cyrilzakka/clinical-trials huggingface dataset:
Single Versus Double Injection Costoclavicular Block

In this trial, the objective is to compare single- and double-injection ultrasound-guided costoclavicular blocks. The rationale behind this idea is that a second local anesthetic injection, inside the costoclavicular space, may compensate for the dynamic cord dispersion seen with the single-injection technique. Thus the research hypothesis is that, compared to its single-injection counterpart, a double injection costoclavicular block will result in a shorter onset time.

The costoclavicular block (CCB) constitutes a relatively novel technique for infraclavicular brachial plexus blockade, whereby local anesthetics (LAs) are injected inside the costoclavicular space. In this location, the 3 cords of the brachial plexus are very tightly clustered together; this topography would theoretically result in a very swift brachial plexus block Unfortunately, in two recent trials comparing CCB and conventional infraclavicular brachial plexus block, the authors were unable to detect differences in success rate, onset times and LA requirement between the 2 methods. It could be speculated that the explanation resides in dynamic cord dispersion. With CCB, the initial needle target lies in the middle of the 3 cords of the brachial plexus. However, with LA injection, the cords can quickly migrate away from each other. Thus, the anatomical benefits conveyed by the initial compact topography may be lost.

In this trial, the objective is to compare single- and double-injection ultrasound-guided costoclavicular blocks. The rationale behind this idea is that a second local anesthetic injection, inside the costoclavicular space, may compensate for the dynamic cord dispersion seen with the single-injection technique. Thus the research hypothesis is that, compared to its single-injection counterpart, a double injection costoclavicular block will result in a shorter onset time.

Eligibility Criteria:
Inclusion Criteria:

* age between 18 and 75 years
* American Society of Anesthesiologists classification 1-3
* body mass index between 18 and 30

Exclusion Criteria:

* adults who are unable to give their own consent
* pre-existing neuropathy (assessed by history and physical examination)
* coagulopathy (assessed by history and physical examination and, if deemed clinically necessary, by blood work up i.e. platelets ≤ 100, International Normalized Ratio ≥ 1.4 or partial thromboplastin time ≥ 50)
* renal failure (assessed by history and physical examination and, if deemed clinically necessary, by blood work up i.e. creatinine ≥ 100)
* hepatic failure (assessed by history and physical examination and, if deemed clinically necessary, by blood work up i.e. transaminases ≥ 100)
* allergy to local anesthetic
* pregnancy
* prior surgery in the infraclavicular costoclavicular region
* chronic pain syndromes requiring opioid intake at home
Antihypertensive Efficacy and Safety of Candesartan/HCT 32/12.5 and 32/25 mg in Comparison With Candesartan 32 mg

In this study it is intended to compare the blood pressure lowering effect of the combination of candesartan cilexetil (candesartan) 32 mg and hydrochlorothiazide (HCT) 25 mg and the combination of candesartan 32 mg and HCT 12.5 mg to that of candesartan 32 mg alone in patients whose blood pressure is not well controlled on candesartan 32 mg monotherapy. The Primary Objectives are to compare sitting BP lowering effect of candesartan/HCT 32/25 mg and candesartan/HCT 32/12.5 mg with that of candesartan 32 mg, respectively.


Eligibility Criteria:
Inclusion Criteria:

* Patients will be eligible for enrolment into the study (Visit 1) if they fulfil all of the following criteria:
* Provision of signed Informed Consent
* Primary hypertension, untreated or treated with a maximum of 2 antihypertensive drugs, which the patient and the physician are willing to withdraw at enrolment and change to candesartan monotherapy
* Mean sitting DBP 90-114 mmHg
* Patients will be eligible for randomisation (Visit 4) if they fulfil the following criterion:
* Mean sitting DBP 90-114 mmHg on treatment with candesartan 32 mg monotherapy (after 2 weeks with candesartan 16 mg and 6 weeks with candesartan 32 mg monotherapy). The run-in period should not be shorter than 8 weeks.

