Comparison of three interventional approaches to prevent ventilator-associated pneumonia in intensive care units (ICUs): A clinical trial study

Background: Ventilator-associated pneumonia (VAP) is an infectious pulmonary disease that develops after 48 hours of ventilation. To date, several methods have been proposed to reduce VAP occurrence, such as the VAP prevention bundle, which involves raising the head of the bed, reducing sedation, avoiding deep vein thrombosis, and preventing peptic ulcer in the gastrointestinal system. The purpose of this study was to evaluate the role of personnel in hand washing, case airway suctioning, and systematic monitoring in the prevention of VAP. Methods: In the current clinical trial, 129 patients hospitalized and intubated at Vali-e-Asr Hospital ICU in Arak, Iran, were included in the study and randomized to one of the three VAP prevention methods: group A, VAP prevention bundle measures; group B, group A measures plus washing of patients’ mouth with 0.12% chlorhexidine and suction of secretion every six hours; and finally group C, group B measures plus 72-hour suction package. Demographic information, VAP diagnosis, and outcome of each patient were recorded in the special checklist. Results: The age of the patients ranged from 18 years to 93 years with a mean of 54.6 ± 21.8 years. There was no significant difference in age, sex, Clinical Pulmonary Infection Score (CPIS), and Glasgow Coma Scale (GCS) between the three groups. However, there is a significant relationship between chest X-ray (CXR) index and pneumonia in the three groups (p < 0.05). The prevalence of pneumonia is generally seen to be higher in patients who were local, diffuse, or patchy than those who had no infiltration (p < 0.05). Conclusion: This study showed that the application of VAP prevention bundle measures, mouthwash with chlorhexidine, personnel hand washing, airway suctioning, and systematic monitoring is an efficient approach to the prevention of VAP in ICUs.

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Graft and patient survival in portal vein thrombosis in living donor liver transplantation

QJM ◽

10.1093/qjmed/hcaa050.070 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A M Ramadan ◽

N M Hytham ◽

K K Mamdouh ◽

A M Fathy

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Lower Survival Rate ◽

Donor Liver Transplantation ◽

Vein Thrombosis ◽

Life Saving ◽

Significant Difference ◽

Group A ◽

Group B ◽

Stay Hospital

Abstract Background and Rational To date, only few studies have evaluated the benefits of anticoagulation in individuals with cirrhosis. An obvious goal of anticoagulation is PV recanalization: when cirrhotic individuals with PVT are treated with anticoagulation, complete recanalization has been described in 33–45% while partial PV recanalization is observed in 15–35% of cases. LDLT has emerged as the alternative life-saving treatment to DDLT. Over the past 2 decades, the number of LDLTs has steadily increased in many transplant centers, especially in Asia. The separation between occlusive and non-occlusive thrombosis is very important; in patients with partial PVT, post-transplant mortality outcomes are no different from non-PVT patients but it is significantly increased in patients with complete PVT. Patients and Methods This randomized prospective study will include 79 patients who will undergo LDLT in Ain Shams Specialized and Egypt Air hospitals, there are two groups of patients according to presence of portal vein thrombosis or not group A 39 patients of non PVT and group B 40 patient of PVT including different grades of PVT according Yerdel classification. Results In this study, there is no significant difference between groups regard age but Males were significantly associated with group B. In this study, there is no significant difference between groups regard CHILD and MELD scores and this findings. In our study there is no significantly difference between groups A and B regarding ICU stay, hospital stay and cell saver. In this study, comparisons of the PVT patients and controls showed no statistical significant differences regard HA thrombosis, post operative pulmonary embolism and biliary leak but PV rethrombosis is significantly associated with PVT patients, mortality sig associated with PVT patients. Conclusion The outcomes of patients with PVT who underwent LDLT are inferior to those without PVT. Patients with PVT has lower survival rate, higher postoperative PV rethrombosis.

