cyrilzakka/clinical-trials huggingface dataset:
Predictors of Primary Ceaseran Section At Women Health Hospital

Predictors of primary Ceaseran section Highlight the most important preventable risk factors that may help decrease rate of ceaseran section in Egypt

A caesarean section is a surgical procedure in which incisions are made through a woman's Anterior abdominal and uterus to deliver the baby. (1) It is performed whenever abnormal conditions are making normal delivery difficult and endangering the life of the mother or the baby. Cesarean section is the most common obstetric surgical procedure worldwide. Although low cesarean delivery rates are associated with an increase in adverse events, higher-than-institution cesarean delivery rates have been shown not to improve maternal or neonatal outcomes but to cause additional costs and unnecessary interventions (2). There is a global concern that the number of cesarean deliveries is increasing worldwide, regardless of health status, age, race, or gestational age. (3) A Cesarean section of can only effectively save the life of mother and child when it is medically justified (4). For mothers or infants who do not require a Cesarean section, there is no advantage to having it. (5) Recently, it has been reported that the rate of cesarean delivery in Egypt is increasing. (6) All women undergoing indicated or voluntary Cesarean section are at risk of various complications and negative consequences for future pregnancies.(7) Therefore, avoiding unnecessary Cesarean section must be a top priority.(8) An increase in Cesarean has been observed to be among women of all ages and race/ethnicities, in every state, and is thought to be due to; decrease in Vaginal Births after Caesarean Section (VBAC), decreased vaginal births of breech presentation, and increased prevalence of high-risk pregnancies such as advanced maternal age and some subjective indications during labour such as non-reassuring fetal status and arrest of dilation

Eligibility Criteria:
a. Inclusion criteria:

1. All pregnant women underwent primary ceaseran section
2. All primiparous women delivered vaginally b. Exclusion criteria:

(1) any women done previous one or more ceaseran section before (2) All pregnant women delivered vaginally before more than one time (2) women had previous uterine scar as hysterectomy, myomectomy (4) any female refused to participate
Proton Versus Photon Radiotherapy for Nasopharyngeal Carcinoma

The purpose of this study is to compare the toxicity and therapeutic efficacy of proton or photon combined with carbon ion radiotherapy for newly diagnosed nasopharyngeal carcinoma.Participants will be randomized to 2 arms. Arm 1, participants received photon combined with carbon ion radiotherapy group, Arm 2, participants received proton combined with carbon ion radiotherapy.

The purpose of this study is to compare the toxicity and therapeutic efficacy of photon or proton combined with carbon ion radiotherapy for newly diagnosed nasopharyngeal carcinoma.Participants will be randomized to 2 arms. Arm 1 participants received photon combined with carbon ion radiotherapy (photon: 56 Gy/28 Fx, plus carbon: 15-17.5 gray equivalent \[GyE\]/5 Fx for boost). Arm 2, participants received proton combined with carbon ion radiotherapy (proton: 56 GyE/28 Fx, plus carbon: 15-17.5 GyE/5 Fx for boost). Adverse events will be documented according to CTCAE v4.03.The response of treatment will be evaluated according to RECIST criteria.

Eligibility Criteria:
Inclusion Criteria:

* Pathologically confirmed Nasopharyngeal carcinoma(WHO II/III type).
* Age ≥ 18 and ≤ 70 years of age.
* Eastern Cooperative Oncology Group score: 0-1.
* Adequate laboratory values within 30 dyas of enrollment to study defined as follows: 1) neutrophil \> 2000/mm\^3; 2) platelet \> 100,000/mm\^3; 3) total bilirubin \< 1.5mg/dl; 4) alanine aminotransferase/aspartate aminotransferase \< 1.5 upper limit of normal; 5) SCr \< 1.5mg/dl; creatinine clearance rate \> 60ml/min.
* Willing to accept adequate contraception for women with childbearing potential.
* Willing to sign the written informed consent; Informed consent must be signed before the enrollment in the trial.

Exclusion Criteria:

* Presence of distant metastasis.
* Received radiotherapy for head and neck before.
* Received surgery(except for biopsy) for primary lesion or cervical lymph node.
* Previous history of malignant tumor (within 5 years) or simultaneous existence of multiple primary tumors.
* Presence of diseases (such as Sjögren syndrome) that may interfere evaluation of xerostomia.
* Accompanied with severe major organ dysfunction.
* Presence of mental disease that may influence the understanding of informed consent.
Intra-aortic Balloon Counterpulsation in Patients Undergoing Cardiac Surgery

The hypothesis of the study is to evaluate if the preoperative placement of IABP reduces clinical complications in high-risk patients undergoing cardiac surgery.

