cyrilzakka/clinical-trials huggingface dataset:
Medial Forefoot Block for Analgesia After Foot Surgery

Forefoot surgery includes bunion surgery and similar reconstructive bone cutting surgery and is very painful. Local anaesthetic nerve blocks are used to provide pain relief after this work. The purpose of this study is to compare two techniques: one using anatomical landmarks alone to guide local anaesthetic infiltration, the other using peripheral nerve stimulation to guide local anaesthetic infiltration (termed medial forefoot block). The two techniques will be compared for reliability of postoperative analgesia.

More extensive description not desired.

Eligibility Criteria:
Inclusion Criteria:

* Fit adults requiring forefoot surgery with bone cutting

Exclusion Criteria:

* Morbid obesity (BMI \> 40)
* Known contraindications to regional anaesthesia
Comparison of the Efficacy of Platelet-rich Fibrin and Connective Tissue Graft in Interdental Papilla Reconstruction

Aim: To evaluate the efficacy of platelet-rich fibrin (PRF) or connective tissue graft (CTG) in papilla reconstruction (PR) with semilunar incision (SI) technique.

Materials and Methods: A total of 55 sites (27 CTG and 28 PRF) from 20 patients who underwent PR with either PRF or CTG placed with SI in the maxillary anterior region were included in the study. Baseline (BL) and follow-up (T1( first month), T3 (third month), T6 (sixth month)) clinical data including periodontal evaluations (gingival index (GI), plaque index (PI), papillary bleeding index, pocket depth (PD), keratinized tissue width (KTW), gingival recession), papilla-associated recordings (alveolar crest-interdental contact point (AC-IC), alveolar crest-papilla tip (AC-PT), papilla tip-interdental contact point (PT-IC), papilla height loss (PHL), interdental tissue stroke (ITS) and papilla presence index (PPI)) and patient satisfaction were analyzed.

PT-IC was taken as the primary outcome measure. Normal distribution was assessed by histogram and Shapiro-Wilk test. Continuous variables were represented as mean±SD whereas the categorical variables were reported as numbers and percentages. Chi-square test was used for the comparison of the categorical variables. Since the data was normally distributed, Friedman test was used to analyze the time-dependent changes in both groups and the inter-group comparisons were made with Mann-Whitney test. Generalized Estimating Equation was used for analyzing qualitative and quantitative data, time-dependent changes, and the difference between two methods. Data analysis was performed in IBM SPSS Statistics Version 23, and p\<0.05 was considered as a significance threshold.

Eligibility Criteria:
Inclusion Criteria:

* All selected patients had consent for using their data.
* The data of the patients who underwent PR surgery by one of the authors (S.O.B.) using SI with either PRF or CTG in the maxillary anterior teeth having contact points,
* at least 2 mm keratinized tissue width (KTW) with probing depth (PD)≤ 3 mm adjacent to the open embrasure were included.
* It was ensured that all baseline (BL) and follow-up data were available and all patients received a comprehensive phase I periodontal treatment prior to the PR procedure.

Exclusion Criteria:

* the patients with systemic problems,
* having medications known to influence the periodontium
* Using tobacco/alcohol
* The relevant regions did not have endodontic problems/needs, caries and history of periodontal surgery.
The Incidence of Hypocalcemia in Pregnant Women at Siriraj Hospital

Calcium is an essential element for fundamental physiological functions and during pregnancy. However, higher calcium intake can induce constipation, flatulence, nausea, or kidney stones. This study aims to evaluate the incidence of hypocalcemia among pregnant women in the first half of pregnancy in Thailand. Also, Comparison of calcium level in pregnant women in the third trimester who received and not received calcium during pregnancy.

The primary outcome is the incidence of hypocalcemia among pregnant women in the first half of pregnancy. This study also has secondary objectives. The one is associating factors with calcium level. After getting the results of maternal calcium level, the normal calcium level group will be divided into 2 groups for receiving calcium 1 g/day and no receiving calcium supplement. Another with hypocalcemia group will be decided into 2 groups for receiving calcium 1 g/day and 2 g/day. The calcium level was collected again in the third trimester.

