Kornimate/medical-research-clean huggingface dataset:
conventional hand sewn end-to-end anastomosis versus side-to-side anastomosis for stoma reversal: a prospective study

Conditions: Stoma Ileostomy; Stoma Colostomy; Anastomosis; Ileus; Leak, Anastomotic; Bowel Obstruction

Summary: the goal of this clinical trial is to compare approaches to enterostomy reversal by hand-sewn end-to-end anastomosis versus side-to-side anastomosis (sub-divided into hand-sewn side-to-side anastomosis and stapled side-to-side anastomosis). the main question it aims to answer is: • if either of the approaches are better than the other with respect to success rates, efficacy, post-operative complications and overall morbidity. participants admitted for stoma reversal will be divided into two groups: 1. ee: conventional hand-sewn end-to-end anastomosis, and 2. ss: side-to-side anastomosis, which will be further divided into 2 sub-groups: 1. hssa: hand-sewn side-to-side anastomosis 2. sssa: stapled side-to-side anastomosis researchers will compare the ee group to ss group overall, and a second comparison will be made between ee, hssa and sssa groups, to see: 1. rates of major post-operative complications 2. rates of short-term complications (within 30 days of surgery) 3. rates of re-operation 4. post-operative length of stay in the hospital


Eligibility criteria:
inclusion criteria: * eligible participants were all the patients admitted in general surgical wards of sms hospital, jaipur, for stoma reversal, after taking written informed consent exclusion criteria: * pre-operatively diagnosed malnutrition or cachexia * bleeding disorders * patients undergoing stoma reversal along with a concurrent abdominal surgery * rectal anastomosis * use of circular stapler for anastomosis.
immune modulation by misoprostol

Conditions: Gynecological Infection

Summary: the present study is designed to address the null hypothesis that there is no difference in the local and systemic immunomodulatory effects of buccally or vaginally administered misoprostol in healthy, reproductive-age women.


Eligibility criteria:
inclusion criteria: * healthy women 18-45 years of age * negative result of urine pregnancy test at screening and prior to each administration of study drug * normal, regularly occurring menses (being 25-35 day cycles) exclusion criteria: * use of hormonal contraception (current or past 3 months) * use of non-steroidal anti-inflammatory drugs (nsaids) or aspirin within two weeks prior to enrollment or planned use of these medications during the study period * allergy to prostaglandins * previous cervical cancer * partial or complete cervical excision * previous hysterectomy * immunosuppression: either pharmacological or due to comorbidities * diabetes mellitus * auto-immune disease * history of lymphoma or leukemia * sexually transmitted infection (by self-report) over previous 1 year * bacterial vaginosis or candidiasis (current or past 3 months)

Keywords: misoprostol mucosal cervical immune buccal vaginal
erector spinae plane block for postoperative pain control in hip replacement surgeries

Conditions: Postoperative Pain

Summary: esp block advantages include its simplicity, easy identifiable ultrasonographic landmarks and low risk for serious complications as injection is into tissue plane that is distant from pleura, major blood vessels and discrete nerves. coupled with the fact that the erector spinae muscle and esp extend down to the lumbar spine, esp block was hypothesized to be performed at the level of l4. in a recent case report, ultrasound guided esp block was successfully performed at l4 transverse process level for postoperative analgesia after total hip arthroplasty. however, confirmation of the efficacy of esp block in hip replacement surgeries needed more investigation.

this study will be performed in cairo university hospital. thirty adult patients of both sexes scheduled for hip replacement surgery under spinal anesthesia will be enrolled in the study. all patients meeting the inclusion criteria will be randomly assigned to one of 2 groups, 15 per group: group e, esp group (n=15): prior to surgical incision, patients will have ultrasound guided esp block before spinal anesthesia. group c, control group (n=15): prior to surgical incision, patients will have spinal anesthesia without esp block . patients will be randomly allocated by a computer-generated table into one of the study groups, the randomization sequence will be concealed in sealed opaque envelopes.

