Patients In Test Group Research Articles

Effect of soft and prolonged Graeco-Arabic massage in low back pain - A randomized controlled clinical trial

BackgroundLow back pain (waja-uz-zahr) due to lumbar spondylosis affects approximately 60–80% of the population at any point of life. The present study was aimed to evaluate the efficacy of soft and prolonged massage with roghan-i-suranjan on low back pain. Material and methodsClinically and radiologically diagnosed patients of low back pain were randomized into test and control groups consisting 20 patients in each group. The patients in test group received soft and prolonged massage with roghan-i-suranjan; while, in control group, short wave diathermy was given on every alternate day up to 20 min for 3 weeks. The patients were assessed before and after the treatment using the VAS and ODI (OLBP) scales. ResultsVAS score was reduced to 42.14%, (p < 0.001) in massage and 13.94%, (p < 0.008) in control group after the treatment [Percentual Change (PC) between the groups = 54.35%, p < 0.001]. OLBP score was improved to 37.16% (p < 0.001) in massage and 5.93% (p < 0.0012) in control group after the treatment [PC between the groups = 29.57%, p < 0.02]. ConclusionApart from the muhallil-i-awram (anti-inflammatory), mulattif (attenuative), daf-i-alam (analgesic), and musakkin (sedative) activities of the tested-drugs, the specific strokes soft and prolonged massage further enhances the evacuative and rejuvenative process through its own action of tahleel (dissolution), talteef (attenuation), taskeen (sedation), and taskheen (diaphoresis) induced by the various manipulations used in this massage. Soft and prolonged massage with tested oil was found effective in reducing the pain and improving the quality of life in the patients of low back pain.

An evaluation of serum Otolin-1 & Vitamin-D in benign paroxysmal positional vertigo.

Serum otolin-1 is an inner ear protein exclusively expressed in otoconia and cells of vestibule and cochlea. Serum otolin-1 is found to be quantifiable in patients with BPPV. Low Vitamin-D is associated with pathogenesis of BPPV. Since otoconia degeneration contributes to BPPV, lack of Vitamin-D may impact otoconia structure and integrity. We aimed at studying the s.otolin-1 as biomarker and significance of vit-D in BPPV. 23 patients in test and control groups respectively were chosen within the age of 20 to 65 years. All the patients were diagnosed using Dix Hallpike menouver and head roll test, patients were treated with appropriate Canal Reposition Menouver (CRM). Serum Otolin-1 levels among the test ranged from 366 to 882 pg/mL with mean of 585.17 pg/mL whereas in control group ranged from 223 to 462 pg/mL with mean of 335.26 pg/mL. Mean Vitamin-D levels among the test group was 22.67 ng/mL (Range = 6.3-68.4) and that of control 15.43 pg/mL (Range = 5.4-27.7) respectively. The relationship between the serum Otolin-1 and Vitamin-D was not statistically significant. Otolin-1 levels is increased in BPPV patients and is sensitive in BPPV, specificity needs to be validated. Role of vitamin-D with respect to inner ear proteins needs further investigation.

Effectiveness of White test versus conventional saline test in minimizing biliary leak in partial liver resection in living donor liver transplant

Abstract Background Intra-operative bile leakage testing is very important in partial liver resection in living donor liver transplant as it allows detection of bile leaking points on the cut surface and decreases postoperative bile leak which is one of the most dreadful complication following liver transplant surgery. In this study we tried to assess the Effectiveness of White test versus conventional saline test in minimizing biliary leak in partial liver resection in living donor liver transplant. Objective In this study, we assess whether the White test is better than the conventional saline test for the intraoperative detection of biliary leakage in patients who will undergo partial liver resection as living donor liver transplant. Methodology In this study, we assess whether the White test is better than the conventional saline test for the intraoperative detection of bile leakage in patients who underwent partial liver resection as a living donor liver transplant. This study included 60 patients who received partial liver resection as a living donor liver transplant. The conventional saline test (injecting an isotonic sodium chloride solution through the cystic duct) was carried out in 30 patients and the White test (injecting a fat emulsion solution through the cystic duct) was carried out in 30 patients Results Incidence of postoperative bile leakage was compared between the conventional method and the White test. Bile leakage occurred in 8 patients (26.7%) in the conventional method group and in 2 patients (6.7%) in the White test group. In addition, the White test detected intraoperative a significantly higher number of bile leakage sites compared with the conventional method. The White test is better than the conventional test for the intraoperative detection of bile leakage. Conclusion Based on our study, we recommend that surgeons investigating bile leakage sites during liver resections should use the White test instead of the conventional saline test.

