scholarly journals CLINICAL EFFICACY OF ARDHAMATRIKA BASTI IN GRIDHRASI

2022 ◽  
Vol 12 (6) ◽  
pp. 50-55
Author(s):  
Aiyanna PP ◽  
Vishnu Prasad V ◽  
Pradeep JM
Keyword(s):  
Clinical Trial ◽  
Sample Size ◽  
Clinical Efficacy ◽  
Study Design ◽  
Marked Improvement ◽  
Selection Criteria ◽  
Assessment Criteria ◽  
Treatment Modalities ◽  
Practical Utility

Gridhrasi, one among the Nanatmaja Vikara, specific Nidana and Samprapti is not explained in classics so that the general Vata Vyadi Nidhana Samprapthi can be considered. The Chikitsa of Gridhrasi includes Sneha, Sweda, Bastikarma and Agni karma. Generally, Basti is the best line of treatment for Vata dosa. References from Acharya Charaka also explain Basti as one of the treatment modalities. With the support of Niruhadikara in Chakradhatta, we have the reference of Ardhamatrika Basti, which is one among Kashaya Basti, here he explains the practical utility along with many added benefits of Bala, Varna, Vrushatha and Pumsavanathva which gifted by Atreya Maharshi. Ardhamatrika Basti, one among Madhutailika Basti (having an equal quantity of Madhu and Taila), can be clinically explored where neither Parihara Kala nor Purva karma like Sneha, Sweda are necessary. The study design selected for the study was a comprehensive clinical trial. The sample size for the present study was 30 patients suffering from Gridrasi as per the selection criteria. Patients were randomly selected irrespective of sex and were treated with Ardhmatrika Basti as a yoga Basti for eight days. Among 30 patients taken for study, marked improvement in the symptomatology of the disease is obtained. 26.7% of patients got complete Shamana, 36.7% achieved Prayika shamana, 30% reported Amsika shamana, and 6.6% had Kinchit shamana. In the assessment criteria taken in patients, Ruja BT - 2.68 after follow up reduced to 1.8, Spandana BT - 2.38 after follow up reduced to 1.73, Sakthana Utksepa-nigraha BT - 2.82 after follow up reduced to 1.58, Gourava BT - 2.5 after follow up reduced to 1.7, Arochaka BT - 2.22 after follow up reduced to 1.87. This result shows that the present study of Ardhamatrika Basti has given a marked improvement in treating Gridhrasi.

Citation Analysis of Articles about Hand Surgery Published in Orthopaedic and Hand Surgery Journals

2019 ◽  
Vol 24 (01) ◽  
pp. 36-44 ◽  
Author(s):  
Yuki Fujihara ◽  
Nasa Fujihara ◽  
Michiro Yamamoto ◽  
Hitoshi Hirata
Keyword(s):  
Clinical Trial ◽  
Sample Size ◽  
Randomized Clinical Trial ◽  
Study Design ◽  
Comparative Studies ◽  
Clinical Studies ◽  
Hand Surgery ◽  
The Impact ◽  
Larger Sample ◽  
Surgery Journals

Background: To date, little is known about the characteristics of highly cited studies in hand surgery compared with other orthopaedic subspecialties. We aimed to assess the position of hand surgery within the orthopedic surgery literature. Methods: We conducted a bibliographic analysis using the Web of Science database to review 1,568 articles published between January 2012 and December 2012 in 4 relevant general orthopedic and 2 hand surgery journals. We used the number of citations within 3 years of publication to measure the impact of each paper. To analyze prognostic factors using logistic regression analysis, we extracted data on orthopedic subspecialty, published journal, location of authorship, and type of study for all articles. For clinical studies, we also recorded details on study design and sample size. Results: Of eligible hand surgery articles (n = 307), the majority (62%) were case reports/series. Only 19% were comparative studies, comprising a significantly smaller proportion of comparative studies from other subspecialties in general orthopedic journals. Systematic reviews/meta-analyses generated a significantly higher number of average citations, whereas educational reviews were consistently cited less frequently than other study types (14.9 and 6.1 average citations, respectively). Being published in the Journal of Bone and Joint Surgery, American volume, having authorship in North America or Europe and Australia, focusing on subspecialties like hip & knee, sports, or shoulder, utilizing a comparative or randomized clinical trial study design, and having a larger sample size increased the odds of receiving more citations. Conclusions: Clinical studies related to hand surgery published in general orthopedic journals are most often of lower quality study design. Having a larger sample size or using a comparative study or randomized clinical trial design can improve the quality of study and may ultimately increase the impact factor of hand surgery journals.