Eligibility criteria:
inclusion criteria: * patients aged from 40 to 65 years old * both sexes. * asa i-ii. * undergo hip replacement surgery. * body mass index (bmi) from 18 to 35 kg/m2. exclusion criteria: * patient refusal. * contraindication to regional anesthesia (bleeding disorder, use of any anticoagulants, local infection, etc. ) * bmi \> 35. * known allergy to local anesthetics. * asa iii-iv. * patients with difficulty in evaluating their level of pain.
effect of closed-chain shoulder girdle scapular depression exercise on shoulder impingement syndrome

Conditions: Shoulder Impingement Syndrome

Summary: forty patients will be assigned randomly into 2 equal groups study group (n=23) will receive "closed-chain shoulder girdle scapular depression exercise" in addition to stretching for posterior capsule \& pectoralis minor, eccentric exercise for external rotators and strength exercises for serrates anterior and low intensity ultrasound control group b (n=23) will receive "shoulder girdle depression against manual resistance exercise" in addition to stretching for posterior capsule \& pectoralis minor, eccentric exercise for external rotators and strength exercises for serrates anterior and low intensity ultrasound . the exercise program will consist of 3 sessions / week for 5 weeks

background: patients with shoulder impingment syndrome report disability, especially during overhead movements, which may hinder activities of daily living . muscular strengthening training influences the resting position and scapular movement pattern of subjects with shoulder impingement syndrome and improve function of the affected shoulder. therefore, the focus of treatment for the syndrome is on performing exercises, including stretching, strengthening, and neuromuscular control exercises. although multiple types of exercise, such as scapular stability exercises, strengthening of the rotator cuff through range, and flexibility exercises for the anterior and posterior shoulder exercise is effective in the management of patients with shoulder impingement syndrome, there is not enough evidence to say whether one mode of exercise is superior to another. research question: are there any difference between closed-chain shoulder girdle scapular depression exercise and shoulder girdle depression against manual resistance exercise on patients with shoulder impingement syndrome methods: forty patients will be assigned randomly into 2 equal groups study group (n=23) will receive "closed-chain shoulder girdle scapular depression exercise" in addition to stretching for posterior capsule \& pectoralis minor, eccentric exercise for external rotators and strength exercises for serrates anterior and low intensity ultrasound control group b (n=23) will receive "shoulder girdle depression against manual resistance exercise" in addition to stretching for posterior capsule \& pectoralis minor, eccentric exercise for external rotators and strength exercises for serrates anterior and low intensity ultrasound . the exercise program will consist of 3 sessions / week for 5 weeks

Eligibility criteria:
inclusion criteria: * patients aged from 25 to 45 years old. * patients with shoulder impingement stage i \&ii as judged by criteria of neer classification. * patients diagnosed by orthopedic surgeon with shoulder impingement, the diagnosis will be confirmed by positive neer and hawkins tests. exclusion criteria: * history of cardiac diseases or dyspnea on exertion * patients with cervical radiculopathy. * patients with shoulder instability. * patients with frozen shoulder. * acute shoulder trauma.
electrocardiogram variations in the prediction of development of atrial fibrillation

Conditions: Atrial Fibrillation

Summary: atrial fibrillation (af) is the most common arrhythmia, affecting 1% of adults, with its prevalence increasing with age \[1\]. it is associated with increased morbidity and mortality. most patients who develop af have architectural and anisotropic micro changes in the atrial myocardium. these cause heterogeneous and discontinuous changes in the patterns of impulse propagation, heterogeneous atrial activation and shortening of atrial refractory period \[2, 3\]. since 1911 the standard ekg \[4\] (approximately 15 seconds of recording and bandwidth 0.05 to 150 hz) is the most used tool for the evaluation of patients with arrhythmias, due to its low cost and high availability. various electrocardiographic patterns are known predictors of af as evidenced by direct visual inspection. for example, prolongation of p wave duration during sinus rhythm would correlate with structural changes such as increasing the size of the left atrium (the increase in left atrial pressure) or a decrease in driving time \[5\]. these changes favor the development of reentry circuits responsible for the development and maintenance of af. the registration of the electrocardiographic activity provides much more information than evidenced by direct visual inspection. biosignal processing of these specific techniques to detect potential delays caused by abnormal conduction of the myocardium that favor re-entry mechanisms \[6-10\]. for this purpose prolonged ecg with 1000 hz sampling frequency. knowledge about the prediction of the development of af with the standard ecg is not obvious on visual inspection is limited. many of these structural changes and anisotropic, occur slowly over time and may be evidenced by direct variations between 2 ecg from the same individual \[11\]. little is known about whether differences in morphology, axis, scope or duration of p wave related to these structural changes may predict the development of af. our main purpose is to evaluate the prognostic performance of a set of parameters as evidenced by direct inspection of the ecg, and ecg changes from 2 to predict the fa development. the design of this tool could allow future generation of software capable of identifying and reporting these variations, most useful prognostic risk in patients with af.

