***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a preliminary study , carriers of hepatitis B virus were treated with a preparation of the plant Phyllanthus amarus for 30 days . 22 of 37 ( 59 % ) treated patients had lost hepatitis B surface antigen when tested 15 - 20 days after the end of the treatment compared with only 1 of 23 ( 4 % ) placebo-treated controls . Some subjects have been followed for up to 9 months . In no case has the surface antigen returned . Clinical observation revealed few or no toxic effects . The encouraging results of this preliminary study recommend continued evaluation of this plant and the active principles isolated from it Background Clinical evidence continues to exp and and is increasingly difficult to overview . We aim ed at conceptualizing a visual assessment tool , i.e. , a matrix for overviewing studies and their data in order to assess the clinical evidence at a glance . Methods A four-step matrix was constructed using the three dimensions of systematic error , r and om error , and design error . Matrix step I ranks the identified studies according to the dimensions of systematic errors and r and om errors . Matrix step II orders the studies according to the design errors . Matrix step III assesses the three dimensions of errors in studies . Matrix step IV assesses the size and direction of the intervention effect . Results The application of this four-step matrix is illustrated with two examples : peri-operative beta-blockade initialized in relation to surgery versus placebo for major non-cardiac surgery , and antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation .  When clinical evidence is deemed both internally and externally valid , the size of the intervention effect is to be assessed . Conclusion The error matrix provides an overview of the validity of the available evidence at a glance , and may assist in deciding which interventions to use in clinical practice OBJECTIVES To analyze sources search ed in Cochrane review s , to determine the proportion of trials included in review s that are indexed in major data bases , and to compare the quality of these trials with those from other sources . METHODS All new systematic review s in the Cochrane Library , Issue1 2001 , that were restricted to r and omized controlled trials ( RCTs ) or quasi- RCTs were selected . The sources search ed in the review s were recorded , and the trials included were checked to see whether they were indexed in four major data bases . Trials not indexed were checked to determine how they could be identified . The quality of trials found in major data bases was compared with those found from other sources . RESULTS The range in the number of data bases search ed per review ranged between one and twenty-seven . The proportion of the trials in the four data bases were Cochrane Controlled Trials Register = 78.5 % , MEDLINE = 68.8 % , Embase = 65.0 % , and Science/Social Sciences Citation Index = 60.7 % . Search ing another twenty-six data bases after Cochrane Controlled Trials Register ( CCTR ) , MEDLINE , and Embase only found 2.4 % additional trials . There was no significant difference between trials found in the CCTR , MEDLINE , and Embase compared with other trials , with respect to adequate allocation concealment or sample size . CONCLUSIONS There was a large variation between review s in the exhaustiveness of the literature search es . CCTR was the single best source of RCTs . Additional data base search ing retrieved only a small percentage of extra trials . Contacting authors and manufacturers to find unpublished trials appeared to be a more effective method of obtaining the additional better quality trials Sixty-five adult asymptomatic chronic carriers of hepatitis B virus were enrolled to the r and omized controlled efficacy study of Phyllanthus amarus . Thirty-four received Phyllanthus amarus 600 mg per day for 30 days and 31 received placebo in identical capsules . The conversion rate of HBsAg was 6 per cent in the study group at day 30 . When 20 subjects in the Phyllanthus amarus group were given a further 30-day treatment and 22 placebo recipients given Phyllanthus amarus 1,200 mg per day for 30 days , the conversion was observed in 1 ( 5 % ) in the higher dose group . Adverse effects were not observed in all patients receiving the plant . The results indicated that Phyllanthus amarus , whole plant except root , grown in the central part of Thail and , given at the studied dosage and duration , had a very minimal effect on eradication of HBsAg from Thai adult asymptomatic chronic carriers BACKGROUND Reports of clinical trials usually emphasize efficacy results , especially when results are statistically significant . Poor safety reporting can lead to misinterpretation and inadequate conclusions about the interventions assessed . Our aim was to describe the reporting of harm-related results from r and omized controlled trials ( RCTs ) . METHODS We search ed the MEDLINE data base for reports of RCTs published from January 1 , 2006 , through January 1 , 2007 , in 6 general medical journals with a high impact factor . Data were extracted by use of a st and ardized form to appraise the presentation of safety results in text and tables . RESULTS Adverse events were mentioned in 88.7 % of the 133 reports . No information on severe adverse events and withdrawal of patients owing to an adverse event was given in 27.1 % and 47.4 % of articles , respectively . Restrictions in the reporting of harm-related data were noted in 43 articles ( 32.3 % ) with a description of the most common adverse events only ( n = 17 ) , severe adverse events only ( n = 16 ) , statistically significant events only ( n = 5 ) , and a combination of restrictions ( n = 5 ) . The population considered for safety analysis was clearly reported in 65.6 % of articles . CONCLUSION Our review reveals important heterogeneity and variability in the reporting of harm-related results in publications of RCTs Background : Previous studies suggested that Phyllanthus species have an anti‐viral effect on hepatitis B , but method ologies have been inadequate BACKGROUND In pre clinical and phase 2 studies , adefovir dipivoxil demonstrated potent activity against hepatitis B virus ( HBV ) , including lamivudine-resistant strains . METHODS We r and omly assigned 515 patients with chronic hepatitis B who were positive for hepatitis B e antigen ( HBeAg ) to receive 10 mg of adefovir dipivoxil ( 172 patients ) , 30 mg of adefovir dipivoxil ( 173 ) , or placebo ( 170 ) daily for 48 weeks . The primary end point was histologic improvement in the 10-mg group as compared with the placebo group . RESULTS After 48 weeks of treatment , significantly more patients who received 10 mg or 30 mg of adefovir dipivoxil per day than who received placebo had histologic improvement ( 53 percent [ P<0.001 ] , 59 percent [ P<0.001 ] , and 25 percent , respectively ) , a reduction in serum HBV DNA levels ( by a median of 3.52 [ P<0.001 ] , 4.76 [ P<0.001 ] , and 0.55 log copies per milliliter , respectively ) , undetectable levels ( fewer than 400 copies per milliliter ) of serum HBV DNA ( 21 percent [ P<0.001 ] , 39 percent [ P<0.001 ] , and 0 percent , respectively ) , normalization of alanine aminotransferase levels ( 48 percent [ P<0.001 ] , 55 percent [ P<0.001 ] , and 16 percent , respectively ) , and HBeAg seroconversion ( 12 percent [ P=0.049 ] , 14 percent [ P=0.01 ] , and 6 percent , respectively ) . No adefovir-associated  resistance mutations were identified in the HBV DNA polymerase gene . The safety profile of the 10-mg dose of adefovir dipivoxil was similar to that of placebo ; however , there was a higher frequency of adverse events and renal laboratory abnormalities in the group given 30 mg of adefovir dipivoxil per day . CONCLUSIONS In patients with HBeAg-positive chronic hepatitis B , 48 weeks of 10 mg or 30 mg of adefovir dipivoxil per day result ed in histologic liver improvement , reduced serum HBV DNA and alanine aminotransferase levels , and increased the rates of HBeAg seroconversion . The 10-mg dose has a favorable risk-benefit profile for long-term treatment . No adefovir-associated resistance mutations were identified in the HBV DNA polymerase gene 
    Output:
    
There is no convincing evidence that phyllanthus compared with placebo  benefits patients with chronic HBV infection .
Phyllanthus plus an antiviral drug may be better than the same antiviral drug alone .