scholarly journals Optimal encephalitis/meningitis roadmap via precise diagnosis and treatment (IMPROVE): a study protocol for a randomized controlled trial

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yi Zhang ◽  
Haocheng Zhang ◽  
Bo Deng ◽  
Ke Lin ◽  
Lei Jin ◽  
...  
Keyword(s):  
Multiplex Pcr ◽  
Diagnostic Methods ◽  
Nucleic Acid Amplification ◽  
Diagnosis And Treatment ◽  
Initial Time ◽  
Controlled Study ◽  
Antibody Testing ◽  
Randomized Controlled ◽  
Group I ◽  
Precise Diagnosis

Abstract Background Encephalitis/meningitis brings a heavy disease burden, and the origin of disease remains unknown in 30–40% of patients. It is greatly significant that combinations of nucleic acid amplification and autoimmune antibody testing improves the diagnosis and treatment of encephalitis/meningitis. Moreover, though several diagnostic methods are in clinical use, a recognized and unified diagnosis and treatment process for encephalitis management remains unclear. Methods IMPROVE is a multicenter, open label, randomized controlled clinical trial that aims to evaluate the diagnostic performance, applications, and impact on patient outcomes of a new diagnostic algorithm that combines metagenomic next-generation sequencing (mNGS), multiplex polymerase chain reaction (PCR) and autoimmune antibody testing. The enrolled patients will be grouped into two parallel groups, multiplex PCR test plus autoimmune antibody group (Group I) or the mNGS plus autoimmune antibody group (Group II) with a patient ratio of 1:1. Both groups will be followed up for 12 months. The primary outcomes include the initial time of targeted treatment and the modified Rankin scale score on the 30th day of the trial. The secondary outcomes are the cerebrospinal fluid index remission rate on the 14th day, mortality rate on the 30th day, and an evaluation of diagnostic efficacy. The two groups are predicted to comprise of 484 people in total. Discussion To optimize the roadmap of encephalitis/meningitis, precise diagnosis, and treatment are of great significance. The effect of rapid diagnosis undoubtedly depends on the progression of new diagnostic tests, such as the new multiplex PCR, mNGS, and examination of broad-spectrum autoimmune encephalitis antibodies. This randomized-controlled study could allow us to obtain an accurate atlas of the precise diagnostic ability of these tests and their effect on the treatment and prognosis of patients. Trial registration ClinicalTrial.gov, NCT04946682. Registered 29 June 2021, ‘Retrospectively registered’, https://clinicaltrials.gov/ct2/show/NCT04946682?term=NCT04946682&draw=2&rank=1

scholarly journals Evaluation and Comparison of Formocresol and Sodium Hypochlorite as Pulpotomy Medicaments in Treatment of Mandibular Primary Molars - A Randomized Controlled Study

2021 ◽  
Vol 6 (4) ◽  
pp. 105-110
Author(s):  
Nadia Irshad Wani ◽  
Navneet Kour ◽  
Manju Verma
Keyword(s):  
Sodium Hypochlorite ◽  
Primary Teeth ◽  
Main Idea ◽  
Permanent Teeth ◽  
Controlled Study ◽  
Primary Tooth ◽  
Second Molar ◽  
Randomized Controlled ◽  
Group I ◽  
Group Ii

Background: the main idea behind the pulpotomy of a primary tooth is to remove the infected or inflamed coronal pulp tissues and cover the pulp with a suitable medicament or dressing which promotes healing and preserve the vitality of the teeth especially in young permanent teeth. A medicament should be biologically compatible, have healing capabilities, should be non cytotoxic, or mutagenic and with no carcinogenic potential. Aim: the main aim of the study was to compare and evaluate the efficacy of commonly used two medicaments i.e. formocresol and sodium hypochlorite in pulpotomy of mandibular primary teeth. Material and methodology: a randomized controlled single blinded clinical trial was done on 50 subjects of age ranging from 3 to 6 years with bilateral mandibular first or second molar requiring pulpotomy. The subjects were randomly divided into two groups with 25 subjects in each. Group I, consisted of subjects on which formocresol medicament was used after extirpation of coronal pulp while in Group II, 3% sodium hypochlorite was used. Clinical along with the radiographic signs and symptoms were blindly recorded at an interval of 1, 3, 6 and 12 months respectively. Results: Statistically significant results were obtained in group II, when patients treated with 3% sodium hypochlorite. There was no major difference between the two medicaments used, but to the various adverse effects of formocresol, its usage has been limited. Conclusion: within the limitation of the study, it was concluded that sodium hypochlorite medicament proved to have better prognosis and can be suggested as a pulpotomy agent for primary teeth. Although formocresol was found to have similar significant results can also be used as a medicament. Keywords: Formocresol, Pulpotomy, Primary Teeth, Sodium Hypochlorite

