Kornimate/medical-research-clean huggingface dataset:
evaluation of the effect of immune modulating enteral nutrition formula

Conditions: Sepsis; Critical Illness

Summary: the aim is to compare the efficacy and tolerability of an immune modulating enteral nutrition formula versus the regular formula on the outcomes of critically ill septic patients by assessment of clinical outcomes, immune profile, tolerability and enteral nutrition intolerance and laboratory markers

nutritional formulas are considered important sources of the dietary components that the body requires. they contain the sources of fats, proteins and carbohydrates and compensate any vitamin and mineral deficiency. there is a special type of formulas called the "immune-enhancing formulas", they supplement the body not only with the energy sources but also, they boost the body's immune system as they contain multiple types of amino and fatty acids. there is an ongoing debate around the efficacy of the immune-enhancing formulas, some studies show that they make a significant difference in enhancing the clinical outcomes compared to traditional formulas while other studies showed no significant difference between the traditional formulas and immune-enhancing formula. the immune-enhancing nutritional formula is used in enteral and oral feeding for critically ill patients. it's mainly indicated in cases of malnutrition, post surgeries and traumas and immunocompromised patients. its composition: composition in approximate %w/w maltodextrin 42.44% sodium caseinate 18.25% mct oil 6.28% arginine 5.21% poly-dextrose 4.00% corn oil 3.48% glutamine 2.61% fish oil 2.32% minerals 1.96% vitamins 0.86% artificial flavor (vanilla) this study analyzed prospectively the clinical and laboratory outcomes of critically ill sepsis patients taking regular enteral nutrition versus immune modulating formulas.

Eligibility criteria:
inclusion criteria: * diagnosed with sepsis according to guideline criteria and * age ≥18 years exclusion criteria: * gastrointestinal tract complications or intestinal failure or any contraindications to receive enteral nutrition * hemodynamic instability on admission

Keywords: malnutrition immune modulating formula
prevena to prevent surgical site infection after emergency abdominal laparotomy

Conditions: Surgical Site Infection; Length of Stay; Seroma; Hematoma

Summary: post-operative wound complications in abdominal surgery have a major impact on patient outcomes and the real impact of closed incision negative pressure therapy (cinvt) is not clear in the literature moreover concerning its potential economic benefits the hypothesis of this study is that cinpt has the potential to reduce surgical site infections. secondly the investigators aim to study the economic impact of cinpt used after abdominal emergency laparotomies.

emergency laparotomies lead to increased morbidity and mortality rates. in this scenario the most frequent wound occurrences are represented by wound infections, skin dehiscence or parietal hernias. despite standard surgical aseptically technique and perioperative prevention management of infections (e.g. antibiotics), wound complications after emergency laparotomies are still an important unmet challenge. moreover, all these complications increase the cost of care requiring new managements. cinpt has been longly used to favour the successful healing of a plethora of open wounds. in particular cinpt is based on the application of local negative pressure to the wound surface. in case of open abdomens, the procedure is performed by applying a sterile abdominal dressing, which consists of a fenestrated soft plastic non-adherent layer with enclosed central foam, which is placed on the surface of the viscera. then, two layers of porous sponge dressings are applied over the plastic layer. finally, a transparent adhesive is placed over the foam and the wound to seal the abdominal cavity. the entire system is then connected, by suction tubes, to a device which ubiquitously applies negative pressure (cyclically or continuously) on the surface. the fluid from the wound is collected into a container. the benefits of negative pressure wound therapy have been reported to include removal of infectious material, reduction in oedema and improved perfusion to tissue. since few years, a new negative pressure wound therapy has been created for closed wounds to reduce time of healing and avoid wound complications.

Eligibility criteria:
inclusion criteria: * adult patient * ≥10cm emergency median laparotomy * abdominal wall and skin closure in first intent * septic peritoneal cavity (purulent and/or fecaloid free liquid and/or abscess) * informed written consent exclusion criteria: * no abdominal wound closure in first intent * allergy or hypersensitivity to silver * application of a mesh for abdominal wall closure * patients under corticosteroids or other immunosuppressive treatment. * women who are pregnant or breast-feeding. * intention to become pregnant during the course of the study. * inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant. * previous enrolment in the current study.

