Kornimate/medical-research-clean huggingface dataset:
mannitol versus nitroglycerin for kidney injury prevention in robotic-assisted radical prostatectomy or cystectomy

Conditions: Prostate Cancer; Bladder Cancer; Surgery; Renal Impairment; Renal Injury, Acute

Summary: laparoscopic and minimally-invasive robotic access has transformed the delivery of urological surgery. while associated with numerous desirable outcomes including shorter post-operative stay and faster return to preoperative function, these techniques have also been associated with morbidity such as reduced renal blood flow and post-operative renal dysfunction. the mechanisms leading to these renal effects complex are multifactorial, and have not been fully elucidated. however they are likely to include direct effects from raised intra-abdominal pressure, and indirect effects secondary to carbon dioxide absorption, neuroendocrine factors and tissue damage from oxidative stress. it is well documented that pneumoperitoneum places profound stress on the cardiovascular, respiratory and gastrointestinal systems; it also places strain on the renal system. during robotic surgery, continuous pneumoperitoneum and continuous rising of intra-abdominal pressure causes transient oliguria. moreover, kidney function, estimated by the gfr, deteriorates during elevated intra abdominal pressure (iap), and most of the studies identified decrease in renal blood flow (rbf) and renal cortical perfusion. studies conducted to assess the contribution of the nitric oxide (no) system to the renal hemodynamic/function alterations during pneumoperitoneum, concluded that these adverse effects are probably related to interference with the no system, and could be partially ameliorated by pretreatment with nitroglycerine. mannitol is an osmotic diuretic and a renal vasodilator that promotes tubular flow, prevents intratubular cast formation, decreases postischemic cellular swelling, and might serve as a free radical scavenger. mannitol has traditionally been administered before renal surgeries to minimize perioperative renal dysfunction according to preclinical animal studies and clinical experience with renal transplantation. however, high-level clinical data in support of this belief are not available. the aim of this study is to characterize the effects of increased intra-abdominal pressure on renal perfusion and function in cases undergoing robotic lower tract urologic surgeries, and to assess the contribution of either mannitol or nitroglycerin infusion to the renal hemodynamic/function alterations during pneumoperitoneum.


Eligibility criteria:
inclusion criteria: * asa class i - iii * normal renal functions or mild renal disease (gfr \ 30 mg/dl) exclusion criteria: * bmi \> 40 * previous renal surgery * moderate (gfr 30 - 59 mg/dl) \& severe (gfr 15 - 29 mg/dl) renal impairment * decompensated cardiac disease: new york heart association (nyha) class 3 or 4 * allergy to mannitol or nitroglycerin

Keywords: radical prostatectomy radical cystectomy robotic anesthesia mannitol nitroglycerin
to investigate the effect of pemf for knee oa patients

Conditions: Knee Osteoarthritis

Summary: health care costs are increasing alarmingly, which will impose an overwhelming economic burden to an aging society like that of hong kong. for example, degenerative musculoskeletal disorders such as osteoarthritis (oa) present a grand challenge with its high prevalence (\>40% in the elderly suffered from knee oa). knee osteoarthritis (oa) is the most common form of arthritis, and around 2 million population worldwide suffer from this disorder. oa is a debilitating progressive disease with typical pathological progress such as cartilage degeneration, inflammation, joint width narrowing and developing osteophytes. the main system of knee oa is acute pain leading to loss of mobility. there is no effective treatment to cure or stop the progression of oa. for now, the main method is to alleviate the pain and symptoms, including control weight, exercise, physical treatment and intake of nsaids/ paracetamol. pulsed electromagnetic field (pemf) treatment has shown to enhance cell activity related to tissue healing, delay bone and cartilage degeneration and give beneficial effects such as relief in pain, anti-inflammation and reduce swelling. in clinic, pemf treatment has been reported to be safe, and has been proved to reduce the usage of nsaids and pain in patients with knee oa. this study aims to investigate the effectiveness of pemf therapy on for patients with knee oa.


Eligibility criteria:
inclusion criteria: * primary osteoarthritis of knee * vas score ≥ 4 * grade 2 and 3 osteoarthritis (kellgren-lawrence criteria) * no alleviation of symptoms after ≥ 3 months of nonsurgical treatment * no acute knee injuries in both limbs in the past 3 months * no muscle strain in both limbs in the past 3 months * voluntarily agreed to participate and signed the informed consent form exclusion criteria: * skin diseases around the target knee joint * severe pain in other areas affects the diagnosis of function and symptoms of knee joints * injection in target knee within 3 months of enrolment * inflammatory joint disease (e.g., rheumatic inflammation) * infectious joint disease (e.g., septic arthritis) * pregnant or breastfeeding * patient with a pacemaker, an implantable defibrillator, neurosurgical clips, a neurostimulator, cochlear implant, a stent, an insulin pump * physical inability to undertake testing procedures * inability to give informed consent
pregabalin and radicular pain study (parps)

