cyrilzakka/clinical-trials huggingface dataset:
Effects of Shi Style Cervical Mobilization Versus SNAGS in Patients With Cervicogenic Headache

Cervicogenic headache (CGH) manifests as unilateral neck pain referred from the neck's soft tissues or bony structures. The aim of this study will be to compare the effectiveness of Shi style cervical mobilization versus Sustained Natural Apophyseal Glides on pain, strength and functional disability in patients with Cervicogenic Headache.

A Randomized Clinical Trial will be conducted at Jinnah hospital Lahore through consecutive sampling technique on 40 patients which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will be treated with shi style mobilizations with 6 sesions over 4 weeks for 20minutes. Group B will be treated with Sustained Natural Apophyseal Glides with Number of repetitions are increased gradually from 6 to 10 and end physiological movement is maintained for 10seconds. Outcome measures will be conducted through NPRS for pain , Deep Neck flexors strength by pressure Biofeedback, Dizziness Handicap Inventory for pain and change in dizziness, NDI for functional impairments and SF 36 for quality of life.Data will be analyzed through SPSS software version 25 .

Eligibility Criteria:
Inclusion Criteria:

* Age:18 to 65 years.
* Both male and females.
* Unilateral dominant headache.
* Positive International Headache Society Diagnostic Criteria (IHS) for cervicogenic headache.
* Decrease strength deep neck flexors by pressure biofeedback.
* Tenderness of the upper 3 cervical spine joints.

Exclusion Criteria:

* • Patients who received any treatment for CGH within the previous 3 months that would interfere with this study.

  * Pregnant females.
  * Inflammatory conditions in which manual therapy is contraindicated(29).
  * Cancer or brain diseases.
  * Recent fracture or injuries.
  * Congenital conditions of the cervical spine.
A RCT to Compare Performance of Two Foam Dressings on Patient Well-being Related Endpoints.

ALLEVYN◊ Life and Mepilex™ Border are both layered foam dressings with a silicone adhesive wound contact layer. Both are indicated for the same uses; however ALLEVYN◊ Life has a number of attributes designed to meet a range of characteristics associated with principles of wellbeing.

The aim for this evaluation is to assess, in a clinical setting and against a number of identified criteria, the performance of the ALLEVYN◊ Life dressing compared to Mepilex™ Border in terms of characteristics of the attributes of wellbeing.

◊ Trademark of Smith \& Nephew

™ All trademarks acknowledged


Eligibility Criteria:
Inclusion Criteria:

Patients ≥18 years old

Males and females (females must not be pregnant and must use contraception if of child bearing potential.)

Presence of a single suitable wound which can be the reference wound without treatment impacting on any other wound(s) on the patient.

Presence of a suitable wound which can be treated with the available sizes and shapes of ALLEVYN◊ Life (10.3cm X 10.3cm, 12.9cm X 12.9cm, 15.4cm X 15.4cm, 21cm X 21cm) and Mepilex™ Border (7cm X 7.5cm, 10cm X 12.5cm, 15cm X 17.5, 17cm X 20cm)

Presence of an exuding wound of at least 6 weeks duration at the point of enrolment, healing by secondary intention

The patient is able to understand the evaluation and is willing to consent to the evaluation.

The patient is available to participate for the anticipated duration of the evaluation.

Exclusion Criteria:

Patients with confirmed or suspected clinically infected reference wounds.

Patients with wounds that, in the opinion of the clinician, is likely to heal within a time period of 4 weeks from point of enrolment.

Patients with a reference wound undergoing treatment with compression therapy.

Patients where a reference wound cannot be treated in isolation from other wounds.

Patients with deep reference wounds that, in the opinion of the clinician, necessitate filler material.

Patients with a known sensitivity to any of the constituents of the evaluation products.

Patients with a known history of poor compliance with medical treatment.

Patients who have participated in this evaluation previously and have been withdrawn from the study.

Patients unable to understand or speak the English language.

Patients without the capacity to understand and answer wellbeing related questions

Females who are pregnant or breast feeding.
Effect of Ketogenic and Carbohydrate Diet in Crossfit

The purpose of the presented study was to assess the influence of Ketogenic (KD) and a carbohydrate diet with a low glycemic index (CHO-LGI) of a 4-week diet on physical and specific performance capacity, exercise metabolism, as well as concentrations of the selected biochemical blood markers in Crossfit- trained athletes, in a randomised and parallel trial.

