cyrilzakka/clinical-trials huggingface dataset:
Screening for Depression and Anxiety in Pregnant and Postpartum Women: Evaluating Prevalence, Risk Factors, and the Stepped Screening Protocol in a Care Pathway

Having a baby is a major life event, and for some women, it can increase the risk of developing mental health issues. A recent survey in the UK found that one in five women experience mental health problems during pregnancy or after giving birth. Unfortunately, many of these problems go unnoticed without regular check-ups, and only one in ten women receive the support they need. Regular mental health screenings can help detect these problems early, ensuring women receive the right care and support.

The study at UZ Gent aims to improve how depression and anxiety are detected in pregnant and postpartum women by using a perinatal screening protocol. This protocol involves screening women for psychosocial risks around the 16th week of pregnancy, which is done by a midwife. Further screenings take place during the second trimester (around 20 weeks) and again six weeks after birth, using questionnaires to assess for depression and anxiety (Whooley, EPDS, GAD-2, GAD-7).

If the assessment of risk factors or the screening for depression and anxiety is positive, further assessment and treatment are offered at the women\&#39;s clinic. A positive screening may lead to a recommendation for a diagnostic interview, such as a semi-structured interview (M.I.N.I.), with a psychiatrist, general practitioner, or psychologist to assess for possible depression or anxiety disorders. If needed, appropriate treatment will be provided.

The study will explore how common depression and anxiety are during and after pregnancy, what factors increase the risk, and whether the screening process improves early detection and treatment. The ultimate goal is to help more women get the mental health support they need during this critical time.


Eligibility Criteria:
Inclusion Criteria:

* Pregnant women aged ≥ 18 years, receiving regular care follow-up in a university hospital

Exclusion Criteria:

* Non-Dutch speakers were excluded. Additionally, no data were collected from women in the vulnerable care pathway, which provides psychosocial support to those facing barriers in employment, income, housing, education, and healthcare. This group includes teenage mothers (under 18), women with intellectual disabilities, new immigrants, refugees, homeless women, and those with severe psychiatric or addiction issues referred by their psychiatrist or GP.
Reduction and Fixation of Metatarsal Neck Fracture by Metaizeau's Technique

Metatarsal fractures represent 3-7% of all fractures of the body and 35% of fractures of the foot and have a rate of 75 new cases per 10,000 persons per year.

The goal of treatment is to achieve a correct reduction of fracture, to avoid prolonged disability and preservation of both soft tissues and bony alignment.

Metaizeau's technique in these fracture of the metatarsal bone respects the soft tissues surrounding the fracture and the periosteum at the fracture site.

Metatarsal fractures represent 3-7% of all fractures of the body and 35% of fractures of the foot and have a rate of 75 new cases per 10,000 persons per year.

Metatarsal fractures have been considered of little importance by many authors over the years, and have received little attention. That is why little literature about operative management of metatarsal fractures can be found (apart from the first and fifth metatarsal bones).

Generally, these are non-displaced fractures. When these fractures show some displacement, reasonable alignment must be obtained because the metatarsals' capability for remodelling is extensive but not infinite.

Displaced metatarsal neck fractures are usually treated by means of retrograde Kirschner wires, which generally requires an open reduction at the fracture site due to the difficulty of reducing the metatarsal head.

Metaizeau's technique can be applied to reduce the displaced metatarsal head distally from the fracture in an easier way and to keep the fracture site closed, as compared with retrograde Kirschner wires method . Open reduction was unnecessary in all cases. This technique permitted correct control of the distal fracture fragment, obtained good reduction of the metatarsal heads without opening the fracture site, and with no lesion of the capsuloligamentous complex of metatarsophalangeal joint. Metaizeau's technique is a valid alternative to retrograde method.

The goal of treatment is to achieve a correct reduction of fracture, to avoid prolonged disability and preservation of both soft tissues and bony alignment. Metaizeau's technique in these fracture of the metatarsal bone respects the soft tissues surrounding the fracture and the periosteum at the fracture site.

