COVID-19 Hyper Coagulability Care by LLLT

Study Overview
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Brief Summary
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COVID-19 clotting Safety

Detailed Description
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Covid-19 patients have liability for hyper coagulability, low level laser Therapy improve circulation and decrease liability for hyper coagulability accompanied with circulatory exercises .

Official Title
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Effect of Low Level Laser Therapy on Hyper Coagulability in Patients With Covid-19

Conditions
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COVID-19 Pneumonia

Intervention / Treatment
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* Radiation: Low level laser Therapy
* Other: Circulatory exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: BMI from 18.5 to 29.9 kg/m2 Moderate elevated percentage of coagulative factors for COVID-19 Diagnosis: Nasopharyngeal swab Sepsis induced coagulopathy score>4 D_dimer≥0,5mg/L Fibrinogen>2,5gm/L C_reactive protein≥10mg/L Lymphocyte count<1,500mm3 Platelet count<150,000mm3 Prothrombin time increase>3sec Activated partial thromboplastin time increase>5sec Same level of physical activity Patients can swallow tablets CT scan screening method for COVID-19 Diagnosis Physical examination Exclusion Criteria: hyper tension Cognitive impairment e.g (delirium) Diabetes mellitus both types dependant or non Disabled musculoskeletal Disorders e.g hemi paresis Coronary artery diseases and heart failure DVT Stroke, bone disease, renal failure, pulmonary embolism Vitamins deficiency 6 months post large surgeries Alcohol intake and smokers Thyroid diseases

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Two groups of 30 patients, 1st circulatory exercise, 2nd LLLT and circulatory exercises.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Circulatory exercises group .<br>Circulatory exercises. | Other: Circulatory exercises<br>* Active assisted or against mild resistance. Supine with leg up position 18degrees measured by the bed water balance in side rails. If patient is not comfortable according to the modified Borg scale or contra indicated for the position then assume the supine position. The subject will have A 3 min rest period to acclimatize themselves to each position. The ankle pumping exercises consisted of simple repetitions of dorsiflexion 1 sec and planter- flexion for 1 sec with three different exercise intervals: repeated dorsiflexion and planter-flexion with no rest (no rest exercise). repeated dorsiflexion and planter-flexion with a 2 sec rest period (2 sec rest exercise). repeated dorsiflexion and planter-flexion with 4sec rest period (4sec rest exercise). Subjects will have practiced ankle pumps before the exercise to get familiar and be educated about the procedure.<br>|
| Experimental: LLLT group .<br>Low level laser Therapy + circulatory exercises. | Radiation: Low level laser Therapy<br>* Pin pointed application of low level laser on 15 acupuncture points each point 1 min time of application 15 min.<br>Other: Circulatory exercises<br>* Active assisted or against mild resistance. Supine with leg up position 18degrees measured by the bed water balance in side rails. If patient is not comfortable according to the modified Borg scale or contra indicated for the position then assume the supine position. The subject will have A 3 min rest period to acclimatize themselves to each position. The ankle pumping exercises consisted of simple repetitions of dorsiflexion 1 sec and planter- flexion for 1 sec with three different exercise intervals: repeated dorsiflexion and planter-flexion with no rest (no rest exercise). repeated dorsiflexion and planter-flexion with a 2 sec rest period (2 sec rest exercise). repeated dorsiflexion and planter-flexion with 4sec rest period (4sec rest exercise). Subjects will have practiced ankle pumps before the exercise to get familiar and be educated about the procedure.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Circulatory group laboratory investigation. | D-dimer≥.5mg/dL, fibrinogen>2.5mg/dL To examine COVID-19 recovery. | Monthly (an average of two months) | 
| Circulatory group: CBC analysis. | Lymphocyte count<1.500mm3, Platelet count<150.000mm3, to examine COVID-19 recovery. | Daily (an average of two months) | 
| Circulatory group (PT, PTT). | Prothrombin time>3 sec, activated partial thromboplastin time>5 sec to examine COVID-19 recovery. | Bi weekly (an average of two months) | 
| Circulatory group physical examination. | by visual analog scale is horizontal line 100mm length the ends defined as extreme limit of the parameter measured (symptom, pain, health) orientated from the left (the worst) the right (the best) 3 times per week to detect DVT. | Every two days (an average of two months) | 
| Circulatory group. BMI. | weight kg on height m2 to detect liability for DVT. | Day one | 
| Especially Lab investigation. | C-reactive protein ≥10mg/l for diagnosis of the recovery. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| LLLT group laboratory investigation. | D-dimer≥,5mg/dl, fibrinogen>2.5mg/dl, c-reactive protein≥10mg/dl to examine COVID-19 recovery. Fibrinogen | Monthly (an average of two months) | 
| LLLT group CBC analysis. | lymphocyte count<1,500mm3, platelet count<150,000mm3, for examine COVID-19 recovery. | Daily (an average of two months) | 
| LLLT group. {PTT, PT}. | Prothrombin time>3 sec, activated partial thromboplastin time>5sec to examine COVID-19 recovery. | Bi weekly (an average of two months) | 
| LLLT group physical examination. | by visual analog scale is a straight horizontal line of fixed length 100mm the end is extreme limit of the parameter measured (symptom, pain, health) orientated from the left (the worst) to the right (the best) 3times per week to detect DVT. | Every two days (an average of two months) | 
| LLLT group. BMI. | Weight kg/height m2 to detect liability for DVT. | Day one | 
| Specifically Lab investigation. | C_reactive protein≥10mg/l.help diagnosis of the recovery. | Baseline |