Comparative efficacy and safety of anti-infective drugs for patients with mild to severe COVID-19: A systematic review and network meta-analysis of randomized controlled trials

Different anti-infecthe drugs have been proposedfor the treatment ofpatients with COVID-19. We carried out a network meta-analysis to assess their relath'e efficacy and safety. Methods: We searched relevant databases for all randomized controlled trials that reported the efficacy and or safety ofany anti-infective drugs published up to April 30, 2022 for different outcomes. We did both painvise and network meta-analysis with 95% confidence intervals using afixed-effect model. We assessed studies for quality of evidence using an extension of the standard Grading ofRecommendations, Assessment, Development and Evaluation approach considering P

Involving parents from the start: formative evaluation for a large randomised controlled trial with Botswana junior secondary school students

While HIV prevention research conducted among adolescent populations may encounter parental resistance; the active engagement of parents from inception to trial completion may alleviate opposition. In preparation for implementing a large randomised controlled trial (RCT) examining the efficacy of a behavioural intervention targeting adolescent sexual risk behaviours; a formative evaluation was undertaken to assess parental reactions to the proposed trial. Six focus groups were conducted with parents of adolescents (aged 13-17) from rural; peri-urban and urban junior secondary schools in Botswana. Focus groups explored comprehension and acceptability among parents of the forthcoming trial including HSV-2 testing; the return of results to the adolescent (not the parent); trial information materials and the parental consent process. Parents welcomed the study and understood and accepted its moral and ethical considerations. Their reactions regarding return of HSV-2 results only to adolescents (not the parent) were mixed. Parents understood the consent process and most agreed to consent; while indicating their desire to remain informed and involved throughout the RCT. The focus group discussions (FGDs) provided valuable information and insights that helped strengthen the study. As a result of parents' feedback; counselling procedures were strengthened and direct linkages to local services and care were made. Informational materials were revised to increase clarity; and materials and procedures were developed to encourage and support parental involvement and parent-child dialogue. Ultimately; parental feedback led to a decision by the Government of Botswana to allow parents to access their child's HSV-2 test results

Gamete Intrafallopian Transfer Versus Super-Ovulation with Intrauterine Insemination for the Treatment of Infertility : a Prospective Randomised Study on Pregnancy Outcome

Background. A prospective randomised controlled trial comparing gamete intrafallopian transfer (GIFT) with intrauterine insemination (IUI) was undertaken at the Fertility and Reproductive Biology Unit of the Department of Obstetrics and Gynaecology; Tygerberg Hospital; between July 1999 and June 2000. Method. Eighty-five women were included the study and were randomly allocated between the two groups after routine infertility investigations; 41 women to IUI and 44 women to GIFT. A combination of clomiphene incitrate and human menopausal gonadotropin was administered to both groups to achieve ovulation. Results. Six (13.6) of the 44 cycles in the IUI group and 24 (53.3) of the 45 cycles in the GIFT group achieved conception. The mean number of cycles needed to achieve pregnancy in IUI was 7.3 (44/6) and in GIFT was 2.05 (45/24). The ongoing pregnancy rate of GIFT was 39.7 more effective than that of IUI (p=0.0001.The total ongoing pregnancy rate of GIFT was 30.8 superior to that of IUI (p=0.0021). When 2 folli-cles were obtained in an IUI cycle; GIFT was 41.6 more effective (p=0.0024); and when more than 2 follicles were obtained; GIFT was 28.3 more effective (p=0.0265). Conclu- sions. The number of mature follicles significantly increased the chance of pregnancy with IUI. In comparing the number of cycles needed to achieve a pregnancy; 1 GIFT cycle is equivalent to more than 3 IUI cycles. It is important to note that 4 IUI cycles will give equivalent or even better results if 2 - 3 follicles are recruited per cycle. In spite of the greater efficacy of GIFT; the authors conclude that at least 3 to 4 IUI cycles should be attempted before GIFT; on the basis that it is more cost effective and less invasive