Kornimate/medical-research-clean huggingface dataset:
efficacy of azelastine and mometasone irrigation in comparison to nasal sprays in patients with chronic rhinitis

Conditions: Chronic Rhinitis

Summary: the goal of this clinical trial is to determine the best combination of drugs and drug delivery routes to treat surgically naive chronic rhinitis patients. the main question it aims to answer is: do high volume, high pressure delivery mechanisms in nasal irrigation improve the efficacy of azelastine combined with nasal steroid mometasone as compared to the standard low pressure, low volume delivery mechanisms in nasal sprays? subjects will complete six months of one of three medication regimens: 1. saline irrigation followed by azelastine spray and mometasone spray 2. mometasone saline irrigation 3. azelastine saline irrigation combined with mometasone saline irrigation.

the purpose of this research is to determine whether patients with chronic rhinitis treated with mometasone and azelastine irrigations will show significant clinical improvement when compared to patients treated with mometasone and azelastine nasal sprays, and also compared to nasal irrigation with mometasone alone. patients with chronic rhinitis require lifelong treatment options that are safe yet efficacious. topical therapies, such as antihistamine sprays and steroid sprays as well as saline irrigations, are appropriate options as they offer symptom control without the side effects often seen in antibiotics. azelastine and mometasone are fda approved medications for the treatment of chronic rhinitis. using these drugs in an off-label format in the form of irrigations rather than sprays is standard of care in rhinology. prior studies suggest irrigation may be better than spray for topical mometasone, but more data is needed to establish the same for the combination of mometasone and azelastine. eligible patients who are enrolled in the study will be randomized and will complete six months of one of three medication regimens. subjects will come back to the office for three follow up visits at 4, 12, and 24 weeks after the treatment, where they will have a basic nasal endoscopy performed and be asked to complete a questionnaire about their nasal blockage symptoms.

Eligibility criteria:
inclusion criteria: * adults 18 years and older seeking treatment for chronic rhinitis and willing to undergo six months of topical therapy. * diagnosis of chronic rhinitis. exclusion criteria: * the patient has diagnosis(es) other than chronic rhinitis that can account for his/her symptoms (septal deviation, nasal valve collapse, chronic sinusitis). * use of oral antihistamines or oral steroids, unless patient undergoes a 4 week washout period. * smokers (tobacco, marijuana, vaping, etc.). * known or suspected pregnancy, or lactation. * other medical conditions that the investigator believed would confound the study. * allergy to study drugs.

Keywords: mometasone azelastine irrigation topical therapy nasal spray chronic rhinitis
comparison of incision angle of mediolateral episiotomy at 40 and 60 degrees

Conditions: Obstetric Labor Complications

Summary: the angle at which an episiotomy can be made is a continuous variable. if the investigators consider midline to be 0 degrees and a lateral episiotomy (never used today) to be 90 degrees, then it is theoretically possible to choose any angle from 0 to 90 degrees.

episiotomy is a surgical incision to the perineum in order to enlarge the vaginal orifice during the second stage of labor. although seven types of episiotomy have been described in the literature , the most frequently performed types are the mediolateral and median episiotomies, with the former being the most common one. despite being a common obstetric practice, the exact definition of a "mediolateral" episiotomy is often unclear. several studies and reports, however, stated that a significant proportion of the so-claimed mediolateral episiotomy were not actually mediolateral. the current trial compares two angles of mediolateral episiotomy , regarding the risk of third- and fourth-degree perineal tearing, episiotomy-related pain and dyspareunia in primiparous women at a large tertiary maternity center, namely ain shams university maternity hospital, cairo, egypt.

Eligibility criteria:
inclusion criteria: 1. primigravida with singleton pregnancy presenting by vertex. 2. gestational age \> 37 weeks 3. no instrumental delivery. 4. no fetal distress or any emergency exclusion criteria: 1. women had an episiotomy because of fetal distress and for technical reasons (emergency or episiotomy incised prior to the fetal head crowning the perineum. 2. inability to understand the informed consent.
hydroxychloroquine efficacy on behcet's disease thrombosis

Conditions: Behcet's Syndrome, Vascular Type

Summary: patients diagnosed with behcet's disease will be randomized to administeration of hydroxychloroquine. assessment will be done for the patients at baseline and every one month in the first three months and then quarterly for one year.


