Kornimate/medical-research-clean huggingface dataset:
zinc supplementation on cellular immunity in thalassemia major

Conditions: Thalassemia; Splenectomy; Status; Immunosuppression

Summary: randomized controlled trial was conducted in post-splenectomy patients aged \>12 years. subjects are randomly assigned to two groups (zinc and placebo). 1.5 mg/kg/day (max 50 mg/day) of zinc is administered.

thalassemia refers to a hereditary anaemic condition that occurs due to a single gene disorder resulting in a defect in globin production. infection is an important cause of morbidity and mortality among thalassemia patients worldwide. thalassemia patients are more prone to infection. mechanism of this susceptibility is related to altered immune response compounded by splenectomy procedures common in patients with thalassemia. zinc on the other hand plays important role in immune responses. this study aims to identify zinc supplementation to cellular immunity of splenectomized patients. randomized controlled trial was conducted in post-splenectomy patients aged \>12 years. subjects are randomly assigned to two groups (zinc and placebo). 1.5 mg/kg/day (max 50 mg/day) of zinc is administered. anamnesis, physical examination, and laboratory results such as peripheral blood, ferritin, transferrin saturation, serum zinc, immunologic markers for cellular immunity (lymphocyte count, cd4+ and cd8+ t lymphocyte count and functions) are evaluated at the start and end of the 12-week study. improvement in immune response is defined as an increase in the t lymphocyte count and cd4+ t lymphocyte count, decrease in cd8+, and increase in the cd4+/cd8+ ratio.12 the mean reference value for cd4+/cd8+ ratio is 1.4 (sd 0.6).15 cd4+ t lymphocyte function refers to its ability to synthesize il-2 and tnf-α following exposure to 100 µl phytohaemagglutinin with proportions measured using flow cytometry. meanwhile, cd8+ t lymphocyte function refers to its ability to synthesize il-2 and tnf-α following exposure to 100 µl phytohaemagglutinin measured using flow cytometry. the frequency of blood transfusion is calculated from the medical records of the subjects during the past 1 year, which is grouped as follows: 1. seldom receive blood transfusions, if within a time period of one year the subject received blood transfusions of \< 1 time. 2. sometimes receive blood transfusions, if within a time period of one year the subject received blood transfusions of 2 - 3 times. 3. often receive blood transfusions, if within a time period of one year the subject received blood transfusions of \> 4 times. analysis was conducted using statistical package for social sciences (spss) version 20.0. changes in immunologic parameters between the two groups that are numeric will be analysed using paired t-test for variables with a normal distribution, and mann-whitney test for numeric variables with non-normal distributions.

Eligibility criteria:
inclusion criteria: * thalassemia major patients * age \> 12 years * agreed to participate and signed the informed consent * no other comorbidity beside thalassemia exclusion criteria: * hiv positive patients * those in steroid medication

Keywords: zinc supplementation immunity thalassemia
aizthromycin or clarithromycin in h-pylori eradication regimen

Conditions: Peptic Ulcer; Dyspepsia; H-pylori

Summary: the aim of this study is comparison between two regimens containing clarithromycinand azithromycin.

eradication of helicobacter pylori is important for treatment of gu but ideal regimen is not available. hp is resistant to metronidazole and clarithromycin, thus clarithromycin is expensive and it is not available in underdevelopment countries. there are different articles about replacement clarithromycin with azithromycin as a method of eradication of hp that is decreases length of therapy and increases, effectiveness of drugs and decreases resistance of drugs. the aim of this study is comparison between two regimens containing clarithromycinand azithromycin.

Eligibility criteria:
inclusion criteria: * patients with peptic ulcer due to h-pylori confirmed endoscopy and biopsy exclusion criteria: * patients who got h-pylori eradication treatment previously * patients who used study drugs during 3months before study

Keywords: h-pylori eradication azithromycin clarithromycin
a study of nivolumab intravenous (iv) to subcutaneous (sc) switch in adjuvant melanoma and bladder cancer

Conditions: Melanoma; Urothelial Carcinoma

Summary: the purpose of this study is to evaluate the switch from nivolumab intravenous (iv) infusions to nivolumab subcutaneous (sc) administration in participants with resected stage iiia/b/c/d or stage iv melanoma or resected invasive urothelial carcinoma (uc) originating in the bladder who have high risk of recurrence.


