cyrilzakka/clinical-trials huggingface dataset:
Preoperative Antibiotics for Carpal Tunnel Release Surgery

This is a clinical trial to determine how effective antibiotics administered prior to endoscopic carpal tunnel release surgery are in preventing surgical site infections.

Study participants will be randomized to a prophylactic IV antibiotic treatment arm (Vancomycin or Cefazolin) or a placebo IV saline solution. Subjects will be monitored following surgery for surgical site infections.

Eligibility Criteria:
Inclusion Criteria:

* High probability (\>12 points) on the Carpal Tunnel-6 diagnostic aide
* Recommendation for carpal tunnel release
* Capable of providing informed consent/LAR to act on subject's behalf

Exclusion Criteria:

* Patients allergic to both penicillin/cephalosporins and vancomycin
* Patient immobilized with splint or cast
* Unwilling unable to provide informed consent
* Children under the age of 18
Methadone vs. Transdermal Fentanyl for Opioid Withdrawal Syndrome

Many patients in the general intensive care unit experience pain, as a result of an injury or underlying disease, surgery or an invasive procedure.

Pain management is an integral part of the treatment of critical patients, and this is first and foremost to alleviate their suffering. Along with this, there is another therapeutic benefit in the form of relief from symptoms accompanying pain such as an increase in oxygen consumption, immune changes, hyper metabolism etc.

Currently, the pain treatment is based on a multi-modal analgesia approach in which drugs from several drug groups and different mechanisms are given, in order to relieve the pain by suppressing several nerve and inflammatory pathways. However, the treatment is still based on opioids, despite multiple adverse effects, including tolerance and withdrawal syndrome.

Opioids affect several receptors, mainly the µ receptor, in an agonistic, antagonistic or agonistic-antagonistic manner. The main opioids used for pain relief in the intensive care unit are morphine, fentanyl and remifentanil.

After prolonged treatment with opioids, a sudden cessation of their use will result in a withdrawal syndrome which will manifest itself in delirium, restlessness, hypertension, anxiety, sweating, vomiting etc. (2-3). In order to avoid the withdrawal syndrome, the dose must be tapered down gradually, often using alternative long-term opioids, such as methadone and buprenorphine (-4).

In the general intensive care unit at our institution, patients were treated with fentanyl patches in decreasing doses in order to lead the patient safely through the withdrawal syndrome, while trying to reduce the negative physiological effects as much as possible. In November 2021, we started using oral methadone instead of fentanyl patches, as a long acting opioid, as used in many ICU's worldwide, in order to avoid withdrawal syndrome in patients who received continuous infusion of short-acting opioids, such as remifentanil, for long periods of time while being intubated and ventilated. In the past year since the methadone treatment was started, 50 patients were treated in the unit with methadone with the indication of relieving the withdrawal symptoms from opioids.

We intent to investigate whether there is a difference in the incidence of delirium in patients who were treated with methadone vs patients who were treated with fentanyl patches in order to alleviate withdrawal symptoms.


Eligibility Criteria:
Inclusion Criteria:All patients aged 18-99 who were treated with methadone in the intensive care unit from November 2021 to November 2022, as well as all patients aged 18-99 who were admitted to the intensive care unit from November 2020 to November 2021 and were treated with a fentanyl patch as a control group.

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Exclusion Criteria:None

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Effects of Kaltenborn and Mulligan Mobilisation in Patients With Carpal Tunnel Syndrome.

Carpal Tunnel Syndrome is the most common mononeuropathy that results from the compression of median nerve in carpal tunnel, leading to entrapment neuropathy. The symptoms become aggravated during drawing, typing or playing video games. The aim of study will be to compare the effects of Kaltenborn and Mulligan mobilisation on pain, disability and hand function in patients with carpal tunnel syndrome.

This research will adopt a Randomized Clinical Trial design. Upon approval of the synopsis, ethical clearance would be taken and necessary permissions from Ejaz Hospital Lahore. Through convenience sampling technique, 48 patients will be included which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Mobilisation technique includes moving the proximal row of carpal bones either dorsally to promote wrist extension or to the palmar side to promote wrist flexion. Group A will be treated with Grade 3 Kaltenborn mobilisation. Grade 3 distraction was chosen to avoid contact between the articular surfaces and to stimulate hypoalgesic factors and Group B will be treated with Mulligan mobilisation. Outcome measures will be conducted through pain, disability and hand function questionnaire after 6 weeks. Data will be analyzed during SPSS software version 25. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups.

