PubMed Health

Ovarian hyperstimulation syndrome (OHSS) occurs as a result of ovulation induction in assisted reproduction technology (ART) treatment. In most cases the condition is mild, but some women get a moderate or severe form of OHSS. The symptoms range from abdominal bloating and a feeling of fullness to shortness of breath and severe abdominal discomfort. Despite measures adopted by physicians to prevent OHSS, these measures are purely preventative as there is no cure for OHSS other than awaiting spontaneous resolution and providing supportive measures. A dopamine agonist cabergoline has been introduced to try and reduce the risk of OHSS. This review included two trials with moderate risk of bias (involving 230 women) and found evidence that an oral dose of 0.5 mg cabergoline daily may reduce the risk of OHSS in high‐risk women, especially moderate OHSS. It had no influence on the pregnancy outcome.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Fungal keratitis (fungal infection of the cornea) occurs rarely in higher income countries but is relatively common in lower income countries. If left untreated the cornea may perforate and may lead to blindness. Although there are a number of medications available, it is not clear which is the most effective and cost‐effective. This review identified nine randomised controlled trials with 568 participants using different combinations of antifungal drugs. The trials were mainly conducted in India; they were small and of variable quality. Although there were some observed differences, these could have occurred by chance; none of the studies were large enough to determine conclusively which agents work best. Further trials with a larger sample size are required in order to answer this important question.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

The common cold is probably the most common illness known and usually presents with a range of symptoms such as sore throat, nasal stuffiness and discharge, sneezing and cough. On average, young children have six to eight colds per year and adults have two to four. It is caused by viruses (more than 200 viruses have been implicated) and is generally not a serious condition which usually resolves by itself within one to two weeks. However, the common cold has a large impact on time lost from work or school and causes substantial discomfort.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

In areas where malaria is common, younger children have repeated episodes of malarial illness, which can sometimes be severe and life‐threatening. In areas where malaria is seasonal, a practical policy option is to give drugs to prevent malaria at regular intervals during the transmission season, regardless of wether the child has malaria symptoms or not. This is known as Intermittent Preventive Treatment (IPTc).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Congenital (present from birth) choanal atresia is a rare abnormality characterized by narrowing or blockage of one or both sides of the nasal airway. It has an incidence of between 1 in 5000 and 1 in 8000 births and is two times more common in females. Choanal atresia is treated by surgery, which aims to open the nasal airway sufficiently, avoid harm to any structure in development and result in a low rate of restenosis (renarrowing) after the operation. The procedure should ideally enable the shortest possible surgery and hospitalization time, and minimize morbidity and mortality. Many different techniques and approaches have been described.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Sumatriptan is one of the triptan family of drugs used to treat migraine attacks. It is widely available as an oral tablet. This review found that a single dose was effective in relieving migraine headache pain and associated symptoms of nausea, sensitivity to light, and sensitivity to sound. Pain was reduced from moderate or severe to no pain by two hours in about 3 in 10 people (32%) taking sumatriptan 100 mg, compared with about 1 in 10 (11%) taking placebo. Pain was reduced from moderate or severe to no worse than mild pain by two hours in 6 in 10 people (61%) taking sumatriptan 100 mg, compared with about 3 in 10 (32%) taking placebo. Almost a quarter (24%) of people taking sumatriptan 100 mg had freedom from pain at two hours which was sustained during 24 hours without the use of rescue medication, compared with fewer than 1 in 10 (8%) taking placebo. In addition to relieving headache pain, sumatriptan also relieved symptoms of nausea and sensitivity to light and sound by two hours in about half of those who took it, compared with about one‐third of those taking placebo. Adverse events were mostly of short duration and mild or moderate in severity, and were experienced by about 4 in 10 (43%) of people taking sumatriptan 100 mg, and by 2 in 10 (23%) taking placebo. The 50 mg dose had slightly lower efficacy, but was associated with fewer adverse events. Treating attacks while pain was still mild was more effective than treating established attacks with moderate or severe pain intensity.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Inhalation of a strong, sterile, salt water solution (known as hypertonic saline) through a nebuliser improves the physical properties of sputum and stimulates cough in people with cystic fibrosis. Regular inhalation improves the clinical outcomes of people with cystic fibrosis. It is not certain whether it is better to inhale hypertonic saline before or after clearing the airways with physical techniques, nor whether it is better to inhale it in the morning or in the evening. We looked for trials that compared these different timing regimens, but were unable to find any such trials. In the absence of this evidence, people with cystic fibrosis might be advised to inhale hypertonic saline before airway clearance, because this is the only timing regimen with established efficacy. Because the long‐term efficacy of hypertonic saline has only been established for twice‐daily inhalations, clinicians should advise patients to inhale hypertonic saline both in the morning and in the evening. However, if only one dose per day is tolerated, the time of day at which it is inhaled could be based on convenience or tolerability until further evidence is available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Kidney stones are most commonly formed from masses of crystals and protein. Movement of stones from the kidney through the urinary tract is a common cause of urinary tract obstruction in adults and can cause severe pain (colic). This review aimed to determine if increased fluids and diuretics or both could hasten the passage of stones and improve symptoms. Neither our initial review nor this subsequent update identified sufficient evidence to enable conclusions to be determined about the safety and effectiveness of increasing fluids or diuretics or both to treat people with acute ureteric colic. More and larger randomised controlled studies are required.