Randomized Trial of Silver Nitrate with Sodium Fluoride for Caries Arrest

Objectives: The aim of this noninferiority double-blind randomized clinical trial was to compare the effectiveness of the topical semiannual application of a 25% silver nitrate (AgNO3) solution followed by a 5% sodium fluoride (NaF) varnish with that of a 38% silver diamine fluoride (SDF) solution in arresting caries among preschool children. Methods: Healthy 3-y-old children with active dentine carious lesions were randomly allocated to 2 groups via computer-generated random numbers. Lesions in group A received applications of a 25% AgNO3 solution followed by a 5% NaF varnish semiannually (every 6 mo). Lesions in group B received semiannual applications of a 38% SDF solution followed by a placebo varnish. A trained examiner recorded the status of caries and oral hygiene at baseline and during follow-up examinations. The examiner, children, and their caretakers were blinded to the intervention allocation. This study adopted an intention-to-treat analysis. A noninferiority test was conducted for the data analysis. Group A’s noninferiority was accepted if the lower limit of the 95% CI for the difference in the mean number of arrested surfaces was >−0.5. Results: A total of 1,070 children were recruited at baseline, with 535 children in each group. After 18 mo, the mean ± SD number of arrested surfaces was 3.3 ± 3.4 in group A (n = 484) and 3.2 ± 3.5 in group B (n = 476; P = 0.664). The difference in the mean number of arrested surfaces between the groups was 0.092 (95% CI, −0.322 to 0.505). Apart from black staining on the arrested lesions, no other significant side effect was observed. Conclusion: A semiannual application of 25% AgNO3 followed by 5% NaF is no worse than a 38% SDF in arresting dentine caries among preschool children over 18 mo. The Hong Kong Research Grants Council (GRF 17107315) funded this trial, which was registered at ClinicalTrials.gov (NCT02019160). Knowledge Transfer Statement: This randomized clinical trial found that silver nitrate solution followed by sodium fluoride varnish is effective in arresting dentine caries among preschool children. As silver nitrate followed by sodium fluoride is a noninvasive and simple protocol, it can be an alternative strategy to manage dental caries among young children, especially in countries where silver diamine fluoride is not available.

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Single Dose or Divided Dose of Polyethylene Glycol in Treatment of Pediatric Functional Constipation: A Randomized Clinical Trial

10.21203/rs.3.rs-977795/v1 ◽

2021 ◽

Author(s):

Heidar Safarpour ◽

Mohammad Hadi Imanieh ◽

naser honar ◽

sajad hekmati ◽

Naeimehossadat Asmarian

Keyword(s):

Clinical Trial ◽

Single Dose ◽

Polyethylene Glycol ◽

Randomized Clinical Trial ◽

Divided Dose ◽

Functional Constipation ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B

Abstract BackgroundThis study aimed to compare different regimens of Polyethylene Glycol (PEG, single dose vs. divided dose) in the treatment of functional constipation among children aged 4-15 years.Materials and MethodsThis double-blind randomized clinical trial was conducted on the children (4-15 years old) with functional constipation who were visited in an outpatient pediatric clinic affiliated to Shiraz University of Medical Sciences between February and July 2021. Among the120 eligible patients, 80 ones who met the inclusion criteria were recruited. The patients were divided into two parallel groups; the children who received single-dose PEG (group A) and those who received PEG in divided doses (group B). The study was performed during 12 weeks and follow-up visits were scheduled at 1, 3, 6, and 12 weeks after enrollment. The outcomes were measured using the Bristol Stool Form Scale (BSFS).ResultsThe study was performed on 78 cases including 45 boys (57.7%) and 33 girls (42.3%) with the mean age of 5.52±1.79 years. After 12 weeks, a significant difference was observed between groups A and B regarding the mean of BSFS (4.94±0.52 vs. 4.50±0.88, p=0.008). However, no significant difference was observed between the two groups regarding the number of defecation times during the study. The detected complications included mild abdominal pain in eight children in group A (5.3%), fecal incontinency in six children in group B (3.8%), and painful defecation in six children in group B (3.8%).ConclusionThis study confirmed that the administration of the single dose (0.4 g/kg) of PEG early in the morning was more effective, well tolerated, and accompanied by fewer complications compared to the divided dose.

