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

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

Background: According to the American Heart Association, post- stroke patients often have neurologic deficits which can lead to a variety of complications. Patient-centered approach to care promotes shared decision-making between physicians and patients regarding treatment plan and may lead to better health outcomes for these post-stroke patients Objective: The effectiveness of patient-centered intervention in improving physical functioning among adult post-stroke patients with residual neurologic deficit was determined. Secondary outcomes such as improvement in social functioning, activities of daily living, quality of life and prevention of negative events such as death, re-hospitalization and depression were also evaluated Method: This systematic review included comparative randomized clinical trials involving humans as the clinical subjects, diagnosed to have had a stroke and appropriately evaluated to be in recovery with residual neurologic deficit, with the intervention described labeled as ‘patient-centered care’, and reporting an outcome on the improvement of physical functioning. Online search was done in Pubmed, CENTRAL, NICE, and the grey literature. Three reviewers independently conducted the search, appraisal and data extraction Results: Results varied depending on the outcome measurement tool utilized by the included studies. There was no difference between groups in terms of overall physical functioning and ADL as measured by SIS 16 and SIS 3.0. However, significant improvement was noted in the following subscales of SIS 3.0: hand movement (0.45,3.18, p=0.009, I2=0%), communication (0.86,2.16, p<0.00001, I2= 0%), and memory and thinking (0.13, 1.74, p=.02, I2= 33%). Physical function, ADL and social functioning using RNLI as an outcome (1.44-3.70] p<0.00001, I2= 0%), and physical functioning, social functioning, ADL and QOL as measured by participation (1.48, 3.74, p<0.00001, I2= 0%) and perception of recovery (2.22, 4.00, p<0.00001, I2=0%) also showed significant improvement Conclusion Patient-centered approaches have potential benefit in improving specific components of physical and social functioning, ADL and quality of life. However, differences in the type of patient-centered intervention and outcome measurement tools warrant further investigation into the specific interventions which will provide the most benefit to post-stroke patients
Meta-Analysis ; Stroke

Introduction: Intralesional purified protein derivative (PPD) is an affordable therapeutic option that has been studied for cutaneous warts. However, the lack of good evidence precludes its widespread use. Objective: To determine the efficacy and safety of intralesional PPD in the treatment of cutaneous warts. Methods: A systematic search for controlled clinical trials comparing intralesional PPD and placebo or any conventional therapy was conducted using electronic databases. The included studies were assessed for risk of bias, and data such as clearance rate of target and distant lesions, recurrence rate, and adverse events were extracted. Analysis was done through RevMan v5.3. Results: Four controlled clinical trials composed of 205 patients were included. All of the studies compared intralesional PPD to placebo as comparator. Intralesional PPD had a significantly higher clearance rate of target wart (RR=0.43[0.22,0.84], P=0.01) and a significantly higher clearance rate of distant lesions (RR=0.59[0.41,0.85], P=0.005) as compared to placebo. However, there was no significant difference in the recurrence rate (RR=0 [-0.07,0.07], P=0.98). Adverse events reported were only considered minor. Conclusion Intralesional PPD is an effective and safe treatment option for cutaneous warts. However, more well-structured RCTs with longer follow-up period and those comparing it with conventional treatment are needed to further support its use.
Warts ; Meta-Analysis ; Tuberculin

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.