***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: Background Approximately 80 percent of pregnant women suffer by some degree of nausea and vomiting . But the treatment of nausea and vomiting of pregnancy is rarely successful . Objectives The aim of this study was evaluation the effect of mint on nausea and vomiting during pregnancy that its treatment in some recent research has been effective . Material s and Methods In this double blind RCT , 60 pregnant women with nausea and vomiting of pregnancy were sample d and divided into two groups with Block-r and omized method . mint group , in addition to giving the routine training , for four consecutive nights , before sleeping , a bowel of water whit four drops of pure mint essential oil placed on the floor near their beds and in control groups were used four drops of normal saline . The severity of nausea by using Visual Analog Scale ( VAS ) and severity of vomiting by counting the number of its in 7 days prior , 4 days during , and 7 days after intervention were assessed . Results The results showed that the severity of nausea and vomiting did not differ between the two groups in 7days before and after intervention by using repeated measurement test . But during intervention , the severity of nausea showed a decreasing trend ( especially in 4th night ) in the mint and an increasing trend in the control group . The severity of nausea within 7 days after the intervention had a decreasing trend in both groups ; however , the intensity was lower in the mint than saline group but not statically significant . No meaningful relationship has been detected during and after intervention for the intensity of vomiting . Conclusions The results of study showed that peppermint essential oil has n't the effect on nausea and vomiting of pregnancy OBJECTIVE To evaluate the effectiveness of Diclectin ( doxylamine succinate 10 mg-pyridoxine hydrochloride 10 mg , delayed-release preparation ) as compared with placebo for nausea and vomiting of pregnancy . STUDY DESIGN A r and omized , double-blind , multicenter placebo controlled trial study ing pregnant women suffering from nausea and vomiting of pregnancy , analyzed by intention to treat . Women received Diclectin  ( n = 131 ) or placebo ( n = 125 ) for 14 days . Nausea and vomiting of pregnancy symptoms were evaluated daily using the pregnancy unique quantification of emesis scale . RESULTS Diclectin use result ed in a significantly larger improvement in symptoms of nausea and vomiting of pregnancy compared with placebo based on both the pregnancy unique quantification of emesis score ( -4.8 ± 2.7 vs -3.9 ± 2.6 ; P = .006 ) and quality of life . After the trial , 64 ( 48.9 % ) women receiving Diclectin asked to continue compassionate use of their medication , as compared with 41 ( 32.8 % ) of placebo-treated women ( P = .009 ) . CONCLUSION Diclectin delayed release formulation of doxylamine succinate and pyridoxine hydrochloride is effective and well tolerated in treating nausea and vomiting of pregnancy This study assesses the effects of ginger on  nausea and vomiting caused by pregnancy and compares it with metoclopramide medicine . This study was a r and omized double-blind controlled trial . Metoclopramide , Ginger and placebo were putted in similar capsules . The medicines were administered three times a day . Then the Rhodes question naire was completed and its score were calculated . Data were analyzed by Chi square test , ANOVA and Repeated measurement . The intensity of changes in nausea , vomiting and Rhodes during study were statistically different in two groups of ginger and metoclopramide compared with placebo ( p < 0.05 ) , but it was not statistically significant between two groups of ginger and metoclopramide . According to our study , ginger is less effective than metoclopramide in reducing nausea and vomiting but it could be a good alternative for metoclopramide OBJECTIVES Recent studies have concluded that acupuncture is safe in the h and s of a qualified practitioner . This study assessed the risk of adverse effects of acupuncture administered during pregnancy . METHODS 593 women with nausea and vomiting in early pregnancy volunteered to participate in a r and omised controlled trial , conducted at the Women 's and Children 's Hospital , in South Australia . Patients were given either traditional acupuncture , formula acupuncture , sham acupuncture or no acupuncture . OUTCOME MEASURES Data were collected on perinatal outcome , congenital abnormalities , pregnancy complications and the newborn . RESULTS No differences were found between study groups in the incidence of perinatal outcome , congenital abnormalities , pregnancy complications and other infant outcomes . CONCLUSION Our findings suggest that no serious adverse effects arise from acupuncture administered in early pregnancy OBJECTIVE Hyperemesis gravidarum , a severe form of nausea and vomiting due to pregnancy for which there is no proven pharmacological treatment , is the third leading cause for hospitalization during pregnancy . Corticosteroids are commonly used for the treatment of nausea and vomiting due to cancer chemotherapy – induced emesis and might prove useful in hyperemesis gravidarum . METHODS A r and omized , double-blind , placebo-controlled trial was conducted in 126 women who previously had not responded to outpatient therapy for hyperemesis gravidarum during the first half of pregnancy .  