Kornimate/medical-research-clean huggingface dataset:
comparing the effect of adding dexmedetomidine to bupivacaine in classical and modified thoracolumbar interfascial plane block on postoperative pain in patients undergoing lumbar disc surgeries

Conditions: Lumbar Disc Surgery

Summary: spinal surgeries are frequently conducted to stabilize the vertebrae and discs of the spine. these surgeries typically require substantial manipulation of subcutaneous tissues, bones, and ligaments . postoperative pain relates to mechanical irritation, compression, and postoperative inflammation. the uncontrolled pain could promote the development of chronic persistent pain and worsen independence, mood, and quality of life. effective pain management facilitates early mobilisation and accelerates hospital discharge. this study aim to investigate the effectiveness of a mixture of dexmedetomidine and bupivacaine in classical thoracolumbar interfascial plane block compare to modified thoracolumbar interfascial plane block on postoperative pain in patients undergoing lumbar disc surgeries.

postoperative pain control after spinal surgeries has been a topic of interest for researchers in the past decade. indeed, poor pain control can not only impact patient satisfaction but also delay rehabilitation and increase healthcare costs. the thoracolumbar interfascial plane (tlip) block was defined by hand et al. for reducing pain following spinal surgery. in this block, the anesthetic drug is administered between the multifidus and longissimus muscles to target the dorsal ramus of the thoracolumbar nerves. the tlip block was later modified by ahiskalioglu et al., with the involvement of the administration of a local anesthetic between the longissimus and iliocostalis, which was observed to demonstrate a dermatomal dispersion similar to that by the tlip block. dexmedetomidine is highly specific and highly selective a2-adrenoceptive agonist and it's action is selective to the cns without the unwanted effect on the cvs that would result from a activation . it has been found that, in many experimental and clinical regional block practices, the addition of dexmedetomidine to the local anesthetic reduces tissue and nerve damage, increases duration of sensory and motor block, and reduces postoperative pain.

Eligibility criteria:
inclusion criteria: * • age \>18 years old * both sex * patients who were in risk-scoring groups i-ii of the american society of anesthesiologists (asa) exclusion criteria: * • patient refusal. * coagulation disorders that affect the blood's clotting activities e.g.: hemophilia. * skin lesions or infection at site of proposed needle. * known allergy to local anesthetics or dexmedetomidine. * patients suffering from mental disease as cannot assess the visual analogue scale (vas) that measures pain intensity as, mental retardation \& psychosis

Keywords: dexmedetomidine classical and modified thoracolumbar interfascial plane block
mri and ct simulation in the evaluation of tumor response and target volume definition for esophageal or esophagogastric cancer patients undergoing chemoradiotherapy

Conditions: Esophagus Cancer; Esophagogastric Junction Cancer

Summary: magnetic resonance imaging (mri) with functional features of diffusion weighted imaging (dwi) are advancing imaging technologies that have potential to overcome limitations of conventional staging methods, radiation treatment planning and the assessment of tumor response in esophageal or esophagogastric cancer. this study aimed to explore the value of mri for the prediction of tumor response to chemoradiotherapy and accurate target volume delineation as compared to ct simulation for patients with unresectable or potentially resectable esophageal or esophagogastric cancer undergoing chemoradiotherapy. the average ct texture features are also extracted before and during treatment to establish a model to predict the prognosis or side effects (e.g. radiation pneumonitis or esophagitis) of patients.

1. both dw-mri and ct simulation will be performed before chemoradiotherapy and after 18-22 fractions. also mri will be performed after treatment. the investigators will contour based on the mri image and compare this with the standard ct plan before and during treatment. 2. the predictive potential of initial tumor adc, and change in adc during and after treatment for tumor response will be assessed. 3. the average ct texture features not only in the present study but also of those who treated previously in our department (since 2014) will be extracted before and during chemoradiotherapy to establish a model to predict the prognosis of patients.

