Comparative Analysis Of Efficacy Research Articles

Optimal Surgical Approaches for Thyroid Cancer: A Comparative Analysis of Efficacy and Complications.

BACKGROUND Completion thyroidectomy (CTx) is performed following hemithyroidectomy (HTx) when the risk of malignancy persists or is discovered postoperatively. Different surgical approaches, including CTx after HTx (CTx-HTx), total thyroidectomy (TTx), and revision surgery after TTx (RTx-TTx), offer varying risks and benefits, including pathological outcomes and complication rates. Understanding the predictors and rates of malignancy in these procedures is crucial for optimizing surgical management of thyroid disorders. MATERIAL AND METHODS This retrospective study analyzed data from January 2014 to October 2019, including 60 patients each in the CTx-HTx and TTx groups, and 47 in the RTx-TTx group. The CTx-HTx group was subdivided based on benign or malignant findings in CTx specimens. Clinicodemographic data and pathological features such as tumor type, size, side, capsular and vascular invasion, extrathyroidal spread, multifocality, and lymph node metastasis were reviewed. RESULTS Age and sex distributions were similar across groups. In the CTx-HTx group, 76.7% of specimens were benign and 23.3% malignant. No significant predictors of malignancy were found between the benign and malignant subgroups in univariate and multivariable analyses. In the TTx group, 75.0% of initial lobes and 13.3% of contralateral lobes were malignant. TTx was associated with a significant postoperative decrease in calcium and longer hospital stays. Multivariable analysis identified TTx as an independent risk factor for hypocalcemia. CONCLUSIONS Reducing overtreatment in thyroid cancer may involve limiting CTx after HTx and considering more conservative initial surgeries, particularly when indications for TTx are not definitive.

Comparative efficacy analysis of mannitol and hypertonic saline in the management of traumatic brain injury: a scientific exploration of neuroprotective strategies

Comparative efficacy analysis of mannitol and hypertonic saline in the management of traumatic brain injury: a scientific exploration of neuroprotective strategies

Comparative Analysis of Efficacy of Lactic Acid 30% with Ferulic Peel 12% (Combination Peel) Versus TCA 10% with Ferulic Peel 12% (Combination Peel) for Photoageing Skin.

Chemical peels are used to treat photoageing, pigmentation, improve complexion and dull skin, fine lines and scars. The objective of this study is to do comparative analysis of Lactic Acid 30% with Ferulic peel 12% (combination peel) versus TCA 10% with Ferulic peel 12% (combination peel) for Photoageing Skin. This is a retrospective study from September 2021 to 2022 with total 50 female patients aged between 25 and 40years were treated. Randomisation of patients was done (simple randomisation using lottery method) for both groups with 25 patients enrolled in each group. The first group (Group A-25 patients) were treated with lactic acid 30% with Ferulic peel 12% (combination peel). The second group (Group B-25 patients) were treated with TCA 10% with Ferulic peel 12% (combination peel). Inclusion and exclusion criteria have been defined for the study. Two scales have been used for assessing the results: Allergan Skin Roughness Scale (ASRS) and Allergan Fine Line Scale (AFLS). ASRS and AFLS scores were assessed at pre-treatment (pre) and post treatment (post-1month after last peel session). Data were summarised in Mean ± SD (standard deviation). Pre and post groups were compared by paired t test. The pre to post change in outcome measures between two independent groups were compared by independent Student's t test. Discrete (categorical) groups were compared by Chi-square (χ2) test. A two-tailed (α=2) P < 0.05 was considered statistically significant. Analyses were performed on SPSS software (Windows version 22.0). Patients were followed up for 6 months post treatment. In Group A, comparing the pre and post ASRS score, paired t test showed significant (P < 0.001) decrease or improvement of 56.1%. In Group B, comparing the pre and post ASRS score, paired t test showed significant (P < 0.001) decrease or improvement of 52.8%. Comparing the pre to post mean decrease or improvement in ASRS score of two groups, Student's t test showed similar (P > 0.05) improvement between the two groups though it was 2.5% higher in Group B as compared to Group A. In Group A, comparing the pre and post AFLS score, paired t test showed significant (P < 0.001) decrease or improvement of 63.2% at post as compared to pre. In Group B, comparing the pre and post AFLS score, paired t test showed significant (P < 0.001) decrease or improvement of 58.8% at post as compared to pre. Further, comparing the pre to post mean decrease or improvement in AFLS score of two groups, Student's t test showed similar (P > 0.05) improvement between the two groups though it was 16.7% higher in Group A as compared to Group B. Study found both the treatments equally effective in the management of ageing skin after 6months of treatment. However, study needs further validation on larger sample size, varied age groups and male gender. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Comparative analysis of efficacy of different forms of Galli Gigerii Endothelium Corneum on functional dyspepsia in rats based on composition-pharmacodynamics

