cyrilzakka/clinical-trials huggingface dataset:
Transversus Abdominis Plan Block, Ultrasound or Laparoscopic?

Abdominal wall blocks are frequently used as part of multimodal analgesia for pain control after abdominal surgery. There are studies using the Transversus Abdominis Plane Block for postoperative pain control in laparoscopic cholecystectomies.

In this study, the investigators aimed to compare the advantages of these two methods by applying the Transversus Abdominis Plan Block for postoperative pain control after laparoscopic cholecystectomy with the help of postoperative USG and laparoscopy during surgery.In this study, the investigators aimed to compare the advantages of these two methods by applying the Transversus Abdominis Plan Block for postoperative pain control after laparoscopic cholecystectomy with the help of postoperative USG and LAPAROSCOPY during surgery.

A total of 60 patients aged 18-65, ASA 1-2-3, who will undergo elective laparoscopic cholecystectomy in our hospital, will be included in the study. Patients will be randomly divided into 3 groups with ultrasound (USG) guided (GROUP 1: USG) , Laparoscopic application (GROUP 2: LAP) and GROUP 3 :No-TAP blok Each group consists of 20 evil people. Written consent will be obtained by explaining the procedure to be performed before the operation to the patients. The Transversus Abdominis Plan Block will be applied to the patients by a blind anesthesiologist according to their group. The block to be made by the anesthesiologist who will apply the block procedure will be given in a closed envelope.

Eligibility Criteria:
Inclusion Criteria:

* ASA I,II,III
* Patients 18-65
* laparoscopic cholecystectomy

Exclusion Criteria:

* ASA III higher
* history of pain relief medication dependence
* history of substance abuse
* end stage chronic kidney disease
* advanced liver disease
* history of chronic pain -history of taking opioids or neuropathic agents regularly prior to surgery-
* BMI of 50 or over
* skin infections at the site of TAP block injection or port sites.
Role of Modified Robbery Exercises on Scapular Dyskinesis in Frozen Shoulder

The study aims to find out the role of the modified robbery exercises in the management of scapular dyskinesia in patients with frozen shoulders. This single-blind randomized clinical study will be conducted at approved study center in Lahore Pakistan in line with the ethical principles stated in Declaration of Helsinki. Pain, muscle Activation, ROM, scapular dyskinesia, muscle strength, functional limitation and participants' wellbeing will be recorded at baseline, after week three, and after week six in both intervention and control groups.

Scapular Dyskinesia is regarded as the altered scapular kinematics, presenting with increased scapular upward rotation and eminence of the medial border in patients with shoulder injuries. Patients with frozen shoulder present with a certain degree of scapular dyskinesia. The objective of the study is to find out the role of the modified robbery exercises in the management of scapular dyskinesia in patients with frozen shoulders. This single-blind randomized clinical study will be conducted at approved study center in Lahore Pakistan. The study will abide by the ethical principles in line with the Declaration of Helsinki. Baseline data of the participants of pain, muscle Activation, ROM, scapular dyskinesia, muscle strength, functional limitation and participants' wellbeing will be recorded. Group A will receive the modified robbery exercises three days a week for six weeks, group B will receive the conventional physical therapy protocol three days a week for six weeks. Outcomes will be assessed at baseline, after week three, and after week six.

Data will be recorded using questionnaires, proforma and the other listed outcome measurement tools. on the base of normality of the data appropriate parametric test or non-parametric test will be applied for intra and inter group comparison.

Eligibility Criteria:
Inclusion Criteria:

* Patients of both genders
* Patients of age 35 to 55 years
* Modified Lateral Scapular Slide Test score \> 1.4 cm
* Pain on VAS ≥4 out of 10.
* Pain in the shoulder for at least 3 months
* Diagnosed unilateral frozen shoulder
* Limited Scapular upward rotation, Capsular pattern (more limited external rotation than abduction),
* Scapular dispositioning and visible Inferior medial border prominence.

