Patients In Experimental Group Research Articles

Early Complications of a Novel Retrograde Intramedullary Femoral Nail in the Treatment of Femur Fractures.

To determine the early implant failure rate of a novel retrograde intramedullary femoral nail. Retrospective cohort study. Academic level 1 trauma center. Patients aged 18 years and older with an acute OTA/AO 32-A, 32-B, 32-C, and 33-A fractures or periprosthetic distal femur fracture from April 2018 to April 2022 were included in the study. The 2 interventions compared were the Synthes Expert retrograde/antegrade femoral nail (or control implant) versus the next-generation retrograde femoral nail (RFN)-advanced retrograde femoral nail (RFNA or experimental implant) (Synthes, West Chester, PA). Early implant-related complications between the experimental and control implants were assessed including locking screw back out, screw breakage, intramedullary nail failure, need for secondary surgery, and loss of fracture reduction. Three hundred fourteen patients were identified with a mean age of 31.0 years, and 62.4% of the patients being male. Open fractures occurred in 32.5% of patients with 3.8% of injuries being distal femur periprosthetic fractures. Fifty-six patients were in the experimental group and 258 patients in the control group. Mean follow-up was 46.8 weeks for the control cohort and 21.0 weeks for the experimental cohort. Distal interlocking screw back out occurred in 23.2% (13 of 56) of the experimental group patients and 1.9% (5 of 258) of the control group patients ( P < 0.0001). Initial diagnosis of interlocking screw back out occurred at an average of 3.2 weeks postoperatively (range, 2-12 weeks). Fifty-four percent of patients who sustained screw back out underwent a secondary operation to remove the symptomatic screws (12.5% of all patients treated with the experimental implant required an unplanned secondary operation due to screw back out). A logistic regression model was used to predict screw back out and found the experimental implant group was 4.3 times as likely to experience distal locking screw back out compared with the control group ( P = 0.01). The retrograde femoral nail-advanced implant was associated with a significantly higher rate of screw back out with a substantial number of unplanned secondary surgeries compared with the previous generation of this implant. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

The effect of informing patients with video before cardiac surgery on intensive care experience: A randomized controlled trial

Objectives: To study the effect of informing patients with video before cardiac surgery on intensive care experience. Methods: This randomized controlled trial was conducted between December 2021 and December 2022 in the cardiovascular surgery clinic of a public hospital with the participation of 90 patients (45 patients in experimental group - 45 patients in control group) who were scheduled to undergo cardiac surgery. Patient Information Form and Intensive Care Experiences Scale were used for study data. Patients in experimental group were informed with video about the intensive care before cardiac surgery. Results: It was found that the total score on ICES of the experimental group (74.5±3.9) was statistically and significantly higher than that of the control group (63.9±6.4) (p&lt;0.001). The sub-dimension of awareness of surroundings (20.8±1.7), the frightening experiences (18.6±1.0), and the recall of experience (18.5±1.5) and satisfaction with care (16.7±1.4) were found to be statistically significantly higher in the experimental group, than in the control group sub-dimension scores (p&lt;0.001). Conclusion: It was found that informing patients with video about the intensive care setting and process before cardiac surgery had a positive effect on the intensive care experience. Note: The study was produced from a master’s thesis and was not presented. All participants gave informed consent for the study, and that their anonymity was preserved. Trial Registration NO.: NCT05255887. doi: https://doi.org/10.12669/pjms.40.6.8627 How to cite this: Kalkan A, Digin F. The effect of informing patients with video before cardiac surgery on intensive care experience: A randomized controlled trial. Pak J Med Sci. 2024;40(6):1067-1072. doi: https://doi.org/10.12669/pjms.40.6.8627 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Benefits and Risks of Receiving Investigational Solid Tumor Drugs in Randomized Trials : A Systematic Review and Meta-analysis.

Many patients participate in cancer trials to access new therapies. The extent to which new treatments produce clinical benefit for trial participants is unclear. To estimate the progression-free survival (PFS) and overall survival (OS) advantage of assignment to experimental groups in randomized trials for 6 solid tumors. ClinicalTrials.gov was searched for trials of investigational drugs with results posted between 2017 and 2021. Investigational drugs were defined as those not yet having full approval from the U.S. Food and Drug Administration for the study indication. Trials were included if they were randomized and tested drugs or biologics. Data extraction was completed by 2 independent reviewers. Data were pooled using a random-effects model. The sample included 128 trials comprising 141 comparisons of a new drug and a comparator. These comparisons included 47 050 patients. The pooled hazard ratio for PFS was 0.80 (95% CI, 0.75 to 0.85), indicating statistically significant benefit for patients in experimental groups. This corresponded to a median PFS advantage of 1.25 months (CI, 0.80 to 1.68 months). The pooled hazard ratio for OS was 0.92 (CI, 0.88 to 0.95), corresponding to a survival gain of 1.18 months (CI, 0.72 to 1.71 months). The absolute risk for a serious adverse event for comparator group patients was 29.56% (CI, 26.64% to 32.65%), with an increase in risk of 7.40% (CI, 5.66% to 9.14%) for patients in experimental groups. Trials in this sample were heterogeneous. Comparator group interventions were assumed to reflect standard of care. Assignment to experimental groups produces statistically significant survival gains. However, the absolute survival gain is small, and toxicity is statistically significantly greater. The findings of this review provide reassuring evidence that patients are not meaningfully disadvantaged by assignment to comparator groups. Canadian Institutes of Health Research.