A systematic evaluation of the differences in the chemical composition and efficacy of the different forms of Galli Gigerii Endothelium Corneum(GGEC) was conducted based on modern analytical techniques and a functional dyspepsia(FD) rat model, which clarifies the material basis of the digestive efficacy of GGEC. Proteins, enzymes, polysaccharides, amino acids, and flavonoids in GGEC powder and decoction were determined respectively. The total protein of the powder and decoction was 0.06% and 0.65%, respectively, and the pepsin and amylase potency of the powder was 27.03 and 44.05 U·mg~(-1) respectively. The polysaccharide of the decoction was 0.03%, and there was no polysaccharide detected in the powder. The total L-type amino acids in the powder and decoction were 279.81 and 8.27 mg·g~(-1) respectively, and the total flavonoid content was 59.51 μg·g~(-1). Enzymes and flavonoids were not detected in the decoction. The powder significantly reduced nutrient paste viscosity, while the decoction and control group showed no significant reduction in nutrient paste viscosity. FD rat models were prepared by iodoacetamide gavage and irregular diet. The results showed that both powder and decoction significantly increased the gastric emptying effect, small intestinal propulsion rate, digestive enzymes activity, gastrin(GAS), motilin(MTL), ghrelin(GHRL) and reduced vasoactive intestinal peptide(VIP), 3-(2-ammo-nioethyl)-5-hydroxy-1H-indolium maleate(5-HT), and somatostatin(SST) content in rats(P&lt;0.05, P&lt;0.01). Comparison of GGEC decoction and powder administration between groups of the same dosage level showed that gastrointestinal propulsion and serum levels of GAS, GHRL, VIP, and SST in the powder group were significantly superior to those in the decoction and that the gastrointestinal propulsion, as well as serum levels of MTL, GAS, and GHRL were slightly higher than those of the decoction with two times its raw dose, and the serum levels of SST, 5-HT, and VIP in the powder group were slightly lower than those of the decoction with two times its raw dose. In conclusion, both decoction and powder have therapeutic effects on FD, but there is a significant difference between the two effects. Under the same dosage, the digestive efficacy of the powder is significantly better than that of the decoction, and the decoction needs to increase the dosage to compensate for the efficacy. It is hypothesized that the digestive efficacy of the GGEC has a duality, and the digestive active ingredients of the powder may include enzymes and L-type amino acids, while the decoction mainly relies on L-type amino acids to exert its efficacy. This study provides new evidence to investigate the digestive active substances of the GGEC and to improve the effectiveness of the drug in the clinic.