Eligibility Criteria:
Inclusion Criteria:

* Both genders between 20 and 45 years of age
* Individuals having localized pain, tingling and numbness in the median nerve distribution
* Positive Tinel sign and positive Phalen's test

Exclusion Criteria:

* Any sensory and/or motor deficit in either the ulnar or radial nerve traumatic neck injury
* Previous hand surgery or trauma or cervical radiculopathy
* Systemic disease e.g. diabetes mellitus or thyroid disease or rheumatoid arthritis
Use of Virtual Reality in Children Undergoing Surgery

Aim: Early mobilization and exercise after surgery are very important to reduce the impact on lung function. The aim of this study was to compare the effects of early mobilization with virtual reality and conservative physiotherapy methods on pulmonary function, dyspnea, exercise capacity, pain, and kinesiophobia in children undergoing surgery.

Methods: The study included 27 children aged 5-18 years who underwent surgery. Among the children randomly divided into two groups, the control group (n = 14) received physiotherapy for 40 min twice a day for 3 days in the hospital after surgery, and the children were mobilized in and out of bed. In the virtual reality group (n = 13), in addition to physiotherapy practices, children were allowed to play virtual reality games for 20 min twice a day. Respiratory function, exercise capacity, and pain assessment were performed before surgery and before discharge.

Aim: Early mobilization and exercise after surgery are very important to reduce the impact on lung function. The aim of this study was to compare the effects of early mobilization with virtual reality and conservative physiotherapy methods on pulmonary function, dyspnea, exercise capacity, pain, and kinesiophobia in children undergoing surgery.

Methods: The study included 27 children aged 5-18 years who underwent surgery. Among the children randomly divided into two groups, the control group (n = 14) received physiotherapy for 40 min twice a day for 3 days in the hospital after surgery, and the children were mobilized in and out of bed. In the virtual reality group (n = 13), in addition to physiotherapy practices, children were allowed to play virtual reality games for 20 min twice a day. Respiratory function, exercise capacity, and pain assessment were performed before surgery and before discharge.

Eligibility Criteria:
Inclusion criteria Between the ages of 5 and 18 undergone surgery for inguinal hernia, undescended testicle, hydrocele, cord cyst, umbilical hernia, circumcision, and distal hypospadias

Exclusion criteria

Children have visual and auditory sensory problems who required immobilization after surgery and had a chronic disease that would affect pulmonary function
Virtual Reality for Anxiety Management in Mechanically Vented Patients

The purpose of this study is to investigate the safety and feasibility of virtual reality for anxiety treatment in mechanically ventilated patients.

Mechanically ventilated patients (those on a breathing machine) often experience heightened levels of anxiety and discomfort. This is usually treated by using sedative medications, however these drugs often have unintended side effects. This study will investigate the safety and feasibility of using relaxing virtual reality environments for reduction of anxiety in mechanically ventilated patients.

Eligibility Criteria:
Inclusion Criteria:

Age: 18 years or older

1. Mechanically ventilated; defined as having an endotracheal tube or tracheostomy and requiring continuous support from a mechanical ventilator.
2. Able to spontaneously maintain a state of wakefulness and alertness and able to follow commands
3. Able to communicate with research staff; defined as writing or head nods/shakes

Exclusion Criteria:

1. Delirious; defined as positive on the Confusion Assessment Method for the ICU (CAM-ICU +)
2. Expected to be liberated from ventilator within 12 hours of potential enrollment
3. Existence of skull injury or recent surgery (craniectomy) which precludes safely wearing VR visor
4. Impaired ability to see or hear, as determined by study investigator
5. Ventilator settings with positive end expiratory pressure (PEEP) greater than 10
6. Inability to be safely removed from physical restraints for VR (virtual reality) sessions
7. Chronic ventilator dependence prior to the present hospitalization
8. Lacking capacity to consent for one's self
9. Known difficult airway; based on review of intubation note
10. Tracheostomy performed within last seven days
11. Pre-existing symptoms overlapping with major symptoms of cyber-sickness: Headache, Vertigo (dizziness), Ataxia (tremor with movement), Nausea, Vomiting.
A Randomized Prospective Analysis of Time to Diagnosis and Length of Stay of Emergency Department Pelvic Ultrasonography

The goal of this project is to compare the efficiency of pelvic ultrasounds performed by emergency medicine residents and attending physicians to the efficiency of pelvic ultrasounds performed by the department of radiology.

This study is a randomized, prospective interventional study of pregnant patients presenting to the emergency department with complaints of pelvic pain and/or vaginal bleeding. This study will be conducted at 4 sites across the United States. Patients who are eligible and consent to participate will be randomized to one of two conditions; 1) a pelvic ultrasound that is performed by a certified emergency department attending or physician, or 2) a pelvic ultrasound that is performed by a certified radiology technician (standard-of-care). The time to diagnosis and emergency department length of stay between the two groups will be compared.