First-line oxaliplatin-based chemotherapy and nivolumab for metastatic microsatellite-stable colorectal cancer-the randomised METIMMOX trial.

We evaluated first-line treatment of metastatic microsatellite-stable colorectal cancer with short-course oxaliplatin-based chemotherapy alternating with immune checkpoint blockade. Patients were randomly assigned to chemotherapy (the FLOX regimen; control group) or alternating two cycles each of FLOX and nivolumab (experimental group). Radiographic response assessment was done every eight weeks with progression-free survival (PFS) as the primary endpoint. Cox proportional-hazards regression models estimated associations between PFS and relevant variables. A post hoc analysis explored C-reactive protein as signal of responsiveness to immune checkpoint blockade. Eighty patients were randomised and 38 in each group received treatment. PFS was comparable-control group: median 9.2 months (95% confidence interval (CI), 6.3-12.7); experimental group: median 9.2 months (95% CI, 4.5-15.0). The adjusted Cox model revealed that experimental-group subjects aged ≥60 had significantly lowered progression risk (p = 0.021) with hazard ratio 0.17 (95% CI, 0.04-0.76). Experimental-group patients with C-reactive protein <5.0 mg/L when starting nivolumab (n = 17) reached median PFS 15.8 months (95% CI, 7.8-23.7). One-sixth of experimental-group cases (all KRAS/BRAF-mutant) achieved complete response. The investigational regimen did not improve the primary outcome for the intention-to-treat population but might benefit small subgroups of patients with previously untreated, metastatic microsatellite-stable colorectal cancer. ClinicalTrials.gov number, NCT03388190 (02/01/2018).

A comparative study of the use of digital technology in the anterior smile experience

Objectivesthis study aims to compare the clinical outcomes of traditional and digital crown extension guides in the aesthetic restoration of anterior teeth. Additionally, the study will analyze the differences in the results of various digital crown extension guides in anterior aesthetic restorations.MethodsSixty-two patients who required aesthetic restoration of their anterior teeth were selected for this study. The patients had a total of 230 anterior teeth and were randomly divided into three groups: a control group of 22 cases who received diagnostic wax-up with pressure film, an experimental group 1 of 20 cases who received 3D printed digital models with pressure film, and an experimental group 2 of 20 patients who received digital dual-positioning guides. The control group had a total of 84 anterior teeth, experimental group 1 had 72 anterior teeth, and experimental group 2 had 74 anterior teeth. The study compared three methods for fabricating crown extension guides: the control group used the diagnostic wax-up plus compression film method, while experimental group 1 used compression film on 3D printed models and experimental group 2 used 3D printed digital dual-positioning crown extension guides. After the crown lengthening surgery, the control group patients wore DMG resin temporary crown material for gingival contouring, while the experimental group patients wore 3D printed resin temporary crowns for the same purpose. The patients were followed up in the outpatient clinic after wearing temporary crowns for 1 month, 3 months, and 6 months, respectively. The clinical results were evaluated in terms of marginal fit, red aesthetic index, and white aesthetic index.ResultsBased on the statistical analysis, the experimental group required significantly fewer follow-up visits and less time for guide design and fabrication compared to the control group. Additionally, the surgical time for the experimental group was significantly shorter than that of the control group. During the postoperative period between the 1st and 3rd month, the PES index scores for the marginal gingival level, proximal, and distal mesiodistal gingival papillae of the experimental group showed a trend of superiority over those of the control group. By the 6th month, the marginal gingival level exhibited a significant difference between the experimental and control groups. The experimental group demonstrated superior results to the control group in terms of shape, contour, and volume of the teeth, color, surface texture, and transparency of the restorations, and features during the 1st and 3rd postoperative months. In the 6th month, the comparative results indicated that the experimental group continued to exhibit superior outcomes to the control group in terms of the shape, color, surface texture, and transparency of the restorations, as well as the characteristics of the teeth. Additionally, the experimental group demonstrated significantly fewer gingival alterations than the control group at 1 month, 3 months, and 6 months post-procedure, with this difference being statistically significant. Furthermore, the combination of 3D printing technology and restorative techniques was utilized, resulting in consistent patient satisfaction.ConclusionDigitalisation plays an important role in anterior aesthetic restorations. The use of digital technology to manage the entire process of anterior cosmetic restorations can improve restorative results, reduce the number of follow-up appointments, shorten consultation time, and achieve better patient satisfaction.