Eligibility Criteria:
Inclusion Criteria:

* Pregnant women who attend antenatal care clinic in Siriraj Hospital
* Pregnant women with gestation less than 20 weeks of gestation
* Singleton pregnancy

Exclusion Criteria:

* Pregnant women who has underlying diseases including liver disease and vitamin D deficiency
* Pregnant women are malnutrition patients
* Pregnant women who receive calcium supplement before enrollment
Comparative Effects of Propioceptive Neuromascular Facilitation and Neural Flossing in Diabetic Neuropathy

To compare the effects of propioceptive neuromascular facilitation and neural flossing on balance and gait in diabetic peripheral neuropathy.

In 2023,conducted systematic review to evaluate the effects of Tai Chi on postural control in people with PN. The meta-analysis found that Tai Chi therapy for people with PN resulted in a smaller sway area, in the double-leg stance with eyes closed test , than that observed in the control group, greater distance covered in the six-minute walking test and faster performance in the timed-up-and-go test, than the baseline. Tai chi effectively enhanced dynamic postural control in people with PN. However, no better effects on postural control from Tai Chi than from other rehabilitation approaches were observed in this study.

In 2023,compare the effects of Functional strength training Versus Neurodynamic exercises on Balance and Gait of patients with Diabetic Peripheral Neuropathy. Both Functional Strength Training Exercises and Neurodynamic Exercises were found to improve the Balance and Gait in patients with Diabetic Peripheral Neuropathy. However, the Functional Strength Training showed more significantly improvement in Balance and Gait subsequently reducing fall and fall risk injury.

As per researcher knowledge, there is no comprehensive study comparing the effects of Proprioceptive Neuromuscular Facilitation (PNF) and Neural Flossing on balance and gait in individuals with diabetic neuropathy. While both methods have been studied independently, a direct head-to-head comparison is needed. Understanding the advantages and limitations of each approach in the context of diabetic neuropathy could provide valuable insights for clinicians and researchers.

Eligibility Criteria:
Inclusion Criteria:

* Clinically Diagnosed with type I and II diabetes
* Patients 45 to 65 years of age
* The participants who scored \<3 as per the Michigan Neuropathy Screening Instrument (MNSI) were included in the study.
* Able to stand and walk without assistance

Exclusion Criteria:

* Patients have other neurological or orthopedic impairments (such as stroke,cerebral palsy, poliomyelitis, rheumatoid arthritis, prosthesis, or moderate or severe osteoarthritis)
* Major vascular complications (venous or arterial ulcers).
* Severe retinopathy
* Severe nephropathy that causes edema or requires haemodialysis
Study To Evaluate Treating Chronic Cerebrospinal Venous Insufficiency (CCSVI) in Multiple Sclerosis Patients

This is a single center, multispecialty, randomized double blind placebo control feasibility clinical trial. The purpose is to evaluate the safety, feasibility and efficacy of percutaneous transluminal angioplasty in treating extracranial venous obstructive lesions, and its influence on the clinical outcomes of Multiple Sclerosis (MS) patients that have been found to have chronic cerebrospinal venous insufficiency (CCSVI).


Eligibility Criteria:
Inclusion Criteria:

* Must be 18 years old or greater and less than or equal to 65 years of age
* Score of 0 to 7 on the EDSS scale
* Diagnosis of relapsing remitting or secondary progressive Multiple Sclerosis by a neurologist and confirmed by one of the independent study neurologists
* Presence of greater than or equal to 50 percent stenosis of the extracranial veins as determined by venogram
* Informed consent signed by patient

Exclusion Criteria:

* Patient is unwilling to comply with the follow up
* Patient is pregnant
* Diagnosis of primary progressive MS by a certified neurologist confirmed by one of the study neurologists
* Presence of less than 50 percent stenosis of the extracranial veins as determined by venogram
* Presence of other medical illnesses or a psychiatric condition that in the opinion of the investigator may cause the subject to be non-compliant with the protocol requirements
* Life expectancy is less than one year
* Lack of mental capacity to consent
* Creatinine level of greater than 2.5 or is dialysis dependant
* Enrollment in another clinical study
Prospective Study of the Impact of Systemic Corticosteroid Use on Measures of Sleep Disordered Breathing

Weight gain is both a significant risk factor for obstructive sleep apnea and a side-effect of long-term systemic steroids therapy.

This study aimed to investigate the impact of long-term systemic steroid treatment on sleep apnea.


