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      Effect of the Mixed Herbal Medicines Extract (Fennel, Chamomile, and Saffron) on Menopause Syndrome: a Randomized Controlled Clinical Trial

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          Abstract

          Introduction: Menopause is the transition from the reproductive phase of a woman to the non-reproductive. It may impair quality of life. The study aims to determine the effectiveness of mixed herbal medicines on menopause symptoms

          Methods: A randomized, triple-blind, clinical trial and placebo-controlled study on 120 peri-menopausal women aged 45-65 years for 12 weeks. All participants took herbal extracts drops orally daily and randomly allocated into four groups: placebo (C), A (250 mg chamomile, 30 mg fennel, 15 mg saffron), B (1000 mg, 120 mg, 60 mg), and D (500 mg, 60 mg, 30 mg). Primary outcome was the mean change in scores of the menopause rating scale that evaluates 11 symptoms.

          Results: The median (IQR) physical score significantly reduced from 8.5(4) to 2(3), in psych score reduced from 12(4) to 2 (2) and in urogenital score reduced from 6.5(3) to 3(2) in group B. In group D physical score decreased from 12(6) to 8(4), in psychological score reduced from12 (3) to 8(4) and urogenital score reduced from 7.5 (3) to 8(3) at week 12. No significant differences in group A and C. With comparison the scores of physical, psych and urogenital domain of MRS questionnaire in 1th ,6th and 12th, no significant difference within group A and C were seen, but statistically significant difference was within group B (p<0.001) and D (p<0.001) in all weeks. The effect size was 0.92.

          Conclusion: A 12 weeks extracts treatment, there were significant improvement in physical, psychological and urogenital domains in group B.

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          Most cited references33

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          On effect size.

          The call for researchers to report and interpret effect sizes and their corresponding confidence intervals has never been stronger. However, there is confusion in the literature on the definition of effect size, and consequently the term is used inconsistently. We propose a definition for effect size, discuss 3 facets of effect size (dimension, measure/index, and value), outline 10 corollaries that follow from our definition, and review ideal qualities of effect sizes. Our definition of effect size is general and subsumes many existing definitions of effect size. We define effect size as a quantitative reflection of the magnitude of some phenomenon that is used for the purpose of addressing a question of interest. Our definition of effect size is purposely more inclusive than the way many have defined and conceptualized effect size, and it is unique with regard to linking effect size to a question of interest. Additionally, we review some important developments in the effect size literature and discuss the importance of accompanying an effect size with an interval estimate that acknowledges the uncertainty with which the population value of the effect size has been estimated. We hope that this article will facilitate discussion and improve the practice of reporting and interpreting effect sizes.
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            Blocked Randomization with Randomly Selected Block Sizes

            When planning a randomized clinical trial, careful consideration must be given to how participants are selected for various arms of a study. Selection and accidental bias may occur when participants are not assigned to study groups with equal probability. A simple random allocation scheme is a process by which each participant has equal likelihood of being assigned to treatment versus referent groups. However, by chance an unequal number of individuals may be assigned to each arm of the study and thus decrease the power to detect statistically significant differences between groups. Block randomization is a commonly used technique in clinical trial design to reduce bias and achieve balance in the allocation of participants to treatment arms, especially when the sample size is small. This method increases the probability that each arm will contain an equal number of individuals by sequencing participant assignments by block. Yet still, the allocation process may be predictable, for example, when the investigator is not blind and the block size is fixed. This paper provides an overview of blocked randomization and illustrates how to avoid selection bias by using random block sizes.
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              The Menopause Rating Scale (MRS) scale: A methodological review

              Background This paper compiles data from different sources to get a first comprehensive picture of psychometric and other methodological characteristics of the Menopause Rating Scale (MRS) scale. The scale was designed and standardized as a self-administered scale to (a) to assess symptoms/complaints of aging women under different conditions, (b) to evaluate the severity of symptoms over time, and (c) to measure changes pre- and postmenopause replacement therapy. The scale became widespread used (available in 10 languages). Method A large multinational survey (9 countries in 4 continents) from 2001/ 2002 is the basis for in depth analyses on reliability and validity of the MRS. Additional small convenience samples were used to get first impressions about test-retest reliability. The data were centrally analyzed. Data from a postmarketing HRT study were used to estimate discriminative validity. Results Reliability measures (consistency and test-retest stability) were found to be good across countries, although the sample size for test-retest reliability was small. Validity: The internal structure of the MRS across countries was astonishingly similar to conclude that the scale really measures the same phenomenon in symptomatic women. The sub-scores and total score correlations were high (0.7–0.9) but lower among the sub-scales (0.5–0.7). This however suggests that the subscales are not fully independent. Norm values from different populations were presented showing that a direct comparison between Europe and North America is possible, but caution recommended with comparisons of data from Latin America and Indonesia. But this will not affect intra-individual comparisons within clinical trials. The comparison with the Kupperman Index showed sufficiently good correlations, illustrating an adept criterion-oriented validity. The same is true for the comparison with the generic quality-of-life scale SF-36 where also a sufficiently close association has been shown. Conclusion The currently available methodological evidence points towards a high quality of the MRS scale to measure and to compare HRQoL of aging women in different regions and over time, it suggests a high reliability and high validity as far as the process of construct validation could be completed yet.
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                Author and article information

                Journal
                J Caring Sci
                J Caring Sci
                J Caring Sci
                JCS
                TBZMED
                Journal of Caring Sciences
                Tabriz University of Medical Sciences
                2251-9920
                September 2019
                01 September 2019
                : 8
                : 3
                : 181-189
                Affiliations
                1Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
                2Department of pharmacology, Faculty of pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
                3Women's Health Research Center, Faculty of Medicine Mashhad University of Medical Sciences, Mashhad, Iran
                4Department of Acupuncture, Faculty of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
                Author notes
                [* ]Corresponding Author: PhD in Midwifery, Email: MirzaiiKH@ 123456mums.ac.ir
                Author information
                https://orcid.org/0000-0003-4381-7902
                https://orcid.org/0000-0001-5068-0217
                https://orcid.org/0000-0002-3483-851x
                https://orcid.org/0000-0003-4593-0917
                https://orcid.org/0000-0003-4724-518x
                https://orcid.org/0000-0003-4139-564x
                Article
                10.15171/jcs.2019.026
                6778311
                75dc2203-2f64-4897-94cf-418e6418ef96
                © 2019 The Author(s).

                This work is published by Journal of Caring Sciences as an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.

                History
                : 28 June 2018
                : 25 August 2018
                Page count
                Figures: 4, Tables: 3, References: 40
                Categories
                Original Research

                menopause,herbal medicines,alternative medicines,menopause rating scale

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