Evaluation of efficacy of aloe vera in the treatment of oral submucous fibrosis – a clinical study Effectiveness of Aloe Vera and Antioxidant along with Physiotherapy in the Management of Oral Submucous Fibrosis. Efficacy of aloe vera gel as an adjuvant treatment of oral submucous fibrosis. Comparative Efficacy of Aloe vera and Benzydamine Mouthwashes on Radiation-induced Oral Mucositis: A Triple-blind, Randomised, Controlled Clinical Trial. Phase II double-blind randomized study comparing oral aloe vera versus placebo to prevent radiation-related mucositis in patients with head-and-neck neoplasms. Evaluation of severity scoring systems in ICUs—translation, conversion and definition ambiguities as a source of inter-observer variability in Apache II, SAPS and OSF Preliminary Antiplaque Efficacy of Aloe Vera Mouthwash on 4 Day Plaque Re-Growth Model: Randomized Control Trial A Phase III Study on the Efficacy of Topical Aloe Vera Gel on Irradiated Breast Tissue Psychological interventions for pediatric chronic pain – The good news and the challenges ahead Effects of Aloe vera cream on posthemorrhoidectomy pain and wound healing: results of a randomized, blind, placebo-control study. Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Randomized, double‐blind, placebo‐controlled trial of oral aloe vera gel for active ulcerative colitis Treatment of surgical patients is evidence-based. Efficacy of vitamin D supplementation in depression in adults: a systematic review protocol Clinical and microbiologic effects of commercially available dentifrice containing aloe vera: a randomized controlled clinical trial. The effect of aloe vera gel/mild soap versus mild soap alone in preventing skin reactions in patients undergoing radiation therapy. Colon Microflora in Infants Fed Formula with Galacto- and Fructo-Oligosaccharides: More Like Breast-Fed Infants The Importance of Sample Size for Reproducibility of tDCS Effects Osteotome sinus floor elevation with and without grafting material in the severely atrophic maxilla. A 1-year prospective randomized controlled study. Prospective, randomized, double-blind, clinical evaluation of Aloe vera Barbadensis, applied in combination with a tongue protector to treat burning mouth syndrome. UK clinical guideline for the prevention and treatment of osteoporosis Clinicobiochemical evaluation of turmeric with black pepper and nigella sativa in management of oral submucous fibrosis-a double-blind, randomized preliminary study. Effect of Aloe vera topical gel combined with tretinoin in treatment of mild and moderate acne vulgaris: a randomized, double-blind, prospective trial
BACKGROUND Oral submucous fibrosis is a chronic disease , treatment of which has largely been symptomatic . Aloe vera has immunomodulatory , anti-inflammatory , wound healing , antioxidant , and antineoplastic activities . All such properties of aloe vera suggest the possibility of its use in the management of oral submucous fibrosis . METHODS Seventy-four patients of oral submucous fibrosis were r and omly divided into 2 groups . Group A patients were treated with systemic ( juice ) and topical aloe vera ( gel ) for 3 months . Group B patients were treated with intralesional injection of hydrocortisone and hyaluronidase for 6 weeks with antioxidant supplements for 3 months . Patients were assessed for reduction in burning sensation and increase in mouth opening , cheek flexibility , and tongue protrusion at an interval of 1 , 2 , and 3 months . RESULTS Both the groups showed statistically significant improvements in all the study parameters at the end of study period ( P < 0.001 ) . The clinical response to aloe vera was comparable to that of intralesional injections of hydrocortisone and hyaluronidase with antioxidant supplementation . CONCLUSION The study concludes that aloe vera can be an alternative , safe , and effective treatment regime in the management of oral submucous fibrosis . Long-term follow-up studies with larger sample size are recommended BACKGROUND Oral submucous fibrosis ( OSMF ) is a well-established precancerous condition affecting the oral mucosa . It is a disease that causes significant morbidity ( in terms of loss of mouth function as tissues become rigid and mouth opening becomes difficult ) and mortality ( when transformation into squamous cell carcinoma occurs ) . AIM The aim of the study is to compare the efficacy of Aloe vera with antioxidant when given along with physiotherapy in the management of OSMF . MATERIAL S AND METHODS Forty patients presenting with clinical signs and symptoms of OSMF were included for the study after informed consent . Group A included 20 patients who received Aloe vera gel ( forever living gel ) along with physiotherapy . Group B included 20 patients who received antioxidant capsules twice daily for 3 months along with physiotherapy exercises four times in a day . The following parameters , that is , burning sensation , mouth opening , tongue protrusion and cheek flexibility were recorded at each visit . RESULTS Majority of the participant enrolled were in the age range of 30 to 35 years . Improvement in all the parameters was seen with the individuals receiving Aloe vera gel in comparison to antioxidants . CONCLUSION So , Aloe vera being a soothing , simple and safe mode of treatment along with proper habit restriction can be considered to be an effectual protocol in the management of OSMF . The analgesic effects of Aloe vera with the physiotherapy exercises provide better results in reducing burning sensation and improving mouth opening , tongue protrusion and cheek flexibility in comparison to antioxidants OBJECTIVE Definitive therapy is not defined for the management of oral submucous fibrosis ( OSMF ) . This study evaluated the efficacy of aloe vera gel as an adjuvant treatment of OSMF . STUDY DESIGN A double-blind , placebo-controlled , parallel-group r and omized controlled trial was conducted on 60 subjects with OSMF divided into medicinal treatment ( submucosal injection of hyaluronidase and dexamethasone , n = 30 ) and surgical treatment ( n = 30 ) categories . Each category was r and omly divided into groups A ( with aloe vera , n = 15 per category ) and B ( without aloe vera , n = 15 per category ) . Follow-up assessment for various symptoms was performed , and results were analyzed using paired and unpaired Student t tests . RESULTS The group receiving aloe vera had a significant improvement in most symptoms of OSMF ( P < .01 ) compared with the non-aloe vera group , in both the medicinal and surgical categories . CONCLUSIONS Aloe vera gel was effective as an adjuvant in treatment of OSMF PURPOSE To compare the efficacy of an Aloe vera mouthwash with a benzydamine mouthwash in the alleviation of radiation- induced mucositis in head and neck cancer patients using a triple-blind , r and omised controlled trial . MATERIAL S AND METHODS Twenty-six eligible head and neck cancer patients who were to receive conventional radiation therapy at the radiation oncology department were r and omised to receive an Aloe vera mouthwash or a benzydamine mouthwash .  Mucositis severity was assessed during the course of radiation therapy using the WHO grading system . RESULTS At baseline , there was no difference in the distribution of mucositis severity between the two groups . The mean interval between radiation therapy and onset of mucositis was similar for both groups ( Aloe vera 15.69±7.77 days , benzydamine 15.85±12.96 days ) . The mean interval between the start of radiation therapy and the maximum severity of mucositis were was also similar in both the Aloe vera and benzydamine groups ( Aloe vera 23.38±10.75 days , benzydamine 23.54±15.45 days ) . Mean changes of mucositis severity over time in both groups were statistically similar and the effect of both treatments did not change signficantly with time ( p=0.09 ) . CONCLUSION Aloe vera mouthwash was as beneficial as benzydamine mouthwash in alleviating the severity of radiation-induced mucositis and showed no side effects .  The Aloe vera mouthwash could be an alternative agent in the treatment of radiation-induced mucositis in patients with head and neck cancers PURPOSE In a single-institution , double-blind , prospect i ve , r and omized trial , we determined whether oral aloe vera gel can reduce radiation-induced mucositis in head- and -neck cancer patients . METHODS AND MATERIAL S We r and omized 58 head- and -neck cancer patients between oral aloe vera and placebo .  To be included in this Phase II protocol , patients had to be treated with radiotherapy with curative intent at Stanford University between February 1999 and March 2002 . We examined patients biweekly for mucositis at 15 head- and -neck subsites and administered quality -of-life question naires . RESULTS Patients in the aloe and placebo groups were statistically identical in baseline characteristics . By the end of treatment , the two groups were also statistically identical in maximal grade of toxicity , duration of Grade 2 or worse mucositis , quality -of-life scores , percentage of weight loss , use of pain medications , hydration requirement , oral infections , and prolonged radiation breaks . CONCLUSION In our r and omized study , oral aloe vera was not a beneficial adjunct to head- and -neck radiotherapy . The mean quality -of-life scores were greater in the aloe vera group , but the differences were not statistically significant . Oral aloe vera did not improve tolerance to head- and -neck radiotherapy , decrease mucositis , reduce soreness , or otherwise improve patient well-being Objective To explore translation , conversion and definition ambiguities , when using severity scoring systems in patients admitted to intensive care units ( ICUs ) . Design A prospect i ve study of the prognosis of acute renal failure in ICUs . Setting The study was conducted in 20 French ICUs . Patients 360 patients