Kornimate/medical-research-clean huggingface dataset:
to compare ilioinguinal/iliohypogastric block to wound infiltration for pain relief after hernia repair in adults

Conditions: To Compare ILI/IHG Block to Wound Infiltration for Pain Relief After Hernia Repair

Summary: this study was conducted to assess the postoperative painscores in patients undergoing open inguinal hernia repair between two groups receiving either u/s guided ilioinguinal/iliohypogastric nerves block with ropivacaine or wound infiltration with ropivacaine.the safety of two analgesic interventions(ilioinguinal/iliohypogastric nerves blocks and wound infiltration) was measured alongwith comparison of opioid use between the two groups over 24 hours postoperatively was made. patient satisfaction between the two groups was also assessed by the likert scale.

pain is a concerning problem in patients with open inguinal hernia repair. hence, multi modal analgesia is recommended to overcome this issue. therefore this randomized controlled trial was conducted to compare the analgesic efficacy of ultrasound guided ilioinguinal/iliohyphogastric nerve block vs. local anaesthetic infiltration of wound with ropivacaine on postoperative pain after open repair of unilateral inguinal hernia in adults. this study was conducted at aga khan university hospital karachi.it is a randomised controlled trial conducted from march 2019 to october 2019. 60 participants for elective unilateral open inguinal hernia repair were included. patients were randomly allocated (30 each) to one of the two groups. group i received ili/ihg nerve block where 20mls 0.25% ropivacaine was infiltrated around the nerves under u/s guidance, and group ii received local anaesthetic infiltration (ropivacaine 20mls 0.25%) at the end of surgery at the incision site to provide postoperative analgesia. postoperative pain at rest (static) and on movement (dynamic) was assessed on vrs scale at 0= no pain , 1-3=mild pain, 4-6=moderate pain, 7-10=severe pain at 0, 2,6, 12, 24 hours, either in person or telephone. total tramadol consumption and time for first tramadol requirement was noted. in addition complications related to ihg block and la infiltration were observed.patient satisfaction was also gauged by the likert scale in the questionairre.

Eligibility criteria:
inclusion criteria: * adult patients between the ages of 18-75 years, scheduled for unilateral open primary hernia repair electively * american society of anaesthesiologists(asa) standard i to iv exclusion criteria: * bmi below 18 or above 35 kg/m2 * local anesthetic allergy * pregnancy * infection at injection site * coagulation disorders * contraindication to any drug used in the standard anesthesia regimen
personalized back rx exercise program as a treatment for discogenic low back pain

Conditions: Low Back Pain

Summary: the prevalence and disability associated with discogenic low back pain are significant, and there is a general lack of widely accepted conservative treatments for the condition. a majority of previous studies that have assessed the efficacy of self-directed exercise-based rehabilitation programs did not include comprehensive metrics to confirm whether participants actually participated in the exercises prescribed. in this pilot study, the investigators hope to determine whether proxies of compliance with a daily, self-directed rehabilitation program for discogenic low back pain are correlated with participant-reported improvements in pain and function. the feasibility of a mobile interface designed to help patients with chronic low back pain track the daily management of their conditions will also be evaluated.


Eligibility criteria:
inclusion criteria: * low back pain with predominantly axial symptoms (axial pain \> leg pain) that are exacerbated with sitting and alleviated with walking * persistence of symptoms for at least 3 months * lumbar intervertebral disc pathology evident on magnetic resonance imaging * 18 to 65 years old * computer literate; have smartphone (iphone 5s or up, android 2.3 or up) * english speaking exclusion criteria: * concurrent pathology that may contribute to patients' axial low back symptoms (e.g., spondylolysis, spondylolisthesis, facet arthropathy) * severe lumbar disc degeneration prior to beginning back rx exercise program * history of lumbar spine surgery or other interventions prior to beginning back rx exercise program * history of trauma * cases involving workers' compensation or other legal claims * non-english speaking
gastric emptying in elderly with hip fracture

Conditions: Gastroparesis; Hip Fracture; Mild Insufficient Nutrition

Summary: the gastric emptying of 400 ml 12.6% carbohydrate rich drink is investigated in elderly women, age 75-100, with acute hip fracture. the emptying time will be assessed by the paracetamol absorption technique, and lag phase and gastric half-emptying time compared with two gender-matched reference groups: elective hip replacement patients, age 45-71, and healthy volunteers, age 28-55.

patients with hip fracture are submitted to prolonged fasting before surgery is undertaken. this is deleterious for their metabolic condition and slows recovery after surgery. a carbohydrate-rich beverage is taken immediately before surgery and gastric emptying rate is assessed in elderly (75-100 yo) women prior to surgery for acute hip fracture. as comparator another two groups of women are used; one scheduled for elective surgery for hip replacement due to osteoarthritis; another healthy female volunteers. on the day of surgery the primary study group of acute hip fracture is given a carbohydrate-rich beverage 400 ml, total 200 kcal in combination with paracetamol 1.5 g. blood samples are intermittently drawn during 180 minutes to measure recovery of paracetamol in plasma and gastric emptying rate calculated according to previously published principles. in the same manner a group of women on waiting list for hip replacement surgery due to osteoarthritis are enrolled for estimation of gastric emptying rate. in addition, another group of completely healthy women are enrolled for assessment of gastric emptying.