Eligibility Criteria:
Inclusion Criteria:

* have a positive serum or urine beta-human chorionic gonadotropin (hCG)
* estimated gestational age (EGA) of less than 20 weeks
* complaint of pelvic pain and/or vaginal bleeding

Exclusion Criteria:

* prior known documentation of an intrauterine pregnancy
* estimated gestational age (EGA) of greater than 20 weeks
* peritoneal findings on physical examination
* unstable vital signs as deemed appropriate by the attending physician
* prisoners
* open cervix upon physical examination
Effects of Schroth-Based Exercise on Kyphosis Angle, Muscle Strength, Balance, Pain, and Quality of Life in Hyperkyphosis With Chronic Neck Pain

Our study is a randomized controlled trial designed to evaluate the effects of Schroth-based three-dimensional exercise program on kyphosis angle, trunk muscle strength, balance parameters, pain and quality of life in individuals with postural hyperkyphosis with chronic neck pain. The aim of our study was to investigate the effects of Schroth 3 dimensional exercise program and posture corrective exercises on kyphosis angle, trunk extensor muscle strength, endurance, and balance in adults with postural kyphosis. The inclusion criteria are as follows; individuals aged 20-50 years with a thoracic kyphosis angle greater than 40 degrees, have neck pain for more than 3 months, participants with a visual analog scale value of 3 and above, no treatment for postural kyphosis in the last 6 months, individuals who do not have a systemic disorder will be included. Exclusion criteria; Participants with a history of trauma or surgery in the spine joints, rheumatologic and metabolic disorders, congenital postural deformity and scoliosis will not be included in the study. In our study, participants will be randomized into two groups using a computer program as Schroth-based three-dimensional exercise group and control group. Our study was planned as a Schroth-based three-dimensional exercise group and a control group for 8 weeks. Both groups will receive a total of 20 sessions of electrotherapy and exercise in the first 4 weeks. At the end of the 4th week, after the electrotherapy sessions are completed, exercise sessions will continue 3 days a week for the next 4 weeks. The study group will receive electrotherapy treatment (hot pack, ultrasound, tens) to the cervical and thoracic region for 30 minutes in each session. In the study group, kyphotic posture correction exercises will be applied. Patients to be included in the control group will receive electrotherapy treatment (ultrasound, tens, hotpack) to the neck area for 30 minutes in each session. Corrective exercises for posture will be applied to participants in the control group. Participants will be evaluated before the treatment, at the end of the 4th week and at the end of the treatment (at the end of the 8th week) by the physiotherapist performing the study.


Eligibility Criteria:
Inclusion Criteria:

* Thoracic kyphosis angle \> 45 degrees,
* Aged between 20 and 50 years,
* Have neck pain for more than 3 months,
* Neck pain visual analogue scale \> 3,
* Not being treated for postural kyphosis in the last 6 months,
* Has no systemic disease

Exclusion Criteria:

* History of trauma or surgery on spinal joints,
* Participants with rheumatological and metabolic disorders,
* Participants with congenital postural deformity and scoliosis
Pharmacovigilance for ACTs in Africa

This is a phase IV open label study assessing the safety and effectiveness of artemisinin derivatives-based combination therapy (ACT) when used on a large scale and under "real life" conditions.

The study will be conducted in a well defined population in Burkina Faso by setting up a population-based monitoring system.

The monitoring for adverse events (AEs) will use two approaches (active and passive) based on a repeat survey of the study population. The active surveillance population will be weekly and actively visited at home at day 7, day 14 and day 28 after drug administration. The passive surveillance population will be encouraged to report passively any AE/ADR and they will NOT be actively visited at home.

In addition, the possible exposure to ACTs of all the pregnant women identified during the repeat surveys in both the active and passive surveillance areas will be extracted from the drug exposure log book or elicited by history, and the data will be entered into a pregnancy register.

For the effectiveness study, patients with a microscopically confirmed diagnosis of malaria (any parasite density), clinical symptoms and a blood sample for thick and thin blood smears, and later PCR analysis (on filter paper) for genotyping will be collected before antimalarial treatment, at day 28 after treatment and at any unscheduled visit. This will be repeated for each confirmed malaria episode.

Eligibility Criteria:
Inclusion Criteria:

* Males and Females living in Nanoro DSS catchment area;
* Signed (or thumb-printed whenever patients are illiterate) informed consent.
* Patients' willingness and ability to comply with the study protocol for the duration of the study.

Exclusion Criteria:

* Severe malaria.
* Danger signs: not able to drink or breast-feed, vomiting (\> twice in 24hours), recent history of convulsions (\>1 in 24h), unconscious state, unable to sit or stand.
Photobiomodulation to Alter Cerebral Blood Flow and to Affect the Emotional Status of Patients With Major Depression

A pilot study to evaluate the ability of photobiomodulation to alter cerebral blood flow in the frontal poles and to affect the emotional status of patients with major depression.

