Blind Control Research Articles

Prevention of dry socket in mandibular 3rd molars with single preoperative oral dose of metronidazole and amoxicillin compared to conventional therapy.

To compare the efficacy of metronidazole and amoxicillin as preoperative single dose treatment with conventional therapy in prevention of dry socket. A double blind randomized controlled trial was conducted at the oral and maxillofacial surgery OPD at DUHS, Karachi. Patients attending and requiring surgical extraction of madibular 3rd molar during October 2018 till April 2019 were randomly divided into 3 groups. Ethical approval was taken from Institutional Review Board of DUHS, Karachi. Informed consent was also taken from patients. First group was given single preoperative oral dose of 400mg metronidazole one hour before extraction, second group was treated with single oral dose of 500mg amoxicillin an hour before tooth extraction, and both of the groups were given painkillers postoperatively. Third group was given 500mg of Amoxicillin BD, 400mg of metronidazole and painkillers postoperatively. Every group had a follow-up on fifth postoperative day. Dry socket was reported among patients 19(8.4 %), among them 4 were males and 15 were females. Chi-square test was used to calculate the p-value (0.066). Results of the present trial were statistically insignificant. Incidence of dry socket in amoxicillin group was 3 (5.5%), in metronidazole was 4 (7.5) and in conventional therapy group was 12(16%). Present trial was not effective in preventing the occurrence of dry socket by means of single preoperative oral dose of metronidazole and amoxicillin compared to conventional therapy. However, clinically percentage of occurrence of dry socket was higher in conventional group compared to amoxicillin and metronidazole group.

Pre-Induction Cervical Ripening Using a Transcervical Foley Catheter Combined with ISMN Vaginal Tablets for Vaginal Birth after Previous Caesarean Section (VBAC)—A Comparative Study

Objective: To compare the effectiveness, safety and client acceptability of concurrent application of transcervical Foley catheter with vaginal ISMN-sustained release (SR) 60 mg tablet versus transcervical Foley catheter alone for pre-induction cervical ripening in women who are undergoing Vaginal birth after C-section (VBAC). Method: A prospective single blind randomized control study was carried out including 110 pregnant women who had unfavorable cervix (MBS less than 6) at 40 weeks and 3 days of gestation. The two groups received either the trans-cervical foley catheter with a vaginal ISMN 60 mg sustained release (SR) tablet on 40 weeks and 3 days (Treatment arm 1, n = 57), or trans-cervical Foley alone on 40 weeks and 3 days (Treatment arm 2, n = 53). Results: At 40 weeks + 3 days gestation, the mean age, mean parity and the mean modified Bishop Score (MBS) were comparable among the two treatment groups. Majority (n = 98, 89.1%) remained without spontaneously establishing labour at 24 hours of intervention. The difference in mean MBS at 40 weeks + 4 days (24-hours following the intervention) in the two groups was statistically not significant (P > 0.05). The group who received concurrent ISMN vaginal tablets achieved a higher number of successful VBACs (n = 33, 62.3%) over the group who received the Foley catheter only method (n = 29, 50.9%), however, not statistically significant (P > 0.05). Conclusions: The concurrent use of vaginal ISMN tablets (60 mg SR) with a transcervical Foley catheter failed to show higher effectiveness compared to a transcervical Foley catheter alone as an induction method.

Accuracy of Statin Side Effect Reporting in Australian Prescribing References

Statin related adverse events reduce medication adherence; however, in randomised, double-blind placebo-controlled trials the rates of many commonly reported adverse events are equal in both arms, suggesting they may be a result of the nocebo effect. Overestimating these side effects in prescribing information may prime patients to experience them. We aimed to compare side effects in Australian prescribing texts with rates in blinded placebo control trials.

Prevalence of refractive errors among the school-going children in East Sikkim.

