Kornimate/medical-research-clean huggingface dataset:
effects of post isometric relaxation with scapular stabilization exercises

Conditions: Upper Cross Syndrome

Summary: the levator scapulae is an important postural muscle that tends to shorten or become tight because of overactivity and bad posture, leading to neck and shoulder pain. levator scapulae syndrome is usually caused by the poor shoulders posture as rounded shoulders as sitting at a computer hunched. it is exacerbated by sustained neck postures, neck movements or levator scapulae muscle palpation. the aim of study will be to determine the effects of post isometric relaxation with scapular stabilization exercises on pain, disability and range of motion in patients with levator scapulae syndrome.

a randomized controlled trial will be conducted at tehsil headquarter hospital sharqpur shareef, sheikhupura through consecutive sampling technique on 30 patients with levator scapulae syndrome which will be allocated using simple random sampling through sealed opaque enveloped into group a and group b. group a will be treated with post isometric relaxation, scapular stabilization exercises along with baseline treatment. group b will be treated with post isometric relaxation along with baseline treatment. baseline treatment includes hot pack, tens, upper trapezius stretch, levator scapular stretch and pectoralis major stretch. both groups will come thrice per week for a total of 4 weeks. outcome measures are nprs, universal goniometer and ndi. data will be analysed during spss software version 25. after assessing normality of data by shapiro-wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups. keywords: disability, levator scapulae, range of motion, pain

Eligibility criteria:
inclusion criteria: * both males and females * age range of 18-40 years * neck and medial border scapular pain for at least 3months * examination - increased muscle tone and tenderness at neck * reduced side flexion and rotation of neck * positive levator scapular length test exclusion criteria: * neuropathies * vertebral fractures * pregnancy * previous cognitive and functional disorders * traumatic neck injury * fibromyalgia * cancer

Keywords: neck muscles neck pain levator scapulae range of motion
effect of breast milk olfactory stimulation

Conditions: Preterm Infant Feeding Outcomes

Summary: breast milk olfactory stimulation will improve preterm infants' outcomes.

the researcher will explain the aim of the study and the components of the tools to the studied nurses. * the researcher will distribute questionnaire to studied nurses for assessing their knowledge and the researcher will observe their practices regarding breast milk olfactory stimulation for premature infants. * the researcher will be divided preterm infant randomly into two equal groups (control and study). while intervention will be directed to study group only before feeding. both groups will be subjected to same routine care of the nicu. * the researcher will be used pibb scale and neonatal behavioral responses sheet to assess the premature infants at 1st day of admission as pre intervention after routine care as "change diaper, eye care, cord care, feeding" at morning shift at ten o'clock and one o'clock in the afternoon for study and control group (pre intervention). * the researcher will apply breast milk olfactory stimulation technique for study group only before feeding but, both groups will be subjected to same routine care of the nicu. * the researcher will assess the effect of used olfactory stimulation technique to study group at 5th and 6th day of admission post intervention.

Eligibility criteria:
inclusion criteria: * preterm infant has gestational of 30 \>37. * birth weight 1000 \> 2500 gm. * preterm infant fed oral or gavage feeding or both of them. exclusion criteria: * preterm infants on mechanical ventilation or complicated case
effect of myodm on quality of life, fatigue and hypersomnia in patients with myotonic dystrophy type 1

Conditions: Myotonic Dystrophy 1

Summary: the purpose of this study is to determine whether myodm (formulated composition containing theobroma cacao supplemented with caffeine (caffeine/theobromine ratio1/1.85, w/w) is effective in the treatment of excessive daytime sleepiness due to myotonic dystrophy type 1 (dm1) and improves the quality of life of these patients.

detailed description: myotonic dystrophy type i (dm1) is the most common form of adult muscular dystrophy, affecting 1 in 8000 individuals. it is an autosomal dominant disorder with multisystemic involvement of multiple organs and tissues, mainly brain, heart, endocrine system, eyes and both smooth and skeletal muscles. hypersomnolence is one of the most frequently reported symptoms in patients with dm1 and often lead to handicap such as cessation of employment and withdrawal from social activities. the present project is a 6 month randomized study to assess the effect of myodm on fatigue, hypersomnia and quality of life in dm1 patients.the patients will be randomized to one of the two study arms. the active arm will receive the myodm treatment and the control arm will not but both will follow the same evaluation program. patients will come to the center every 3 months for evaluations.