Keywords: pnpwt prevena ssi morbidity dehiscence
effect of denosumab in erosion healing in ra

Conditions: Rheumatoid Arthritis

Summary: to evaluate the effects of denosumab on erosion healing and change in physical function in ra patients.

this is a randomized, double-blind, placebo-controlled study, which aimed to evaluate the effects of denosumab on erosion healing and change in physical function in rheumatoid arthritis (ra) patients in low-disease activity or remission receiving synthetic dmards (sdmards) treatment using high-resolution peripheral quantitative ct (hr-pqct).

Eligibility criteria:
inclusion criteria: * ≥18 years old * das28 ≤5.1 * without severe deformity in mcp joints which would influence the longitudinal assessment of hr-pqct exclusion criteria: * ra functional status class iv (limited in ability to perform usual self-care, vocational, and avocational activities) * treatment with any biologic dmards for ra treatment within 8 weeks before randomisation * pregnancy or premenopausal women planning pregnancy * previous use of denosumab, zoledronic acid or teriparatide * hyperparathyroidism * contraindications to denosumab * bisphosphonate, biologic dmards and the use of oral glucocorticoid \>10 mg/day (prednisolone equivalent)

Keywords: rheumatoid arthritis hr-pqct erosion denosumab
ralpps in patients with hilar and intrahepatic cholangiocarcinoma

Conditions: Hilar Cholangiocarcinoma; Intrahepatic Cholangiocarcinoma

Summary: unsatisfactory immediate outcomes of associating liver partition and portal vein ligation for staged hepatectomy (alpps) in surgery of cholangiocarcinoma suggested that patients with biliary cancer should not be treated by alpps. short-term results of alpps variants with reduced surgical trauma on the first stage in patients with cholangiocarcinoma were not yet estimated. the objective of the study was estimation of the short-term results of split-in-situ resection with radio-frequency ablation (rfa) instead of liver partition on the first stage (ralpps) in patients with hilar (h-cca) and intrahepatic (i-cca) cholangiocarcinoma compared with portal vein embolization (pve).

alpps has been recently proposed as the most effective method to induce marked and rapid hypertrophy of flr with 95-100% completion rate of the second stage. the most common indication for alpps is locally advanced multiple colorectal liver metastases. unsatisfactory immediate outcomes of alpps in surgery of cholangiocarcinoma (cca) including high mortality reached 48% in patients with h-cca suggested that patients with biliary cancer should not be treated by alpps. recently reported modifications of in situ splitting (partial alpps, ralpps (radio-frequency-assisted liver partition with portal vein ligation for staged hepatectomy) and altps (associating liver tourniquet and right portal vein ligation for staged hepatectomy) etc) have been aimed to minimize the operating injury on the first stage, hereby reducing postoperative morbidity. the other important idea was to preserve all initial benefits of alpps in terms of liver hypertrophy and completeness of the second stage. to date, there is no evidence of the benefits of any new alpps modification over others in reducing the morbidity of procedure, particularly in patients with cca..

Eligibility criteria:
inclusion criteria: * h-cca, type ii-iv, t1-3n0-1m0, volume of flr\<40% * i-cca, t1-3n0-1m0, volume of flr\<40% * physical status 1-4 according to american society of anesthesiologists physical status classification system * bmi up to 40 kg/m2 * if cirrhosis is present, class a according to child-turcotte-pugh score exclusion criteria: * h-cca, stage 4a, b * i-cca, stage 4b * i-cca, t4n0-1m0 * i-cca, h-cca with volume of flr \>45% * acute cholangitis and/or infected fluid collections, liver abscesses, other unresolved surgical complications of biliary draining procedures. * jaundice with total bilirubin \>50 µmol/l * prior anamnestic allergic reaction or any other sign of intolerance to iodinated contrast media * age under 18 years * age above 80 years * persons who are incapable of giving consent * pregnant or breast-feeding women * physical status \>4 according to american society of anesthesiologists physical status classification system * bmi \> 40 kg/m2 * if cirrhosis is present, class b, c according to child-turcotte-pugh score

Keywords: alpps ralpps portal vein embolization hilar cholangiocarcinoma intrahepatic cholangiocarcinoma
safety and immunogenicity of two doses, administered three weeks apart, of two(surface antigen adjuvanted with mf59c.1) influenza vaccines in non-elderly adult and elderly subjects

Conditions: Pandemic Influenza Disease

Summary: the present study aims to evaluate safety and immunogenicity of two doses, administered three weeks apart, of two influenza vaccines containing 7.5 micrograms or 15 micrograms of h5n1 influenza antigen, in non-elderly adult and elderly subjects.


