OBJECTIVE: To assess the effectiveness of cervical pessary in the prevention of preterm births in multiple pregnancies with a short cervix (<25 mm).
SEARCH STRATEGY: Major databases from 2006 to 20th November 2016 were searched for relevant terms.
SELECTION CRITERIA: We included randomized controlled trials that assessed the effectiveness of cervical pessary on pregnancy outcomes in multiple pregnancies with a short cervix.
DATA COLLECTION AND ANALYSIS: Risk ratio was used as the summary measure with random effects model. We assessed heterogeneity between studies using the I2 index. Quality assessment was done based on Cochrane Handbook Method.
MAIN RESULTS: Pooled data showed no benefit of using cervical pessary in the prevention of preterm births, birth weights less than 1500 g, less than 2500 g, adverse neonatal events and fetal/neonatal deaths in twin pregnancies with a short cervix.
CONCLUSION: We are unable to show benefit of using cervical pessary in preventing preterm births in twin pregnancies with a short cervix. However, as cervical pessary is a reasonable intervention, there is a need for more randomized controlled trials in this area.
Methods: This is a cross-sectional study conducted among fourth year medical students (n=92) during their seven week postings in Obstetrics and Gynaecology. Five sets of online formative assessments in the format of one best answers (OBA), Objective structured practical examination (OSPE) and Short answer question (SAQ) with feedback were delivered over five weeks through the online portal. The mean scores of the end of posting summative exam (EOP) of those who participated in the assessments (OFA users) and of those who did not (non-OFA users) were compared, using Students t test. The frequency of tool usage was analysed and satisfaction surveys were utilized at the end of the course by survey questionnaire using the five point Likert scale.
Results: The mean scores of the students in end of posting summative examination marks for students who had participated in the online formative assessment (OFA users) and for those who had not (non OFA users) showed no significant difference in all the three components OBA, SAQ and OSPE (p=0.902, 0.633, 0.248). Majority of the students perceived that OFAs fulfilled the stated aims and objectives and so they would persuade their peers to participate in the OFAs.
Conclusions: Online formative assessments are perceived as tools that promote self-directed learning, improved knowledge and tailor learning for individual learning needs and style.
Methods: A systematic literature search was done in health-related electronic databases. The search was limited to studies published in English until September 2017. We also checked the references of retrieved articles and relevant reviews for any additional studies. The methodological quality of the studies included in this review was assessed using the 'Scales for Quality Assessment'. The I2 test was used to quantify between-study heterogeneity. A value of I2 > 50% indicated substantial heterogeneity. For the pooled analysis, summary odds ratio (OR) and its 95% confidence interval (CI) in random effect model were used.
Results: Eight case-control studies (1192 cases with diabetic nephropathy and 2399 controls) met the inclusion criteria. Three groups of people namely Africans, Asians and Caucasians were included in this review. There were significant protective effects of SNP -819 C/T in overall population (OR 0.32, 95% CI 0.26-0.4) and - 1082 A/G SNP in the Asian population (OR 0.64, 95% CI 0.47-0.86) on diabetic nephropathy in the recessive model. There was no significant effect of -592 A/C on diabetic nephropathy.
Conclusion: The findings suggest the protective effects of -1082A/G and -819G/A polymorphisms on the risk of developing diabetic nephropathy in type 2 diabetes mellitus, especially in the Asian population. Well- designed, prospective studies with sufficient number of participants are recommended to substantiate these findings.
METHOD: A systematic search was conducted employing PubMed, Cochrane and ScienceDirect from inception until May 2021. The quality of four CPGs were evaluated by two appraisers independently using the AGREE II checklist.
RESULTS: Four international CPGs that fulfilled the criteria were included in this review; all scored over 50% according to the AGREE II tool. Applying a modified categorisation standard, CPGs were considered as either 'recommended' or 'recommended with modifications'.
DISCUSSION: The synthesis of all four CPGs suggested similar management strategies for HG, with minor differences. Medical practitioners could use the guiding principles of management on the basis of the needs of individual patients.