Kornimate/medical-research-clean huggingface dataset:
serplulimab combined with folfiri and bevacizumab in the treatment of colon cancer peritoneal metastases

Conditions: Unresectable Colon Cancer Peritoneal Metastases; PMMR/Ras/BRAF Wild-type

Summary: multicentric randomised trial. the goal of this clinical research study is to evaluate the efficacy and safety of serplulimab combined with folfiri+bevacizumab in the treatment of pmmr/ras/braf wild-type unresectable peritoneal metastasis of colon cancer.


Eligibility criteria:
inclusion criteria: * 1. colon cancer was confirmed by histology, and its gene detection was pmmr/mss and ras/braf wild-type. imaging showed peritoneal metastasis. * 2. peritoneal metastatic carcinoma that could not reach cc0/1 was detected surgically. * 3. patients with the following general characteristics: 1. age between 18 and 75 years 2. performance status (ecog) 0, 1 or 2, life expectancy \> 12 weeks 3. adequate renal, and bone marrow function: a. leukocytes \>/= 3,000/microl; b. absolute neutrophil count \>/= 1,500/microl; c. platelets \>/= 100,000/ul; d. serum creatinine \</= 1.5 mg/dl * 4. hepatic function: ast (sgot)/alt (sgpt) \</= 5 x institutional (upper limit of normal) uln. * 5. able to tolerate immunotherapy, chemotherapy and surgery. * 6. patients will be informed and a signed consent before initiating any procedure specific to the trial. exclusion criteria: * 1. age \>75years or age\<18years. * 2. cancers of non colonic origin. * 3. history of cancer (excepted cutaneous basal cell carcinoma or in situ carcinoma of the uterine cervix) with a recurrence during the 5 previous years. * 4. known hiv, hepatitis b or hepatitis c positive. * 5. pregnant women or likely to be pregnant. * 6. persons under guardianship. * 7. subjects deemed unable to comply with study and/or follow-up procedures. * 8. subjects with a known hypersensitivity to protocol systemic chemotherapy that was life-threatening, required hospitalization or prolongation of existing hospitalization, or resulted in persistent or significant disability or incapacity
electrophysiology of the human pituitary gland

Conditions: Pituitary Adenoma; Pituitary Tumor; Diabetes Insipidus Cranial Type; Endocrine; Deficiency

Summary: measurment of electrophysiological properties of the human pituitary gland during removal of a pituitary adenoma. assessment if these properties are sufficient for intra-operative identification of different tissues.

in this study, patients undergoing a surgical resection of a pituitary adenoma as part of standard care will undergo an extra measurement of the electrophysiological properties of the pituitary gland. a single-unit microlectrode will be introduced and placed in the adenoma tissue, anterior piuitary lobe and posterior pituitary lobe. apart from this measurement, no other interventions are performed and standard care will continue. six months after measurements the patients chart will be assessed for the occurrence of remission and endocrine deficiencies. an assessment will be made if these properties are distinctive enough to allow intra-operative identification of the different tissues and thereby increase chances of maximal tumour removal and decrease chance of endocrine deficiencies.

Eligibility criteria:
inclusion criteria: * male and female patients undergoing transsphenoidal surgery for pituitary adenoma. * identification of the posterior lobe on preoperative mri. this is most common in patients with micro-adenomas or small macroadenomas. * age \>18 years exclusion criteria: * emergency surgery * cognitive impairments * pregnancy * pre-existing diabetes insipidus

Keywords: electrophysiology
retention of bonded amalgam sealants versus resin-based sealants