The Effect of Training and Phone Counselling Provided to Hypertension Patients on their Medication Adherence and Rational Drug Use: A Single-blind Randomised Controlled Trial

Background: Hypertension is a chronic disease characterised by high blood pressure, which is an important public health problem that causes serious complications. It is very important to provide training and remote telephone counselling to patients for them to comply with the drug treatment of hypertension disease and to comply with the principles of rational drug use. Aim: This study aimed to define the effect of training and phone counselling provided to hypertension patients on their medication adherence and rational drug use. Methods: The study was conducted randomised controlled as a single-blind experimental study between July 2021 and June 2022. The study universe consisted of hypertension patients admitted to hospital, and the sample consisted of 92 patients. The block randomisation method was used. The study data were collected using a Patient Identification Form; the Medication Adherence Self-efficacy Scale; and the Rational Drug Use Scale. The experimental group received training once, in addition to a total of four phone counsellings (week 2-4-8-12). Results: According to the group-by-time interaction of control/experimental group patients, a statistical difference was found between the median scores of the Medication Adherence Self-efficacy Scale and the Rational Drug Use Scale (p&lt;0.001). The pre-test median of the Medication Adherence Self-efficacy Scale of the experimental group patients was 30.00, and the post-test median was 46.00. The pre-test median of the Rational Drug Use Scale of the experimental group patients was 43.00, and the post-test median was 68.00. Conclusion: In the study, it was determined that the application of education and telephone counselling to hypertension patients increased patients’ medication compliance and rational drug use. In systolic-diastolic blood pressure levels, which are critical for hypertension patients, it was determined that the application of education and telephone counselling significantly decreased the blood pressure of patients.

The efficacy of heart rate variability biofeedback training on sleep disorders and impact of fibromyalgia: Results of a phase II randomized controlled trial

ObjectiveFibromyalgia syndrome (FMs) is a chronic, musculoskeletal pain disorder characterized by sleep disturbances, fatigue, and cognitive dysfunction. Heart rate variability biofeedback (HRV-BF) aiming to improve self-regulation and strengthen the parasympathetic nervous system has been shown to be effective in several pain syndromes, but its efficacy in FMs has not been adequately investigated. This Phase II trial aimed to assess the feasibility and preliminary measurement of the improvement induced by HRV-BF in FMs. MethodsSixty-four patients with FMs were recruited. Patients were randomly assigned to either the experimental group (EG) or the control group (CG). The EG received 10 HRV-BF training sessions in addition to pharmacological standard therapy. The CG received standard therapies for 10 weeks. The FMs impact on daily life, sleep regularity, sense of coherence, depression symptoms and pain has been assessed as primary outcomes, quality of life as secondary. Result23 (71.9%) of EG patients completed the intervention and 20 (62.5%) of the CG were re-evaluated at time T1. No side effects were reported. It was not found any statistical differences between groups over time in primary and secondary outcomes. ConclusionsThe HRV-BF intervention did not demonstrate efficacy in both primary and secondary outcomes. However, it is quite feasible in terms of drop-out rate and side effects. Further studies with larger sample sizes are needed to determine its actual efficacy.ClinicalTrials.gov with code: NCT04121832

Involved-site Radiation Therapy is Equally Effective and Less Toxic Than Involved-field Radiation Therapy in Patients Receiving Combined Modality Treatment for Early-stage Unfavorable Hodgkin Lymphoma—An Analysis of the Randomized Phase 3 HD17 Trial of the German Hodgkin Study Group

