Kornimate/medical-research-clean huggingface dataset:
immediate treatment vs colposcopic follow-up for biopsy-proven cin 1

Conditions: Cervical Intraepithelial Neoplasia

Summary: this study looks at immediate treatment of a cervix with cin 1 versus regular six-month follow-up with colposcopy and treatment if cin 1 progresses.

in women who present with biopsy-proven cin 1, to compare the management approach of regular colposcopic follow-up and only treating progressive disease using the leep, with an approach of immediate treatment using leep. the primary outcome is progression to more advanced disease (i.e., cin 2, cin 3 or cancer).

Eligibility criteria:
inclusion criteria: * eligible patients will: * have documented cin 1 by histologic assessment as the highest grade lesion present, * have the lesion confined to the cervix and completely visualized, * be 16 years or older. exclusion criteria: * any one of the following will be an excluding characteristic: * index pap smear showing cin 2, cin 3 or cancer; * index pap smear shows atypical glandular cells of unknown significance, glandular dysplasia, or malignancy requiring immediate investigation; * patients with previously identified cin 1 by biopsy who are already in a colposcopic surveillance program; * unsatisfactory colposcopic exam defined as inability to see the extent of the lesion in the endocervical canal or absence of a lesion on the ectocervix but endocervical curettage shows cin 1; * pregnancy; * prior therapy for dysplasia including medical (5fu), surgical (laser, leep) or cryotherapy; * prior gynecologic cancer; * prior pelvic radiation therapy; * inability to attend outpatient follow-up visits because of geographic inaccessibility; * other malignancies except non-melanoma skin cancer; * immunosuppression due to diseases such as aids, organ transplantation, or on immunosuppressive medications such as prednisone, imuran or chemotherapy for diseases like systemic lupus; * cognitively impaired or otherwise unable to obtain written informed consent; * extension of the cin 1 lesion to vagina or a separate vaginal lesion showing dysplasia; * colposcopically visible condyloma outside of the transformation zone; * known allergy to local analgesics; * clinically evident vaginitis must be treated and resolved prior to entry on the trial; * inability to read and respond in english/french; * failure to provide informed consent.

Keywords: cin 1 cervical intraepithelial neoplasia cervix cancer loop electrosurgical excision procedure leep expectant management human papilloma virus hpv colposcopy
"the effects of low level laser therapy versus strain/counter strain technique in acute soft tissue injuries"

Conditions: Hamstring Injury; Strain Counter Strain

Summary: muscle strain injuries are common in sports but are often misdiagnosed and maltreated. their significance is often underestimated because most athletes can continue their daily activities soon after the injury. proximal hamstrings strains have attracted greater attention because they have a high incidence which is approximately 42%.

it will be randomized control trial with 60 patients with acute hamstring injuries divided into 3 groups. one group will be given laser therapy, 2nd will be given strain/counter strain technique and 3rd will be given both the techniques in combination this study will be conducted in rehabilitation setup of pakistan hockey federation lahore, and institute of orthopedics and rehabilitation center garden town lahore. non probability convenience sampling technique will be utilized

Eligibility criteria:
inclusion criteria: hamstring injury patient with grade 2 or 1 both male and female local tenderness on palpation pain with resisted knee flexion pain with resisted hip extension pain on stretching of effected area exclusion criteria: * patient with fracture * patient with grade 3 orthopedic condition like ankylosing spondylitis medically unstable
the relationship of stump length with muscle strength in patients with traumatic unilateral transfemoral amputation

Conditions: Amputation, Traumatic

Summary: amputation is the loss or removal of a body part such as an arm or leg. it is the last option in trauma treatment and irreversible procedure. amputation rehabilitation begins in the pre-amputation period. the goal of rehabilitation after an amputation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life. many factors can affect the success of lower limb amputation rehabilitation, and stump length is one of them. a sufficient stump length provides a large contact surface and increases the stability of the socket unit.

amputation is the loss or removal of a body part such as an arm or leg. it is the last option in trauma treatment and irreversible procedure. amputation rehabilitation begins in the pre-amputation period. the goal of rehabilitation after an amputation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life. many factors can affect the success of lower limb amputation rehabilitation, and stump length is one of them. a sufficient stump length provides a large contact surface and increases the stability of the socket unit. people with unilateral transfemoral amputation have lost their knee and ankle joint. this causes a loss of proprioceptive feedback from the ankle joint, knee joint and related muscles. muscle weakness, muscle atrophy and balance problems are common in amputee patients. there is not enough data to reveal the relationship between stump length and muscle strength, balance, and proprioception. the aim of this study to evaluate the relationship of stump length with muscle strength, balance, and proprioception in patients with traumatic unilateral transfemoral amputation.