presenting with severe acute renal failure were studied during their ICU stay . Measurements and results The inter-observer variability of Apache II ( acute physiology and chronic health evaluation ) , SAPS ( simplified acute physiology score ) , and OSF ( organ-system failure ) was considered . For Apache II , we explored the uncertainty of measurements arising from conversion into SI units , the rounding procedures used for the non-inclusive intervals defined for quatitative parameters such as age , mean arterial pressure ( MAP ) or serum creatinite , the absence of definition of acute renal failure ( ARF ) and its consequence on doubling serum creatinine values , and the absence of guidelines in the case of spontaneous ventilation when arterial blood gases ( ABG ) and forced inspiratory oxygen ( FIO2 ) were not measured . The result ing variability was evaluated , calculating the lowest and the highest value of the scoring system for each patient . The mean difference by patient was greater than 1.5 ( p<0.0001 ) . Other examples were presented and discussed for SAPS and OSF . Conclusions Translation , conversion and definition ambiguities are a source of inter-observer variability and increase the risk of classification and /or selection biases . This gives rise to particular concern in the design and analysis of multicenter trials or meta- analysis , and improvement of these scoring systems should be envisaged in the future Background Due to increasing resistance to antibiotics and rising incidence of oral diseases , there is a need for alternative treatment modalities to combat oral diseases . The aim of the present study was to access the effect of Aloe vera mouthwash on the dental plaque in the experimental period of 4 days and to compare it with the bench mark control chlorhexidine and placebo ( saline water ) . Material and Methods A total of 300 systemically healthy subjects were r and omly allocated into 3 groups : Aloe vera mouthwash group ( n=100 ) , control group (=100)-chlorhexidene group and saline water-Placebo ( n=100 ) . To begin with , Gingival index ( GI ) and plaque index ( PI ) were recorded . Then , baseline plaque scores were brought to zero by professionally cleaning the teeth with scaling and polishing . After r and omization of the participants into three groups they were refrained from regular mechanical oral hygiene measures . Subjects were asked to swish with respective mouthwash ( Aloe vera mouthwash , 0.2%chlorhexidine gluconate mouthwash , or normal saline ) as per therapeutic dose for 4 days . Results The results showed that Aloe vera mouthrinse is equally effective in reducing plaque as Chlorhexidine compared to placebo over a period of 4 days . There was a significant reduction on plaque in Aloe vera and chlorhexidine groups and no statistically significant difference was observed among them ( p>0.05 ) . Aloe vera mouthwash showed no side effects . Conclusion The results of the present study indicated that Aloe vera may prove an effective mouthwash due to its ability in reducing dental plaque The aim of the study was to see if topical aloe vera gel would be beneficial in reducing the identified skin side-effects of radiation therapy , including erythema , pain , itching , dry desquamation , and moist desquamation , when compared with aqueous cream . The secondary aim was to assess the effect of other factors known to predict severity of radiation skin reaction , ie , breast size , smoking habit , and one or more drainages of lymphocele after surgery , on other skin side effects . A Phase III study was conducted involving 225 patients with breast cancer after lumpectomy or partial mastectomy , who required a course of radiation therapy using tangential fields . Patients were r and omized to either topical aloe vera gel or topical aqueous cream to be applied 3 times per day throughout and for 2 weeks after completion of radiation treatment . Weekly skin assessment s were performed by nursing staff . Aqueous cream was significantly better than aloe vera gel in reducing dry desquamation and pain related to treatment . Subjects with D cup or larger size breasts experienced significantly more erythema , regardless of treatment arm . For subjects who had undergone lymphocele drainage , the aloe vera group experienced significantly more pain than the aqueous cream group . Within the aqueous cream arm , smokers were significantly more likely to experience itching within the treatment field than were nonsmokers . Within the aloe vera arm , subjects who had undergone one or more lymphocele drainages after surgery were significantly more likely to experience erythema and itching within the treatment field than those who did not have drainage . In this study , aloe vera gel did not significantly reduce radiation-induced skin side effects .  