Eligibility Criteria:
Inclusion Criteria:

* For inclusion, a scheduled therapy with a minimum daily dose of 10 mg prednisone (or equivalent) for at least 3 months was required

Exclusion Criteria:

* Patients younger than 18 years and those with known sleep apnea or other forms of sleep-disordered breathing were excluded
Innovative Treatment for Scarred Vocal Cords by Local Injection of Autologous Stromal Vascular Fraction

Post-operative scarring on vocal cords is responsible for disorders of the vibration of the lining to the original dysphonia can be troublesome for the patient both in his private and professional life. There is no currently codified treatment for this type of situation and no therapeutic antifibrotic has been effective. Cell therapy is a promising new approach.After a liposuction and removing of mature adipocytes (40 to 60%), the remaining cells called stromal vascular fraction (SVF) could be isolated. SVF consists of a heterogeneous cell population including multipotent stem cells similar to mesenchymal stem cells present in bone marrow. The investigators hypothesis is that the trophic and antifibrotic properties of SVF could benefit patients with vocal cords scarring responsible for dysphonia.


Eligibility Criteria:
Inclusion Criteria:

* Vocal Difficulties felt as crippling (VHI \> 60/120)
* Presence of scar hurts of the caused vocal cords is by the initial surgery (micro-laryngoscopy in suspension with or without laser) or by a congenital pathology of glottidis sulcus
* Scar Aspect of vocal cords judged on a stroboscopic examination
* Delay of at least 1 year with regard to the initial surgery

Exclusion Criteria:

* Patients refusing the speech therapy
* Patients operated for a malignant lesion or in malignant potential serious dysplasia of the scar vocal cord
* Contraindication in the anesthesia
* Patients under anti-coagulants
* Patients presenting disorders of the coagulation
* Active infectious diseases
Auricular Acupressure in Prehabilitation

Complementary medicine is recognized for its ability to enhance appetite, increase energy, reduce anxiety, decrease pain, and improve sleep, among many other benefits. Acupuncture is among the most frequent types of complementary medicine practiced in the US, and Medicare currently includes back pain as a reimbursable indication for this therapy. Acupuncture-related therapies may enhance efforts at prehabilitation in candidates for major lung resection.

The plan is to use a small number of points for auricular acupressure that are selected to improve overall health, both physical and mental. Auricular acupuncture for management of pain using 5 points, informally referred to as "battlefield acupuncture" has demonstrated significant improvement in acute and chronic pain management. Auricular acupressure using a similarly small number of points has demonstrated improvement in chemotherapy-related disturbed sleep, fatigue, and appetite, postpartum depression and fatigue, and chemotherapy related fatigue and depression. It appears that auricular acupressure may be suitable for enhancing prehabilitation interventions for preoperative patients.

Patients will be selected from among individuals being considered for major lung surgery (wedge resection, segmentectomy, lobectomy, bilobectomy, or pneumonectomy; open or minimally invasive) who are expected to pursue a period of prehabilitation of 2 or more weeks prior to surgery.

Eligibility Criteria:
Inclusion Criteria

* Being considered for major lung surgery
* Surgery is not scheduled for at least 2 weeks
* Age ≥ 50 years
* Able to understand English at a 4th grade level
* No known contraindications to prehabilitation (strength, endurance, balance exercises)
* Able to provide informed consent for participation
* Has an adult care partner who will be available and capable of placing seeds
* Has access to smart phone for communication and image sharing
* Underwent frailty screening (given any score)
* Able to perform spirometry testing in clinic

Exclusion Criteria:

* Allergy to Vaccaria seeds
* Medical condition affecting either ear preventing use of auricular acupressure such as eczema, frostbite, sunburn
Use of Oxybutynin to Treat Axillary Hyperhidrosis

The objective of this study was to evaluate the effectiveness and patient satisfaction with the use of oxybutynin at low doses for treating axillary hyperhidrosis in a large series of patients.


Eligibility Criteria:
Inclusion Criteria:

* patients with axillary hyperhidrosis

Exclusion Criteria:

* glaucoma and micturition disorders, pregnancy
Modified Non-clarithromycin Triple Therapy in Eradicating Helicobacter Pylori

Helicobacter pylori (H. pylori) infects more than 50% of the population in the world(1), especially 47-66% in China.


Eligibility Criteria:
Inclusion Criteria:

* Patients who were intend to undergo upper endoscopy for any purpose and volunteered to written inform consent.