Purpose:Vision plays an important role in child's development for learning and communication. Uncorrected refractive error (URE) has become a major challenge to health care policy makers especially in school going children. We aim to report the prevalence of refractive error among the school students of the east district of Sikkim, India.Methods:A cross-sectional study was carried out among 15,954 school children under school health program of national program for control of blindness. The screening was conducted in 40 schools of east district which included primary, higher secondary, monastic and private schools.Results:The prevalence of refractive error was 6.7% among which myopia was the most common error present in 335 (31.1%) children, followed by astigmatism in 317 (29.4%) and the remaining 29 (2.6%) with hyperopia. The age group between 14-17 years had high prevalence of refractive error (9.2%). Females had slightly higher refractive error (6.93%) than males (5.9 %). Most backward classes were found to be highest suffering from refractive error (26.65%) and the least seen was found in schedule tribe (11.6%).Conclusion:The study provides a useful and baseline data about the refractive error amongst the school children of east Sikkim. A larger study needs to be conducted in all the schools of the state to get a clearer picture of RE and other eye related diseases to detect vision problem as early as possible.

Compliance of spectacle wear among school children.

Purpose:In India, school eye screening is an important component of the National Programme for the Control of Blindness providing spectacles free of cost to children from primary section. The primary aim of this study was to know the compliance of wearing spectacles provided during school screening program and to find out reasons for noncompliance. The secondary aim of this study was to get information regarding the types of modifications required in the school eye screening program to improve the compliance level.Methods:It was a cross-sectional follow-up study involving school children of age group 10–16 years, class 5–9 from different parts of the country. Public or private schools were randomly selected based on their distance from the base hospitals/partner organizations. Data were collected by standard format directly from the students after informed written consent from school principal or class teacher.Results:The utilization of spectacles was found to be only 29.8% (n = 289) within 2 years of receiving the spectacles. Thirty-five percent (n = 108) students were using spectacles with less than 0.75 D. Appearance of the frame was a deciding factor. It was observed that the frames provided by the DBCS were especially not liked by the children. Twenty-five percent (n = 79) children were found to be wearing adult frames.Conclusion:Less than a third of the students were compliant with their spectacle prescription in this study. To improve the compliance, children should not be prescribed spectacles for nonsignificant refractive errors, should be given choices for frames and quality of work being conducted under school screening program needs a review.

COVID-19 positivity rate in corneal tissue donors - A cause for concern!

Purpose:To determine the postmortem positivity for COVID-19 among voluntary eye donors who had been certified to have died of non-COVID-19 causes.Methods:All donors who donated their corneas (from March 2021 onward) were assessed for COVID-19 positivity tested by nasopharyngeal swab reverse transcription-polymerase chain reaction (RT-PCR) test. Relevant screening history was taken prior to collection. Strict precautions were taken during the retrieval as per the guidelines issued by the National Program for Control of Blindness and Visual Impairment and the Eye Bank Association of India, and the tissues were handled as per standard operating protocol.Results:85 eye calls were attended during this period, of which 56 were home-based and 29 were from a hospital setting. Samples from 12 of the former group of donors were found to be positive for COVID-19 (14%).Conclusion:This study highlights the possibility of postmortem RT-PCR positivity in voluntary corneal tissue donors without a prior history of symptoms, signs, or diagnosis of illness suggestive of COVID-19. It is recommended that postmortem testing of donors should be done by RT-PCR for retrievals made during the pandemic.

Primary Prevention of Heterotopic Ossifications After Total Hip Replacement: Electromyotomy Technique