Exclusion Criteria:

* Patients with frozen shoulders having less than 90 degrees of flexion and abduction.
* Participants with cervical radicular pain
* Pregnant females
* Presence of red flags to the treatment
* History of recent trauma to the spine or the shoulder complex.
* History of recent shoulder surgery
* Any neurological deficit i.e winged scapula
* Other pathologies like cervical myelopathy and prolapsed cervical disc.
* Known cases of neurological, radiculopathy, and inflammatory diseases.
* Having spinal deformities such as scoliosis or kyphosis.
* Vestibular or respiratory disorder, Auditory or cognitive impairment
* Taking medication that may affect the balance and coordination.
MNCH Programming in Southwest Uganda Maternal and Child Health In Bushenyi and Rubirizi Districts, UGANDA

The investigators will assess whether in Bushenyi District in southwestern Uganda, a two year intervention providing comprehensive MNCH programming will:

* Reduce morbidity and mortality for children under five years old and;
* Improve access to maternal health services Compared to a control community without MNCH intervention?

Hypothesis:

Comprehensive maternal, newborn and child health programming in Bushenyi Distrcit can have a positive impact on morbidity and mortality for children under five years and will improve access for women to maternal health services which may lead, in the longer term, to decreased maternal mortality.

A detailed impact assessment will be carried out for the duration of the MNCH training and support initiative in Bushenyi District, using mixed methods. The study will assess 8 of the 11 key core MNCH indicators as identified by CIDA as a priority. Other information to be collected such as demographics and patterns of health care use, and prevalence of disease will help health planners in the districts, and will be helpful in sub analysis and interpretation of findings. The main study will use household surveys in both districts at baseline, midline and endline. Other tools will include pre and post qualitative surveys (FGDs, KII) and analysis of operational data.

The main study group will be representative communities and health centres within Bushenyi District who will receive intervention between 2012 and 2014; Rubirizi District will serve as a control area for this study but will received selected MNCH services starting in 2013 after midline data are collected.

Eligibility Criteria:
Inclusion Criteria:

* all households living in selected communities; all women 15-49 living in selected communities Exclusion Criteria: none
Trial of the Clinical and Cost Effectiveness of a Specialist Expert Mood Disorder Team for Refractory Unipolar Depressive Disorder

The purpose of this study is determine whether a specialised mood disorder service, which offers tailored psychological and pharmacological treatment, is more effective in the treatment of chronic unipolar depressive disorder then treatment as usual.

A pragmatic randomised controlled trial of a specialist mood disorder intervention versus treatment as usual will be conducted. Patients will be individually randomised with stratification by mental health trust to either treatment by a specialist team offering tailored psychological and pharmacological treatment or treatment as usual.

The specialist mood disorders team will include a psychiatrist and health professionals providing cognitive behaviour therapy. Together the team will assess participants and then provide a co-ordinated and supervised combination of pharmacological and psychological treatment according to guidelines developed by NICE and the British Association of Psychopharmacology. Each participant will receive a treatment plan that is tailored to his/her specific needs. The participants in the treatment as usual team will have their usual access to the same treatments. The outcome in terms of improvement in depressive symptoms, function and costs will be examined after one year in service users with chronic depression.

Eligible patients will be followed for 12 months and the primary outcomes will be observer rated depressive symptoms and cost effectiveness from a health and social care perspective. Along side the RCT, implementation analysis and audit of the standard care and specialised care for depression will be carried out.

Eligibility Criteria:
Inclusion Criteria:

* The responsible medical officer or care coordinator leading care considers the patient to be suffering from a primary unipolar depressive disorder which is not a consequence of having another axis 1 or 2 psychiatric disorder.
* Age over 18 years.
* Able and willing to give oral and written informed consent to participation in the study.
* From the date of first assessment by a health professional working for the index mental health trust, they have been offered or received direct care from one or more health professionals from the Trust three or more occasions for 6 months.
* Meet NICE criteria for moderate depression, namely the presence of five out of nine symptoms of (NICE, 2004), have a Hamilton Depression Rating Scale of at least 20, and score 60 or less on the Global Assessment of Functioning Scale (American Psychiatric Association, 1994).

