Review-Vitamin D and the prevention of preeclampsia: A systematic review.

To identify the effect of Vitamin D in reducing the risk of preeclampsia in pregnant women. The review was conducted from December 2011 to March 2012 at the University of Sheffield. Studies were included from the Medline data base, Web of Science (Web of Knowledge), Ovid database and Google Scholar. Studies were limited to published literature only; published between January 1992 to March 2012. A total of seven studies were selected for this review based on the inclusion criteria. One was non-randomized clinical trial, three were cohort studies and three were nested case-control studies. The clinical trial showed a positive association between Vitamin D supplements and the reduction of preeclampsia risk in pregnant women. In addition, one large cohort and two nested case-control studies also showed a protective effect of vitamin D in preventing the risk of preeclampsia. However, the other two cohort studies and a nested case-control study could not find any association between vitamin D levels and the risk of preeclampsia in pregnant women. The studies included in this review show conflicting results about the association of vitamin D levels and the risk of preeclampsia. However, in this review more than half of the studies showed a positive link between Vitamin D deficiencies and Preeclampsia. There is a clear need for further trials and other robust studies to identify the effect of Vitamin D on preeclampsia.

Effectiveness of topical corticosteroids in addition to antiviral therapy in the management of recurrent herpes labialis: a systematic review and meta-analysis.

BACKGROUND: Recurrent herpes labialis (RHL) is one of the most common viral infections worldwide. The available treatments have limited efficacy in preventing the recurrence of ulcerative lesions and reducing the duration of illness. The objective of this review was to identify the effectiveness of topical corticosteroids in addition to antiviral therapy in the treatment of RHL infection. METHODS: A systematic review of randomized clinical trials comparing the efficacy of combined therapy (topical corticosteroids with antiviral) with placebo or antiviral alone in the management of RHL was conducted. MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane library, and Google Scholar databases were searched. We used RevMan software to conduct the meta-analysis. A fixed-effects model was used for mild to moderate heterogeneity, whereas a random-effects model was used for significant heterogeneity. Heterogeneity among trials was established using I(2) and chi-square test for heterogeneity. RESULTS: Four studies that fulfilled the selection criteria were included in this review. The total number of participants across included studies was 1,891 (range, 29 to 1,443). The antiviral drugs used were acyclovir, famciclovir, and valacyclovir. Corticosteroids used were 1% hydrocortisone and 0.05% fluocinonide. Pooled results showed that patients receiving combined therapy had a significantly lower recurrence rate of ulcerative lesions compared to those in both the placebo group (OR, 0.50; 95% CI, 0.39-0.66; P < .001) and the antiviral treatment alone group (OR, 0.73, 95% CI, 0.58-0.92; P = .007). The healing time was also significantly shorter in combined therapy in comparison to placebo (P < .001). However, there were no significant differences in healing time between combined therapy and antiviral alone. The adverse reactions in combined therapy were not significantly different than the placebo group (OR, 1.09; 95% C, 0.75-1.59; P = .85). CONCLUSION: Treatment with combined therapy is safe and more effective than placebo or antiviral alone for preventing the recurrence of ulcerative lesions in RHL infection.