Development of the Efficient Scheme of Cow Mastitis Prophylaxis

Introduction. Among many diseases reducing cow milk productivity, mastitis occupies a special place — the milk yield losses due to this widespread infectious disease equal, in average, to 8–15% of the total losses caused by all diseases in cows. Only an integrated approach can ensure achievement of the best results in solving this acute problem. Within the integrated approach, the use of various sanitary disinfectants before and after milking is primary important. To multiply the effect, we decided to combine the disinfecting treatment with the vaccination of cows against mastitis — a preventive measure becoming popular nowadays. The aim of the research is to develop the efficient scheme of cow mastitis prophylaxis based on the comparative efficacy analysis of applying the various disinfectants in immunized and nonimmunized animals.Materials and Methods. The research was carried out at the premises of the Agricultural Production Cooperative “Plemzavod Maiskii” (Maiskii Breeding Farm) during five months after the vaccination of cows (from November 2021 to March 2022). The cows were vaccinated with the home-developed inactivated associated vaccine against mastitis of cows. The post-milking treatment was carried out with the disinfectants “ProfiClean Iodine” and “Lorena”. For conducting the study, 4 groups of cows per 10 heads each were selected: the control group (in which only “ProfiClean Iodine” disinfectant was used), the experimental groups No. 1 (in which "Lorena" disinfectant was used), No. 2 (in which “ProfiClean Iodine” disinfectant was used in vaccinated animals) and No. 3 (in which “Lorena” disinfectant was used in vaccinated animals). The vaccination efficacy coefficient was calculated according to the formula EC = ((B – A)/B) × 100, where EC is the efficacy coefficient (%); A — is the cow mastitis incidence in vaccinated animals; B — is the cow mastitis incidence in non-vaccinated animals.Results. It has been established that the efficacy of “ProfiClean Iodine” for mastitis incidence prophylaxis in vaccinated animals compared to the non-vaccinated animals was 78.0%; the same prophylactic efficacy indicator of “Lorena” lotion was 89.0%. Monthly bacteriological examinations of the cow udder secretion resulted in isolation of the Staphylococcus aureus (S. aureus) culture, which is the prevailing infectious agent of cow mastitis, in 30.0% of cows in the control group. Pathogenic streptococci and enterobacteria have not been isolated. Opportunistic pathogenic staphylococci have been found in the udder secretion of animals in all studied groups, whereas the maximum amounts have been recorded in the control group and group No. 1 (50.0 and 40.0 % respectively) and the minimum – in groups No. 2 and 3 (10.0% each).Discussion and Conclusion. The research clearly demonstrates the efficacy of the integrated approach in solving the problem of the cow mastitis incidence — the incidence was 4.5 times lower in the experimental group No. 2 and 9.0 times lower in experimental group No. 3 compared to the control group. The combined use of the disinfectants and the inactivated associated vaccine against cow mastitis is a workable scheme providing 78.0 – 89.0% prophylactic efficacy, therefore it can be recommended for implementation into the agricultural enterprises of the appropriate profile.

A Comprehensive Review of Current Management Trends in Medial Compartment Arthritis of the Knee Joint.

Medial compartment arthritis of the knee joint presents a significant clinical challenge, with diverse management options ranging from nonsurgical interventions to various surgical procedures. This comprehensive review synthesizes current evidence on the management trends in medial compartment arthritis, highlighting both nonsurgical approaches such as physical therapy, pharmacological interventions, and intra-articular injections as well as surgical interventions, including arthroscopic debridement, high tibial osteotomy, and knee arthroplasty. Through a comparative analysis of efficacy, complication rates, and patient outcomes, this review underscores the importance of tailoring treatment strategies to individual patient characteristics and preferences. Furthermore, emerging techniques and technologies promise to advance the field, necessitating ongoing research efforts to refine treatment algorithms and establish standardized guidelines. By adopting a multidisciplinary approach and integrating evidence-based practices, clinicians can optimize the management of medial compartment arthritis and enhance patient care outcomes.

Assessing cardiac resynchronization therapy response in heart failure patients: a comparative analysis of efficacy and outcomes between transvenous and epicardial leads

Cardiac resynchronization therapy (CRT) is an effective treatment for selected heart failure (HF) patients. Although transvenous implantation is the standard method, it is not feasible in some patients, so the epicardial lead emerges as an alternative. We aim to compare CRT response, procedure-related complications, and the occurrence of clinical outcomes between patients with transvenous and epicardial leads. In a single-center retrospective study, we enrolled consecutive HF patients submitted to CRT implantation with a defibrillator between 2013 and 2022. Clinical response was defined as an improvement of at least one of the New York Heart Association classes with no occurrence of cardiovascular death or HF hospitalization in the first year of follow-up. Echocardiographic response was attained with an increase in left ventricular ejection fraction 10% or a reduction of left ventricular end-diastolic volume &gt;15% at 6-12 months after CRT implantation. Major adverse cardiovascular events (MACE) (cardiovascular mortality and HF hospitalization) and all-cause mortality were evaluated. From a total of 149 patients, 38% (n=57) received an epicardial lead. Clinical (63% versus 60%, p=0.679) and echocardiographic (63% versus 60%, p=0.679) responses were similar between the transvenous and epicardial groups. Patients in the transvenous group had a shorter hospital stay (2 versus 7 days, p&lt;0.001). Procedure-related complications were comparable between groups (24% versus 28%, p=0.572), but left ventricular lead-related complications were more frequent in the transvenous group (14% versus 2%). During a median follow-up of 4.7 years, the rate of MACE was 30% (n=44), with no differences in both groups (p=0.591), neither regarding HF hospitalization (p=0.917) nor cardiovascular mortality (p=0.060). Nevertheless, the epicardial group had a higher rate of all-cause mortality (35% versus 20%, p=0.005), the majority occurring during long-term follow-up (&gt;12 months), with no deaths in the postoperative period. Considering the comparable rates of CRT response, procedure-related complications, and MACE between groups, we conclude that epicardial lead is a feasible alternative for CRT when transvenous lead implantation is not possible. The occurrence of a higher number of all-cause deaths in epicardial patients in the long-term follow-up was mainly due to infectious complications (unrelated to the lead) and the progression of oncological/chronic diseases.