Eligibility criteria:
inclusion criteria: * male and female volunteers 18 years of age or older exclusion criteria: * any auto-immune disease or other serious acute, chronic or progressive disease * hypersensitivity to eggs, chicken protein, chicken feathers, influenza viral protein, neomycin or polymyxin or any other component of the vaccine. * history of neurological symptoms or signs, or anaphylactic shock following administration of any vaccine. * within the past 7 days, they have experienced: any acute disease, infections requiring systemic antibiotic or antiviral therapy.

Keywords: influenza pandemic influenza influenza vaccine adjuvanted influenza vaccine
breather trainer versus pulmonary rehabilitation on cardiopulmonary efficiency

Conditions: COVID-19; COPD

Summary: the purpose of the study is to determine the difference between the breather respiratory muscle trainer and pulmonary rehabilitation in patients with copd post covid-19.

the main concern in post covid-19 patients is the involvement of respiratory system and cardiovascular system which may result in dyspnea, low blood oxygen saturation, and decrease cardiopulmonary efficiency. in cases of post covid-19 patients with copd their state is deconditioned and more critical than normal to be either in the zone of progression or regression or stability as the studies showed that handling of these cases during (3-6 months post-covid) will prevent these symptoms from becoming permanent.

Eligibility criteria:
inclusion criteria: 1. spo2 ≥ 93% 2. their age ranges from 30-40 years old. 3. copd patients gold1 (mild fev1≥80% predicted) and gold2 (moderate 50% ≤fev1\<80%predicted) (manian, 2019) 4. patients diagnosed as post covid-19 pneumonia between 3 and 6 months ago with ct scan and pcr testing. 5. their body mass index (bmi) ranged from 20 to 29.9kg/m2. 6. stable medical cases with dyspnea exclusion criteria: patients who will meet one of the following criteria will be excluded from the study: 1. patients with cardiac problems e.g. atrial fibrillation, left bundle-branch block, heart failure. 2. sever cases of copd (fev1/fvc\< 50%) 3. mitral or aortic valvular disease, pericardial effusion. 4. recent myocardial infarction.
randomized, double-blind, placebo-controlled, crossover study of trans sodium crocetinate in healthy volunteers exercising at altitude

Conditions: Healthy Volunteers With Induced Hypoxia

Summary: this is a randomized, placebo-controlled, crossover study of trans sodium crocetinate (tsc) in healthy volunteers, age 18-40 (inclusive), exercising at altitude. the primary objective is to determine the effect of (tsc) on partial pressure of oxygen (pao2) and maximal oxygen consumption (vo2 max); the secondary objective is to assess the effect of tsc on oxygen saturation (spo2).


Eligibility criteria:
inclusion criteria: 1. healthy males and females ages 18-40 2. non-smoking 3. able to provide informed consent and agree to adhere to all study visits and requirements. 4. females of childbearing potential must have a negative blood pregnancy test at screening and agree to use one of the accepted contraceptive regimens, or a double method of birth control during the study and at least 30 days after the last dose of study drug. 5. males who engage in sexual activity that has the risk of pregnancy must agree to use a double barrier method and agree not to donate sperm during the study and for at least 90 days after the last dose of study drug exclusion criteria: 1. allergy to study medication 2. pregnant or breast feeding 3. received investigational medicine (imp) within past 30 days 4. vo2 max \< 35 ml/kg/min (male), \< 30 ml/kg/min (female) at screening 5. abnormal pulmonary function testing at screening 6. surgery or hospitalization in past 3 months determined by the pi to be clinically relevant 7. history of ongoing alcohol or substance abuse 8. known cardiovascular disease, including treated or untreated hypertension 9. respiratory disease and/or any other significant medical condition, including psychiatric disorders 10. clinically significant abnormality on ecg per pi discretion 11. blood donation (excluding plasma donation) of approximately 500 ml within 56 days prior to screening 12. plasma donation within 7 days prior to screening 13. treatment with an investigational drug within 30 days or 5 times the half-life (whichever is longer) prior to screening 14. history of smoking 15. urine screen positive for drugs or positive breathalyzer for alcohol (at screening and treatment visit day 1) 16. history of seizures 17. previous pneumothorax or pneumomediastinum 18. hypo/hyperglycemia 19. diabetes 20. regularly taking medications which may alter heart rate, blood pressure or cardiac output 21. previous history of middle ear equalization problems at discretion of pi
erector spinae plane block versus perioperative intravenous lidocaine for thoracotomy

