scholarly journals Comparison of current and emerging strategies for treating hepatic encephalopathy.

2021 ◽  
Vol 28 (12) ◽  
pp. 1705-1710
Author(s):  
Sadia Rehman ◽  
Qurat Ul Ain Fatima ◽  
Suniya Rehman ◽  
Zara Sami ◽  
Hasan Ali ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Group Treatment ◽  
Controlled Trial ◽  
Safety Margin ◽  
P Value ◽  
Group Efficacy ◽  
Randomized Controlled ◽  
Trust Hospital ◽  
Cirrhotic Patients ◽  
Trial Setting

Objective: To compare the efficacy of rifaximin and metronidazole which are the most commonly used antibiotics used in treating this disorder. Study Design: Randomized Controlled Trial. Setting: Department of Medicine, Sharif Trust Hospital. Period: Jan 2018 to July 2018. Material & Methods: In this study cirrhotic patients irrespective of etiology were enrolled. West Haven Criteria (WHC) was utilized for grading the symptoms of HE at baseline and after 7 days of treatment. The study subjects were further subdivided into two groups: rifa group and metro group, and were given rifaximin and metronidazole respectively along with lactulose. The efficacy of the treatment and adverse effects in both the groups were estimated. Results: Total 180 subjects with HE (grade- III or IV) were selected, 90 subjects were subdivided into each group. Out of 90 subjects of Rifa group, efficacy of treatment was noted in 14 (15%) patients and out of 90 subjects of Metro Group, treatment was found effective in 45 (50%) patients with p value of 0.0001. Conclusion: The conclusion of this study is that metronidazole is superior to rifaximin in terms of efficacy in the management of an acute phase of hepatic encephalopathy due to chronic liver cirrhosis. Hence, due to its cheaper cost and a good safety margin its use is recommend in poor resource settings.

scholarly journals A pilot randomized controlled trial of a tailored smoking cessation program for people living with HIV in the Washington, D.C. metropolitan area

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Elexis C. Kierstead ◽  
Emily Harvey ◽  
Denisse Sanchez ◽  
Kimberly Horn ◽  
Lorien C. Abroms ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Self Efficacy ◽  
Text Messaging ◽  
Controlled Trial ◽  
P Value ◽  
People Living With Hiv ◽  
Randomized Controlled ◽  
Living With Hiv ◽  
Pilot Randomized Controlled Trial

Abstract Objective Morbidity and mortality from smoking-related diseases among people living with HIV (PLWH) in the U.S. surpasses that due to HIV itself. Conventional smoking cessation treatments have not demonstrated strong efficacy among PLWH. We conducted a pilot randomized controlled trial (RCT) to evaluate a tailored smoking cessation intervention based on the minority stress model. We compared standard of care counseling (SOC) to a tailored intervention (TI) including one face-to-face counseling session incorporating cognitive behavioral therapy to build resilience, and 30 days of 2-way text messaging. Results The primary outcome was smoking cessation. Secondary outcomes included cigarettes per day (CPD), exhaled carbon monoxide (CO), and cessation self-efficacy. A total of 25 participants were enrolled (TI:11, SOC:14), and 2 were lost to follow-up. There were no significant differences in quit rates between study groups. However, there was a significantly greater decrease in CPD in the TI versus SOC (13.5 vs. 0.0, p-value:0.036). Additionally, self-efficacy increased in both groups (TI p-value:0.012, SOC p-value:0.049) and CO decreased in both groups (TI p-value: < 0.001, SOC p-value:0.049). This intervention shows promise to support smoking cessation among PLWH. A larger study is needed to fully evaluate the efficacy of this approach. Clinical trial: Trial Registration: Retrospectively registered (10/20/2020) NCT04594109.

scholarly journals A Randomized Controlled Trial Evaluating Integrative Psychotherapeutic Group Treatment Compared to Self-Help Groups in Functional Vertigo/Dizziness