PurposeCombined modality treatment (CMT) with chemotherapy followed by consolidation radiotherapy (RT), provides excellent outcomes for patients with early-stage Hodgkin lymphoma (HL). The international standard of care for consolidation RT, involved-site/involved-node radiotherapy (ISRT/INRT), has never been evaluated in a randomized phase III trial against the former standard involved-field radiotherapy (IFRT). Methods and materialsIn the multicenter phase III AnonymizedStudyGroupXXX AnonymizedStudyYYY trial, patients with early stage unfavorable HL were randomized between the standard CMT group and a positron-emission tomography (PET) -guided group. In the standard group, patients received two cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP) and two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by 30 Gray (Gy) IFRT. In the experimental group patients received no further therapy if post-chemotherapy PET was negative, and 30 Gy AnonymizedStudyGroupXXX -INRT, comparable and therefore termed here ISRT, if PET was positive. Here, we analyze the interim PET positive patients in a post hoc analysis, and therefore the randomized comparison of IFRT versus INRT/ISRT. Results1,100 patients were randomized, of which 311 had a positive PET after chemotherapy. Kaplan-Meier estimates of 4-year progression-free survival (PFS) were 96.8 % (95% CI: 91.6% – 98.8%) in the IFRT group and 95.4% (95% CI: 89.9% – 97.9%; HR: 1.40, 95% CI: 0.44 – 4.42) in the ISRT group. Pattern of recurrence analyses indicated that none of the cases of disease progression or recurrence in the ISRT group would have been prevented by the use of IFRT. Acute grade III/IV toxicities occurred in 8.5% of IFRT patients and 2.6% of ISRT patients (p=0.03). ConclusionsFor the first time, consolidation INRT/ISRT was randomly compared to IFRT in a phase III trial. Regarding PFS, no advantage for IFRT could be demonstrated. In summary, our data confirm the place of INRT/ISRT as the current standard of care.

Abstract 2522: Predictive value of tumor mutational burden (TMB) in patients with metastatic microsatellite-stable (MSS) colorectal cancer (CRC) given first-line oxaliplatin-based chemotherapy and immune checkpoint blockade (ICB)

Abstract Purpose: Most CRC patients harbor primarily non-immunogenic MSS tumor. The randomized METIMMOX trial (NCT03388190) examined if patients with previously untreated, unresectable abdominal metastases from MSS-CRC may achieve therapeutic efficacy from short-course oxaliplatin-based chemotherapy (FLOX) and sequential ICB (nivolumab) repeatedly. Half of study patients assigned to this experimental treatment had significantly extended progression-free survival (PFS) while the other half had shortened PFS, compared to the control-group patients given standard FLOX chemotherapy with median PFS 9.3 months. Here we explored if somatic mutations (mut) unveiled by next-generation sequencing might provide insights into responsiveness to the METIMMOX regimen. Procedures: Patients had MSS-CRC with infradiaphragmatic metastases deemed unresectable and were eligible for first-line oxaliplatin-based therapy. They were randomly assigned to the control group of FLOX (oxaliplatin, 5-fluorouracil, folinic acid) Q2W or the experimental group of alternating 2 cycles each of FLOX Q2W and nivolumab Q2W, with prespecified break periods. Radiologic response assessment was done every 8 weeks with PFS as the primary endpoint. Diagnostic tumor biopsies and baseline metastasis biopsies were sequenced with the TruSight Oncology 500 assay. TMB was calculated using only coding, non-synonymous single-nucleotide variants and insertions/deletions with variant allele frequency ≥5% and sequencing depth ≥50 ×, applying the effective panel size as the megabases (Mb) denominator. Results: Sequencing data were acquired from 20 experimental-group patients with median PFS 7.9 months (minimum 2.0, maximum 41.6). Median TMB was 5.1 mut/Mb (minimum 0.8, maximum 11.8), concordant in patient-paired primary tumor and metastasis specimens. The TMB was associated with treatment outcome; the higher TMB, the better PFS with hazard ratio 0.83 (95% confidence interval (CI) 0.70-0.98; p = 0.026, Cox regression) for a PFS event with increasing TMB. TMB cut-off as low as 5.0 mut/Mb distinguished between patient groups (p = 0.007, log-rank test) with median PFS 34.9 months (95% CI 10.6-59.2; TMB&amp;gt;5, n = 10) and median PFS 4.6 months (95% CI 2.7-6.5; TMB≤5, n = 10). In the TMB&amp;gt;5 group, 8/10 were KRAS- or BRAF-mutant cases. In the TMB≤5 group, 9/10 metastasis specimens were RAS/BRAF-wildtype cases. Conclusions: TMB &amp;gt;5 mut/Mb was associated with tumor KRAS or BRAF driver mutation and remarkably long PFS in first-line treatment of patients with abdominal metastases from MSS-CRC with alternating short-course oxaliplatin-based chemotherapy and ICB. Citation Format: Anne Hansen Ree, Paula A. Bousquet, Hilde L. Nilsen, Torben Lüders, Shixiong Wang, Tina Visnovska, Diana L. Bordin, Eirik Høye, Hanne M. Hamre, Christian Kersten, Eva Hofsli, Marianne G. Guren, Halfdan Sorbye, Kjersti Flatmark, Sebastian Meltzer. Predictive value of tumor mutational burden (TMB) in patients with metastatic microsatellite-stable (MSS) colorectal cancer (CRC) given first-line oxaliplatin-based chemotherapy and immune checkpoint blockade (ICB) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2522.