Conditions: Thoracic Diseases

Summary: thoracotomy surgery is the most painful of all surgical procedures. inadequate postoperative pain control in these patients may cause serious morbidity related to pulmonary, cardiovascular and emotional systems. erector spinae plane block (espb) was first described in 2016 and, it is frequently used for postoperative analgesia in thoracic surgery. intravenous lidocaine exhibit analgesic activity through both the peripheral and central nervous system. intravenous lidocaine has been shown to reduce postoperative pain intensity and accelerate postoperative recovery in many surgeries. the investigators aimed to compare the effect of lidocaine infusion and erector spinae plane block on postoperative opioid consumption and pain scores.


Eligibility criteria:
inclusion criteria: * american society of anesthesiologist's physiologic state i-iii patients undergoing thoracotomy surgery exclusion criteria: * chronic pain, bleeding disorders, renal or hepatic insufficiency, non cooperative patient, * patients with allergies to one of the drugs used in the study.
oral administration of colostrum to premature babies: impact on the oral microbiota

Conditions: Changes in the Oral Microbiota

Summary: oropharyngeal administration of mother's colostrum to premature infants has been proposed as a stimulus to the oropharyngeal lymphatic tissues to decrease the incidence of pneumonia and sepsis, particularly in intubated babies. we propose to study the impact of this intervention on the composition of the oral microbiota.


Eligibility criteria:
inclusion criteria: * premature infant with birth weight \< 1500 * intubated in the first 48 hours of life * available maternal colostrum exclusion criteria: * lethal condition
effect of sustained natural apophyseal glide combined with strengthening exercises of lower fibers of trapezius in patient with unilateral neck pain

Conditions: Neck Pain

Summary: neck pain is considered one of the very common cause behind musculoskeletal pain and is 4th leading cause of disability . cervical pain is among 5 most contributing factors in causing years lived with disability.individuals with unilateral neck pain exhibit significantly less lower trapezius strength than middle and upper trapezius fibers .mulligan is one of the mobilization techniques that can be applied in case of neck pain.in prolong neck pain there is a hyperactivation and shortening of upper trapezius which makes the lower trapezius weak this leads to imbalance between cervical and scapular muscles and result in impaired biomechanics. so mostly treatment focused on upper trapezius and neglecting the lower trapezius and this create increase chances of recurrency of neck pain because the imbalance remains present. so, this study aims at evaluating the effects of snags combined with strengthening exercises of lower fibers of trapezius .


Eligibility criteria:
inclusion criteria: * individuals aged 18-35 years * both gender * unilateral neck pain * symptoms of duration more than 3 months. * nprs scoring of greater than or equal to 4 points. * neck disability index score of 20% or above. * manual muscle testing : grade 3 exclusion criteria: * prior cervical and thoracic spine fractures, dislocations, or surgeries, spinal osteoporosis or infection, or whiplash. * any trauma or localized infection in neck region * psychiatric diseases such as phobia/obsession and depression
rifaximin therapy vs low fodmap diet in ibs

Conditions: Irritable Bowel Syndrome; Small Intestinal Bacterial Overgrowth

Summary: functional gastrointestinal disorders (fgids) are common and from the most recent global epidemiology study, an estimated 40% of the world population suffer from the condition. fgids cause significant morbidity to patients, despite not influencing mortality. ibs is among the most important functional gastrointestinal disorder with an estimated 3.8 to 9.2 % of the general population worldwide were affected by this disorder. rifaximin (gut specific antibiotic) and low fodmap diet (dietary based therapy) were proven to be effective in treating irritable bowel syndrome (ibs), however there was no head-to-head study comparing both treatments. this study will help doctors to understand the efficacy of different ibs/sibo treatments. with the evaluation of factors that can predict treatment response, doctor could potentially treat ibs and sibo more effectively in future. the purpose of the study is to compare the clinical symptoms and psychological improvement in patients with irritable bowel syndrome (ibs) after treatment with rifaximin versus treatment with low fodmap diet. the factors that is associated with treatment response will also be evaluated. in ibs patients with small intestinal bacterial overgrowth (sibo), eradication rate of sibo will be evaluated.


