***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE To evaluate the efficacy of phloroglucinol in preventing  bladder spasm after transurethral resection of the prostate ( TURP ) . METHODS Using the r and om sampling method , we assigned 74 cases of TURP into a treatment group ( n = 39 ) , given 80 mg phloroglucinol every day for 3 days , and a control group ( n = 35 ) , left untreated . Then we observed the frequency , duration and pain of bladder spasm within the 3 days and compared them between the two groups . RESULTS The mean frequency , duration and pain visual analogue score of bladder spasm were ( 4.3 + /- 1.2 ) times , ( 7.2 + /- 2.1 ) min and 3.2 + /- 1.6 respectively in the treatment group , as compared with ( 7.5 + /- 2.4 ) times , ( 15.6 + /- 6.8 ) min and 4.7 + /- 2.3 in the control , with statistically significant differences between the two groups ( P < 0.05 ) . And no obvious adverse reactions were found in the treatment group . CONCLUSION Phloroglucinol is safe and effective for the prevention and treatment of bladder spasm following TURP BACKGROUND The excruciating pain of patients with renal colic on presentation to the emergency department requires effective analgesia to be administered in the shortest possible time . Trials comparing intramuscular non-steroidal anti-inflammatory drugs with intravenous opioids or paracetamol have been inconclusive because of the challenges associated with concealment of r and omisation , small sample size , differences in outcome measures , and inadequate masking of participants and assessors . We did this trial to develop definitive evidence regarding the choice of initial analgesia and route of administration in participants presenting with renal colic to the emergency department . METHODS In this three-treatment group , double-blind , r and omised controlled trial , adult participants ( aged 18 - 65 years ) presenting to the emergency department of an academic , tertiary care hospital in Qatar , with moderate to severe renal colic ( Numerical pain Rating Scale ≥ 4 ) were recruited . With the use of computer-generated block r and omisation ( block sizes of six and nine ) , participants were assigned ( 1:1:1 ) to receive diclofenac ( 75 mg/3 mL intramuscular ) , morphine ( 0.1 mg/kg intravenous ) , or paracetamol ( 1 g/100 mL intravenous ) . Participants , clinicians , and trial personnel were masked to treatment assignment . The primary outcome was the proportion of participants achieving at least a 50 % reduction in initial pain score at 30 min after analgesia , assessed by intention-to-treat analysis and per- protocol analysis , which included patients where a calculus in the urinary tract was detected with imaging . This trial is registered with Clinical Trials.gov , number NCT02187614 . FINDINGS Between Aug 5 , 2014 , and March 15 , 2015 , we r and omly assigned 1645 participants , of whom 1644 were included in the intention-to-treat analysis ( 547 in the diclofenac group , 548 in the paracetemol group , and 549 in the morphine  group ) . Ureteric calculi  were detected in 1316 patients , who were analysed as the per- protocol population ( 438 in the diclofenac group , 435 in the paracetemol group , and 443 in the morphine group ) . The primary outcome was achieved in 371 ( 68 % ) patients in the diclofenac group , 364 ( 66 % ) in the paracetamol group , and 335 ( 61 % ) in the morphine group in the intention-to-treat population . Compared to morphine , diclofenac was significantly more effective in achieving the primary outcome ( odds ratio [ OR ] 1·35 , 95 % CI 1·05 - 1·73 , p=0·0187 ) , whereas no difference was detected in the effectiveness of morphine compared with intravenous paracetamol ( 1·26 , 0·99 - 1·62 , p=0·0629 ) . In the per- protocol population , diclofenac ( OR 1·49 , 95 % CI 1·13 - 1·97 , p=0·0046 ) and paracetamol ( 1·40 , 1·06 - 1·85 , p=0·0166 ) were more effective than morphine in achieving the primary outcome . Acute adverse events in the morphine group occurred in 19 ( 3 % ) participants . Significantly lower numbers of adverse events were recorded in the diclofenac group ( 7 [ 1 % ] participants , OR 0·31 , 95 % CI 0·12 - 0·78 , p=0·0088 ) and paracetamol group ( 7 [ 1 % ] participants , 0·36 , 0·15 - 0·87 , p=0·0175 ) than in the morphine group . During the 2 week follow-up , no additional adverse events were noted in any group . INTERPRETATION Intramuscular non-steroidal anti-inflammatory drugs offer the most effective sustained analgesia for renal colic in the emergency department and seem to have fewer side-effects . FUNDING Hamad Medical Corporation Medical Research Center , Doha , Qatar To investigate whether the addition of phloroglucinol to parecoxib could improve the efficacy in patients with acute renal colic . Patients of acute renal colic were r and omly allocated to receive intravenous Parecoxib 40 mg plus placebo or Parecoxib 40 mg plus phloroglucinol 80 mg , respectively . Pain intensity was recorded using a visual analog scale ( VAS ) before drug administration and 5 , 15 , 30 , 60 , and 120 min after treatment start . The primary outcome was the mean pain intensity difference ( PID ) at each checkpoint and the effectiveness of drugs ( ≥50 % decrease in VAS score at the end checkpoint ) . The need for rescue analgesics and the incidence of adverse effects were considered as secondary outcome of the study . Among 236 patients enrolled in the study , 119 patients received intravenous parecoxib plus placebo  and 114 patients received intravenous parecoxib plus phloroglucinol , the remaining 3 patients given up treatment . Baseline demographics were similar between two groups . There are significant differences in the PID at 15 and 30 min between two groups ( P15 min = 0.011 , P30 min = 0.013 ) . Rescue analgesics were required by 17 patients ( 14.3 % ) receiving parecoxib , 7 patients ( 6.1 % ) receiving parecoxib plus phloroglucinol ( P = 0.041 ) . There were no differences in PID at other checkpoints between two groups , as well as in the incidence of adverse events and the drug