Eligibility criteria:
inclusion criteria: * age between 18-65 years * time after amputation ≥ 6 months * unilateral transfemoral traumatic amputation exclusion criteria: * bilateral transfemoral amputation * unilateral non-traumatic transfemoral amputation * presence of neurological, auditory, or vision-related disease that may affect balance and proprioception * presence of cardiovascular or pulmonary disease that will affect muscle strength

Keywords: amputation stump length muscle strength balance proprioception
efficacy of ramdicivir and baricitinib for the treatment of severe covid 19 patients

Conditions: Covid19; Covid-19 ARDS

Summary: this study was designed to evaluate the efficacy of remdesivir and baricitinib combination therapy for the treatment of severe acute respiratory distress syndrome (ards) caused by coronavirus disease 2019 (covid-19). our aim is to compare the outcome of the "remdesivir + baricitinib" combination against "remdesivir + tocilizumab" therapy and find the best option for the management of ards in covid-19 patients.


Eligibility criteria:
inclusion criteria: severe covid-19 patients require hospitalization under hdu/icu. the sarscov-2 infection will be confirmed by rt pcr / ct chest in every case. exclusion criteria: participants with uncontrolled clinical status who were hospitalized from the before. contraindication / possible drug interaction. participants who have any severe and/or uncontrolled medical conditions like, severe ischemic heart disease, epilepsy, malignancy, pulmonary/ renal/hepatic disease, aids, pulmonary tb, pregnancy, corpulmonale, and etc.

Keywords: covid 19 covid-19 ards tocilizumab remdicivir baricitinib
octreotide in treating patients with locally advanced or metastatic liver cancer

Conditions: Liver Cancer

Summary: rationale: octreotide may stop or slow the growth of tumor cells and may be an effective treatment for liver cancer. purpose: this phase ii trial is studying how well octreotide works in treating patients with locally advanced or metastatic liver cancer.

objectives: primary * to verify that long-acting somatostatin analog octreotide (sandostatin lar) depot will extend median survival from 5 months to 8.75 months in patients with locally advanced or metastatic hepatocellular carcinoma with a clip score of 3 or more. secondary * to document tolerability of this drug in this patient population. outline: patients are stratified according to underlying degree of liver disease as defined by clip score classification. patients receive short-acting octreotide subcutaneously three times daily on days 1-21 or days 1-28. if the patient tolerates short-acting octreotide, the first dose of long-acting octreotide (sandostatin lar) depot will be given intramuscularly beginning on day 8 or day 15. treatment with long-acting octreotide repeats every 28 days in the absence of disease progression or unacceptable toxicity. after the completion of study treatment, patients are followed monthly for 6 months.

Eligibility criteria:
disease characteristics: * newly diagnosed or recurrent hepatocellular carcinoma (hcc) as defined by tissue biopsy or alpha fetoprotein (afp) \> 1,000 ng/ml with compatible mass on ct scan or mri * recurrence of previously resected hcc will not require tissue confirmation if there is clear radiographic recurrence, in the judgment of the investigator * locally advanced or metastatic disease * unmeasurable disease allowed if initial diagnosis was made according to the above criteria and/or recurrence has been confirmed by tissue biopsy or radiological imaging * clip score ≥ 3 * not a candidate for surgical resection or liver transplant * not a candidate for loco-regional therapy (e.g., ablation, embolization, hepatic arterial infusion therapy), but could have received such therapy in the past * no fibrolamellar hcc * no clinically apparent central nervous system metastases or carcinomatous meningitis patient characteristics: * life expectancy ≥ 8 weeks * karnofsky performance status 60-100% * hemoglobin ≥ 8.5 g/dl * platelet count ≥ 50,000/mm³ * total bilirubin ≤ 5.0 mg/dl * ast or alt ≤ 5 times upper limit of normal (uln) * creatinine ≤ 2 times uln * pt ≤ 28 * inr ≤ 2.5 * no active variceal bleeding within the past 3 months * no encephalopathy grade 3-4 * no ongoing ethanol or intravenous drug abuse * not pregnant or breast feeding prior concurrent therapy: * see disease characteristics * any number of prior therapies (e.g., chemotherapy, resection, embolization, or radiofrequency/ethanol ablation therapy) allowed * no concurrent chemotherapy, radiotherapy, or immunotherapy