A randomized comparative study of platelet-rich fibrin along with hydroxyapatite graft for the treatment of 3-walled defects in chronic periodontitis.

Platelet Rich Fibrin (PRF) is a concentrate of leucocyte and platelets that contains various polypeptide growth factors. It has immense potential for use as a periodontal regenerative material in periodontal defects. Porous hydroxyapatite (HA) has long been used as bone grafting material. Recently it has been reported that when PRF is used in combination with HA, itgives a synergistic effect and results in a better periodontal regeneration. The present study aims to explore the clinical and radiographic effectiveness of autologous PRF versus PRF+HA in the regenerative treatment of intrabony defects (IBD) in patients with chronic periodontitis. Sixty patients with IBDs were divided into test and control groups. The test group patients were treated with autologous PRF, whereas the control group patients were treated with PRF+HA. Clinical parameters were recorded at baseline, three months, six months and nine months' time interval. Radiographic measurements were recorded at baseline and nine months. A reduction in PI, MGI, PPD, RAL, and IBD was observed in both the groups at nine months. Mean IBD reduction in the control group was 3.70 ± 1.16 mm, whereas, the mean reduction in the test group was 4.80 ± 1.03 mm, showing a significant reduction in IBDs. Similarly, the percentage of bone fill in the test group was 65% ± 3.67%, whereas bone fill in controls was 56.7% ± 3.56%, showing a significant bone fill in the study group. Treatment of IBDs with PRF+HA showed a significant improvement in all the clinical and radiographic parameters. When HA was added to PRF, it increased the regenerative effect in the treatment of 3 wall IBDs.

Effect of trans retinoic acid on patients with oral submucous fibrosis-randomized single-blind monocentric study.

Various treatment modalities have been practiced for the suppression of premalignant conditions such as oral submucous fibrosis (OSMF) to prevent their differentiation into malignant lesions. Conventional treatment includes steroids, enzymes like hyaluronidase, trypsin, chymotrypsin and placental extracts which are advocated intralesionally and oral drugs like carotenoids, alpha lipoic acid, lycopene, vitamins, microelements and tea pigments have also been advocated.In this study, a total number of 30 patients with OSMF were taken and randomly divided into two groups with 15 patients each according to Khanna and Andrade group of classification 1995. Group 1 (test group) received the test drug Tretiome 20 mg, whereas Group 2 (control group) received an antioxidant lycopene 20 mg/day for a period of 1 month and the effect of the therapy with the changes in the symptoms was recorded every 1 week, 15 days and 30 days of follow-up. The result of this study showed an improvement in the mouth opening of the patients of test Group with a significant decrease in the burning sensation as compared to the control group (P < 0.05). Xerostomia and headache were the two most commonly seen side effects which were reported in the patients of the test group, of which headache was associated with the withdrawal symptom of habit cessation and xerostomia was taken care by increase in hydration.

Effects of mirror therapy on motor aphasia after acute cerebral infarction: A randomized controlled trial.

Mirror therapy (MT) has proven to be beneficial for treating patients suffering from motor aphasia after stroke. However, the impacts of MT on neuroplasticity remain unexplored. In this paper we conducted a randomized controlled trial to evaluate the treatment using the MT on motor aphasia following acute cerebral infarction. We randomly assigned 30 patients into test and control groups, with test group patients treated with MT, whereas control group patients were treated with sham MT. At 24 hours prior to and after the intervention, we obtained functional magnetic resonance imaging (fMRI) data from study subjects. At baseline, after treatment and 12-week follow-up, we additionally evaluated patients with the Modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), and the aphasia quotient (AQ) in the western aphasia test. After 2 weeks of treatment, the test group demonstrated significant improvements in AQ values, naming, repetition, spontaneous speech, and mRS scores compared to the control group (P < 0.05). Furthermore, in the follow-up time point (12 weeks), we found that the test group exhibited significantly better NIHSS scores and AQ evaluation indicators than the control group (P < 0.05). Specifically, the fMRI study shows that functional connectivity significantly improved in test group patients mainly among frontal, temporal, and parietal lobes of the left hemisphere with each other than controls group. Meanwhile, we found significantly enhanced functional connectivity with the hippocampus (P < 0.01). Our results indicate that the MT can expedite the recovery of language function during the early phases of stroke recovery. These findings may elucidate the underlying mechanism of MT and the application of this therapy as an adjunct rehabilitation technique in language recovery.