Conditions: Cervical Spondylosis; Cervical Spondylotic Myelopathy; Cervical Spondylotic Radiculopathy

Summary: this study is designed to investigate the effectiveness of pregabalin (lyrica) on nerve pain caused by degenerative neck problems. pregabalin is a new drug registered for use in nerve pain worldwide

the treatment of neuropathic pain is clinically challenging, and pain from cervical spondylosis (cs) is a common variant. this may result from degenerative spinal canal/cord stenosis (cervical spondylotic myelopathy (csm)) or lateral recesses compromise, leading to nerve root compression (cervical spondylotic radiculopathy (csr)). pregabalin is a newly registered drug for the treatment of neuropathic pain. its efficacy has been proven in randomised, placebo-controlled trials for post-herpetic neuralgia and diabetic neuropathy. however, its efficacy in cs with underlying csr or csm has not been established. additionally, there are no data to date on its use in asian patients. in this study, we prospectively evaluate its efficacy for treating neuropathic pain in degenerative csr/ csm 60 patients in an open-labelled, add on fashion. self-evaluation and investigator rated scoring will be implemented. the results will be of value in the non-operative management of cs.

Eligibility criteria:
inclusion criteria: * clinical \& mri, or electrophysiological evidence of pain due to radiculopathy * patients with cs and csr or csm with neuropathic pain due to the above in the neck and upper limbs or lower limbs (including dysesthesia, paresthesia, hyperalgesia). exclusion criteria: * diabetic neuropathy or other underlying neuropathic conditions * contraindications and allergy to pregabalin * previously treated with gabapentin in the last 8 weeks * pregnant or breast feeding * history of renal impairment * history of other causes of neuropathic pain
effect of daytime variation on postoperative hyperalgesia induced by opioids

Conditions: Postoperative Hyperalgesia

Summary: to explore the effect of daytime variation on postoperative hyperalgesia induced by opioids. patients receiving endoscopy surgery under general anesthesia during 08:00-12:00(morning group, n=30) and 14:00-18:00(afternoon group, n=30) using remifentanil for anesthesia maintenance were respectively included. postoperative hyperalgesia at pacu and 24 hours after surgery were assessed through mechanical pain measurement. comparative analysis of postoperative hyperalgesia levels, pain and analgesic requirements between morning group and afternoon group were performed.


Eligibility criteria:
inclusion criteria: * american society of anesthesiologists classification i-ii * abdominal endoscopy surgery * estimated surgery duration 1-2h * right handedness * voluntarily receive postoperative intravenous controlled analgesia exclusion criteria: * heavy smoking or alcohol dependence * puerpera or lactation women * history of chronic pain * analgesic use within one month before surgery * allergy to opioids * can not follow with the study procedure
the efficacy of focus extracorporeal shock wave therapy on hamstring tightness

Conditions: Hamstring Tightness

Summary: to study efficacy of focus extracorporeal shock wave therapy on the flexibility of hamstring muscles in healthy subjects


Eligibility criteria:
inclusion criteria: * limited hamstring flexibility; passive knee extension degree \>20 * no underlying disease exclusion criteria: * patients with history of physical therapy in past 3 month * patient with analgesic drug such as muscle relaxant or nsaid. * patient with limited hamstring flexibility due to neurological or musculoskeletal diseases. * patient with cardiac pacemaker, pregnancy, hypercoagulable conditions, severe osteoporosis, malignancy or active infection around intervention site. * patient with history of chronic knee or back pain * patient cannot follow home stretching exercise program
a smartphone application to improve medication adherence among people with type 2 diabetes mellitus in singapore

Conditions: Diabetes Mellitus

Summary: background: diabetes mellitus (dm) is a major cause of morbidity and mortality worldwide. long-term glycemic control is important to prevent or delay the onset of dm related complications. patients often fail to achieve optimal glycemic control from pharmacotherapy due to non-adherence. with the high prevalence of smartphone usage locally and among the developed countries, there has been a growing interest to deliver interventions through mobile applications. in this study, a mobile application targeted at improving medication adherence among people with type 2 dm will be developed and evaluated. aims: this study aims to (i) design a smartphone application to improve medication adherence and (ii) evaluate its impact on clinical outcomes, health-related quality of life (hrqol) and health status among patients with type 2 dm. hypothesis: the use of a smartphone application can improve medication adherence among patients with type 2 dm, as well as clinical outcomes, hrqol and health status. methods: this is a randomized, open-label controlled trial involving patients with type 2 dm managed at singapore general hospital. patients seen at the institution's diabetes centre and those referred to the pharmacist-led medication therapy management service are eligible to participate. patients in the intervention group will have the mobile application downloaded onto their smartphones, while those in the control group will receive the usual standard of care. the primary outcome will be change in self-reported medication adherence, determined using the 8-item morisky medication adherence scale. secondary outcomes include change in hba1c, blood glucose, frequency of dose titrations, addition or removal of oral hypoglycemic agents, hrqol (measured using the audit of diabetes dependent quality of life) and health status (measured using the euroqol-5d-5l and euroqol visual analogue scale). all outcomes will be measured at baseline and at the end of the 6-month study period (± 4 weeks). significance: the development and evaluation of a mobile application to improve adherence among patients with type 2 dm in singapore is the first of its kind, and the findings of this study will provide the much-needed evidence to demonstrate the effectiveness of this intervention.