Keywords: adult primary hepatocellular carcinoma advanced adult primary liver cancer localized unresectable adult primary liver cancer recurrent adult primary liver cancer
diagnostic imaging of myeloma bone lesions

Conditions: Multiple Myeloma

Summary: the purpose of this study is to compare the current standard whole-body x-ray with the advanced imaging techniques fdg-pet-ct, naf-pet-ct and whole-body mri in the detection of myeloma bone lesions.

accurate detection of bone lesions in myeloma patients is essential for treatment planning and patient survival. newly diagnosed multiple myeloma patients can be enrolled in this study. all participants will at time of diagnosis undergo three project scans (fdg-pet-ct, naf-pet-ct, whole-body mri) as well as whole-body x-ray as part of clinical routine practice. experienced specialists in the field of radiology and nuclear medicine interpret the images. each reader performs the evaluations blinded to other imaging results as well as to the patient's clinical information. the reader assesses whether myeloma indicative bone lesions are present in eight predefined skeletal body regions. endpoint is purely diagnostic. statistics: cochran's q-test: to compare the proportion of patients with bone disease detected by the four scanning methods. two-sided anova: to compare the average number of regions detected with bone disease by the four scanning methods. tukey's comparison test: to compare the difference between each pair of means.

Eligibility criteria:
inclusion criteria: * newly diagnosed multiple myeloma (biopsy proven) exclusion criteria: * prior malignancy * are not able to undergo a mri scan due to mri contraindications (e.g. pacemaker) * has any condition that places the subject at an unacceptable risk if he/she undergoes a diagnostic ct scan with iv. contrast (e.g. history of severe allergic reaction to the contrast agent) * severe claustrophobia
caffeine in the prevention of post-operative nausea and vomiting

Conditions: Postoperative Nausea and Vomiting

Summary: the objective of this study is to determine if caffeine 500 mg intravenously is efficacious when added to standard anti-emetic prophylaxis in the prevention of post-operative nausea and vomiting (ponv) in patients undergoing ambulatory surgery under general anesthesia.

this is a prospective, randomized, double-blind, placebo-controlled study of caffeine, 500 mg, intravenously, in addition to standard anti-emetic prophylaxis, in the prevention of post-operative nausea and vomiting in patients undergoing ambulatory surgery under general anesthesia. consenting patients will be randomized to receive either a single dose of caffeine, 500 mg, or saline placebo, administered as a single iv dose approximately 15 minutes before emergence from anesthesia. all patients will receive our customary anti-emetic prophylaxis, determined by four major risk factors for ponv: female gender, nonsmoking status, history of ponv or motion sickness, and perioperative opioid use. patients at low risk for ponv (no risk factors) will receive no prophylaxis; patients at moderate risk for ponv (1 or 2 risk factors) will receive dexamethasone 8 mg at induction plus dolasetron 12.5 mg approximately 15 min before the end of anesthesia; patients at high risk for ponv (3 or 4 risk factors) will receive the same treatment as those at moderate risk, plus additional prophylaxis at the discretion of the attending anesthesiologist (e.g., scopolamine patch, metoclopramide 10 mg iv, or other standard drugs). postoperatively, the presence of ponv will be recorded. if rescue medication is used, the amount and time of administration will be recorded. the length of stay in the pacu (phase i and phase ii) will be recorded. patients will be asked to report any headache, and to rate their nausea, pain, alertness, fatigue, and overall satisfaction in the pacu, and again by phone 24 hours postoperatively. amount of pain medication utilized in the pacu will also be measured.