Eligibility criteria:
inclusion criteria: * all patients diagnosed with behcet's disease on any dmards exclusion criteria: * patients with critical conditions * patients with hypersensitivity or adverse drug reactions to hydroxychloroquine.
reduced nicotine content cigarettes and tobacco switching behaviors

Conditions: Tobacco Addiction; Dual Tobacco Use

Summary: the main focus of this study is to determine the use of nicotine-containing products across the three experimental conditions. subjects will be monitored to determine their continued use of assigned cigarettes, switching to other combusted and/or non-combusted tobacco, or cessation of all tobacco containing products.

this is a single site, single-blind, randomized trial with three experimental conditions tested for a period of 8 weeks: 1) very low nicotine content (vlnc) cigarettes (0.07 nicotine yield) with access to combusted (except cigarettes) and non-combusted tobacco and medicinal nicotine products; 2) vlnc cigarettes with access to only non-combusted tobacco and medicinal nicotine products; and 3) conventional nicotine (cn) content experimental cigarettes (0.8 mg nicotine) with access to combusted and non-combusted products. this study will examine the use of nicotine-containing products across the three experimental conditions. subjects will be monitored to determine their continued use of assigned cigarettes, switching to other combusted (e.g., little cigars, large cigars, pipes) and/or non-combusted tobacco products (e.g., conventional smokeless tobacco, snus for smokers, dissolvables, e-cigarettes, medicinal nicotine), or cessation of all tobacco containing products. toxicant exposure across the three conditions will also be examined. eligible subjects will be provided very low nicotine content cigarettes and are told to use the product ad lib for 8 weeks. subjects will complete questionnaires on demographics, smoking and health history, drug and alcohol use history, mood and perceptions of the study tobacco product. biomarker samples will be analyzed for exposure levels of nicotine and tobacco-related toxicants.

Eligibility criteria:
inclusion criteria: * male or female subjects who are at least 18 years of age with a history of regular smoking for at least 1 year and no serious quit attempts in the last 3 months * no unstable and significant medical or psychiatric conditions, including lack of stabilization of medications. * subject has provided written informed consent to participate in the study exclusion criteria: * regular use of tobacco products (including e-cigarettes) other than cigarettes * regular use of nicotine replacement or other tobacco cessation products for purpose of quitting. * pregnant or breastfeeding (due to toxic effects from tobacco products). * planned quit date within the next two months. * does not have a way that the research team can communicate with them by phone or e-mail. * not able to read and write english well enough to complete study activities without translation.

Keywords: cigarette smoking very low nicotine content cigarettes (vlnc) dual tobacco use
steroid-induced reduction of surgical stress study

Conditions: Coronary Artery Stenosis; Coronary Artery Bypass Graft Surgery

Summary: the stress response as induced by myocardial cellular damage during cardiac surgery may lead to myocardial stunning and apoptosis, and could therefore impair postoperative patient recovery. surgical trauma typically induces the liberation of cytokines. some of these cytokines are strongly associated with the initiation of intracellular proapoptotic pathways through activation of tyrosine kinases and integrins. the latter are known for their deteriorating effects on cardiac function and are strongly involved in cardiac remodeling. dexamethasone is typically administered prior to cardiac surgery in order to especially reduce the release of proinflammatory cytokines. it has however never been investigated whether this additionally reduces proapoptotic signaling in the human heart, thereby eliminating risk factors for the induction of cardiac dysfunction. in the present study, the investigators therefore aim to investigate whether dexamethasone inhibits proapoptotic pathways in patients undergoing cardiac surgery. furthermore, the investigators would like to elucidate whether this proposed effect of dexamethasone is related to the reduction of the stress response in the heart or indirectly by suppression of cytokine release. for this purpose the investigators will obtain cardiac biopsies and plasma from patients, who are randomly assigned to placebo or dexamethasone treatment and undergo on and off-pump coronary artery bypass grafting (cabg) surgery.