The impact of various dietary strategies, including the alternative ketogenic diet - recently popular among strength athletes, has not been unequivocally assessed in the high-intensity sport disciplines that Crossfit belongs to. There is also a lack of data in these disciplines about the potential longer adaptation of athletes to the very low carbohydrate intake resulting from the ketogenic diet and its impact in high-intensity Crossfit training. Therefore, the purpose of this study was the assessment of the influence of a 4-week KD and a CHO-LGI diet on physical and specific performance capacity, exercise metabolism, as well as concentrations of the selected biochemical blood markers in Crossfit- trained athletes, in a randomised and parallel trial.

Eligibility Criteria:
Inclusion Criteria:

* written consent to participate,
* a current medical clearance to practice sports,
* training experience: at least 2 years,
* minimum of 4 workout sessions (Crossfit) a week.

Exclusion Criteria:

* current injury,
* any health-related contraindication,
* declared general feeling of being unwell,
* unwilling to follow the study protocol,
* smoking, illicit drug use, alcohol consumption greater than 1-2 drinks/week, dietary supplements use less than 3 weeks before the study,
* females- being pregnant or planning to become pregnant during the study.
Assessing Urinary Hormones in Female Cancer Survivors

Women of late to mid reproductive age may participate in a study using novel methodology to identify subtle changes in the reproductive endocrine axis via daily urine hormone analysis, which may have important implications for reproduction and may signal reproductive senescence.

Women with a reduced follicular pool either from natural aging or previous chemotherapy, may not have any clinical signs or symptoms and traditional measures of ovarian reserve, such as basal Follicle Stimulating Hormone may be within the normal range. However, there may be alterations in the luteal or follicular phases(shortened follicular phase and luteal insufficiency) due to compromised follicle competency and alterations in the H-P-O axis. Therefore this aim uses novel methodology to identify subtle changes in the reproductive endocrine axis which may have important implications for reproduction and may signal reproductive senescence. Compared to yearly follicular measures of reproductive hormones, daily urine hormone analysis provides a more integrative assessment.

Three groups of subjects will be recruited:

Group 1: Otherwise healthy, mid-reproductive aged women between the ages of 20 and 35 years previously exposed to high dose alkylating agent therapy (or have an alkylator score of 1 or more), and at least 1 year from cancer treatment.

Group 2: healthy, mid-reproductive aged women between the ages of 20 to 35 who have not been exposed to cancer therapy.

Group 3: healthy, late reproductive aged women between the ages of 43-50 who have not been exposed to cancer therapy, nor have a history of infertility.

Subjects in all groups must have regular menstrual cycles every 21-35 days, and have a uterus and both ovaries. Each participant will complete daily urinary collections for 2 menstrual cycles to assess reproductive hormones. The ultimate goal of this work is to better estimate the reproductive window, or time to menopause.

Eligibility Criteria:
Inclusion Criteria for Group 1:

* Otherwise healthy, mid-reproductive aged women between the ages of 20 and 35 years previously exposed to high dose alkylating agent therapy (or have an alkylator score of 1 or more), and at least 1 year from cancer treatment.

Inclusion Criteria for Group 2:

* Healthy, mid-reproductive aged women between the ages of 20 to 35 who have not been exposed to cancer therapy.

Inclusion Criteria for Group 3:

* Healthy, late reproductive aged women between the ages of 43-50 who have not been exposed to cancer therapy, nor have a history of infertility.

Exclusion Criteria for all subjects:

* Pregnancy or lactation within the previous 3 months
* Use of hormonal contraception or replacement within the previous 3 months
* Body Mass Index greater than 30 kg/m2
* Excessive exercise greater than 1 hour per day
* Any medical condition other than cancer known to be associated with premature ovarian failure (such as Turners Syndrome or Fragile X) or ovulatory dysfunction (such as thyroid disease, congenital adrenal hyperplasia, Cushings syndrome, hyperprolactinemia, and polycystic ovary syndrome)
Effect of Perioperative i.v. Low-dose S(+) Ketamine

The purpose of this study is to determine whether the use of perioperative intravenous S (+) ketamine reduces the amount and degree of postoperative pain.