Eligibility Criteria:
Inclusion Criteria:

* Adult patient with displaced fracture neck of the 2nd, 3rd or 4th metatarsal

Exclusion Criteria:

* Poly_traumatized patient .
* Patient with fracture first and fifth metatarsal bone .
* Fracture shaft metatarsal bone , first MB, fifth MB.
* Open fractures of the foot .
* Intraarticular fracture of metatarsals .
* Lisfranc fracture .
* Segmental fracture of the metatarsals
L-arginine in Treatment of Intrauterine Growth Restriction

Intrauterine growth restriction is an important problem in neonatal care. Intrauterine growth restriction (IUGR) is defined as a fetal weight below the 10th percentile for gestational age. One of the main causes of IUGR is placental insufficiency.

Nitric oxide(NO) increases placental blood flow. So,it might be useful to improve IUGR pregnancy outcome .

The study population includes pregnant women attending Antenatal care clinic of Ain Shams University Maternity Hospital who first time diagnosed of IUGR at our antenatal care outpatient clinic either referred for this cause After confirm diagnosis of IUGR and distributing patient into two groups Patient in first group will receive oral L-arginine 3000mg/day till delivery and Acetylesalicylic acid 75mg once daily.

Patients in second group will receive Acetylesalicylic acid 75mg once daily. then follow up of both group by:

1. Daily fetal movement counting
2. Day after day CTG
3. Doppler twice weekly
4. Pelvic u/s weekly for:

A) Head circumference, Abdominal circumference, femur length B) Fetal weight C) Liquor amount: Amniotic Fluid Index Or MeanVertical Pocket

Decision of delivery will be determined when:

A) Fetal distress (non stress CTG) B) Mother starts labour C) Reversed umbilical artery Doppler.

Eligibility Criteria:
Inclusion Criteria:

* All pregnant women diagnosed with IUGR from 28 weeks
* Singleton pregnancy
* No maternal systemic disease
* No congenital fetal malformation
* Estimated fetal weight below 10th percentile

Exclusion Criteria:

* All pregnant woman diagnosed with IUGR before 28 weeks
* Multiple pregnancy
* Maternal systemic disease
* Congenital fetal malformation
Dose-finding and Safety of 2 Intradermal MEN-ACYW135-conjugate Vaccines

Invasive meningococcal disease is a worldwide problem with serious repercussions for those affected. Vaccination is recognized as the best way to combat it. The cost of vaccination is prohibitive in many low-resource settings at home and abroad. By harnessing the special immunologic properties of the skin, a dose reduction may be achieved by intradermal administration of the vaccine. The cost savings associated with dose reduction will increase availability of the vaccine.


Eligibility Criteria:
Inclusion Criteria:

Meningococcal C naive subjects are required to fulfill all of the following criteria:

* Age ≥ 30 years
* Good health according to the investigator
* Willingness and ability to adhere to the study regimen
* Able to give informed consent

Meningococcal C experienced subjects are required to fulfill all of the following criteria:

* Age ≥ 18 years
* Good health according to the investigator
* Willingness and ability to adhere to the study regimen
* Able to give informed consent

Exclusion Criteria:

Meningococcal C naïve subjects should not have:

* Known previous invasive meningococcal infection
* Known or suspected previous vaccination against meningococcal disease
* Known or suspected allergy against any of the vaccine components
* Close contact in the last 60 days with a person known to be Neisseria positive
* History of unusual or severe reactions to any previous vaccination
* Family history of Guillain-Barré Syndrome
* Known or suspected immune deficiency, either congenital or acquired
* Administration of plasma or blood products less than three months prior to inclusion in the study
* Pregnancy (breastfeeding is allowed)
* Fertile female not conforming to prescribed contraceptive use (await first menstruation after vaccination before getting pregnant)
* Any infectious disease
* Bleeding disorders or use of anticoagulants
* Participation as a subject in another trial in the last 3 months

Meningococcal C experienced subjects should not have:

* Known or suspected allergy against any of the vaccine components
* Known previous vaccination with a quadrivalent meningococcal vaccine (either conjugate or polysaccharide)
* Close contact in the last 60 days with a person known to be Neisseria positive
* History of unusual or severe reactions to any previous vaccination
* Family history of Guillain-Barré Syndrome
* Known or suspected immune deficiency, either congenital or acquired
* Administration of plasma or blood products less than three months prior to inclusion in the study
* Pregnancy (breastfeeding is allowed)
* Fertile female not conforming to prescribed contraceptive use (await first menstruation after vaccination before getting pregnant)
* Any infectious disease
* Bleeding disorders or use of anticoagulants
* Participation as a subject in another trial in the last 3 months
Wharton's Jelly Eye Drops in the Treatment of Chronic Keratitis

The purpose of this open, non-comparative, multicenter trial is to assess the impact of eye drops made of Wharton's jelly extract in the treatment of chronic keratitis that failed available therapies.