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Immediate Post-Operative Outcomesof Stapled and Hand Sewn Techniques during Oesophagogastrostomy: A Randomized Clinical Trial

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v6i1.48029 ◽

2020 ◽

Vol 6 (1) ◽

pp. 43-47

Author(s):

Mohammad Zakir Hossain Bhuiyan ◽

Syed Aminul Haque ◽

Mohammad Ahtashamul Haque ◽

Farhana Tarannum

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Single Centre ◽

Anastomotic Complications ◽

Operative Outcomes ◽

Group A ◽

Cardia Carcinoma ◽

The Mean ◽

One Year ◽

Group B

Background: Oesophagogastrostomy is a very crucial surgical management. Objective:The purpose of the present study was to observe the immediate post-operative outcomes of stapled and hand sewn techniques during oesophagogastrostomy. Methodology: This single centre, parallel randomized clinical trial was conducted in the Department of Thoracic Surgery at National institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh from January 2011 to December 2011 for a period of one year. Prior to commencement of this study the study protocol was approved by the thesis committee of NIDCH. Patients were purposefully selected from different surgery ward of NIDCH irrespective of age and sex of patients for the study.Patients were divided into two groups designated as group A and B.Stapled oesophagogastric anastomosis was performed in group A and hand sewn anastomosis was done in group B.Immediate post-operative complication were recorded. Result: A total of 60 patients of oesophageal or gastric cardia carcinoma were recruited for this study. Of them 32 cases were assigned to Stapler method and 28 cases to Hand-sewn method of oesophagogastrostomy. The mean age of the patients of group A and group B were 56.1±12.7 years and 55.3±8.3 years respectively. Regarding blood loss during operation, the table shows that in group A mean + SD were 430.4±63.2 ml and in group B mean + SD were 529.6 +86.9 ml. In one stage operation in group A it was mean + SD i.e. 362.2±38.3 ml and in group B it was mean + SD 529.6±86.9 ml. In two stage operation in group A it was mean 466.2±39.7 ml and in group B it was mean±SD 585.6±62.2 ml. Respiratory complication developed in 9.4% of the patients in group A and 17.9% patients in group B. Cardiac complication developed in 3.1 % of the patients in group A and 7.1 % of patients in group B. Wound infection developed in 12.5% of the patients in group A and 10.7% of the patients in group B. Conclusion: In conclusion most of the immediate anastomotic complications are less in stapled anastomotic technique than hand sewn technique Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 43-47

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Comparative Study of Topical Oxiconazole Cream (1%) Versus Ketoconazole Cream (2%) in the Treatment of Inguinocrural Dermatophytoses

Medicine Today ◽

10.3329/medtoday.v28i2.32926 ◽

2017 ◽

Vol 28 (2) ◽

pp. 57-61

Author(s):

Farzana Afroz ◽

Md Shahidullah ◽

Mohd Nurul Alam ◽

Humaira Afreen ◽

Tahmina Sultana ◽

...

Keyword(s):

Clinical Trial ◽

Comparative Study ◽

Once Daily ◽

Male And Female ◽

Medical College ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B

A clinical trial was carried out for the duration of six months from September' 2012 to February' 2013 in the Department of Dermatology and Venereology, Shaheed Monsur Ali Medical College, Uttara Dhaka and patients attending private clinical chamber. To evaluate the effectiveness of oxiconazole cream in comparison to the ketoconazole cream for the treatment of inguinocrural dermatophytoses.A total number of 60 patients with inguinocrural dermatophytoses were included in the study of which 30 patients were treated with oxiconazole (Group A) and the rest 30 patients were treated with ketoconazole (Group B)once daily for 21 days and weekly the outcome of lesions were clinically evaluated and recorded.In group A, male and female were 17 (56.7%) cases and 13 (43.3%) cases respectively. In group B, male and female were 16 (53.3%) cases and 14 (46.7%) cases respectively.The mean age with SD in group A and group B were 28.93 ± 8.29 years and 31.36 ± 8.36 years respectively. The mean scoring with SD in group A and group B were 6.26 ± 2.22 minutes and 6.53 ± 1.81 minutes respectively at the time of observation and 4.23 ± 1.50 minutes and 5.13 ± 1.45 minutes respectively after 1 week and 2.00 ± 1.22 minutes and 3.25 ± 1.07 minutes respectively after 2 weeks. The difference between the mean score of the two group is significant (p=0.006). The mean scoring with SD in group A and group B were 0.00 ± 0.00 minutes and 1.75 ± 0.95 respectively after 3 weeks.Sotopical treatment oxiconazole has revealed itself to be as efficient as ketoconazole and it seems more effective and better tolerated than ketoconazole.Medicine Today 2016 Vol.28(2): 57-61

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Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

TAJ Journal of Teachers Association ◽

10.3329/taj.v33i1.49824 ◽

2020 ◽

Vol 33 (1) ◽

pp. 41-47

Author(s):

Mohsena Akhter ◽

Ishrat Bhuiyan ◽

Zulfiqer Hossain Khan ◽

Mahfuza Akhter ◽

Gulam Kazem Ali Ahmad ◽

...