Aqueous cream was useful in reducing dry desquamation and pain related to radiation therapy In a 2002 systematic review of pediatric clinical trials Eccleston et al. [ 1 ] found that psychological therapies had a significant effect on pain reduction . Although that review sought to include all pain conditions , the available studies at the time focused almost exclusively on treatment of pediatric headache . In recent years , r and omized clinical trials ( RCTs ) have been published on other pediatric pain conditions , including abdominal pain and fibromyalgia . In addition , effects of psychological therapies on clinical outcomes beyond pain reduction , such as functional disability and emotional distress were examined . In this issue of Pain , Palermo et al. [ 4 ] present a timely meta-analytic review paper that reflects on these new developments OBJECTIVE Aloe vera is an herbal medicine , which has wound healing effects in burn injury . This study assessed the effects of Aloe vera cream in reducing  postoperative pain , postdefection pain  , and its promotion of wound healing after open hemorrhoidectomy . DESIGN A prospect i ve , r and omized , double-blind , placebo-controlled trial was conducted comparing the effects of a cream containing Aloe vera versus a placebo cream on  posthemorrhoidectomy pain .  The study preparations were applied by patients to the surgical site 3 times per day for 4 weeks after hemorrhoidectomy .  Pain was assessed with a visual analog scale immediately postoperatively and at hours 12 , 24 , and 48 after surgery and at weeks 2 and 4 . Wound healing was examined and evaluated at the end of 2 and 4 weeks . The use of analgesics was recorded . RESULTS Forty-nine ( 49 ) patients were r and omly assigned to receive aloe ( n = 24 ) or placebo ( n = 25 ) . Patients in the topical aloe cream group had significantly less postoperative pain at hours 12 , 24 , and 48 hours and at 2 weeks . Aloe cream reduced the pain after defecation in 24 and 48 hours postsurgery ( p < 0.001 ) . Wound healing at the end of the second postoperative week was significantly greater in the aloe group compared with the placebo group ( p < 0.001 ) . Patients required fewer additional analgesics posthemorrhoidectomy ( p < 0.001 ) . CONCLUSIONS Application of Aloe vera cream on the surgical site is effective in reducing postoperative pain both on resting and during defecation , healing time , and analgesic requirements in the patients compared with the placebo group PURPOSE Considerable pilot data and clinical experience suggested that an aloe vera gel might help to prevent radiation therapy-induced dermatitis . METHODS AND MATERIAL S Two Phase III r and omized trials were conducted . The first one was double blinded , utilized a placebo gel , and involved 194 women receiving breast or chest wall irradiation . The second trial r and omized 108 such patients to aloe vera gel vs. no treatment .  Skin dermatitis was scored weekly during both trials both by patients and by health care providers . RESULTS Skin dermatitis scores were virtually identical on both treatment arms during both of the trials . The only toxicity from the gel was rare contact dermatitis . CONCLUSIONS This dose and schedule of an aloe vera gel does not protect against radiation therapy-induced dermatitis Background : The herbal preparation , aloe vera , has been cl aim ed to have anti‐inflammatory effects and , despite a lack of evidence of its therapeutic efficacy , is widely used by patients with inflammatory bowel disease OBJECTIVES To assess the type of evidence that supported our management of surgical patients . DESIGN Retrospective audit . SETTING Teaching hospital , Republic of Irel and . PATIENTS All 222 patients admitted by two surgical teams during one month . Patients admitted for diagnostic procedures were included if they were treated as a result . MAIN OUTCOME MEASURES Diagnosis and treatment were established from the notes . Evidence for each intervention was then sought in MEDLINE 1986 - 1999 , Best Evidence 1991 - 1999 , and the Cochrane Data base of Systematic Review s Issue 3 , 1999 , and grade d into one of five categories : systematic review , meta- analysis , r and omised controlled trial , prospect i ve study , or retrospective study . RESULTS Treatment was supported by systematic review in 14 , by meta- analysis in 12 , by r and omised controlled trial in 75 , by prospect i ve studies in 55 , by retrospective studies in 58 , and by no evidence in 8 . CONCLUSIONS Everyday surgical practice in our unit is supported by good quality evidence from recent publications Background The role of vitamin D in management of depression is unclear . Results from observational and emerging r and omized controlled trials ( RCTs ) investigating the efficacy of vitamin D in depression lack consistency - with some suggesting a positive association while others show a negative or inconclusive association . Methods / Design The primary aim of this study is to conduct a systematic review of RCTs to assess the effect of oral vitamin D