Exclusion Criteria:

* Involvement in the planning and conduct of the study (applies to both AstraZeneca staff, CRO staff or staff at the investigational centre)
* Pregnant or lactating women, or women of childbearing potential not practising an adequate method of contraception eg, intrauterine device, oral contraception or progesterone implant and verified by a negative pregnancy test at Visit 1
* Secondary or malignant hypertension
* Sitting SBP of 180 mmHg or more
* Patients who are treated with candesartan 16 mg in combination with a diuretic or with candesartan 32 mg with or without any additional antihypertensive treatment
* Myocardial infarction, stroke, coronary bypass surgery or transient ischaemic attack within 6 months before enrolment
* Angina pectoris requiring more treatment than short-acting nitrates
* Chronic use of NSAIDs
* Aortic or mitral valve stenosis
* Cardiac failure requiring treatment
* Cardiac arrhythmia requiring treatment
* Gout
* Renal artery stenosis or kidney transplantation
* Intravascular volume depletion
* Hypersensitivity to any component of the investigational products
* Concomitant disease which may interfere with the assessment of the patient
* Past or present alcohol or drug abuse, or any condition associated with poor compliance
* Chronic liver disease or known liver enzyme values above three times the upper limit of the reference range for S-ASAT or S-ALAT
* Concomitant or previous treatment with other investigational drugs within 20 days of enrolment
* Previous enrolment in the present study
* S-creatinine of 180 μmol/l or above for men and of 140 μmol/l or above for women
* S-sodium or S-potassium outside the reference range
* Less than 85% compliance with study medication during the run-in phase
Retina Microvascularisation and Cardiovascular Heart Disease Prediction

Earlier studies have found that retinal photography could be very useful for evaluating the condition of microcirculation and the risk of cardiovascular diseases in patients. The architectural changes in retinal vascularisation strongly correlates with macrovascular remodeling. Also, recent founding suggests a possible close anatomical parallel between both the macrovascular and the microvascular blood.

Our objectives are to assess (1) in which age and sex subgroups, if any, retinal vascular alteration in arterioles and venules can be predictive for cardiovascular morbidity and mortality; and (2) whether variations in arteriolar or venular caliber will predict better cardiovascular pathogenesis in normal and patient population. If the association between the diameter of the retinal vessels and the risks of cardiovascular disease is verified during this study, the impact on prevention would be enormous. The retinal microvascular change could become a powerful biomarker in the early detection of the cardiovascular pathogenesis and death risk


Eligibility Criteria:
Inclusion Criteria:

* Age between 50 to 70 years old (male/female)
* indication of coronarography within the last 3 month preceding the enrollment
* Patients with history of stroke, heart failure or arteriosclerosis.
* At least one of the following risk factors for cardiovascular complication:

  * Hypertension
  * Coronary heart disease (CHD)
  * Diabetes
  * Structural heart disease
  * Dyslipidemia
  * Obesity

Exclusion Criteria:

* Patients with a permanent pacemaker or ICD
* Nephrosis or chronic renal failure
* The study interferes with therapeutic or diagnostic procedures
* Patients with inability to consent or comply with follow up requirements
* Patients with glaucoma
* Patients with any retina degeneration disease vascular age-related macular degeneration or any -retina degeneration disease
* Patients who are pregnant
Effects of Manual Therapy Versus Stretching Exercise Versus Routine Physical Therapy on Work-related Pain, Among Chefs

The aim of this research is to analyze the effect of Mulligan technique versus stretching techniques and versus routine physical therapy on pain, range of motion and functional disability among restaurant chefs presenting with non-specific chronic pain.

A Randomized Control Trail study will be conducted, at Riphah International University Faisalabad after the approval of synopsis. Purposive sampling will be used to enroll the patients. Patients will be selected according to the pre-defined inclusion and exclusion criteria. The patients who will meet the inclusion criteria are allocated into three groups. The patients of group A will receive Routine physical therapy only. Group B will receive manual therapy and routine physical therapy while Group C will receive stretching exercises and routine physical therapy. The outcomes will be measured by the Neck Disability Index, visual analogue scale and bubble inclinometer. The data of patients will be recorded pre-treatment and post-treatment. The comparison between pre-treatment and post-treatment data will be done after 3 months. Informed consent will be taken from each patient. Data entry and analysis will be done with Statistical Package of Social Sciences Version 20 software.