Intravenous methylprednisolone ( 125 mg ) was followed by an oral prednisone taper ( 40 mg for 1 day , 20 mg for 3 days , 10 mg for 3 days , 5 mg for 7 days ) versus an identical-appearing placebo regimen . All women also received promethazine 25 mg and metoclopramide 10 mg intravenously every 6 hours for 24 hours , followed by the same regimen administered orally as needed until discharge . The primary study outcome was the number of women requiring rehospitalization for hyperemesis gravidarum . RESULTS A total of 110 women delivered at our hospital and had pregnancy outcomes available for analysis ; 56 were r and omized to corticosteroids and 54 were administered placebo . Nineteen women in each study group required rehospitalization ( 34 % versus 35 % , P = .89 , for corticosteroids versus placebo , respectively ) . CONCLUSION The addition of parenteral and oral corticosteroids to the treatment of women with hyperemesis gravidarum did not reduce the need for rehospitalization later in pregnancy Background . To determine whether low dosages of prednisolone are effective in the treatment of out patients with hyperemesis gravidarum Objective To compare the effectiveness of acupressure and vitamin B6 in the outpatient treatment of nausea and vomiting in early pregnancy . Study design Pregnant volunteers with symptoms of mild to moderate nausea and vomiting between 6 and 12 weeks ’ gestation participated in a 7-day clinical trial . Participants were r and omly assigned to receive a device for acupressure therapy and placebo drug or an otherwise identical but non-stimulating placebo device and vitamin B6 . The primary outcome measure was self-recorded symptoms according to Rhodes index . Secondary outcome measures were weight gain and medication use . Results The mean change in Rhodes index was not significantly different between the two groups . There were no statistically significant differences in weight gain and medication use between the two groups . Conclusion Acupressure therapy is not more effective than vitamin B6 in reducing nausea and vomiting in symptomatic women in the first trimester of pregnancy BACKGROUND Although the effectiveness of prednisolone therapy for severe hyperemesis gravidarum has been demonstrated , there is no consensus on how to assess severity to justify such treatment , nor any information on whether such therapy affects birth weight . AIM To document the effect of prednisolone therapy in women with defined severity of hyperemesis gravidarum . DESIGN Single centre , observational study of 30 consecutive pregnancies complicated by hyperemesis and weight loss of > 5 % of pre-pregnant weight between April 1995 and July 2000 . Comparison of birth weight with a contemporaneous control series of women admitted with hyperemesis that was judged insufficiently severe to require steroids .  RESULTS Treatment with prednisolone 10 mg tid rapid resolved nausea and vomiting , allowing discharge in 3 ( range 1 - 6.5 ) days . Steroid therapy , which was reduced in a stepwise manner , was discontinued at a median gestation of 20 weeks . Maternal weight gain in pregnancy was restored to normal . Median birth weight in the severe , steroid-treated group was 3.33 ( range 2.80 - 3.27 ) kg vs. 3.27 ( range 3.04 - 3.53 ) kg in the less severe group . CONCLUSION Weight loss > 5 % served as a criterion to define a subset of women with severe hyperemesis gravidarum . In these women , steroid therapy was uniformly successful result ing in the prompt resolution of symptoms . Steroid therapy did not affect birth weight OBJECTIVE Our purpose was to investigate the efficacy of P6 acupressure in reducing or relieving symptoms of nausea with or without vomiting and retching  during pregnancy . STUDY DESIGN Symptomatic pregnant volunteers ( n=161 ) participated in a 7-day community-based clinical trial . All participants were assigned to one of three groups ( i.e. , P6 acupressure , placebo [ acupressure b and s inappropriately placed ] , or control ) on the basis of a process of blocked r and omization . Data were analyzed by error bar charts and analysis of variance of difference scores . RESULTS Of 161 women , 149 ( 92.5 % ) completed the protocol . Irrespective of group assignment , participants reported significant decreases in nausea ( p<0.0009 ) and vomiting or retching ( p<0.0009 ) . However , there was no differential treatment effect as a result of acupressure . CONCLUSION There was no apparent medical benefit from the use of P6 acupressure . Our findings differ from