Exclusion Criteria:

* negative in rapid urease test (RUT)
* previous standard eradication therapy for H. pylori;
* history of esophagectomy or gastrectomy;
* gastrointestinal malignancy;
* contraindications or allergic to study drugs;
* user of taking medicine that may affect the result of the study within 4 weeks (e.g., proton-pump inhibitors, H2-receptor antagonists, bismuth or antibiotics etc.);
* cardiopulmonary, hepatic or renal insufficiency, and/or severe current diseases or malignancy;
* pregnant or lactating women;
* participants of other trial within the past 3 months;
* unwilling or unable to participate in the study.
Effects Of Muscle Energy Versus Counter Strain Technique on Pain, Function and Satisfaction Level in Planter Fasciitis

Previous studies has discussed the effects of muscle energy technique and counterstrain technique in upper trapezius and low back pain but no comparative study is found on planter fasciitis patients. In this study we are going to compare the effects of muscle energy technique and counterstrain technique with routine physical therapy in relation with pain, functional status and satisfaction level in planter fasciitis patients

Heel pain is one of the most prevalent musculoskeletal diseases of the lower limb, affecting both physically active and sedentary people. Amongst the possible causes, planter fasciitis is one of the most common cause of heel pain.

Planter fasciitis is a degenerative syndrome resulting from the repeated injury at its origin on the calcaneus. Its most common symptom is discomfort in the plantar area of the foot and, more specifically, in the inferior part of the heel. It is frequently more intense while taking your first steps in the morning or after a period of physical inactivity, and it worsens with prolonged standing or weight-lifting activities. It is not frequently linked to nocturnal discomfort or paresthesia.

Different physiotherapy treatment conventions help in pain relieving for example, rest, taping, stretching, orthosis-night brace, Silicon heel cups and myofascial release. This study will compare the effects of Muscle Energy Technique versus Counterstrain Technique in patients with plantar Fasciitis.

Eligibility Criteria:
Inclusion Criteria:

* Age 20 to 68 years.

  * Both male and female.
  * Patients are clinical diagnosed by the orthopedic surgeon.
  * Patients present with pain that persist for more than 4 weeks in heel and planter surface of foot.
  * Pain with the first steps after inactivity

Exclusion Criteria:

* • Patients with history of ankle and foot fracture.

  * Congenital or acquired deformity of ankle and foot.
  * Patients with arthritis.
  * Pervious history of surgery for planter fasciitis.
  * Patients use an assistive device for walking.
  * Patients use corticosteroid injection in heel.
Study Of Disc Anaesthesia For The Preoperative Diagnosis Of Chronic Lower Back Pain

The primary objective of this study is to document and compare diagnostic test results and procedure safety in subjects undergoing both Functional Anaesthetic DiscographyTM (F.A.D.) and provocative discography (PD) and determine the appropriateness of the F.A.D. procedure data collection script for use in a larger clinical trial.


Eligibility Criteria:
Inclusion Criteria:

* Age \> 21.
* Chronic axial low back pain without radicular pain for \> six months, not responding to at least three months of non-surgical management under the direction of a physician.
* One or two discs at L5/S1, L4/L5 or L3/L4 with abnormal findings by MRI, including any of the following: loss of disc hydration, loss of disc height, high intensity zone (HIZ), Modic changes at adjacent vertebral endplates, or herniation without nerve root compression.
* Subject states that he/she is willing to undergo lumbar spinal fusion, disc replacement, or other definitive treatment if eventual diagnosis supports such treatment.
* Physician believes that discography is clinically indicated for the purpose of surgical decision-making for the subject.
* Pre-treatment low back pain by numerical rating scale (NRS) score \> 4 (measured as average in last 24 hours on a 0-10 scale).
* Pre-treatment Oswestry Disability Index (ODI) \> 40 (0 - 100 scale).
* Subject states availability for all study visits.
* Subject is able to understand the risks and benefits of participating in the study and provides written informed consent.