Transcatheter Intracerebral Laser Photobiomodulation Therapy for Treatment of the Consequences of Ischemic Stroke with Distal Atherosclerotic Lesion

The present research is dedicated to the application of intracerebral laser PBMT for the treatment of the consequences of ischemic stroke. The effectiveness of intracerebral laser PBMT is compared to that of the conservative therapy methods. Recent studies have demonstrated a high potential of laser technology PBMT in the treatment of various ischemic lesions of the brain. A total of 836 patients who had experienced ischemic strokes of different degrees of severity in the period ranging from 6 months to 6 years prior to the treatment were included in the research. The age of these patients ranged between 29 and 81 years (average age: 74.9 years). There were 593 men (70.93%) and 243 women (29.07%). The patients were divided into two groups - the Test Group and the Control Group. The Test Group comprised 511 (61.12%) patients with distal lesions of the intracerebral arteries. These patients underwent transcatheter intracerebral laser PBMT. The Control Group comprised 325 (38.88%) patients with similar distal lesions of the intracerebral arteries. These patients, however, received the conservative treatment. The Test Group patients exhibited good clinical results in 259 (87.21%) cases after small focal strokes, in 94 (60.26%) cases after medium focal strokes, and in 12 (20.69%) cases after macro-focal strokes. The Test Group patients exhibited satisfactory clinical results in 33 (11.11%) cases after small focal strokes, - in 39 (25.00%) cases after medium focal strokes, and- in 22 (37.93%) cases after macro-focal strokes. In the Control Group, 51 (21.07%) patients exhibited good clinical results after small focal strokes, while none of the patients exhibited good results after medium focal strokes and macro-focal strokes. In the Control Group, satisfactory clinical results were exhibited by 60 (24.79%) patients after small focal strokes and 8 (19.05%) patients after medium focal strokes, while none of the patients exhibited satisfactory results after macro-focal strokes. Transcatheter intracerebral laser PBMT is an effective, pathogenetically substantiated method for the treatment of the consequences of ischemic stroke. This method enables the restoration of daily-life activities and cognitive and mental functions, thereby enabling the patients to be fully active in their lives again.

Effect of periodontal disease on circulatory system via vascular endothelial function

In establishing better interconnectedness between different branches of medicine, new advancements can be made. Instead of focusing on the affected region of a body, it can be helpful to look at a bigger picture and explore the links to other body parts. For example, there are links between dentistry and general medicine but yet there remains a separation between the two. There is a growing awareness of how oral health can impact on the rest of the body, such as links between periodontal disease and cardiovascular diseases, and this is the context of Associate Professor Norio Aoyama's work. He is based at Kanagawa Dental University, Japan, where he is exploring the links between the cardiovascular system and the oral environment. He hopes that his work can enhance awareness of the relationship between medical care and dentistry. Periodontal disease can lead to chronic infection and eventual loss of teeth. One hallmark of this chronic infection is the related chronic immune response with inflammation and Aoyama believes the link between periodontal and cardiovascular disease is due to this chronic element. Aoyama and his team try demonstrating a causal link between the two diseases by recruiting patients to create control and test groups. The patients in the main test group, with periodontal disease but no cardiovascular risk factors, might have their vascular endothelial dysfunction examined using reactive hyperaemia peripheral arterial tonometry.

Clinical study: Evaluation of the effect of topical nepafenac on central foveal thickness and visual acuity post panretinal photocoagulation in diabetic retinopathy