Eligibility criteria:
inclusion criteria: * participant must have eastern cooperative oncology group (ecog) performance status score of 0 or 1. * participants must be eligible for adjuvant therapy for melanoma or muscle-invasive urothelial carcinoma (uc) originating from the bladder. * all participants must have disease-free status (dfs) documented by a complete physical examination and imaging studies within 4 weeks prior to treatment assignment. exclusion criteria: * history of ocular or uveal or mucosal melanoma. * upper tract uc (ureter, renal pelvis), non-muscle-invasive uc. * concurrent malignancy (present during screening) requiring treatment or history of prior malignancy active within 2 years prior to treatment assignment. * untreated/unresected central nervous system (cns) or leptomeningeal metastases. other protocol-defined inclusion/exclusion criteria apply

Keywords: resected invasive urothelial carcinoma nivolumab bladder melanoma adjuvant subcutaneous
closed suction drain vs no drain on symptomatic seroma formation after laparoscopic inguinal hernia repair

Conditions: Inguinal Hernia Without Obstruction or Gangrene

Summary: the current study aims to determine whether a use of closed suction drain following laparoscopic inguinal hernia surgery performed for an inguinoscrotal variety can decrease the incidence of symptomatic seroma formation requiring interventions and thus, prevent postoperative morbidity.

patients with laparoscopic inguinal repair, tep as well as tapp approach, which matches the inclusion criteria will be randomized intraoperatively, based on a complete assessment of eligibility, just before the mesh placement. patients recruited in closed suction drain arm will receive suction drain(14 french sizes) in preperitoneal space via a separate incision. the patients without drain arm, the regular postoperative course will be followed. the drain will be removed once the output falls below 50 ml per day. both groups will be followed up until three months post-surgery. clinical suspicion of seroma in symptomatic patients will be confirmed by ultrasound. seroma will be managed conservatively till three weeks in the post-op period.

Eligibility criteria:
inclusion criteria: all patients having an inguinoscrotal hernia (complete type) exclusion criteria: obstructed, incarcerated or strangulated hernia patients unwilling to participate

Keywords: complete inguinal hernia inguinoscrotal hernia laparoscopic hernia repair
act combined yoga for parental burnout in parents with autistic children

Conditions: Autism Spectrum Disorder

Summary: objective: to explore the intervention effect of act combined with a yoga intervention program on parenting burnout in parents with asd. methods: this study used a combination of qualitative research and quantitative analysis to examine the intervention effects of an act-centered intervention program on parenting burnout in parents of children with asd, and to clarify the evaluations and perceptions of parents with asd about the research program through qualitative research. results and conclusion: to clarify the intervention effect of act combined with yoga intervention program on parenting burnout of asd parents.

this study will focus on parents of children with asd, and through literature review, intervention research, qualitative research, and other methods, based on pro, adopt acceptance commitment therapy as the core intervention program to explore the improvement of parenting burnout, stress level and quality of life of parents, to enhance the psychological flexibility of parents with asd, so that parents can positively cope with negative emotions and adverse events in life, and to promote the physical and mental health of parents and the quality of child care, so as to enhance the well-being and quality of life of families with asd, and to enhance the well-being and quality of life of families with asd. the program promotes the physical and mental health of parents and the quality of care for their children, thereby enhancing the well-being and quality of life of families with asd.

Eligibility criteria:
inclusion criteria: * parents of children diagnosed with asd based on dsm-5 * parental burnout exists in parents * parents have normal speech, hearing and cognitive functioning * is the primary caregiver for children * informed consent and voluntary participation exclusion criteria: * untreated ongoing or severe psychiatric disorders such as anxiety disorders, depressive disorders, schizophrenia, etc.; * other more serious psychosomatic disorders that would interfere with the intervention.