Eligibility criteria:
inclusion criteria: * patients undergoing coronary artery bypass surgery (cabg) * age 18-75 years * informed consent exclusion criteria: * re-operations and emergency operations * patient with anemia (hb \< 5.0) * emergency operation * patients receiving blood transfusions \< 3 months before operation * insulin depended diabetes mellitus * hepatic or renal failure * pregnancy * use of steroids
suxiao jiuxin pills in microvascular obstruction in patients with acute coronary syndrome

Conditions: Acute Coronary Syndrome

Summary: microvascular obstruction is the severe complication of percutaneous coronary intervention (pci) in patients with acute coronary syndrome. microvascular obstruction after pci is often association with poor prognosis. current treatments do not show improvement in prognosis of microvascular obstruction. suxiao jiuxin pills (sxjx) was shown associated with a reduction in mace, and an improvement of heart function and quality of life in acute coronary syndrome (acs) patients with early pci. to evaluate the effectiveness and safety of sxjx in microvascular obstruction after pci, the investigators designed this study.


Eligibility criteria:
inclusion criteria: * meet the diagnosis of ami, prepare for pci reperfusion therapy; * between the ages of 18-75; * volunteer to participate in this study and have signed an informed consent form; * have a correct understanding of the significance of drug research, and have a good compliance with the observation and evaluation. exclusion criteria: * not suitable for coronary intervention; * with unstable hemodynamics; * platelet count\<100×109; * suspected aortic dissection or acute pulmonary embolism; * with mechanical complications; * with uncontrolled acute left heart failure and pulmonary edema; * with known bleeding history, active bleeding, bleeding constitution, or severe hemostatic and coagulation dysfunction; * meantain anticoagulants (such as warfarin or new anticoagulants); * severe liver and kidney insufficiency (child-pugh b and above, cr\>177μmol/l (2mg/dl) or egfr\<45ml/min/1.73m2); * cto, stent stenosis, or severe left main disease; * history of coronary artery bypass graft surgery; * other pathophysiological conditions whose expected survival period is less than 1 year; * allergic history to suxiao jiuxin pills; * pregnant or lactating women; * participating in other clinical studies; * with other diseases that are not suitable for participating in clinical research.

Keywords: microvascular obstruction acute coronary syndrome percutaneous coronary intervention suxiao jiuxin pills
the treatment of magnesium sulfate and nifedipine in preterm labor threat

Conditions: Preterm Labor Without Delivery; Pregnancy Preterm

Summary: comparison of the effects of nifedipine and mgso4 therapies on maternal and fetal blood flow.

in this study, the investigators aim to compare the effect of nifedipine and mgso4 therapies on doppler parameters of the uterine, umbilical, middle cerebral arteries, and ductus venous in the first 48 hours of therapy in pregnancies with preterm labor threat and also compare perinatal outcomes after delivery between the groups.

Eligibility criteria:
inclusion criteria: * pregnancies with preterm labor threat between 28-34 weeks gestational ages exclusion criteria: * cervical dilatation at \> 4 cm and/or cervical effacement \>80%, * multiple pregnancies, * pregnancy complications including preeclampsia, ablatio placenta, intrauterine growth restriction, placenta previa, gestational diabetes

Keywords: nifedipine magnesium sulfate pregnancy preterm labor threat
use of long-acting bupivacaine in lower extremity amputation

Conditions: Amputation; Anesthesia, Local; Opioid Use

Summary: the purpose of this investigator-initiated study is to assess the use of liposomal bupivacaine in major extremity amputation and its effects on post-operative opioid narcotic use, length of stay, and in-hospital costs. liposomal bupivacaine is an encapsulated, injectable amide anesthetic intended for use in long-acting local anesthesia. it has been shown in randomized trials to be effective in reducing post-operative pain while reducing opioid narcotic use and length of hospital stay following several surgical procedures, particularly after total knee arthroplasty. extremity amputation is a painful operation often performed in seriously ill or debilitated patients, often related to infection, trauma or malignancy. application of liposomal bupivacaine in extremity amputation is not well described. the investigators intend to enroll adults greater than age 18 years of age who are to undergo major extremity amputation. patients will receive targeted injections of liposomal bupivacaine during their procedure. patient pain scores, total opioid use, and length of hospital stay will be tracked. patients receiving liposomal bupivicaine will be compared to similarly matched subjects who received standard anesthesia regimens without liposomal bupivicaine. the investigators hypothesize that liposomal bupivicaine used during major amputation decreases opioid use, hospital stay, and in-hospital costs.


