. Methods: Major healthcare databases were searched from May to September 2016. Evaluation of relevant trials, assessment of risk of bias, collection and analyses of data were performed. Results: A total of 1,774 adult participants with AD were pooled from the two trials included. Pooled data showed that after 24 weeks of treatment, no significant difference was noted between Donepezil 23 mg/day and Donepezil 10 mg/day in terms of cognitive function (1.06 SIB points [-0.13, 2.26]; 1704 participants) and in terms of global clinical assessment (-0.02 CIBIC+ points [-0.13, 0.09]; 1705 participants). The participants who took the higher dose were at higher risk to experience “any adverse event” than those who received the lower dose (1.17 RR [1.09, 1.26]; 1785 participants). Conclusion Current evidences do not support the routine use of Donepezil 23 mg tablet for the improvement of cognitive function and global clinical status of patients with AD. The higher dose is also marked with an increased incidence of adverse events compared to the lower dose.
Meta-analysis

No abstract available.
Meta-Analysis as Topic

I. Introduction of film-coating technique; II. Materials: films, pigments and solvents; III. Equipment: Modified coater, Fluidized-bed coater; IV. Formulating solution: Formulating, Calculating amount of solution; V. Types of film: Protective film, Bowel dissoluble film, longer releasing film; IV. Film coating technique using water instead of organic solvent; VII. Testing quality of film coat: Testing polymer and formula, Testing protective, bowel dissoluble and longer releasing film.
Pharmaceutical Preparations ; Meta-Analysis

Meta-Analysis as Topic

Background: Dexamethasone, an anti-inflammatory drug, has an assumed analgesic effect when given epidurally, with less side effects5,7. Although numerous studies have evaluated dexamethasone, there is a paucity of studies assessing its intrapartum use. Objectives: To determine the effectiveness of epidural dexamethasone when used as an adjuvant for labor analgesia. Materials and Methods: A meta-analysis guided by the Cochrane handbook was performed. Articles were searched through PubMed, MEDLINE, CENTRAL, Google Scholar and ClinicalTrials.gov using search strategies such as keywords and MeSH terms. Cochrane version 2 risk-of-bias tool for randomized trials (RoB 2) was used to assess for quality. Quantitative data were pooled and analyzed using Review Manager 5.4.1. Results: A total of five trials involving 309 women in labor were analyzed. The pooled mean difference showed prolonged duration of epidural analgesia on patients who received epidural dexamethasone; pooled risk ratio between the experimental and control group demonstrated no significant maternal adverse events such as nausea and vomiting, shivering, hypotension, and fever. Pooled risk ratio and mean difference also showed that epidural dexamethasone had no significant effect on the neonatal APGAR and neonatal umbilical pH. Conclusion Present data demonstrated the potential role of dexamethasone as an adjuvant to epidural solution during labor analgesia on providing local anesthetic dose sparing effect through prolongation of the duration of epidural analgesia, with limited maternal and neonatal adverse events. These results should be interpreted with caution before adopting this technique in routine clinical practice.
Dexamethasone ; Meta-Analysis

Background: Preterm birth is an important health concern in countries with limited resources and healthcare access. Topical therapy may be effective for improving outcomes in preterm neonates whose skin barriers are compromised due to immaturity. Objectives: To systematically review the topical VCO's effects in preterm infants on infection, mortality, and dermal maturity. Methodology: Systematic review and meta-analysis of RCTs of topical VCO in preterm infants were conducted. Databases included PubMed, Google Scholar, Clinical trials.gov, Trip, Cochrane Library, and HERDIN. The risk of bias was assessed by two authors independently. RR with 95% CI was used for the pooled estimate of dichotomous outcomes including infection prevention, mortality reduction, and skin irritation. Mean differences with 95% CI were used for the pooled estimate of weight loss and NSCS. Results: Of 110 records identified, 3 RCTs with 2440 patients were included. Prevention of infection had a trend toward VCO (RR = 0.90, [95% CI: 0.64, 1.27] while the results for mortality reduction were inconclusive (RR = 0.45, [95% CI: 0.06, 3.38]. NSC scores showed a beneficial trend toward VCO (RR = -0.03, [95% CI: -0.16, 0.09]. Both secondary outcomes of skin irritation and weight loss had inconclusive results. Conclusions This review showed the lack of evidence of the effectiveness of topical VCO in improving various outcomes in premature infants. The effects on infection prevention and dermal maturation were favorable. However, its effects on preventing mortality, skin irritation, and weight loss were inconclusive.
Meta-Analysis ; Infections ; Mortality

