cyrilzakka/clinical-trials huggingface dataset:
The Potential Therapeutic Role of Hydroxyethyl Starch and Hydrocortisone in Acute Aluminum Phosphide Poisoning

Aluminum phosphide (ALP) is a widely used fumigant due to its efficiency as pesticides. It is available as tablets of Celphos, Alphos or Quickphos which are known as rice tablets. Each tablet weights 3 grams and contains 56% ALP and 44% of aluminum carbonate and paraffin. The incidence of ALP poisoning increased steadily specially in developing countries . ALP poisoning is considered to be one of the major causes of suicidal poisoning owing to its wide accessibility and low cost. However, accidental poisoning may occur during occupational exposure

Aluminum phosphide (ALP) is a widely used fumigant due to its efficiency as pesticides. It is available as tablets of Celphos, Alphos or Quickphos which are known as rice tablets. Each tablet weights 3 grams and contains 56% ALP and 44% of aluminum carbonate and paraffin. The incidence of ALP poisoning increased steadily specially in developing countries . ALP poisoning is considered to be one of the major causes of suicidal poisoning owing to its wide accessibility and low cost. However, accidental poisoning may occur during occupational exposure.

Signs and symptoms of acute AlP poisoning include gastrointestinal, cardiovascular, hepatic, renal, and neurologic (1). Ingestion of ALP causes mild gastrointestinal (GIT) manifestations as nausea, vomiting, abdominal pain, in addition to chest tightness, hypotension, headache and dizziness. In severe cases, GIT hemorrhage, shock, severe metabolic acidosis, cardiac arrhythmia, convulsions and coma may occur. Later, signs of hepatic damage and renal insufficiency may develop.

Death usually occurs in 30-70% of cases within the first 24 hours resulting from refractory cardiogenic shock, cardiac arrhythmia, severe hypotension and metabolic acidosis.The main causes of cardiovascular collapse are increase capillary permeability, insufficient systemic vasoconstriction with low ventricular ejection fraction. On autopsy examinations, point to extravasation of fluid into the third space.

The management is exclusively supportive as gastric lavage with KMnO4 solution, treatment of hypotension and acidosis in view of the fact that there is no specific antidote available.

Eligibility Criteria:
Inclusion Criteria:

* Patients with severe acute aluminum phosphide poisoning
* systolic blood pressure (SBP) ≤90 mmHg
* PH ≤ 7.2
* HCO3 ≤15 meq/L
* during the first six hours of admission

Exclusion Criteria:

* Pregnant and lactating women
* Asymptomatic patients with history of acute aluminum phosphide exposure.
* Patients with co-ingestion to other substances in addition to aluminum phosphide.
* Patients with other major medical conditions (e.g. cardiovascular disease, renal or hepatic failure).
* Patients with previous medical intervention (fluid therapy and vasopressors).
A Prospective Study: the Value of Using iFlow and PBV in the Endovascular Treatment of Infrapopliteal Arterial Occlusive Diseases

Color coded blood flow and blood perfusion techniques are applied to the endovascular treatment of infrapopliteal arterial occlusion,to establish a method of quantitative evaluation of blood flow and tissue perfusion,to improve the level of calculation of condition and curative effect. So as to establish a new complete evaluation system of infrapopliteal arterial occlusive disease, to guide clinical further. At the same time establish a digital information platform for clinical, lay the foundation for the large research.


Eligibility Criteria:
Inclusion Criteria:

1. Patients are diagnosed as lower limb atherosclerosis occlusion from June 2016 to June 2018 in our centre;
2. All participating patients provided written informed consent and willing to participate;
3. aged 40 years and more;
4. the class of lower ischemia is upon 4;
5. below-the-knee arteries stenosis or occlusion is indicated by duplex or computed tomographic angiography;
6. there is no heavy stenosis in superficial femoral artery (stenosis\<30%), or short length lesion(length≤5cm, stenosis≥30%);
7. infection or ulceration don't happen in the area of surgery;
8. below the inguinal ligament arteries don't have the history of bypass or interventional surgery.