Keywords: autism spectrum disorder parental burnout acceptance commitment therapy yoga psychosomatic intervention
low dialysate temperature during sled

Conditions: Acute Kidney Injury; Intra-dialytic Hypotension

Summary: objectives: this study is evaluating the hemodynamic effects of lowering the dialysate temperature in acute kidney injury (aki) patients submitted to sustained low efficiency dialysis (sled) in a single large center. methods: participants will be randomly assigned to two treatment groups. one group will be started treatment with low temperature (set point 5 on the machine which is around 35°c) for one treatment and then alternate between high and low temperatures for a maximum of 8 treatments. the other group will be started with high temperature (set point 9 on the machine which is around 37°c) for the first treatment then alternate between high and low temperatures for a maximum of 8 treatments. each participants will need at least two treatments, one with each temperature to be included in the analysis. the investigators will be looking for the number of events during a sled treatment. events will be defined as drop in systolic blood pressure ≥ 20 mmhg or drop in mean arterial pressure (map) of ≥10 mmhg, requirement of resuscitation with ivf after initiation of sled, initiation or increase requirement of vasoactive drugs.


Eligibility criteria:
inclusion criteria: * 18 years of age or older, aki stage 3 requiring rrt, maximum two pressers, initial temperature of 36°c or higher. exclusion criteria: * initial temperature less than 36°c, esrd, three or more pressers, requirement of antihypertensive medications.
a study to compare ocular safety and tolerability of prednisolone acetate 0.5% eye drops versus vehicle in healthy volunteers

Conditions: Healthy

Summary: the objective of this trial was to confirm the tolerability of prednisolone acetate 0.5% eye drops by testing the hypothesis that the ocular safety and tolerability of prednisolone acetate 0.5% eye drops are equivalent to vehicle. thus healthy volunteers have been selected and have been treated by using a crossover design.


Eligibility criteria:
inclusion criteria: * healthy subjects of either gender, 18 years or older, who were able to give an informed consent * a score for ocular discomfort of 0-20 mm on the visual analogue scale (vas) prior to treatment exclusion criteria: * known hypersensitivity to any of the constituents of the medications * known corticosteroid responder (elevation of intraocular pressure \[iop\]) * known allergic disposition (e.g. hay fever) * need of ocular antiallergic treatment * wearing of contact lenses * any kind of current eye disease (e.g. dry eye) * any kind of concomitant ocular treatment * any injury or infection in either eye during the last 3 months prior to the first application * any medication taken within the last 28 days prior to the first application, except hormonal contraceptives * concomitant or previous treatment with antihistamines within a week prior to enrolment * pregnant or breast feeding women * participation in another clinical study within 4 weeks prior to enrolment * hematological diseases such as aplastic anemia, panmyelopathy, or hemolytic icterus; with severe dysfunction of the liver. * any medical or laboratory condition which, in the investigator's opinion, would preclude the participant from adhering to the protocol or completing the trial per protocol * subjects with history of malignancy of any organ system, treated or untreated, within the past five years, whether or not evidence of local recurrence or metastases exist, are excluded, with the exception of localized basal cell carcinoma of the skin

Keywords: prednisolone acetate eye drops tolerability healthy volunteers
removal of uremic toxins with nocturnal dialysis versus standard dialysis

Conditions: Chronic Renal Failure

Summary: dialysis patients, who decide to switch from standard dialysis (3 times 240-270 min/week) to nocturnal dialysis (3 times 480 min/week), will be followed. in parallel a control group with patients staying on standard dialysis will be followed. the study will last 30 weeks. during this period blood samples (pre- and post-dialysis: 10 times; inlet and outlet of dialyzer: 3 times) will be collected on predetermined time points. concentration of several uremic retention solutes will be determined.


Eligibility criteria:
inclusion criteria: * age \> 18 years exclusion criteria: * pregnancy
safety study of stopping thromboprophylaxis based on ultrasound results after total knee replacement

Conditions: Thromboembolism; Arthroplasty Replacement, Knee

Summary: the purpose of this study is to determine whether stopping low molecular weight heparin (lmwh) thromboprophylaxis is safe after total knee joint replacement. the investigators select patients without proximal thromboembolism assessed by bilateral venous ultrasound examination 7-10 days after surgery. the investigators hypothesis is that stopping thromboprophylaxis is equally effective than prolonging thromboprophylaxis in order to prevent post-surgery complications in this population.