Comparative Analysis of Efficacy of Epidural Analgesia vs Intra-operative Cocktail for Post-operative Pain Management in Total Knee Replacement (TKR) Patients

Comparative Analysis of Efficacy of Epidural Analgesia vs Intra-operative Cocktail for Post-operative Pain Management in Total Knee Replacement (TKR) Patients

Evaluation of Nitazoxanide versus Metronidazole in Pediatric Giardia lamblia-Induced Diarrhea: A Comparative Efficacy Analysis

Background: The choice between shorter-duration Nitazoxanide and longer-duration Metronidazole regimens for treating Giardia lamblia-induced diarrhea in children requires careful consideration of efficacy, safety, and treatment adherence. Objective: The objective of this study is to compare the efficacy of a 3-day treatment regimen with Nitazoxanide to a 5-day treatment regimen with Metronidazole in children with diarrhea caused by Giardia lamblia. Study Design: Randomized controlled trial (RCT). Settings: Department of Paediatric, Shahida Islam Medical College, Lodhran Pakistan. Duration: From 1st September, 2022 to February 2023. Methods: Pediatric patients aged 1 to 12 years diagnosed with diarrhea attributed to Giardia lamblia infection. Exclusion criteria were children suffering from chronic gastrointestinal diseases, immunodeficiency disorders, or those who had undergone anti-parasitic medication in the last month. Subjects were randomised to one of two treatment groups in a random manner: Nitazoxanide Group: The patients were administered a 3-day regimen of Nitazoxanide at a dosage of 15 mg/kg/day, split into two separate doses. Metronidazole Group: Patients were administered a 5-day regimen of Metronidazole at a dosage of 30 mg/kg/day, which was divided into three equal doses. The primary outcome measure was the resolution of diarrhea, assessed by the absence of loose or watery stools for at least 24 hours. Statistical analysis was performed using SPSS to compare outcomes between the two treatment groups. Results: The mean age of patients in the Nitazoxanide group was 6.7 ± 2.3 years, while in the Metronidazole group, it was slightly lower at 6.3±2.1 years. In terms of gender distribution, there were 40 males (53.3%) and 35 females (46.7%) in the Nitazoxanide group, whereas in the Metronidazole group, there were 35 males (46.7%) and 40 females (53.3%). In the Nitazoxanide group, 90% of patients achieved resolution, with 68 patients. In contrast, 85% of patients in the Metronidazole group had resolved diarrhea, totaling 64 patients. Conclusion: In conclusion, our study found comparable efficacy between nitazoxanide and metronidazole for treating Giardia lamblia-induced diarrhea with 95% parasite clearance in nitazoxanide and 90% in metronidazole. However, nitazoxanide exhibits superior parasite clearance, suggesting its potential as a promising alternative in pediatric clinical practice.

Comparative analysis of efficacy and safety of ChAdOx1 nCov-19 and AD26.COV2.S

Vaccine technology has been going through some radical and incremental advancement over the years for its importance as the most crucial tool in the prevention and elimination of transmissive diseases. Since the outbreak of COVID-19, several vaccine platforms were being studied, developed, and entered the market. Among the platforms, vector viral vaccines attracted particular attention for the cooperation of viral vectors to deliver genetic material of the pathogens. While the mechanism has improved the flexibility of vaccine design and efficacy, the adverse events after vaccination were worth attention at the same time. Taking ChAdOx12 nCov-19 and AD26.COV2.S. as the subjects, the efficacy and safety of the two vaccine platforms were compared and analyzed. In this paper, the initial vaccine efficacy, the resistances against virus variants, and various post vaccination adverse events were looked in more detail to identify the different factors that could affect the performance of viral vector vaccines.