retrospective cohort of patients 18 years or older with 2 ekg with sinusal rithm between 2004 - 2011.

Eligibility criteria:
inclusion criteria: 1. patients over 18 years health plan members of the italian hospital of buenos aires with at least 2 ecg separated . exclusion criteria: 1. patients with sinus rhythm different. 2. patients with a history of congenital heart disease (tetralogy of fallot, cia) 3. patients with implanted defibrillator or pacemaker. 4. patients with a history of cardiac surgery or performing heart surgery from the last ecg and the development of af. 5. patients with a history of radiofrequency ablation for treatment of arrhythmias.

Keywords: ekg af biosignals
patient-derived tumor-like cell clusters predict progesterone sensitivity in patients with early endometrial cancer

Conditions: Endometrial Carcinoma Stage I; Atypical Endometrial Hyperplasia

Summary: to construct a prediction model of progesterone sensitivity in patients with endometrial cancer treated with fertility preservation

after diagnosed of early endometrial carcinoma (eec) or atypical endometrial hyperplasia (aeh) by hysteroscopy, patients meet the study criteria will be enrolled. patients will receive mpa (medroxyprogesterone acetate) 250-500mg or ma (megestrol acetate) 160-320mg by mouth daily. then hysteroscopy will be used to evaluate the endometrial condition every 3 months, and intra-operative findings will be recorded. hysteroscopy will continue until pathology confirms complete response. complete response (cr) is defined as the reversion of endometrial atypical hyperplasia to proliferative or secretory endometrium; partial response (pr) is defined as regression to hyperplasia with or without atypic; stable disease (sd) is defined as the persistence of the disease; and progressive disease (pd) is defined as the appearance of higher pathological progression, or myometrial invasion, or extra-uterine metastasis. continuous therapies will be needed in pr or sd. patients with pd will be recommended for hysterectomy. during each hysteroscopy, the intraoperative residual tissues were sent to the laboratory of college of future science and technology of peking university for culture as patient-derived tumor-like cell clusters (ptc), and the content of lipids (lipid droplet size and cholesterol content) was measured by stimulated raman scattering imaging and recorded. after collecting the data of 148 cases, the prediction model was constructed. then the model is validated in the validation set composed of 96 new cases. in order to determine the accuracy and sensitivity of the model. if a patient has achieved a pathological complete response and a high lipid content is detected in the tissue by stimulated raman scattering imaging, we will follow up for subsequent recurrence.

Eligibility criteria:
inclusion criteria: * have a confirmed pathological diagnosis based upon hysteroscopy: atypical endometrial hyperplasia or histologically prove well-differentiated eec g1 without myometrial invasion * no signs of suspicious extrauterine involvement on enhanced magnetic resonance imaging (mri) or enhanced computed tomography (ct) or ultrasound * have a desire for remaining reproductive function or uterus * good compliance with adjunctive treatment and follow-up exclusion criteria: * acute liver disease or liver tumor (benign or malignant) or renal dysfunction * pregnancy or potential pregnancy * confirmed diagnosis of any cancer in reproductive system * acute severe disease such as stroke or heart infarction or a history of thrombosis disease * hypersensitivity or contradiction for using mpa or ma * with other factors of reproductive dysfunction; * strong request for uterine removal or other conservative treatment

Keywords: progesterone patient-derived tumor-like cell clusters endometrial carcinoma
open-label extension study of abobotulinumtoxina (dysport®) for the treatment of cervical dystonia

Conditions: Cervical Dystonia

Summary: the aim of this study is to assess longer term safety and effectiveness of dysport®.