Exclusion Criteria:

* Is receiving emergency care for suicide risk, risk of severe neglect or homicide risk and requires it; however, patients will not be excluded because of such risk provided the risk is adequately contained with their current care setting and the primary medical responsibility for care remains with the referring team.
* Does not speak fluent English.
* Is pregnant
Immunogenicity and Safety of Verorab™ in Indian Population

* To demonstrate that rabies vaccine administered according to the Thai Red Cross, (TRC)-ID regimen (2-2-2-0-1-1) is not inferior to rabies vaccine administered according to the ESSEN IM regimen in terms of Geometric Mean Titers (GMTs) at D28, in subjects with a WHO category III rabies exposure,or,
* To demonstrate that Rabies vaccine administered according to the ZAGREB-IM regimen (2-1-1) is not inferior to Rabies vaccine administered according to the ESSEN IM regimen in terms of GMTs at D28, in subjects with a WHO category III rabies exposure.

Secondary objectives:

1. To describe the immunogenicity profile of each regimen
2. To assess the safety of the vaccine in each group.


Eligibility Criteria:
Inclusion Criteria:

* Subject with WHO category III rabies exposure
* Subject aged at least 2 years old (day of second birthday)

Exclusion Criteria:

* Subject unable to comply with the follow-up schedule of the protocol
* Delayed post-exposure treatment (\>72 hours between incident and treatment
* Subject bitten by an observable animal at the inclusion visit
* Subject with immune-compromised or underlying diseases which may lead to inferior immune response
* Subject with known pregnancy at the time of inclusion
* Subject enrolled or scheduled to be enrolled in another clinical study.
* Subject with acute febrile illness/ axillary temperature \> 37.5 degree celsius
* Subject in whom blood sampling will be difficult.
* Subject receiving chloroquine or other anti-malarial treatment
* Subject receiving immunosuppressive therapy, other immune-modifying drug or cytotoxic drugs
* Subject with known chronic illnesses (ie. heart, lung, kidney, liver) including immunosuppressive diseases (cancer, HIV, etc.)
* Previous rabies immunization
* Subject having received any vaccine within the previous 30 days, except tetanus toxoid and tetanus immunoglobulin
* Subject with clinical signs of rabies
* Subject with known allergy to vaccine components (e.g. neomycin)
* Subject who received blood and/or plasma transfusion within the past 3 months
Implementation of ABI and WIfI in Rural Health Clinics

The objective of this project is to assess the fidelity and sustainability of in improving provider performance with Ankle Brachial Index (ABI) assessment and ulcer staging with the would ischemia foot infection (WIfI) tool for new patients with lower extremity ulcers due to peripheral artery disease (PAD) and diabetes mellitus (DM) at RHCs in the telemedicine network through a rural provider education program that is aligned with preexisting continuing medical education activities.


Eligibility Criteria:
Inclusion Criteria:

To be eligible for the educational program, an RHC must:

* already have telemedicine capabilities with the UC Davis CHT,
* be within 3 hours driving time form UC Davis Medical Center,
* have a lead practitioner willing to act as the clinic's point person for the proposed educational project, and
* have seen at least 10 patients in the prior 3 months with foot ulcers due to DM, PAD or combined disease.

Exclusion Criteria:

To be eligible for the project, a RHC must NOT:

* have a dedicated foot ulcer assessment program with on-site measurement of arterial perfusion, and
* be located within a 45 minute drive of a vascular surgeon
Effects of Nonsteroidal Anti-inflammatory Drug (NSAID) on Inflammatory Lesion of Axial Spondyloarthritis

Axial Spondyloarthritis (SpA) is a kind of inflammatory arthritis which includes ankylosing spondylitis. Common symptoms of axial SpA are inflammatory back pain, morning stiffness, peripheral arthritis, enthesitis. Controlling aforementioned symptoms are one of the goal in treatment, and another goal is preventing bony ankylosis of axial skeleton such as spine. Ankylosis can limit range of motion and lower the quality of life.

Non-steroidal antiinflammatory drug (NSAID) and Tumor necrosis factor (TNF)-a inhibitor are the current treatment options for axial SpA. These medications can improve pain and stiffness of axial SpA patients, however preventing bony ankylosis is not proven. Current study showed attenuating inflammation at early stage could prevent further bony destruction and ankylosis in axial SpA. Present study is designed to discover the therapeutic effect of NSAID whether NSAID could recover the early inflammatory bony change (bone marrow edema at MRI) and prevent further bony change.