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Esthetic and Clinical Performance of Implant-Supported All-Ceramic Crowns Made with Prefabricated or CAD/CAM Zirconia Abutments: A Randomized, Multicenter Clinical Trial

Journal of Dental Research ◽

10.1177/0022034516681767 ◽

2016 ◽

Vol 96 (2) ◽

pp. 163-170 ◽

Cited By ~ 31

Author(s):

J.G. Wittneben ◽

J. Gavric ◽

U.C. Belser ◽

M.M. Bornstein ◽

T. Joda ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Performance ◽

Multicenter Clinical Trial ◽

Anterior Maxilla ◽

Single Crown ◽

Significant Difference ◽

All Ceramic ◽

Cad Cam ◽

Group A ◽

Group B

Patients’ esthetic expectations are increasing, and the options of the prosthetic pathways are currently evolving. The objective of this randomized multicenter clinical trial was to assess and compare the esthetic outcome and clinical performance of anterior maxillary all-ceramic implant crowns (ICs) based either on prefabricated zirconia abutments veneered with pressed ceramics or on CAD/CAM zirconia abutments veneered with hand buildup technique. The null hypothesis was that there is no statistically significant difference between the 2 groups. Forty implants were inserted in sites 14 to 24 (FDI) in 40 patients in 2 centers, the Universities of Bern and Geneva, Switzerland. After final impression, 20 patients were randomized into group A, restored with a 1-piece screw-retained single crown made of a prefabricated zirconia abutment with pressed ceramic as the veneering material using the cut-back technique, or group B using an individualized CAD/CAM zirconia abutment (CARES abutment; Institut Straumann AG) with a hand buildup technique. At baseline, 6 mo, and 1 y clinical, esthetic and radiographic parameters were assessed. Group A exhibited 1 dropout patient and 1 failure, resulting in a survival rate of 94.7% after 1 y, in comparison to 100% for group B. No other complications occurred. Clinical parameters presented stable and healthy peri-implant soft tissues. Overall, no or only minimal crestal bone changes were observed with a mean DIB (distance from the implant shoulder to the first bone-to-implant contact) of −0.15 mm (group A) and 0.12 mm (group B) at 1 y. There were no significant differences at baseline, 6 mo, and 1 y for DIB values between the 2 groups. Pink esthetic score (PES) and white esthetic score (WES) values at all 3 examinations indicated stability over time for both groups and pleasing esthetic outcomes. Both implant-supported prosthetic pathways represent a valuable treatment option for the restoration of single ICs in the anterior maxilla ( ClinicalTrials.gov NCT02905838).

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Comparing the effectiveness of mulligan mobilization versus cyriax approach in the management of patients with subacute lateral epicondylitis

Journal of the Pakistan Medical Association ◽

10.47391/jpma.399 ◽

2020 ◽

pp. 1-11

Author(s):

Aqeel Ahmed ◽

Muhammad Ibrar ◽

Aatik Arsh ◽

Sonia Wali ◽

Shoukat Hayat ◽

...

Keyword(s):

Clinical Trial ◽

Functional Disability ◽

Tennis Elbow ◽

Lateral Epicondylitis ◽

Evaluation Index ◽

Pain Subscale ◽

Significant Difference ◽

Group A ◽

Physical Tests ◽

Group B

Abstract Objective: To determine the effectiveness of Mulligan mobilisation versus Cyriax approach in the management of patients with subacute lateral epicondylitis. Methods: The clinical trial was conducted at the District Headquarter Hospital, Bahawalnagar, Pakistan, from September to December 2018, and comprised lateral epicondylitis patients having symptoms for >2 weeks. The diagnosis was confirmed on the basis of physical tests and musculoskeletal ultrasound. The subjects were randomly allocated to two equal groups A and B. Group A received deep transverse friction and Mill’s manipulation according to Cyriax approach, while group B received Mulligan mobilisation with movement techniques. Patient-related tennis elbow evaluation index was used to collect data which was analysed using SPSS 20. Results: Of the 60 patients, there were 30(50%) in each of the two groups. The overall mean age was 35.27±7.30 years, and 38(63.3%) participants were male. After 4 weeks of treatment sessions, both groups showed significant improvements (p<0.05) in pain and functional disability scores. Group A showed significantly more improvement (p<0.05) in pain subscale scores compared to group B, while group B showed significant improvement (p<0.05) in functional disability subscale scores compared to group A. There was no significant difference (p>0.05) between the groups on total the patient-related tennis elbow evaluation index score. Conclusion: Both Mulligan mobilisation with movement and Cyriax approach decreased pain and improved functional status in lateral epicondylitis patients. Key Words: Elbow, Lateral epicondylitis, Massage, Mobilisation, Physiotherapy. Continuous..,

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LAND BASED EXERCISES VERSUS POOL BASED EXERCISES FOR SWIMMER’S SHOULDER IN COMPETITIVE SWIMMERS: RANDOMIZED CLINICAL TRIAL