PP172 Comparative analysis of efficacy of first-line CDK 4/6 inhibitor plus endocrine therapy in HR-positive, Her2-negative metastatic breast cancer: Real world experience

PP172 Comparative analysis of efficacy of first-line CDK 4/6 inhibitor plus endocrine therapy in HR-positive, Her2-negative metastatic breast cancer: Real world experience

Comparative analysis of clinical efficacy and safety of omalizumab biosimilar in the treatment of patients with chronic spontaneous urticaria

BACKGROUND: Importance of optimizing strategy for treatment of chronic spontaneous urticaria is highly becoming relevance for the clinicians. Nowadays monoclonal antibodies are preferred option of treatment the refractory chronic spontaneous urticaria, main of that is omalizumab.&#x0D; AIM: to establish comparative analysis of the efficacy and safety of Genolair (JSC Generium, Russia) and Xolair (Novartis Pharma AG, Switzerland) in the treatment of patients with chronic spontaneous urticaria.&#x0D; MATERIALS AND METHODS: A 36-week, open parallel-group study was conducted. Were included 43 adult patients with chronic spontaneous urticaria who were resistant to ongoing therapy with standard and escalated doses of second-generation H1-antihistamines. All patients were divided into 2 groups: the main group (MG; n=18) ― patients who administrated Genolair; the comparison group (CG; n=25) ― patients who firstly administrated Xolair and then switching therapy to Genolair. Throughout the study period, patients completed questionnaires on the assessment of disease activity (UAS 7), urticaria control (UCT), quality of life index (DLQI). Additionally, the level of total IgE in blood serum was assessed. For statistical data processing, EXCEL 2010 and STATISTICA 7.0 software packages were used.&#x0D; RESULTS: After 4 weeks from the start of monoclonal antibody therapy, patients in both groups were responders to omalizumab. At the same time, there were no significant differences when comparing scores on the UAS 7, UCT scale between patients of the MG and the CG during the entire observation period (p 0.05). The change in treatment paradigm in CG also did not have a statistically significant effect on the indicators of urticaria activity and disease control (p 0.05). At the same time, the quality of everyday life changed more positively in the MG, which was reflected in a more pronounced change in the DLQI index at the time of the control assessment since 20 weeks of therapy (p=0.032). An increase in the level of total IgE in the blood serum of all patients with chronic spontaneous urticaria after the initiation of a course of immunobiological therapy was demonstrated, while there were no statistically significant intergroup differences in relation to changes in this laboratory parameter (p 0.05).&#x0D; CONCLUSION: During the treatment of patients with severe chronic spontaneous urticaria, resistant to ongoing therapy with standard and escalated doses of second-generation H1-antihistamines, comparable clinical efficacy and safety of the study drug Genolair and the reference drug Xolair were shown.

Optimal load frequency control of multi-area multi-source deregulated power system with electric vehicles using teaching learning-based optimization: a comparative efficacy analysis

Optimal load frequency control of multi-area multi-source deregulated power system with electric vehicles using teaching learning-based optimization: a comparative efficacy analysis

Neuronavigation-assisted neuroendoscopy versus conventional craniotomy for hypertensive cerebellar hemorrhage: A comparative analysis of efficacy and outcomes