other recently published studies that did not include a control group In the GRADE approach , r and omized trials start as high- quality evidence and observational studies as low- quality evidence , but both can be rated down if most of the relevant evidence comes from studies that suffer from a high risk of bias . Well-established limitations of r and omized trials include failure to conceal allocation , failure to blind , loss to follow-up , and failure to appropriately consider the intention-to-treat principle . More recently recognized limitations include stopping early for apparent benefit and selective reporting of outcomes according to the results . Key limitations of observational studies include use of inappropriate controls and failure to adequately adjust for prognostic imbalance . Risk of bias may vary across outcomes ( e.g. , loss to follow-up may be far less for all-cause mortality than for quality of life ) , a consideration that many systematic review s ignore . In deciding whether to rate down for risk of bias -- whether for r and omized trials or observational studies -- authors should not take an approach that averages across studies . Rather , for any individual outcome , when there are some studies with a high risk , and some with a low risk of bias , they should consider including only the studies with a lower risk of bias Objective To determine the effectiveness of ginger for the treatment of nausea and vomiting of pregnancy . Methods Women with nausea and vomiting of pregnancy , who first attended an antenatal clinic at or before 17 weeks ' gestation , were invited to participate in the study . During a 5-month period , 70 eligible women gave consent and were r and omized in a double-masked design to receive either oral ginger 1 g per day or an identical placebo for 4 days . Subjects grade d the severity of their nausea using visual analog scales and recorded the number of vomiting episodes in the previous 24 hours before treatment , and again during 4 consecutive days while taking treatment . At a follow-up visit 7 days later , five-item Likert scales were used to assess the severity of their symptoms . Results All participants except three in the placebo group remained in the study . The visual analog scores of posttherapy minus baseline nausea decreased significantly in the ginger group ( 2.1 ± 1.9 ) compared with the placebo group ( 0.9 ± 2.2 , P = .014 ) . The number of vomiting episodes also decreased significantly in the ginger group ( 1.4 ± 1.3 ) compared with the placebo group ( 0.3 ± 1.1 , P < .001 ) . Likert scales showed that 28 of 32 in the ginger group had improvement in nausea symptoms compared with 10 of 35 in the placebo group ( P < .001 ) . No adverse effect of ginger on pregnancy outcome was detected . Conclusion Ginger is effective for relieving the severity of nausea and vomiting of pregnancy OBJECTIVE The aim of this study was to determine the effects of ginger in nausea and vomiting of pregnancy . DESIGN This was a single blind clinical trial study . SETTING The study was conducted in a selected prenatal care clinic of Isfahan City hospitals . SUBJECTS The subjects included 67 pregnant women who complained of nausea and vomiting from Isfahan city hospitals participated in the study . INTERVENTION The participants were r and omly assigned to two groups , an experimental group and a control group . The groups were matched according to the age , gestational age , parity , occupational status , and educational level of the participants . The experimental group received ginger 250 mg capsules for 4 days , and the control group received placebo with the same prescription form . OUTCOME MEASURES Effects of treatment of nausea were evaluated twice daily for 4 days by a before- and - 
    Output:
    
Diclectin ® [ Duchesnay Inc. ; doxylamine succinate ( 10 mg ) plus pyridoxine hydrochloride ( 10 mg ) slow release tablet ] is more effective than placebo and ondansetron is more effective at reducing nausea than pyridoxine plus doxylamine .
Diclectin before symptoms of NVP begin for women at high risk of severe NVP recurrence reduces risk of moderate/severe NVP compared with taking Diclectin once symptoms begin .
Promethazine is as , and ondansetron is more , effective than metoclopramide for severe NVP/HG .
I.v .
fluids help correct dehydration and improve symptoms .
Dextrose saline may be more effective at reducing nausea than normal saline .
Transdermal clonidine patches may be effective for severe HG .
Enteral feeding is effective but extreme method treatment for very severe symptoms .
Day case management for moderate/severe symptoms is feasible , acceptable and as effective as inpatient care .
The economic analysis was limited by lack of effectiveness data , but comparison of costs between treatments highlights the implication s of different choices .
There was evidence of some improvement in symptoms for some treatments , but these data may not be transferable across disease severities .