The Successful Treatment of Elephantiasis Nostras Verrucosa With Ablative Carbon Dioxide Laser

2018 ◽  
Vol 22 (6) ◽  
pp. 611-613 ◽  
Author(s):  
Caitlin G. Robinson ◽  
Kory R. Lee ◽  
Valencia D. Thomas
Keyword(s):  
Carbon Dioxide ◽  
Study Design ◽  
Successful Treatment ◽  
Carbon Dioxide Laser ◽  
Skin Condition ◽  
Treatment Modalities ◽  
Medical Benefit

Background and Objective: Elephantiasis nostras verrucosa (ENV) is a disfiguring skin condition that is difficult to treat. Existing treatment modalities serve to improve cosmesis or treat symptoms. Herein, we report a case of ENV with lymphocutaneous fistula successfully treated with ablative carbon dioxide laser. Study Design/Patients and Methods: A 57-year-old woman with biopsy-proven ENV with lymphocutaneous fistula was treated with ablative carbon dioxide laser to the symptomatic area of her right thigh in 3 treatment sessions over 6 months. Results: The patient had resolution of lymphocutaneous drainage as well as 90% improvement in the appearance of ENV lesions at the 1-month follow-up visit. Conclusion: Ablative carbon dioxide laser may provide cosmetic, symptomatic, and medical benefit for patients with localized ENV.

scholarly journals Clinical effects of probiotic or azithromycin as an adjunct to scaling and root planning in the treatment of stage III periodontitis: a pilot randomized controlled clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alicia Morales ◽  
Rafael Contador ◽  
Joel Bravo ◽  
Paola Carvajal ◽  
Nora Silva ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Lactobacillus Rhamnosus ◽  
Stage Iii ◽  
Treatment Modalities ◽  
Controlled Clinical Trial ◽  
Clinical Effects ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Probing Pocket Depth

Abstract Background The aim of this triple-blind placebo-controlled parallel-arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis. Methods Forty-seven systemically healthy participants with stage III periodontitis were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; (1) placebo (n = 15), (2) probiotics (n = 16) and (3) antibiotics-azithromycin (n = 16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated. Results All 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p < 0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p = 0.002) and the antibiotic-azithromycin (p = 0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p = 0.003). The number of sites and teeth with PPD ≥ 5, ≥ 6 and ≥ 7 mm were significantly reduced in all groups at 12 months follow-up (p < 0.025) irrespective of the treatment regime and without significant differences between the groups. Conclusion The use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of stage III periodontitis. The benefits of these two treatment regimes as an adjunct to SRP remain unclear. Trial registration NCT02839408, 10/28/2017, Clinicaltrial.gov.

Engaging patients and stakeholders in the process of designing a clinical trial and patient education platform.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 63-63
Author(s):  
Lauren M. Rosati ◽  
Sarah Douglas ◽  
Roger Leventer ◽  
Laurie Singer Sievers ◽  
Randall W. Swan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Patient Education ◽  
Study Design ◽  
Patient Engagement ◽  
Performance Status ◽  
Poor Performance Status ◽  
Initial Survey ◽  
Education Platform ◽  
Study Participants