Exclusion Criteria:

* Known osteoporosis or osteopenia, metabolic bone disorder, or history of chronic steroid use (the equivalent of 7.5 milligrams of daily prednisone use for \> 6 months).
* Suspected painful disc degeneration (based on clinical examination and MRI findings) outside of L5/S1, L4/L5 or L3/L4 levels.
* MRI shows disc abnormalities (listed in Inclusion Criteria #3) at all 3 lower lumbar discs (L3/L4, L4/L5 and L5/S1).
* Abnormal neurologic exam attributable to lumbar disc disease, herniation, or lumbar stenosis.
* Back, buttock or pelvic pain suspected to be due to spinal stenosis, spinal fractures, infection, cancer, facet arthropathy or other hip or pelvis pathology.
* Schmorl's node or endplate disruption evident on MRI at L5/S1, L4/L5, or L3/L4.
* Medical history, physical examination or radiographic evidence (e.g., disc height too narrow) to suggest that either PD or F.A.D. may not be technically feasible.
* Any previous lumbar spine fusion or disc replacement.
* More than grade 1 spondylolisthesis as assessed by x-ray or MRI.
* Significant clinical comorbidity that may potentially interfere with data collection or follow-up (e.g., dementia, severe comorbid illness).
* History of major depression, psychosis or somatization disorder, or panic disorder.
* Allergy to any materials used in PD or F.A.D. devices, contrast, lidocaine, or bupivacaine.
* Any evidence of disc or systemic infection.
* Pregnant or child-bearing potential and not currently on adequate birth control method.
Clinical Trial Using Bipolar Technology for Transurethral Resection of Bladder Tumor

Bladder cancer is a common urological malignant disease. Patients with bladder cancer will first be managed with transurethral resection (TUR) of bladder tumor. For many years, monopolar transurethral resection of bladder tumor (TURP) has been the gold standard for treatment. However, complications including bleeding, bladder perforation and inadequate sampling of deep tumor biopsy remain the major concerns. Recently published papers suggested that the newer bipolar TUR technology has similar surgical outcomes but less complications comparing with monopolar TUR. In this study, investigators will investigate the benefit of new technology as compared with conventional monopolar resection on tumor clearance, complication and recurrence rates.

Transurethral resection (TUR) of bladder tumor is one of commonest procedures in urology practice. It is the surgery of choice for staging and treating non-muscle invasive bladder cancer. Short lengths of hospital stay, simple and safe are the main advantages of the surgery. Conventional TUR is performed with monopolar diathermy, which commonly elicits obturator reflexes in lateral-located tumor. However, it is not without complication. Bleeding and bladder perforation with or without obturator reflex are the most significant complications after TUR of bladder tumor. The charring effect of monopolar is also a concern as the diagnosis of muscle invasion by tumor is determined by the integrity of tumor base biopsy. Mariappan et al. reported that as high as 33% of the specimen had no detrusor muscle present for assessment. The absent of muscle not only affect the staging procedure but also associated with higher cancer recurrence rate.

Bipolar resection has been widely used in transurethral resection of prostate (TURP). As compared with the traditional monopolar technology, the electric current passes through the instrument sheath. The advantage of bipolar technology includes less obturator reflex, good hemostasis and early recovery. Study has showed that the cautery artifact is more severe on monopolar resection as compared with bipolar in prostate tissues. Due to the clean and precise cutting, there will be less charring on the specimen and thermal injury to peripheral tissues. Applying to bladder tumor resection, this will improve the staging accuracy with better determination of the depth of invasion. Furthermore, with the use of saline instead of glycine as irrigation fluid, risk of TUR syndrome is minimized. There is no randomized trial on the benefit of using bipolar instrument on TUR bladder cancer. In this study, investigator will investigate the role of bipolar technology in TUR bladder cancer as compared with traditional monopolar resection.

Eligibility Criteria:
Inclusion Criteria:

* Adult male or female patients (age ≥ 18)
* Patients who have diagnosed with bladder cancer (either primary or recurrent) by cystoscopy

Exclusion Criteria:

* Patients who are scheduled for second TUR within 6 weeks after the previous TUR
Lifestyle Improvement for Teens With Bariatric Surgery

The purpose of this study is to Conduct a proof of concept study to assess feasibility, acceptability, and effectiveness of an Metabolic and bariatric surgery (MBS) -supported healthy lifestyle behavioral intervention among adolescent patients, their families, and their clinical team.


Eligibility Criteria:
Inclusion Criteria

* Must meet National Institutes of Health criteria to qualify for MBS for adolescents (BMI \>35 kg/m2 and at least one existing co-morbidity \[e.g. elevated blood pressure, hypercholesterolemia, etc.\] or a BMI\>40kg/m2).
* received psychological clearance for surgery

Exclusion Criteria:

* is not medically referred by a physician for bariatric surgery
* Refuses to participate in the study