Eligibility criteria:
inclusion criteria: * able to provide informed consent * genetically proven dm1 * able to walk independently exclusion criteria: * regular intake of plant stanols or other nutritional supplement * co-morbidity interfering with the interventions or possibly influencing outcomes. * participation in another clinical trial at the same time * unable to complete study questionnaires.
study of experience of high-frequency repetitive transcranial

Conditions: Chronic Schizophrenia

Summary: objective: to understand the personal experience of schizophrenia patients following repetitive transcranial magnetic stimulation (rtms) and its connection with changes in mental symptoms, thereby enhancing the overall understanding of tms. method: the investigators selected eligible schizophrenia patients for fixed-parameter rtms treatment. a self-experience checklist post-tms treatment and positive and negative symptom scales (panss) were applied to evaluate the treatment.

the investigators recruited male subjects admitted to who met the criteria. they were divided into a control and a treatment group. a double-blind approach was adopted. the subjects were unaware of whether real/pseudo stimulation was applied, and the evaluators did not know the grouping specifics. all of the enrolled cases were tested for stimulation thresholds in the bilateral prefrontal cortex. the tms treatment device was a magstim rapid2 neuromagnetic stimulator (magstim) with an "8"-type coil. the study group was administered real stimulation. the treatment parameters were as follows: frequency range, 20 hz; 90% motion threshold; 3 s of stimulation; a 57 s interval; 15 min of stimulation for each side, five times per week for a total of 20 times. for the control group, a 60% motion threshold was set; the remaining parameters were consistent with the study group but with no stimulating energy output. the therapeutic instrument model, appearance, operation process, and sounds when effecting treatment were the same for both groups. a self-experience checklist post-tms treatment and positive and negative symptom scales (panss) were applied to evaluate the treatment.

Eligibility criteria:
inclusion criteria: * 1) were aged 18-65 years; * 2) fulfilled the diagnosis of international classification of diseases edition 10 schizophrenia; * 3) had been diagnosed with schizophrenia more than five years previously; * 4) were in a stable condition; * 5) whose medication remained unchanged during treatment; * 6) who did not have a history of epilepsy (including drug-derived); * 7) had no brain trauma or surgery history; * 8) who accepted treatment voluntarily and provided signed informed consent for inclusion in the study exclusion criteria: * 1) showed contraindications to rtms intervention; * 2) had other neuropsychiatric disorders; * 3) received non-convulsive electroshock treatment a month preceding the start of the study; * 4) indicated an impulse for attacking actions and engaged in destructive and self-harming behavior; * 5) experienced generalized or electricity-related delusionsof reference,influence, andpersecution.
a phase 2 study of intravenous or subcutaneous dosing of sotatercept (ace-011) in patients with end-stage kidney disease on hemodialysis

Conditions: Anemia; Kidney Failure, Chronic

Summary: to determine the optimal route of administration, dose level, and safety of intravenous and subcutaneous dosing of sotatercept for maintaining hemoglobin levels in subjects who are on hemodialysis.