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Glaucoma is a leading cause of irreversible blindness in the world. Angle‐closure glaucoma describes one of the mechanisms which leads to glaucoma. In angle‐closure, the "angles" that act as drains for the aqueous in the eye are closed which leads to high eye ball pressure. Treatment is aimed at opening the drainage system and lowering the pressure in the eye with medical or surgical treatment or both. Laser peripheral iridoplasty is used in patients with angle‐closure when other treatments fail to open the anterior drainage system. It works by shrinking and pulling the peripheral iris tissue away from the trabecular meshwork (angles). Although one randomised controlled trial with 158 participants was found, due to its limitations and the lack of a statistically significant difference observed with laser peripheral iridoplasty intervention, this review found no strong evidence for the use of laser peripheral iridoplasty in the treatment of angle‐closure in the non‐acute setting.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Vitamin D is produced by the human body from exposure to sunlight and can also be consumed from foods such as fish‐liver oils, fatty fish, mushrooms, egg yolks, and liver. Vitamin D has many functions in the body; it helps maintain bone integrity and calcium homeostasis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Delayed onset muscle soreness commonly results after sports and exercise activity. Cold‐water immersion (CWI), which involves people immersing themselves in water at temperatures of less than 15°C, is sometimes used to manage muscle soreness after exercise and to speed up recovery time.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Cystic fibrosis is a serious genetic disorder which affects the lungs and the exocrine glands (sweat glands and others). Most people with cystic fibrosis develop persistent lung infections and they may receive frequent courses of intravenous antibiotics. Once‐a‐day doses reduce the cost and the time involved in giving the antibiotics, compared to several dose per day. This review includes four trials with a total of 328 people. All trials compared once‐a‐day dosing with three times‐a‐day dosing. The review found that giving the antibiotics once per day was just as good at treating lung infections in people with cystic fibrosis as the alternative treatment. The review found that giving the antibiotics once per day was just as good at treating lung infections in people with cystic fibrosis as the alternative treatment, though once daily appears less toxic to the kidneys in children. There were no differences between treatments for other outcomes. While once‐daily treatment can be just as effective and more convenient than three‐times daily treatment, we recommend further studies to look at the long‐term safety of this treatment regimen.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Atrophic rhinitis is a chronic nasal condition with unknown cause. It is characterised by the formation of thick dry crusts in a roomy nasal cavity, which has resulted from progressive wasting away or decrease in size (atrophy) of the mucous nasal lining (mucosa) and underlying bone. The various symptoms include foetor (strong offensive smell), crusting/nasal obstruction, nosebleeds, anosmia (loss of smell) or cacosmia (hallucination of disagreeable odour), secondary infection, maggot infestation, nasal deformity, pharyngitis, otitis media and even, rarely, extension into the brain and its membranes. Atrophic rhinitis can be classed as primary or, where it is a consequence of another condition or event, secondary. Its prevalence varies in different regions of the world but it is common in tropical countries. A wide variety of treatments have been described in the literature, however treatment is usually conservative (for example, nasal irrigation and douches; nose drops (e.g. glucose‐glycerine, liquid paraffin); antibiotics and antimicrobials; vasodilators (drugs that cause dilation of blood vessels) and prostheses). Surgical treatment aims to decrease the size of the nasal cavities, promote regeneration of normal mucosa, increase lubrication of dry nasal mucosa and improve the vascularity (blood flow) of the nasal cavities.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Rotavirus infection is one of the most common causes of diarrhoea in infants and young children, and the symptoms can range from mild illness, to hospitalization, and death. Rotavirus infections cause about half a million deaths per year in children younger than five years, mainly in low‐ and middle‐income countries. Since 2009, the World Health Organization (WHO) has recommended rotavirus vaccine be included in all national immunization programmes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Chronic heart failure (CHF) (also called congestive heart failure, cardiac and heart failure) is a disorder in which the heart loses its ability to pump blood efficiently throughout the body. The oxygen and nutrients in the blood provide the body with the energy it needs to operate efficiently. CHF causes breathlessness and fatigue because the heart cannot function as it should. Heart failure may affect the left, right, or both sides of the heart. If the left half of the heart fails, fluid will build up in the lungs due to congestion of the veins of the lungs. If the left half of the heart fails, general body vein pressure will increase and fluid will accumulate in the body, especially the tissues of the legs and abdominal organs. Often left heart failure leads to right heart failure causing biventricular failure. Fluid may build up in the lungs and legs. Coronary artery disease, a heart attack, or high blood pressure are some of the causes of heart failure. Drug treatments include digitalis, angiotensin‐converting enzyme (ACE) inhibitors, beta‐blockers and diuretics. Diuretics are important as they relieve symptoms quickly and control fluid retention. Some of the diuretics used are furosemide, bumetanide and chlorothiazide. The available data from several small controlled trials show that in patients with CHF, conventional diuretics appear to reduce the risk of death and worsening heart failure when compared to an inactive sugar pill (placebo). About 80 deaths may be avoided for every 1000 people treated. Diuretics also increase the ability to exercise, by about 28% to 33% more than with other active drugs. These conclusions were based on 14 controlled trials (525 people), of which three trials noted deaths in 202 people randomised to receive either diuretic or placebo, and two trials, a total of 169 people, looked at hospitalisation for worsening heart failure. Of the seven trials comparing diuretic treatment with another drug, the effects on exercise were studied in four trials where 91 people were randomised to receive either a diuretic or an ACE inhibitor or digoxin. Most of the trials had small numbers and lasted from 4 to 24 weeks, a short time for a chronic disease. The age of the participants was 59 years, which is relatively young, and the use of diuretic drug was not standardised across the studies. More research would be needed to further confirm the long term benefits of diuretic treatment for CHF patients because these studies were small.