Objectives: To study the effect of topical nepafenac in patients with diabetic retinopathy following PRP in terms of Central foveal thickness (CFT) and Best corrected visual acuity(BCVA). Materials and Methods: This is a hospital based randomized control study conducted in Minto ophthalmic hospital, Regional institute of ophthalmology and Bowring and Lady Curzon hospital, from November 2018 to May 2020. Patients with proliferative diabetic retinopathy (PDR) without macular edema were subjected to PRP after detailed clinical evaluation and were divided into test and control groups. All the patients in two groups were matched based on: age, gender, type of diabetes, HBA1C levels and duration of type II diabetes. All patients underwent three sittings of PRP with a gap of one week interval between the sittings. Nepafenac eye (Nevanac, Alcon Laboratories Inc, Texas, USA) drops were used three time a day for a month followed by two time a day for three months in the test group and moxifloxacin eye drops (placebo)(moxicip, Cipla Ltd, India) three time a day for a month followed by two times for 3 months were used in the control group following PRP. Results: The patients in both test and control group were followed up at 1,2 and 4 months after PRP completion and the changes in CFT and BCVA were recorded. There was increase in CFT on each follow up visit in both test and control group. However increase in CFT in test group was less compared to control group which is statistically significant.(p=0.0001) There was worsening of BCVA in the test group was less compared to control group which is clinically significant but statisticially insignificant. Conclusion: Using topical Nepafenac eye drops following PRP for PDR is effective in reducing central foveal thickness and preventing the corresponding worsening of BCVA. Keywords: Panretinal Photocoagulation, OCT, Central Foveal Thickness, Nepafenac.

Does Submandibular Gland Sacrificing Neck Dissection Decrease Salivary Output and Quality of Life?

Purpose: Our study aimed to quantify the impact of submandibular gland (SMG) resection during Level I neck dissection (ND) on stimulated salivary output (SSO) and xerostomia-related quality of life in patients with head and neck cancer (HNC). Methods: A retrospective cohort was formed from 32 patients that underwent unilateral or bilateral Level I ND and a control group of 23 patients that had level II–IV ND. SSO (Saxon test) and University of Washington Quality of Life survey results for both groups were compared. Results: Mean SSO was 3.41 g in the SMG resection group and 3.86 g in the control group, with no significant statistical difference. There was no difference in mean SSO between patients with 2 SMGs, a single remaining SMG, or no glands. The mean SSO of SMG resection cases with a history of adjuvant RT was 2.61 g which was below the xerostomia threshold for the Saxon test (2.75 g) and control group patients with RT had a significantly higher mean SSO (4.07 g). The lowest UW-QoL saliva domain score average (53.8) was in the SMG-resected, RT-positive group. Conclusion: Results indicate unilateral or bilateral resection of SMG does not reduce SSO to a significant extent. Adjuvant radiotherapy and SMG resection are additive risk factors for xerostomia and the related loss in quality of life. SMG sparing may be necessary in HNC patients with higher risk for the need of adjuvant radiation.

Improved adherence with Medicines Use Review service in Slovenia: a randomized controlled trial

BackgroundBased on several existing patient-oriented activities, Medicines Use Review (MUR) service was standardized and officially adopted in Slovenia in 2015. Service aims to provide adherence support and ensure safe and effective medicines use. Therefore, the aim of the study was to evaluate the benefits of MUR in Slovenia, primarily the impact on medication adherence.MethodsA randomised controlled trial was performed in community pharmacies to compare MUR with standard care. Patients were randomised into either the test (patients received MUR by a certified MUR provider at visit 1), or control group. The study primary outcome was self-reported adherence to multiple medications, assessed by electronic ©Morisky Widget MMAS-8 Software at the first visit (V1) and after 12 weeks (V2). A sub-analysis of intentional and unintentional non-adherence was performed. MUR impact was defined as the relative difference in ©MMAS-8 score after 12 weeks between the test and control group. A multiple linear regression model was used to predict MUR impact based on baseline adherence (low versus medium and high). Several secondary outcomes (e.g. evaluation of drug-related problems (DRPs)) were also assessed.ResultsData from 153 (V1) and 140 (V2) patients were analysed. Baseline adherence was low, moderate and high in 17.6, 48.4 and 34.0% patients, respectively. In the low adherence subpopulation, test group patients showed a 1.20 point (95% CI = 0.16–2.25) increase in total ©MMAS-8 score (p = 0.025) compared to control group patients. A 0.84 point (95% CI = 0.05–1.63) increase was due to intentional non-adherence (p = 0.038), and a 0.36 point (95% CI = − 0.23-0.95) was due to unintentional non-adherence (p = 0.226). Additionally, statistically significant decrease in the proportion of patients with manifested DRPs (p < 0.001) and concerns regarding chronic medicines use (p = 0.029) were revealed.ConclusionMUR service in Slovenia improves low medication adherence and is effective in addressing DRPs and concerns regarding chronic medicines use.Trial registrationClinicalTrials.gov - NCT04417400; 4th June 2020; retrospectively registered.