Exclusion Criteria:

1. disagree and refuse to the free therapy;
2. lesion length of superior artery is more than 5cm;
3. history of heart dysfunction: congestive heart failure,, myocardial infarction, severe arrhythmia;
4. With severe metabolic disease, renal impairment(serum creatinine\>1.4mg/dL, glomerular filtration rate\<60) affect the excretion of contrast agents;
5. have the diseases or agents which will reduce the viable of data;
6. allergy to iodinated contrast medium.
Comparative Evaluation of Instrumentation Time Using Pediatric Rotary Versus Hand (Flare) File Systems

The study will be conducted to evaluate instrumentation time, obturation quality, and child's behavior using pediatric rotary versus hand flare file systems in treatment of primary molars.

Statement of the problem:

Pulpally affected primary teeth is a common problem in children due to lower mineralization, the presence of large pulp chamber with high pulp horns, and thin layers of enamel and dentin .

Manual files system is usually used for management of pulpally affected primary molars. This system has shown through the past years an acceptable clinical success rate but it also have many problems such as long visit time affecting the child behavior and causing fatigue to the dentist, difficulty in dealing with thin and curved canals due to limited flexibility of manual files causing incomplete removal of pulp tissue, and also difficulty in the determination of the actual working length due to the presence of physiologic and pathologic root resorption.

Rationale for conducting the research:

Pulp therapy in primary molars becomes compromised sometimes after delayed treatment due to dental neglect of children till caries progression to the pulp leading to severe symptoms associated with excessive pulp inflammation, root resorption, or periradicular bone resorption with a less favorable prognosis for conventional endodontic therapy. In the current era, a new perspective which is less time consuming with an acceptable success rate could be a spark of hope for the pediatric patient as well as the dentists.

Many studies were done comparing manual vs pediatric rotary files but without definitive conclusion. So further studies should be done with higher sample size to determine the superiority of one system over the other.

Benefits for the practitioner:

* Providing new and alternative treatment options.
* Shorter instrumentation time.
* Less fatigue.
* Better preparation of the canal.

Benefits for the patient:

* A faster and easier process leading to a more efficient dental procedure which could develop better outcomes in terms of success.
* Improvement in patient as well as parent satisfaction.

Benefits for community:

* Using alternative technique that can be faster, with a better success rate.
* To boost overall oral health.

Eligibility Criteria:
Inclusion Criteria:

Children:

* Cooperative children.
* 4-6 years old children.
* Children who will attend follow up.

Teeth:

* Bilateral lower second primary molars.
* Pulpally involved molars indicated for pulpectomy.

Exclusion Criteria:

Children:

* Children with physical or emotional alteration.
* Children with systemic diseases.
* Children of parents who don't accept to participate in the study.

Teeth:

* Teeth with more than 1/3 of root resorption.
* Teeth with pathological mobility.
* Necrotic teeth with periapical or furcal lesions.
* Non restorable teeth.
Periurethral vs Intravaginal Estrogen for Prevention of Recurrent Urinary Tract Infections

Due to rising antibiotic resistance, there has been a focus on non-antibiotic prophylactic measures for postmenopausal patients with recurrent urinary tract infections (rUTI), one of which is the safe and efficacious option of vaginal estrogen therapy. Standard application of vaginal estrogen cream entails intravaginal application of the cream twice a week, but some providers counsel patients with rUTI to apply a small, pea-sized amount to the periurethral area. This ideally reduces the amount of vaginal estrogen used while attaining a similar effect. However, to date, there is no data to prove that the periurethral technique of application is similar or non-inferior to intravaginal application in preventing UTI.