Eligibility criteria:
inclusion criteria: 1. males or females ≥ 18 years of age. 2. subjects on at least 6 hours of hemodialysis per week, for at least 12 weeks before screening 3. subjects must be on a stable intravenous or subcutaneous dose of erythropoietin stimulating agents (excluding methoxy polyethylene glycol-epoetin beta \[mircera\]) to maintain hemoglobin. 4. a mean predialysis hemoglobin concentration ≥ 10 g/dl (grams per deciliter) to ≤ 12 g/dl (≥ 100 g/l (grams per liter) to ≤ 120 g/l) obtained from three consecutive days. 4. a body mass index value ≥ 18.5 kg/m2 (kilograms per m2) at screening. 5. understand and voluntarily sign an informed consent document prior to any study related assessments/procedures are conducted. 6. able to adhere to the study visit schedule and comply with all protocol requirements. exclusion criteria: 1. non renal causes of anemia 2. subjects on peritoneal dialysis. 3. systemic hematological disease 4. uncontrolled diabetes mellitus (hba1c (hemoglobin a1c) \> 9%) at screening. 5. uncontrolled hypertension defined as mean of home systolic blood pressure \> 160 mm hg (millimeter of mercury) or mean of home diastolic blood pressure \> 90 mm hg calculated once during the screening period prior to randomization 6. subjects with heart failure 7. history of malignancy (except excised and cured non-melanoma skin cancer, or cervical carcinoma in situ that was surgically ablated more than 5 years ago). 8. anticipated or scheduled living donor renal transplant during the course of the study.

Keywords: anemia end stage kidney disease chronic kidney disease dialysis erythrpoietin stimulating agent (esa)
endothelial dysfunction in acute exacerbations of chronic obstructive pulmonary disease (copd)

Conditions: Chronic Obstructive Pulmonary Disease (COPD); Inflammatory Disease; Endothelial Dysfunction

Summary: the purpose of the study is to determine a possible association between the clinical entity of exacerbation, markers of systemic inflammation and endothelial dysfunction in patients with copd.

chronic obstructive pulmonary disease (copd) is a chronic inflammatory disease of the lungs; however, there is cumulating data suggesting that the inflammatory reaction associated with copd is not restricted to the lungs but has systemic effects. patients with copd have increased cardiovascular morbidity and mortality. the suspected link between increased cardiovascular mortality and systemic inflammation is endothelial dysfunction, which in turn is caused by impaired activity of no. endothelial dysfunction has been demonstrated in patients with copd. furthermore there is a close correlation between endothelial dysfunction in coronary and peripheral vessels, which allows assessing flow-mediated dilation (fmd) in the brachial artery via high resolution ultrasound as an early predictor of atherosclerosis. moreover, systemic inflammatory markers correlate with endothelial dysfunction in patients with stable copd. exacerbations of copd are episodes of worsening symptoms characterized by increased airway and systemic inflammation. if systemic inflammation is a cause of endothelial dysfunction in copd, endothelial function would be suspected to be further impaired during exacerbation and recover thereafter. the purpose of this study is to determine a possible association between the clinical entity of exacerbation, markers of systemic inflammation and endothelial dysfunction in patients with copd.

Eligibility criteria:
inclusion criteria: * presence of copd according to standard criteria * acute exacerbation of copd according to recommended international criteria * over 40 years of age * history of at least 10 py exclusion criteria: * pneumonia * history or signs of congestive heart failure, * acute myocardial infarction * thoracotomy incl. resection of lungtissue * interstitial lung disease * acute or chronic renal failure * active malignancy * autoimmune disease

Keywords: chronic obstructive pulmonary disease acute exacerbation endothelial dysfunction flow mediated dilation systemic inflammation
time-restricted feeding(trf) on overweight/obese women with polycystic ovarian syndrome (pcos)

Conditions: Polycystic Ovary Syndrome (PCOS); Overweight and Obesity

Summary: the aims of the present study is to examine whether time-restricted feeding (trf) is a safe and effective regimen to improve insulin resistance and decrease body weight in overweight/obese polycystic ovary syndrome (pcos) patients over 16 weeks compared to reduced energy restriction.