Eligibility criteria:
inclusion criteria: 1. patients diagnosed with irritable bowel syndrome using rome iii diagnostic criteria with abdominal pain/ discomfort intensity of weekly average of worst abdominal pain/ discomfort in past 24 hours score of ≥ 3.0 on a 0 to 10 point scale and stool consistency of at least 2 days per week with at least one stool that has a consistency of type 6 or type 7 bss or \<3 csbm per week 2. subject who can provide written informed consent and willingness to comply with the requirement of the protocol 3. able to communicate in english, malay, or mandarin languages exclusion criteria: 1. patients with known hypersensitivity or contraindication to rifaximin 2. pregnant / breastfeeding women 3. patients who are on probiotics for the past 1 month 4. presence of family history of gi malignancy or alarm features suggested malignancy - e.g. unintentional weight loss (≥ 10% of body weight in recent 6 months), gi bleeding 5. history of gastrointestinal (gi) malignancy 6. patients with any hepatobiliary or pancreatic diseases 7. patients with severe depression, anxiety, or other psychological disorder 8. patients with any terminal disease 9. other conditions determined by the investigator to be inappropriate for this clinical study

Keywords: rifaximin low fodmap diet ibs sibo
lars in ovarian cancer patients

Conditions: Low Anterior Resection Syndrome

Summary: background: low anterior resection syndrome (lars) is a common functional disorder after low anterior resection impacting quality of life. data on lars derives nearly exclusively from rectal cancer studies. therefore, the study was designed to assess lars in advanced epithelial ovarian cancer (eoc) patients, who underwent rectal resection and to compare it with a female rectal cancer cohort. methods: a cross-sectional multi-centre analysis was performed for female patients suffering from either rectal or eoc who received a low anterior resection as part of their therapy regimen. none of the patients received pre- or postoperative radiotherapy. lars was defined by using the validated lars score and its severity was divided into "no", "minor" and "major lars".


Eligibility criteria:
inclusion criteria: * low anterior resection because of ovarian or rectal cancer exclusion criteria: * neoadjuvant or adjuvant radiotherapy
evaluating a cognitive remediation intervention for women during the menopausal transition

Conditions: Menopause

Summary: the goal in this study is to evaluate the effectiveness of a cognitive remediation program that was designed specifically to address the concerns related to cognitive difficulties that are often reported among women in the menopausal transition. this cognitive remediation program has been created to provide our clients with an opportunity to learn more about the relation between menopause and cognitive function, to learn new strategies to enhance thinking skills (e.g., memory, attention) and to hear about lifestyle changes that are known to have a beneficial effect on mental functioning.


Eligibility criteria:
inclusion criteria: * currently in menopausal transition * subjective cognitive complaints * presence of vasomotor menopausal symptoms (i.e., hot flashes) exclusion criteria: * individuals with acute and severe depression * suicidal ideation * severe ptsd * psychosis * severe alcohol/substance use issues
comparison of ultrasound and hysterosalpingography in evaluation of uterine abnormality in patients with infertility

Conditions: Uterine Abnormality

Summary: the leading issue that every couple is experiencing in present era is infertility and it has become the major problem worldwide. many hormonal disorders, weight, diet, and uterine abnormalities contributes in infertility.

to compare diagnostic effectiveness of ultrasound and hysterosalpingography in detecting uterine abnormalities among primary and secondary infertile women. in order to obtain the necessary results, 73 patients were examined on ultrasound and then referred for hysterosalpingography at radiology department of dr.essa lab and punjab radiology. patients with primary and secondary infertility between the age of 18 to 45 were included whereas pregnant women and women with pid and gti were excluded. the data were collected utilizing the questionnaire and then processed in spss version 25.

Eligibility criteria:
inclusion criteria: * primary and secondary infertile women exclusion criteria: * pregnant women. women with pid