Eligibility criteria:
inclusion criteria: * 18 years of age or older * patients who underwent unilateral or bilateral lower extremity major amputation, either primary or revision: partial foot, ankle disarticulation, transtibial, knee disarticulation, transfemoral \[1 year retrospective analysis\] * patients who meet clinical indication for unilateral or bilateral lower extremity major amputation, either primary or revision: partial foot, ankle disarticulation, transtibial, knee disarticulation, transfemoral exclusion criteria: * minor amputations * liver dysfunction (impaired metabolism of amides) * concomitant psychiatric or chronic pain disorders * pregnancy * amide anesthetic allergy * presence of perioperative sepsis or acute organ dysfunction * need for icu admission at any point * polytrauma * quadriplegic/paraplegic/insensate

Keywords: lower extremity amputation liposomal bupivacaine expedited recovery vascular surgery pain management
evaluation of liver fibrosis with 2d-shear wave elastography

Conditions: Chronic Hepatitis B; Sonoelastography; Fibrosis, Liver

Summary: the aims of this study are to evaluate liver fibrosis with two-dimensional (2d) shear wave elastography (swe) technique in inactive hepatitis b surface antigen (hbsag) carriers and patients with active chronic hepatitis b (chb), with the help of a propagation map, compare this method with histopathological results in patients with chb and determine the suitability of 2d-swe for use instead of liver biopsy by evaluating fibrosis before and after treatment.

a total of 253 patients with chb and inactive hbsag carriers as well as a control group of 30 healthy individuals were included in the study between january 2019 and october 2020. liver stiffness measurements with 2d-swe, fibrosis-4 (fib-4) and aspartate aminotransferase to platelet ratio index (apri) scoring and additional liver biopsy in patients with chb were performed in all cases with the help of the propagation map. depending on the degree of fibrosis, liver stiffness was measured again at 24 and 48 weeks in patients who received antiviral therapy. spearman rank correlation test was used for analysing correlation between variables, and receiver operating curve analysis was used to evaluate diagnostic performance in terms of fibrosis.

Eligibility criteria:
inclusion criteria: 1. being infected with the hepatitis b virus, 2. \> 18 years old 3. \< 64 years old exclusion criteria: 1. co-infection with hepatitis c or d 2. have chronic or acute fulminant liver disease 3. have dm disease 4. hypertriglyceridemia, obesity, grade2 and higher hepatosteatosis, 5. long-term drug use, alcohol intake that may damage the liver 6. under the age of eighteen 7. over sixty-five years old 8. transplantation patients

Keywords: shear wave elastography propagation map chronic hepatitis liver fibrosis
aldara for the treatment of extensive alopecia areata

Conditions: Alopecia Areata

Summary: we propose to examine the efficacy and tolerability of aldara cream 5% for the treatment of extensive alopecia areata. aldara is a immune-response modifier. the drug induces the production of cytokines which are small, hormone-like proteins involved in cellular communication during immune responses. we hypothesize that this drug will effect the inflammatory cells present around hair follicles in patients with alopecia areata.

ten patients with extensive scalp alopecia areata (\>95% hair loss)of less than 2 years duration will be invited to participate in this study. for six months each person will be asked to apply aldara cream 5% daily to the right half of the scalp. no drug will be applied to the left side. skin biopsies will be taken of the right scalp before and at the completion of the therapy.

Eligibility criteria:
inclusion criteria: * must give written informed consent. * must be 18 years of age, male or female of any race. * subjects must have extensive scalp alopecia areata (\>95% involvement) of less than 2 years duration. * in good general and mental health based on a medical history and physical exam. * patient must be willing to refrain from all other alopecia areata treatments during the course of the study. * must agree to shampoo daily with free and clear shampoo. exclusion criteria: * history of any illness or condition that in the opinion of the investigator might confound the results of the study or pose additional risk in administering the drug to the patient. * significant abnormalities on screening clinical examination. * previous use of aldara cream 5% * history of drug or alcohol abuse. * use of ultraviolet radiation, including tanning beds and puva therapy for treatment of acne, psoriasis, or any other skin condition within 2 months prior to study initiation. * use of systemic or topical glucocorticoids, corticosteroids. estrogenic, progestogenic, androgenic, or antiandrogen drugs, cyclosporine, fk506 or immunotherapy with dncb, sadbe, or dcp within 6 months of study initiation. * use of a topical medication within six weeks prior to the study. * alterations in thyroid medication within 6 months of study initiation. * pregnant or nursing females.
intrawound administration of vancomycin in tka

Conditions: Knee Osteoarthritis

Summary: the purpose of this study is to determine the intra-articular and serum levels of vancomycin over the first 24 hours postoperatively after intra-articular administration of a standard dose of vancomycin in primary total knee arthroplasty.


