Oral antihistamine-decongestant-analgesic combinations for the common cold

Background : Although combination formulas containing antihistamines, decongestants and/or analgesics are sold over-the-counter (OTC) in large quantities for the common cold, the evidence of effectiveness is limited. Objectives : To assess the effectiveness of antihistamine-decongestant-analgesic combinations in reducing the duration and alleviating the symptoms of the common cold in adults and children. Search methods : We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4), which contains the Cochrane Acute Respiratory Infections Group's Specialised Register, OLDMEDLINE (1953 to 1965), MEDLINE (1966 to November Week 3, 2011) and EMBASE (1990 to December 2011). Selection criteria : Randomised controlled trials (RCTs) investigating the effectiveness of antihistamine-decongestant-analgesic combinations compared with placebo, other active treatment (excluding antibiotics) or no treatment in children and adults with the common cold. Data collection and analysis : Two review authors independently extracted and summarised data on general recovery, nasal obstruction, rhinorrhoea, sneezing, cough and side effects. We categorised the trials according to the active ingredients. Main results : We included 27 trials (5117 participants) of common cold treatments. Fourteen trials studied antihistamine-decongestant combinations; two antihistamine-analgesic; six analgesic-decongestant; and five antihistamine-analgesic-decongestant combinations. In 21 trials the control intervention was placebo and in six trials an active substance. Reporting of methods in most trials was poor and there were large differences in design, participants, interventions and outcomes. Pooling was only possible for a limited number of studies and outcomes. Antihistamine-decongestant: 12 trials. Eight trials report on global effectiveness, six could be pooled; n = 309 on active treatment, n = 312 placebo) the odds ratio (OR) of treatment failure was 0.27 (95% confidence interval (CI) 0.15 to 0.50); the number needed to treat for an additional beneficial outcome (NNTB) was four (95% CI 3 to 5.6). On the final evaluation day 41% of participants in the placebo group had a favourable response compared to 66% on active treatment. Of the two trials that were not included in the pooling, one showed some global effect, the other showed no effect. Antihistamine-analgesic: three trials. Two reported on global effectiveness, data from one study was presented. (n = 290 on active treatment, n = 292 ascorbic acid). The OR of treatment failure was 0.33 (95% CI 0.23 to 0.46) and the NNTB was 6.67 (95% CI 4.76 to 12.5). After six days of treatment 43% were cured in the control group and 70% in the active treatment group. The second study also showed an effect in favour of active treatment. Analgesic-decongestant: six trials. One trial reported on global effectiveness: 73% benefited compared with 52% in the control group (paracetamol) (OR 0.28, 95% CI 0.15 to 0.52). Antihistamine-analgesic-decongestant: Five trials. Four trials reported on global effectiveness, two could be pooled: global effect reported (less than one severity point on a four or five-point scale) with active treatment (52%) and placebo (34%); the OR of treatment failure was 0.47 (95% CI 0.33 to 0.67) and the NNTB was 5.6 (95% CI 3.8 to 10.2). Two other trials found no beneficial effect. Two other studies did not show any effect. Two studies with antihistamine-decongestant (113 children) could not be pooled. There was no significant effect of the active treatment. Adverse effects: the combination of antihistamine-decongestant had more adverse effects than the control intervention but the difference was not significant: 157/810 (19%) versus 60/477 (13%) participants suffered one or more adverse effects (OR 1.58, 95% CI 0.78 to 3.21). Analgesic-decongestant combinations had significantly more adverse effects than control (OR 1.71, 95% CI 1.23 to 2.37); the number needed to treat for an additional harmful outcome (NNTH) was 14. None of the other two combinations caused significantly more adverse effects. Antihistamine-analgesic: 11/90 with combination suffered one or more adverse effects (12%) versus 9/91 (10%) with control (OR 1.27, 95% CI 0.50 to 3.23). Antihistamine-analgesic-decongestant: in one study 5/224 (2%) suffered adverse effects with active treatment versus 9/208 (4%) with placebo. Two other trials reported no differences between treatment groups but numbers were not reported. Authors' conclusions : Current evidence suggests that antihistamine-analgesic-decongestant combinations have some general benefit in adults and older children. These benefits must be weighed against the risk of adverse effects. There is no evidence of effectiveness in young children

Effects of pH on the stability of cyanidin and cyanidin 3-O-β-glucopyranoside in aqueous solution

The colour variation, colour intensity and stability at various pH values (2.0, 4.0, 7.0 and 9.0) of cyanidin 3-O-β-glucopyranoside (Cy3Glc) and its aglycone cyanidin was investigated during a period of 8 hours storage at 25ºC. Our data showed that pH of aqueous solution had impact on spectroscopic profile of cyanidin and Cy3Glc. Beginning with the most acidic solutions, increasing the pH induce bathochromic shifts of absorbance maximum in the visible range for all examined pH values (with the exception pH 4.0 for cyanidin), while the presence of the 3-glucosidic substitution induce hypsochromic shift. Compared to cyanidin, Cy3Glc has higher colour intensity and higher stability in the whole pH range, except at pH 7.0. The 3-glucosidic substitution influences on the colour intensity of Cy3Glc in the alkaline region. After 8-hour incubation of Cy3Glc and cyanidin at pH 2.0 and 25 ºC, 99% of Cy3Glc and only 27% of cyanidin remained unchanged

Effect of gentisic acid on the structural-functional properties of liposomes incorporating beta-sitosterol

Multifunctional liposomes incorporating beta-sitosterol were developed for delivery of gentisic acid (GA). The interactions of both compounds with phospholipid bilayer were interpreted viaeffects of different beta-sitosterol content (0, 20 and 50 mol %) and different gentisic acid to lipid ratio (n(GA)/n(lip) from 10(-5) to 1) on membrane fluidity and thermotropic properties. Multilamellar vesicles of phosphatidylcholines (with size range between 1350 and 1900 nm) effectively encapsulated GA (54%) when n(GA)/n(lip) was higher than 0.01. Suppression of lipid peroxidation was directly related to concentration of GA. The resistance to diffusion of gentisic acid from liposomes increased for (similar to)50% in samples incorporating 50 mol % beta-sitosterol compared to sterol-free liposomes. Finally, simulated in vitro gastrointestinal conditions showed that the release was mainly affected by low pH of simulated gastric fluid and the presence of cholates in simulated intestinal fluid, rather than by enzymes activity

Correlates of business survival: empirical evidence on youth-owned micro and small enterprises in Urban Ethiopia

Abstract This paper investigates the effects of person-, firm-, industry-, and business strategy-specific characteristics on the survival of youth-owned urban micro and small enterprises in Ethiopia. It employs nonparametric and semi-parametric methodologies using a retrospective data. The hazard rate reaches the highest point at business 2 years for micro enterprises and 4 years for small enterprises. Owner-, firm-, and industry-specific characteristics are important factors for micro and small enterprises’ (MSEs’) survival. Marketing and financial management strategies are playing a crucial role on extending MSEs’ survival duration. The study implies there should be more effective and longer period of support for micro than small enterprises