Eligibility criteria:
inclusion criteria: * subjects enrolled in the y-47-52120-051 study, who have completed all study visits up to week 12, or up to week 4 in the event of an early withdrawal * returned to pre-treatment status as judged by the investigator exclusion criteria: * pure anterocollis or pure retrocollis * known antibodies to botulinum toxin type a * requirement for botulinum toxin injections to site(s) other than the neck and unable to avoid such treatment for the duration of the study * known significant underlying swallowing or respiratory abnormality which might be exacerbated by botulinum toxin treatment
inhaled nitric oxide and inhaled prostacyclin after cardiac surgery for heart transplant or lvad placement

Conditions: Heart Failure

Summary: research study evaluating the individual and combined effects of inhaled nitric oxide (ino) and inhaled prostacyclin (ipgi2), on the function of the right heart after surgery for either heart transplant or for left ventricular assist device (lvad) placement. the investigators hope to learn if these two medications, when given together after surgery, improve right heart function by lowering blood vessel pressures in the lungs. the investigators hope to learn if the combined effects of these two medications are better than either medication used alone. participants were selected as a possible participant in this study because right heart problems are common during and after surgery for heart transplant and for lvad placement. in addition, ino is always given during and after these two types of surgeries at stanford to help improve how the right heart functions.

the study will begin once the participant arrives in the cardiothoracic intensive care unit (cticu) after heart surgery for either heart transplant or lvad placement. as is standard of care after these types of surgeries, the participant will arrive in the cticu with a breathing tube already in place, receiving ino, and connected to a breathing machine. the participant will be receiving relaxing medication in an intravenous line provided by the cardiac anesthesiologist and the cticu physicians. the participant will be unaware of the study period while the participant is sedated. data will be collected from the monitor screen connected to the participant's arterial and venous lines, and if placed, lvad monitor. these data are: central venous pressure (cvp) mean arterial pressure (map) mean pulmonary artery pressure (mpap) cardiac index (ci) systemic vascular resistance (svr) pulmonary vascular resistance (pvr) right ventricular stroke work index (rvswi) lvad flow lvad pulsatility index (pi) these data will be collected at five different time periods during the first eight hours after surgery. 1. time zero. data will be collected after surgery upon your arrival to the cticu while receiving ino. 2. after two hours of ino treatment data will be collected. ipgi2 will then be combined with the current ino. 3. after two hours of combined ino and ipgi2 treatment, data will be collected. ino will then be stopped. 4. after two hours of ipgi2 treatment data will be collected. ino will be restarted. 5. after two hours of combined ino and ipgi2 treatment, data will be collected. the study ends after this data collection time.

Eligibility criteria:
inclusion criteria: * adult cardiac surgical patients scheduled to undergo either heart transplantation or lvad placement exclusion criteria: * patients with prior documented allergic reactions or intolerance to either nitric oxide or prostacyclin will be excluded. patients not undergoing heart transplantation or lvad placement will be excluded.

Keywords: heart failure hypertension, pulmonary heart failure, right-sided heart-assist devices heart transplantation
comparative pharmacokinetics of yh14659

Conditions: Acute Coronary Syndrome

Summary: the objective of this study is to compare pharmacokinetics after single oral administration of 2 capsules of yh14659, a fixed-dose combination of clopidogrel and aspirin developed by yuhan corporation versus co-administration of plavix (clopidogrel) and astrix (aspirin) in healthy male volunteers.