Eligibility Criteria:
Inclusion Criteria:

* Men or women between 18 and 70 years old.
* Persistent corneal ulceration.
* Resistance to medical treatment for more than one month or recurrence after medical treatment.
* Patient who underwent a wash-out period of 15 days with no use of eye drops with preservative.
* Patient with dry eye treatments that can be kept: tear substitutes, cyclosporine.
* Informed and consenting patient.
* Patient affiliated to a social security system or beneficiary of such a system.

Exclusion Criteria:

* Patient with active infectious or traumatic keratitis such as burns.
* Patient with herpetic keratitis.
* Patient currently wearing contact lens, including scleral lenses concomitant with the treatment.
* Patient currently treated with NSAIDs in eye drops or any eye drops containing preservatives.
* Patient treated with antibiotic, anti-viral or anti-parasitic eye drops; with autologous or allogeneic serum; with platelet derivatives; with eye drops claiming healing properties; with eye drops containing growth factors, hyaluronic acid or trehalose.
* Patient with hypersensitivity to fluorescein.
* Patient with identified causes for keratitis for which discontinuation of medical treatment is beneficial.
* Monophthalmic patients.
* Persons deprived of liberty by a judicial or administrative decision.
* Adults who are subject to a legal protection measure or who are unable to express their consent.
* Pregnant woman.
Whole Body Vibration and BOSU Ball in Spastic Cerebral Palsy

Cerebral palsy is a non-progressive neurodevelopmental disorder, also known as littles disease. The most common cause of physical and mental disabilities in the pediatric population. Cerebral means brain and palsy means weakness or problems in muscles. Spastic cerebral palsy is the common type of cerebral palsy characterized by spasticity or high muscle tone, results in stiffness etc.

This will be a randomized clinical trial, data will be collected from Sehat medical complex Lahore. Study will be conducted on 30 patients. Inclusion criteria of this study is spastic diplegic CP children with age between 6 to 12 years, with GMFCS level 1 and 2 and those both male nd female, able to understand command will be included. Those diplegic spastic CP who have orthopedic intervention/surgery, botulinum toxin injection within past six months, or medical problems such as pneumonia that prevented children from participating in exercises will be excluded.

Group A: whole body vibration therapy group This group will be provided with whole body vibration therapy in spastic cerebral palsy children. Exercise will be conducted 3 times a week for 8 weeks. Pre and post session functional mobility and balance will be measured by pediatric balance scale and time up and go test. Along routine physical therapy such as stretching exercise of achilles tendon, hamstring muscles, hip flexors and adductors, shoulder internal rotators, and wrist flexors, pronators, and ulnar deviator etc.

Group B: BOSU ball training group This group will be provided with both sides up ball BOSU training in spastic cerebral palsy children. Exercise will be conducted 3 times a week for 8 weeks. Pre and post session functional mobility and balance will be measured by pediatric balance scale and time up and go test. Along routine physical therapy such as stretching exercise of achilles tendon, hamstring muscles, hip flexors and adductors, shoulder internal rotators, and wrist flexors, pronators, and ulnar deviator etc.

Eligibility Criteria:
Inclusion Criteria:

* Spastic diplegic CP with GMFCS level I-II
* Age 6-12 years
* Both male and female.
* Able to understand command

Exclusion Criteria:

* Orthopedic surgery within 6 months
* Botulinum injection
* Parents refuse to participate
* Other diseases as Pneumonia
Sensory Motor Arousal Regulation Treatment (SMART) Study

This study will investigate whether a movement and body-based treatment can benefit adults with Post-traumatic Stress Disorder (PTSD). The treatment is called Sensory Motor Arousal Regulation Treatment, or "SMART", and study participation involves 8 sessions of SMART, as well as pre-treatment, post-treatment, and 3-month follow-up assessments.