Keyword(s):

Skin Diseases ◽

Close Contact ◽

Randomized Study ◽

Sarcoptes Scabiei ◽

Efficacy And Safety ◽

Common Skin ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

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Telemanagement of Home-Isolated COVID-19 Patients Using Oxygen Therapy With Noninvasive Positive Pressure Ventilation and Physical Therapy Techniques: Randomized Clinical Trial (Preprint)

10.2196/preprints.23446 ◽

2020 ◽

Author(s):

Aya Sedky Adly ◽

Mahmoud Sedky Adly ◽

Afnan Sedky Adly

Keyword(s):

Health Care ◽

Clinical Trial ◽

Physical Therapy ◽

Randomized Clinical Trial ◽

Health Care System ◽

Oxygen Therapy ◽

Early Stage ◽

Home Based ◽

Group A ◽

Group B

BACKGROUND With the growing stress on hospitals caused by the COVID-19 pandemic, the need for home-based solutions has become a necessity to support these overwhelmed hospitals. OBJECTIVE The goal of this study was to compare two nonpharmacological respiratory treatment methods for home-isolated COVID-19 patients using a newly developed telemanagement health care system. METHODS In this single-blinded randomized clinical trial, 60 patients with stage 1 pneumonia caused by SARS-CoV-2 infection were treated. Group A (n=30) received oxygen therapy with bilevel positive airway pressure (BiPAP) ventilation, and Group B (n=30) received osteopathic manipulative respiratory and physical therapy techniques. Arterial blood gases of PaO2 and PaCO2, pH, vital signs (ie, temperature, respiratory rate, oxygen saturation, heart rate, and blood pressure), and chest computed tomography scans were used for follow-up and for assessment of the course and duration of recovery. RESULTS Analysis of the results showed a significant difference between the two groups (P<.05), with Group A showing shorter recovery periods than Group B (mean 14.9, SD 1.7 days, and mean 23.9, SD 2.3 days, respectively). Significant differences were also observed between baseline and final readings in all of the outcome measures in both groups (P<.05). Regarding posttreatment satisfaction with our proposed telemanagement health care system, positive responses were given by most of the patients in both groups. CONCLUSIONS It was found that home-based oxygen therapy with BiPAP can be a more effective prophylactic treatment approach than osteopathic manipulative respiratory and physical therapy techniques, as it can impede exacerbation of early-stage COVID-19 pneumonia. Telemanagement health care systems are promising methods to help in the pandemic-related shortage of hospital beds, as they showed reasonable effectiveness and reliability in the monitoring and management of patients with early-stage COVID-19 pneumonia. CLINICALTRIAL ClinicalTrials.gov NCT04368923; https://clinicaltrials.gov/ct2/show/NCT04368923

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Which Surgical Method is More Effective in the Fifth Metatarsal Base Fracture?

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000242 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0002

Author(s):

Jun-Beom Kim ◽

Chi Ahn ◽

Byeong-Seop Park

Keyword(s):

Clinical Results ◽

Plate Group ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B ◽

Clinical And Radiological Results ◽

Mean Time ◽

Screw Group

Category: Trauma Introduction/Purpose: The aim of this study was to evaluate and compare the clinical and radiological results of internal fixation with headless cannulated screw and locking compression distal ulna hook plate for the fracture at the base of fifth metatarsal bone, Zone 1. Methods: From April 2012 to April 2015, thirty cases (29 patients) were evaluated retrospectively. The mean follow up periods was 13 months. There were divided two groups based on use of the screw (group A, n=15) or the plate (group B, n=15).We measured the displacement to diastasis of the fracture on the foot oblique radiographs taken pre- and post-operatively in each group, checked the time to bone union and the difference of the reduction distance in each group. Clinical results were evaluated using American Orthopedic Foot and Ankle Society (AOFAS) midfoot score at 12 months postoperative. Results: In group A, the mean time to union was 54.2±9.3 days, the mean displacement to diastasis improved to 0.3±0.4 mm postoperatively (p<0.001), and the mean reduction distance was 2.9±1.0 mm. In group B, the mean time to union was 41.5±7.0 days, the mean displacement to diastasis improved to 0.06±0.2 mm postoperatively (p<0.001), and the mean reduction distance was 4.1±1.6 mm. AOFAS score was verified 97.7±3.4 in group A and 98.2±3.2 in group B. The time to union was significantly different between groups A and B (p=0.01).There were no complications. Conclusion: We suggest that the plate is more effective method for the shorter union time in surgical treatment of fifth metatarsal base fractures.