Eligibility criteria:
inclusion criteria: 1. age between 50 and 80 2. total knee arthroplasty for primary osteoarthritis. primary diagnosis of knee osteoarthritis exclusion criteria: 1. diminished mental capacity 2. vancomycin allergy 3. chronic kidney disease stage iii and stage iv
upper limb muscle strength models for patients with motor impairment.

Conditions: Stroke; Multiple Sclerosis; Spinal Cord Injuries

Summary: upper limb motor impairments are common. they affect quality of life and can lead to dependency. they are mainly due to neurological conditions such as stroke, multiple sclerosis, and traumatic spinal cord injury. however, the contractile properties of muscle, in particular the maximum force that can be generated voluntarily (mvf) depending on joint angle and motion speed, have been mainly studied and modeled in healthy people. this study aims at developing mathematical models describing residual muscle forces in patients with motor impairments. the knowledge could guide patients' rehabilitation and could be useful for the development of robotic assistance systems that use patients\&#39; residual capacities to control the level of assistance provided.


Eligibility criteria:
inclusion criteria: * patients aged between 18 and 85 * a patient who is a member or beneficiary of a social security scheme * patients hospitalised at the saint-hélier rehabilitation centre for a stroke more than 15 days old, ms or sci * patients with a motor deficit ≤3/5 on the mrc (medical research council) scale in both internal-external shoulder rotation and elbow flexion-extension. * patient with voluntary consent to participate in this study. exclusion criteria: * spasticity \&gt;3/4 on the aschworth scale in the shoulder abductor or elbow flexor muscles. * cognitive impairment that may interfere with measurements (moca \&lt; 20/30) * presence of a pressure sore \&gt; stage 2 at the ischial level * recent trauma to limbs or spine * decompensated heart disease or other unbalanced pathology which contraindicates or may hinder isokinetic testing. * persons deprived of their liberty by a judicial or administrative decision * pregnant women, women in labour or nursing mothers.

Keywords: muscle strength modeling upper limb motor impairment
treatment for whiplash injury

Conditions: Cervical Facet Joint Pain

Summary: objective: cervical facet joint (cfj) pain is commonly seen after whiplash injuries, and is frequently refractory to physical therapy and oral medication. the investigators will evaluate the effectiveness of intra-articular corticosteroid injection for managing whiplash-related cfj pain. methods: the investigators will recruit 32 patients with chronic and persistent cfj pain (≥ 3 on the numeric rating scale \[nrs\]) despite physical therapy and oral medication. under fluoroscopy guidance, the investigators will inject 10 mg (0.25 ml) of triamcinolone acetonide, mixed with 0.25 ml of 0.125% bupivacaine and 0.5 ml of normal saline. at 1 and 2 months after the injection, pain intensity will be reassessed using the nrs.


Eligibility criteria:
inclusion criteria: * history of a traffic accident * ≥ 3-month history of axial cervical pain after the accident without radicular symptoms * whiplash-associated disorder (wad) severity of grade ii (neck complaint, decreased range of motion of neck, and point tenderness) at first hospital visit * failure to respond to physical therapy and oral medication (axial cervical pain of ≥ 3 on the numeric rating scale (nrs 0-10; 0, no pain; 10, worst pain imaginable) * ≥ 80% temporary pain relief following a diagnostic block with an intra-articular (ia) injection of 0.3 ml of 2% lidocaine exclusion criteria: * presence of cervical spine fracture, coagulopathy, iodinated contrast allergy, rheumatic disorders, and any uncontrolled medical or psychiatric condition

Keywords: whiplash injury cervical facet joint chronic pain neck pain corticosteroid injection