We compared the benefit of modification in surgical technique in relation to primary prophylaxis of heterotopic ossifications after total hip replacement with straight stem. This modification contains the so-called electromyotomy technique and was compared versus standard „cold blade“ technique. Two groups were assessed and matched by BMI, sex, age and arthrosis type undergoing hip replacement. Traumatic, dysplastic and rheumatic hips were excluded. A total of 682 patients were evaluated, 262 cemented, 402 uncemented and 18 hybrid types with minimum of 1 year follow-up (average 5.6 years). The standard “sharp blade” technique contained 313 hips, the alternative contained 369 hips. Surgeries were performed according to the same protocols and by one team via anterolateral approach. Patients with risk factors for heterotopical ossifications and administration of secondary prophylaxis modalities were excluded. The development of heterotopic ossification were assessed with blind control of radiologic specialists (Brooker´s grades). Heterotopic ossification (HO) developed in 32.69%, totally in 223 patients. Of those clinically relevant (Brooker III and IV grades) were 8.94%, in 61 patients. In standard group there were 137 HO in 313 hips (43.76%), clinically relevant in 12.78%, 40 patients. In this group there were 123 cemented hips with 53 HO, 174 uncemented with 74 HO and 16 hybrid prostheses with 10 HO. Average age was 68.53 years, 153 males, 160 females. In alternative electromyotomy group there were 369 hips with 86 HO (23.30%), clinically relevant HO cases developed in 5.69%, 21 patients. HO in particular types: 139 cemented hips with 43 HO, uncemented 228 with 42 HO and hybrid 2 with 1 HO. Average age was 70.56y, males 171, females 198. Statistic values of HO occurence between these groups favourising the electromyotomy group were significant, such as comparing the particular Brooker grades distribution and prosthesis type (cemented, uncemented). Significant decrease was observed mainly in uncemented joint replacements and in clinically relevant grades in electromyotomy group. A novel perspective on primary prophylaxis of heterotopic hip ossification after straight femoral stem total hip replacement with engagement of modification in surgical technique so called electromyotomy is presented. Statistical analysis of results in ossification development significantly favorising modified technique in all types of prosthesis fixation, notably in uncemented prosthesis types. The main drop in counts of clinicaly relevant grades of osifications is also statistically relevant. According to these findings this surgical step is routinely implemented in our technique of straight stem implantations nowadays.

Effect of HMB on Phase Angle of Maintenance Hemodialysis Patients

Objective To observe and evaluate the effect of β- hydroxy-β- methylbutyric acid (HMB) on phase angle (PA) in maintenance hemodialysis (MHD) patients. Methods From March 2018 to August 2019, 64 patients who received maintenance hemodialysis, at Chengdu Fifth People's Hospital, were selected as subjects, and they were divided into experimental group and control group with single center, random, single dose, single blind control design, and 32 patients in each group. HMB intervention was performed in the trial group and placebo in the control group for 12 weeks. Human component analysis (Inbody S770) was performed before and after intervention in the two groups to observe the change of phase angle. Scored Patient-Generated Subjective Global Assessment (SGA) and Malnutrition Inflammatory Score (MIS) were used to assess the nutritional status of MHD patients before and after group entry, to observe the correlation of its numerical change and the phase angle. Results The PA, SGA, MIS of the experimental group was significantly higher (p<0.05) than that of the control group (p<0.05), and the test group increased better than the control group (p<0.05). Positive correlation between PA and SGA, MIS (p<0.05). Conclusions By giving patients complementary HMB, to improve patient nutritional status, to improve the patient phase angle, and improve the patient prognosis.

935. Effect of Tesamorelin in People with HIV with and without Dorsocervical Fat: Post Hoc Analysis of Phase III Double Blind Placebo Control Trial