High-risk patients undergoing cardiac surgery are at high risk for myocardial ischemia, arrhythmia, cardiogenic shock and other clinical complications. Different therapeutic options are available to support these patients in the perioperative period including inotropes, vasopressors, and vasodilators, and also assist devices such as intra-aortic balloon pump (IABP) and others.

IABP increases myocardial oxygen supply by increasing diastolic coronary perfusion pressure and decreases myocardial oxygen demand by reducing left ventricular afterload. Additionally, IABP can also improve cardiac output and systemic perfusion. The hypothesis of this randomized and controlled trial is that the placement of IABP immediately before the cardiac surgery reduces clinical complications in high-risk patients.

Eligibility Criteria:
Inclusion Criteria:

* Age equal to or higher than 18 years old
* EuroSCORE equal to or higher than 6 or ejection fraction equal to or lower than 40%
* Written informed consent

Exclusion Criteria:

* Cardiogenic shock
* Acute myocardial infarction (AMI) \< 48 hours
* Mechanical complications of AMI
* Peripheral vascular disease (aorta, iliac or femoral)
* Severe aortic regurgitation
* Neoplasm
* Pregnancy
* Tachyarrhythmia
* Procedures of the aorta
* Coagulopathy
* Thrombocytopenia
* Cardiac transplantation, congenital heart disease or endocarditis
* Refusal to consent
NOW Thai HAART Study

After Initiation of HAART in peoples who living with HIV/AIDS in Thailand by the year 2000, rapidly expanded HAART access of national project has been promoted in 2004. Free ARVs (For CD4\<200cell/cu.mm. or in symptomatic HIV with CD4\<250 cell/cu.mm. )and CD4 monitoring has been available. The first-line regimen is d4T+3TC+NVP in mainly the first time (Naive) patients. CD4 response ), rate of opportunistic infection, and neurological outcomes were measured. Rate of ARV change, adverse events,treatment failure, TB co-infection rate, percent changing to EFV-based regimen or PI-based regimen were recorded.

Any Adverse Events including, Sever rash, Severe Hepatitis, Lipid abnormalities, Severe Anemia and Other, common AEs will be analysed.


Eligibility Criteria:
Inclusion Criteria:

* HIV/AIDS patients.
* Age \>15 years.
* informed consent

Exclusion Criteria:

* Not informed consent
AVS After 1mg DST to Determine Subtype in PA

To compare the effect of different procedures of AVS(after 1mg DST or not) in determining the subtypes and long-term outcomes of PA

All paticipants will be randomly divided into 1mg DST group(Intervention group,n=43) and placebo group(Control group,n=43) and to determining the subtypes and to compare the long-term outcomes of patients with PA.

Eligibility Criteria:
Inclusion Criteria:

1. Age 18 or above, male or female, with legal capacity;
2. Patients who diagnosed as primary aldosteronism and willing to surgery

Exclusion Criteria:

1. Pregnant or lactating women
2. Patients with a history of malignant tumors or complicated with severe heart disease, eGFR\<30ml/min/1.73m2, severe anemia (Hb\<60g/L), stroke or acute coronary syndrome within 3 months, severe liver disease
3. Having contraindications or refusal to undergo AVS or unilateral adrenalectomy, or allergy to ACTH;
4. PA combined with Cushing syndrome (including subclinical Cushing); or considering glucocorticoid-suppressible aldosteronism (GRA) or adrenocortical carcinoma;
Linking Epigenomics With Prescription Opioid Abuse and High Impact Musculoskeletal Pain

Genetic variability from epigenetic modification of genes related to pain physiology and opioid pharmacodynamics may influence susceptibility to high-impact chronic musculoskeletal pain, opioid efficacy, and vulnerability to opioid abuse. Exploring the role of epigenomics and opioid addiction may improve understanding and treatment of these complex multifactorial conditions and, potentially, reduce their development.

Over 19 million adults suffer with chronic pain, which frequently limits life or work activities. Many of these patients are chronic prescription opioid consumers and may be at risk for opioid use disorder. Genetic variability of genes related to pain physiology and opioid pharmacodynamics may influence susceptibility to high-impact chronic musculoskeletal pain (HICMP), opioid efficacy, and vulnerability to opioid abuse. There is a paucity of research on the epigenetic profile of patients with HICMP and of those who fall in the spectrum between opioid addicted and opioid naive. Exploring the role of epigenomics in HICMP and opioid addiction may improve understanding and treatment of these complex multifactorial conditions and, potentially, reduce development.