Conditions: Incipient Enamel Caries; Fissure, Dental

Summary: dental caries, is one of the major public health problem in pakistan. dental sealants are known cost effective preventive measure of dental caries as compared to other preventive measures. resin based sealants, is a proven treatment of pits and fissure sealants but retention is still problem. this trial will assess the use of amalgam sealants as an effective and retentive preventive measure in preventing dental caries in children as compared to the standard resin-based sealants. the findings of this randomized controlled trial will be used to raise awareness among the health care professionals, help them to choose amalgam sealants as an effective caries prevention method thereby reducing the burden of cost as amalgam is cheaper material compared to resin-based sealants. the research question is there any difference in the six months retention of bonded amalgam sealants compared to resin-based sealants among 12 to 16 years old children in karachi

objective: to compare the six month retention of bonded amalgam sealants with that of resin-based sealants among 12 to 16 year old children in karachi methods: the study design will be parallel group, equivalence randomized controlled trial. aim is to determine the equality of the amalgam sealants retention compared to resin based sealants retention. outcome: the primary outcome will be retention, divided into complete retention, partial retention and dislodgement of the sealant material.

Eligibility criteria:
inclusion criteria: * children of aged 12 to 16 years (male and female) who will visit to the study site and fulfilled the eligibility criteria * teeth should be caries free at the time of sealants placement. as dental sealant is a preventive treatment it is placed in a caries free surface. incipient carious lesions will also be included. * teeth should be completely erupted, as incomplete eruption of teeth is highly correlates to the partial retention of sealants. * children who will give assent to participate in a study and their parents will give consent. exclusion criteria: * special needs children (because they need special attention of parents) * children who have blood disorder like (leukemia, lymphoma, and thalassemia) * persons with impaired vision, speech and hearing (because either they may not be able to respond to questionnaire or conducting baseline dental training will be difficult).
a prospective study of hypothyroidism after radiotherapy for breast cancer

Conditions: Breast Neoplasms; Hypothyroidism; Radiation Toxicity

Summary: this study is to prospectively investigate the incidence of hypothyroidism after postoperative radiotherapy and identify risk factors for development of hypothyroidism. patients with breast cancer treated with surgery followed by radiotherapy is enrolled. thyroid function was assessed at baseline and different times after radiotherapy. the radiation technique, thyroid dose parameters and hypothyroidism are prospective evaluated, and the dose-effect relationship is analyzed.

breast cancer patients treated with radiotherapy after surgery are prospectively enrolled. thyroid function is evaluated mainly by the measurement of thyroid-stimulating hormone (tsh), free triiodo-thyronine (ft3) and free thyroxine (ft4). thyroid function is regularly assessed before and after radiotherapy. the radiation technique and thyroid dose parameters are assessed. development of subclinical or biochemical hypothyroidism is noted. the incidence and risk factors of hypothyroidism is analyzed. the dose-volume constraints that correlate with functional impairment of the thyroid in breast cancer patients treated with radiotherapy is discussed.

Eligibility criteria:
inclusion criteria: breast cancer patients at first diagnosis, patients who are treated with radiotherapy after breast conserving surgery or modified radical mastectomy, no medical history of hyperthyroidism, hypothyroidism or thyroiditis, have never taken thyroxine, no thyroid surgery. exclusion criteria: absence or ectopic thyroid gland, previous radiotherapy of the neck, diseases of thalamus or pituitary, previous radiotherapy of thalamus or pituitary
tubeless intersegmentectomy plane identification with fluorography

Conditions: Operation Time; Postoperative Complications

Summary: background: we aimed to evaluate the combination of inflation- deflation method and fluorography with the icg injection in the tubeless minimally invasive segmentectomy (no intubation, vats or robotic). methods: a one- armed, prospective randomized controlled study was designed. the intersegmental plane was not so clear during the tubeless minimally invasive segmentectomy, and the presentation of the plane sometimes cost more time. this study will evaluate consecutive patients with the combination of inflation- deflation method and fluorography with the icg injection.


