***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: 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 Background and objective : Sore throat and hoarseness rank , besides pain and nausea , among the most frequent subjective complaints after  tracheal intubation  for general anaesthesia . Our intention was to determine the incidence of postoperative sore throat from a large sample of patients and thus to identify the most important associated factors . Methods : We prospect ively followed up 809 adult patients who underwent elective surgical interventions and examined their history , the applied anaesthetic techniques , perioperative course and the occurrence , intensity and duration of postoperative throat complaints . The assignment and professional experience of the involved intubators were also assessed . The influence of a multitude of variables on postoperative throat complaints was statistically analysed . Results : Postoperative sore throat was present in 40 % overall being significantly higher in female than in male ( 44 % vs. 33 % ; P = 0.001 ) . The mean pain intensity in the affected patients ( n = 323 ) was 28 ± 12 mm on a visual analogue scale where 0 = no pain and 100 = extreme pain . The average duration was 16 ± 11 h. Main factors associated with throat complaints were female sex , history of smoking or lung disease , duration of anaesthesia , postoperative nausea , bloodstain on the endotracheal tube and natural teeth . We could find no influence on the occurrence or intensity of throat complaints by the professional assignment or the length of professional experience of the personnel involved . Conclusions : Postoperative throat complaints frequently arise after tracheal intubation for general anaesthesia in the first 2 postoperative days , but they are of limited intensity and duration Background and Aims :  Postoperative sore throat ( POST )  is a well-recognized complication after general anesthesia ( GA ) . Numerous nonpharmacological and pharmacological measures have been used for attenuating POST with variable success . The present study was conducted to compare the efficiency of preoperative nebulization of normal saline and magnesium sulfate in reducing the incidence of POST following GA . Material s and Methods : Following institutional ethical committee approval and written informed consent , a prospect i ve r and omized double-blinded study was conducted in 100 cases divided into two equal groups . Patients included in the study were of either gender belonging to American Society of Anesthesiologist ( ASA ) status 1 or 2 undergoing elective surgery of approximately 2 h or more duration requiring tracheal intubation . Patients in Group A are nebulized with 3 ml of normal saline and the patients in Group B are nebulized with 3 ml of 225 mg isotonic nebulized magnesium sulfate for 15 min , 5 min before induction of anesthesia . The incidence of POST at rest and on swallowing and any undue complaints at 0 , 2 , 4 , and 24 h in the postoperative period are evaluated . Results : There is no significant difference in POST at rest during 0th , 2nd and 4th h between normal saline and MgSO4 . Significant difference is seen at 24th h , where MgSO4 lessens POST . There is no significant difference in POST on swallowing during 0th and 2nd h between normal saline and MgSO4 . Significant difference is seen at 4th h , where MgSO4 has been shown to lessen POST . Conclusions : MgSO4 significantly reduces the incidence of POST compared to normal saline BACKGROUND Postoperative sore throat is a common complication of anaesthesia and can lead to dissatisfaction after surgery . Many factors can contribute to postoperative sore throat and the incidence varies with the method of airway management . METHODS In this prospect i ve observational study elective gynaecological and general surgical patients were interviewed 24 hours postoperatively to determine the presence of sore throat . Information collected included demographic data , surgical procedure , duration of surgery , airway device used and position of patient during surgery . This study was done over a period of 3 months . RESULTS 312 patients were interviewed . 81(26 % ) patients suffered with sore throat postoperatively . 