Eligibility Criteria:
Inclusion Criteria:

1. 2009 Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis
2. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) \> 4
3. definite bone marrow edema on Sacroiliac joint MRI

Exclusion Criteria:

1. Patients who have underling cancer / infectious disease / kidney disease / liver disease / cardiovascular or cerebrovascular disease
2. Patients who is using TNF-a inhibitor
3. Patients with side effects of NSAID
4. Patients with history of peptic ulcer
5. Patients who can't keep NSAID treatment
Detection of 2019 Novel Coronavirus in Multiple Organ System and Its Relationship With Clinical Manifestations

Outbreak of 2019 Novel Coronavirus infection quickly spread to the world. Confirmed patients were isolated and treated in our department. 2019 Novel Coronavirus was detected in multiple organ system. Clinical data was recorded to investigate the its relationship with viral detection.

Medical date of suspected patients of 2019 Novel Coronavirus infection, who came to outpatient department of the Third Affiliated Hospital of Sun Yat-sen University, were sent to an expert group if they met the inclusion criteria. The expert group discussed and made a decision if the patient would be admission to isolation unit. Pharyngeal swabs of the patients were obtained and sent to local Center for Disease Control and Prevention (CDC) for detection the 2019 Novel Coronavirus after patients were admission to isolation unit. Diagnosis of 2019 Novel Coronavirus infection was confirmed if the result was positive or excluded if two consecutive results were negative. Patients' demographic data and clinical characteristics were recorded. Clinical characteristics including epidemiological history, past history, personal history, symptoms, signs, blood cells count, biochemical test results, chest computed tomography (CT) images. 2019 Novel Coronavirus RNA was detected in pharyngeal swab, anal swab, urine and blood samples by using quantitative real-time polymerase chain reaction (qPCR). Comprehensive treatments were given to the patients.

Eligibility Criteria:
Inclusion Criteria:

1. Epidemiological history including resident of Hubei province, or travel history to Hubei province or exposure to suspected patients in the past two weeks.
2. Symptoms like fever, fatigue, myalgia, headache, cough, sputum production, chest tightness, dyspnea, etc.
3. White blood cells decreased or were normal, or lymphocytes decreased, and chest CT images showed typical findings of viral pneumonia.
4. Detection of 2019 Novel Coronavirus nucleic acid is positive by local Center for Disease Control and Prevention (CDC).

Exclusion Criteria:

1. Patients can not follow-up;
2. Investigator considering inappropriate.
Evaluation of Cell-mediated Immune Response by QuantiFERON Monitor® Assay in Kidney Transplant Recipients

All kidney transplant recipients require immunosuppression, the net level of which is difficult to assess. Current practice in assessing immune reactivity is to monitor levels of some immunosuppressive drugs. QuantiFERON Monitor® (QFM) is an in vitro diagnostic test that detects interferon-γ (IFN-γ) release in peripheral blood. Its clinical utility in assessment of the net state of immunosuppression in kidney transplant recipients has not been well studied. The aim of our study is to evaluate the discriminating value of QFM testing results for infection and rejection in a single-centre cohort of kidney transplant recipients.


Eligibility Criteria:
Inclusion Criteria:

* Kidney/Liver kidney/Simultaneous pancreas and kidney transplantation

Exclusion Criteria:

* none
Descriptive Assessment of Practice in Anaesthesia : Lidocaine 1% Adrenaline Under in Axillary Block Realization

Axillary block is the good anesthetic technique for upper limb surgery without exceeding a certain total dose injected of Local Anesthetic (AL).

The maximal recommended dose of Lidocaine adrenaline in the upper limb is 500 mg. The use of ultrasound helps guiding the locoregional anesthesia, and allows to decrease the AL concentration, thus decreasing the risks.

No previous study estimated a concentration of lidocaine lower than 1,5 % to realize upper limb surgery by axillary block.

The literature overestimating probably the rate of failure of the locoregional anesthesia under ultrasound-guidance, we suggest to estimate the rate of failure of the axillary block ultrasound-guided with the lidocaine 1 % adrenaline for realizing upper limb surgery in standard practice.