This study will investigate the use of SMART (Sensory Motor Arousal Regulation Treatment) with adults experiencing symptoms related to PTSD (Post-Traumatic Stress Disorder). In addition to the more well-known symptoms of PTSD (e.g., intrusive memories, avoidance, hypervigilance, and emotion dysregulation), chronic traumatic stress seems to overwhelm the brain's capacity to make sense of sensory information, affecting how traumatized people experience their own bodies and their surroundings. SMART builds on the sensory integration theory of intentionally engaging the senses via movement, touch, body awareness, and balance. The SMART protocol has been used effectively to treat children who have experienced psychological trauma, and the investigators will be investigating its use with adults. Participants enrolled in the study will be randomly assigned to one of two treatment conditions - i) SMART, or ii) wait list (i.e., delayed treatment). Study participation will involve 8, 1-hour sessions of SMART, as well as pre-treatment, post-treatment, and 3-month follow-up assessments. For those assigned to the wait list condition, the same 8 SMART sessions will be offered after the 3-month follow-up assessment is complete, with no further assessment required.

Eligibility Criteria:
Inclusion Criteria:

1. Adults, aged 18-65
2. A primary diagnosis of PTSD as determined by our pre-treatment assessment
3. Ability to provide informed consent
4. Fluency in written and spoken English (to be able to complete assessments)

Exclusion Criteria:

1. any implants, conditions, etc. that do not comply with 7T (Tesla) fMRI research safety standards (e.g., pacemaker, pregnancy/possible pregnancy)
2. history of significant head injury/lengthy loss of consciousness (e.g., a Glasgow Coma Scale Score \< 15 at the time of incident as assessed retrospectively by participant)
3. significant untreated medical illness
4. history of neurological or neurodevelopmental disorder
5. history of any pervasive developmental disorder
6. lifetime bipolar or psychotic disorder
7. alcohol/substance abuse or dependence within the last 3 months
8. extensive narcotic use (e.g., fentanyl, oxycodone, etc.)
9. anyone who would not be suitable for short-term treatment (as determined by our pre-treatment assessment)
10. suicide attempt in last 6 months
Effects of Dry Needling in Teres Major in Patients With Shoulder Pain

The aim of the study is to investigate the effects of the dry needling technique in teres major muscles on pain, range of motion, strength and extensibility of the posterior part of the tissues of the shoulder in athletes with shoulder pain.


Eligibility Criteria:
Inclusion Criteria:

* Athletes with Shoulder pain
* Glenohumeral internal rotation deficit
* Presence of active MTrP in the teres major muscle

Exclusion Criteria:

* Previous surgery in the upper limb
* Previous physiotherapy treatments in the shoulder
* Dry needling contraindications
* Previous dry needling experience to mantain the blinding
Visual Perceptual Learning Based Digital Therapeutics for Visual Field Defect After Stroke

This study evaluates the efficacy of visual perceptual learning for the treatment of visual field defect caused by brain disease. Half of participants will receive visual perceptual training using the VIVID Brain. The other half will not receive any training because there is no standard treatment for visual field defect caused by brain disease.


Eligibility Criteria:
Inclusion Criteria:

* 19 years and older
* At least 3 months after brain disease related to visual field defect
* Verified brain disease in visual pathway related to occipital lobe, parietal lobe, temporal lobe or etc. using CT or MRI
* Brain disease induced visual field defect
* Able to use the VR(Virtual Reality) device
* Able to use the app with a smart phone
* Patient/legally authorized representative has signed the informed consent form

Exclusion Criteria:

* Complete hemianopsia
* Epilepsy, photosensitivity, Parkinson's disease
* Bilateral visual field defect
* Hemispatial neglect
* Ophthalmologic disorder that may interfere the trial. (Ptosis of Eyelid, Corneal Opacity, Diabetic Retinopathy, Glaucoma, Macular Degeneration etc.)
* Inability to discontinue psychostimulants such as methylphenidate, modafinil, and amphetamine.
* Candidate for carotid endarterectomy or stenting
* Received ophthalmologic surgery or laser surgery within 3 months, except for the cataract surgery
* Pregnant or breast feeding
* Participating in other clinical trial
* Any other condition that, in the opinion of the investigator, precludes participation in the trial
The Effect of Birth Ball and Perineal Massage on Perineal Pain, Perineal Trauma and Birth Satisfaction

One of the important causes of perineal trauma is perineal tension. By reducing this tension, perineal trauma can be prevented. Perineal trauma is a birth complication that can be prevented with midwifery approaches. The aim of this study was to investigate the effect of birth ball and perineal massage on perineal pain, perineal trauma and labor satisfaction in the intrapartum period.