BackgroundLipohypertrophy is defined as excess fat deposition in abdominal defined as visceral adipose tissue (VAT) as well as in the dorsocervical region, breasts, trunk, and along with possible fat deposition in liver, muscle, myocardium and epicardium. Multiple factors have been described as contributing to lipohypertrophy in people living with HIV (PLWH), including patient characteristics, antiretroviral therapy (ART) and also impaired growth hormone (GH) secretion. Tesamorelin, a synthetic form of growth-hormone-releasing hormone (GHRH), is indicated for reduction of excess abdominal fat in PLWH with lipodystrophyMethodsPost-hoc analysis was done on phase 3 randomized, double-blind, multicenter trials. Patients were eligible if between 18 and 65 years of age, had confirmed HIV infection, had evidence of excess abdominal fat accumulation and on stable ART regimen for 8 weeks or more. Participants were randomized to receive tesamorelin 2 mg daily or placebo daily for 26 weeks. Only tesamorelin responders, defined as patients with at least 8% decrease in VAT and who were adherent to the medication, were used for this analysis. Results are reported for patients with and without dorsocervical (DC) fat deposition.ResultsDemographic characteristics of responders at week 26 are shown according to presence or absence of DC fat (Table 1). At week 26, on average, the patients with DC fat deposition had higher BMI and waist circumference (WC) than the group without DC fat. Most patients in both groups had lipoatrophy. Metabolic and anthropometric parameters were measured at week 26 in patients with and without DC fat (Table 2). There was a decrease in VAT and also an improvement in their WC at week 26 in both groups.Table 1: Baseline Characteristics of Tesamorelin Responder Subjects at Week 26, by Dorsocervical Status Table 2: Change in Abdominal Adiposity, Insulin-Like Growth Factor-1 Levels, and Metabolic Parameters Between Baseline and Week 26 Among Tesamorelin Responders ConclusionThis data demonstrates that tesamorelin is effective at reducing VAT in both patients with and without DC fat. The medication was well tolerated without significant changes to metabolic based measurements. Treatment of excessive VAT with tesamorelin has seemingly positive results in fat reduction in patients with or without DC fat deposition and our study contributes to the growing literature.DisclosuresMarilyn de Chantal, PhD, Theratechnologies Inc (Employee) Pedro Mesquita, PhD, Theratechnologies, Inc. (Employee) Judith A. Aberg, MD, Theratechnology (Consultant)

The Effect of Direct Health Education on the Uptake of Screening by First Degree Relatives of Glaucoma Patients in Nigeria.

First degree relatives (FDRs) of glaucoma patients are more likely to present for screening when they are directly contacted and educated by health workers on the phone compared with when they are only invited by their relative with glaucoma. The aim was to determine the effect of direct health education by phone calls on the uptake of glaucoma screening among FDRs of primary open angle glaucoma patients as a glaucoma blindness control strategy in an asymptomatic high-risk African population. This was a randomized clinical trial in which 102 primary open angle glaucoma patients (probands) were randomized into control and intervention groups. Both proband groups were educated about glaucoma and requested by the investigator to invite their adult FDR to attend a screening clinic within 1 month. In addition, the FDRs in the intervention group were directly contacted, educated, and invited for examination by phone calls. A total of 560 FDRs were enumerated by the probands. The main outcome measure was proportion of FDR that presented for screening. A total of 218 (38.9%) FDRs took up glaucoma screening services. Eighty-nine (30.1%) of the 296 FDRs in the control group and 129 (48.9%) of the 264 FDRs in the intervention group presented for examination. After multivariate analysis, FDRs in the phone call group were 2.506 times [95% confidence interval (CI): 1.695-3.706] more likely to present than FDRs in the no phone call group. Young FDRs were more likely to present [odds ratio (OR)=3.593; 95% CI: 1.613-8.007] than the elderly FDRs, while FDRs living within 200 km of the hospital were also more likely to present (OR=5.200; 95% CI: 2.860-9.456) than those living far (>200 km) away. Probands with moderate to severe visual impairment were significantly more likely (OR=3.073; 95% CI: 1.845-4.352) to have their FDRs present than probands with mild or no visual impairment. Direct contact and health education of FDRs through phone calls had a significant positive effect on the uptake of glaucoma screening by FDRs. We recommend direct contact and education of the FDRs of glaucoma patients.

How do the blind 'see'? The role of spontaneous brain activity in self-generated perception.