Eligibility Criteria:
Inclusion Criteria:

* For at least 3 months, you've been suffering from neck pain
* Any Neurological problems
* For the previous three months, the patient has taken some analgesic drug for neck pain.
* Rheumatological issues
* Non-specific neck pain
* Age 18-60 years

Exclusion Criteria:

Neck pain due to,

* Tumors
* Ankylosing Spondylitis
* Fracture
* Dislocation
* Cord compression
* Insufficiency of the vertebrobasilar artery
* Osteoprosis
* Anticoagulant or corticosteroid therapy for a long period of time
* Pain due to any congenital deformity, inflammation or any infection
* Carcinoma
Effect Study of Montelukast to Treat Asthma Detected by LTD4 Bronchial Effect Study of Montelukast to Treat Asthma Detected by LTD4 Bronchial Provocation Test

To determine whether LTD4-BPT could be an effective indicator for predicting efficacy of anti-leukotriene therapy, allowing objective proofs for the use of LTRA among asthmatics in a specific sensitive to leukotriene population of asthma.

Hypothesis ：Monteluakst can better improve pre-challenge FEV1 from baseline in leukotriene-sensitive group than leukotriene-insensitive group.


Eligibility Criteria:
Inclusion Criteria:

1. Aged 15-60 years, male or female.
2. Mild to moderate persistent asthma.
3. Mini AQLQ score ≤6 or ACQ score ≥1.
4. Giving written informed consent.

Exclusion Criteria:

1. Current smoker or quitted smoking ≤12 months.
2. Significant allergen exposure.
3. Respiratory tract infection within 2 weeks before or during the study.
4. Cardiovascular disease.
5. History of malignant disease within the preceding 5 years.
6. And/or concomitant pulmonary disease.
7. Pregnant or breast-feed period.
8. Use of leukotrienes receptor antagonist within 5 days
Liver Fibrosis in Peri-menopausal Women

This is a prospective observational study in a single medical center.

The aim is to evaluate the status of fibrosis and steatosis of liver parenchyma in peri-menopausal women using noninvasive methods of vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP) and serum biomarkers.

Recruitment period: 2018/08/01 to 2019/07/31

Patient number: 200 females

Inclusion criteria:

1. Females, age of 46-55 years
2. Willing and able to comply with the study requirements
3. Willing and able to provide written informed consent to participate in the study

Exclusion criteria:

1. Unable to complete the noninvasive procedure of VCET and CAP
2. Unwilling to provide written informed consent to participate in the study

Laboratory tests and examinations:

Baseline and two follow-up visits (every 6 months):

1. Blood pressure
2. BW, BH, waist circumference, BMI
3. Complete blood cell (CBC) count
4. Albumin, AST, ALT, alkaline phosphatase, total bilirubin, r-GT, uric acid, hsCRP
5. Sugar (fasting), HbA1c, insulin, HOMA-IR
6. DM lipid profiles, adiponectin, leptin
7. Liver ultrasound, FibroScan touch 520
8. FSH, Estrodiol (E2), LH
9. TSH, free T4
10. HBsAg, anti-HCV, HBV DNA, HCV RNA, HBsAg quantification, HBV genotype (if HBsAg or anti-HCV positive)
11. ANA, Anti-mitochondrial antibody
12. Review history of drug and menstruation cycles


Eligibility Criteria:
Inclusion Criteria:

1. Females, age of 46-55 years
2. Willing and able to comply with the study requirements
3. Willing and able to provide written informed consent to participate in the study

Exclusion Criteria:

1. Unable to complete the noninvasive procedure of VCET and CAP
2. Unwilling to provide written informed consent to participate in the study
Evaluation of Healing Process After Laser Asissted Gingivectomy Techniques

Objective: The aim of this study was to evaluate and determine clinical and biochemical comparison of 3 different methods including Er:YAG laser, diod laser, and conventional techniques.

Method: This study was conducted on 32 female, 13 male, a total of 45 individuals (study group patients) with an indication of resective gingival surgery in the anterior region of the maxillar anterior regions and 11 female, 4 men, a total of 15 individuals (negative control group patients) with a healthy gingiva. Clinical periodontal parameters, gingival crevicular fluid (GCF) KGF-2 and VEGF-A levels and gingival temperature levels were recorded before the investigation and during operations with 3 different techniques, gingival temperature was measured. Gingival temperature and epithelization levels in 3, 7, 14 and 21 days; GCF KGF-2 and VEGF-A levels in 14 and 21 days and pain levels between 1-7 days of post-operative healing process were evaluated. Preoperative anxiety and postoperative satisfaction were evaluated through questionnaires

Objective: The aim of this study was to evaluate and determine clinical and biochemical comparison of 3 different methods including Er:YAG laser, diod laser, and conventional techniques commonly used in resective gingival surgeries in terms of preoperative anxiety, postoperative satisfaction, epithelization, gingival temperature, inflammation and pain levels in post-operative healing process.