Mitomycin C–Enhanced Revision Endoscopic Dacryocystorhinostomy

2012 ◽  
Vol 147 (5) ◽  
pp. 937-942 ◽  
Author(s):  
Sameh M. Ragab ◽  
Hossam S. Elsherif ◽  
Emad M. Shehata ◽  
Ahmed Younes ◽  
Ahmed M. Gamea
Keyword(s):  
Mitomycin C ◽  
Controlled Study ◽  
Safe Procedure ◽  
Endoscopic Dacryocystorhinostomy ◽  
Randomized Controlled ◽  
Group I ◽  
Significant Difference ◽  
Endoscopic Dcr ◽  
Causes Of Failure

Objectives (1) To conduct an adequately powered randomized controlled trial investigating the safety and efficacy of mitomycin C–enhanced revision endoscopic dacryocystorhinostomy (DCR) and (2) to analyze causes of failure after primary endoscopic DCR. Study Design A randomized controlled study. Setting General hospital. Subjects and Methods Seventy-six revision endoscopic DCRs were randomized into 2 groups: endoscopic DCR with mitomycin (group I), where 0.5 mg/mL mitomycin C was applied for 10 minutes, and endoscopic DCR without mitomycin (group II). Follow-up settings were done to document the patient’s subjective improvement, to judge ostium patency on irrigation, and to record any complications. Results Causes of failure in the original 92 patients included canalicular obstruction (14%), small misplaced bony window (43%), very small nasolacrimal stoma due to development of synechia (23%), and complete closure of nasolacrimal stoma with tough fibrous tissue (63%). There was no significant difference between the 2 groups in subjective and objective success rates and adverse events. Group I demonstrated a significantly longer operative time and a significantly lower number of debridement sessions (mean of 1.2 vs 1.9). Conclusions Recurrent nasolacrimal duct obstruction after primary endoscopic DCR is mainly due to reclosure of the nasolacrimal stoma with synechia and fashioning of the small misplaced bony window. Mitomycin C does not increase the success rate of revision endoscopic DCR. It is a safe procedure and may be of value only in patients inaccessible to strict follow-up because it induces a better healing profile in terms of mucosal recovery, wound healing, and less need for debridement sessions.

scholarly journals Are Synbiotics added to the Standard Therapy to eradicate Helicobacter pylori in Children Beneficial? A Randomized Controlled Study

2017 ◽  
Vol 7 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Banu N Şirvan ◽  
Merve K Usta ◽  
Nuray U Kızılkan ◽  
Nafiye Urgancı
Keyword(s):  
Helicobacter Pylori ◽  
Abdominal Pain ◽  
Triple Therapy ◽  
Standard Therapy ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Group I ◽  
Dyspeptic Symptoms ◽  
H Pylori

ABSTRACT Aim We aimed to evaluate the role of the addition of Bifidobacterium lactis-containing synbiotic to the triple therapy in the case of Helicobacter pylori eradication, the dyspeptic symptoms, and reducing the side effects of antibiotics. Materials and methods A total of 104 children aged between 5 and 17 years, who were histopathologically diagnosed with H. pylori were enrolled in this study, of whom 100 were included in the analysis. Patients were randomly classified into two groups. In the first group, 50 patients were administered amoxicillin + clarithromycin + lansoprazole for 14 days and B. lactis-containing synbiotic. In the second group, 50 patients were treated with the standard triple therapy. All patients were given information after completion of therapy. Results H. pylori eradication was achieved in 88% in group I who received standard therapy with additional synbiotic and 72% in group II (p = 0.046). The number of patients in the second group who suffered from abdominal pain between the 3rd and 14th day of the treatment was higher (p < 0.05). The addition of probiotics to the triple therapy significantly reduced the frequency of diarrhea, but no significant difference was detected in the frequency of metallic taste (p = 0.04, p = 0.418 respectively). Conclusion The addition of synbiotic to the triple therapy is effective for eradicating H. pylori infection in children and is usually helpful to reduce or eliminate dyspeptic symptoms like abdominal pain, diarrhea, and vomiting. This study suggest that improved tolerance to the eradication treatment also reduces the treatment failure by adding probiotics and encourages the future study using probiotic supplementation in H. pylori treatment. How to cite this article Şirvan BN, Usta MK, Kızılkan NU, Urgancı N. Are Synbiotics added to the Standard Therapy to eradicate Helicobacter Pylori in Children Beneficial? A Randomized Controlled Study. Euroasian J Hepato-Gastroenterol 2017;7(1):17-22.