ObjectiveHypertensive cerebellar hemorrhage is a severe condition in neurosurgery, associated with high disability and mortality rates. The present study compares the efficacy and outcomes of neuronavigation-assisted neuroendoscopy versus conventional microscope (craniotomy) in treating patients with hypertensive cerebellar hemorrhage. MethodsA retrospective study was conducted by analyzing medical records of patients with hypertensive cerebellar hemorrhage treated at Wuhan No.1 Hospital between February 2015 and February 2019. The study included 65 patients who underwent either neuronavigation-assisted neuroendoscopy (n = 35) or conventional microscopy treatment (n = 30). All patients underwent standard neurological and clinical examinations, as well as routine laboratory tests upon admission. The diagnosis of hypertensive cerebellar hemorrhage was based on computed tomography (CT) findings. Basic parameters, clinical status on admission, imaging results, management, and outcome measures were evaluated and compared between the two groups. ResultsNeuronavigation-assisted neuroendoscopy showed advantages over craniotomy in terms of surgical procedure time and intraoperative blood loss ((81.91 ± 17.77) min vs (195.20 ± 31.97) min, (63.66 ± 12.42) ml vs (335.00 ± 104.26) ml, P < 0.01). The hematoma evacuation rate was higher in neuroendoscopy group ((94.37 ± 5.174)% compared to the craniotomy group ((90.80 ± 5.404)%, P < 0.01). Additionally, the time of ventricular drainage was shorter in the neuroendoscopy group ((4.83 ± 1.671) days) than in the craniotomy group ((7.70 ± 1.878) days, P < 0.01). Neuroendoscopy group also resulted in fewer surgical complications and a shorter hospital stay (P < 0.05). There was no significant difference in the risk of rebleeding and mortality between the neuroendoscopy and craniotomy group (P > 0.05). ConclusionNeuronavigation-assisted neuroendoscopy is a rapid, safe, and effective minimally invasive technique for the treatment of hypertensive cerebellar hemorrhage. It offers potential benefits in reducing surgical complications and hospital stay compared to conventional craniotomy.

Selective versus strategic control against Rhipicephalus microplus in cattle: A comparative analysis of efficacy, animal health, productivity, cost, and resistance management

This study compared selective control versus strategic control against Rhipicephalus (Boophilus) microplus, under conditions of a real dairy farm. Strategic control requires that all animals be treated with acaricide at regular pre-determined intervals. Selective control only requires treatment of infested animals and only when they are at or above a pre-determined threshold. Tick counts on animals and in pasture were performed and the susceptibility of tick populations to the different treatment methods was evaluated at the beginning and end of the study using the Larval Packet Test, Larval Immersion Test, and Adult Immersion Test. Over the four years of the study strategic control was more advantageous than the selective control as the group experienced lower tick burden on animals and in pasture, absence of skin lesions and myiases, lower operating costs, treatments concentrated in fewer months of the year and lower resistance pressure.

Retracted: Comparative Analysis of Efficacy and Prognosis of Hemodialysis and Peritoneal Dialysis for End-Stage Renal Disease: A Meta-analysis.

[This retracts the article DOI: 10.1155/2022/6007698.].

Topical glucocorticoids in ophthalmology: a comparative analysis of efficacy and safety

The symptoms of most pathological conditions in ophthalmology are based on inflammations of varying severity. Valuable tools against inflammation are topical glucocorticoids (tGCs), whose molecules are able to actively overcome biological membranes and ensure a rapid clinical response. The use of tGCs is accompanied by a wide range of effects, including side effects, a rise in intraocular pressure being one of the most significant ones. The review focuses on a comparative analysis of the efficacy and safety of various tGCs, including “soft steroids”. We show the relationship between the structure of the drugs, their pharmacodynamic effects and the possibility of being used in various eye diseases.

Lymphoplasmapheresis versus plasma exchange in severe myasthenia gravis: a retrospective cohort study.