Reduction of extrinsic tooth stain by a toothpaste containing 10% high cleaning silica, 0.5% sodium phytate and 0.5% sodium pyrophosphate: an 8-week randomised clinical trial

ObjectiveTo assess the effects for controlling extrinsic tooth stain of a whitening toothpaste containing 10% high cleaning silica, 0.5% sodium phytate and 0.5% sodium pyrophosphate, in comparison with a negative control toothpaste.MethodsA total of 86 adults who met with the inclusion and exclusion criteria were invited to take part in the study. They were distributed into test and control groups randomly. At baseline, 4 weeks and 8 weeks, the same examiner provided the clinical examinations, including evaluations of oral soft and hard tissues and measurements of tooth stain of the anterior teeth using the Lobene Stain Index. Adverse events and any changes in general health conditions of the patients were monitored.ResultsWhen the study was completed, comparisons between patients in test and control groups yielded statistically significant differences in Lobene stain adjusted mean area score [0.83 (0.05) vs. 1.13 (0.05)], Lobene stain adjusted mean intensity score [0.99 (0.06) vs. 1.32 (0.06)] and Lobene stain adjusted mean composite score [1.45 (0.13) vs. 2.50 (0.13)] (All, P < 0.001). Patients in the test group exhibited reductions of 26.55%, 25% and 42%, respectively in Lobene stain area, intensity and composite scores, relative to patients in the control group. Comparisons within groups showed that all three Lobene scores at 8 weeks in both groups were lower than those at baseline (All, P < 0.001).ConclusionThis study demonstrates that 8-week use of a toothpaste containing 10% high cleaning silica, 0.5% sodium phytate and 0.5% sodium pyrophosphate can effectively reduce extrinsic tooth stain.Trial registration NCT04238429 (before enrollment of the first participant). Data register: March 4, 2018.

Performance evaluation of case definitions of type 1 diabetes for health insurance claims data in Japan

BackgroundNo case definition of Type 1 diabetes (T1D) for the claims data has been proposed in Japan yet. This study aimed to evaluate the performance of candidate case definitions for T1D using Electronic health care records (EHR) and claims data in a University Hospital in Japan.MethodsThe EHR and claims data for all the visiting patients in a University Hospital were used. As the candidate case definitions for claims data, we constructed 11 definitions by combinations of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. (ICD 10) code of T1D, the claims code of insulin needles for T1D patients, basal insulin, and syringe pump for continuous subcutaneous insulin infusion (CSII). We constructed a predictive model for T1D patients using disease names, medical practices, and medications as explanatory variables. The predictive model was applied to patients of test group (validation data), and performances of candidate case definitions were evaluated.ResultsAs a result of performance evaluation, the sensitivity of the confirmed disease name of T1D was 32.9 (95% CI: 28.4, 37.2), and positive predictive value (PPV) was 33.3 (95% CI: 38.0, 38.4). By using the case definition of both the confirmed diagnosis of T1D and either of the claims code of the two insulin treatment methods (i.e., syringe pump for CSII and insulin needles), PPV improved to 90.2 (95% CI: 85.2, 94.4).ConclusionsWe have established a case definition with high PPV, and the case definition can be used for precisely detecting T1D patients from claims data in Japan.

Clinical, inflammatory and microbiological outcomes of full-mouth scaling with adjunctive glycine powder air-polishing: A randomized trial.

To determine the effects of glycine powder air-polishing (GPAP) as an adjunct to full-mouth scaling and root planing (SRP) on clinical, inflammatory and microbiological outcomes in patients with untreated periodontitis. Forty-one patients were randomly assigned to the control group A (SRP) and test groups B1 (subgingival GPAP right after SRP) and B2 (subgingival GPAP right before SRP). Clinical examinations and sample collections (saliva, subgingival plaque, serum and gingival crevicular fluid) were performed at assessment visits and before therapies at clinical visits of baseline, 6-week and 3-month. C-reactive protein, IL-6 and TNF-α were assessed in serum and gingival crevicular fluid, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum were measured in saliva and subgingival plaque. Patients in control and test groups did not significantly differ by age, sex and disease severity at baseline. Participants in control and intervention groups had similar improvements in clinical parameters (PD, BOP, PLI and BI). All groups had a similar percentage of sites showing PD reduction of ≥2mm between baseline and follow-up visits, with a few exceptions. Reduced C-reactive protein, IL-6 and TNF-α in serum were found after treatments. Full-mouth SRP with and without GPAP resulted in largely similar clinical, inflammatory and microbiological outcomes in the care of untreated periodontitis.