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Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

Journal of Perinatal Medicine ◽

10.1515/jpm-2013-0162 ◽

2014 ◽

Vol 42 (4) ◽

Cited By ~ 1

Author(s):

Maria Angelica Zoppi ◽

Ambra Iuculano ◽

Giovanni Monni

Keyword(s):

Umbilical Vein ◽

First Trimester ◽

Volume Flow ◽

Crown Rump Length ◽

Normal Outcome ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B ◽

Group D

AbstractWe investigated the umbilical vein volume flow (UVVF) at 11–14 weeks in monochorionic-diamniotic (MCDA) twins, focusing on the occurrence of complications. We considered 87 MCDA pregnancies. We used “E-flow” to detect the umbilical vein and measured the mean velocities and diameters of veins, also calculating the UVVF. Pregnancies were divided into four groups: a (twin-to-twin transfusion, TTTS); b (selective intrauterine growth restriction, sIUGR); c (discordance of fluid, DF); and d (with “normal” outcome). The main outcome of the study was the assessment of the difference of UVVF between twin 1 and twin 2 (larger and smaller twin). In eight of eight pairs of group a and seven of seven pairs of group b, the UVVF of fetuses 1 were significantly different than fetuses 2 (P<0.05). The UVVFs of fetuses 2 of group a were significantly lower in respect to the UVVFs of fetuses 2 of group d (P<0.05). We provide evidence of an important difference in UVVF in pairs that successively developed TTTS or sIUGR. The smaller fetuses of group a (TTTS) showed a lower venous return than fetuses 2 of group d (normal). First-trimester UVVF is lower in fetuses with a smaller crown-rump length in twin pairs at risk of TTTS or IUGR.

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The Role of Using Motorized Diamond Burr Polisher Instrument in Minimizing the Recurrent Rate of Pterygium Excision

Kurdistan Journal of Applied Research ◽

10.24017/science.2020.ichms2020.14 ◽

2020 ◽

pp. 129-136

Author(s):

Sakar Abdulkarim Nidhamalddin

Keyword(s):

Diamond Polishing ◽

Corneal Scar ◽

Group A ◽

Iop Measurement ◽

The Mean ◽

Diamond Burr ◽

Pterygium Excision ◽

The Difference ◽

Group B ◽

Primary Pterygium

To compare the effects of using motorized diamond burr polisher in pterygium excision versus manual polishing of the corneoscleral bed in reducing the recurrent rate. A prospective, comparative and interventional study of 90 consecutive patients with different grads of primary pterygium, who underwent pterygium excision at Shahid Aso teaching eye hospital in Sulaimani city, between August 2018 till September 2019, which was performed by single surgeon. In group A (45) eyes polishing of the corneoscleral bed done using motorized diamond polishing burr, and in group B (45) eyes using manual crescent blade for polishing. Recurrent rate was evaluated after about (8±2) months postoperatively. Ethical consideration of the risks and the benefits of the procedure was observed for each individual patient. A 90 patients with the mean age of group A (48.84±12.7) years and group B (49.67±12.3) years, complained of different grads of primary pterygium, group A had 31(68.9%) male and 14(31.1%) female, while group B had 22(48.9%) male and 23(51.1%) female. Each individual factors like age, gender, visual acuity, BCVA pre and postoperatively, IOP measurement, dryness of the eye and risk factors like smoking and UV exposure affecting the recurrence were assessed. In both groups the main indication for surgery was sign of irritation. The mean surgical time was calculated and the difference between two groups were significant. After follow-up of average six months the outcomes and recurrent rate were checked, recurrent rate was in group A 1(2.2%) while in group B was 6(13.3%) patients. it significantly decreased. Corneal scar happens in only 1(2.2%) case of group A while in 11(24.4%) cases in group B, Corneal scar was statistically significant. In both groups the change of BCVA was significant but the visual change was more significant in group A in compare to group B. Motorized diamond burr is a safe instrument for polishing the cornea during pterygium excision, it is easy to handle, low price, need lesser operative time, its effect on recurrence postoperatively is significant and beside it leaves lesser corneal scar and early visual recovery postoperatively.