Furthermore the purpose of this study is to determine whether the use of perioperative intravenous S (+) ketamine effects cognitive function in the early postoperative period.

The mechanism of development of postoperative pain is complex. Central and peripheral sensitization are playing an important role and this can lead to postoperative hypersensitization. Several studies have shown, that S (+) ketamine can be effective to reduce sensitization and postoperative pain. Ketamine (2-O-chlorophenyl-2-methylamino cyclohexanone) is a N-Methyl-D-Aspartat (NMDA) receptor antagonist. S (+) ketamine has a four times stronger affinity to the NMDA receptor compared to R (-) ketamine. The duration of action for S (+) ketamine is shorter than R (-) ketamine and it has fewer side-effects.

The purpose of this study is to compare the analgetic effect of pregabalin and placebo used in the perioperative period.

The hypothesis is that perioperative intravenous S (+) ketamine gives significant better analgesia than placebo without effecting cognitive function.

The study is including patients undergoing hemorrhoidectomy.

Eligibility Criteria:
Inclusion Criteria:

* Clinical diagnosis of disc prolapse
* Age 18+
* ASA (American Society in Anesthesiology) I-II
* written consent

Exclusion Criteria:

* Age \< 18
* ASA \> II
* liver failure
* renal failure
* heart failure
* glaucoma
* pregnancy
Meclizine Plasma Levels in Responders and Non-responders

Motion sickness is a debilitating condition that can effect many crew members. Meclizine has long been known as an effective anti motion sickness drug. The response to the drug is variable - some are responders, while others are resistant to the drug. The aim of the present study is to examine whether there is a correlation between meclizine plasma levels and clinical response.


Eligibility Criteria:
Inclusion Criteria:

* Seasickness questioner (WIKER) score of 7.
* Subjective functioning at 1 meter sea voyage - 5/10 and lower.
* Subjects who were prescribed 25mg of meclizine.
* Subjects who did not take any other drugs 48 prior to their participation in the study.

Exclusion Criteria:

* Known hearing loss or any vestibular impairment
* Vertigo complains
* Any ear infection
* Use of Scopolamine based anti-seasickness drugs.
* Use of meclizine 50mg.
Automated Anesthesia During Bronchoscopy

The purpose of this study is to compare manual administration of propofol and remifentanil and dual closed-loop using bispectral index as the control variable during rigid bronchoscopy.

The Bispectral Index (BIS) is an electroencephalogram-derived measure of anesthetic depth. We have built a combined closed-loop anesthesia system using BIS as the control variable, two proportional-integral-differential control algorithms, a propofol and a remifentanil target-controlled infusion systems as the control actuators. A recent study has shown that such system is able to provide clinically adequate anesthesia. The aim of the present study is to assess the system during rigid bronchoscopy. Two groups of patients are compared: one in which propofol and remifentanil are administered by the anesthesiologist using target-controlled infusion systems, and one in which propofol and remifentanil are administered automatically by the combined closed-loop anesthesia system. In both groups, the goal is to maintain BIS between 40 and 60, the recommended range during anesthesia by the manufacturer. We expect the combined closed-loop anesthesia system group to do similar or better.

Eligibility Criteria:
Inclusion Criteria:

* patients undergoing rigid bronchoscopy under general anesthesia

Exclusion Criteria:

* pregnant women
* allergy to propofol or remifentanil
* neurological disorder
* psychotrop treatment
Indicators of Neuronal Insult in Newborns of COVID-19 Positive Mothers.

The coronavirus disease (COVID- 19) is now a global pandemic that was first reported in China (Wuhan) in December of 2019. Multiple placental abnormalities including fetal and maternal vascular malperfusion have been described in pregnant women infected with (COVID- 19). To date, there are far fewer reports about the specific effects of (COVID- 19) in the newborns delivered for (COVID- 19) positive mothers.

COVID-19 in pregnant women has important impacts on perinatal and neonatal outcomes. Authors reported positive COVID infection in neonates born to COVID-19 positive mother.

The finding of a recent study suggested that intrauterine or intrapartum transmission is possible and recommended for further investigation. Furthermore, reports showed newborns of COVID-19 positive mother that suffered from catastrophic sequelae of hypoxic ischemic encephalopathy (HIE). These events could be attributed to COVID-19 positive status of the mother.