Eligibility criteria:
inclusion criteria: 1. cardio- pulmonary function can tolerate the minimally invasive surgery (including vats and robotic surgery); 2. benign pulmonary lesion considering for segmentectomy; 3. ≤2cm pulmonary adenocarcinoma with ground- glass components, considering for segmentectomy. exclusion criteria: 1. cardio- pulmonary function can not tolerate the minimally invasive surgery (including vats and robotic surgery); 2. segmentectomy is not considered as the surgery plan.
non invasive positive pressure ventilation to minimize aerosolization for covid 19

Conditions: COVID-19

Summary: patients presenting to the emergency department, or needing hospitalization, for a variety of medical conditions often require non-invasive ventilation (breathing support). for example, for a person with shortness of breath as a complication of copd (chronic obstructive pulmonary disease) the gold standard of care requires application of a bipap machine. however, in the current environment of covid-19, the aerosols produced by this machine in a covid-19 positive patient pose serious potential harms to healthcare providers and other patients. all patients with similar symptoms to covid-19 need to be treated as positive until definite testing determines otherwise. the best test available for covid-19 takes up to 4 hours to determine the patients status, which is too long to delay application of a bipap. this could lead to either a delay in care or the need for invasive breathing measures (intubation), which requires intense resource utilization, may not be in line with a patient's goals of care, and could cause serious harms (i.e. infection, medication reactions, etc.) in patients who do not need it. the use of a closed-loop bipap machine in which no expired air is released into the environment would solve these problems. building off the failures of a similar approach that was trialed in italy in response to the covid-19 crisis, this project will develop and test a novel closed-loop bipap system.


Eligibility criteria:
inclusion criteria: * patient with respiratory failure due to primary pulmonary pathology. * patient who is selected for bipap or cpap by the health care provider exclusion criteria: * age \<18 years. * respiratory failure due to non-pulmonary pathology. * impaired consciousness (glasgow coma scale \<10). * patients with contraindications of niv. * severe upper gastrointestinal bleeding. * chest trauma. * agitated or violent patient.
effectiveness of a stigma directed interventional program in schizophrenia

Conditions: Schizophrenia; Stigma, Social

Summary: randomized controlled study measuring the effectiveness of stigma focused intervention in patients suffering from schizophrenia

effectiveness of a stigma directed intervention program in schizophrenia it is a randomized controlled trial that aims at: * assessment of the relationship between self- stigma and 1. family burden on the caregiver (family member). 2. medication adherence by patients. * assessment of the effectiveness of the family incorporation in the process of psychoeducation delivered to the patients suffering from schizophrenia on the self-stigma and family burden of patients with schizophrenia patients. the study will be held in mansoura university hospital psychiatry department and will include 80 egyptian patients with schizophrenia or schizoaffective disorder will be recruited from psychiatry department of mansoura university hospital

Eligibility criteria:
inclusion criteria: 1. patients meet the diagnosis of schizophrenia or schizoaffective disorder according to dsm5.the clinical condition is stabilized. 2. age range between 18 to 50 years. 3. male and female sexes are included. 4. availability of close relative in direct contact with the patient. inclusion criteria for the family members: 1. primary caregiver and the family member share household with patient. 2. no history of receiving treatment of psychiatric disorders. 3. no history of serious head trauma. exclusion criteria : 1. co morbid substance abuse or dependence disorder. 2. co morbid intellectual disability. 3. co morbid chronic medical or neurological condition or history of serious head trauma. exclusion criteria for family members: -sever physical illness that hinders their participation- -

Keywords: stigma intervention program schizophrenia
qol & functional outcomes after combined modality tx for anal ca: comparison of conventional vs imrt

Conditions: Anal Cancer

Summary: the purpose of this study is show that intensity-modulated radiotherapy (imrt), as compared with conventional radiotherapy, improves the precision of tumor targeting and reduces the acute and late effects of radiation toxicity when used to treat anal cancer. results from this work will provide a basis for incorporating the use of imrt to treat anal cancer in future treatment protocols.

the objectives of this study are three-fold. first, we would like to learn and compare the doses of radiation received by the tumor and the normal tissues in anal cancer patients treated with imrt, and in those treated with conventional radiotherapy. second, we wish to compare the acute effects of radiation treatment in both groups of patients. our third objective is to evaluate the late effects of radiation treatment in both groups of patients. the first two objectives will be studied using a retrospective analysis of patients with anal cancer treated at stanford university medical center. the third objective will require these patients to complete and return three quality of life questionnaires.