Eligibility criteria:
inclusion criteria: * patient having ambulatory surgery * patient receiving general anesthesia exclusion criteria: * patient is not willing to sign informed consent * patient does not speak or understand sufficient english
early angiotensin ii in the emergency department

Conditions: Septic Shock

Summary: this pilot study will enroll 20 patients with septic shock and require emergent vasopressor support in the emergency department (ed). the primary objective of the study is to determine the feasibility of early peripheral administration of angiotensin ii for treatment of septic shock in the ed

following informed consent, patients will receive intravenous angiotensin ii (at-ii) infusion for blood pressure support. the patient will remain on the at-ii infusion for 60 minutes prior to determining patient response which will be determined by recording the concurrent dose of norepinephrine and map every 10 minutes from initiation. if a positive response (e.g., norepinephrine dose reduction) is witnessed, the at-ii infusion will be titrated off after a maximum of 6 hours or when infusion is completed, whichever occurs first.

Eligibility criteria:
inclusion criteria 1. age ≥18; and 2. requiring norepinephrine at a dose of 0.05-0.25 mcg/kg/min mcg/kg/minute despite adequate fluid resuscitation; and 3. receiving intravenous antibiotics or clinician's intention to administer antibiotics at the time of enrollment; and 4. can provide written informed consent (or legally authorized representative). exclusion criteria 1. acute coronary syndrome; 2. cardiogenic shock; 3. patients with a history of mesenteric ischemia; 4. patients with a history of having an aortic dissection or abdominal aortic aneurysm; 5. patients with an expected lifespan of \<12 hours; 6. patients with hemorrhagic shock (e.g., actively receiving transfusion of packed red blood cells); 7. active administration of two vasoactive agents before enrollment; and 8. pre-existing thromboembolic disease or inability to tolerate pharmacologic vte prophylaxis.

Keywords: angiotensin ii
phototherpy versus tapwater iontophoresis for management of atopic dermatitis in children.

Conditions: Atopic Dermatitis

Summary: this study is conducted to compare the effect of phototherapy" psoralen plus uva " bath puva to tap water iontophoresis in the treatment of atopic dermatitis in children.

sixty children were selected from the department of dermatology, banha university hospital. patients were randomly assigned to (group- a):- 20 children patients, aged between 6-16 years old. be treated with phototherapy, for 3 sessions per week for 8 weeks plus the traditional medical treatment. which is the betamethasone dipropionate 0.05% " diprolene for 2 times a day for 8 weeks. (group b): 20 children patients, in group-b are treated with tap water iontophoresis, for 8 weeks, 3 sessions /week: the intensity were increased according to the patient's tolerance, for 20 minutes. plus the traditional medical treatment. (group -c) the control group will treated by only the traditional medical treatment which is the betamethasone dipropionate 0.05% " diprolene" cream, two times a day for 8 weeks skin thickness by ultrasonography and patient oriented eczema measure(poem) are measured before and after 8 weeks of treatment.

Eligibility criteria:
inclusion criteria: * age between 9 to 16 years. * suffering from ad of dyshidrotic as well as dry types of more than 6-months duration * traditional types of treatment options, including oral or topical corticosteroids, proved ineffective. exclusion criteria: * intolerance history to uv radiation. * skin malignancy at the area to be treated. * acute infection at the treated area. * children received radiotherapy in the area to be treated during the last 6 months. * children received corticosteroid therapy topically within 14 days before treatment, or systemic corticosteroids or any immunosuppressive drugs within the last 4 weeks. * circulatory and sensory disorders and children with diabetes mellitus.

Keywords: atopic dermatitis, phototherapy, iontophoresis
doubling the maintenance dose of clopidogrel in patients with high on-clopidogrel platelet reactivity

Conditions: Stable Angina Pectoris; Ad Hoc Percutaneous Coronary Intervention

Summary: the purpose of the study is to determine whether administration of 150 mg clopidogrel is effective in reducing the one-year incidence of thromboischemic events in patients with high on-clopidogrel platelet reactivity compared to 75 mg clopidogrel after elective percutaneous coronary intervention.