Eligibility Criteria:
Inclusion Criteria:

* Postmenopausal (definition: No menses for 1 or more years or surgical menopause (bilateral oophorectomy). If there is a past history of hysterectomy, patient must be age 56 or older (95th percentile for age at menopause) or have laboratory evidence of menopause (ie. FSH \>30)
* Meets criteria for recurrent urinary tract infections (UTIs) with 2 or more UTI in 6 months or 3 or more UTI in 1 year
* May include patients who used vaginal estrogen previously if they have stopped use for 3 or more months prior to inclusion into study.
* Patients must be recommended vaginal estrogen as part of normal clinical care for prevention of recurrent UTI

Exclusion Criteria:

* Current use of vaginal or oral estrogen products
* Inability or refusal to use vaginal estrogen
* Daily antibiotic use
* Significant vaginal stenosis (eg. due to lichen sclerosis, radiation or obliterative prolapse surgery) that would prohibit use of a vaginal applicator (ie. genital hiatus \<1cm)
* Inability to use vaginal applicator and without caregiver who can administer (eg. provider-managed pessary use, significant arthritis)
* Frequent (1x weekly or more frequent) use of bladder instillations containing an antibiotic
* Known hydronephrosis as a result of incomplete bladder emptying
* Use of intermittent or indwelling urinary catheterization
* Known bladder stones, mesh erosion into bladder, or foreign object in bladder
* Unable to consent for self
* Active treatment for an estrogen-dependent malignancy
Effect of Pilates Exercises on Forward Head Posture in Breastfeeding Women

Musculoskeletal postural issues stemming from infant care positions can exert a significant impact on the cervical, thoracic, and lumbar spine. These positions can induce mechanical alterations in the spine's natural curvature, potentially resulting in long-term deformities in postnatal women such as forward head posture (FHP), ultimately contributing to physical disability over the long term.so, The purpose of this study is to determine the effect of Pilates exercises on FHP in breastfeeding women.

seventy-four breastfeeding women having forward head posture (FHP) will participate in this study. They will be selected randomly from the outpatient clinic of orthopedic of Suez Canal Authority Hospital in Portsaid, Egypt.

Group (A) (Control group): will consist of 37 breastfeeding women. They will receive ergonomic breastfeeding training for 8 weeks.

Group (B) (Study group): will consist of 37 breastfeeding women. They will receive the same ergonomic breastfeeding training plus Pilates exercises 3 times per week for 8 weeks.

Eligibility Criteria:
Inclusion Criteria:

* All women are breastfeeding and will have FHP.
* They are between six to twelve months post-delivery.
* They should have a single, healthy, and full-term baby without complications.
* Their body mass index (BMI) will not exceed 30 Kg/m2.
* Their parity will range from 2 to 3 children.
* They are housewife.

Exclusion Criteria:

* Cancer of the breast or the surrounding area, any previous breast or chest surgery, breast infection, retracted, cracked, inflamed or inverted nipples.
* Any cardiorespiratory disease, anemia, or diabetes mellitus.
* Recent fracture or surgery of the cervical spine or shoulder.
* History of physical and mental diseases.
Evaluation of Safety and Efficacy of Symbicort® pMDI, With or Without Spacer, in Children (6-11 Years) With Asthma

The purpose of the study is to compare Symbicort pMDI with and without spacer in terms of steroid potency, improvement of lung function and asthma symptoms in children with asthma (6-11 years).


Eligibility Criteria:
Inclusion Criteria:

* children 6-11 years, diagnosed asthma treated
* 6 months, PEF
* 50% of predicted normal value pre-bronchodilator

Exclusion Criteria:

* current systemic glucocorticosteroids usage
* current respiratory infection
* any significant disease or disorder as judged by investigator
Transcranial Magnetic Stimulation for Binge Eating Disorder

The primary goal of this study is to elucidate the impact of disorder provocation on the efficacy of TMS for the treatment of BED. In order to meet this objective, the investigators propose to evaluate this relationship in using a crossover study. Secondary objectives of this study include determining whether TMS with or without BED symptom provocation has effects in altering neurophysiology as detected by fMRI.

Current literature has demonstrated that transcranial magnetic stimulation (TMS) targeting the dorsolateral prefrontal cortex (DLPFC) has some efficacy in treating binge eating disorder. The investigators believe that TMS may be beneficial in the treatment of binge eating disorder. The purpose of this study is to determine whether TMS has efficacy for binge eating disorder and if symptom provocation affects treatment. This study will be conducted as a pilot study in the Keck Hospital clinics. 32 adult patients with a clinical diagnosis of binge eating disorder will be recruited.