Systematic reviews and meta-analysis combine results and analysis of data from different primary studies (e.g. cross-sectional studies, case-control studies, cohort studies) conducted on similar or related research topics. They are secondary studies that guide clinical decision-making, delivery of care and policy development. This article aims to discuss how to conduct a systematic review and meta-analysis. The steps in conducting a systematic review and meta-analysis include: 1) Identify the purpose including formulating the research question and validating the purpose of the literature scan, 2) Formulate the objectives, 3) Literature search including selection of studies based on population, intervention, comparison and outcome, 4) Retrieval of full text articles, 5) Critical appraisal of articles, 6) Data extraction, 7) Data analysis and 8) Writing the final report. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) is a useful guide in conducting and write systematic review and meta-analysis. While ethics approval is not usually required for systematic review and meta-analysis, authors of such study should still observe good practices including avoiding plagiarism, maintaining transparency and ensuring data accuracy.

Aims: This meta-analysis aims to synthesize available evidence from published studies on the effectiveness of parental non-pharmacologic smoking cessation programs which aim to reduce children's exposure to secondhand smoke.

Methodology: A database search using The Cochrane Library, PubMed®, Medline, Embase, and Google Scholar, was done by the investigators. This study included 20 randomized controlled trials published up to 2020. Pooled estimates of risk ratio (RR) for quit rates were computed using the random effects model.

Results: Overall, the quit rate among those who underwent parental smoking cessation was 13.4% while the quit rate for controls was 11.9%. The pooled RR demonstrated that the parental smoking cessation program was significantly associated with higher quit rates (RR = 1.22, 95%CI = 1.01 to 1.46, p-value = 0.04). The studies demonstrated moderate heterogeneity only (I2 = 54%). Among studies published prior to year 2000, no significant difference was observed between parental smoking cessation program and control (RR = 1.02, 95% CI = 0.62 to 1.70, p-value = 0.93). On the other hand, the pooled RR demonstrated that among studies published after 2020, parental smoking cessation program was significantly associated with higher quit rates (RR = 1.27, 95%CI = 1.03 to 1.56, p-value <0.0001). Among studies with self-help interventions, parental smoking cessation program has no additional benefit on quit rates (RR = 1.20, 95%CI = 0.94 to 1.58, p-value = 0.14). Among studies with biofeedback intervention also, no significant difference was observed (RR = 1.27, 95% CI = 0.86 to 1.89, p-value = 0.23).

Conclusions: This meta-analysis demonstrated sufficient evidence that non-pharmacologic interventions for parental smoking cessation are effective.

A systematic review summarizes the results of a number of individual studies that address a focused clinical question. It may be accompanied by a meta-analysis, which is a quantitative method of combining the results of all these studies in order to come up with a summary statistic of the overall effect of an intervention. Single studies may be unrepresentative of the total body of evidence, that is why combining the results of several studies in a systematic review increases precision, provides better estimates of effect, and includes a greater range of patients thus facilitating better clinical decision making. This must be done in a systematic and reproducible manner.
Systematic Review ; Meta-Analysis

Background: The aim of this study was to determine the effectiveness of community-based programs in preventing dengue thru systematic review and meta-analysis of randomized control trials. Methods: All randomized control trials on the evaluation of the effectiveness of community-based programs in dengue prevention were searched on reliable databases (MEDLINE/PubMed, Embase, ClinicalTrials.gov, Google Scholar, etc.). From a total of 32 studies that were identified as of April 2021, there were 11 studies that were included after screening of the titles and abstracts by the review authors. A computer software Revman v.5.4 was used for the statistical analyses needed for the study. All the included studies were encoded in the said software and the effect of the interventions were estimated using odds ratio for the different measurable dengue indices along with an encoded 95% confidence interval Results: The community-based programs used in the included studies were generally effective in preventing dengue using House index (OR=0.83 (95% CI=0.70-0.98), p=0.03), Container index (OR=0.61 (95% CI=0.50-0.74), p<0.01) and Breteau index (OR=0.92 (95% CI=0.81-1.04), p=0.18) as the outcome of measure. The subgroup analysis showed that environmental manipulation [(HI: OR=0.59 (95% CI=0.37-0.92), p= 0.02); (CI: OR=0.54 (95% CI=0.20-1.44), p=0.22); (BI: OR=0.58 (95% CI=0.33-0.88), p=0.010)] had a greater effect towards dengue prevention as compared to human behavior alone or in combination with it. Conclusion We conclude that environmental management or programs involving community participation is an effective strategy in dengue prevention. Community empowerment and capacity building are indeed important elements to achieve dengue control.
Dengue ; Meta-Analysis