Journal of medical pharmaceutical and allied sciences ◽

10.22270/jmpas.v10i4.1305 ◽

2021 ◽

Vol 10 (4) ◽

pp. 3296-3299

Author(s):

Waqar M. Naqvi

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Shoulder Pain ◽

Pain Disability Index ◽

Pain Disability ◽

Significant Difference ◽

Shoulder Strength ◽

Group A ◽

Group B ◽

Competitive Swimmers

To compare the effect of Land based exercises and Pool based exercises for shoulder strength to reduce shoulder pain in competitive swimmers using Shoulder Pain Disability Index (SPADI) score, Hand-Held dynamometer (HHD), Randomized Clinical trial.29 competitive swimmers with age group between 8 to 18 years were evaluated for shoulder pain using Shoulder Pain Disability Index Score [SPADI] and shoulder strength was evaluated using Hand Held Dynamometer [HHD] before and after the study. Then all the subjects were divided into 2 groups, for Group A Pool based exercises were given and for Group B Land based exercises were given. Statistically there is significant difference in values of outcome measures after the study in both groups but there is more significant difference in Group A than Group B. Pool based exercises showed more significant effect on shoulder pain than land based exercises in swimmer’s shoulder.

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Efficacy of Locally Administered 1.2% Rosuvastatin Gel in Patients with Periodontitis: A Randomized Placebo Controlled Clinical Trial

European Journal of Dentistry ◽

10.1055/s-0039-1688522 ◽

2019 ◽

Vol 13 (01) ◽

pp. 029-035 ◽

Cited By ~ 1

Author(s):

Debopriya Chatterjee ◽

Anjali Kapoor ◽

Sharmistha Vijay ◽

Geetika Sobti ◽

Dheeraj Kara ◽

...

Keyword(s):

Clinical Trial ◽

Phase 1 ◽

Colony Count ◽

Controlled Clinical Trial ◽

Clinical Parameters ◽

Pharmacological Agents ◽

Intergroup Comparison ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Objective Periodontitis initiation and progression are a result of host immune inflammatory response to oral pathogens. Several pharmacological agents are being delivered locally, to improve periodontal health. Hence, the present randomized placebo controlled clinical trial is designed to check the clinical and antimicrobial efficacy of locally delivered 1.2% rosuvastatin (RSV) in intrabony defects (IBD) in periodontitis patients. Materials and Methods One-hundred patients were randomly allotted into two treatment groups: group A received 1. 2% RSV gel, scaling and root debridement and group B received placebo gel, scaling and root debridement. Clinical parameters, including modified sulcus bleeding index (mSBI), probing depth (PD), clinical attachment level (CAL), and plaque index (PI), were recorded at baseline before phase 1 and after 6 months. Radiographic assessment of IBD was done by cone beam computed tomography at baseline and after 6 months. Anaerobic colony count was done at baseline and after 180 days. Results On intragroup comparison, there is a significant improvement in periodontal parameters in both the groups. On intergroup comparison, there is significant gain in CAL in group A than group B (p = 0.04). There is significant decrease in PD in group A, compared to group B. There is significant bone fill in group A (p = 0.034), compared to group B. With respect to mSBI, PI, and anaerobic colony count, there is no significant difference between the two groups after 6 months. No adverse effect was noticed in any subjects. Conclusion The author concludes that 1.2% RSV gel when delivered locally into IBD improved periodontal clinical parameters such as PD and CAL and showed significant bone fill.

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Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

Journal of University of Shanghai for Science and Technology ◽

10.51201/jusst/21/05166 ◽

2021 ◽

Vol 23 (05) ◽

pp. 421-432

Author(s):

Dr. Mohammad Kheiri Mahmod ◽

◽

Dr. Bashar Naser Hussein ◽

Dr. Ammar Hamid Hanoosh ◽

◽

...

Keyword(s):

Clinical Trial ◽

Laparoscopic Cholecystectomy ◽

Postoperative Pain ◽

Analgesic Effect ◽

Analgesic Requirement ◽

Pain Scores ◽

Post Operative Pain ◽

Significant Difference ◽

Group A ◽

Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

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Evaluation of the effect of three supplementary oral hygiene measures on salivary mutans streptococci levels in children: A randomized comparative clinical trial

European Journal of Dentistry ◽

10.4103/1305-7456.172616 ◽

2015 ◽

Vol 09 (04) ◽

pp. 462-469 ◽

Cited By ~ 1

Author(s):

M. Manju ◽

P. Prathyusha ◽

Elizabeth Joseph ◽

Rupali Borkar Kaul ◽

Srinivas L. Shanthraj ◽

...