supplementation versus placebo on depression symptoms measured by scales and the proportion of patients with symptomatic improvement according to the authors ’ original definition . Secondary aims include assessing the change in quality of life , adverse events and treatment discontinuation . We will conduct the systematic review and meta- analysis according to the recommendations of the Cochrane H and book for Systematic Review s of Interventions . We will search the Cochrane Central Register of Controlled Trials ( CENTRAL ) , MEDLINE ( 1966 to present ) , EMBASE ( 1980 to present ) , CINAHL ( 1982 to present ) , PsychINFO ( 1967 to present ) and Clinical Trials.gov . Unpublished work will be identified by search ing two major conferences : the International Vitamin Conference , the Anxiety Disorders and Depression Conference , while grey literature will be acquired by contacting authors of included studies . We will use the r and om-effects meta- analysis to synthesize the data by pooling the results of included studies . Discussion The results of this systematic review will be helpful in clarifying the efficacy of vitamin D supplementation and providing evidence to establish guidelines for implementation of vitamin D for depression in general practice and other relevant setting s. Study registration Unique identifier : CRD42013003849 BACKGROUND Certain plants used in folk medicine serve as a source of therapeutic agents that have antimicrobial and other multipotential effects . This prospect i ve , r and omized , placebo , and positively controlled clinical trial was design ed to evaluate the clinical and microbiologic effects of a commercially available dentifrice containing aloe vera on the reduction of plaque and gingival inflammation in patients with gingivitis . METHODS Ninety patients diagnosed with chronic generalized gingivitis were selected and r and omly divided into three groups : group 1 , placebo toothpaste ; group 2 , toothpaste containing aloe vera ; and group 3 , toothpaste with polymer and fluoride containing triclosan .  Clinical evaluation was undertaken using a gingival index , plaque was assessed using a modification of the Quigley-Hein index , and microbiologic counts were assessed at baseline , 6 weeks , 12 weeks , and 24 weeks . A subjective evaluation was also undertaken by question naire . RESULTS Toothpaste containing aloe vera showed significant improvement in gingival and plaque index scores as well as microbiologic counts compared with placebo dentifrice . These improvements were comparable to those achieved with toothpaste containing triclosan . CONCLUSION Toothpaste containing aloe vera may be a useful herbal formulation for chemical plaque control agents and improvement in plaque and gingival status PURPOSE / OBJECTIVES To determine whether the use of mild soap and aloe vera gel versus mild soap alone would decrease the incidence of skin reactions in patients undergoing radiation therapy . DATA SOURCES Prospect i ve , r and omized , blinded clinical trial . SETTING Radiation therapy outpatient clinic in a cancer center affiliated with a major teaching medical facility . SAMPLE The mean age of the participants was 56 years . The group consisted of Caucasians ( 74 % ) and African Americans ( 26 % ) . The ethnic mix was non-Hispanic ( 65 % ) and Hispanic ( 35 % ) . METHODS Prophylactic skin care began on the first day of radiation therapy . Patients cleansed the area with mild , unscented soap . Patients r and omized into the experimental arm of the trial were instructed to liberally apply aloe vera gel to the area at various intervals throughout the day . FINDINGS At low cumulative dose levels < or = 2,700 cGy , no difference existed in the effect of adding aloe . When the cumulative dose was high ( > 2,700 cGy ) , the median time was five weeks prior to any skin changes in the aloe/soap arm versus three weeks in the soap only arm . When the cumulative dose increases over time , there seems to be a protective effect of adding aloe to the soap regimen . IMPLICATION S FOR NURSING PRACTICE Skin products used to treat radiation dermatitis vary among institutions . Nurses should be aware that some patients may be predisposed to skin problems . Nurses must be aware of newly developed products and research regarding these products so that effective treatment can be instituted Objectives : The intestinal flora of breast-fed infants is generally dominated by Bifidobacteria . We aim ed to investigate whether an infant formula supplemented with galacto-oligosaccharides and fructo-oligosaccharides ( GOS/FOS ) is able to establish a bifido-dominant microflora , not only in numbers but also with respect to the metabolic activity in the colon . Methods : Two groups of infants fed infant formula with 0.8 g/100 ml GOS/FOS in a ratio of 9:1 ( OSF group ) , or control formula ( SF group ) were evaluated in a r and omised , double blind , placebo controlled intervention study . A breast-fed group was studied in parallel . At study onset and after 4 and 6 weeks , faecal sample s were examined for the number of bifidobacteria , pH , short chain fatty acids and lactate . Results : After 6 weeks , the mean proportion of bifidobacteria was significantly higher in the OSF group ( 59.6 % versus 49.5 % in the SF group ; P < 0.05 ) . Compared with controls , infants in the OSF group had a lower stool mean pH and an increased proportion of acetate and a decreased proportion of propionate . The mean pH in the OSF and SF groups were 5.7 and 6.3 , respectively ( P < 0.001 ) . Conclusions : The addition of the prebiotic GOS/FOS mixture to an infant formula has a stimulating effect on the growth of bifidobacteria and on the metabolic activity of the total intestinal flora . The changes in short chain fatty acids , lactate and pH in the prebiotic group represent a fermentation profile that is closer to that observed in breast-fed infants compared to infants fed control formula Cheap , easy to apply , well-tolerable , with the potential of altering cortical excitability , and for testing causalities — these are attributes that have made transcranial direct current stimulation ( tDCS ) a highly popular research tool in cognitive neuroscience . Since its re introduction over 15 years ago by Nitsche and Paulus ( 2000 ) , the number of publications reporting tDCS results has risen exponentially ( a Scopus ® literature search indicates over 500 such journal articles published in 2015 alone ) . Recently however , the efficacy of tDCS to alter cognitive performance has been called into question , in particular among healthy participants , but also in certain clinical sample s ( Horvath et al. , 2015 ; Hill et al. , 2016 ; Mancuso et al. , 2016 ) . A number of empirical studies reported not having been able to detect any facilitatory effects of anodal tDCS or inhibitory effects of cathodal tDCS on various cognitive processes ( e.g. , Wiethoff et al. , 2014 ; Minarik et al. , 2015 ; Sahlem et al. , 2015 ; Horvath et al. , 2016 ; Vannorsdall et al. , 2016 ) . In fact , in a recent meta- analysis Horvath et al. ( 2015 ) argue that in young , healthy participants there is no effect of  tDCS on cognition whatsoever , whereas other meta- analyses do find specific modulation of cognitive processes by tDCS ; however , these effects seem to be rather weak ( Hill et al. , 2016 ; Mancuso et al. , 2016 ) . In a recent commentary the field of tDCS research was even called a research area of bad science ( Underwood , 2016 ) in desperate need of further meticulous evaluation . Although there seems to be some inconsistency of effects there is also current work by Cason and Medina ( 2016 ) suggesting no evidence for p-hacking ( strategic testing and analysis procedures to increase likelihood of obtaining significant effects ) in tDCS research . However , Cason and Medina ( 2016 ) find average statistical power in tDCS studies to be below 50 % . Therefore , one potential reason for the reported inconsistencies might be that sample size is usually very small in most tDCS studies ( including those from our research group ) . Whilst this issue is not specific to tDCS studies ( in fact Button et al. , 2013 estimate the median statistical power in neuroscience in general being only 21 % ) , it could lead to weaker effects often not being detected , and consequently meta- analyses suggesting small or no efficacy of tDCS . In addition , the assessment of the real effect of tDCS is further complicated by potential publication bias ( file drawer problem ) leading to over-reporting significant tDCS findings . That is , a publication bias favoring studies with significant effects might lead to an inflation of the reported efficacy of tDCS . Thus , depending on which studies are included in systematic review s and meta- analyses ( i.e. , findings published in peer- review ed journals ; unpublished nil-effects ; nil-effects reported as an additional finding in papers with the actual focus on another , significant , effect , etc . ) , small sample size in tDCS research could lead to both under— and overestimation of tDCS efficacy . Some current meta- analyses ( e.g. , Mancuso et al. , 2016 ) , however , include an estimation of publication bias ( e.g. , using the “ trim and fill ” procedure in which funnel plots are used for determining whether there is a bias toward studies with significant effects in the literature included in the meta- analysis ) ; and overall effect size can then be adjusted accordingly . Taking publication bias into account it becomes evident that efficacy of tDCS is rather weak ( Mancuso et al. , 2016 ) . As indicated by quite some inconsistency in literature on the efficacy of the stimulation , the field of tDCS research is clearly struck by the replication crisis that we also find in psychology and neurosciences in general ( Button et al. , 2013 ; Open Science Collaboration , 2015 ) . But