Eligibility criteria:
inclusion criteria: * histologically confirmed squamous cell carcinoma, adenocarcinoma of the esophageal or esophagogastric junction * unresectable or potentially resectable tumor (ct3-4n0-1m0-m1a, according to ajcc 6th) based on standard primary staging by eus and ct * age\>18 years * no distant metastasis other than supraclavicular lymph nodes * no prior history of thoracic radiation or chemotherapy * patients must have normal organ and marrow function as defined below: leukocytes: greater than or equal to 3,500 g/l; platelets: greater than or equal to 100,000/mm3 .hemoglobin:greater than or equal to 10g/l .total bilirubin: within normal institutional limits; ast/alt: less than or equal to 1.5 times the upper limit; creatinine within normal upper limits * informed consent exclusion criteria: * contraindication for mri scanning * patients with other cancer history except cervical carcinoma in situ and non-malignant melanoma skin cancer * pregnant or lactating females * contraindication for radiotherapy or chemotherapy
narrow band imaging for diagnosis of proximal serrated polyps

Conditions: Colonic Neoplasm

Summary: although colonoscopy is considered the gold standard for diagnosis of colonic polyps, the missed rate for colonic adenoma ranged from 15-32%. in particular, missed colonic polyps in the right side colon have been suggested to be the cause for interval cancer that developed after a prior negative colonoscopy. different endoscopic image enhanced modules like the narrow band imaging (nbi) have been developed to improve colonic polyp detection. however, it remains controversial whether the previous version of nbi helps to improve colonic polyp detection. the new generation colonoscope is equipped with high definition and improved narrow band imaging (nbi) which gives at least twice the viewable distance and contrast. the images obtained are far brighter with better resolution than the previous version. it however remains to be determined whether this enhanced imaging technique could help to improve colonic polyps detection. hypothesis: the new generation nbi increases the detection rate of proximal serrated polyps and reduces the missed rate of all colorectal polyps. aims: * to determine whether the new generation nbi improve the detection rate of proximal serrated polyps. * to determine whether the new generation nbi improve the detection rate of all colorectal adenoma and polyps. * to determine whether the new generation nbi reduce the miss rate of colorectal adenoma and polyps.

design: prospective randomized trial inclusion: • all patients scheduled to have screening or scheduled colonoscopy exclusion: * history of crohn's or ulcerative colitis * surveillance for known polyposis syndrome (fap or hnpcc) * previous colonic resection (except appendectomy) * refused consent * deranged coagulation profile that preclude polypectomy

Eligibility criteria:
inclusion criteria: * all patients scheduled to have colonoscopy exclusion criteria: * history of crohn's or ulcerative colitis * surveillance for known polyposis syndrome (fap or hnpcc) * previous colonic resection (except appendectomy) * refused consent * deranged coagulation profile that preclude polypectomy

Keywords: colonoscopy colonic adenoma serrated polyps
drug abuse among elective surgeries: an observational study.

Conditions: Drug Abuse

Summary: drug abusers and addicts form a challenge to the anesthetist because of the added potential risks involved in the administration of anesthesia to this subset of patients, including potential unforeseen drug-drug interactions. in this study, we aimed at screening all patients scheduled for elective orthopedic or general surgeries at the cairo university teaching hospital during a set period of time for the most commonly abused drugs in egypt.

all patients included in the study consented to take part in this study. each patient was asked to answer a questionnaire and submit a urine sample in order to be screened for the most commonly abused drugs in egypt (hashish, tramadol, benzodiazepine, and morphine). patients were then followed up both intra and post-operatively. values of patient vital signs, richmond agitation-sedation scale (rass) scores as well as clinical recovery scores (crs) were all diligently recorded and analyzed.