Eligibility Criteria:
Inclusion Criteria:

* Patients operated for the upper limb under block axillaire
* Adult
* non-opposition

Exclusion Criteria:

* medical advice to realize axillary block
* medical advice to local anaesthetic
* Allergy
* Pregnant
* ASA 3 or more
Epidemiology of Viral Hepatitis Among Subjects in Precarious

Social insecurity is a significant cost in human terms (health and societal), it defines evil and can be identified as difficulties accessing health and especially water.

We chose to take stock of these populations defined by difficulties accessing water as precarious setting. Subjects homeless population fall into this by accident of life, a life "homeless" or migrant subjects often illegally having only transitory access (associative or charitable structures host) the conditions precarious sanitation including drinking water or toilet. Populations of slums in the same conditions or the presence rationed water (one tap for 150 people) restricts hygiene.

Social insecurity is a significant cost in human terms (health and societal), it defines evil and can be identified as difficulties accessing health and especially water.

We chose to take stock of these populations defined by difficulties accessing water as precarious setting. Subjects homeless population fall into this by accident of life, a life "homeless" or migrant subjects often illegally having only transitory access (associative or charitable structures host) the conditions precarious sanitation including drinking water or toilet. Populations of slums in the same conditions or the presence rationed water (one tap for 150 people) restricts hygiene.

The sampling system as part of a consultation in routine care (will be in DBS (blotter) only alternative to invasive venous sample and requiring heavier care facility. The capillary sampling on filter will also detect a marker of malnutrition .

Thus in live in large social precariousness adult this study should show which interventions in public health and management proposals are most appropriate for this population.

Eligibility Criteria:
Inclusion Criteria:

* Population homeless (SDF)
* Population living in slums.

Exclusion Criteria:

* Pregnant or lactating women
Caudal Versus Intravenous Dexmedetomidine for Supplementation of Caudal Analgesia in Children

The purpose of this study is to compare the effects of caudal dexmedetomidine with intravenous dexmedetomidine on caudal levobupivacaine analgesia in children undergoing lower abdominal surgeries.

Single shot caudal epidural block is one of the most widespread technique for pediatric pain management after infraumbilical surgical procedures.However, in a significant proportion of patients, despite good initial analgesia from a caudal block with local anesthetic, pain develops after the block resolves.

Dexmedetomidine is used increasingly in pediatric anesthesia practice to prolong the duration of action of caudal block with a local anesthetic agent.But which route of administration of clonidine is the most beneficial remains unknown.

The investigators performed prospective randomized double-blind study to compare the effects of caudal dexmedetomidine with intravenous dexmedetomidine on postoperative analgesia after caudal levobupivacaine for inguinal herniorrhaphy or orchidopexy surgery.

90 children (ASAⅠorⅡ,aged 2-5 yr) undergoing unilateral orchiopexy or inguinal herniorrhaphy were included in this study. Anesthesia was induced with sevoflurane via a facemask, followed by placement of a laryngeal mask airway. Anesthesia was maintained with sevoflurane 2-3% in oxygen-air.Then,caudal block was applied. Patients were randomly assigned in three groups. Group Cau-DEX (n = 30): Caudal Levobupivacaine 0.25% 1ml/kg plus dexmedetomidine 1µg/kg and 10 ml normal saline i.v.;Group IV-DEX(n = 30): Levobupivacaine 0.25% 1ml/kg and dexmedetomidine 1µg/kg(10 ml)i.v.;Group Placebo(n = 30): Levobupivacaine 0.25% and 10 ml normal saline intravenous.

Eligibility Criteria:
Inclusion Criteria:

* ASA status I-II
* aged 2-5 yr
* Undergoing unilateral orchiopexy/inguinal hernia repair

Exclusion Criteria:

* Hypersensitivity to any local anesthetics
* Patient has history of allergy, intolerance, or reaction to dexmedetomidine
* Infections at puncture sites
* Bleeding diathesis
* Preexisting neurological disease
* Diabetes mellitus
* Children with uncorrected cardiac lesions
* Children with heart block or liver impairment