Machine learning predicts lymph node metastasis of poorly differentiated-type intramucosal gastric cancer

To construct a machine learning algorithm model of lymph node metastasis (LNM) in patients with poorly differentiated-type intramucosal gastric cancer. 1169 patients with postoperative gastric cancer were divided into a training group and a test group at a ratio of 7:3. The model for lymph node metastasis was established with python machine learning. The Gbdt algorithm in the machine learning results finds that number of resected nodes, lymphovascular invasion and tumor size are the primary 3 factors that account for the weight of LNM. Effect of the LNM model of PDC gastric cancer patients in the training group: Among the 7 algorithm models, the highest accuracy rate was that of GBDT (0.955); The AUC values for the 7 algorithms were, from high to low, XGB (0.881), RF (0.802), GBDT (0.798), LR (0.778), XGB + LR (0.739), RF + LR (0.691) and GBDT + LR (0.626). Results of the LNM model of PDC gastric cancer patients in test group : Among the 7 algorithmic models, XGB had the highest accuracy rate (0.952); Among the 7 algorithms, the AUC values, from high to low, were GBDT (0.788), RF (0.765), XGB (0.762), LR (0.750), RF + LR (0.678), GBDT + LR (0.650) and XGB + LR (0.619). Single machine learning algorithm can predict LNM in poorly differentiated-type intramucosal gastric cancer, but fusion algorithm can not improve the effect of machine learning in predicting LNM.

Effect of preoperative multimedia based video information on perioperative anxiety and hemodynamic stability in patients undergoing surgery under spinal anesthesia.

Background and Aims:Pre-anesthesia checkup (PAC) gives unique opportunity for providing necessary information, patient education and allaying anxiety. Our objective was to measure the effect of preoperative multimedia video information (self made short video of 12 minutes) on patient's anxiety and hemodynamic parameters during surgery under spinal anesthesia.Methods:This prospective randomized study was conducted in 80 patients of either sex with ASA physical status I and II posted for lower limb surgery under spinal anesthesia. Patents were randomized to control or test group. At the end of preoperative visit, patients in test group watched the film and patient in control group did not watch any video. Verbal briefing by the attending anesthesiologist on the day of surgery was given to all patients of both the groups. Anxiety using Amsterdam Preoperative Anxiety and Information Scale (APAIS) and hemodynamic parameters (SBP, DBP and HR) at various time intervals (A1: Baseline, A2: post intervention, A3: just before surgery, A4: after surgery) were measured.Results:Baseline anxiety (A1) scores were severe in both the groups and showed no statistical significance (P = 0.436). Patients in test group (video) showed better/lower anxiety levels than the control group (non video) at A2 (P = 0.020) and A3 (P = 0.005) respectively, similarly hemodynamic parameters were better controlled and showed lesser deviation from baseline values in test group as compared to control group and showed statistical significant difference (P < 0.001) just before surgery.Conclusion:Combination of multimedia based video information at the time of PAC and short verbal briefing on the day of surgery by the attending anesthesiologist provides effective management of perioperative anxiety. It can be cost effective way of enhancing patient care and providing adequate information to people with reading and comprehension difficulties.

Machine Learning Can Predict Total Death After Radiofrequency Ablation in Liver Cancer Patients.

Objective:Over 1 million new cases of hepatocellular carcinoma (HCC) are diagnosed worldwide every year. Its prognosis remains poor, and the 5-year survival rate in all disease stages is estimated to be between 10% and 20%. Radiofrequency ablation (RFA) has become an important local treatment for liver cancer, and machine learning (ML) can provide many shortcuts for liver cancer medical research. Therefore, we explore the role of ML in predicting the total mortality of liver cancer patients undergoing RFA.Methods:This study is a secondary analysis of public database data from 578 liver cancer patients. We used Python for ML to establish the prognosis model.Results:The results showed that the 5 most important factors were platelet count (PLT), Alpha-fetoprotein (AFP), age, tumor size, and total bilirubin, respectively. Results of the total death model for liver cancer patients in test group: among the 5 algorithm models, the highest accuracy rate was that of gbm (0.681), followed by the Logistic algorithm (0.672); among the 5 algorithms, area under the curve (AUC) values, from high to low, were Logistic (0.738), DecisionTree (0.723), gbm (0.717), GradientBoosting (0.714), and Forest (0.693); Among the 5 algorithms, gbm had the highest precision rate (0.721), followed by the Logistic algorithm (0.714). Among the 5 algorithms, DecisionTree had the highest recall rate (0.642), followed by the GradientBoosting algorithm (0.571).Conclusion:Machine learning can predict total death after RFA in liver cancer patients. Therefore, ML research has great potential for both personalized treatment and prognosis of liver cancer.