63 Background: Patient engagement during the initiation, development, and implementation of a study has been shown to improve the ethical nature of research and the appropriateness of treatment methods, and insights into how best to partner with patients are needed. We describe our patient engagement experience in developing a clinical trial for non-metastatic pancreatic cancer (PCA). Methods: A team of patient research partners (PRPs) was consulted to design a multi-institutional study to evaluate the efficacy of chemotherapy, stereotactic body radiation therapy, and early palliative care (EPC) in patients with PCA who are typically ineligible for clinical trials due to advanced age, poor performance status, or preexisting comorbidities. PRPs included patients, caregivers, clinical researchers, patient advocacy organizations, and pharmaceutical companies. A 22-item initial survey on personal interests and a 5-item follow-up survey on study design were anonymously completed after two in-person meetings. Results: Of 15 PRPs involved, 9 completed the initial survey and 10 completed the follow-up survey. PRPs were most interested in improving quality of life (QOL, 89%), care coordination (78%), symptom management (67%), stress/anxiety (56%), and survival (56%). Confidence in the care team, hope, QOL, education and understanding, dignity, and pain management were reported to be the most important factors throughout the cancer experience. The majority (89%) requested that study participants have access to the study protocol and research publications supporting the study design. Because all PRPs suggested that a personal website be used to provide information to study participants and to disseminate the results of the study, an online patient education platform was adopted and customized for patients (and caregivers). Furthermore, integration of EPC into the treatment regimen was unanimously endorsed. Conclusions: Engaging PRPs in the process of designing a clinical trial for PCA appears to be feasible and valuable in identifying the study objectives most important to patients. PRPs conveyed that maintaining a good QOL is essential, and adoption of EPC in these patients should be considered.

Sample Size Considerations in Designing Studies with Intra-oral Models

1992 ◽  
Vol 71 (3_suppl) ◽  
pp. 819-821 ◽  
Author(s):  
G.K. Stookey ◽  
B.P. Katz ◽  
B.B. Beiswanger ◽  
A.J. Dunipace
Keyword(s):  
Sample Size ◽  
Clinical Efficacy ◽  
Study Design ◽  
Relevant Information ◽  
Preclinical Models ◽  
Within Subjects ◽  
Clinical Models ◽  
Sources Of Variation ◽  
Uptake Data ◽  
Proper Consideration

Especially during recent years, the use of pre-clinical models for predicting the efficacy of fluoride systems has assumed greater importance within the scientific community. Originally utilized primarily to screen experimental fluoride delivery systems, preclinical models are now being considered as predictors of clinical efficacy in lieu of controlled clinical caries trials. Of the various preclinical models presently available, human intra-oral models have the greatest potential for reflecting intended usage conditions and therefore may be the most meaningful models for predicting clinical efficacy. However, only with the proper consideration of numerous critical variables can studies using intra-oral models be appropriately designed to achieve the desired objectives. Clearly, these models must provide relevant information in a manner which reflects clinically established cariostatic activity and be capable of detecting established differences in the amount of cariostatic activity, i.e., dose-response effects. Three sources of variation must be considered before an appropriate study design and sample size can be chosen. Based on fluoride uptake data from an intra-oral model with proximally-located enamel specimens, estimates of variation among subjects, within subjects, and among specimens within subjects were obtained. Multiple specimens per panelist do not affect the first two sources of variation. Thus, the number of panelists, and not the number of specimens, is of primary importance when pre-test data are used to choose the appropriate study design and calculate the required sample size.

scholarly journals Role of Plasmapheresis and Extracorporeal Membrane Oxygenation in the Treatment of Leptospirosis Complicated with Pulmonary Hemorrhages

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
C. L. Fonseka ◽  
S. Lekamwasam
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Extracorporeal Membrane Oxygenation ◽  
Study Design ◽  
Case Reports ◽  
Pulmonary Hemorrhage ◽  
Treatment Modalities ◽  
Current Evidence ◽  
Membrane Oxygenation ◽  
Severe Leptospirosis

