Cochrane Db Syst Rev
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Carbamazepine and valproate are drugs of first choice for epilepsy. Despite the lack of hard evidence from individual randomized controlled trials, there is strong clinical belief that valproate is the drug of choice for generalized epilepsies and carbamazepine for partial epilepsies. ⋯ We have found some evidence to support the policy of using carbamazepine as the first treatment of choice in partial epilepsies, but no evidence to support the choice of valproate in generalized epilepsies, but confidence intervals are too wide to confirm equivalence. Misclassification of patients may have confounded our results, and has important implications for the design and conduct of future trials.
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Cochrane Db Syst Rev · Jan 2000
ReviewEpidural versus non-epidural analgesia for pain relief in labour.
Epidural analgesia is effective in reducing labour pain, but the possible adverse effects are not clear. ⋯ Epidural analgesia appears to be very effective in reducing pain during labour, although there appear to be some potentially adverse effects. Further research is needed to investigate adverse effects and to evaluate the different techniques used in epidural analgesia.
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Cochrane Db Syst Rev · Jan 2000
ReviewFetal electrocardiogram plus heart rate recording for fetal monitoring during labour.
It is thought that adding fetal electrocardiography (ECG) to cardiotocography (CTG) alone may provide better information about fetal heart activity. ⋯ Analysis of the fetal electrocardiographic waveform during labour may be associated with reduced obstetric intervention without jeopardising fetal outcome.
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Cochrane Db Syst Rev · Jan 2000
ReviewExpanding the roles of outpatient pharmacists: effects on health services utilisation, costs, and patient outcomes.
In recent years pharmacists' roles have expanded from packaging and dispensing medications to working with other health care professionals and the public. ⋯ Only two studies compared pharmacist services with other health professional services. Both had some bias and did not allow us to draw conclusions about comparisons 1 and 3. The other studies supported the expanded roles of pharmacists in patient counselling and physician education. However, doubts about the generalisability of the studies, the poorly defined interventions, and the lack of cost assessments and patient outcome data, indicate that more rigorous research is needed to document the effects of outpatient pharmacist interventions.
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When pregnant women near term lie in the supine position the uterus can compress the inferior vena cava, interfering with venous return to the heart. This can result in hypotension, reduced placental perfusion and decreased fetal oxygenation. ⋯ There is not enough evidence from these trials to evaluate use of lateral tilt during caesarean section.