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Objectives To evaluate the analgesic and anti‐haemorrhagic efficacy of platelet‐rich plasma (PRP) among patients undergoing tonsillectomy. Design A systematic review and meta‐analysis of randomised controlled trials (RCTs). Setting PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases were screened from inception until July 2021, and updated in December 2021. Participants Patients undergoing tonsillectomy. Main outcome measures The efficacy endpoints of postoperative pain and haemorrhage were summarised as standardised mean difference (SMD) and risk ratio (RR), respectively, with 95% confidence interval (CI). Results Seven RCTs Seven RCTs were analysed, comprising a total of 392 patients. Risk of bias evaluation showed an overall high risk in one RCT, low risk in four RCTs and some concerns in two RCTs. The pooled results revealed that the mean postoperative pain score was significantly reduced in favour of the PRP group compared with the control group (SMD = −1.38, 95% CI [−1.91, −0.85], p < 0.001). Subgroup analysis showed the effect estimate was statistically significant for early postoperative pain (Day 0 to Day 3), without substantial difference between both groups on late postoperative pain (Days 5 and 7). Moreover, the rate of postoperative haemorrhage was significantly reduced in favour of the PRP group compared with the control group (RR = 0.16, 95% CI [0.05, 0.50], p = 0.001). Subgroup analysis showed the effect estimate was statistically significant for the rate of primary and secondary haemorrhage. Conclusion PRP was associated with significant reduction in postoperative pain and haemorrhage among patients undergoing tonsillectomy.

OBJECTIVE Health care workers_ the first line army in the current pandemic_ are the most vulnerable group for COVID-19 infection. Vaccination of health care workers is strongly recommended to salvage our army. However, more research is needed to determine the safest and most effective vaccine. In our study, we assessed the safety and effectiveness of the first approved vaccine in Egypt_ the Sinopharm vaccine. DESIGN, SETTING: An ambispective cohort study was conducted in fifteen triage and isolation hospitals, from the 1st of March till the end of September 2021. Participants are either fully vaccinated or unvaccinated. OUTCOMES AND MEASURES: Efficacy outcome to assess vaccine effectiveness, severity outcome to assess incidence rate of hospitalized cases (severe to critically ill) or the COVID-19 related mortality, in addition to the safety of the vaccine. INTERPRETATION: From the selected hospitals, we included 1228 of 1364 interviewed healthcare workers. Vaccine effectiveness was 67% to protect against symptomatic PCR confirmed cases and 46% for total COVID-19 infection after adjusting hazard ratio. Incidence rate ratios of vaccinated to unvaccinated group were 0.39 (95%CI, 0.24–0.65) for PCR confirmed symptomatic case, 0.63 (95%CI, 0.46–0.86) for total COVID-19 infection, 0.45 (95% CI, 0.15–1.31) for hospitalization, 0.71 (95% CI, 0.07– 6.39) for mechanical ventilation and only one COVID-19 death among unvaccinated group. Most adverse events are mild and well-tolerated. Pregnant and lactating vaccinated mothers did not report any sentinel adverse events. CONCLUSION Sinopharm was effective in protecting health care workers from the highly transmissible COVID-19 infection when the predominant Delta variant was ambient.

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