Perineal trauma is the disruption of perineal integrity that develops in the genital area at birth and occurs spontaneously or as a result of surgical intervention. One of the important causes of perineal trauma is perineal tension. Perineal traumas can be prevented by reducing this tension.Birth ball and perineal massage are recommended approaches to prevent perineal trauma from the active phase. As a result of these approaches, an increase in birth satisfaction, an increase in quality of life, a decrease in perineal pain and continuity of communication between mother and baby are provided.Massage is started by applying a lubricant to the hands and the fingers are placed into the vagina until the first knuckle. The thumb and index fingers are moved in a "U" shape by pressing the rectum and the tension of the perineal muscles is reduced. In the Positive Birth Experience Booklet published by the World Health Organization, it recommends perineal massage in the second stage of labor to facilitate vaginal delivery and reduce perineal trauma. At a high level of evidence, perineal massage is recommended to prevent third and fourth degree perineal trauma. Perineal trauma care is a condition that increases the cost of delivery, and perineal massage reduces the cost of care and provides quality midwifery care.The use of a birth ball in the intrapartum period increases uterine blood flow, relaxes the muscles and thus reduces pain. Its use is recommended because of its effects on the birth process such as completing the engagement of the fetal head, shortening the duration of the latent phase and increasing the comfort of labor. In addition, the movement of the mother on the birth ball increases the flexibility of the perineal muscles and reduces the risk of perineal trauma. The use of a birth ball is recommended in the first and second stages of labor.

Eligibility Criteria:
Inclusion Criteria:

* Between 18-35 years old
* Active phase
* Multipar
* Singleton pregnancy
* No risky pregnancy
* No complications for vaginal delivery
* Gestational week between 37-42
* The amniotic membrane has not opened
* No perineal scar tissue
* The anterior cephalic position of the fetal head
* Can speak and understand Turkish
* Pregnant women who agreed to participate in the study

Exclusion Criteria:

* Macrosomic fetus (birth weight over 4000 grams according to ultrasound calculation)
* Vaginal infection and/or sexually transmitted disease

Research Termination Criteria

* Cesarean section decision following trauma (due to fetal distress etc.)
* Pregnant women who develop complications during labor (instrumental delivery, etc.)
* Pregnant women who wish to withdraw from work
Addressing Sleep Problems in Older Adults

As many as 57% of older adults complain of major disruption of sleep, 29% struggle to fall asleep and 19% complain of early-morning awakening. The implications of this sleep deprivation are sobering, particularly among older individuals.

The primary goal of this study is to determine whether a palatable foodstuff which contains a fruit/honey drink and which is taken every evening before bedtime leads to improved sleep in community-living individuals with sleep problems.

This is a randomized, placebo-controlled double-blinded pilot study to explore the use of a fruit/honey drink product for improving sleep in older adults. The purpose of this study is to estimate the effects of a fruit/honey drink using various assessment tools when used as short-term intervention.

This trial proposes to enroll a total of 60 community based older adults. All study patients will be instructed to take the study product every day for 28 days. During which time, study subjects will return weekly to complete study visits for a total of 4 visits.

Eligibility Criteria:
Inclusion Criteria:

1. Age ≥ 60 years old at the time of study registration.
2. Individual describes trouble either falling asleep or staying asleep at study entry.
3. Willing to participate in all aspects of the study.
4. Willing to avoid kiwifruit, cherry, and honey for 4 weeks while on this study.
5. Willing to avoid changes to current sleep medications (may use a stable dose of a currently prescribe sleep medication during the first 4 weeks after stating the intervention).

Exclusion Criteria:

1. Allergic to kiwifruit, cherries, honey, apples, or bananas.
2. Hospitalized or living in a care facility at the time of enrollment.
3. Clinical evidence of active malignant disease (cancer), as per healthcare provider's clinical judgment.
4. Any cancer therapy (for example, chemotherapy, hormonal therapy, radiation, surgery, immunotherapy) in the preceding 3 months.
5. Healthcare provider does not think that study candidate has a specific health problem that precludes participation.
6. Allergy or intolerance of milk products.
7. Women of child bearing potential.