A Randomized Controlled Trial on Pranayama and Yoga Nidra for Anxiety and Depression in Patients With Cervical Cancer Undergoing Standard of Care.

Introduction Cervical cancer might intensify the psychological distress among patients with cervical cancer and the distress caused by the diagnosis and treatment. So, depression and anxiety are at higher levels in patients with cervical cancer. Yoga Nidra and Pranayama are thought to reduce the aftereffects of chemotherapy and radiotherapy potentially. So, in this study, we used the techniques of Yoga Nidra and Pranayama to evaluate their effect on patients with cervical cancer undergoing standard care. Methodology Seventywomen with cervical cancer were randomized into experimental and control groups. The experimental group of patients with cervical cancer received 30 minutes of yoga intervention twice daily five days a week, for six weeks. The control group was given only the standard of care. The outcome measures were assessed using the Hospital Anxiety and Depression Scale (HADS) questionnaire. The assessment was done at baseline, second, fourth, and sixth weeks. Results The results of within‑group comparisons in both groups showed that there was a significant improvement in depression and anxiety scores, with P ≤ 0.05 being considered statistically significant. Between groups, analysis shows that in the preintervention, there was no difference between the yoga and control group as P > 0.05. After the yoga intervention, there was an enhancement in depression and anxiety scores. Conclusions The results of thestudy concluded that the Yoga Nidra and Pranayama module can be given as adjuvant therapy to the standard of care in patients with cervical cancer for treating the disease and treatment-related anxiety and depression.

Integrative effects of transcutaneous auricular vagus nerve stimulation on esophageal motility and pharyngeal symptoms via vagal mechanisms in patients with laryngopharyngeal reflux disease.

Laryngopharyngeal reflux disease (LPRD) is primarily characterized by discomfort in the pharynx and has limited treatment options. This research aimed to assess the efficacy of transcutaneous auricular vagus nerve stimulation (tVNS) in patients with LPRD and delve into the potential underlying mechanisms. A total of 44 participants, diagnosed with LPRD were divided into two groups randomly. Twice-daily stimulation was delivered for 2 weeks for patients in experimental group, with stimulation ranging from 1.0 mA to 1.5 mA (n = 22), while the control group underwent sham tVNS (n = 22) with the same stimulation parameters and different anatomical location. The severity of symptoms and levels of anxiety and depression were monitored using questionnaires. High-resolution esophageal manometry data were collected, and the patients' autonomic function was assessed through heart rate variability analysis. There was a positive correlation between reflux symptom index (RSI) scores and low frequency/high frequency (LF/HF) ratio (r = 0.619; p < 0.001), Hamilton anxiety scale (HAMA) scores (r = 0.623; p < 0.001), and Hamilton depression scale (HAMD) scores (r = 0.593; p < 0.001). Compared to the pre-tVNS phase, RSI (p < 0.001), HAMA (p < 0.001), and HAMD (p < 0.001) scores were significantly reduced after 2 weeks of treatment. Additionally, the resting pressure of the upper esophageal sphincter (UESP; p < 0.05) and lower esophageal sphincter (LESP; p < 0.05) showed significant enhancement. Notably, tVNS led to an increase in root mean square of successive differences (RMSSD; p < 0.05) and high frequency (HF; p < 0.05) within heart rate variability compared to the pre-treatment baseline. Compared to the control group, RSI (p < 0.001), HAMA (p < 0.001), and HAMD (p < 0.001) scores in tVNS group were significantly lower at the end of treatment. Similarly, the resting pressure of UESP (p < 0.05) and LESP (p < 0.05) in tVNS group were significantly higher than that of control group. Notably, RMSSD (p < 0.05) and HF (p < 0.05) in tVNS group were significantly higher than that of control group. This study demonstrated that tVNS as a therapeutic approach is effective in alleviating LPRD symptoms. Furthermore, it suggests that improvements in esophageal motility could be associated with vagus nerve-dependent mechanisms.