Keyword(s):

Clinical Trial ◽

Oral Hygiene ◽

Oral Care ◽

Total Sample ◽

Mutans Streptococci ◽

Signed Rank ◽

Hygiene Measures ◽

Significant Difference ◽

Group A ◽

Group B

ABSTRACT Objective: The aim of this study was to evaluate and compare the effect of tongue scraping, tongue brushing, and saturated saline on salivary MS levels. Materials and Methods: A single-blinded, randomized, parallel group clinical trial was conducted in children aged 9–12 years. Total sample of 45 subjects were randomly assigned to three groups, that is, Group A, Group B, and Group C comprised of 15 each. Group A, Group B, and Group C were asked to do tongue scraping, tongue brushing and saturated saline rinsing twice daily, respectively for 21 days. Saliva samples, collected from the subjects on the baseline, 7th day and 21st day, were inoculated on mitis salivarius bacitracin agar and incubated at 37°C for 48 h. The mean streptococcal colony forming counts were enumerated. The data were subjected to statistical analysis using Wilcoxon signed rank sum test for intragroup comparisons and Mann–Whitney U-test for intergroup comparisons. Results: Intragroup comparisons showed statistically significant reduction in MS levels (P < 0.01). However, the intergroup comparisons showed no statistically significant difference (P > 0.05). Conclusion: The oral hygiene measures evaluated proved equal efficacy in reducing the colony counts. Hence, there is a need to emphasize the importance of incorporating supplementary oral hygiene measures in daily oral care.

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The Effect of Oral Administration of Pistacia Atlantica Kurdica Gum on the Eradication of Helicobacter Pylori in Patients with Dyspepsia: A Randomized Clinical Trial

Global Journal of Health Science ◽

10.5539/gjhs.v9n2p256 ◽

2016 ◽

Vol 9 (2) ◽

pp. 256 ◽

Cited By ~ 1

Author(s):

Hamidollah Afrasiabian ◽

Mohammad Hadi Imanieh ◽

Mohammad Ali Nejati ◽

Alireza Salehi

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Demographic Situation ◽

Significant Difference ◽

Before And After ◽

Group A ◽

H Pylori ◽

Group B ◽

Group D ◽

Common Infections

H. pylori infection is one of the most common infections in the world so that the aim of this study was to evaluate the antimicrobial P. Atlantica Kurdica gum in the eradication of H. pylori. This study is a randomized clinical trial; Patients with positive Urea Breath Test and symptoms of dyspepsia were entered. Patients were randomly divided into four groups. Group A: three drugs including 500 mg of Amoxicillin twice a day (bd), Clarithromycin 500 mg bd and Omeprazole 20 mg (bd) and Group B: Group A drugs plus the capsule containing 1 g of powdered P. Atlantica Kurdica gum (bd). In Group C: the capsule containing 1 g of powdered P. Atlantica Kurdica gum (bd) and Group D: this group took placebo-containing capsule (bd) for 14 days respectively. Dyspeptic symptoms before and after healing period and the UBT results two days before the start of treatment and 30 days after the completion were compared in 4 groups. Patients were not statistically significant difference from each other in the four groups regarding the demographic situation. Moreover, H. pylori eradication rate was 19/24 in Group A, 18/24 in Group B, 10/23 in Group C and 2/24 in Group D. Relieving symptoms of dyspepsia in Groups B and C were significantly higher than in Group D (P=0.025 and p=0.006 respectively). P. Atlantica Kurdica significantly led to the treatment of dyspepsia symptoms and H. pylori eradication.

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COMPARATIVE EVALUATION OF THE EFFICACY OF 4% MANGOSTEEN GEL AND 1% CHLORHEXIDINE DIGLUCONATE GEL IN MANAGEMENT OF PATIENTS WITH CHRONIC GINGIVITIS: A RANDOMIZED CLINICAL TRIAL

International Journal of Research in Ayurveda and Pharmacy ◽

10.7897/2277-4343.1206161 ◽

2022 ◽

Vol 12 (6) ◽

pp. 6-11

Author(s):

Vinayaka A.M. ◽

Gayathri G.V. ◽

Triveni M.G.

