RECENT RESEARCH pregnancies . We evaluated the risk of bias using a modified Newcastle-Ottawa Scale .
Results : We screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women . Pregnant women with SARS-CoV-2 infection — as compared with uninfected pregnant women — were at significantly increased risk of maternal mortality ( 10 studies ; n = 1490 ; RR 7.68 , 95 % CI 1.70 to 34.61 ); admission to intensive care unit ( 8 studies ; n = 6660 ; RR 3.81 , 95 % CI 2.03 to 7.17 ); receiving mechanical ventilation ( 7 studies ; n = 4887 ; RR 15.23 , 95 % CI 4.32 to 53.71 ); receiving any critical care ( 7 studies ; n = 4735 ; RR 5.48 , 95 % CI 2.57 to 11.72 ); and being diagnosed with pneumonia ( 6 studies ; n = 4573 ; RR 23.46 , 95 % CI 3.03 to 181.39 ) and thromboembolic disease ( 8 studies ; n = 5146 ; RR 5.50 , 95 % CI 1.12 to 27.12 ). Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth ( 7 studies ; n = 7637 ; RR 1.86 , 95 % CI 1.12 to 3.08 ); be born preterm ( 7 studies ; n = 6233 ; RR 1.71 , 95 % CI 1.28 to 2.29 ) or moderately preterm ( 7 studies ; n = 6071 ; RR 2.92 , 95 % CI 1.88 to 4.54 ); and to be born low birth weight ( 12 studies ; n = 11 930 ; RR 1.19 , 95 % CI 1.02 to 1.40 ). Infection was not linked to stillbirth . Studies were generally at low or moderate risk of bias .
Conclusions : This analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death , severe maternal morbidities and neonatal morbidity , but not stillbirth or intrauterine growth restriction . As more data become available , we will update these findings per the published protocol .
Herbal medicine
Rostamkhani H , Veisi P , Niknafs B , Jafarabadi MA , Ghoreishi Z . The effect of zingiber officinale on prooxidant-antioxidant balance and glycemic control in diabetic patients with ESRD undergoing hemodialysis : a double-blind randomized control trial . BMC Complementary Medicine and Therapies . 2023 , 23 , Article number : 52 .
Background : Diabetes management in hemodialysis patients with endstage renal disease needs precision to avoid complications . The study aimed to investigate the effect of ginger supplementation on prooxidantantioxidant balance , glycemic management , and renal function in diabetic hemodialysis patients .
Trial design and methods : Forty-four patients were randomly allocated to either the ginger or the placebo group in this randomized , double blind , placebocontrolled study . Patients in the ginger group received 2000 mg / d ginger for eight weeks , whereas those in the placebo group received equivalent placebos . After a 12- to 14-h fast , serum levels of fasting blood glucose ( FBG ), insulin , urea , creatinine , and prooxidant-antioxidant balance ( PAB ) were measured at baseline and at the end of the study . The homeostatic model evaluation of insulin resistance was used to determine insulin resistance ( HOMA-IR ).
Results : Serum levels of FBG ( p = 0.001 ), HOMA-IR ( p = 0.001 ), and urea ( p = 0.017 ) were considerably lower in the ginger group compared to baseline , and the difference was significant when compared to the placebo group ( p < 0.05 ). Moreover , ginger supplementation decreased serum levels of creatinine ( p = 0.034 ) and PAB ( p = 0.013 ) within the group , but the effect was insignificant between groups ( p > 0.05 ). On the other hand , insulin levels did not vary significantly across and among the groups ( p > 0.05 ).
Conclusion : In summary , this study indicated that in diabetic hemodialysis patients , ginger could result to lower blood glucose levels , enhanced insulin sensitivity , and lower serum urea levels . Further studies with a more extended intervention period and various doses and forms of ginger are needed .
Bazrafshani MS , Pardakhty A , Khandani BK , Tajadini H , Pour SG , Hashemi S , … Sharifi H . The prevalence and predictors of herbdrug interactions among Iranian cancer patients during chemotherapy courses . BMC Complementary Medicine and Therapies . 2023 ; 23 , Article number : 41 .
Background : The concurrent usage of herbal medicines with conventional therapies is an important concern in cancer treatment which can lead to unexpected consequences like herbdrug interactions . This study aimed to determine the prevalence of potential herb-drug interactions and to predict factors associated with herb-drug interactions for cancer patients .
Methods : This cross-sectional study was conducted among a convenience sample of 315 cancer patients referring to the oncology clinics of Kerman city in 2018 . Data were collected via comprehensive face-to-face interviews and medical chart reviews . A drug interaction checker was used to determine herbdrug interactions . The information of patients was compared based on herbdrug interactions using bivariable logistic regression models , and predictors were determined by the multivariable logistic regression model . All analyses were performed by Stata software version 16 .
Results : Of 262 patients ( 83.2 % of the patients ) who used herbal medicines , 209 patients [ 79.8 % ( 95 % Confidence Intervals ( CI ): 75.2 – 85.1 )] had potential herb-drug interactions . Chamomile was the most popular herbal medicine ( n = 163 , 78.0 %), and minor and moderate herb-drug interactions were caused by green tea ( n = 34 , 16.3 %) and peppermint ( n = 78 , 37.5 %). The number of chemotherapeutic agents ( OR : 1.92 , 95 % CI : 1.43 – 2.58 ; P-value < 0.0001 ) and the experienced of pain during chemotherapy courses ( OR = 2.22 , 95 % CI : 1.00 – 4.94 ; P-value = 0.04 ) were some of the predictors of herb-drug interactions among cancer patients .
Conclusion : Herbal medicine use during chemotherapy was found prevalent among cancer patients ; of them , the experience of potential herbdrug interactions was highly frequent . Oncologists and clinical pharmacologists are recommended to take into account challenges associated with herb-drug interactions in their routine practices , particularly during chemotherapy among these patients .
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