Eligibility criteria:
inclusion criteria: * male or female patients classified as american society of anaesthesiology (asa) i or ii patients * patients between 15 and 60 years of age * patients scheduled for elective surgery. exclusion criteria: * emergency surgery * those with disturbed conscious levels * history of psychological illness * who refused to give consent

Keywords: drug abuse cairo teaching hospital elective surgery
alfuzosin for treating acute urinary retention

Conditions: Acute Urinary Retention

Summary: the primary objective of the study is to assess the efficacy of alfuzosin 10mg daily in the return to successful voiding after removal of the catheter following a first episode of acute urinary retention (aur) in patients suffering from benign prostatic hyperplasia (bph).


Eligibility criteria:
inclusion criteria: * first episode of painful aur related to bph requiring catheterization * residual volume between 500ml and 1500ml obtained at the time of catheterization and during the first one hour after catheterization exclusion criteria: * participated in another investigational study within 3 months before recruitment * suspect bladder neuro-dysfunction unrelated to etiology; * single bladder neck disease; * acute/chronic prostatitis; * diagnosed prostate carcinoma; * suspected prostate carcinoma diagnosed by ultrasound wave; * surgical history of prostate and urethra; * diagnosed/suspected abnormality in urethra structure; * bladder stone; * blood urine retention caused by any reason; * residual volume less than 500 ml * residual volume more than 1500 ml * aur not due to bph * parkinson's disease * insulin dependent diabetes * known/suspected multiple sclerosis; * stroke/mi within 6 months prior to enrolment; * ast, alt and creatinine \> 1.5x upper limit; neutrophil \< 3,000/mm³; platelet \< 100,000/mm³; * unstable/severe heart failure; * history of postural hypertension/hypotension; * known hypersensitivity to α-receptor blocker; * suspected/diagnosed expansible nerval disease; * treatment with sympathomimetic agent within 1 week prior to enrolment, except otc drug for cold intermittently; * treatment with α1-receptor blocker within 1 month prior to enrolment; * treatment with tricyclic antidepressants, anticholinergic agents, sympathomimetic agent (other than the above reason), first generation antihistaminic, except the treatment with stable β sympathomimetic agent/ anticholinergic agents lasting more than 1 week for asthma and copd (chronic obstructive pulmonary disease); * treatment with disopyramide the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
microbiome in head and neck squamous cell carcinoma

Conditions: Head and Neck Cancer; Lip Cancer; Oral Cancer; Pharynx Cancer

Summary: this study aims to determine whether dysbiosis actively contributes to hnscc and if so, the underlying molecular mechanisms.

hnsccis a lethal cancer with a 5-year survival rate below 50%. although smoking, alcohol intake, and human papillomavirus (hpv) infection are linked to hnscc, only a small proportion of individuals exposed to these factors develop cancer and not all cases progress. thus, additional environmental or host factors must contribute to hnscc. the study team and others have observed significant oral dysbiosis in human hnscc cases, both before and after treatment. this study aims to determine whether dysbiosis actively contributes to hnscc and if so, the underlying molecular mechanisms.

Eligibility criteria:
inclusion criteria: 1. subjects equal to or above the age of 18. 2. patients who are seen and evaluated by a provider within the adult otolaryngology clinic at the university of colorado health. 3. patients that present with a diagnosis of oscc. 4. an equal number of age-matched patients who are visiting the clinic for reasons other than oscc diagnoses, as the control group. 5. ability to understand and willingness to sign a written informed consent document exclusion criteria: 1. subjects under the age of 18 or over the age of 100 2. subjects unwilling to particiapte
swallowing difficulties in people over 60 years: prevalence, degree of difficulty and intervention

Conditions: Dysphagia; Intervention; Ageing

Summary: participants included in scapis2 (swedish cardio pulmonary bioimage study) are screened regarding swallowing difficulty using a timed water swallow test. participants who show signs of swallowing difficulty (dysphagia) are included in the present study, which encompasses s flexible endoscopic evaluation of swallowing function (fees). participants showing a moderate-severe dysphagia are randomized into one of three intervention groups: muscle strengthening training, skill-based swallowing training and a control group who will receive compensatory treatment. the study is expected to improve diagnostics and treatment of swallowing difficulties in an ageing population.