Impact of multiplex PCR on antimicrobial treatment in febrile neutropenia: a randomized controlled study

2015 ◽  
Vol 204 (5) ◽  
pp. 585-592 ◽  
Author(s):  
Evgeny A. Idelevich ◽  
◽  
Gerda Silling ◽  
Yvonne Niederbracht ◽  
Hanna Penner ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Multiplex Pcr ◽  
Antimicrobial Treatment ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled

Comparison of pre-treatment with low -dose midazolam versus low- dose etomidate for prevention of etomidate induced myoclonus and pain at intubation - A randomized controlled study

2021 ◽  
Vol 19 (1) ◽  
pp. 21-26
Author(s):  
Neha Sharma ◽  
Keyword(s):  
Normal Saline ◽  
Severe Pain ◽  
Statistical Difference ◽  
Low Dose ◽  
Controlled Study ◽  
Group Iii ◽  
Randomized Controlled ◽  
Group I ◽  
Grade 3 ◽  
Group 1

Background: Etomidate a commonly used induction agent in anesthesia is associated with pain and episodes of myoclonus post induction. This study was designed to evaluate and compare Midazolam and low dose of Etomidate in prevention of these symptoms on injection. Methods: This prospective randomized controlled study was conducted on 90 patients allocated to three study groups. Group 1 patients received 0.015 mg/kg of Midazolam i/v diluted to 5 ml in normal saline, Group II received 0.03 mg/kg of Etomidate i/v diluted to 5 ml in normal saline and Group III received 5 ml normal saline intravenously as premedication. Five minutes after receiving the study drugs, patient was preoxygenated with 100% oxygen for 3 min along with anesthesia induction with 0.3 mg/kg etomidate injected intravenously over the period of 20-30 sec. The patients were observed for etomidate induced myoclonus and pain. Results: The incidence of myoclonus in Group II was least with 46.67% having no myoclonus as compared to group I and III where Majority of patients had grade 3 myoclonus (50%; Group I) and (46.67%; Group III). There was statistical difference between the groups in terms of myoclonus grading. Further, there was statistical difference between the groups in pain score with majority of group 1 patients having grade 3 (severe pain = 46.67%) pain and group 3 patients with 43.3% having severe pain. Group 2 on the contrary majorly reported no pain (46.6%). Conclusions: The current study indicated pre induction of etomidate in low dose as an effective strategy in prevention of EIM as compared to Midazolam.

scholarly journals AB1310-HPR EFFECTS OF INSTRUMENT-ASSISTED SOFT TISSUE MOBILIZATION ON FROZEN SHOULDER: A RANDOMIZED CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1945.2-1945
Author(s):  
E. Kaya Mutlu ◽  
T. Birinci ◽  
S. Kilic
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Frozen Shoulder ◽  
Controlled Study ◽  
Joint Mobilization ◽  
Randomized Controlled ◽  
Constant Murley Score ◽  
Group I ◽  
Group Ii ◽  
Soft Tissue Mobilization