Eligibility criteria:
inclusion criteria:histologically confirmed diagnosis of squamous cell carcinoma of the anus. must be able to provide informed consent. exclusion criteria:history of new malignancy since the time of treatment for anal cancer. non-english speaking.
efficacy and safety of drug eluting beads tace in treatment of hcc in egyptian patients

Conditions: HepatoCellular Carcinoma

Summary: this study aimed to to compare the conventional transarterial chemoembolization (ctace) with chemoembolization using doxorubicin drug eluting beads (deb-tace) for the treatment of hepatocellular carcinoma regarding short term efficacy and safety in first 3 months after embolization

this prospective case control was conducted at the department of tropical medicine and hcc clinic, ain shams university hospitals (cairo, egypt), the patients were divided according to the line of treatment into 2 groups: 1. group (i): twenty-five patients underwent chemoembolization with drug eluting beads. 2. group (ii): twenty-five patients underwent conventional chemoembolization (ctace) the total number of procedures was 77 sessions (37 sessions of tace with beads and 40 sessions of conventional tace).post-procedure follow up: schedule of follow up: all included patients were checked at: 1. one week after the procedure to detect early post chemoembolization complications and patients were subjected to liver function tests, kidney function tests, complete blood count and abdominal ultrasound. 2. one and four months after the maneuver. patients were subjected to the following in each visit: 1. complete history taking 2. thorough clinical examination 3. laboratory investigations including: 1. liver function tests 2. kidney function tests 3. cbc 4. serum alpha-fetoprotein. 4. triphasic pelvi-abdominal ct follow up imaging was performed at the first and fourth months after embolization and every 3 months thereafter. repeated embolization was scheduled "on demand" basis, if there was residual viable tumor deemed unsuitable for radiofrequency ablation or surgery.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of hcc according to the european association of study of liver diseases * early stage hcc (stage a), using the barcelona clinic liver cancer (bclc) staging system, (single or 3 nodules \< 3cm ps 0) whenever curative measures were contraindicated and bclc stage b (intermediate hcc). * patent portal vein and its main branches * informed consent from all participants before enrollment in the study. exclusion criteria: * patients with child class c according to child classification (bclc d). * patients with diffuse hcc (non-measurable lesion). * patients with thrombosis of main portal vein or one of its main branches (bclc c). * patients with extra hepatic invasion. * patients refused to participate in the study
multidrug resistant shigella infection in bangladesh

Conditions: Diarrhea; Shigella

Summary: the purpose of this project is to systematically collect clinical and nutritional outcomes information on patients treated for shigella infection so that physicians and clinical laboratories can better define which shigella infections are "resistant" to antibiotics and which are "susceptible", focusing on azithromycin a last-line drug to treat drug resistant shigella

2000 suspected shigella cases will be recruited from international centre for diarrhoeal disease research hospital, dhaka who are presenting with diarrhea at the hospital. a stool sample will be collected from the participants after consenting by the study staff. stool microscopy will be performed to see the white blood cells(wbc) and red blood cells (rbc). if wbc \> 10 hpf (4) with any rbc present, culture will be performed from this stool to identify shigella. such patients with invasive diarrhea are treated with azithromycin per local standard of care. enrolled participant will be invited for further follow up when culture from the stool is shigella positive. minimal inhibitory concentration (mic) testing of shigella isolates and molecular testing of shigella isolates will be performed from shigella cultures. this is an observational study. this study does not provide any treatment to the study participants; they will receive treatment as per international centre for diarrhoeal disease research dhaka hospital guidelines. we will then examine the effect of the azithromycin minimal inhibitory concentration on clinical outcome.