2021 ◽  
Vol 10 (10) ◽  
pp. 2215
Author(s):  
Karina Limburg ◽  
Katharina Radziej ◽  
Heribert Sattel ◽  
Peter Henningsen ◽  
Marianne Dieterich ◽  
...  
Keyword(s):  
Group Treatment ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Controlled Trial ◽  
Clinical Psychologist ◽  
Control Group ◽  
Attrition Rates ◽  
Randomized Controlled ◽  
Self Help ◽  
Self Help Groups

We tested the efficacy of an integrative psychotherapeutic group treatment (IPGT) in reducing vertigo/dizziness-related impairment along with depression, anxiety, and somatization by conducting a randomized controlled superiority trial comparing IPGT to self-help groups moderated by a clinical psychologist (SHG). Adult patients with functional vertigo and dizziness symptoms were randomly allocated to either the IPGT or SHG as active control group. Outcomes were assessed at baseline (t0), after treatment lasting 16 weeks (t1), and 12 months after treatment (t2). A total of 81 patients were assigned to IPGT and 78 patients were assigned to SHG. Vertigo-related impairment was reduced in both conditions (IPGT: t0–t1: d = 1.10, t0–t2: d = 1.06; SHG: t0–t1: d = 0.86, t0–t2: d = 1.29), showing the efficiency of both IPGT and SHG. Clinically relevant improvements were also obtained for depression in both groups. Linear mixed model analyses revealed no differences between groups for all outcomes (effect of group for the primary outcome: b = −1.15, SE = 2.13, t = −0.54, p = 0.59). Attrition rates were higher in SHG (52.6%) than in IPGT (28.4%). Both conditions improved primary and secondary outcomes while IPGT was better accepted by patients than SHG. Trial registration: ClinicalTrials.gov, Identifier: NCT02320851.

Comparative Study on Vit. E & Mefenamic acid vs Mefenamic acid alone on mean reduction in pain in Primary Dysmenorrhea

2021 ◽  
Vol 15 (12) ◽  
pp. 3195-3197
Author(s):  
Fariha Sadiqa ◽  
Mufakhara Fatimah ◽  
Abdul Mudabbir Rehan ◽  
Sidra Mushtaq ◽  
Asia Firdous ◽  
...  
Keyword(s):  
Vitamin E ◽  
Mefenamic Acid ◽  
Controlled Trial ◽  
Acid Group ◽  
P Value ◽  
Primary Dysmenorrhea ◽  
High Concentration ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Menstrual Fluid

Background: Pelvic pain around the time of mensturation without any identifiable pathologic lesion present from menarche is called primary dysmenorrhea. The pain is believed to be related to prostaglandin (PG). Women with dysmenorrhoea have a relatively high concentration of PGF 2 alpha in menstrual fluid and suppression of PG synthesis has become the main treatment. Aim: To compare mean reduction in pain in patients presenting with primary dysmenorrhea given vitamin E & Mefenamic acid versus Mefenamic acid alone. Results: It was a randomized controlled trial which was conducted in Department of Obstetrics & Gynecology, THQ Raiwind Hospital, Lahore for 6 months duration w.e.f 01/02/2017 to 31/07/2017. In this study, 18(36%) in Vitamin-E group and 21(42%) in Mefenamic acid group were between 15-20 years while 32(64%) in Vitamin-E group and 29(58%) in Mefenamic acid group were between 21-25 years, mean±sd was calculated as 20.86±2.92 and 20.66±2.86 years respectively, mean dysmenorrheal pain at baseline was recorded as 50.06±10.27 in Vitamin-E group and 50.14±10.28 in Mefenamic acid group, p value < 0.754, showing that both groups are insignificant, mean dysmenorrheal pain after treatment was recorded as 20.50±10.04 in Vitamin-E group and 30.22±10.28 in Mefenamic acid group, p value was < 0.002 showing significant difference between the two group, comparison of mean reduction in dysmenorrheal pain after treatment was recorded as 20.56±0.91 in Vitamin-E group and 10.92±0.75 in Mefenamic acid group, p value was < 0.000, showing significant difference. Conclusion: We concluded that there is a significant mean reduction in dysmenorrhic pain in patients given Mefenamic Acid + Vitamen E as compared to patients given Mefenamic Acid alone. Keywords: Dysmenorrhic pain, Mefenamic Acid + Vitamen E, mean reduction in dysmenorrhic pain

