***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: The effectiveness of cabbage leaf extract was compared with that of a placebo in treating breast engorgement in lactating women . In a double-blind experiment with a pretest/posttest design , 21 participants received a cream containing cabbage leaf extract , while 18 received placebo cream .  The placebo group received equal relief to the treated group , with the two groups showing no difference on all outcome measures . However , mothers perceived both creams to be effective in relieving discomfort . Feeding had a greater effect than the application of cream on relieving discomfort and decreasing tissue hardness . It is therefore recommended that lactation consultants encourage mothers to breastfeed if possible to relieve the discomfort of breast engorgement We evaluated an anti-inflammatory enzyme drug Danzen ( Serrapeptase : Takeda Chemical Industries , Ltd. ) on 70 patients complaining of breast engorgement . These patients were r and omly divided into 2 groups , a treatment group and a placebo group . A single observer , unaware of the group the patients were in , assessed the severity of each of the symptoms and signs of breast engorgement before treatment was commenced , and daily for 3 days , during which therapy was administered . Danzen was noted to be superior to placebo for improvement of breast pain , breast swelling and in duration and while 85.7 % of the patients receiving Danzen had " Moderate to Marked " improvement , only 60.0 % of the patients receiving placebo had a similar degree of improvement . " Marked " improvement was found in 22.9 % of the treatment group and 2.9 % of the placebo group . These differences were statistically significant ( P less than 0.05 ) . No adverse reactions were reported with the use of Danzen . Danzen is a safe and effective method for the treatment of breast engorgement The aim of this study was to test the efficacy of thermal ultrasound therapy as a treatment for severe post partum breast engorgement .  A r and omised double-blind , placebo-controlled trial was conducted on 197 breasts . Two ultrasound machines of identical appearance were used . One was working normally , the other had the crystal replaced with a resistor producing surface heat only . Assessment of effectiveness was subjective , using visual analogue scales for pain and hardness , and objective , using tonometry . Results indicate that both the true and sham machines were effective in reducing subjectively perceived pain and hardness . However , the results of this study show that the effect can not be attributed to the ultrasound component This study compared the effectiveness of chilled green cabbage leaves and chilled gelpaks in reducing breast engorgement in postpartum mothers . Thirtyfour lactating women with breast engorgement used chilled cabbage leaves on one breast and chilled gelpaks on the other for up to eight hours . Their pain levels were established pre-treatment and compared post-treatment for both conditions . There was no difference in the post-treatment ratings for the two treatments . Mothers reported a statistically significant drop in pain with both treatments ; 68 percent obtained relief within one to two hours . The majority of mothers preferred the cabbage leaves A r and omized , controlled trial was conducted to evaluate the effect of cabbage leaves on mothers ' perceptions of breast engorgement and the influence of this treatment on breastfeeding practice s. The subjects , 120 breastfeeding women 72 hours postpartum , were r and omly allocated to an experimental group who received application of cabbage leaves to their breasts , or to a control group who received routine care . The experimental group tended to report less breast engorgement , but this trend was not statistically significant . At six weeks , women who received the cabbage leaf application were more likely to be breastfeeding exclusively , 76 and 58 percent ( 35/46 vs 29/50 ; P = 0.09 ) , and their mean duration of exclusive breastfeeding was longer ( 36 vs 30 days ; P = 0.04 ) . The greater breastfeeding success in the experimental group may have been due to some beneficial effect of cabbage leaf application , or may have been secondary to reassurance and improved confidence and self-esteem in these mothers This study compared the effectiveness of chilled and room temperature green cabbage leaves in reducing the discomfort of breast engorgement in postpartum mothers . Twenty-eight lactating women with breast engorgement used chilled cabbage leaves on one breast and room-temperature cabbage leaves on the other for a two-hour period . Pre-treatment pain levels were compared with post-treatment levels for both conditions . There was no difference in the post-treatment ratings for the two treatments ; mothers reported significantly less pain with both treatments . We concluded that it is not necessary to chill cabbage leaves before use 
    Output:
    
Ultrasound treatment and placebo were equally effective .
Oxytocin and cold packs had no demonstrable effect on engorgement symptoms .
REVIEW ER 'S CONCLUSIONS Cabbage leaves and gel packs were equally effective in the treatment of engorgement .
Since both cabbage extract and placebo cream were equally effective , the alleviation in symptoms may be brought about by other factors , such as breast massage .
Ultrasound treatment is equally effective with or without the ultra-wave emitting crystal , therefore its effectiveness is more likely to be due to the effect of radiant heat or massage .
Pharmacologically , oxytocin was not an effective engorgement treatment while Danzen and bromelain/trypsin complex significantly improved the symptoms of engorgement .