Current medical research and opinion
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Review Meta Analysis
Intravenous Ringer's lactate versus usual care during labor in nulliparous women: a systematic review and meta-analysis of randomized controlled trials.
Due to limited research on the effectiveness and safety of intravenous (IV) fluids administered during labor, there are no guidelines available. Thus, this meta-analysis aims to evaluate efficacy of IV Ringer's lactate during labor as compared to usual care. ⋯ IV Ringer's lactate reduced the duration of active labor, the need for oxytocin augmentation and the prolonged labor incidence. However, it did not differ in effect on immediate neonatal health but was found to have more potential for reducing maternal vomiting as compared to usual care with unrestricted oral intake. Further research is needed to explore its effects in the larger and more diverse populations and with different IV fluids for evidence-based guidelines.
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Review Meta Analysis
Cold polypectomy techniques for small and diminutive colorectal polyps: a systematic review and network meta-analysis of randomized controlled trials.
In the management of small and diminutive polyps, cold polypectomy is favored over electrocautery polypectomy. However, the optimal cold polypectomy technique is still controversial. Hence, this review aims to investigate the most effective cold technique for small and diminutive colorectal polyps. ⋯ CFP is the least effective method for small and diminutive polyps' removal, and any snare polypectomy technique will achieve better results, warranting more large-scale RCTs to investigate the most effective snare polypectomy technique.
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Review Meta Analysis
The efficacy and safety of vibrating capsules for functional constipation: a systematic review and meta-analysis of randomized controlled trials.
Chronic constipation is a challenging functional gastrointestinal disorder that remains a global burden. Pharmacologic therapy, including laxatives and dietary fibers, are suggested as lines of treatment. Recent trials introduced an orally ingested vibrating capsule (VC) as an eligible option for chronic constipation management. ⋯ VC was not effective to improve bowel movement in patients with functional constipation with no difference in response rate. However, evidence is still uncertain, with only three small RCTs that yielded heterogenous findings, mainly due to the different vibration protocols. Also, our findings suggest that VC is safe and well-tolerated, with no significant harmful effects observed. Therefore, more large-scale RCTs are needed to confirm the efficacy and safety of VC in patients with functional constipation, determining the most effective dose, frequency, and duration of treatment.
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Colonoscopy is the gold standard method for colorectal cancer screening. Looping occurs in 91% of cases undergoing colonoscopy and can cause patient discomfort, prolonged cecal intubation time (CIT), and colon perforation. This meta-analysis investigates the impact of abdominal compression devices (ACD) on colonoscopy outcomes. ⋯ ACD during colonoscopy may enhance patient comfort by reducing CIT, pain, and postural changes. Nevertheless, additional RCTs are necessary to validate these results and determine the most suitable approach to utilize ACD for colonoscopy.
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Review Meta Analysis
Meta-analysis and GRADE assessment of randomized controlled trials on the efficacy and safety of bimekizumab in psoriatic arthritis patients.
A persistent immune-mediated inflammatory disorder called psoriatic arthritis affects about 25% of persons with psoriasis. Bimekizumab, a humanized monoclonal IgG1 antibody, is a novel therapeutic approach that inhibits homodimers and heterodimers of IL-17A and IL-17F by binding to comparable locations in these molecules. Bimekizumab was the subject of a meta-analysis to assess its efficacy and safety in psoriatic arthritis patients. ⋯ In comparison to a placebo, bimekizumab treatment significantly improved joint and skin efficacy outcomes. Also, its safety results were acceptable.