Method: This study was conducted on 32 female, 13 male, a total of 45 individuals (study group patients) with an indication of resective gingival surgery in the anterior region of the maxillar anterior regions and 11 female, 4 men, a total of 15 individuals (negative control group patients) with a healthy gingiva. Clinical periodontal parameters, gingival crevicular fluid (GCF) KGF-2 and VEGF-A levels and gingival temperature levels were recorded before the investigation and during operations with 3 different techniques, gingival temperature was measured. Gingival temperature and epithelization levels in 3, 7, 14 and 21 days; GCF KGF-2 and VEGF-A levels in 14 and 21 days and pain levels between 1-7 days of post-operative healing process were evaluated. Preoperative anxiety and postoperative satisfaction were evaluated through questionnaires

Eligibility Criteria:
Inclusion Criteria:

* systemically healthy individuals
* the existence of at least 20 functioning teeth,
* the existence of chronic inflammatory gingival enlargement

Exclusion Criteria:

* pregnancy/lactation,
* drug use,
* previous periodontal therapy within 6 months
Evaluation of the Sarcopenia in Hepatobiliary Surgery

The sarcopenia is defined as a loss of muscle mass and a loss of muscle function ( strength or performance). Some studies showed that the sarcopenia increase the postoperative complications and the overall survival in abdominal surgery. But the sarcopenia is not evaluated in the Hepatobiliary surgery. This prospective, monconcentrique study aim to evaluate the prevalence of sarcopenia, and its associated morbimortality in hepatobiliary surgery for malignant or benign tumors.


Eligibility Criteria:
Inclusion Criteria:

* hepatobiliary surgery
* scheduled surgery
* oral consent

Exclusion Criteria:

* pregnancy
* patient under low protection
* emergency surgery
* hepatic encephalopathy stage II, III and IV
Evaluation of the Effect of Micro-osteoperforation on the Rate of Bone Anchored Molar Distalization

The primary aim of the current study was to evaluate three dimensionally, using digital models and cone beam computed tomography imaging, the effect of micro-osteoperforations on the rate of tooth movement in the first molar distalization.

The design of this randomized controlled clinical trial is a parallel group, two arms trial

* Preparatory phase

  * Self-drilling mini-screws will be placed buccally between upper 2nd premolar and 1st molar bilaterally in the last NiTi wire insertion visit.
  * After the completion of levelling and alignment phase an intra oral scan will be made for the upper arch and a rigid stainless-steel retraction arch wire 0.017" x 0.025" will be inserted.
  * The patient will then be referred to the radiology center and a pre-retraction cone beam computed tomography (CBCT) image will be taken for the maxillary arch (T0).
* Experimental phase

  * Subjects will receive MOPs randomly to either the left or right maxillary molar buccal alveolar regions. MOPs will be performed at the first day of the distalization treatment (T0) and will repeated every 2 months.
  * Molar distalization will started immediately after performing the MOPs using sliding jig distalizer.
  * The force will be applied to the mini-screw with the sliding jig mechanics on average 300 gm using Nickel-titanium closing coil springs.
  * Before leaving the clinic, the patient will be asked to:
  * Use chlorhexidine three times per day for 3 days after MOP applications.
  * avoid using pain killers (except Panadol when needed).
  * fill in a Numeric pain rating scale.
* Follow up phase

  * Follow up visits will be scheduled every 4 weeks for reactivation coil spring and check TADs stability.
  * An intra oral scan for the upper arch will made every visit.
  * The study time will be continued for 6 months (T1, T2, T3, T4, T5, T6).
  * The same technique of MOP will be repeated after 2 and 4 months of follow up (T2,T4).
  * After 6 months of follow up, the final dental model will made, and the patient will be referred to the same radiology center to acquire the post-distalization CBCT.

Eligibility Criteria:
Inclusion Criteria:

1. Adult patients
2. Skeletal Class I or mild Class II relationship
3. Dental class II bilaterally (non-extraction cases)
4. Full permanent dentition including 2nd maxillary molars
5. Good oral hygiene
6. Medically free

Exclusion Criteria:

1. Systemic diseases that may interfere with the treatment
2. Use of any medications that might have affected the biology of tooth movement
3. unilateral Class II molar relationship
4. extreme skeletal Class II relationship (ANB \>7°)
5. periodontal disease or alveolar bone loss
6. Patients with dental anomalies in maxillary 1st molar
Physical Training During Hospital Admission With Community-Acquired Pneumonia

The purpose of this study is to assess the effect of standard usual care combined with daily supervised physical training during hospitalization with community-acquired pneumonia (CAP) compared to standard usual care alnone.