Eligibility criteria:
inclusion criteria: * clopidogrel-naïve stable angina pectoris (ccs i-iii) * coronary angiography that reveals significant de novo coronary stenosis (diameter stenosis greater than 50% in two independent projections) feasible for ad hoc stent implantation exclusion criteria: * acute coronary syndrome (stemi, nstemi or unstable angina) * administration of clopidogrel/ticlopidine/coumarin in the past 6 weeks * contraindication to antiplatelet therapy * significant lm stenosis * pci due to instent restenosis * lesion located in bypass grafts * stroke in past one year * reduced life expectancy

Keywords: clopidogrel, thrombosis, percutaneous transluminal coronary angioplasty, stents
effectiveness of a typhoid conjugate vaccine in drc

Conditions: Typhoid Fever

Summary: this is a prospective cohort evaluation of vaccine effectiveness of a single dose of typbar-tcv® against symptomatic blood culture-confirmed typhoid fever when administered through a mass vaccination campaign to children 9 months to \<16 years of age in kisantu, drc.

this study is conducted in kisantu, drc and is comprised of a mass vaccination campaign of children aged 9 months to \<16 years with a single dose of typbar-tcv® and a concomitant surveillance study to assess the incidence of culture-confirmed typhoid fever in the population during a period of three years following vaccination. safety events will be monitored for 30 minutes following vaccination for all participants. in a subset of age-eligible participants living in the study area, the investigators will assess local and systemic solicited adverse events/adverse reactions and unsolicited adverse events occurring within the first 7 days post-vaccination and unsolicited and serious adverse events within 28 days post-vaccination. a population census will be conducted at baseline to enumerate and characterize the population under study and demographic information will be collected to allow for minimization of potential sources of bias during analysis. an interim censuses and a census at study closure will be carried out to update population information. the investigators hypothesize that the typbar-tcv® vaccine is effective in large scale vaccination campaigns, thereby lowering the incidence of blood-culture confirmed typhoid fever in children. lessons and experiences on vaccination feasibility and uptake will be important for informing tcv introduction across the african continent.

Eligibility criteria:
inclusion criteria: * parent/guardian willing and able to provide informed consent; assent will be sought for participants between 12 and \<16 years of age * resident of the defined study area, kisantu health zone at the time of vaccination * age between 9 months and \<16 years (i.e., ≤15 years and 364 days) on the day of vaccination exclusion criteria: * the participant has a known allergy to any of the vaccine components, * any medical reason perceived to increase risk to health posed by vaccination as judged by a medical professional * self-reported pregnancy in females greater or equal to 11 years of age who have reported menarche

Keywords: typhoid conjugate vaccine vaccine effectiveness mass vaccination campaign democratic republic of congo (drc)
what is the impact of probiotics on weight loss maintenance in individuals with obesity?

Conditions: Obesity

Summary: weight loss maintenance is the biggest challenge in obesity management, with the majority of weight-reduced individuals experiencing weight regain. the intake of probiotics has been shown to help in weight loss, but its potential in maximizing weight loss maintenance remains unknown. therefore, the main aim of this study is to investigate the impact of probiotic consumption on weight loss maintenance. secondary aims are to investigate if the intake of probiotics influences gut microbiota, cardio-metabolic profile, appetite and inflammatory markers.


Eligibility criteria:
inclusion criteria: * class i or ii obesity (30 kg/m2 \ 40 kg/m2) * weight stable (\<2 kg variation in weight within the last 3 months) * not currently dieting to lose weight * dietary intervention of 1000 kcal energy restriction for 8 weeks using a powder based low energy diet product, followed by 4 week weight stabilization phase (re-introduction of food) * women who are either post-menopausal, taking oral contraceptives or with a normal cycle (28 ± 2 days) exclusion criteria: * consumption of probiotics 6 months before taking part in the study * pregnant * breast-feeding * drug or alcohol abuse within the last two years * currently taking medication known to affect appetite or induce weight loss * enrolled in another obesity treatment program * history of psychological disorders * having had bariatric surgery * metabolic diseases (such as hypo/hyperthyroidism and diabetes type 1 or 2) * eating disorders * lactose intolerance * gastrointestinal (particularly cholelithiasis), kidney, liver, lung, cardiovascular disease * malignancies

Keywords: probiotics appetite regulation gastrointestinal microbiome caloric restriction body weight maintenance body composition