Eligibility criteria:
inclusion criteria: * participation in scapis2 * swallowing dysfunction according to timed water swallow test or * swallowing dysfunction according to self-report exclusion criteria: * severely impaired intellectual abilities. * inability to consent to inclusion in the study. * inability to answer written questionnaires in swedish inclusion of non-dysphagia control cohort: no signs of aspiration, slow swallowing (\&lt;10 ml/sec) or self-rated difficulties with eating and swallowing in sub-study scapis2

Keywords: dysphagia age-related dysphagia health-related quality of life dysphagia intervention dysphagia characteristics
the study of two different chinese traditional medicine treatment on chronic hepatitis b

Conditions: Hepatitis B， Chronic

Summary: although the incidence of hepatitis b has been decreased a lot recently years, there are still quite a few chronic hepatitis b patients in china. the anti-virus drugs of western medicine such as entecavir and tenofovir have been proved effective on decreasing the serum hepatitis b virus (hbv) level, on the other hand, chinese materia medica showed effective on tcm syndromes of chronic hepatitis b (chb) such as hypochondriac pain, jaundice and abdominal mass. besides, the hepatic fibrosis could be delayed after the appropriate treatment of tcm. this study is a multicenter, randomized, open label, parallel group clinical trial to evaluate the efficacy of two different traditional chinese medicine (tcm) herbal treatment on chronic hepatitis b.


Eligibility criteria:
inclusion criteria: * 18\<=age at treatment\<=65 years old * was diagnosed as chronic hepatitis b (icd10:k73.901) and one of the following chinese syndromes: hypochondriac pain (tcd:bng010), jaundice(tcd:bng020) or abdominal mass (tcd:bng040). exclusion criteria: * combined with other virus hepatitis or alcoholic hepatitis * combined with autoimmune disease * combined with liver cancer or cirrhosis * combined with severe hepatitis with or without complications * combined with unstable cardio-cerebrovascular disease * combined with severe lung, kidney, endocrine system, nervous system and hematological system diseases * combined with tuberculosis * chronic hepatitis patients with ongoing inf treatment * woman with pregnancy or breasting feeding * mental disorder and can not express self clearly * cannot speak chinese * allergic constitution or allergy to multiple drugs * refuse to enroll into the study
effectiveness of a cognitive-functional (cog-fun) intervention for children with adhd

Conditions: ADHD

Summary: scientific rationale: many children with adhd have serious difficulties in participation in daily occupations in their ecological settings. these difficulties have a pervasive negative impact on their everyday functioning and quality of life (qol). although pharmacological treatment has been proven effective in treating adhd symptoms in many children, as have psychosocial interventions such as parent training, there is little evidence for integrative approaches that address the cognitive, volitional and social-environmental barriers to participation with this population. although preliminary positive effects of a cognitive-function (cog-fun) treatment in occupational therapy on this population have been demonstrated, additional evidence is needed to confirm these initial findings. methods: initial results of our pilot study (n=17 children with adhd) demonstrated significant moderate to large effects of cog-fun treatment, which targeted participation and executive functions in daily life. significant effects were also found for a measure of self-efficacy and neuropsychological measures of attention, planning and organization. parent ratings showed significant reduction of adhd symptoms and improved qol. the purpose of the current study is to replicate the pilot study findings in a randomized controlled trial. the study will be a randomized controlled trial with a crossover design, including 2 groups of children with adhd attending elementary school and their parents. the research group (group a, n=50) will receive three months of the cog-fun treatment, designed for a parent/child dyad and the control group (group b, n=50) will be wait-listed and receive treatment after three months. outcomes will include measures of participation, executive functions in daily life, child and parental self-efficacy, adhd symptoms and qol. the investigators expect to find a significant main effect of time (pre-post intervention), group (research vs. control) and a significant interaction effect (group x time) on executive and occupational outcome measures.