Eligibility criteria:
inclusion criteria: * female gender, age 75 years or above, and hip fracture within 24 hours of admission. exclusion criteria: * gastro-esophageal reflux disease, peptic ulcer disease, gastrointestinal motility disorder, pulmonary or cardiac disease, pharmacological treatment with motility-stimulating agents such as dopamine-receptor blockers or macrolides, as well as previous long-term opioids or acid inhibitory agents, or cognitive impairment at the discretion of the investigator
steroid-reducing effects of crisaborole

Conditions: Atopic Dermatitis; Eczema

Summary: atopic dermatitis, or eczema, is a chronic skin condition affecting many children. crisaborole is a non-steroid topical medication which is fda approved for children aged 2 and older for eczema. this research study seeks to investigate whether crisaborole reduces topical steroid use in children with atopic dermatitis.

atopic dermatitis (ad) is a chronic skin disease and a common affliction among children. twice daily topical corticosteroid (tcs) use over several weeks is recommended for active inflammatory disease. side effects of tcs range from cutaneous atrophy to hypothalamic-pituitary-adrenal axis suppression. steroid phobia and misunderstanding often lead to poor compliance and inadequate disease control. topical calcineurin inhibitors (tcis) are currently recommended as steroid-reducing agents, especially on sensitive areas such as the face and skin folds. however, tcis are associated with burning reactions and come with black box warnings. crisaborole (eucrisa), the newest topical prescription option for ad, is a phosphodiesterase-4 inhibitor with demonstrated efficacy in patients aged 2 and older with mild to moderate ad. given the good tolerability and favorable safety profile, crisaborole makes for an alternative topical option to its predecessors. however, corresponding data are lacking. it would be of great interest to patients, patients' families and providers if crisaborole can be shown to reduce the amount of tcs necessary for control of ad. the investigators therefore propose a proof-of-concept study to investigate whether crisaborole can serve as an effective steroid-reducing agent.

Eligibility criteria:
inclusion criteria: * children aged 2 or older (\<18). * diagnosed with atopic dermatitis. * at baseline, ad is mild to moderate (score of 2 \[mild\] to 3 \[moderate\]) on the investigator's global assessment scale (iga; scores range 0-4, higher indicates greater severity). exclusion criteria: * known allergy to a constituent of the studied products (crisaborole, vehicle, aquaphor, topical steroids \[hydrocortisone 2.5% ointment and triamcinolone acetonide 0.1% ointment\]). * at baseline, ad is severe (score of 4 \[severe\] on the iga scale). * medical problems which interfere with completion of protocols in this study. * pregnant or lactating females. (females who have experienced menarche will be required to take a urine pregnancy test.) * participant is enrolled in another research study. * participant or participant's guardian(s) are unable to follow instructions as required in this study.

Keywords: topical steroid crisaborole topical calcineurin inhibitor
neuropsychologic, neuroradiologic, endocrinologic, and genetic aspects of klinefelter syndrome

Conditions: Klinefelter Syndrome

Summary: the purpose of this study is to investigate the following: 1. whether klinefelter syndrome is associated with altered total and regional brain volumes and altered brain activity. 2. the influence of genetic factors and testosterone treatment on the neuropsychological phenotype, total and regional brain volumes and brain activity in men with klinefelter syndrome.