The long-term goal is to create a profile of genetic and psychosocial risk factors for identifying patients susceptible to HICMP and opioid abuse. The objective of this pilot study is to gather preliminary data on the association of epigenetic modification of genes with HICMP and prescription opioid abuse.The study team propose to compare COMT and OPRM1 DNA methylation patterns in patients with HICMP (Group 1) to those without HICMP (Group 2).The investigators will also correlate OPRM1 DNA methylation patterns with the likelihood of misuse and abuse in chronic opioid consumers. It is hypothesized: (1) the promoter region of the COMT and OPRM1 genes will be hypo- and hyper-methylated, respectively, in Group 1 compared to Group 2; and (2) the OPRM1 gene in patients at high risk for opioid misuse and abuse will be hyper-methylated.

Eligibility Criteria:
Inclusion Criteria:

* Patients age ≥18 years with chronic musculoskeletal pain (pain present for 3 or more months) treated with prescription opioids on most days in the past 3 months.

Exclusion Criteria:

* Patients who are non-English speaking,
* Patients who are incarcerated
* Patients who are unable to provide consent will be excluded.
Use of MUAC as Basic Criterion for Admission, Follow-up and Exit From the Ambulatory Nutrition Program

The aim of this study is to provide comprehensive documentation of the relevant results and operational implications of this new model using Mid-Upper Arm Circumference (MUAC) as the single anthropometric criterion for admission, monitoring and exit of non- complicated in Niger.

This is a first operational experiment using Mid-Upper Arm Circumference (MUAC) as the single anthropometric criterion for the admission, monitoring and exit of the management of uncomplicated SAM (Severe Acute Malnutrition) in Niger, specific data as well as data from routine program will be collected to allow comprehensive documentation of all relevant results and operational implications of this new model. The experiment based on the use of the single anthropometric threshold for admission of a Mid-Upper Arm Circumference (MUAC)\<120 mm, which includes both children currently classified as having SAM (currently with PB \<115 mm) and acute malnutrition moderate (MAM, currently with a Mid-Upper Arm Circumference (MUAC)\<125 mm), as well as a follow-up of children with a Mid-Upper Arm Circumference (MUAC)≥ 120 mm, will identify how children respond to treatment and benefit of the spectrum of acute malnutrition.

Eligibility Criteria:
Inclusion Criteria:

* All children admitted for non-complicated SAM (Severe Acute Malnutrition) treatment

Exclusion Criteria:

* Children between the ages of 6 and 59 months who were recently excluded from treatment by admission criteria based on MUAC (Sabon Guida site) but were previously eligible for treatment (ie MUAC ≥ 120 and Z score \<-3).
A Study Assessing the Safety and Effectiveness of IC2000 and SPY Fluorescence Imaging Systems (SPY-PHI) in the Visualization of Lymphatic Vessels and Identification of Lymph Nodes During Sentinel Lymph Node Biopsy in Subjects With Breast Cancer

This is a prospective, open label, multicenter, non-inferiority within-patient study to determine the effectiveness of IC2000 (Indocyanine Green (ICG) for Injection) and the SPY Portable Handheld Imaging System (SPY-PHI) as an intraoperative fluorescence visualization tool, in the visual identification of lymphatic vessels and lymph nodes (LNs) during lymphatic mapping and sentinel lymph node biopsy (SLNB) procedures as confirmed by Technitium99m (Tc99m) and Gamma Probe.


Eligibility Criteria:
Inclusion Criteria:

1. Be 18 years of age or older
2. Subjects with American Cancer Society Clinical Stage 0 Ductal Carcinoma in Situ (DCIS) (Stage 0, Tis, N0, M0), IA (T1\*, N0, M0), IB ((T0, N1mi, M0) or T1\*, N1mi, M0)) or Stage IIA (T0, N1\*\*M0, or T1, N1\*\*, M0 or T2, N0, M0)1 breast cancer undergoing surgery to remove tumor draining LNs.