how to estimate efficacy of tDCS , if it is not clear , how many unsuccessful experimental attempts end up in the file drawer ? As discussed above , one possibility is to adjust for publication bias in meta- analyses . Another strategy is pre-registering tDCS studies and reporting their outcome , independent of whether the results are significant or not — be it in peer review ed journals or platforms such as the Open Science Framework ( https://osf.io ) ; this can result in more accurate estimates of efficacy . Moreover , allowing open access to the acquired data ( open data ) offers the opportunity that research ers could pool raw data from experiments with small sample s but similar experimental design s. By doing so , they overcome the problem of under-powering , an issue that seems so fundamental in tDCS research . Therefore , to investigate the effect of sample size on tDCS efficacy and to contribute to increased research transparency we design ed a simple , pre-registered study ( https://osf.io/eb9c5/?view_only=2743a0c4600943c998c2c37fbfb25846 ) with a sufficiently large number of young , healthy volunteers estimated with a priori power analysis . Furthermore , we make all the acquired data publicly available . In a choice reaction time task ( CRT ) participants underwent either anodal or cathodal tDCS applied to the sensorimotor cortex . Jacobson et al. ( 2012 ) suggest that for the motor domain with tDCS over sensorimotor cortex anodal-excitation and cathodal-inhibition effects ( AeCi ) are quite straight forward , whereas in other cognitive domains AeCi effects seem not particularly robust . Since we stimulated the sensorimotor cortex we decided to contrast anodal with cathodal tDCS ( instead of sham stimulation ) for obtaining the largest possible effect . We expected anodal stimulation to result in faster response times compared to cathodal tDCS in accordance with findings by Garcia-Cossio et al. ( 2015 ) . To demonstrate the importance of sample size for finding the predicted effect , r and om sample s of different sizes were drawn from the data pool and tested statistically . This way the probability of identifying the predicted effect was obtained as a function of sample size OBJECTIVES ( 1 ) To measure and compare endo-sinus bone levels around implants r and omly placed with an osteotome sinus floor elevation ( OSFE ) procedure in grafted ( control ) and non-grafted ( test ) sinuses , ( 2 ) to evaluate the OSFE efficacy with short , tapered , and chemically modified hydrophilic surfaced implants in extremely atrophic maxillae , ( 3 ) to show that fused corticals may constitute a complication risk . MATERIAL AND METHODS The TE ( ® ) SLActive 8 mm-long implants ( Straumann AG ) were placed using an OSFE procedure in 4 mm or less of bone height . Healing time before prosthetic rehabilitation was 10 weeks . One year after implant placement , bone levels were measured on st and ardized periapical radiographs . RESULTS Thirty-seven ( 17 tests , 20 controls ) implants were placed in 12 patients with a mean maxillary residual bone height ( RBH ) of 2.4 ± 0.9 mm . Before loading , two control implants failed ( RBH 1.4 and 1.2 mm ) ; two others rotated at loading ( one test , RBH 0.9 mm ; one control , RBH 1.5 mm ) but were uneventfully loaded after three additional months of healing . These adverse events and complications occurred when implants were placed in merged corticals . Endo-sinus bone gain was 3.9 ± 1.0 and 5.0 ± 1.3 mm for the test and control groups ( P = 0.003 ) . The 1-year success rate was 100 % and 90 % , respectively ( P = 0.49 ) . CONCLUSION Although more bone is gained when grafting material is used , this may not be required to promote endo-sinus bone gain . The OSFE procedure with or without grafting material could be efficient when the RBH is ≤ 4 mm . However , when both corticals merged , the risk of complication could increase OBJECTIVES The aim of this study was to evaluate the efficacy of aloe vera ( AV ) applied in combination with a tongue protector , comparing this with a placebo . METHODS A total of 75 patients with burning mouth syndrome ( BMS ) were divided into three groups r and omly : Group I ( tongue protector three times a day ) , Group II ( tongue protector and 0.5 ml AV at 70 % three times a day ) and Group III ( tongue protector and 0.5 ml placebo three times a day ) . Symptoms were evaluated by visual analogue scale ( VAS ) , while patient psychological profiles were assessed using the Hospital Anxiety-Depression scale and their quality of life using the Oral Health Impact Profile 49 ( OHIP-49 ) . Treatment continued for 3 months . RESULTS Visual analogue scale pain values improved for all three study groups but without statistically significant differences between the groups ( P = 0.210 ) . Regarding quality of life , no significant differences were found between groups with the exception of the OHIP-49 score for h and icap . The overall