Methylprednisolone and local anesthetic for long-term postherpetic neuralgia: a meta-analysis.

OBJECTIVE: The purpose was to evaluate the efficacy of methylprednisolone combined with local anesthetics on the incidence or intensity of long-term Postherpetic neuralgia (PHN). METHODS: We have performed comprehensive literature research in PubMed, Web of Science, Cochrane library, and China national knowledge infrastructure (CNKI) databases (inception through October 19 2021). Relevant randomized controlled trials (RCTs) with long-term duration were included, regardless of the injection method. The indicators were the incidence of PHN and the Visual Analog Scale (VAS) scores. RESULTS: Five RGTs with 980 patients were retrieved. Compared with standard treatment (antivirals) alone, the combination of methylprednisolone, local anesthetic, and standard treatment exhibited a significant decrease in the incidence of PHN in 1 month (RR = 0.38, 95% confidence interval (CI): 0.19-0.76), 3 months (RR = 0.40, 95% CI: 0.19-0.84), and 6 months (RR = 0.37, 95% CI: 0.15-0.94) after zoster onset. In VAS scores, there was also a significant difference between the two groups in long-term PHN (3 months: WMD=-1.57, 95% CI: -2.84 to -0.30; 6 months: WMD=-0.72, 95% CI: -1.29 to -0.16). CONCLUSION: The combination of methylprednisolone, local anesthetic, and standard treatment appears to be an ideal option for patients with PHN. Further investigation is needed for the safety of this therapy.

The efficacy and safety of fractional lasers for alopecia in mono and adjunctive therapy: A systematic review and meta-analysis.

BACKGROUND: Hair loss is affecting over half of the population worldwide, leading to noticeable psychotic disorders in a considerable proportion of patients. The current treatments remain unpredictable and disappointing. OBJECTIVE: This study aimed to evaluate the efficacy and safety of fractional lasers compared with other conventional treatments as either mono or combined therapy in the treatment of alopecia. METHODS: We have conducted a thorough literature search in PubMed, Web of Science, Embase, Cochrane library, and China national knowledge infrastructure databases (from inception to February 9, 2022). Relevant clinical trials, mainly randomized controlled trials, were included, regardless of their comparisons. The Cochrane risk of bias assessment was used for quality appraisal. Outcomes were evaluated by efficiency rate, hair density, etc. RESULTS: Thirteen controlled clinical trials, including nine randomized controlled trials, with 606 patients were retrieved. As an individual therapy, the fractional laser is superior to any other therapy in total efficiency (RR = 1.58, 95% CI: 1.16-2.14, p = 0.003). When the fractional laser was applied in combined treatments, the result showed a significant difference (RR = 1.23, 95%CI: 1.02 to 1.49, P = 0.03) compared with other treatments. Although both mono and adjunctive groups were confirmed to be efficient, there were no statistical differences between the two of them (RR = 1.24, 95% CI: 0.87-1.77, p = 0.24). CONCLUSION: Our results showed that the fractional laser has a significant efficacy as either mono or adjuvant therapy. Further research and exploration of fractional lasers with larger sample sizes are required to confirm the efficiency and safety of this treatment.