Community-acuired pneumonia (CAP) is a leading cause of hospitalization worldwide. Despite increased focus on mobilization, hospitalization is associated with bed rest. Bed rest with low levels of physical activity leads to functional deline as well as increased risk of complications.

This study is a randomized controlled trial, which investigates the effect of standard usual care combined with daily supervised physical training in patients hospitalized with CAP compared to standard usual care alone.

Eligibility Criteria:
Inclusion Criteria:

* Patients 18 years of age or older admitted to hospital with CAP defined as a new infiltrate on chest X-ray/CT and minimum one of the following symptoms: temperature \<35˚C or ≥38˚C, cough, pleuritic chest pain, dyspnea, or focal chest signs on auscultation.
* Patients should have an expected admission length of ≥72 hours.
* Patients should be able to move their legs.

Exclusion Criteria:

* Patients unable to give written consent.
* Hospital admission within the last 14 days.
* Severe immunosuppression (cancer chemotherapy ≤28 days, neutropenia ≤1000 cells/μL, ≥20 mg prednisolone-equivalent/day \>14 days or other immunosuppressive drugs, HIV infection, former transplant).
Making Decisions About the Measles-Mumps-Rubella Vaccine

The goal of this study is to determine whether a computer-based intervention that delivers individually-tailored educational messages about the MMR vaccine increases MMR vaccine-hesitant parents' intentions to have their children vaccinated.

This will be a randomized controlled intervention trial for MMR vaccine-hesitant parents of children ages six years and younger who have not yet received the MMR vaccine. Parents will complete a three-item measure that assesses their baseline intentions for having their children vaccinated with MMR. Participants will then fill out a short, computer-based survey that assesses demographic factors, prior experience with MMR, and views about a variety of potential barriers to MMR vaccination. Following the survey, the intervention group (40 parents) will view a series of tailored educational messages resembling web pages that uses their survey data to address at an individual level their specific concerns about the MMR vaccine. The control group (40 parents) will view a series of generic educational messages resembling web pages that is similar in appearance to the intervention, but contains only untailored information about the vaccine. After navigating through these educational messages, MMR vaccination intention will be reassessed using the same three-item measure as for the baseline assessment of vaccination intention. The vaccine administration records of the children of these parents will be accessed after parents' participation in the study to assess whether the MMR vaccine was provided to the child.

Eligibility Criteria:
Inclusion Criteria:

* Parent is greater than or equal to 18 years of age
* Parent has a child 6 years of age or younger
* When asked to describe how he/she feels about getting child vaccinated against MMR, parent responds "I don't want to get my child vaccinated" or "I'm unsure if I want my child to get vaccinated"

Exclusion Criteria:

* Cannot read/speak English
Serological Evaluation of 77A/G and 11A/12A Gene of MMP-13 in Periodontitis Affected and Healthy Individuals

50 periodontitis 50 healthy individuals serological evaluation will done to see association of 77A/G AND 11A/12A gene polymorphisms of MMP-13

* The study will be conducted on 100 individuals
* 50 chronic periodontitis and 50 healthy individuals will be recruited from the Out Patient Department of Periodontics in the study.
* An informed consent will be obtained from patients who wish to participate in the study.
* Patients will be categorized by Periodontal Disease Index (PDI) by P. Ramfjord(1959)
* After clinical examination, blood samples will be collected and assessed for MMP 13 Gene Polymorphisms.
* Subjects will be selected according to the study criteria and divided into two groups (50 each).

  1. Test group
  2. Control group

Eligibility Criteria:
Inclusion Criteria:• Test group

1. Patients with chronic periodontitis classified according to American Academy of Periodontology ( AAP) 1999
2. Subjects aged between 30-55 years

   * Control group Systemically and periodontally healthy individuals of same age group

Exclusion Criteria:

1. Present and past Smokers
2. Presence of any systemic diseases.
3. Oral diseases other than Periodontitis
4. With a previous history of periodontal treatment in the past 6 months and subjects under any medications.
5. Family history of any diagnosed genetic disorders.