Eligibility criteria:
inclusion criteria: * the patient or legally authorized representative must sign a written informed consent, prior to the any procedure, using a form that is approved by the local institutional review board after detail explanation of the purpose, contents, and characteristic of the drug * healthy male volunteers of aged between 20 years to 55 years * have standard weight of ≤ ±20% based on broca index\* (broca index: ideal weight(kg) = (height(cm)-100) x 0.9) * have no history of neither congenital nor chronic disease * have no history of abnormal symptoms or opinions as a result of physical examination (medical checkup) * eligible subjects with acceptable medical history, physical examination laboratory tests, ecg during screening period exclusion criteria: * received any drug that induce or/and inhibit drug metabolizing enzyme such as barbital within the last 28 days prior to the first administration * shown symptoms doubtful as an acute disease within the last 28 days prior to the first administration * have signs of bleeding symptoms or/and history of disease such as: gum bleeding, hard to control hemorrhage, easily suffer from bruise, and etc. * have disease that can affect absorption, distribution, metabolism and excretion of the drug such as: inflammatory bowel disease, gastric ulcer, duodenal ulcer, hepatic disorders, and gastrointestinal tract surgery except appendectomy * have a known allergy(except mild allergic rhinitis which does not require treatment) or hypersensitivity to drugs * have the following abnormal findings on diagnosis; * have ast or alt \> 1.25 times of normal upper limit * have total bilirubin \> 1.5 times of normal upper limit * have higher pt, appt, bt than normal range * have plt below 150,000 or above 350,000 * have been drug abuse, excessive caffeine (\> 5 cups/day), heavy smoking (\>10 cigarettes/day), continuous alcohol intake (\> 30g/day) or have drunk within the last 7 days prior to the first administration * have been on a diet that can affect absorption, distribution, metabolism and excretion of the drug (especially grapefruit juice 7 days prior to the first administration) * donated blood within 60 days prior to the first administration * participated in any other clinical trials within 60 days prior to the first administration * have used any drug which is thought to affect this study by principal investigator 10 days prior to the first administration * subject who is judged to be ineligible by principal investigator or sub-investigator

Keywords: yh14659 aspirin clopidogrel yuhan
intraarticular platelet-rich plasma injections versus corticosteroid injections in primary knee osteoarthritis

Conditions: Osteoarthritis

Summary: aim: to study and compare the clinical effects of platelet-rich plasma (prp) injections and intra-articular (ia) corticosteroid injections in patients with primary osteoarthritis (oa) of the knee. this study aims to demonstrate this by using the oxford knee score and western ontario and mcmaster universities arthritis index (womac) to illustrate quantifiable difference between the two treatment modalities. patient satisfaction will be compared by utilizing the short-form survey-12 (sf-12) score. our null hypothesis states that intra-articular prp injections is more beneficial in the long-term treatment of primary oa of the knee.

this is a single blinded, randomized clinical trial. subjects will be male or female patients with grade 1,2 or 3 oa of the knee classified based on the radiological kellgren -lawrence grading system. 100 patients will be recruited for this study and 50 patients each will be randomized to one of the treatment groups using block randomization i.e. receiving either treatment ia corticosteroids or ia prp injections. the patients will be informed of and will be consented to the treatment they will be receiving. an investigator from the research team, blinded to group assignment, will assist patients in completing the oxford knee score, womac and sf-12 scores prior to receiving the treatment and at 6 weeks, 3 months and 6 months after receiving the treatment. in addition, they will be followed by regularly (at 3 weeks, 9 weeks, 4 months and 5 months) via telephone to inquire about any side effects of the treatment and to document patient satisfaction. subjects in both groups will continue to receive concomitant treatments both pharmacological and nonpharmacological. all subjects will receive physiotherapy sessions with their respective intervention. subjects will continue to receive treatment even if they wish to withdraw from the study at any point.

Eligibility criteria:
inclusion criteria: * clinical and radiological diagnosis of primary osteoarthritis of knee joint * grade 1, 2, or 3 as per kellgren and lawrence radiological grading system. * symptomatic at presentation as per visual analogue pain scale * above 18 years of age * consenting to participate exclusion criteria: * deformities * malalignments * rheumatoid lesions * gouty lesions * bmi more than 35 * use of steroids in the recent 6 weeks * pregnant * breast feeding * active malignancy * active infections * hemoglobin less than 11 * platelet less than 150,000/mm3 and * bleeding disorders/blood dyscrasias or hemoglobinopathies * any contraindications to treatments * uncontrolled diabetes.

Keywords: knee osteoarthritis bahrain prp steroid womac oxford knee score platelet-rich plasma