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Comparison of Preemptive Analgesic Effects of Intravenous Ketorolac and Oral Pregabalin in Patients Undergoing Mandibular Fracture Surgery: A Randomized Clinical Trial

Avicenna Journal of Dental Research ◽

10.34172/ajdr.2020.11 ◽

2020 ◽

Vol 12 (2) ◽

pp. 51-57

Author(s):

Javad Yazdani ◽

Saeed Nezafati ◽

Ali Mortazavi ◽

Farrokh Farhadi ◽

Milad Ghanizadeh

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Postoperative Period ◽

Opioid Analgesic ◽

Mandibular Fractures ◽

Analgesic Effects ◽

Group A ◽

The Mean ◽

Group B ◽

Intravenous Ketorolac

Background: Preemptive analgesia is one of the techniques to manage postoperative pain, which increases patient satisfaction and decreases the duration of hospitalization. The present study aimed to evaluate and compare the pain relief achieved by preoperative intravenous ketorolac and oral pregabalin in patients undergoing surgery for mandibular fractures. Methods: In the present clinical trial, 60 patients with unilateral fractures of the mandible were randomly assigned to two groups. In group A, intravenous injections of ketorolac 30 mg and in group B, pregabalin 150 mg capsules were administrated one hour preoperatively. The severity of pain was determined using a visual analog scale (VAS) up to 24 hours postoperatively. Finally, the total doses of an opioid analgesic (pethidine) prescribed for each patient in mg during the first 24 hours and the time for the request of the first analgesic dose in minutes were recorded for each patient. Then, their means were compared between the two groups. Results: Maximum pain severity was experienced immediately after surgery, which decreased gradually during the 24-hour postoperative period (P < 0.0001). The mean severity of pain immediately after regaining consciousness and the mean pain score during the 24-hour postoperative period were lower in the pregabalin group than in the ketorolac group (P < 0.0001). In the ketorolac group, a slightly higher dose of the opioid was administered; however, the difference was not significant (P > 0.05). Conclusions: The oral administration of pregabalin 150 mg one hour preoperatively was more effective than the intravenous administration of ketorolac 30 mg in relieving postoperative pain.

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GESTATIONAL DIABETES

The Professional Medical Journal ◽

10.29309/tpmj/2015.22.10.983 ◽

2015 ◽

Vol 22 (10) ◽

pp. 1298-1303

Author(s):

Tayyaba Majeed ◽

Rabia Adnan ◽

Irum Mubshar ◽

Hamis Mahmood ◽

Kanwal Saba ◽

...

Keyword(s):

Oral Route ◽

Outcome Study ◽

Neonatal Hypoglycemia ◽

Consecutive Sampling ◽

Pregnant Females ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B ◽

Study Setting

Objectives: To compare the efficacy of Metformin with insulin in gestationaldiabetes mellitus in terms of fetomaternal outcome. Study Deign: Randomized clinicaltrial study. Setting: Lady Aitchison Hospital Lahore. Period: January 2014 to March 2015.Methodology: Total 500 pregnant females with GDM were included in the study through nonprobability,consecutive sampling. Patients were divided into 2 equal groups (A: B). Patientsin group A were given tablet metformin 500 mg by oral route and group B was administratedregular injection Insulin by subcutaneous route. Results: The mean age of females was32.14±6.13 years. The mean gestational age was 31.07±3.8 weeks. There were 78 (15.6%)females who had 0 parity, 107 (21.4%) females had parity 1, 175 (35%) females had parity2, 95 (19%) females had parity 3, 33 (6.6%) females had parity 4 and 12 (2.4%) femaleshad parity 5.There were 54 (10.8%) cases had PTB, out of which 12 (4.8%) had PTB withmetformin while 42 (16.8%) had PTB with insulin. There were 115 (23%) neonates requiredNICU admission, out of which 37 (14.8%) neonates with metforminand78 (31.2%) neonateswith insulin. There were 87 (17%) neonates who had neonatal hypoglycemia, out of which23 (9.2%) neonates with metformin and64 (25.6%) neonates with insulin. The difference wassignificant between both groups for all fetal outcomes (P<0.05). Conclusion: The metforminis more effective in preventing adverse fetal and maternal outcome as compared to insulin.

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