klinefelter syndrome (ks) is the most common sex-chromosome disorder in men with a prevalence of 1 in 660 men. men with the syndrome have an additional x-chromosome. the syndrome is associated with cognitive and behavioral dysfunction and also with hypogonadism. magnetic resonance imaging have pointed to different volumetric alterations in several brain structures. several genetic factors involving the x-chromosome have been suggested to influence the neuropsychological phenotype in men with ks. the aim of this study is to investigate the following: 1.whether ks is associated with altered total and regional brain volumes and altered brain activity. 2.whether genetic factors influence the neuropsychological phenotype, total and regional brain volumes, and brain activity in men with ks. 3.whether testosterone treatment improves cognitive skills and change brain activity in men with ks. participants are divided in 5 groups: 1. 50 men with ks who receive testosterone treatment. 2. 50 men ks who do not receive testosterone treatment. 3. 100 age-matched control men.4. 50 age-matched control women are included as a control group for x-chromosome inactivation pattern. 5. parents of ks subjects in group 1 and 2 are included to determine the parental origin of the supernumerary x-chromosome. methods include a 3-hour battery of standardized neuropsychological tests to cover a broad range of cognitive domains and to assess major domains of personality. we use magnetic resonance imaging to measure total and regional brain volumes and functional magnetic resonance imaging to measure brain activity while subjects are performing a attention-demanding cognitive task. the genetic testing includes the parental origin of the supernumerary x-chromosome, the pattern of x-chromosome inactivation, androgen receptor (ar) cagn repeat length, and gene expression profile of brain-expressed genes.

Eligibility criteria:
inclusion criteria: * age between 18 and 60 years * verified ks karyotype (ks patients) exclusion criteria: * present or past neurological diseases * present or past head trauma * contraindication to perform mr scans(claustrophobia,magnetic or electric foreign bodies - including cardiac pacemakers, magnetic cerebrovascular clips and electric non-removable appliances dosing medicine) * extreme adiposity (bmi \> 35 kg/m2)

Keywords: klinefelter syndrome neuropsychology neuroradiology genetics
capsaicin lozenges in treating patients with mucositis caused by radiation therapy

Conditions: Head and Neck Cancer; Radiation Toxicity

Summary: rationale: capsaicin lozenges may be effective treatment for mucositis caused by radiation therapy. it is not yet known whether capsaicin lozenges are more effective than no treatment for mucositis caused by radiation therapy. purpose: randomized phase iii trial to study the effectiveness of capsaicin lozenges in treating patients with mucositis caused by radiation therapy.

objectives: i. determine the efficacy of capsaicin lozenges in terms of frequency, duration, and severity of mouth pain caused by radiation therapy to the oral cavity. ii. evaluate the toxicity of this regimen in these patients. outline: this is a randomized, double blind, placebo controlled study. patients are stratified according to dentures (yes vs no), smoking history (none vs currently vs past only), radiation therapy (primary vs postoperative adjuvant), planned radiation dose (5000-6000 cgy vs greater than 6000 cgy), planned fluoride use (yes vs no), and amount of oral mucosa in radiation field (one- to two-thirds vs greater than two-thirds). patients receive one lozenge orally of capsaicin or placebo four times daily. treatment begins within the first 3 days of radiation therapy and continues during and for two weeks after radiation therapy is completed.

Eligibility criteria:
disease characteristics: scheduled to receive radiation treatment to at least one third of the oral cavity at a total dose of at least 5000 cgy using 200 cgy/fraction must be entered on study within first 3 days of radiation no open mouth sores at study entry patient characteristics: age: 18 and over performance status: not specified life expectancy: not specified hematopoietic: not specified hepatic: not specified renal: not specified other: no known intolerance to capsaicin no allergy to citric acid, cherry flavorings, or fc and c red dye #3 or #40 prior concurrent therapy: biologic therapy: not specified chemotherapy: no concurrent chemotherapy endocrine therapy: not specified radiotherapy: no prior radiotherapy to the oral mucosa surgery: not specified other: no requirement for tube feeding
importance of early rehabilitation in stroke patients

Conditions: Stroke

Summary: stroke is one of the leading health problems in the community and it is the most common life-threatening neurological disease impairing the quality of life. early rehabilitation of stroke is very important. the purpose of our study was to evaluate, through clinical examination, whether there was any difference between patients who underwent early rehabilitation and those who underwent late rehabilitation in terms of improvements in motor and functional impairment after rehabilitation, and also to evaluate this difference objectively by analyzing white-matter pathways (corticospinal tracts) using dti.

methods: twenty-eight (28) adults (12 women, 16 men, average age 58 years) with first-time stroke who met the study criteria were divided into two groups depending on the duration of their stroke at the time of their presentation to our facility. group 1 consisted of patients who underwent rehabilitation program within the first 1-4 weeks after stroke, whereas group 2 consisted of patients who underwent rehabilitation program within 5-8 weeks after stroke. both groups were evaluated using the brs, fma scale, fac and bi scales. for cranial imaging, dti was obtained 1 day before and 1 day after treatment. fa and adc values of corticospinal tracts were performed using dti. intervention: patients were enrolled in a rehabilitation program, which was designed for a total of 4 weeks, with daily sessions lasting a total of 1 h on 5 days of a week.