Eligibility criteria:
inclusion criteria: * first total knee joint replacement * signed informed consent non-inclusion criteria: * history of venous thromboembolism/major bleeding/heparin induced thrombopenia * active cancer * long-term anticoagulation

Keywords: tkr ultrasonography asymptomatic deep venous thrombosis extended duration prophylaxis short duration prophylaxis
symphonie - a comparison of symbicort single inhaler and conventional best practice for the treatment of persistent asthma in adolescents and adults

Conditions: Asthma

Summary: the purpose of the study is to compare the efficacy of a flexible dose of symbicort with conventional stepwise treatment according to asthma treatment guidelines in patients with persistent asthma.


Eligibility criteria:
inclusion criteria: * minimum of 3 months history of asthma, diagnosed according to the american thoracic society (ats) definition. prescribed inhaled gcs at a dose of ³400 µg/day and within the approved label for the relevant drug during the last 3 months prior to visit 1. exclusion criteria: * use of any b-blocking agent, including eye-drops, use of oral gcs as maintenance treatment, a history of smoking ³ 10 pack years (1 pack year = 1 pack (20 cigarettes) per day for one year or equivalent).
home bicycle exercise and aerobic capacity

Conditions: Metabolic Cardiovascular Syndrome

Summary: the subjects with mets or type 2 diabetes were enrolled for this exercise-training program. all participators underwent an indoor bicycle exercise for twelve weeks. in addition to demographic data and biochemical tests were determined after an overnight fasting. extension of muscle strength was detected in the dominant lower extremity.

this prospective open-labeled study was conducted in taichung veterans general hospital. the adult participants with metabolic syndrome and/or type 2 diabetes were enrolled. mets. the procedures were fully explained to all subjects before the cardiopulmonary exercise test. ll enrolled subjects received a scheduled twelve-week program for exercise-training program. a commercially available bicycle with an indoor bicycle trainer are used as the home exercise training modality. all medications were not allowed to be changed during the study.

Eligibility criteria:
inclusion criteria: * adult with metabolic syndrome or type 2 diabetes exclusion criteria: * hyperglycemic crisis or hba1c \> 12%; * serum creatinine levels greater than 200 mmol/l; * acute or chronic infectious diseases; * limitations in the ability to undertake regular exercise

Keywords: metabolic syndrome diabetes muscle strength aerobic exercise bicycle brain-derived neurotrophic factor
the effect of mouthwash containing pomegranate peel extract and chlorhexidine mouthwash on bleeding on brushing

Conditions: Gingival Bleeding

Summary: to evaluate the clinical effectiveness of mouthwash containing pomegranate peel extract and chlorhexidine mouthwash on bleeding on brushing and counting of streptococcus mutans among a group of egyptian children with permanent dentition.

to evaluate the clinical effectiveness of mouthwash containing pomegranate peel extract and chlorhexidine mouthwash on bleeding on brushing and counting of streptococcus mutans among a group of egyptian children with permanent dentition. pico: population (p): children with full permanent dentition. intervention (i): pomegranates peel extract. comparator (c): chlorhexidine. outcome(o): primary outcome: bleeding on brushing, criteria:asking patient, unit:binary. secondary outcome:counting streptococcus mutans, criteria: agar plate, unit: cfus/ml

Eligibility criteria:
inclusion criteria: * children aged 12-15 years old. * cooperative children. * both genders. * medically free. exclusion criteria: * children undergoing orthodontic treatment. * children using any other oral hygiene aid other than routine teeth brushing. * children with known history of allergy to any mouth rinse or drug. * parents unable to give informed consent.