intermittent fasting regimens involve periods fasting followed by periods of eating freely. time-restricted feeding (trf) is a new form of intermittent fasting and involves shortening the eating window to 4-10 h/day. trf is a safe lifestyle intervention for weight loss in adults with obesity. accumulating evidence suggests that trf is an effective means of decreasing body weight and improving insulin resistance but did not have any negative impact on eating disorder symptoms, body image perception, or eating behaviors. polycystic ovary syndrome (pcos) is the most common endocrine condition in productive-aged women. about 60-70 % of women with pcos are obese or overweight, and obesity is associated with insulin resistance. since many women with pcos seem to have insulin resistance, compensatory hyperinsulinemia is thought to contribute to hyperandrogenism by direct stimulation of ovarian production of androgens and by inhibition of liver synthesis of shgb. it is important to ameliorate insulin resistance in pcos patients.the aims of the present study is to examine whether trf is a safe and effective regimen to improve insulin resistance and decrease body weight in overweight/obese pcos patients.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * bmi≥24kg/m2 * polycystic ovary syndrome has been diagnosed exclusion criteria: * taking medications affecting weight or energy intake/energy expenditure in the last 6 months, including weight loss medications, antipsychotic drugs or other medications as determined by the study physician; * the body weight fluctuated more than 5% in recent 3 months. * liver and kidney dysfunction: renal impairment, creatinine clearance rate \< 30 ml/min/1.73 m2, transaminase increased, more than three times higher than the normal limit; * history of serious cardiovascular or cerebrovascular disease (angina, myocardial infarction or stroke) in the past 6 months; * history of thyroid diseases; * having been in pregnancy. * researchers believe that there are any factors that affect assessing subjects' participation in trial. * history of malignant tumors; * history of cushing's syndrome, hypothyroidism, acromegaly, hypothalamic obesity; * currently participating in weight loss programs or weight change in the past 3 months (\> 5% current body weight) * patients who cannot be followed for 16 months (due to a health situation or migration) * patients who are unwilling or unable to give informed consent.

Keywords: polycystic ovary syndrome overweight and obesity time-restricted feeding intermittent fasting regimens
best biliary drainage option in advanced klatskin tumor

Conditions: Cholangitis

Summary: to investigate the biliary drainage-related cholangitis and other complications of percutaneous transhepatic biliary drainage (ptbd) in the management of klatskin tumor (kt) compared with endoscopic biliary drainage (ebd).

operative treatment combined with preoperative biliary drainage (pbd) has been established as a safe management strategy for kt. preoperative cholangitis was an independent risk factor for patients undergoing resection for kt. however, controversy exists regarding the preferred technique for pbd.

Eligibility criteria:
inclusion criteria: * type ii、iii、iv klatskin tumor patients; * 18-90 years old exclusion criteria: * unwillingness or inability to consent for the study; * coagulation dysfunction (inr\> 1.3) and low peripheral blood platelet count(\<50×109 / l) or using anti-coagulation drugs; * previous endoscopic sphincterectomy (est) or endoscopic papillary balloon dilatation (epbd); * any type of gi reconstruction; * combined with mirizzi syndrome and intrahepatic bile duct stones; * preoperative coexistent diseases: acute pancreatitis, gi tract hemorrhage, severe liver disease, primary sclerosing cholangitis (psc), septic shock; * biliary-duodenal fistula; * pregnant women

Keywords: ercp ptbd ebd cholangitis complication klatskin tumor
the use of collaborative care in general practice for elderly patients with depression

Conditions: Depression in Old Age

Summary: the first part of this study aims to identify the occurence of depression in the elderly. in the second part, older patients with depression will be invited to a collaborative care with his or her family physician and a psychiatrist specialized in psychiatry in the elderly in accordance with a study protocol. the intervention includes two sessions where the patient will meet the psychiatrist together with the family physician, and between the two sessions the patient will have three treatment sessions with the family physician based on the evaluation by the psychiatrist. following the last session with the psychiatrist the intervention ends with three more treatment sessions with the family physician.

