Background: The rapid increase in published research poses challenges for healthcare professionals aiming to stay updated. While systematic reviews help synthesize findings, their abundance can overwhelm readers. Umbrella reviews address this by summarizing multiple systematic reviews, offering a comprehensive perspective on specific topics. Methods: This article offers a practical, step-by-step guide for conducting an umbrella review, aimed at researchers and clinicians alike. Results: Umbrella reviews effectively integrate data from systematic reviews, ensuring clearer evidence synthesis. Tools like Rayyan and Covidence streamline processes such as screening and data extraction. Strategies for managing overlapping studies and assessing methodological quality enhance the validity of findings. Conclusion: Umbrella reviews are invaluable for evidence-based decision-making, especially in healthcare. This guide equips researchers and clinicians with a structured approach to navigate and synthesize the growing body of systematic reviews, fostering reliable and actionable insights.

Phototherapy is the standard treatment for neonatal jaundice. We aimed to review the efficacy and safety of fenofibrate as an adjunct therapy. Twelve databases were searched and a systematic review and meta-analysis were conducted. Mean change (MC), mean difference (MD), and risk ratios (RR) with a 95% confidence interval (CI) were calculated using a random effects model. The GRADE approach was used to evaluate the evidence's certainty. Nine randomized trials were included. The MC of total serum bilirubin (mg/dl) (TSB) was significant at 12, 24, 36, 48 and 72 hours with respective MC (95% CI) values of -0.46 (-0.61, -0.310), -1.10 (-1.68, -0.52), -2.06 (-2.20, -1.91), -2.15 (-2.74, -1.56), and -1.13 (-1.71, -0.55). The FEN+PT group had a shorter duration of phototherapy (MD -14.36 hours; 95% CI -23.67, -5.06) and a shorter hospital stay (MD: -1.40 days; 95% CI: -2.14, -0.66). There was no significant difference in the risk of complications (RR: 0.89; 95% CI: 0.54, 1.46) or the need for exchange transfusion (RR: 0.58; 95% CI: 0.12, 2.81). The certainty of the evidence was very low for all outcomes. In conclusion, fenofibrate might be a safe adjunct to neonatal phototherapy. Larger RCTs are needed for confirmation of these results.

Nonvigorous newborns often require immediate resuscitation, and early cord clamping (ECC) is the conventional approach. Alternative strategies, such as intact cord resuscitation (ICR) and umbilical cord milking (UCM), may provide additional benefits without compromising safety. To compare the effectiveness and safety of different umbilical cord management strategies for nonvigorous newborns. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and searched six databases for randomized controlled trials comparing different umbilical cord management approaches in nonvigorous newborns. Outcomes assessed included resuscitation effectiveness, hematological parameters, neonatal morbidities, and mortality. The Cochrane Collaboration tool RoB2 was used to assess the risk of bias. Ten studies with 2,541 newborns were included, with seven studies contributing to the meta-analysis. No significant differences were observed in resuscitation requirements, Apgar scores, or mortality between ECC, ICR, and UCM. However, at 5 minutes, ICR showed a small but statistically significant higher Apgar score compared with other interventions (mean difference [MD] = 0.3, 95% confidence interval [CI] [0.05, 0.55]). Additionally, heart rate was lower in the intact ICM (I-UCM) group (MD = −34.75 beats/min, 95% CI [−61.84, −7.66]). Cut UCM was associated with significantly higher serum ferritin levels at 6 weeks (MD = 40.44 µg/L, 95% CI [26.45, 54.43]). Initial hematocrit levels were also higher in the ICR group compared with ECC. ICR and UCM might be safe and effective alternatives to ECC for nonvigorous newborns, with potential hematological benefits. However, further large-scale studies are needed to confirm these findings and evaluate long-term neurodevelopmental outcomes.