Eligibility criteria:
inclusion criteria: * patients suffering cerebrovascular accident (cva)-associated stroke for the first time with a cortical or subcortical unilateral ischemia or hemorrhage * the patients aged 35-75 years * patiients with ability to understand and follow the instructions * patients with the absence of serious cognitive deficits. exclusion criteria: * patients who had spinal-cord lesion * patients who had history of traumatic brain injury, * patients who had accompanying neurological disease (multiple sclerosis, parkinson's disease, dementia) * patients who had tumor * patients who had history of convulsions

Keywords: stroke rehabilitation diffusion tensor imaging
evaluation of the effect of preoperative intravenous amantadine sulfate on the postoperative early cognitive functions in a elderly patient with laparoscopic radical prostatectomy

Conditions: Postoperative Cognitive Dysfunction

Summary: evaluation of the effect of preoperative intravenous administration of amantadine sulfate on the prevention of the development of early cognitive dysfunction in elderly patients undergoing laparoscopic radical prostatectomy

investigators believe that the preoperative prophylactic amantadine sulphate will reduce the incidence of postoperative cognitive disfunction (pocd) in patients with laparoscopic radical prostatectomy due to the neuroprotective effect, alertness enhancing effect and neuron protective effects.

Eligibility criteria:
inclusion criteria: - asa ii-iii patient exclusion criteria: * history of disease related to central nervous system, history of psychiatric disease, history of previous open heart surgery, history of previous craniotomy, renal insufficiency, hepatic failure, history of arrhythmia pre-applied standardized mini mental test (smmt) less than 24 points

Keywords: amantadine sulphate postoperative cognitive dysfunction laparoscopic radical prostatectomy
effectiveness of the hf-acp website study

Conditions: Heart Failure; Advance Care Planning

Summary: this study evaluates the effectiveness of an interactive website on advance care planning for patients living with heart failure (hf-acp website). the investigators will randomize patients to either the hf-acp website or usual care to determine if the participants who use the hf-acp website have higher advance care planning completion rates than participants assigned to usual care.

advance care planning is a process that supports adults at any age or stage of health to understand and share their personal values, life goals and preferences in order to prepare for future decisions regarding medical care. public awareness campaigns to promote acp have been taking place for about 10 years without significant improvements in acp completion rates. content intended for use by the general public may be too vague for those living with a chronic illness. framing acp within the context of a specific disease may provide the impetus for a person to engage in acp. the investigators believe the hf-acp website will improve patient understanding of the life-limiting nature of hf, the acp process and the need to plan ahead to help ensure the care they receive matches their treatment preferences.

Eligibility criteria:
inclusion criteria: * over the age of 18, * a regular patient in our clinic, * able to read and write english, * familiar with the use and have access to a personal computer, email and the internet. exclusion criteria: * ineligible for participation in the trial if they do not meet the inclusion criteria described above.
tailored teen alcohol and violence prevention in the emergency room (er)

Conditions: Violence; Alcohol Abuse

Summary: this study is designed to address both alcohol misuse and violence among adolescents ages 14-18 seeking care in an urban emergency department (ed). the study is a randomized controlled trial comparing the effectiveness of a combined adapted motivational interviewing and skills training intervention, delivered either by a computer or by a counselor, and an informational handout control condition.

this study will screen \~3000 adolescents in the ed (ages 14-18) over 30 months. eligible adolescents will be asked to participate in the longitudinal study, stratified by age and gender and randomized to conditions (n=225/group): computer prevention program, counselor prevention program, or an informational handout control condition. primary outcomes will be evaluated at 3, 6 and 12-months and include alcohol use/misuse, violent behaviors, illicit drug use, unintentional injury, delinquency, and weapon carriage. the proposed study integrates brief intervention strategies for alcohol misuse and violent behaviors using state-of-the-art technology to tailor the interventions to the specific risk factors of the adolescent. tailored computerized programs use available technology to replace the need for clinical staff in the ed setting, where there is limited staff time to effect behavior change. this project will provide the critical first step toward the implementation of an integrated prevention program addressing overlapping risk factors that has the potential to be delivered to the millions of adolescents visiting urban emergency departments each year.

Eligibility criteria:
inclusion criteria: * adolescents (ages 14-18) presenting to the ed for a medical injury or illness (except exclusions as noted below) * adolescents ability to provide informed assent/consent depending on age * access to a parent or guardian to provide informed consent exclusion criteria: * adolescents who do not understand english * prisoners * adolescents classified by medical staff as "level 1" trauma * adolescents deemed unable to provide informed consent * adolescents treated in the ed for suicide attempts * adolescents triaged to the psychiatric ed

Keywords: alcohol violence alcohol consumption alcohol, drinking