The Effectiveness of Behavior Modification Therapy on Level Of Anxiety Among Substance Addicted Patients in Selected De-Addiction Center Meerut

Statement of the Problem: A study to assess the effectiveness of behavior modification therapy on level of anxiety among substance addicted patients in selected de-addiction center Meerut, U.P. Objectives: 1. To assess the level of anxiety among substance addiction patients in experimental and control group. 2. To deliver the behavioral modification therapy in experimental group. 3. To evaluate the effectiveness of behavioral modification therapy on level of anxiety among substance addiction patients in experimental group. 4. To compare the level of anxiety among substance addiction patients in experimental and control group. 5. To associate the level of anxiety and their selected variables among the substance addiction patients in experimental and control group . Methods: A quasi experimental study was conducted on 60 substance addicted patients, 30 in experimental group and 30 in control group selected by purposive sampling technique having kept the inclusion and exclusion criteria. The tools used for this study was Standardized Hamilton Anxiety scale for assessing the level of anxiety among substance addicted patients and its demographic variables. Results: Major findings of the study: Findings of the study reveals that the effectiveness of behavioural modification therapy is help to decrease the level of anxiety Among Experimental Group Pre-test scores shows that that majority of samples 16(53%) had mild to moderate anxiety, 08 (27%) had mild anxiety and 04 (13%) had moderate to severe anxiety and post-test data represented that majority of samples 20(66%) had mild anxiety, 06 (20%) had mild to moderate anxiety, and 02 (7%) had severe anxiety. Conclusion: The results and findings of this study shows that Behavior modification therapy is very effective and significant to decrease the level of anxiety among substance use patients from selected rehabilitation center, Meerut.

Hybrid Neuro-Fuzzy Classifier for Monitoring the Effectiveness of Treatment of Diseases of the Respiratory System, Taking into Account Comorbidity

The purpose of research is to develop a hybrid neuro-fuzzy classifier for remote monitoring of the severity of community-acquired pneumonia, taking into account the risk of concomitant diseases.Methods. To assess the severity of community-acquired pneumonia and determine the effectiveness of its treatment plan, a hybrid neural network is included in the hybrid neuro-fuzzy classifier, which contains three macrolayers: PNNFNN-FNN*. The number of decisive blocks of the PNN macrolayer is equal to the number of segments allocated in the space of informative features, and the output of each PNN block produces risk and non-risk assessments of communityacquired pneumonia by severity clusters. Aggregation of decisions made over N segments of the space of informative features is carried out in the FNN layer, which has the structure of a fuzzy decision-making module. The aggregation of 2L PNN-FNN outputs occurs in the FNN* macrolayer. The same macrolayer takes into account the influence of comorbidity on the severity of community-acquired pneumonia.Results. The testing of a hybrid neuro-fuzzy classifier of the severity of community-acquired pneumonia was carried out on an experimental group of patients with community-acquired pneumonia with comorbidity in the form of coronary heart disease. Indicators of the quality of classification of the severity of pneumonia taking into account the risk of comorbid disease using the example of coronary heart disease showed that the aggregation of the classifier of the severity of community-acquired pneumonia and the classifier of the risk of comorbid disease in the form of a hybrid neuro-fuzzy classifier makes it possible to improve the quality of assessing the severity of community-acquired pneumonia by more than 10% for all quality indicators.Conclusion. A hybrid neuro-fuzzy classifier, built on different pattern recognition paradigms, makes it possible to identify clusters of disease severity and improve the quality indicators for classifying the severity of community-acquired pneumonia in the presence of comorbidity by an average of 12%.

Effectiveness of Percutaneous Electrical Nerve Stimulation Versus Conventional Therapy in Adults with Plantar Fasciitis

Background: Plantar Fasciitis is a degenerative condition of the heel. Percutaneous electrical nerve stimulationand conventional therapy was used as intervention treatment for heel pain.Purpose: The Purpose of this was to compare the efficacy of Pens and Conventional therapy in management ofplantar fasciitis.Materials and Methods: The experimental and control groups included 30 young males and females who wererandomly assigned to each group. The experimental group patients underwent Pens and conventional groupunderwent ultrasound treatment, plantar stretch, and exercise. Before and after four -week sessions of therapyeach participant was asked to score their morning pace using a numerical rating scale and functional foot indexas outcome measures.Result: The experimental group showed a substantial difference compared to the conventional group (p &lt;0.0001),indicating a statistically significant outcome. When comparing both groups there was a statistically significantdifference after intervention.Conclusion: Patients treated for heel pain reacted well to the conventional strategy used in this study, but Pensfollowed by active stretching dramatically reduced pain severity and improved the quality of foot function.