Background:Frozen shoulder has a greater incidence, more severe course, and resistance to treatment in patients. Management is based on the underlying cause of pain and stiffness. Joint mobilization has been reported to improve joint range of motion in frozen shoulder. However, there is no information regarding the effect of instrument-assisted soft tissue mobilization (IASTM) in frozen shoulder. We proposed that there would be no significant difference between the two manual physical therapy techniques with relatively similar treatment effects in the frozen shoulder.Objectives:The aim of this randomized controlled study was to compare the effectiveness of IASTM and joint mobilization in the treatment of patients with frozen shoulder.Methods:Thirty patients with phase II frozen shoulder (mean age 50,9 years, age range 39–65 years) were randomly assigned to one of the two treatment groups: Group I received joint mobilization combined with manual stretching exercise and Group II received IASTM with manual stretching exercise (two days per week for six weeks) (Figure 1). The pain level was evaluated with a visual analogue scale (VAS) and the active range of motion (ROM) was measured with a universal goniometer. The Disabilities of the Arm, Shoulder and Hand score and the Constant-Murley score were used for functional assessment. The assessments were performed at baseline and after the 6-week intervention.Figure 1.Instrument-Assisted Soft Tissue MobilizationResults:Both groups had a significant decrease in pain according to VAS and a significant increase in ROM and function level (p<0.05). After the 6-week intervention, improvement of shoulder abduction ROM in Group I was found significantly higher than Group II (p=0.01), on the other hand, Constant-Murley score in Group II was found significantly higher compared to Group I (p=0,001).Conclusion:Our results supported the hypothesis that either joint mobilization or IASTM, performed in addition to stretching exercise, provided similar improvements in pain levels in patients with the frozen shoulder.References:[1]Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL, et al. Shoulder Pain and Mobility Deficits: Adhesive Capsulitis, J Orthop Sports Phys Ther, 2013:43:1-31.[2]Celik D, Kaya Mutlu E.Does AddingMobilization toStretchingImprove Outcomes for People with Frozen Shoulder? A Randomized Controlled Clinical Trial, Clin Rehab, 2016: 30(8): 786-794.[3]Iked N, Otsuka S, Kawanishi Y, Kawakami Y. Effects of Instrument-Assisted Soft Tissue Mobilization on Musculoskeletal Properties, Med Sci Sports Exerc, 2019:51(10): 2166-2172.Disclosure of Interests:None declared

The study of the effectiveness of actography in the risk group of placental dysfunction in the third trimester of pregnancy

2017 ◽  
pp. 107-110
Author(s):  
S.I. Zhuk ◽  
◽  
V.I. Oshovskiy ◽  
Ye.G. Solovey ◽  
◽  
...  
Keyword(s):  
Fetal Growth ◽  
Growth Retardation ◽  
Risk Group ◽  
Diagnostic Methods ◽  
Controlled Study ◽  
Fetal Growth Retardation ◽  
Placental Dysfunction ◽  
Group I ◽  
Fetal Movements ◽  
Evening Peak

The objective: was to compare the frequency of diagnosis of fetal pathological conditions in the risk group of placental dysfunction (PD) in the III trimester of pregnancy. Patients and methods. In a randomized controlled study, 240 pregnant women in the III trimester of pregnancy with risk factors for PD development participated. In group I (intervention group, n=115), instruction was given on the daily actography. Patients were advised to consider fetal movements after 28 weeks of pregnancy in the evening peak of emotional activity (from 20 to 22 hours) – at least 10 movements within 2 hours. In the absence of sufficient movements, it was recommended to record CTG in the morning peak of emotional activity (7–11 H). In the 2nd (control) group (n=125), the patients received standard prenatal care. Results. The features of the course of the III trimester, childbirth and the early postpartum period were analyzed. It was revealed that the calculation of fetal movements in the evening peak of emotional activity does not affect perinatal indices, however it allows to improve detection of fetal growth retardation and does not increase the use of medical resources. Conclusion. Increasing maternal awareness of the calculation of motor activity in the fetus ensures the optimization of antenatal monitoring. The correct application of the fetal counting technique will allow the use of additional diagnostic methods in the presence of alarm signals, which, in turn, may have economic feasibility for the healthcare system. Key words: actography, fetal monitoring, placental dysfunction, fetal growth retardation.

Role of lung ultrasound in the assessment of recruitment maneuvers in ventilated preterm neonates with respiratory distress syndrome and its correlation with tracheal IL-6 levels: A randomized controlled trial

2020 ◽  
pp. 1-6
Author(s):  
N.M.A. Shady ◽  
H.A.S. Awad ◽  
D.R. Kamel ◽  
E.M. Fouda ◽  
N.T. Ahmed ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Controlled Trial ◽  
Controlled Study ◽  
Preterm Neonates ◽  
Invasive Ventilation ◽  
Randomized Controlled ◽  
Group I