Use of Antimicrobial Photodynamic Therapy as an Adjunct in the Treatment of Peri-Implantitis: A Prospective Study with 24 Months Follow up

Introduction: Despite the long-term predictability of Osseointegrated implants, biologic, biomechanical and esthetic complication can occur in a small percentage of cases. With increasing use of dental implants for rehabilitation of missing teeth there is increase in cases of peri-implantitis. Use of photodynamic therapy has showed promising results for management of peri-implantitis. Materials and methods: Sixteen patients of peri-implantitis were selected and randomly assigned to test or control group. Readings were taken at baseline, 6 weeks, 6 months, and 24 months for Probing Pocket Depth (PPD), and Bleeding on Probing (BOP). Control group patients were treated with periodontal therapy whereas test group patients were given photodynamic therapy additionally. Result: 64% reduction in PPD was observed in test group whereas BOP and suppuration were absent. Significant reduction in PPD was seen in control group as well. After 24 months test group had average pocket depth of 2 mm and control group 3 mm. Conclusion: Use of photodynamic therapy added therapeutic benefit to conventional management and should be considered as a part of peri-implantitis management therapy.

EFFECT OF ZANJABĪL (ZINGIBER OFFICINALE) IN NON-ALCOHOLIC FATTY LIVER DISEASE- A RANDOMIZED CONTROLLED TRIAL

Non Alcoholic Fatty Liver Disease (NAFLD) is a reversible condition of the liver, wherein large vacuoles of triglyceride fat accumulates in liver cells via the process of steatosis, despite any evidence of excessive alcohol consumption. In view of present scenario of high prevalence and limited treatment options, this study was conducted to assess the effect of Murabba-i- Zanjabīl in NAFLD. Present study was designed as a randomized placebo controlled trial with 30 patients in test group and 10 patients in control group. Participants in test group were administered with Murabba-i- Zanjabīl, 5 gm twice daily, 30 minutes before food for 45 days and those in control group were given 1 capsule of 500 mg each containing wheat flour twice daily, 30 minutes before food for 45 days. All the participants were asked to follow up at every 15 days for assessment of subjective parameters. Objective parameter was assessed before and after the trial period. On statistical analysis the test formulation showed significant reduction in scores (p&lt;0.05) for most of the parameters on both inter and intra group analysis, while the reduction in control group was not found to be statistically significant (p.0.05). This study lays out that Murabbā-i Zanjabīl in a dose of 5gm twice daily given for 45 days is more effective than placebo in treating NAFLD. There was no adverse effect reported during the trial. It was thus concluded that Murabbā-i Zanjabīl is effective and safe in therapeutic management of NAFLD.

Role of Metformin in Combination with Neoadjuvant Chemotherapy in Treatment of Breast Cancer

Backgound: Globally, breast cancer is the most frequently diagnosed malignancy and the leading cause of cancer death in women. Improvements in chemotherapy, surgery, lymph node evaluation and hormone receptor blocking therapy have successfully doubled the survival of breast cancer patients. Objective: To determine whether metformin use was associated with improvement in pathologic complete response (PCR) rate in patients with breast cancer receiving neoadjuvant chemotherapy. Patients and Methods: This prospective study was conducted at the Clinical Oncology Department, Aswan University and Upper Egypt Hospitals in the period between 1/7/2016 and 1/9/2019. This study included 50 patients divided into 2 groups, test group (metformin group) and standard group (non-metformin group). Histopathology was confirmed by tissue core biopsy. Results: All patients in the two groups in our study achieved either pathological complete response or partial response. No patients developed disease progression or were still stable disease. Among the patients in test group (metformin group), 15 patients (60%) achieved pathological complete response (PCR) while 10 (40%) patients did not achieve PCR. However, among the patients in standerd group (non-metformin group) 9 patients (36%) achieved pathological complete response (PCR) while 16 (64%) patients did not achieve PCR. There was statistically significant difference between the two groups regarding the response with better PCR in metformin group (p value is 0.089). Conclusion: The addition of metformin to neoadjuvant chemotherapy has a significant impact on pathological complete response (PCR) in female patients with advanced breast cancer.