effectiveness . Parecoxib in combination with phloroglucinol for acute renal colic has a faster action , also reduces the dem and of rescue analgesics PURPOSE Recent studies show the interesting efficacy of different drug combinations for the spontaneous expulsion of distal ureteral stones . We performed a r and omized , prospect i ve study to assess and compare the efficacy of 3 drugs as medical expulsive therapy for distal ureteral calculi . MATERIAL S AND METHODS A total of 210 symptomatic patients with distal ureteral calculi greater than 4 mm were r and omly allocated to home treatment with phloroglucinol , tamsulosin or nifedipine ( groups 1 to 3 , respectively ) . Each group was given a corticosteroid drug and antibiotic prophylaxis with an injectable nonsteroidal anti-inflammatory drug was also used on dem and . The primary end point was the expulsion rate and the secondary end points were expulsion time , analgesic use , need for hospitalization and endoscopic treatment as well as the number of workdays lost , quality of life and drug side effects RESULTS The expulsion rate was significantly higher in group 2 ( 97.1 % ) than in groups 1 ( 64.3 % , p < 0.0001 ) or 3 ( 77.1 % , p < 0.0001 ) . Group 2 significantly achieved stone passage in a shorter time than the other 2 groups and showed a significantly decreased number of hospitalizations as well as a better decrease in endoscopic procedures performed to remove the stone . The control of renal colic pain was significantly superior in group 2 compared with the other groups , result ing in fewer workdays lost . Group 3 showed lower analgesic use and decreased workdays lost compared with group 1 . No difference in side effects was observed among the groups . CONCLUSIONS Medical expulsive therapy should be considered for distal ureterolithiasis without complications before ureteroscopy or extracorporeal lithotripsy . The use of tamsulosin in this treatment regimen produced stone expulsion in almost all cases in a short time , allowing complete home patient treatment To assess the spasmolytic effect of  drotaverine hydrochloride  in colicky pain caused by renal and ureteric stones BACKGROUND & AIMS Abdominal pain is the main symptom in patients with irritable bowel syndrome ( IBS ) .  Glycerol is an irritant of colonic mucosa . The aim of this study was to evaluate the effects of an intraluminal injection of glycerol on colonic motility and tone in patients with IBS and their modulation by drugs . METHODS Colonic motility was evaluated using electromyography , and colonic tone was assessed using a barostat . Glycerol was injected in the right colon or the rectum . RESULTS After intracolonic injection of glycerol , a strong abdominal colic occurred and was associated with an increase in long spike burst activity ( + 280 % ) , which was eliminated by previous administration of lidocaine and was not observed after paraffin oil . When glycerol was injected intrarectally , abdominal pain occurred and long spike burst activity was increased ( + 240 % ) in the left colon . Simultaneously , colonic tone decreased ( -70 % ) and high-amplitude phasic contractions occurred ( 10 + /- 1/patient ) . This rectocolonic reflex was reproducible in the same patient . Drugs acting on visceral afferent pathways ( octreotide and granisetron ) did not modify this reflex , whereas the spasmolytic drug phloroglucinol inhibited phasic contractions without affecting tone . CONCLUSIONS Intraluminal injection of glycerol triggers viscerovisceral reflexes , result ing in abdominal pain in patients with IBS . It could be used as a model for the study of effects of drugs on pain in these patients Twenty patients ( 15 women , 5 men , mean age : 46.3 + /- 11.82 years , mean weight : 70.9 + /- 8.83 kg ) presenting with a 8.5 + /- 4.7 years ' history of irritable bowel syndrome associated predominantly with postpr and ial abdominal pain were recruited into the study . They underwent , after an enema , a rectosigmoid manometry ( 4 channels , low compliant infusion pump and catheters ) before and after a 1000 kcal st and ardized meal . At the end of the meal they were administered intravenously phloroglucinol ( two 40 mg ampoules ) or placebo ( two ampoules ) . Both treatments were strictly similar and the order of administration was r and omly assigned Motor activity at the rectum , rectosigmoid , lower sigmoid and sigmoid level was determined using a motor index calculated for each 15 min period . Three prepr and ial and four postpr and ial indices were calculated . Both groups were statistically similar for sex ratio , age and history of disease . A slight difference was noted for mean weight : the caloric instake per kg of weight was a little higher in the phloroglucinol group . Mean prepr and ial indices were comparable in both groups . Variance analysis showed that the increase in postpr and ial motor indices was statistically less pronounced in the phloroglucinol group than in the placebo group . In the placebo group a clear cut increase in motor activity was assessed , which was not observed in the phloroglucinol group . This variation of motricity , which was observed at every level , was more pronounced for the first two postpr and ial indices than for the last two ones . These results suggest that phloroglucinol is able to reduce rectosigmoid motor response after a test meal . This could explain its activity in abdominal pain associated with irritable bowel syndrome PURPOSE We tested whether the addition of phloroglucinol to piroxicam could improve pain relief in patients with acute renal colic visiting the emergency department . MATERIAL S AND METHODS Patients with a diagnosis of acute renal colic were prospect ively r and omized to receive intravenous phloroglucinol ( 200 mg ) or placebo combined with intramuscular piroxicam ( 20 mg ) . We monitored the visual analogic scale ( VAS ) , heart rate , arterial blood 
    Output:
    
Discussion There is insufficient data to justify the wide-spread prescription of phloroglucinol for alleviating abdominal pain