BACKGROUND: This study’s aim is to evaluate lung ultrasound (LUS) efficacy in detecting opening and closing lung pressures and its correlation with the tracheal interleukin 6 (IL-6) level. METHOD: This single-blinded randomized controlled study was done at Ain Shams University Children’s Hospital neonatal intensive care units, Egypt. It consists of 44 mechanically ventilated preterm neonates with Respiratory Distress Syndrome (RDS). Initial LUS assessment was done followed by randomization to one of 2 groups; group I: 22 patients underwent LUS guided RM and group II: 22 patients underwent non-ultrasound guided RM. Tracheal IL-6 level was measured before and after RM in both groups. RESULTS: The LUS scores showed a sensitivity of 86.7% , specificity of 62.10% and accuracy of 70.45% at the cut-off point >B1 grade. After RM, there was a higher percentage of changes in mean airway pressure (p = 0.03), FiO2 (p = 0.01), PaO2/FiO2 ratio (p = 0.01), and IL-6 (p <  0.01) in group I. The duration of oxygen requirement (6 vs.13.5 days, p = 0.01), invasive ventilation (3 vs.5.5 days, p = 0.03), non-invasive ventilation (2.5 vs. 5 days, p = 0.02) and NICU stay (21.5 vs. 42.5 days, p = 0.03) was less in group I. A positive correlation between reaeration score and the duration of O2 requirement (p = 0.002), duration of invasive ventilation (p = 0.001), NICU length of stay (p = 0.002) and negative correlation with PaO2/FiO2 ratio before RM (p = 0.012). The best cut-off point for the reaeration score is >21 with a sensitivity of 75% , specificity of 71.43% and area under the curve of 78.1% . CONCLUSION: LUS-guided RM achieved earlier lowest FiO2, shorter O2 dependency, lesser NICU stay and marked decrease in lung inflammation by decreasing atelectotrauma and shortening the duration of invasive ventilation.

scholarly journals In shoulder adhesive capsulitis, ultrasound-guided anterior hydrodilatation in rotator interval is more effective than posterior approach: a randomized controlled study

2020 ◽  
Author(s):  
Basant Elnady ◽  
Elsayed M. Rageh ◽  
Manal Shawky Hussein ◽  
Mohammed Hassan Abu-Zaid ◽  
Dalia El-Sayed Desouky ◽  
...  
Keyword(s):  
Posterior Approach ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Controlled Study ◽  
Rotator Interval ◽  
Ultrasound Guided ◽  
Randomized Controlled ◽  
Group I ◽  
Interval Approach ◽  
Group Ii

Abstract Shoulder adhesive capsulitis, also called frozen shoulder, is a musculoskeletal disorder associated with pain and functional disability. This study aimed to compare the effectiveness of shoulder ultrasound-guided hydrodilatation with corticosteroid, via rotator interval (RI) anteriorly, versus posterior approach, in adhesive capsulitis patients. All patients received exercise program following injection. Patients and methods A prospective randomized controlled study among 60 consecutive adhesive capsulitis patients was randomized into two equal groups. Group I received ultrasound-guided hydrodilatation with corticosteroid, saline, and local anesthetic via posterior intra-articular approach; group II received the same ultrasound-guided hydrodilatation via anterior rotator interval approach. Both groups received guided stretching exercises for 3 months after injection. Baseline and 3 months evaluation of pain by visual analogue scale (VAS), shoulder pain and disability index (SPADI), and range of motion (ROM) had been recorded for all patients. Results Both groups showed significant improvement 3 months after hydrodilatation regarding VAS pain, external rotation, and SPADI. Only in group II (RI anterior approach) improvement was observed regarding flexion and abduction. There was no improvement regarding extension or internal rotation in either group. When comparing the improvement in both groups after hydrodilatation, group II (anterior approach) showed a statistically significant higher level of improvement regarding VAS pain (p = 0.003), SPADI, flexion, abduction, and external rotation, compared to group I (p < 0.001). Extension, internal rotation, and adduction were not different. Conclusions Ultrasound-guided anterior rotator interval hydrodilatation for adhesive capsulitis, followed by guided exercise, is clinically and functionally more effective than the conventional posterior approach. Key Points• Ultrasound-guided hydrodilatation (with prednisolone acetate (40 mg), 1 ml of 2% lidocaine, and 15 ml saline) for adhesive capsulitis followed by guided exercise is clinically and functionally effective.• The ultrasound-guided anterior rotator interval approach is clinically and functionally significantly more effective than the conventional intra-articular posterior approach as it targets mainly the area of pathology.• This is the first prospective study comparing the effect of the anterior rotator interval approach versus the posterior approach in ultrasound-guided hydrodilatation in adhesive capsulitis patients.

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