   Where:
   * Tis = Ductal carcinoma in situ
   * T0 = No evidence of primary tumor
   * T1 = Tumor ≤ 20 mm in greatest diameter
   * T1\* = Includes T1mi
   * T2 = Tumor \>20 mm but ≤ 50 mm in greatest diameter
   * N0 = No regional lymph node metastasisq1'
   * N1 = Metastasis to movable ipsilateral level I, II axillary LNs
   * N1\*\* = T0 and T1 tumors with nodal micro-metastasis only are excluded from Stage IIA and are classified Stage IB.
   * mi = Micro-metastasis
   * M0 = Disease has not metastasized from Stage IIA and are classified Stage IB.
   * M0= No evidence of metastasis
   * mi= Micrometastasis
3. Subjects with clinically negative nodal status (N0) with or without neoadjuvant chemotherapy
4. Subjects with negative metastatic involvement (M0)
5. Subjects of child-bearing potential must not be pregnant or lactating and must have a negative pregnancy test at Baseline
6. Have signed an approved informed consent form for the study
7. Be willing to comply with the protocol

Exclusion Criteria:

1. Have had prior axillary surgery or ipsilateral radiation in the breast(s) that is planned for the procedure
2. Advanced breast cancer subjects with stage IIB, III and IV
3. Known allergy or history of adverse reaction to ICG, iodine or iodine dyes
4. Subjects who have participated in another investigational study within 30 days prior to surgery
5. Pregnant or lactating subject
6. Subjects who, in the Investigator's opinion, have any medical condition that makes the subject a poor candidate for
Condylar Position Changes and TMJ Functions After BSSO Mandibular Setback, Low Medial Cut.

This study hypotheses that using low medial cut osteotomy BSSO in mandibular setback can be an efficient and effective method to limit the bony segment interferences , decreasing muscles stripping during osteotomy ,decrease condylar torque and so securing preoperative condylar position during BSSO in comparison with using high medial cut BSSO.

Research question:

Description of research question:

P: Population: Patients with facial skeletal deformity and need for mandibular setback using bilateral sagittal split osteotomy (BSSRO) alone or combined with lefort osteotomy.

I: Intervention: Patients with facial skeletal deformity and need and for mandibular setback using low medial cut osteotomy as modification of bilateral sagittal split ramus osteotomy (BSSRO).

C: Comparator: Patients with facial skeletal deformity and need and for mandibular setback using traditional high medial cut osteotomy bilateral sagittal split ramus osteotomy (BSSRO).

O: Outcome: Comparing the post-operative condylar positions changes and TMJ functions of two osteotomies.

Research question:

Is using low medial cut osteotomy modification in BSSRO in mandibular setback will provide more control over proximal segment position than traditional high medial cut through:

1. limit the segments interference and so maximizes the passive bony contact across the osteotomy site after surgically repositioning the distal segment
2. Passively positioned the proximal segment without displacement of the condyle from its normal position.

Eligibility Criteria:
Inclusion criteria:

* Age of the patient between (18-60) years
* Patients in need of mandibular setback using bilateral sagittal split osteotomy.
* All patients are free from any systemic disease that may affect normal bone healing.
* Patient with facial deformity will be treated with mandibular setback either mono or bimaxilary surgeries
* Patient with facial deformity will be treated with mandibular setback either surgery first approach or orthofirst approach.
* Sufficient dentition to reproduce the occlusal relationships
* Patient's consent to participate

Exclusion criteria:

* Patients with any systemic disease that may affect normal healing
* Intra-bony lesions or infections that may interfere with surgery.
* Previous orthognathic surgeries.
* Patients with all types of facial clefts
Effect of Two Different Digital Construction Techniques of Implant-assisted Overdentures

twenty patients received mandibular overdenture constructed by different construction techniques were classified equally and randomly into two groups peri implant bone loss was assessed by CBCT at baseline (T0), at1 year(T1), at 3 years(T3) and posterior ridge resorption was assessed by CBCT at baseline (T0), at 1 year( T1), at 3 years (T3). By superimposition of pre and post CBCT.

twenty patients received mandibular overdenture constructed by different construction techniques were classified equally and randomly into two groups (n = 10 per group): Group A: received milled mandibular overdenture opposed by maxillary complete denture. Group B: received 3D-printed mandibular overdenture opposed by maxillary acrylic complete denture. peri implant bone loss was assessed by CBCT at baseline (T0), at1 year(T1), at 3 years(T3) and posterior ridge resorption was assessed by CBCT at baseline (T0), at 1 year( T1), at 3 years (T3). By superimposition of pre and post CBCT.

Eligibility Criteria:
Inclusion Criteria:

* All patient wearing maxillary conventional denture.
* All patients had temporary mandibular overdenture supported by vertically inserted 4-implant at least six months ago.
* A Cone Beam Computed Tomography (CBCT) done to verify the accurate position and success of the inserted implant.
* They were healthy, free from any systemic diseases relating to bone resorption such as uncontrolled diabetics or osteoporosis. This was achieved through medical history and clinical examination by physician.
* At least 15 mm restorative space must be available (from the mucosa covering the crest of the residual ridge to proposed occlusal plane) to permit construction of all types of tested prosthesis (class I according to Ahuja and Cagna). This was detected by a tentative jaw relation.
* All patients are of angel's class I maxillo-mandibular relationships.