PRECIPITATING FACTORS AND EFFICACY OF COMBINING LACTULOSE PLUS RIFAXIMIN IN THE TREATMENT OF HEPATIC ENCEPHALOPATHY DUE TO CIRRHOSIS AT CHO RAY HOSPITAL

2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastrointestinal Bleeding ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
P Value ◽  
Precipitating Factors ◽  
Overt Hepatic Encephalopathy ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin

Effect of a Novel Thermostatic Device on Meibomian Gland Dysfunction: A Randomized Controlled Trial in Chinese Patients

2021 ◽  
Author(s):  
Siyuan Li ◽  
Ke Yang ◽  
Jingyi Wang ◽  
Shang Li ◽  
Lei Zhu ◽  
...  
Keyword(s):  
Group Treatment ◽  
Controlled Trial ◽  
Anterior Segment ◽  
Meibomian Gland ◽  
Chinese Patients ◽  
Meibomian Gland Dysfunction ◽  
Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Meibomian Glands ◽  
Thermostatic Device

Abstract BackgroundAs a chronic disease, meibomian gland dysfunction (MGD) which causes excessive evaporation of tears by changing the tear film composition, is considered a leading cause of dry eye. Although a variety of physical therapy equipment, there is currently no economical and effective treatment for MGD. The aim of this study was to evaluate the effectiveness and safety of the MiBoFlo Thermoflo® (Mibo Medical, Dallas, TX, USA), a new thermostatic device, on both objective symptoms and subjective signs in Chinese MGD patients.MethodsThis was a prospective, randomized, controlled clinical trial. 108 eyes of 54 MGD patients in Beijing Tongren Hospital were recruited and randomized 1:1 to MiBoFlo (n = 54 eyes) or LipiFlow® (TearScience, Morrisville, NC, USA) (n = 54 eyes) treatment group. In the MiBoFlo group, treatment for each eye took 10 minutes and proceeded every two weeks for a total of three times. Patients in the LipiFlow group received a single 12-minute treatment. Main Outcome Measures: The primary outcomes include changes in Ocular Surface Disease Index (OSDI) score, Meibomian Glands Yielding Liquid Secretion (MGYLS) score and Meibomian Glands Secretion (MGS) score from baseline to 2 months. The secondary outcomes include Tear Meniscus Height (TMH), Non-invasive Keratograph Break-up Time (NIKBUT), Corneal Fluorescein Staining (CFS) and Meibomian Glands (MG) loss from baseline to 2 months. Safety outcomes include visual acuity (VA), intraocular pressure (IOP), anterior segment and facial skin.ResultsThe OSDI score, MGYLS score and MGS score all improved from baseline to 1 month in both MiBoFlo and LipiFlow group, and these improvements were maintained at 2 months. CFS score, NIKBUT and MG loss had no significant change in both groups. CFS score improvement in MiBoFlo group were significantly more obvious than in LipiFlow group in the follow-up visit (p<0.01).ConclusionAs a portable and comfortable device, MiBoFlo treatment can offer an advancement for the treatment of MGD and a course of treatment results in at least two months of sustained improvement in both symptoms and meibomain gland function.

scholarly journals Social cognitive group treatment for impaired insight in psychosis: A multicenter randomized controlled trial

2019 ◽  
Vol 206 ◽  
pp. 362-369 ◽  
Author(s):  
G.H.M. Pijnenborg ◽  
A.E. de Vos ◽  
M.E. Timmerman ◽  
M. Van der Gaag ◽  
B.E. Sportel ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Group Treatment ◽  
Social Cognitive ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial
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