We wish to study whether photobiomodulation (PBM) with near infrared (NIR) light emitting diodes (LED), a non-ionizing phototherapy, in patients with major depression, can acutely alter frontal brain blood flow measured by near infrared spectroscopy (NIRS).

Secondarily, we will examine whether PBM can improve emotional state immediately and over the following month.

We see this as a pilot study to gather preliminary data that will guide future studies.

Eligibility Criteria:
Inclusion Criteria:

* All patients must be right handed, between the ages of 18 and 60, and meet criterion for depression on a Structured Clinical Diagnostic Interview
* Enrollment will be made without regard to gender or ethnicity
* Patients who are receiving treatment for depression, either psychological or pharmacological, may continue their treatment during the time of the study, but will be asked to try not to alter their treatment from one month prior to the onset of the experiment until its conclusion. If they must alter their treatment, the patient will continue in the study for observation, but will be excluded from any follow-up statistical comparisons

Exclusion Criteria:

* Past history of psychotic disorder (including schizophrenia or schizoaffective disorder
* Bipolar disorder
* Obsessive compulsive disorder)
* Substance abuse disorder that has been active with the past 6 months,
* A history of violent behavior
* A history of a past suicide gesture or attempt
* A history of current suicidal ideation
* A history of a neurological condition (e.g. epilepsy, traumatic brain injury, stroke)
* Pregnancy
* Current acute or chronic medical condition requiring a medications that has psychological side-effects
* Any person whom we judge to have an impaired decision-making capacity
KTP (Potassium-titanyl-phosphate) Laser Versus TUR-P (Transurethral Resection of Prostate)

The purpose of this study is to compare safety and efficacy of Green Light PVP (Photoselective Vaporisation of the Prostate) compared to TUR-P.


Eligibility Criteria:
Inclusion Criteria:

* Men undergoing surgery for BPH

Exclusion Criteria:

* Previous prostate surgery
* Carcinoma of the prostate
* Neurogenic bladder
* Bladder carcinoma
Evaluating a Group-based Therapeutic Yoga Program for Burnout

This study is evaluating a group-based therapeutic yoga program for burnout. This study aims to understand the feasibility of running the program (i.e. of recruiting participants, the resources required to run the program, etc) and the effectiveness of the program (i.e. in decreasing participants' mental health symptoms).

A primary care group-based therapeutic yoga program, the Yoga MD program, was developed by a primary care / emergency physician practicing in Toronto, Ontario. The program was started in 2014 and is run through a medical centre in Toronto, Ontario. The purposes of the program are to understand:

* key concepts of yoga, mindfulness, compassion, acceptance and how these can help with personal transformation
* how stress is carried in the body (embodiment of stress) and how stress manifests as anxiety, pain, or other symptoms
* what happens when stress accumulates in the body
* the role of self-compassion in the response to stress
* how to cope with difficult emotions that may contribute to stress
* how to deal with difficult people and trying relationships
* the importance of connecting with, and caring for ourselves to reduce accumulated stress
* how to solidify healthier patterns to build resilience to stress faced in daily life.

This study evaluates the 9 weekly sessions using a before-after interventional design. Participants have data collected at baseline, and at 9 weeks and 8 months after the yoga program ends, and changes in mental health outcomes are observed.

Eligibility Criteria:
Inclusion Criteria:

* Age of 18
* Must be enrolled in therapeutic yoga program

Exclusion Criteria:

* no formal exclusion criteria
Evaluation of Robotic Arm Rehabilitation in Stroke Patients

The purpose of this study is to compare 2 training programs using robotic exercise devices to supervised arm exercises in stroke patients with chronic stable deficits.

A robotic exercise device has been developed(MIT-MANUS)capable of providing therapy to the arm for patients with weakness due to stroke. The randomized trial will compare conventional care, planar robot intervention and an intervention of planar and vertical robot training among patients with chronic, stable deficits. We will evaluate motor outcomes, effectiveness, cost, patient satisfaction and quality of life. The study will determine the efficacy of upper extremity robot therapy compared to supervised self-administered exercise therapy in patients with deficits due to stroke.

Eligibility Criteria:
Inclusion Criteria:

* Subjects must have a clinically, defined, unilateral, hemiparetic stroke with radiologic exclusion of other diagnoses
* Stroke onset greater than six months before randomization for ischemic stroke patients and one year before randomization for hemorrhagic stroke patients
* A grade 3 or lower in Manual Muscle Test in the hemiparetic elbow flexion and shoulder abduction

Exclusion Criteria:

* Subjects unable to give informed consent
* Serious complicating medical illness
* Contracture or orthopedic problems limiting the range of joint movement in the study arm
* Visual loss
* Stroke occurred within 6 months for ischemic stroke patients, one year for hemorrhagic patients
* Botox treatment within 3 months of enrollment