clinical improvement was greater for Group II , with a difference almost reaching significance . CONCLUSIONS The concomitant prescription of tongue protector and AV is effective for treating patients with BMS Introduction In 2008 , the UK National Osteoporosis Guideline Group ( NOGG ) produced a guideline on the prevention and treatment of osteoporosis , with an up date in 2013 . This paper presents a major up date of the guideline , the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men age 50 years or over . Methods Where available , systematic review s , meta-analyses and r and omised controlled trials were used to provide the evidence base . Conclusions and recommendations were systematic ally grade d according to the strength of the available evidence . Results Review of the evidence and recommendations are provided for the diagnosis of osteoporosis , fracture-risk assessment , lifestyle measures and pharmacological interventions , duration and monitoring of bisphosphonate therapy , glucocorticoid-induced osteoporosis , osteoporosis in men , postfracture care and intervention thresholds . Conclusion The guideline , which has received accreditation from the National Institute of Health and Care Excellence ( NICE ) , provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals who are involved in its management OBJECTIVE To investigate the effectiveness of turmeric with black pepper and nigella sativa in oral submucous fibrosis ( OSMF ) . STUDY DESIGN Forty OSMF patients were r and omly divided into two groups . The study was performed under a double-blind , r and omized design . Group A received turmeric with black pepper and group B received nigella sativa for 3 months .  Clinical evaluation was done every 15 days . Patients ' serum superoxide dismutase ( SOD ) levels were assessed before and after treatment and also compared with healthy controls . The response to treatment was analyzed using analysis of variance , paired t test , and unpaired t test . RESULTS After the treatment , groups A and B showed 3.85 ± 0.22 mm and 3.6 ± 0.07 mm improvement in mouth opening , respectively ( P < .01 ) ; 87.90 % and 78.91 % reduction in burning sensation , respectively ( P < .01 ) ; and + 0.62 U/mL and + 0.74 U/mL improvement in serum SOD levels , respectively ( P < .05 ) . The maximum mouth opening achieved was 8 mm in group A and 7 mm in group B. The mean pretreatment SOD level for controls and patients was 3.61 ± 0.24 U/mL in group A and 2.63 ± 0.18 U/mL in group B. CONCLUSION Turmeric with black pepper and nigella sativa  improved mouth opening , burning sensation , and SOD levels in the present OSMF study patients ; however , further investigations are needed Background : Topical retinoids are considered first-line therapy in the treatment of acne vulgaris , yet can be associated with cutaneous irritations .  Combination therapy with natural preparations could be effective in treatment and decreasing adverse events . Objective : The aim of this study was to compare the efficacy and safety of the combination of tretinoin ( TR ) cream ( 0.05 % ) and Aloe vera topical gel ( 50 % ) with TR and vehicle . Material and methods : The r and omized , double-blind , prospect i ve 8-week trial evaluated inflammatory and non-inflammatory lesion scores and tolerability in 60 subjects with mild to moderate acne vulgaris ( global acne grading system scale ) . Results : Several formulations of A. vera leaf gel were prepared and the most stable one was selected for clinical study based on physicochemical evaluations . The combination therapy showed superior efficacy to TR and placebo . TR/Aloe vera gel ( AVG ) was significantly more effective in reducing non-inflammatory ( p = 0.001 ) , inflammatory ( p = 0.011 ) and total ( p = 0.003 ) lesion scores than control group . The highest percentage of adverse cutaneous effect was reported for scaling . At the end of study , erythema in the TR/AVG-treated group was significantly less severe ( p = 0.046 ) . Conclusion : The combination TR/AVG was well tolerated and significantly more effective than TR and vehicle for the treatment of mild to moderate acne vulgaris
The results of meta- analysis showed statistically significant differences between aloe vera and control groups in alleviating pain/burning sensation at the end of the first and second month , in favor of aloe vera , but no significant differences were found at the end of the third month .
With regard to objective clinical outcomes , no statistically significant differences were found between the groups .
Aloe vera has a promising effect in reducing pain/burning sensation and clinical improvement in patients with OSF .
The management of oral submucous fibrosis ( OSF ) is quite challenging , and as yet , no effective therapy is available for its management .
The present systematic review and meta- analysis sought to assess the effectiveness of aloe vera in alleviating pain and clinical signs of OSF .