Keyword(s):

Clinical Trial ◽

Plaque Index ◽

Age Group ◽

Chlorhexidine Digluconate ◽

Gingival Index ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B

To clinically evaluate & compare the efficacy of 4% Mangosteen Gel and 1% chlorhexidine digluconate gel in managing patients with chronic gingivitis. Materials and Methods: A total of 50 patients with an age group of 20-45 years diagnosed with generalized plaque-induced gingivitis were selected for this clinical trial once attaining their informed consent. A thorough case history was chronicled comprising plaque index (P.I.), gingival index (G.I.) and Sulcus bleeding index (SBI) at baseline; then full-mouth scaling and polishing (SAP) was performed by a solitary attuned examiner. Patients were then randomly assigned into two groups using a computer-generated random numbering sequence system. Patients in group A received 4% Mangosteen Gel, and group B received 1% chlorhexidine digluconate gel for home application. The post-treatment follow-up examination for P.I., G.I. and SBI changes were assessed after 14 days and 21 days and compared with baseline data. Results: In both the groups, the mean plaque index, gingival index and sulcus bleeding index scores were significantly decreased after the 14th and 21st day compared to baseline scores. There was no significant difference between the groups, but only in group B, there was a substantial difference in SBI scores observed on day 21. Conclusion: 4% Mangosteen Gel and 1% chlorhexidine digluconate gel were clinically effective when used as an adjunct to SAP in managing patients with gingivitis. Hence, 4% Mangosteen Gel can be considered an alternative to 1% chlorhexidine digluconate gel without any side effects in managing generalized plaque-induced gingivitis.

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Efficacy of 0.05% cyclosporine A on the lipid layer and meibomian glands after cataract surgery: A randomized, double-masked study

PLoS ONE ◽

10.1371/journal.pone.0245329 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245329

Author(s):

Min Seung Kang ◽

Jonghoon Shin ◽

Jeong Min Kwon ◽

Jin Huh ◽

Ji Eun Lee

Keyword(s):

Clinical Trial ◽

Cataract Surgery ◽

Cyclosporine A ◽

Ocular Surface ◽

Lipid Layer ◽

Significant Difference ◽

Group A ◽

Meibomian Glands ◽

Group B

Purpose To quantitatively evaluate the effects of 0.05% cyclosporine A (CsA) on lipid layer thickness (LLT) and meibomian glands after cataract surgery using the LipiView® ocular surface interferometer. Methods This study was a prospective randomized double-masked clinical trial conducted by Pusan National University Yangsan Hospital between April 04, 2019, and November 31, 2019. Sixty-two participants were recruited, and 12 of them were not enrolled because they had undergone previous treatments for ocular surface diseases. The participants were adult patients with cataract, exhibiting normal lid position; they did not present any other ocular disease and did not meet the exclusion criteria of the clinical trial. Fifty subjects were enrolled in the study. The randomized subjects received treatment with 0.05% CsA (group A) or 0.5% carboxymethyl cellulose (CMC) (group B) over the 3 months following the cataract surgery. Subjective and objective assessments were performed at preoperative and postoperative visits. Ocular Surface Disease Index (OSDI), tear breakup time (TBUT), and Schirmer’s I test were performed by the same surgeon, and LLT and meiboscore were determined using the LipiView® interferometer. Results Fifty subjects subjects enrolled consisted of men (50%) and women (50%), with a mean (SD) age of 65.94 (10.35) years. Four subjects in group A and five in group B were excluded from the analysis as they were lost to follow-up within 1 month after cataract surgery. Thus, the study comprised 41 eyes of 41 subjects; 21 subjects were treated with CsA and 20 subjects with CMC. Comparing the clinical measurements between groups A and B taken at the last visit, while controlling the effects of the preoperative values, TBUT and LLT showed significant differences (p = 0.035 and p = 0.047, respectively, by ANCOVA). The TBUT between the subjects using CsA and those using CMC after cataract surgery showed a significant difference during follow up (p = 0.003 by repeated measures ANOVA). In the multivariate analysis, preoperative LLT and the use of CsA were found to be independent parameters for postoperative LLT (R2 = 0.303; p = 0.008 and p = 0.045, respectively), whereas the follow-up duration exhibited a positive correlation with the difference between the preoperative and postoperative values of LLT in the group treated with CsA (R2 = 0.738 and p < 0.001). Conclusion Treatment with 0.05% CsA following cataract surgery is effective in improving TBUT and LLT in comparison with 0.5% CMC. A higher preoperative value of LLT and the postoperative use of CsA could be significant determinants of a higher postoperative LLT value. Trial registration ISRCTN registry with ISRCTN 10173448.

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