Eligibility criteria:
inclusion criteria: * existing type 2 dm managed at sgh diabetes centre and those referred to the pharmacist-led mtm service * age≥ 40 years * hba1c≥ 8.0 * suspected non-adherence (e.g. admitted to have missed doses, hba1c not at target despite frequent dose titrations, recent dm related hospitalization/ emergency visit) * owns a ios smartphone with wi-fi or data plan exclusion criteria: * unable to manage own medications (e.g. taken care of by caregiver, nursing home patients, cognitive impairment) * unable to read and comprehend english * physical impairment that precludes the use of smart phone functions (e.g. deformed finger joints, amputation)

Keywords: diabetes mellitus medication adherence compliance mobile health
effect of radial extracorpeal shock wave on pain and function

Conditions: Hemiplegia

Summary: the purpose of the current study will be focused on the following issues. evaluation of the effect of radial extracorporeal shock wave on the pressure pain threshold and disability in stroke hemiplegic shoulder.

further understanding of rotator cuff tendon impairment and other shoulder soft tissue structural abnormalities in stroke patients may help clinicians in assigning more complete therapeutic plans to hemiplegic patients. the radial extra-corporeal shock-wave therapy has promising results in patients with musculoskeletal problems and in those with various causes of hsp, including spasticity, rotator cuff problems, adhesive capsulitis, and complex regional pain syndrome.

Eligibility criteria:
inclusion criteria: 1. patient's age ranges from 40 to 60 years. 2. spasticity of upper limb ranges from mild to moderate (grade 1+: 2) according to modified aschworth scale (mas). 3. patients with sufficient cognitive abilities that enables them to understand and follow instructions (mini-mental scale \>24). 4. patient who understand the study process and signed the informed consent form. 5. patient with stroke more than 3 months ago. 8. patient with shoulder pain and limited range of motion (rom) or loss of motion in the proximal arm on the hemiplegic side. exclusion criteria: * 1. patients who cannot express their own pain intensity. 2. patients with a history of trauma or surgery to the shoulder on the affected side. 3. patients with history of oral nsaids 3 days before this study or take warfarin medication with an international normalized ratio above 4.0. 4. patients with a history of shoulder pain before the stroke. 6. patients who have received a previous shoulder intra-articular injection or other interventions on the affected shoulder within one month before reswt. 7. patients with cardiac pacemaker. 8. patients who have osteoporosis. 9. patients with psychological problems.

Keywords: pain thrshold rom
effects of baduanjin exercise on heart failure patients

Conditions: Heart Failure

Summary: this study was a parallel, randomized controlled trial with a longitudinal research design. participants were randomly assigned to either the baduanjin exercise group or the control group. the baduanjin exercise group received a 12-week baduanjin exercise programme. the control group received usual care. fatigue, sleep quality, psychological distress, quality of life were assessed by a structured questionnaire at baseline, 4 weeks, 8 weeks, and 12 weeks after enrollment.

this study was a parallel, randomized controlled trial with a longitudinal research design. participants were randomly assigned to either the baduanjin exercise group or the control group. patients in the intervention group underwent a 12-week baduanjin exercise programme consisting of 12 weeks of baduanjin exercise, a 35-min baduanjin exercise demonstration video, a picture-based educational brochure, and a performance record form. the control group received usual care. fatigue, sleep quality, psychological distress, quality of life were assessed by a structured questionnaire at baseline, 4 weeks, 8 weeks, and 12 weeks after enrollment.

Eligibility criteria:
inclusion criteria: * diagnosed with stable heart failure by a physician according to the new york heart association (nyha) class i and ii * aged 20 years or older * able to communicate and speak chinese * have video devices available to use at home exclusion criteria: * impaired mobility, defined as a limitation in independent, purposeful physical movement of the body or of one or more extremities * unstable angina or myocardial infarction, unstable serious arrhythmia, unstable structural valvular disease, open-heart surgery, or chronic obstructive pulmonary disease (copd) * diagnosis of major depression and cognitive disorders * unstable vital signs (defined as blood pressure \> 180/110 mmhg or \ 100 beats/min).