Keywords: gingival bleeding on probing
effect of tourniquet binding of cervical on the blood volume of amniotic fluid in cesarean section

Conditions: Amniotic Fluid Embolism; Pulmonary Hypertension

Summary: this study was conducted to investigate whether the use of tourniquet after delivery of the fetus could reduce the amount of amniotic fluid entering the bloodstream and thus reduce the incidence of intraoperative adverse events.

amniotic fluid embolism (afe) is a rare complication specially to obstetrics.when amniotic fluid enters the maternal circulation , a sudden onset of a series of pathophysiologic changes such as pulmonary hypertension, hypoxemia, circulatory failure, disseminated intravascular coagulation, and multiorgan failure may occur. routinely, the typical afe triad is uneasy to discover, and nonspecific adverse reactions such as irritability, chills, chest tightness and shortness of breath, transient drop in blood pressure, and nausea and vomiting are often seen during delivery of the fetus and placenta. all of the above symptoms may suggest that the amniotic fluid has entered into the bloodstream. in clinical anesthesia, investigators observed that women with placenta praevia and placenta implantation were less likely to suffer these nonspecific symptoms after delivery of the fetus compared with women with normal pregnancies.the investigators speculated it might be related to the fact that obstetricians used tourniquets to reduce intraoperative hemorrhage in the former, blocking venous return to the lower uterine segments to reduce the inflow of amniotic fluid into the uterus. therefore, this study was conducted to investigate whether the use of tourniquet after delivery of the fetus could reduce the amount of amniotic fluid entering the bloodstream and thus reduce the incidence of intraoperative adverse events.

Eligibility criteria:
inclusion criteria 1. single pregnancy 2. be in good health, with no high blood pressure or heart disease during pregnancy 3. without placenta previa and placenta implantation 4. no abdominal adhesions, suitable for operation 5. signed informed consent by the pregnant woman and her family exclusion criteria 1. serious coagulation abnormality 2. preoperative severe cardiac, cerebral, pulmonary, hepatic, renal and other important organs insufficiency and electrolyte abnormality combined with placenta praevia or placenta implantation 3. multiple pregnancies 4. previous history of abdominal surgery 5. intraoperative drug allergy

Keywords: amniotic fluid entering the bloodstream blood volume of amniotic fluid amniotic fluid embolism
impact of a regional antimicrobial stewardship on the length of stay of patients admitted to hospital with pneumonia

Conditions: Pneumonia

Summary: this study evaluates the effectiveness of an antimicrobial stewardship program to reduce the length of stay of patients admitted to hospital with a diagnosis of pneumonia. the antimicrobial stewardship program will be implemented in several hospitals in ontario, canada. the program will identify patients with pneumonia, review their charts and make recommendations to their attending physicians about antibiotic management.

antimicrobial stewardship is defined as any activity that promotes the appropriate selection, dosing, route and duration of antibiotic therapy. antimicrobial stewardship programs usually include pharmacists and/or doctors with expertise in infection diseases management. prospective chart review and physician feedback is a common intervention used by antimicrobial stewardship programs to improve antibiotic utilization and patient outcomes. pneumonia is the most common reason for antibiotic utilization in hospitals. significant variation in antibiotic utilization for patients with pneumonia has been repeatedly demonstrated in published studies despite the existence of best-practice treatment guidelines. treatment variation from these guidelines has been demonstrated to result in worse outcomes such as increased mortality. antimicrobial stewardship programs can help reduce the treatment variation from guidelines. despite improvements in certain outcomes, antimicrobial stewardship programs have not demonstrated any impact on the length of stay of patients admitted to hospital with pneumonia. part of this absence of evidence may be due to poor study design and failure to recruit sufficient patients. this study will include the implementation of an antimicrobial stewardship program across many hospitals and the study design and analysis will account for the design problems of the previous studies.

Eligibility criteria:
inclusion criteria: * community-acquired pneumonia * immunocompetent * age \> 18 years exclusion criteria: * admitted to an intensive care unit or high intensity unit * requiring invasive or non-invasive ventilation * life expectancy less than 3 months * hospitalization within the previous 3 months for at least 48 consecutive hours * immunocompromised defined as defined as having leukemia, lymphoma, hiv with cd4 count \<=200, splenectomy or on cytotoxic chemotherapy * neutropenic \[defined as a pmn count\<=0.5x109 cells/l\] from any cause * receiving immunosuppressants \[defined as \>=40 mg prednisone daily (or steroid equivalent) for \>=2 weeks preceding hospitalization or any other immunosuppressant used for systemic illness or to prevent transplant rejection

Keywords: community-acquired pneumonia pragmatic study multi-center time-dependent bias antimicrobial stewardship prospective audit and feedback