Effects of lavender essential oil inhalation aromatherapy on depression and sleep quality in stroke patients: A single-blind randomized controlled trial

Background and purposePost-stroke depression (PSD) has major implications for rehabilitation, motor recovery, activities of daily living, social and interpersonal functioning, and mortality. In view of the side effects of antidepressants, aromatherapy, a widely used non-pharmacological therapy, has received growing attention in recent years for its benefits of reduced complications, accessibility, and effectiveness. This study was designed to assess the effects of inhalation aromatherapy with lavender essential oil on depression and sleep quality in patients with PSD. Materials and methodsForty patients with PSD were enrolled and randomized into experimental and placebo groups. Experimental-group patients inhaled microencapsulated lavender essential oil every night at bedtime over a period of 4 weeks. A nonwoven bag containing 2.3 g of microcapsules with about 1.5 g of lavender essential oil was placed on or under the patient's pillow, depending on the patient's scent sensitivity. Placebo-group patients used the empty nonwoven bags for the same period as the experimental group. The 17-item Hamilton Rating Scale for Depression (HAMD-17), the Zung Self-Rating Depression Scale (SDS), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure outcomes. ResultsThe HAMD-17 score, SDS score, and PSQI score showed statistically significant differences between both groups before and after intervention (P ≤ 0.01). The improvement in the experimental group was more marked than in the placebo group (P < 0.05). ConclusionLavender essential oil inhalation aromatherapy may help reduce depression and improve sleep quality in patients with PSD.

Effect of atorvastatin calcium plus clopidogrel in the treatment of patients with transient ischemic attacks and its effect on blood lipids and platelets

Objective To explore the clinical effect of atorvastatin calcium combined with clopidogrel in the treatment of patients with transient ischemic attacks (TIAs) and its effect on blood lipids and platelets. Methods Low-density lipoprotein cholesterol (LDL-C)], platelet-related parameters [prothrombin time (PT), activated partial thromboplastin time (APTT), platelet count (PLT)], incidence of cerebral infarction, and adverse reactions. Results The clinical outcomes of the experimental group patients were significantly better than those of the control group patients (p < 0.05). The experimental group exhibited notably lower levels of TG, TC, and LDL-C compared to the control group (p < 0.05). Platelet-related indices—PT, APTT, and PLT—showed no significant differences between groups before and after treatment (p > 0.05). The incidence of cerebral infarction was notably lower in the experimental group (p < 0.005), while the occurrence of adverse reactions showed no significant difference between groups (p > 0.05). Conclusion Atorvastatin calcium combined with clopidogrel demonstrates a positive impact on individuals with TIAs by significantly lowering levels of LDL, total cholesterol, and triglycerides. However, it is noteworthy that platelet-related indices did not exhibit significant differences between the experimental and control groups. While the observed improvements in blood lipids are attributed to the effects of atorvastatin, the combination with clopidogrel did not show a substantial influence on platelet-related parameters. Thus, the overall therapeutic impact, particularly on platelet-related indices, may require further investigation and clarification. Despite these nuances, our findings suggest potential benefits in reducing the risk of adverse reactions and cerebral infarction, supporting the consideration of this approach for wider clinical use.

The application of dual-heart nursing mode in patients with coronary heart disease and angina pectoris and its impact on anxiety, depression, and quality of life

To diagnose and treat patients with coronary heart disease and angina pectoris with dual heart care mode and analyze the treatment effect. Three hundred cases meeting the inclusion criteria were equally divided into 3 groups, each containing 50 male and female cases. The patients in experimental group 1 took the dual heart nursing method proposed by the subject; experimental group 2 received betastatins; control group received conventional treatment. After 12 weeks of treatment, Hamilton depression scale scored the 3 groups, and their anxiety and depression scores, clinical manifestations, symptom scores and self-acceptance were analyzed. The chi square value of these data was compared with P, and judge whether they meet the needs and differences of statistical data. Then compare their scores before and after treatment to identify the treatment status. The anxiety and depression scores of experimental group 1 were the lowest among the 3 groups, with the values of 59.62 ± 7.925 and 58.64 ± 6.416; The total patients who responded effectively to treatment in experimental group 1 accounted for 83%, and the patients who responded effectively to treatment rate was the highest in the 3 groups; The effect of decreasing the score of complications in experimental group 1 was also the most obvious, from 9.07 ± 4.28 to 3.14 ± 2.07, which was the best in the 3 groups; the self-evaluation of patients in experimental group 1 was the highest among the 3 groups, 89.72 ± 4.28. The proposed dual heart care and treatment method can effectively treat coronary heart disease and angina pectoris, and can effectively improve the clinical performance and self-acceptance of patients. It can effectively restore the anxiety and depression of patients after treatment, and then improve patients’ life quality, which has the value of popularization and use.

Discussion on the influence of optimizing the perioperative management on the recovery after laparoscopic hysterectomy.

