Application of cinnarizine in migraine prevention: A systematic review and meta-analysis.

OBJECTIVE: To investigate and analyze the available data on the prophylactic effectiveness of cinnarizine in migraine disorder. BACKGROUND: Cinnarizine has demonstrated encouraging potential in preventing the attacks of migraine. Therefore, we opted to evaluate whether its sole administration leads to positive outcomes. METHODS: The PubMed, Scopus, Web of Science, and Embase databases were searched for English-only original interventional studies published until April 2022, then screened for relevancy and eligibility. The resulting data from the included studies, including the primary (ie, headache episode frequency, intensity, duration, monthly timing, and analgesic intake frequency) and secondary (ie, reported adverse events, quality of life, and activities of daily living) outcome changes compared to placebo and active controls (e.g., sodium valproate and propranolol) were then recorded by two independent assessors. Ultimately, these data were synthesized qualitatively and quantitatively (achieved by determining the mean difference via the random-effects model). RESULTS: A total of 10 studies comprising seven randomized controlled trials and three quasi-experimental studies were included. Compared to placebo, cinnarizine demonstrated significant improvements in migraine episode frequency (Mean difference = -3.10; Confidence interval = [-3.33, -2.88]; p-value < 0.001; I2  < 0.001%), and intensity (Mean difference = -1.54; Confidence interval = [-2.08, -0.99]; p-value < 0.001; I2  < 37.97%). Moreover, cinnarizine led to similar or better results when compared to active controls, including sodium valproate, topiramate, and propranolol. CONCLUSIONS: Cinnarizine can be considered a safe and effective medication for migraine prophylaxis. However, the relatively small sample size made reaching a definite conclusion impossible. Therefore, a higher number of randomized controlled trials are recommended to be taken place to clarify the situation further.

Lasers for the treatment of erythema, dyspigmentation, and decreased elasticity in macular acne scars: a systematic review.

Scarring is one of the most esthetically challenging and psychologically burdening aspects following inflammatory acne. While "macular" disease is the scar subtype with the least complicated outcome, its phase can be regarded as the most defining in the ultimate scar appearance. Moreover, with lasers recently gaining much popularity in the scientific community for managing several dermatologic conditions, we aimed to evaluate whether they would lead to significant benefits. For this systematic review, four databases consisting of PubMed, Scopus, Embase, and Web of Science were searched using a comprehensive string, with the data from the relevant yet eligible identified records qualitatively synthesized. After investigating the data obtained from the nine included studies, we found the utilized lasers, namely neodymium-doped yttrium aluminum garnet, fractional carbon dioxide, pulsed dye, erbium:glass, pro-yellow, and high-power optically pumped semiconductor, to be highly effective in managing the erythematous or dyspigmented appearance with the reduced elasticity also significantly improving. Moreover, the adverse events were both bearable and minimal, and transient. However, the degree of improvement each type of scar demonstrated following laser therapy varied based on the laser used. Neodymium-doped yttrium aluminum garnet, fractional carbon dioxide, and pulsed dye are the most commonly investigated lasers for managing macular acne scars, demonstrating eye-catching capabilities in managing either erythema or dyspigmentation. However, we still recommend that further comparative interventional studies be carried out, while the intended outcomes also assessed with objective measures for further clarification.

Cutaneous adverse reactions following COVID-19 vaccinations: A systematic review and meta-analysis.

BACKGROUND: COVID-19 vaccines are currently the most effective interventions in controlling and preventing severe disease progression. Dermatologic reactions to COVID-19 vaccinations may be rare among clinical trial participants. However, since global mass vaccination became a reality, these adverse effects may become more widespread, and different skin reactions would arise. OBJECTIVE: To systematically review the cutaneous adverse reactions in cases subject to vaccines for COVID-19. METHODS: We searched the PubMed, SCOPUS, Web of Science, and Embase databases, identifying the relevant records and including the eligible observational ones. After assessing the methodological quality of the included studies, we qualitatively and quantitatively synthesized the data regarding the cutaneous side effects experienced by those in the studies' population. RESULTS: Overall, 36 studies were included in our systematic review, with the majority being cross-sectional. We found that pain, erythema, and swelling were the most common local side effects, while different types of rashes, urticaria, and angioedema were the most non-local. Few cases also reported experiencing flare-ups of their underlying diseases or developing newly-onset diseases of various etiologies. Our meta-analyses also found that while viral vector-based vaccines are, though insignificantly, safer in injection site complaints, individuals who received mRNA vaccines developed significantly fewer non-local cutaneous adverse events. DISCUSSION: Cutaneous reactions to the COVID-19 vaccines are similar to common cutaneous drug eruptions and COVID-19 cutaneous manifestations. However, we believe that further high-quality research is needed to assess better how and why cutaneous reactions occur in different vaccines.

Carboxytherapy in dermatology: A systematic review.

INTRODUCTION: The overall effects of Carboxytherapy, defined as the administration of carbon dioxide, have been studied for many years. It has been suggested that by improving oxygenation, interacting with the tissue perfusion regulators, and disrupting the adipose cell membranes, the method can lead to notable improvements in different esthetic and pathological conditions. Therefore, we aimed to systematically review the available studies evaluating the potential benefits of carboxytherapy in dermatological conditions and how it objectively stands against scientific scrutiny. METHODS: We searched the PubMed, Scopus, Embase, and Web of Science databases, including the studies exploring the method's efficacy in managing any dermatological condition. RESULTS: A total 27 of studies were identified (with a pooled sample of over 700 cases), most of which were clinical trials. Facial wrinkles, periorbital hyperpigmentation, skin laxity deficiency, scars, striae distensae, localized lipolysis and cellulite, alopecia, chronic diabetic wounds, and psoriatic plaques comprised the package of the dermatological conditions that were studied. Except for a few studies, the method mainly demonstrated significant improvements on all of the mentioned conditions. The inter- and post-operational adverse events were mild and transient, including erythema, pain, crepitus, and ecchymoses. DISCUSSION: Carboxytherapy can provide those practicing in the field with sustainably favorable results. However, the numbers of cases on whom the fat-reducing capabilities of the method were studied and experienced varying degrees of recurrence caught our eye. In addition, we observed a notable disparity between the outcome measures utilized in the studies. The modest sample size in each condition also added to the injury, as the conditions on which the method was evaluated are pretty common in the general population. Therefore, for a definite conclusion, more randomized controlled trials with the shortcomings mentioned well addressed need to be conducted.