Introduction. Leptospirosis is an emerging infectious disease associated with multiorgan involvement and significant morbidity and mortality. Although pulmonary hemorrhage due to leptospirosis has a high fatality, specific treatment options are limited and their efficacy is not adequately proven. We opted to find out the current evidence on plasmapheresis and extracorporeal membrane oxygenation (ECMO) in pulmonary hemorrhages due to leptospirosis. Methods. The first search was conducted in PubMed, OVID, Google Scholar, and Cochrane clinical trial registry using keywords “leptospirosis” OR “Leptospira” OR “Weil’s disease” AND “plasmapheresis” OR “plasma exchange” AND “pulmonary hemorrhage” OR “alveolar hemorrhage” OR “lung hemorrhage” and the second search was done using keyword “leptospirosis” OR “Leptospira” OR “Weil’s disease” AND “ECMO” OR “Extracorporeal membrane oxygenation.” The searches were not limited by study design or the date of publication. Only articles written in English were reviewed. Although we intended to include only clinical trials, it was decided later to include other information such as case reports and case series which addressed these treatment modalities. Two authors selected articles independently in a blinded manner using a set of inclusion and exclusion criteria and discrepancies were solved after discussions. Results. The information found was very limited. This included one clinical trial which showed a significant survival benefit with plasmapheresis but the study design had many limitations. Two case reports described the benefit of plasmapheresis in severe leptospirosis with pulmonary hemorrhages. There were eight case reports where ECMO was performed and out of all only one patient has died. One retrospective study on patients with severe leptospirosis mentioned that four out of five patients with pulmonary hemorrhages survived after being treated with ECMO. Conclusions. Current evidence is insufficient to recommend the routine use of plasmapheresis or ECMO for patients presenting with pulmonary hemorrhages due to leptospirosis. ECMO may be a promising mode of treatment in acute respiratory failure in leptospirosis related pulmonary hemorrhages. These treatment modalities, however, can be applied based on the availability of resources and expertise at the discretion of the clinician in charge, considering patient related factors such as cardiovascular stability and derangement of coagulation profile. Clinical trials conducted adhering to standard procedures are urgently required to establish the efficacy of these treatment modalities.

scholarly journals Comparing Effectiveness of Letrozole Versus Clomiphene Citrate to Evaluate the Ovulation Induction in patients with POS

2021 ◽  
Vol 15 (10) ◽  
pp. 2685-2688
Author(s):  
Tehmina Zafar ◽  
Fiza Asif ◽  
Rubina Naurin ◽  
Tayyaba Majeed ◽  
Zahid Mahmood
Keyword(s):  
Sample Size ◽  
Ovulation Induction ◽  
Selection Criteria ◽  
Polycystic Ovarian Syndrome ◽  
Clomiphene Citrate ◽  
Female Infertility ◽  
P Value ◽  
The Mean ◽  
Ovarian Syndrome

Background: Anovulation is the commonest cause of female infertility and polycystic ovarian syndrome (PCOS) is the most frequently seen cause of anovulation among infertile females. Letrozole and Clomiphene Citrate are two common drugs for PCOS. But controversial data was noticed regarding their effectiveness. Aim: To compare effectiveness of Letrozole versus Clomiphene Citrate to evaluate the ovulation induction in patients with polycystic ovarian syndrome Methods: After fulfilling the selection criteria, total 360 females were enrolled according to calculated sample size and were randomly divided into two equal groups. One is treated with letrozole and other is clomiphene citrate. Successful ovulation was noted on follow up. Data was collected in proforma and later on analyzed in SPSS version 23. Results: The mean age of patients in letrozole group was 26.61± 4.81 years and in clomiphene citrate was it 27.89±4.24 years. Successful ovulation induction was noted in 172 with letrozole and 150 with clomiphene citrate i. e p-value=0.001. Conclusion: Letrozole has significantly better efficacy for successful ovulation than Clomiphene Citrate for PCOS. Keywords: Ovulation, Clomiphene citrate, Letrozole, polycystic ovarian syndrome

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