Neuron specific enolase is a biomarker for neuronal injury and synaptic dysfunction and have been correlated with tissue damage in different experimental models. The increased serum levels of neuron specific enolase are associated with the clinical outcome in patients with anoxic encephalopathy. Neuron specific enolase can be a candidate for a diagnostic/prognostic biomarker for neuroinflammation in COVID-19.

Additionally, the cytokines are candidate biomarkers after hypoxic-ischemic injury. Macrophage migration inhibitory factor (MIF) is a multifunctional protein that has been identified as proinflammatory cytokine and activates the production of inflammatory cytokines such as tumor necrosis factor-α, interleukin-1β, interleukin-6, and interferon.

Macrophage migration inhibitory factor plays a central role in controlling the inflammatory and immune response, which may be of particular importance during the development of organ dysfunction in COVID-19 patients. Furthermore, it carries out the apoptosis of the cells. Significant increase of neuronal apoptosis and caspase-3 expression was demonstrated in the brain of neonatal mice exposed to hypoxic injury.

There are a limited number of studies investigating the effect of the pandemic period on the brain of the newborns. With this study, we aim to determine the impact of the COVID-19 outbreak on the neuronal functions in the neonates. The current study searches for a diagnostic/prognostic biomarker for neuroinflammation in neonate born to COVID-19 positive mothers.

Eligibility Criteria:
Inclusion Criteria:

* The following inclusion criteria will be used (all necessary): Covid-19 positive mothers, term newborn (\>37 completed gestational weeks), free from severe malformations. All infants will be examined generally, systemically and neurologically at birth for clinical assessment of HIE if present and for detection of outcome of these neonates.

Exclusion Criteria:

* free from severe malformations
The Effect of Using the Combat Attention App on the Risk of Post-traumatic Symptoms

Military service and reserve duty in combat units entails exposure to traumatic events that require mental adjustment. In light of the results of controlled studies that proved the effectiveness an response-time based mechanized training protocol in reducing risk for post-trauma symptoms in deployed combat soldiers, the Israeli Defense Forces decided at the beginning of the Iron Swords War to implement an internet-based App of the intervention. Soldiers and combat reservists were invited to use the Combat Attention App. The purpose of this study is to examine the effectiveness of the Combat Attention App in relation to a control group of soldiers who did not use the App in reducing risk for post-traumatic stress symptoms of deployed soldiers.

Participants who used the Combat Attention App before combat deployment and a group of matched (age and sex) participants who did not use the App will be compared on PTSD, depression, and anxiety symptoms post deployment.

Eligibility Criteria:
Inclusion criteria:

* Age over 18 years.
* Served as an enlisted soldier or reservist during the Iron Swards War.
* Used the Combat Attention App or can serve as a matched control who did not use the App.
* Colloquial Hebrew sufficient to fill out the research questionnaires.

Exclusion criteria:

* Below 18 years of age.
* Colloquial Hebrew that is insufficient to fill out the research questionnaires.
Reduction of Anterior Glenohumeral Dislocation in Ventral Decubitus Versus Dorsal Decubitus Under Procedural Sedation

The anterior glenohumeral dislocation is frequently encountered in emergency medicine. It represents about 50% of the total dislocation and affects 1 resident for 10 000 in France.

In Nord Franche-Comte Hospital, 1 to 2 patients per day present this diagnosis in the emergency department, which requires reduction by external manoeuvres.

A retrospective study shows the interest of the ventral decubitus compared to dorsal decubitus reduction in the care of patients with anterior glenohumeral dislocation. None prospective study has already demonstrate the interest of the ventral decubitus compared to the dorsal decubitus in the reduction of anterior glenohumeral dislocation.

The main objective is to evaluate the speed of the reduction of the anterior dislocation of the shoulder by the ventral decubitus technique compared to the conventional technique in dorsal decubitus.