Eligibility Criteria:
Inclusion Criteria:

* English speaking (EPSI and Binge Eating Disorder Scale available only in English)
* Diagnosed with binge eating disorder as defined by the DSM-5 and in treatment for at least 6 months
* Stable doses of medications for at least 6 weeks
* Female subjects of childbearing age must consent to pregnancy tests at the beginning of each treatment session; will be counseled to use barrier methods during the course of this study

Exclusion Criteria:

Contraindications to receiving TMS such as:

1. Aneurysm clips or coils
2. Stents in the neck or brain
3. Deep brain stimulators
4. Electrodes to monitor brain activity
5. Metallic implants in ears and eyes
6. Shrapnel or bullet fragments in or near the head
7. Facial tattoos with metallic or magnetic-sensitive ink
8. Other metal devices or object implanted in or near the head
SOLUTION: Study of Oral Liprotamase Unit-Matched Therapy Of Non-Porcine Origin in Patients With Cystic Fibrosis

Liprotamase powder is a non-porcine, soluble and stable mixture of three digestive enzymes including lipase, protease, and amylase. The purpose of the present study is to provide additional efficacy and safety data compared to approved, porcine-derived, enterically-coated and encapsulated pancreatic enzyme replacement therapy. The primary efficacy endpoint of the study will be comparative efficacy measured as the change in the coefficient of fat absorption (CFA) in Cystic Fibrosis patients with exocrine pancreatic insufficiency (EPI).

Liprotamase is stable in stomach and digestive fluids allowing administration in a variety of convenient formulations and with a number of foods without enteric coating.

Porcine derived enzymes are used for pancreatic enzyme replacement therapy in patients with cystic fibrosis (CF). Liprotamase is a biotechnology-derived enzyme replacement without enteric coating. This is an open-label, assessor blind, parallel group, multicenter, international trial to evaluate the noninferiority of liprotamase and pancrelipase in CF patients aged ≥7 years with pancreatic insufficiency. Subjects were randomized to liprotamase or pancrelipase, dose-matched to pre-study lipase doses. The lower bound of the 95% confidence interval (CI) for noninferiority was -15% for treatment difference in change from baseline coefficient of fat absorption (CFA).

Eligibility Criteria:
Inclusion Criteria:

* Diagnosis of Cystic Fibrosis based on presentation, genotype and/or sweat chloride
* Fecal elastase \<100 mcg/g stool
* Minimum Coefficient of Fat (CFA) at screening while on stable PERT therapy
* Good nutritional status

Exclusion Criteria:

* History or diagnosis of fibrosing colonopathy
* Distal intestinal obstruction syndrome in 6 months prior to screening
* Receiving enteral tube feedings
* Chronic diarrheal illness unrelated to pancreatic insufficiency
* Liver abnormalities, or liver or lung transplant, or significant bowel resection
* Forced expiratory volume in 1 second (FEV1) \<30%
The Effect of Lactation on Insulin Sensitivity and Lipolysis in Women

This purpose of this study is to investigate whether lactation improves insulin sensitivity and increases lipolysis in women.

There are two aims that this research will address.

In Aim 1, the research question is "Does lactation improve insulin sensitivity and increase lipolysis in women?" In this Aim, researchers will assess whether lactation amongst women with a history of gestational diabetes mellitus (GDM) will improve whole body insulin sensitivity as well as increase whole body lipid turnover by using hyperinsulinemic-euglycemic clamps combined with \[6,6-2H\]-glucose and \[2H5\]-glycerol infusions. These stable, non-radiating isotopes have been used extensively and safely to study the mechanisms of insulin resistance amongst non-pregnant as well as pregnant humans; however, these techniques have not previously been applied to the study of insulin sensitivity during lactation. Therefore, the goals will be two-fold: 1) to determine whether lactation induces similar changes in insulin sensitivity in humans as in mice and 2) to pilot the feasibility of performing larger, more detailed metabolic studies in this population of women post-partum.

The second aim (Aim 2) will use a retrospective chart review of women with a history of GDM who had an oral glucose tolerance test (OGTT) 6-8 weeks post-partum as part of standard of care.