Spontaneous activity of the human brain has been well documented, but little is known about the functional role of this ubiquitous neural phenomenon. It has previously been hypothesized that spontaneous brain activity underlies unprompted (internally generated) behaviour. We tested whether spontaneous brain activity might underlie internally-generated vision by studying the cortical visual system of five blind/visually-impaired individuals who experience vivid visual hallucinations (Charles Bonnet syndrome). Neural populations in the visual system of these individuals are deprived of external input, which may lead to their hyper-sensitization to spontaneous activity fluctuations. To test whether these spontaneous fluctuations can subserve visual hallucinations, the functional MRI brain activity of participants with Charles Bonnet syndrome obtained while they reported their hallucinations (spontaneous internally-generated vision) was compared to the: (i) brain activity evoked by veridical vision (externally-triggered vision) in sighted controls who were presented with a visual simulation of the hallucinatory streams; and (ii) brain activity of non-hallucinating blind controls during visual imagery (cued internally-generated vision). All conditions showed activity spanning large portions of the visual system. However, only the hallucination condition in the Charles Bonnet syndrome participants demonstrated unique temporal dynamics, characterized by a slow build-up of neural activity prior to the reported onset of hallucinations. This build-up was most pronounced in early visual cortex and then decayed along the visual hierarchy. These results suggest that, in the absence of external visual input, a build-up of spontaneous fluctuations in early visual cortex may activate the visual hierarchy, thereby triggering the experience of vision.

Comparing palonosetron and lignocaine pretreatment with venous occlusion on reducing rocuronium associated withdrawal movements. A double blinded randomized control trial

Introduction: Use of rocuronium has been associated with withdrawal movements of injected arm during its administration. Our study is to compare the effectiveness of palonosetron vs. lignocaine pretreatment with venous occlusion on reducing withdrawal movements associated with rocuronium injection. Materials and Methods: This prospective randomized double blind trial includes 150 patients aged between 18 and 65 years undergoing elective day-care surgeries. Patients were randomly divided into 3 groups of 50 patients each with assistance from computer generated random number table. Group P received palonosetron 075mg, Group L received Lignocaine 30 mg and Group S received Normal saline as pretreatment. The degree of withdrawal of limb was graded on four-point scale. Haemodynamic changes namely HR and MAP following administration of study drugs and complications following administration of the study drugs like urticaria, wheal and rash were also monitored. Results: Overall incidence of rocuronium induced withdrawal movements was significantly more in-group S (84%) than other study groups (p Conclusion: Study demonstrated that palonosetron pretreatment and venous occlusion has reduced rocuronium induced withdrawal movements more effectively than lignocaine. Keywords: Palanosetron, Rocuronium, Withdrawal movements, Lignocaine.

Mifepristone for cervical ripening and induction of labour

Objective: To study the efficacy of oral mifepristone in pre induction cervical ripening and induction of labour in term pregnancy. Materials and Methods: This is a single blind randomised control trial. 200 women with term pregnancy and bishop score < 6 were recruited and randomly allocated into two groups. Women who received tablet mifepristone 400 mg were assigned to study group (n=100) and who received placebo orally were assigned to control group (n=100). At the end of 48 hours, change in the bishop was assessed and accordingly induction/ augmentation of labour was done. Analysis regarding safety and efficacy of the drug was done with regards to maternal and perinatal outcome. Results: Among 200 women, 100 received mifepristone and 100 received placebo. In mifepristone group, 75% patients entered into labour within 48 hours of induction as compared to 48% in placebo group. The mean time interval between induction to start of labour pains was 28 hours 54 min in group A and 42 hours 18 min in group B. This difference was statistically significant. (p=0.000). In the study group 70% patients delivered within 48 hours of treatment as compared to 38% patients in control group. Mean induction delivery interval was 35 hours 38 min in study group and 49 hours 52 min in control group (p=0.000). There were fewer caesareans in the mifepristone treated group (10%) than placebo group (20%) particularly for failed induction (2 versus 6) and non progress of labour (2 versus 5). There was no statistically significant different in perinatal outcome between two groups. Conclusion: Mifepristone has modest affect on cervical repining when given 48 hour prior to labour induction and appears to reduce need for further induction compared to placebo. Mifepristone is a simple and effective method of inducing labour in women with term pregnancy and unripe cervix. The use of Mifepristone provides an interesting new alternative to classic uterotonic agents when induction of labour is neces