28 % of patients with endotracheal intubation ( ETT ) and 3.5 % of patients with laryngeal mask airway had a sore throat . Female patients reported more sore throat than male patients ( 27.1 % vs. 19.1 % ) . Sore throat was found to be more common with older age group , grade of difficulty in intubation , duration of surgery and patient 's position during surgery . CONCLUSION Awareness of the factors responsible for increased incidence of postoperative sore throat and appropriate care especially during endotracheal intubation can help to reduce the incidence of postoperative sore throat BACKGROUND  Postoperative sore throat ( POST )  has been one of the most common complaints after anesthesia . In Siriraj Hospital , a high volume of general anesthesia is performed annually , but there was limited data regarding this complaint . OBJECTIVE To describe the incidence of POST and to determine risk factors associated with the occurrence of POST MATERIAL AND METHOD : Three hundred eighty seven patients were prospect ively studied .  Demographic data , airway management , and intra-operative data  were recorded . Sore throat occurrence and its intensity at postoperative 24 hours as well as patient satisfaction were assessed . RESULTS The overall incidence of POST was 35.7 % ( 95 % confidence interval [ CI ] 30.9 - 40 . 7 % ) with the mean intensity of 29.8 + /- 21.2 . Operation of the neck was found to be an independent risk factor of 24-hour POST ( odds ration [ OR ] 3.43 , 95 % confidence interval [ CI ] 1.88 - 6.25 , p < 0.001 ) , whereas in gynecological surgery the occurrence was significantly attenuated ( OR 0.49 , 95 % CI 0.26 - 0.95 , p = 0.035 ) . CONCLUSION POST was common after general anesthesia . Careful airway management might be the key to prevent this occurrence and to improve the quality of anesthetic care Background Diffusion of nitrous oxide into the cuff of the endotracheal tube results in an increase in cuff pressure . Excessive endotracheal tube cuff pressure may impair tracheal mucosal perfusion and cause tracheal damage and sore throat . Filling the cuff of the endotracheal tube with saline instead of air prevents the increase in cuff pressure due to nitrous oxide diffusion . This method was used to test whether tracheal morbidity is related to excess in tracheal cuff pressure during balanced anesthesia . Methods Fifty patients with American Society of Anesthesiologists physical status I or II were r and omly allocated to two groups with endotracheal tube cuffs initially inflated to 20–30 cm H2O with either air ( group A ) or saline ( group S ) . Anesthesia was maintained with isoflurane and nitrous oxide . At the time of extubation , a fiberoptic examination of the trachea was performed by an independent observer , and abnormalities of tracheal mucosa at the level of the cuff contact area were scored . Patients assessed their symptoms ( sore throat , dysphagia , and hoarseness ) at the time of discharge from the postanesthesia care unit and 24 h after extubation on a 101-point numerical rating scale . Results Cuff pressure increased gradually during anesthesia in group A but remained stable in group S. The incidence of sore throat was greater in group A than in group S in the postanesthesia care unit ( 76 vs. 20 % ) and 24 h after extubation ( 42 vs. 12%;P < 0.05 ) . Tracheal lesions at time of extubation were seen in all patients of group A and in eight patients ( 32 % ) of group S ( P < 0.05 ) . Conclusion Excess in endotracheal tube cuff pressure during balanced anesthesia due to nitrous oxide diffusion into this closed gas space causes sore throat that is related to tracheal mucosal erosion Context : Postoperative sore throat ( POST ) is a complication that is unresolved in patients undergoing endotracheal intubation . Aim : To compare the effects of ketamine and magnesium sulfate nebulizations in two strengths , on the incidence and severity of POST , hoarseness , and cough . Setting s and Design : Sixty surgical patients undergoing elective abdominal and lower limb surgeries under combined epidural and general anesthesia were included in this prospect i ve , r and omized , double-blinded study . Subjects and Methods : Patients in each group were nebulized with the respective study drug 15 min prior to the surgery , i.e. , ketamine in Group K , magnesium sulfate 250 mg , and 500 mg in Group M1 and Group M2 , respectively , and normal saline as control in Group C. A st and ardized anesthesia protocol was followed for all patients . After extubation , the patients were asked to grade POST , hoarseness , and cough at 0 , 2 , 4 , 12 , and 24 h. Statistical Analysis Used : One-way analysis of variance , Chi-square test , Fisher 's exact test , paired t-tests , and Wilcoxon 's signed-rank test as applicable . Results : Ketamine and magnesium sulfate 500 mg demonstrated a statistically significant decrease in POST at 0 , 2 , and 4 h , and postoperative hoarseness at 0 h. There was decrease in the incidence and severity of sore throat , hoarseness , and cough at all periods in the study groups as compared with control . Conclusion : Nebulization with ketamine 50 mg and magnesium sulfate 500 mg , 15 min before induction of general anesthesia and intubation , reduce the incidence and severity of POST and hoarseness of voice BACKGROUND Sore throat is a common complication of anaesthesia that affects patient satisfaction after surgery . METHODS We studied 5264 ambulatory surgical patients prospect ively to determine the patient , anaesthetic , and surgical factors associated with sore throat .  