The efficacy of aloe vera used for burn wound healing: A systematic review

Aloe vera has been traditionally used for burn healing but clinical evidence remains unclear. We conducted a systematic review to determine the efficacy of topical aloe vera for the treatment of burn wounds. We electronically searched relevant studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, South-East Asia Database, Chinese Databases, and several Thai local Databases (1918-June 2004). Only controlled clinical trials for burn healing were included. There were no restrictions on any language of publication. Two reviewers independently extracted data on study characteristics, patient characteristics, intervention, and outcome measure. Four studies with a total of 371 patients were included in this review. Based on a meta-analysis using duration of wound healing as an outcome measure, the summary weighted mean difference in healing time of the aloe vera group was 8.79 days shorter than those in the control group (P=0.006). Due to the differences of products and outcome measures, there is paucity to draw a specific conclusion regarding the effect of aloe vera for burn wound healing. However, cumulative evidence tends to support that aloe vera might be an effective interventions used in burn wound healing for first to second degree burns. Further, well-designed trials with sufficient details of the contents of aloe vera products should be carried out to determine the effectiveness of aloe vera.

Utilisation review of clopidogrel: are they used under the FDA-approved indications?

BACKGROUND

Clopidogrel has shown benefit in patients with increased risk of cardiovascular diseases. Due to its high acquisition cost and its increased use, this study was conducted to review the use of clopidogrel based on the Food and Drug Administration (FDA)-approved indications and the ST-segment elevation myocardial infarction (STEMI).

METHOD

This was a cross-sectional study conducted at a tertiary-care, university-affiliated hospital in the Northern part of Thailand. Medical records of patients receiving clopidogrel during January 2005 to February 2006 were reviewed. Baseline characteristics of patients along with specific information regarding the use of clopidogrel were collected. Data were analysed using descriptive statistics.

RESULT

A total of 191 patients were included in this utilisation review (95 and 96 were inpatient and outpatient, respectively). The use of clopidogrel was deemed appropriate in 82.7% of cases including 72.2% for FDA-approved indications and 10.5% for STEMI. Clopidogrel/aspirin combination was indicated in 93 patients; however, 22 patients received clopidogrel monotherapy. On the contrary, 10 patients received clopidogrel/aspirin combination when only clopidogrel monotherapy was indicated. Moreover, 60% of patients who received clopidogrel monotherapy had no history of aspirin intolerance or recurrent events while on aspirin therapy.

CONCLUSION

The results showed that the majority of clopidogrel use was deemed appropriate based on FDA-approved indications and for medically justified indication. However, a significant number of patients received clopidogrel instead of aspirin while no aspirin intolerance was documented. Therefore, efforts should be made to promote the appropriate use of this agent to improve patient outcomes.