Foley's Catheter with or without Misoprostol in Induction of labor: (Randomised Double Blind Control Study)

Background: Labor induction is the initiation of labor at a viable pregnancy duration by artificial means, and occurs before the spontaneous onset of labor. The goal of labor induction is to achieve a timely and uncomplicated vaginal delivery with minimal adverse effects on the mother or newborn.Aim: This study aimed to compare the efficacy of the use of Foley’s catheter with either misoprostol or placebo to improve induction to delivery interval in women with unfavorable cervix undergoing induction of labor.Materials and Methods: The present study is a randomized double blind controlled study that that was conducted at Maternity Hospital of Ain-Shams University. The study included 100 candidates on 4 equal goups :50 nulliparas randomized into 2 groups and 50 multiparas randomized into 2 groups. Each group underwent labor induction by Foley's catheter and Misoprostol or placebo.Results: Labor stages were significantly shorter in combined group than in Foley's group, but no significant difference in third stage. Oxytocin duration and total dose were significantly lower in combined group. No significant difference among studied groups regarding mode of delivery or fetal or maternal complications.Conclusion: Combined Foleys catheter and misoprostol provides a shorter duration of cervical ripening, less oxytocin required with no added complications compared to Foley’s catheter alone.

Cataract surgery barriers, cataract surgical coverage and outcome among rural population of Dhule district in Maharashtra

Background: In India the coverage and outcome of cataract management are through camps and hospital undertaking rural cataract surgical services. There are varied outcomes of cataract surgery in population based studies within our country while cataract surgical outcomes have inbuilt dependency on various factors. National program for control of blindness and visual impairment aims in improvement of vision of the cataract patients. Thus evaluating cataract outcome would help top strengthen the national program.Methods: The study was part of population based blindness survey carried out among 40 years and above rural population in Dhule district of Maharashtra during 2019. In the survey 2370 villagers, 40 years and above were surveyed for blindness prevalence by 30 Cluster sampling technique having 79 peoples from each cluster. Collection of baseline data with information of eye care services and ophthalmic examination was done.Results: Prevalence of cataract in 40 year and above population in study was 20.78%. In present study predominant barrier in cataract operation in 71.1% participants for not having consultation was belief it to be destiny or God’s will. 20.3% cataract patients with visual impairment had visual acuity of 6/60 and 18.4% had less than 3/60 visual acuity. Maximum participants had cataract operated in government hospital 61.7%. In the study cataract surgical coverage was 72.7% by eyes and 81.7% by person for visual acuity &lt;3/60.Conclusions: Efforts to increase cataract surgical coverage would help to reduce the prevalence of visual impairment due to cataract.

The effectiveness of routine physiotherapy with and without neuromobilization on pain and functional disability in patients with shoulder impingement syndrome; a randomized control clinical trial

BackgroundThe objective of the study was to compare the effects of neuromobilization (NM) techniques and routine physiotherapy on pain and functional disability in patients having shoulder impingement syndrome (SIS). Present study was aimed to discover evidence based conservative and cost effective remedy on pain and functional disability.Study designSingle blinded randomized control clinical trial.MethodsA total of 80 patients with SIS were randomly assigned into care and experimental groups (40 in each group). After the baseline assessment routine physiotherapy was executed on both groups, while NM was applied additionally to experimental group. Pain and functional disability score were evaluated by Visual Analogue Scale and University of California at Los Angeles rating score at baseline, 5th and 11th week. Differences in outcome between groups were evaluated with clinical improvement.ResultsThe experimental group compared with care group at 11th week had lower mean pain score 2.15(1.66–2.64) vs 4.90(4.41–5.40); between group difference, 1.82; 95% (CI), − 2.38 to − 1.25; P < 0.001 and Partial ƞ2 = 0.33, similarly functional disability score 28.58(27.32–29.83) vs 20.10(18.84–21.36); between group difference,5.62; 95%CI, (4.32–6.92); P< 0.001 and Partial ƞ2 = 0.49 respectively. In experimental group NM was a more effective technique to reduce the pain severity and disability in SIS patients as compare to care group.ConclusionNeuromobilization techniques in addition to routine physiotherapy were significantly effective for the treatment of SIS.Trial registrationIRCT20190121042445N1, Registered 19 February 2019.