The concept of enhanced recovery after surgery (ERAS) was first proposed by Professor Kehlet from the University of Copenhagen in Denmark in 1997. The aim is to optimize multiple perioperative management measures, promote rapid postoperative recovery, shorten hospital stay, and reduce surgical related costs, this article explores the effect of optimizing perioperative bowel preparation and diet management under the strategy of ERAS on the postoperative recovery of patients undergoing laparoscopic hysterectomy for benign gynecological diseases. We selected 90 patients who underwent laparoscopic total hysterectomy for benign gynecological diseases at Hebei General Hospital from June 2018 to June 2019, these patients are between the ages of 40 and 65. Divide these 90 patients into an experimental group and a control group using a random number table method (n = 45). The experimental group of patients applied the concept of accelerated rehabilitation surgery for perioperative intestinal preparation and dietary management. The control group patients received routine perioperative management. Compare the first postoperative exhaust time, first postoperative defecation time, incision healing status 7 days after surgery, and pelvic infection status 1 month after surgery between 2 groups of patients. The first postoperative exhaust time and first postoperative bowel movement time of the experimental group patients were shorter than those of the control group (P < .05), and the difference was statistically significant; The incidence of poor incision healing 7 days after surgery was lower than that of the control group (P < .05), and the difference was statistically significant; There was no statistically significant difference in the incidence of postoperative pelvic infection between the experimental group and the control group (P > .05). Perioperative intestinal preparation and dietary management under the concept of accelerated rehabilitation surgery can promote postoperative recovery of patients undergoing laparoscopic total hysterectomy, promote incision healing, and have good safety.

Effect of RhD and RhE sample phenotypic blood transfusion on the prognosis of hepatocellular carcinoma.

This study aimed to analyze the therapeutic effects and clinical outcomes of HCC patients, who received both RhD and RhE same phenotypic blood transfusion during perioperative period. Microcolumn gel technology (MGT) was used to detect Rh blood group phenotyping in 98 HCC patients. Patients received RhD and RhE same phenotypic transfusion were defined experimental group, and those received only RhD same phenotypic but RhE different phenotypic transfusion were included in control group. Hemoglobin (Hb) and hematocrit (HCT) before and after perioperative transfusion were analyzed. The occurrence of adverse transfusion reactions were observed. Survival analysis was performed using the Kaplan-Meier method. After the transfusion treatment, the Hb (118.9 ± 34.8 g/L vs 99.6 ± 26.9 g/L) and HCT [(34.0 ± 7.6)% vs (29.9 ± 8.8)%] of experimental group and the Hb (104.3 ± 36.2 g/L vs 94.8 ± 25.0 g/L) of control group were significantly higher than those before blood transfusion, respectively (all P < .05). In addition, Hb and HCT in experimental group were significantly higher than those in the control group after transfusion (P < .05). For the adverse blood transfusion reactions, the incidence of backache was reduced in the patients received Rh same phenotypic transfusion compared with those in control group (1.9% vs 15.2%, P = .024). The overall survival of patients in experimental group was better than that in control group (log-rank P = .036). Our study indicated that both RhD and RhE same phenotypic transfusion significantly increased Hb and HCT and reduced backache incidence than RhE different phenotypic transfusion in HCC patients. The overall survival of patients was improved by RhD and RhE same phenotypic transfusion.

A Study to Assess The effectiveness of Hot Application on Prevention of Thrombophlebitis among patients with a Peripheral Intravenous Cannula admitted in selected hospitals of Mehsana

Introduction: Thrombophlebitis occurs when a blood clot causes inflammation in one or more of the veins near the surface of the skin. Damage to a vein can occur as a consequence of indwelling catheters, trauma or the infection of the irritating substances. Objectives: 1. To assess the occurrence of thrombophlebitis among patients with a peripheral intravenous cannula by using modified thrombophlebitis scale in experimental and control group. 2. To assess the effectiveness of hot application on experimental group. 3. To compare the occurrence of thrombophlebitis among patients with an intravenous cannula in experimental and control group. 4. To find out the association between the occurrence of thrombophlebitis with their selected demographic variables. Hypothesis: H0: There will be no significant difference in the occurrence of thrombophlebitis among patients with a peripheral intravenous cannula in experimental group and control group. H1: There will be a significant difference in the occurrence of thrombophlebitis among patients with a peripheral intravenous cannula in experimental group and control group. Design: A quantitative approach using quasi experimental two group post test. Participants: 30 patient in experimental group and 30 patients in control group were selected using Non-Probability convenient sampling technique. Tool: standardized phlebitis scale for using the assess thrombophlebitis among patients with peripheral IV cannula. Results: The mean score of experimental group patients 0.46 was less than control group patients 2.83 and ‘t’ test show that there was a significant difference in the occurrence of thrombophlebitis (‘t’=8.43, p&gt;0.05) between experimental group and control group. Conclusion: From the above findings, it evident that hot application is effective on prevention of thrombophlebitis among patients with peripheral IV cannula.