Keywords: heart failure baduanjin exercise fatigue sleep quality psychological distress quality of life
the effect on back pain and fatigue level of acupressure

Conditions: Coronary Angiography

Summary: this research was conducted with the aim of determining the effect of acupressure on the level of back pain and fatigue after coronary angiography.

to prevent bleeding, hematoma, and embolism after coronary angiography, patients are asked to stay in bed for 6 to 24 hours. during complete bed rest for at least 6 hours, the patient should keep his/her feet flat. the patient should lie in the supine position and avoid rapid movements. long-term bed rest (at least 6 hours) in post-angiographic patients causes weakening of the lower back muscles and fatigue due to the pressure constantly applied to the same muscles, while muscle fatigue causes muscle spasms and lower back pain. today, acupressure is also used along with various pharmacological treatments to relieve pain and fatigue. acupressure is a massage technique that ensures the proper functioning of energy channels by applying some pressure to certain parts of the body with the thumbs or index fingers, hands, palms, wrists and knees for therapeutic purposes. acupressure points are the same as acupuncture points. although there is no needle inserted into the body as in acupuncture. according to g-power analysis, the total number of samples was calculated as 120. a total of 120 participants will be randomly assigned to the acupuncture group (n=40), sham acupuncture group (n=40) and control group (n=40). a personal information form and visual analog scales for pain and fatigue will be used to collect data.

Eligibility criteria:
inclusion criteria: * planned coronary angiography from the femoral region * not diagnosed with low back pain * no stent or other interventional procedure was performed during the coronary angiography procedure. exclusion criteria: * those who have had acupressure before for any purpose * problems such as bleeding and dysrhythmia occur after coronary angiography, * those with burns, scars, scratches and deformities at the acupressure point * having any psychological disorder,

Keywords: coronary angiography acupressure low back pain fatigue, muscle
ultrasound staging in the placenta accreta

Conditions: Obstetric Labor Complications; Staging of Placental Invasion

Summary: the investigators evaluated the efficacy of a staging system introduced by the american institute of ultrasound in medicine 2015 including sonographic parameters associated with morbidly adherent placenta for antenatal prediction of placental invasion.

morbidly adherent placenta (map) defines a spectrum of conditions, including placenta accreta, increta, and percreta, which are associated with significant maternal and fetal morbidity and mortality. ultrasound evaluation, with grayscale, is the recommended first-line modality for diagnosing map. grayscale ultrasound features suggestive of placenta accreta include the loss of myometrial interface or retroplacental clear space, reduced myometrial thickness and the presence of intraplacental lacunae. using a staging system by antenatal ultrasound can predict placental invasion antenatally.

Eligibility criteria:
inclusion criteria: * prior lower segment cesarean section * low lying anterior placenta * singleton pregnancy exclusion criteria: * medical disorders * vasa previa
prevalence of oral mucosal alterations in diabetes mellitus type2

Conditions: Oral Disease; Diabetes

Summary: there are severe deficiency of database concerning the oral health status in egyptian patients with diabetes type 2. our aim in the present study is to study the prevalence of oral mucosal alterations in type 2 dm patients and the effect of hyperglycemia on these alterations in controlled and uncontrolled patients to increase their awareness and minimize all the possible risk factors,to achieve a proper management for all oral problems.

the study will be held in the endocrine clinic at el kasr al-ainy cairo university hospital for patients with diabetes mellitus type2. the data collected through the questionnaire will be obtained through an interview between the investigator and the patient.clinical examination will be performed for the oral cavity.blood sample will be withdrawn from each participant and collected in the clinical pathology lab in el kasr al ainy to measure the glycosylated hemoglobin concentration.the salivary gland function will be determined through a small questionnaire and clinical examination of the patient. selection bias: will be minimized by enrolling the participants in the study in a consecutive order of the entering the clinic. non-respondent bias: will be minimized by explaining to the participants the aim of the study and their importance and role in the study. incomplete records: will be excluded from statistical analysis with reporting the cause of not completing the record. sample size estimation: based on the previous papers by al-maweri,et al ,2013, the prevalence of oral mucosal alterations in diabetic patients 45.1%.using a precision of 5, a design effect set at 1 with 95% ci (confidence interval), a total sample size of 381 will be sufficient. the sample size was calculated by epi info.

Eligibility criteria:
inclusion criteria: 1. adult patients 2. patients \>25years old 3. patients diagnosed with diabetes type 2. 4. egyptian patients. exclusion criteria: 1. females diagnosed with gestational diabetes. 2. patients not physically able to participate in survey or clinical oral examination. 3. patients with other systemic diseases which may cause oral manifestation as liver disorders. 4. patients under immunosuppressive drugs. 5. patients under corticosteriods. 6. patients with organ transplantation.

Keywords: oral health status oral findings oral manifestations patients with diabetes