Eligibility criteria:
inclusion criteria: * diagnosis of adhd * 7-10 years old * regular education system * no moderate or severe neurological and/or psychiatric disorders exclusion criteria: * moderate or severe neurological and/or psychiatric disorders

Keywords: age 7-10 years old regular education system no moderate or severe neurological and/or psychiatric disorders
pattern of intestinal parasitic infection among cirrhotic patients in sohag university hospital

Conditions: Liver Cirrhosis

Summary: chronic hepatic illness is one of the most serious health issues . liver cirrhosis as the latest phase of chronic liver disease causes a disorder called cirrhosis-associated immune dysfunction syndrome (caids) . cirrhosis comes to be a systemic disease, with several organ disorders. at this phase, patients become highly vulnerable to various infections because of caids, which comprises both innate and adaptive immunity). patients with hepatic cirrhosis and ascites are more liable to other complications of liver disease, including hyponatremia, refractory ascites, or hepatorenal syndrome (hrs) . liver cirrhotic patients are considered to be as immunosuppressed and are vulnerable to a different species of entero-parasites . intestinal parasitic diseases have been reported in association with diabetes mellitus (dm) which is considered a predisposing factor to infection in cirrhotic patients . immunosuppression among dm cases is due to increased blood glucose levels, which modifies several immune responses and this renders the body susceptible to various opportunistic infections comprising parasitic infections intestinal parasites such as blastocystis hominis, cryptosporidium spp., isospora belli, cyclospora cayetanensis, and microsporidia have appeared as significant opportunistic parasites that are responsible for severe illness in immunocompromised patients , subsequently, patients suffer from severe morbidity and high mortality).


Eligibility criteria:
inclusion criteria: * patients diagnosed to have liver cirrhosis with or without hepatocellular carcinoma. exclusion criteria: * . cirrhotic patients with renal impairment. * . cirrhotic patients with cardiac diseases.
user evaluation of the minimed 620g and 640g insulin pumps

Conditions: Type 1 Diabetes; Type 2 Diabetes

Summary: this six center international study will include two united kingdom national health service centers, two centers in melbourne, australia and one center each in denmark and spain. the objective of the study is to evaluate subject acceptance of the a new insulin pump and transmitter together with the accompanying training materials. descriptive data from participant questionnaires and device uploads will be evaluated. pediatric subjects between the ages of 7 - 18 years and adults from the age of 19 years of age upwards, who currently use an insulin pump in the management of their type 1 or type 2 diabetes, will be invited to participate. each subject will be trained on the study device and then use it for approximately six weeks. during this time there will be three in-clinic visits and four follow-up phone calls, scheduled at the subjects' convenience. at the end of this period, they will revert back to their original insulin pump and complete a questionnaire on the study pump training materials, features and usability.


Eligibility criteria:
inclusion criteria: * subject is 7 years or older at time of screening * subject is current insulin pump user for at least 3 months * subject has the following continuous glucose monitoring experience as determined by the investigator: * has experience and is able to insert/change sensor by herself/himself and * has experience and can recharge the transmitter and * has experience and can read sensor data in real-time on her/his pump screen * subject has signed a patient informed consent form and is willing to comply with the study procedures; * subject is willing to complete study questionnaires throughout the study * must have one of the following clinical diagnosis: * type 1 diabetes, for a minimum of 6 months prior to enrollment * insulin requiring type 2 diabetes, for a minimum of 6 months prior to enrollment exclusion criteria: * female subject has a positive urine pregnancy screening test. * female subject who plans to become pregnant during the course of study. if a woman becomes pregnant during participation, she will be withdrawn * subject has any condition that, in the opinion of the investigator or qualified investigational center staff, may preclude him/her from participating in the study and completing study related procedures. * subject has impaired vision or hearing problems that could compromise the handling of the device as determined by investigator or qualified investigational center staff * subject is actively participating in an investigational study (drug or device) wherein he/she has received treatment from an investigational study drug or investigational study device in the last 2 weeks.