Efficacy of early structured pulmonary rehabilitation program in pulmonary function, exercise capacity, and health-related quality of life for patients with post-tubercular sequelae: A pilot study

BackgroundResidual structural changes in the lung along with pulmonary impairment remain in a large number of patients of tuberculosis after microbiological cure. The aim of this study was to determine whether 12 weeks of a structured pulmonary rehabilitation program (PRP) administered along with antitubercular treatment improved the baseline measurement of pulmonary function, exercise capacity, and health-related quality of life (HRQOL). MethodsA pilot study with single blind randomized control design was carried out in a tertiary care chest center. Spirometry, exercise capacity by 6-minute walk distance (6MWD), and HRQOL using St George respiratory questionnaire (SGRQ) score were evaluated in 62 patients, divided into 2 groups: intervention group (IG) (n = 31) and control group (CG) (n = 31) patients at baseline and at end of 12 weeks. IG completed 12 weeks of PRP. ResultsSignificant difference in forced expiratory volume in 1st second (FEV1) (2.94 L at baseline vs 3.18 L at end of 12 weeks of PRP, diff 0.239 L, p-0.001), forced vital capacity (FVC) (3.43 L vs 3.75L, p −0.00), 6MWD (440.6 m vs 574.6 m, p = 0.00), and SGRQ score of at baseline (24.5 m vs 11.1m, p = 0.00) was seen in the IG. At end of 12 weeks, there was statistically significant difference in FEV1(L) (p = 0.01, 95% CI −0.317 to −0.046), FVC(L) (p = 0.00, 95% CI −0.359 to −0.139),6MWD(m) (p = 0.00; 95% CI −101.6 to −49.57) between CG and IG. There was no statistically significant difference in SGRQ scores between the 2 groups (p = 0.231). ConclusionPRP administered along with treatment is beneficial in reducing residual pulmonary impairment.

"Fenofibrate as an adjuvant to phototherapy in pathological unconjugated hyperbilirubinemia in neonates: a randomized control trial."

Despite widespread phototherapy usage, many new-born infants remain in need of other invasive lines of therapy, such as intravenous immunoglobulins and exchange transfusions. Assessment of the efficacy and the safety of adding fenofibrate to phototherapy for the treatment of pathological jaundice in full-term infants. We conducted a double blinded randomized control study on 180 full-term infants with pathological unconjugated hyperbilirubinemia admitted to the NICU at Mansoura University Children's Hospital. They were randomly assigned to receive either oral fenofibrate 10 mg/kg/day for 1 day or 2 days or placebo in addition to phototherapy. The primary outcome was total serum bilirubin values after 12, 24, 36, 48, and 72 h from intervention. Secondary outcomes were total duration of treatment, need for exchange transfusions and intravenous immunoglobulin, exclusive breast-feeding on discharge, and adverse effects of fenofibrate. This study was registered at www.clinicaltrials.gov (NCT04418180). A total of 180 full-term infants were included, 60 in each group. Infants in group I and II showed significant reduction of bilirubin levels at 36, 48, and 72 h from intervention compared to group III, respectively. Fenofibrate administration was associated with significantly shorter duration of phototherapy, shorter hospital stay, and higher frequency of exclusive breast-feeding compared to phototherapy alone. Fenofibrate as an adjuvant to phototherapy in term neonate with pathological jaundice is well tolerated and associated with significant reduction of serum bilirubin levels, a shorter duration of phototherapy, shorter hospital stay and higher frequency of exclusive breast-feeding, without significant adverse effects in either the single or double dosage.