the frequency of depression in the elderly is little known and experiences from family practice indicate that older people not always communicate their mental health issues or present physical complaints which may arise from a state of depression. in this study we aim to register the occurence of depression among all patients at the age of 65 or older who visit their family physician. during a period of four weeks, all patients meeting the eligibility criteria will be asked to answer a questionnaire about mental and physic health issues. those who respond in a manner that gives reasons to believe there is a depression will be contacted by their family physician to meet for a consultation and examination. if this examination confirms the diagnosis the patient will either be treated as usual by their family physician (control group) or be invited to a collaborative care with the family physician in cooperation with a psychiatrist who is specialized in psychiatry in the elderly (intervention group). in the control group the patients will receive usual care at their family physician or be referred to a psychiatrist or a psychologist if appropriate. in the intervention group the patients will have a evaluation session with the family physician and the psychiatrist together. following this session, the patient and the family physician will meet for three treatment consultations based on the evaluation and recommendations given by the psychiatrist. then there will be one more joint session with the patient, the family physician and the psychiatrist and the whole treatment program ends with three more treatment consultations at the family physician. - the aim of this intervention is to examine whether this treatment program is more or equally efficient to treat depression in the elderly as usual care and at lower cost and use of specialized care.

Eligibility criteria:
inclusion criteria: * all patients visiting one of the collaborative family physicians during the enrollment period of four weeks exclusion criteria: * cognitive dysfunction * speaking norwegian language

Keywords: depression elderly family practice
impact of mastoid condition on results of endoscopic management of cholesteatoma

Conditions: Cholesteatoma of Attic; Cholesteatoma, Middle Ear

Summary: the goal of this interventional study is to learn about the effect of mastoid process status and the method of ossicular reconstruction on the results of the procedure transcanal endoscopic management of patients with localized atticoantral cholesteatoma

acquired cholesteatoma is a special form of chronic otitis media in which keratinizing squamous epithelium grows from the tympanic membrane or/and the auditory canal skin into the middle ear mucosa. acquired cholesteatomas of the middle ear are further divided into primary acquired and secondary acquired forms. the primary acquired cholesteatoma is the most frequent type of acquired cholesteatoma and develops by the progression of an initial retraction pocket into a cholesteatoma. primary acquired cholesteatomas are named relative to the site of the pocket origin: (1) attic cholesteatoma consecutive to a pars flaccida pocket,(2) mesotympanic cholesteatoma due to a pars tensa pocket, and (3) combined forms, due to double pockets. the predominant form of acquired cholesteatoma in children develops in 80% from retraction pockets of the pars tensa whereas in adults, this form develops mainly in the pars flaccida. the diagnosis of cholesteatoma is made on otoscopic examination, including endoscopic and microscopic evaluation, imaging, or surgical exploration. the symptoms of cholesteatoma vary; some cholesteatomas are asymptomatic, whereas others become infected and rapidly cause bone destruction. some patients will present with slowly progressive conductive hearing loss and, frequently, with chronic otitis and purulent otorrhea. the otorrhea from an infected cholesteatoma often is malodorous because of the frequent infection with anaerobic bacteria. some patients will have signs and symptoms of the complications of a cholesteatoma: vertigo and hearing loss caused by a labyrinthine fistula, facial nerve paralysis, or intracranial infection. there are some contraindications to the use of exclusively endoscopic approaches. for example, if cholesteatoma involves the mastoid cavity, it is not possible to control and remove it by only a transcanal approach; the use of the microscope in combination with the endoscope is recommended. also, a narrow external ear canal, or external ear malformation, can pose general anatomical difficulties for exclusively endoscopic approaches.

Eligibility criteria:
inclusion criteria: * patients presenting with primary acquired localized atticoantral cholesteatoma. exclusion criteria: * age group: patients below 12 years old. * patients presenting with congenital or secondary acquired cholesteatoma. * patients presenting with extensive, residual, or recurrent cholesteatoma. * patients with craniofacial anomalies.

Keywords: cholesteatoma endoscopic ear surgery mastoid process