Exclusion Criteria:

* Patients had head and neck radiotherapy, patients with bleeding disorders or hepatic patients.
* Patients with metabolic disorders as diabetes mellitus, osteoporosis and hepatic disorders that might affect osseointegration.
* Long term immunosuppress and corticosteroid drug therapy.
* Patient with abnormal habits as clenching and bruxism.
* Smoking patient.
* Uncooperative patients.
* Neuromuscular diseases.
* Patient with problems in TMJ.
Evaluation of Patients After Cardiac Surgery: Novel Ultrasound Parameters for Quantification of Renal Perfusion & Analysis of Phenylephrines' Effect on Invasive Haemodynamics and Echocardiographic Measures

To investigate the influence of PEEP (Positive end-expiratory pressure), changes in preload (patient position) and changes in afterload (phenylephrine) on ultrasound measures of renal perfusion in patients after uncomplicated cardiac surgery.

To investigate the effects of phenylephrine on both invasive measures of the systemic- and pulmonary circulation and, secondarily, to assess the induced changes in echocardiographic indices of left- and right ventricular systolic- and diastolic function.


Eligibility Criteria:
Inclusion Criteria:

* All patients ≥ 18 years scheduled for open elective cardiac surgery at the Department of Cardiothoracic \& Vascular Surgery, Aarhus University Hospital.

Exclusion Criteria:

* Insufficient ultrasonographic imaging of the kidneys
* Known morphological kidney disease
* Preoperative dialysis
* Chronic atrial fibrillation
* Planned mitral valve surgery
Developing E-liquid Product Standards (Sweet Spot Study)

The Sweet Spot Study aims to evaluate the effect of e-liquids with nicotine varying in freebase (FB) levels and concentrations on the appeal of electronic cigarettes (ECs) in young adult EC users with minimal/no history of smoking and older adult smokers.


Eligibility Criteria:
Inclusion criteria:

1. Young adult e-cigarette user or older adult smoker
2. Willing to abstain from all nicotine product use for 12 hours prior to the study visit
3. Read and speak English

Exclusion criteria:

1. Currently attempting to quit nicotine products
2. Currently pregnant, planning to become pregnant, or breastfeeding
3. Current or past use of tobacco products other than e-cigarettes or cigarettes
4. Self-reported diagnosis of lung disease
5. Self-reported new or unstable cardiovascular disease
Puberty in Girls Followed for Cystic Fibrosis

In the general population, age of puberty, and age of menarche in girls, are closely correlated with those of their mother. The severity of chronic disease has an impact on the stature, the weight gain and the onset of puberty: age of menarche is even later that chronic illness is serious. Cystic fibrosis is one of the major chronic diseases of children.

Neonatal screening is organized since 2002, most girls with cystic fibrosis therefore currently have a very specialized and early care. Older patients were diagnosed during childhood. The optimization of the nutritional and respiratory management has allowed over the past two decades a significant improvement in the survival of these patients. Most young people reach adulthood, puberty and reproductive desire are a crucial issue in the care of these young adults.

In literature, it is often noted an age of menarche delayed an average of 2 years compared to the general population, but correlated with the age of menstruation from the mothers.

The factors involved in the conduct of cycles in the girl followed for cystic fibrosis are poorly known and there are few data on the characteristics of cycles. The menstrual irregularity and amenorrhoea episodes concern nearly half of women.

On the pathophysiological level, studies in animals show that there is a direct effect of CFTR (Cystic Fibrosis Transmembrane Regulator) on the hypothalamic pituitary gonadal and reproductive capacity in mice.

The literature data on the pubertal development, fertility and hormonal profile of these girls are for studies with low numbers and are very old. There is to date no French cohort study on this topic.

The study is a multicenter cross-sectional descriptive study for pubertal and gynecological characteristics in girls followed annually in the reference centers Cystic Fibrosis two inter-region.


Eligibility Criteria:
Inclusion Criteria:

* Patient diagnosed with cystic fibrosis
* Girl aged 8 years of age, adolescents and young adults, had period or not,
* visit the Reference and Competence Center of Cystic Fibrosis.
* Affiliated to a social security scheme

Exclusion Criteria:

* Lack of consent of the legal representative or the relevant patient.
* Patient majoring in legal disability or minor patient whose legal representative is legal disability