Efficacy of Low Daily Dose of Tadalafil as Mono-Therapy for Diabetic Patients With Lower Urinary Tract Symptoms Suggestive of Benign Enlargement of Prostate

Objective: To assess efficacy of tadalafil or tamsulosin versus placebo for LUTS/BEP. Methods: This was a triple blind randomized control trial (RCT). This study was done on 150 cases of well controlled diabetic patients with LUTS/BEP after screening. The patients were &gt;45 years of age, international prostate symptom score (IPSS) &gt; 13, maximum urine flow rate (Qmax) 10-15 ml/sec. Selected patients were randomized in to 1:1:1 ratio to once-daily tadalafil 5 mg, tamsulosin 0.4 mg, or placebo for 12 weeks. Efficacy measures were assessed by IPSS, Qmax, post-voidal residue (PVR) in ultra-sonogram. Results: IPSS significantly improved versus placebo through 12 wk with tadalafil (-4.81; p&lt;0.001) and tamsulosin (-4.03; p&lt;0.001) and as early as 1 wk (tadalafil -2.04; p=0.001 and tamsulosin -2.14; p &lt; 0.001). The IPSS Quality-of-Life Index improved significantly versus placebo with tadalafil (p&lt;0.001) and with tamsulosin (p&lt;0.001) but outcome was better with tadalafil. Qmax increased significantly versus placebo with both tadalafil (6.52 ml/s; p&lt;0.001) and tamsulosin (6.64 ml/s; p&lt;0.001). Adverse event profiles were consistent with previous reports. Conclusion: Monotherapy with 5 mg daily tadalafil or 0.4 mg daily tamsulosin resulted in significant and similar improvements versus placebo in IPSS+QOL in diabetic patients with LUTS/BEP staring from week one and maintained throughout the week 12. It However, Tadalafil also significantly improve Qmax. The adverse event profile was minimal and consistent with those previously reported with these drugs. Bangladesh Journal of Urology, Vol. 20, No. 1, January 2017 p.18-25

Efficacy of Lidocaine and Ketamine Combination on Reduction of Pain Intensity, Improvement of Functional State and Central Desensitization of Chronic Low Back Pain

Abstract&#x0D; Background: Chronic low back pain (LBP) prevalence is approximately 20% of world population. Central and peripheral sensitization are considered as the main mechanism of pain chronification. This study hypothesize that lidocaine and ketamine combination reduces pain intensity, improves functional state and central desensitization of chronic low back pain. It is by modulating central sensitization in sub-anesthetic dose, prolonging inactivation of Na-channel, blocking NMDA-receptor and preventing secondary hyperalgesia.&#x0D; Aim of study: To evaluate the efficacy of lidocaine and ketamine combination on the intensity of pain, functional state and central desensitization of chronic low back pain.&#x0D; Methods:. This double blind randomized control trial study was carried out in Mohammad Hoesin General Hospital, Palembang, Indonesia from May 2018 to January 2019. A total of 20 patients with low back pain that last for more than 3 months, aged &gt;18 years old, of either sex who were willing to be enrolled in this study, were randomly allocated into one of the two groups of 10 each. The treatment group (n=10) received standardized therapy (analgesic and physiotherapy) + intravenous ketamine 0.5 mg/kg + lidocaine 2 mg/kg and the control group (n=10) received standardized therapy + 100 ml Nacl 0.9%. Pain intensity, functional state, and central desensitization were measured before the treatment, day 7 after treatment, and a month after treatment using Numeric Pain Rating Scale (NPRS), Functional Pain Scale (FPS), and Central Sensitization Inventory (CSI).&#x0D; Results: The administration of ketamine 0.5 mg/kg + lidocaine 2 mg/kg resulted in NPRS and CSI changes was effective since the 7th day post intervention (p-value=0.021 and p-value=0.001) while on FPS changes, it was effective since the 30th day post intervention (p-value=0.000)&#x0D; Conclusion: From the result, it could be concluded that the administration of ketamine and lidocaine is effective on decreasing pain intensity and central desensitization in chronic LBP.