RESULTS In 5264 patients , 12.1 % reported a sore throat .  Patients with tracheal tube  had the greatest incidence , 45.4 % , followed by patients with laryngeal mask airway  , 17.5 % , while patients with a facemask  had a lower incidence of sore throat , 3.3 % . Female patients had more sore throats than male patients ( 13.4 vs 9.1 % ) . Airway management had the strongest influence on the incidence of sore throat . Sore throat in ambulatory surgical patients was associated with female sex , younger patients , use of succinylcholine , and gynaecological surgery . CONCLUSION Airway management , female sex , younger patients , surgery for gynaecological procedure , and succinylcholine predicts postoperative sore throat . Increased awareness of the predictive factors can help to avoid this combination and improve patient satisfaction BACKGROUND Sore throat and hoarseness are common complications , but these have not been studied after total i.v . anaesthesia . METHODS We prospect ively studied 418 surgical patients , aged 15 - 92 yr , after total i.v . anaesthesia with propofol , fentanyl and ketamine  to assess possible factors associated with  sore throat and hoarseness . RESULT We found sore throat in 50 % and hoarseness in 55 % of patients immediately after surgery . This decreased to 25 % for sore throat and 24 % for hoarseness on the day after surgery . Both sore throat and hoarseness were more common in females and when lidocaine spray had been used . Cricoid pressure during laryngoscopy was inversely associated with the risk of sore throat . CONCLUSION Knowledge of these factors may reduce postoperative throat complications , and improve patient satisfaction S ystematic review s are relied upon by clinicians and policymakers as high- quality evidence for decision-making . In some hierarchies of evidence quality , systematic review s are ranked at the top , higher than r and omized controlled trials . A properly conducted systematic review that is based on high- quality articles provides very strong evidence ; policymakers recognize this value and solicit many such review s. Busy clinicians rely on well-executed systematic review s to quickly synthesize the literature and guide them in managing patients . However , there are important inherent weaknesses that can limit the quality of systematic review s and can lead to erroneous conclusions . Consumers of systematic review s should approach them with a healthy sense of skepticism . Unfortunately , many of these weaknesses may not be obvious to the various stakeholders who routinely invest their trust in such review s. The first bias one encounters is inherent in the research enterprise . Generally , research ers design studies to demonstrate maximum effect ; hence they are careful about the population selected , the interventions tested , and the outcomes assessed . For example , interventions are often tested in population s that are at high risk for experiencing the outcome in question and are likely to respond to the intervention . Not only can this make results difficult to generalize , but it often results in studies that overstate the benefit ; subsequent studies frequently find less benefit . This is particularly common when the pool of available studies consists of small , single-center investigations , trials that are particularly likely to show large effects . While usually not intentional , the combination of careful selection of population and outcomes can 
    Output:
    
The trial sequential analysis suggested that there is adequate evidence supporting the efficacy of topical magnesium in preventing postoperative sore throat .
Conclusion Our study suggests that preoperative topical magnesium can effectively prevent postoperative sore throat .
ConclusionS elon les résultats de notre étude , l’application préopératoire topique de magnésium  est efficace pour prévenir les maux de gorge postopératoires .