Lymphoplasmapheresis (LPE) is a new therapy developed on the basis of traditional plasma exchange (PE) in combination with leukapheresis. Currently, it remains unclear whether PE and LPE show differences in efficacy for severe MG. A retrospective analysis was conducted on 198 MG patients, 75 in the PE group and 123 in the LPE group, and the patients' Myasthenia Gravis Foundation of America (MGFA) Clinical Classification was Class IV. The treatment outcome was the change in Quantitative Myasthenia Gravis Score (QMGS) from baseline to the end of treatment. Propensity score matching (PSM) was applied for the balance of confounders between the two groups. In this study cohort, the safety profile of LPE and PE was good and no serious adverse events were observed. Based on PSM, 62 patients treated with LPE and 62 patients treated with PE were entered into a comparative efficacy analysis. In the PE group, patients underwent a total of 232 replacements, with a mean of 3.74. PE significantly improved the patients' QMGS performance, with the mean QMGS decreasing from 22.98 ± 4.03 points at baseline to 18.34 ± 5.03 points after treatment, a decrease of 4.68 ± 4.04 points (p < 0.001). A decrease of ≥3 points in QMGS was considered a significant improvement, with a treatment response rate of 67.7% in the PE group. In the LPE group, patients received a total of 117 replacements, with a mean of 1.89. The patients' mean QMGS was 23.19 ± 4.11 points at baseline and was 16.94 ± 5.78 points after treatment, a decrease of 6.26 ± 4.39 points (p < 0.001). The improvement in QMGS was more significant in patients treated with LPE compared to the PE group (p = 0.039). The treatment response rate in the LPE group was 79%, which was not significantly different compared to the PE group (p = 0.16). The LEP group had a shorter mean length of stay compared to the PE group (10.86 ± 3.96 vs. 12.14 ± 4.14 days), but the difference was not statistically significant (p = 0.13). During the 2-month follow-up period, LPE may be associated with better functional outcomes for patients, with lower QMG score and relapse rate. LPE and PE were both effective in reducing the levels of inflammatory cytokines (TNF-α, IL-1β, and IL-6) and AChR-Ab. Compared to PE, LPE was superior in the reduction of AChR-Ab titer. In severe MG, LPE may be a more preferred treatment option than PE. It achieves treatment outcomes that are not inferior to or even better than PE with fewer replacements. This study provides further evidence to support the application of LPE as a new treatment option for MG.

Comparative Analysis of Efficacy &amp; Post-Operative Analgesia with Hyperbaric Bupivacaine and Nalbuphine Combination Versus Hyperbaric Bupivacaine and Fentanyl Combination in Infraumbilical Surgeries

Spinal anaesthesia is one of the most commonly used technique for lower abdominal and lower limbs surgeries. However its short duration of action and early arising post-operative pain moves the focus towards the use of adjuvant to it. So numbers of adjuvant from different groups were used and evaluated. Out of which opioids are the most commonly used family as an intrathecal adjuvant to local anaesthetics. Our aim of the study to evaluate the analgesic efficacy of hyperbaric Bupivacaine &amp; Nalbuphine versus hypebaric Bupivacaine &amp; Fentanyl in infraumbilical surgeries. The study was conducted during period of 2020 to 2022 at tertiary care center. Total 100 patients were participated in study each group includes 50. Demographic data, onset of sensory &amp; motor block, duration of sensory and motor block, two segment regression time and first rescue analgesia time were noted. The onset of sensory and motor block was earlier in Bupivacaine plus Nalbuphine (BN) combination as compared to Fentanyl plus Bupivacaine (BF) combination. Two segment regression time was longer with BN group. Nalbuphine also shows good hemodynamic stability. Rescue analgesia time with Nalbuphine was much longer than Fentanyl. The adverse effect was also much less with Nalbuphine. Nalbuphine could be a better and settle alternative to the Fentanyl and other opioids as adjuvant to intrathecal local anaesthetics.

Abemaciclib, Palbociclib, and Ribociclib in Real-World Data: A Direct Comparison of First-Line Treatment for Endocrine-Receptor-Positive Metastatic Breast Cancer.

By the end of 2020, there were more than 8 million women alive who had received a breast cancer diagnosis in the previous 5 years, making it the most prevalent neoplasia in the world. About 70% of breast-cancer cases present positivity for estrogen and/or progesterone receptors and a lack of HER-2 overexpression. Endocrine therapy has traditionally been the standard of care for ER-positive and HER-2-negative metastatic breast cancer. In the last 8 years, the advent of CDK4/6 inhibitors has shown that adding them to endocrine therapy doubles PFS. As a result, this combination has become the gold standard in this setting. Three CDK4/6 inhibitors have been approved by the EMA and the FDA: abemaciclib, palbociclib, and ribociclib. They all have the same indications, and it is at each physician's discretion to choose one or the other. The aim of our study was to perform a comparative efficacy analysis of the three CDK4/6i using real-world data. We selected patients diagnosed with endocrine-receptor-positive and HER2-negative breast cancer who were treated with all three CDK4/6i as first-line therapy at a reference center. After 42 months of retrospective follow up, abemaciclib was associated with a significant benefit in terms of progression-free survival in endocrine-resistant patients and in the population without visceral involvement. In our real-world cohort, we found no other statistically significant differences among the three CDK4/6 inhibitors.