The focus of this protocol registration will be Aim 1.

Eligibility Criteria:
Inclusion Criteria:

* A history of GDM (as defined as the American Diabetes Association criteria)
* Delivered a singleton, live birth at ≥ 35 weeks gestation within the past 18 months
* HbA1C \< 6.5% at time of screening
* Delivery within the past 18 months
* Breast Feed Group: exclusively or mostly breast-fed (\< 6 ounces of formula/24 hours at 6-9 weeks of delivery) for at least 4-6 months

Exclusion Criteria:

* Currently lactating or lactation within the past 1 month at the time of the screening visit
* Diagnosis of diabetes (T1D or T2D) prior to pregnancy
* Current use of any glucose-lowering agents
* Pregnancy related medical problems including preeclampsia
* Major congenital fetal anomalies
* Creatinine \> 1.5mg/dL, Hematocrit \< 35%, ALT and AST \> 2.5X upper limit of normal
* Known psychiatric disorders, alcohol abuse, HIV, hepatitis, renal disease, hepatic disease, untreated heart disease, untreated thyroid disease, active systemic infection or malignancy
* Illicit drug use (by the participant's self-report)
* History of post-partum depression
* Use of weight loss supplements or dieting 6 months prior to study
* Corticosteroid or opiate use within 6 months of study
Study of Five Different Methods Of Delivering A Lifestyle Modification Program for Weight Loss

The aim of the study was to compare 5 methods of delivering a weight loss lifestyle modification program to obese patients on a background of sibutramine. The methods differed in the type and frequency of counseling utilized to deliver dietary, physical activity and behavioral recommendations for weight loss.


Eligibility Criteria:
Inclusion Criteria:

* 1- Body mass index -calculated as weight in kilograms divided by the square of height in meters- ≥30 and \<40 kg/m2.
* 2- Eligibility to be prescribed sibutramine, following the eligibility requirements listed in the US Package Insert
* 3- Willingness and ability to comply with study related procedures
* 4- Access to Internet and email

Exclusion Criteria:

* Uncontrolled blood pressure (defined as ≥140/90 mmHg), diabetes, coronary heart disease, chronic congestive heart failure, stroke, significant metabolic, hepatic or renal disease, current malignancy, gastric bypass surgery or had a weight loss ≥10%, participated in a structured weight loss program, or had taken weight loss agents during the past 6 months. Women were excluded if pregnant or breastfeeding; women of childbearing potential had to use adequate contraception.
International Immune Tolerance Study

The purpose of this study is to see if a low-dose arm or a high dose-arm of immune tolerance is more effective in eliminating inhibitors in patients with hemophilia A.

Subjects will be randomized into a low-dose or high-dose immune tolerance regimen and this study will compare the success rates, the time to achieve tolerance,the complications and the cost of both regimens.It will also aim to identify predictors of successful immune tolerance.

Eligibility Criteria:
Inclusion Criteria:

* Severe hemophilia A (FVIII level \<1%).
* A maximum historical inhibitor titer of between 5 BU and 200 BU that must be confirmed once prior to the beginning of ITI.
* The inhibitor titer should be \<10 BU at the start of ITI, confirmed once.
* The inhibitor must be present for \<24 months when ITI begins.
* Maximum age of 7 at the start of ITI.
* Willingness to comply with the protocol.

Exclusion Criteria:

* Moderate or mild hemophilia A (FVIII level \>1%).
* Spontaneous disappearance of the inhibitor prior to ITI.
* Historical maximum inhibitor titer \<5 BU or \> 200 BU before starting ITI.
* Inhibitor titer \> 10 BU at the start of ITI.
* Inhibitor present for more than 24 months before starting ITI.
* Systemic immunomodulatory drug therapy during immune tolerance e.g. corticosteroids (\< 5 days every 2 months maximum dose 2 mg/kg or 60 mg/day), azathioprine, cyclophosphamide, high-dose immunoglobulin or the use of a protein A column or plasmapheresis.
* Age \> 7 years at the start of ITI.
* Inability or unwillingness to comply with the protocol.
* Previous attempt at ITI.