Eligibility Criteria:
Inclusion Criteria:

* Patients with radiological confirmed anterior glenohumeral dislocation
* Patient affiliated or entitled to a social security scheme
* Oral informed consent form

Exclusion Criteria:

* Glenohumeral fracture or vasculoneural lesion associated
* Dislocation for more than 12 hours
* Homolateral shoulder surgery antecedent
* Contraindication to other analgesics (morphine, sedation)
* BMI \> 40
* Patient \< 18 year
* Pregnancy or nursing woment
* Person under guardianship or curatorship
Genetic Markers and Proliferative Diabetic Retinopathy

Type 2 Diabetes (TD2) is the leading cause of new cases of preventable blindness in these countries (and the gold-standard treatment, laser photocoagulation has proven to be effective in preventing vision loss at the end stage of eye disease due to proliferative diabetic retinopathy (PDR) that occurs in 3 to 6 % of the cases.Therefore, the ongoing search for predictive factors of sight threatening stages of diabetic retinopathy has become more important.

Previous studies that have examined candidate predictive factors for diabetic eye disease have mostly focused on systemic risk factors leading to PDR. Among various clinical parameters, increased HbA1c % levels, uncontrolled blood pressure, diabetes duration, neuropathy and elevated triglycerides have been associated with PDR.

Some genetic factors may also account for the development of PDR and are prospectively considered in this study .

In a previous study (2011), investigators demonstrated a statistically significant relation between the Endothelial Lipase(EL) c.584C\>T polymorphism and the occurrence of diabetic retinopathy in 396 french patients with diabetes type 2 (DT2) with a longitudinal follow-up.

Secondly (2014) in a subgroup of 287 DT2 patients, investigators showed the impact of the EL rare T allele was consistent with a recessive mode of inheritance, with homozygotes for the rare allele differing from the carriers of the major allele. Importantly, the homozygotes for the rare T allele were more likely to present with advanced stages of diabetic retinopathy (severe non proliferative and proliferative disease) and particularly with proliferative diabetic retinopathy (PDR).

Based on this model investigators decided to conduct a case-control prospective study comparing 155 french patients with DT2 with PDR (cases) and 155 french patients with DT2 without PDR (controls) on the basis of two genetic parameters: EL c.584C\>T polymorphism that investigators previously studied and the C(-106)T aldose reductase polymorphism widely studied in diabetic retinopathy.

Eligibility Criteria:
Inclusion Criteria:

* type 2 diabetic patients
* patient with proliferative diabetic retinopathy (for arm 1)
* patient with non proliferative diabetic retinopathy (for arm 2)
* patient older than 18 years
* patient consenting to participate to the study
* patient enrolled in the national healthcare insurance program
Evaluation of Renal Oxygenation by NIRS in Pediatric Endourologic Stone Surgery

The study aims to compare renal oxygenation levels in retrograde intrarenal surgery (RIRS) and ureteroscopy (URS) procedures with a control group. Additionally, it seeks to determine if there is a connection between postoperative infection parameters and intraoperative renal oxygenation measurements.

The study will involve ASA class I-III pediatric patients aged 1-18 undergoing RIRS, URS, and hypospadias surgery under general anesthesia. Patients will be divided into three groups: Group R (RIRS), Group U (URS), and Group H (Hypospadias/Control). Data collection will include patient height and weight. In Groups R and U, pre- and postoperative measurements such as hemoglobin, hematocrit, leukocyte count, BUN, serum creatinine, procalcitonin, interleukin-6, and CRP values will be recorded.

All three groups will undergo NIRS monitoring alongside routine ASA monitoring. Renal NIRS probes will be positioned using ultrasonography, and the average of three measurements will determine the regional oxygen saturation index (rSO2) as the initial value. NIRS, pulse oximetry, and hemodynamic data will be recorded every 5 minutes until recovery from anesthesia just prior to induction. A decrease of 20% or more than 20% when comparing NIRS values during follow-up with the baseline will be considered significant. The study will also document anesthesia and surgery times, as well as postoperative fever and the amount of irrigation fluid used in Groups R and U.

Eligibility Criteria:
Inclusion Criteria:

* 1-18 years ASA I-III class,
* Patients who will undergo RIRS, URS and Hypospadias surgeries under standard general anesthesia.
* Patients whose informed consent form is approved by their parents will be included in the study.

Exclusion Criteria:

* Exclusio criteria were the history of renal failure, renal tumors, infection of the perirenal region; receiving colloid or blood transfusion, having abscess, body mass index (BMI) not in the normal limits (≤3% or ≥97%)
* Patients whose parents do not approve the informed consent form will not be included in the study.