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Diabetes mellitus, a condition which leads to high blood glucose concentrations, is a common condition with around 2.8 million people affected in the UK (approximately 4.3% of the population). Wound dressings are widely used to treat foot ulcers in people with diabetes. There are many types of dressings that can be used, which also vary considerably in cost. This review (six studies involving a total of 375 participants) identified no research evidence to suggest that alginate wound dressings are more effective in healing diabetic foot ulcers than other types of dressing. More, better quality research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Sweet potato (Ipomoea batatas) is a plant found in the tropical and subtropical belts and is one of the most nutritious tropical and subtropical vegetables. Besides its popularity in the cuisines of countries in Asia‐Pacific, Africa and North America, sweet potato is also used in traditional medicine practices for the treatment of diabetes mellitus. However, the current evidence does not warrant using the plant in treating this disease. This review of randomised controlled trials found only three studies of altogether very low quality evaluating the effects of sweet potato for type 2 diabetes mellitus. Two studies with 122 participants showed improved long‐term metabolic control as measured by glycosylated haemoglobin A1c (HbA1c): At three to five months 4 g per day sweet potato preparations compared to placebo resulted in a ‐0.3% decrease of HbA1c which was statistically significant but not clinically relevant. The duration of treatment ranged from six weeks to five months and altogether 140 patients with type 2 diabetes mellitus participated in the studies. No study investigated diabetic complications, death from any cause, health‐related quality of life, well‐being, functional outcomes or costs. Adverse effects were mostly mild, including abdominal distension and pain. There are many varieties of sweet potato vegetables and preparations. More trials are needed to assess the quality of the various sweet potato preparations as well as to evaluate further the use of varieties of sweet potato in the diet of diabetic people.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Cancer patients are more likely than patients without cancer to develop blood clots in their veins (venous thromboembolism), either in the lungs (pulmonary embolism) or the deep venous system (deep vein thrombosis or DVT). Chemotherapy further increases this risk. Yet bleeding at the site of the cancer and a relative decrease in number of platelets in the blood (thrombocytopenia) caused by the chemotherapy may make cancer patients more likely to have bleeding complications with blood thinning agents. This systematic review looked at the effectiveness and safety of blood thinning agents (anticoagulants) when used to prevent blood clots in cancer patients receiving chemotherapy. Nine randomised controlled studies with a total of 3538 patients investigated the prevention of blood clots in patients without a history of blood clots. The use of low molecular weight heparin was associated with a reduction in blood clots (the number needed‐to‐treat to prevent a symptomatic blood clot was 60) without any clear benefit in survival as the number of major bleeding events was increased, although this was not statistically significant and further study is needed. The findings from two studies of the vitamin K antagonist warfarin, one comparing warfarin with low molecular weight heparin in patients with myeloma, were too limited to support a beneficial effect of warfarin in the prevention of blood clots in cancer patients. Antithrombin was evaluated in one study in children and had no significant effect on blood clots or major bleeding when compared with an inactive control.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Incisional hernias are caused by the failure of the wall of the abdomen to close after abdominal surgery. This leaves a hole through which the viscera (guts) protrude. Hernias are repaired with further surgery, during which the insertion of a drain to remove excess fluid is common practice. It is not known whether or not these drains help the wounds to heal. Drains may produce undesired results such as an increased risk of infection, pain, and an increased length of hospital stay after surgery. We reviewed all the available trial evidence to see whether drains help or hinder recovery after operations for incisional hernia repair. We found that no trials that compared people who had drains inserted for this type of surgery against those who did not. One trial compared two types of drain against each other, and both models of drain performed similarly well. Further trials need to be carried out before being able to answer the question about the benefits, or otherwise, of drains inserted during repair of incisional hernias.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Stress incontinence is losing urine when coughing, laughing, sneezing or exercising. Usually muscles and tissue form a cushion supporting the base of the bladder and closing the urethra (the passage through which urine leaves the body). If they do not, artificial cushioning can be created by injecting bulking agents into the area around the urethra. The review of 14 trials, which included 2004 women, found some limited evidence that this can relieve stress incontinence in women. Other treatments such as surgery might be better. Using the women's own fat tissue as the agent injected can cause serious complications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.