Eligibility criteria:
inclusion criteria: * diarrheal illness less than 96 hours duration * microscopic evidence of inflammatory diarrhea * plus mucus in stool * plus abdominal pain/cramps * subject or parents or legal guardian willing to come for follow up at hospital or allow study staff for home visit * residence in dhaka region * presentation during daytime hours exclusion criteria: • not receiving treatment with azithromycin at enrolment

Keywords: multidrug resistant
home-based preoperative exercise training for lung cancer patients undergoing surgery

Conditions: Lung Neoplasm

Summary: lung cancer accounts for over 11% of global cancer incidence and is the leading cause of cancer death, with numbers in 2020 reaching 1.8 million deaths worldwide. for early-stage lung cancer patients, surgical resection is the recommended treatment and the intervention associated with a better prognosis. however, in consequence of surgery there is a substantial deterioration in health-related quality of life across most dimensions, especially in the first month, with 100% of lung cancer patients concerned about the limitations in their physical function and 96% about the levels of fatigue and pain after lobectomy. additionally, some patients developed postoperative pulmonary complications, which are associated with increased length of hospital stay and higher risk of mortality. in this context, and considering that the number of lung cancer cases with an indication for surgery will increase by 60% from 2018 to 2040, to find feasible and effective interventions that could optimize postoperative recovery is of major clinical relevance. the primary purpose of this study will be to evaluate the efficacy of home-based preoperative exercise training to improve health-related quality of life after lung cancer surgery. the secondary purpose of this study will be to evaluate the efficacy of the home-based exercise program to improve physical performance and to reduce postoperative complications /length of hospital stay. participants will be randomly allocated to a preoperative exercise intervention, that will consist of combined aerobic and resistance exercise, or to a control group that will receive usual care (i.e., no exercise training). based on the strong evidence indicating a therapeutic effect of exercise training on fatigue and physical function, domains of hrqol especially affected after lung cancer surgery, the investigators hypothesized that the home-based exercise program will be effective to improve these domains before surgery and attenuate its deterioration after surgery, optimizing the recovery in postoperative hrqol.


Eligibility criteria:
inclusion criteria: * scheduled for surgical treatment of suspected or confirmed lung cancer (clinical stage iiia or less) * waiting time for surgery of at least two weeks from baseline assessment * medical clearance to exercise. * signed informed consent prior to initiation of study-related procedures exclusion criteria: * metastatic cancer * presence of physical or mental disabilities that contraindicated exercise training or physical testing * unable to communicate in portuguese or english * performing combined aerobic plus resistance training over the past month (self-reported ≥2 days a week, ≥30 minutes each session).
electrocardiographic and cardiac magnetic resonance predictors of ventricular arrhythmias in cardiomyopathic patients

Conditions: Premature Ventricular Complex

Summary: this study aims to assess ecg changes for predicting ventricular arrhythmia in cardiomyopathic patients

this study aims to assess ecg markers based on 24-hour holter ecg recordings for predicting ventricular arrhythmia in patients with structural heart disease who have left ventricular dysfunction and left ventricular ejection fraction ≤40%. with special concerns to underlying structural abnormalities in cardiomyopathic patients using cardiac magnetic resonance to determine ventricular function, scar distribution, and grey zone analysis

Eligibility criteria:
inclusion criteria: * patients with ischemic and non-ischemic cardiomyopathy, ef \< 40 % * patient haemodynamically stable * patients accept to make test exclusion criteria: 1. patients with underlying arrhythmia ex heart block or atrial arrhythmia like pacs, af. 2. patients on arrhythmogenic drugs ex digitalis, amiodarone. 3. patients on underlying pacemaker device or crt-d. 4. patients with mi in less than 40 days 5. patients refuse to make test .