Lancet
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Letter Case Reports Clinical Trial Controlled Clinical Trial
Haem-arginate plus tin-protoporphyrin for acute hepatic porphyria.
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Patients with burns often suffer severe pain, especially during dressing of wounds, but there are no established alternatives to potent opiate analgesics, with their various side-effects. Intravenous lignocaine infusion strikingly reduced self-assessed pain scores in 7 patients during the first 3 days after second-degree burns, without need for supplementary opiate analgesia.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group.
A randomised double-blind prevention trial with a factorial design was conducted at 33 centres in seven countries to determine whether supplementation with folic acid (one of the vitamins in the B group) or a mixture of seven other vitamins (A,D,B1,B2,B6,C and nicotinamide) around the time of conception can prevent neural tube defects (anencephaly, spina bifida, encephalocele). A total of 1817 women at high risk of having a pregnancy with a neural tube defect, because of a previous affected pregnancy, were allocated at random to one of four groups--namely, folic acid, other vitamins, both, or neither. 1195 had a completed pregnancy in which the fetus or infant was known to have or not have a neural tube defect; 27 of these had a known neural tube defect, 6 in the folic acid groups and 21 in the two other groups, a 72% protective effect (relative risk 0.28, 95% confidence interval 0.12-0.71). ⋯ There was no demonstrable harm from the folic acid supplementation, though the ability of the study to detect rare or slight adverse effects was limited. Folic acid supplementation starting before pregnancy can now be firmly recommended for all women who have had an affected pregnancy, and public health measures should be taken to ensure that the diet of all women who may bear children contains an adequate amount of folic acid.