Prospective Controlled Clinical Study Research Articles

A Comparison of Outcomes of Staged Laparoscopic traction Orchiopexy and Two Stage Fowler-Stephens Orchiopexy in the management of Intra-abdominal Testicle; Prospective controlled clinical trial study.

A Comparison of Outcomes of Staged Laparoscopic traction Orchiopexy and Two Stage Fowler-Stephens Orchiopexy in the management of Intra-abdominal Testicle; Prospective controlled clinical trial study.

Clinical analysis of the tooth-implant papilla for two narrow-diameter titanium-zirconium implants in the anterior area: prospective controlled clinical study

BackgroundRehabilitation of the anterior area when the mesio-distal space is reduced is a challenge for the clinician, due to the patient’s anatomical limitations and aesthetic requirements. Narrow Diameter Implants (NDI) are an option of treatment when the standard diameter implant is not possible, but the evidence is scarce. This prospective clinical study aims to analyze the formation of the tooth-implant papilla between the implant and the adjacent natural tooth in the maxillary lateral incisors and mandibular incisors.MethodsA total of 40 patients treated with NDI, of titanium-zirconium (Ti-Zr) alloy i.e., 2.9 mm Test Group (TG) and 3.3 mm Control Group (CG), were included. The mesiodistal distance between the adjacent natural teeth was used for implant selection, maintaining 1.5 mm between the fixation and the adjacent tooth. Clinical assessment was performed by a clinical examiner at 6 and 12 months after the final prosthesis. The primary variable was the Jemt Papillary Index. Also, implant survival rate (SR), complications, Implant Stability Quotient (ISQ), and patient-reported outcomes measures (PROMs) such as aesthetics, chewing, phonation, comfort, and self-esteem were analyzed.ResultsA significant amount of papilla filling was observed concerning the baseline, with a trend towards more formation of the papilla in the TG, with a JPI score of 3. No significant differences were observed between the two groups regarding implant SR, clinical parameters, and complications. In terms of PROMs, a higher satisfaction in the TG was observed, with significant intergroup differences for aesthetics, comfort, self-esteem, and primary stability ISQ (TG: 59.05 (SD: 5.4) vs. CG: 51.55 (SD: 5.7)).ConclusionsThe 2.9 mm diameter Ti-Zr implants achieved a formation of papilla similar to 3.3 mm implants in the anterior region at 12 months of follow-up after the final prosthetic restoration. The use of Ti-Zr implants with a diameter of 2.9 mm to rehabilitate single teeth in areas of the anterior region, where the mesiodistal distance is limited, showed favorable clinical results and a high degree of satisfaction during 1 year of observation similar to 3.3 mm dental implants.Trial registrationThis study was retrospectively registered in ClinicalTrials.gov with the number NCT05642520, dated 18/11/2022.

Selection of surgery type for patients with inguinal hernias

The purpose of the study: to investigate the quality of life of patients with inguinal hernias after Lichtenstein’s surgery using the implants with a tissue-gripping system and conduct a comparative assessment of this technique and the results of classical laparoscopic surgery. The prospective controlled clinical study included the results of follow-up of 99 patients with inguinal hernias. The first group included the patients who underwent LHR surgery of the inguinal canal using a composite self-fixing polypropylene mesh. In the patients of the second group, LHR was performed using a composite polypropylene mesh, which was fixed with polypropylene suture material. The third group consisted of the patients operated on using the technique of laparoscopic transabdominal preperitoneal surgery. Indicators of physical and psychological health components were studied in the patients using the SF-36 questionnaire in the preoperative period and 3, 6, and 12 months after surgery. Results: The patients with inguinal hernias in the long-term postoperative period had different periods of restoration of quality of life, which were determined by the type of surgical intervention and the type of fixation of the synthetic implant. Three months after surgery, significant signs of normalization of indicators of the physical health component were recorded only in groups of the patients after LHR using self-fixing implants and TAPP. In the patients with suture fixation of implants during LHR, the first signs of restoration of the physical component of health, comparable to self-fixing meshes, were observed 6 months after surgery. Changes in indicators of the psychological health component in the patients of the LHR and TAPP groups did not differ at all study intervals. Conclusion: The use of implants with a tissue-gripping system when performing LHR leads to optimization and reduction of physical rehabilitation in patients with inguinal hernias, which makes it possible to recommend the use of self-fixing meshes for open repair in cases of relative and absolute contraindications to TAPP.

Effect of betamethasone injection into the pterygomandibular space on the neurosensory disturbance after bilateral sagittal split ramus osteotomy: a pilot study

AimThe aim of this study was to evaluate the effect of local betamethasone injection into the pterygomandibular space on postoperative neurosensory deficits.Materials and methodsA prospective controlled clinical study was conducted on 16 patients (6 male, 10 female; mean age, 24.95 ± 9.22 years) who underwent bilateral sagittal ramus osteotomy for mandibular discrepancies. One side of each patient’s mandible was randomly selected as the control side, and the opposite side as the experimental side. On the experimental side, a solution of betamethasone (6 mg/1 ml) was injected into the pterygomandibular space after the completion of wound closure. Neurosensory tests, including light touch, two-point discrimination, direction of movement, thermal sensitivity, and pin-prick discrimination, were performed. The follow-up period ranged between 6 and 12 months, according to the particular sensory test. The Fisher exact test was used to analyse the data.ResultsThe light touch sensation was abnormal in 75% of the control side and 31% of the study side, with the difference being significant (p = 0.03). However, at 6 months, all the study cases regained touch sensation, compared to 69% of the control side. No significant difference in direction movement discrimination was seen; however, at 3 months, the study side showed significantly less direction sensation (19%) compared to the control side (56%) (p = 0.02). There was no significant difference in the two-point discrimination; however, at 3 months, the study side had a significantly less abnormal two-point sensation (13%) than the control side (56%) (p = 0.02). In addition, no significant difference was noted in thermal sensitivity or pin-prick sensation.ConclusionBetamethasone injection into the pterygomandibular space reduces neurosensory disturbances after bilateral sagittal split ramus osteotomies nd leads to faster recovery of sensations.

Selecting and justifying prognostic criteria to assessing the severity of condition during traumatic illness in combined chest and abdominal trauma after acute traffic accidents

Relevance. Improving prognostic criteria to assess the severity of combined chest and abdominal trauma is urgently needed to justify the scope of intensive care in victims of road accidents during acute traumatic illness.Objective. The objective of the study is to improve the results of treatment during acute traumatic illness in combined chest and abdominal trauma after road accidents, as well as to enhance efficiency of prognostic criteria for severity assessment.Methods. A single-center retrospective and prospective controlled clinical study was conducted in 1400 victims who were treated at the N.S. Karpovich Krasnoyarsk Interdistrict Clinical Hospital of Emergency Care Medicine from 2012 to 2022 and were diagnosed with isolated or combined chest and abdominal trauma. To assess the severity of injury and perform triage, the specific method of severity assessment in combined trauma after road traffic accidents was used, which was developed by the research team of the Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University.Results and discussion. A detailed analysis of the indicators applied to patients of different severity showed that mild and moderate chest and abdomen injuries led to changes in hemodynamic parameters within the physiological norm. The injury in question did not cause consciousness or respiratory disorders in victims of road traffic accidents. Severe injuries led to the development of shock and respiratory failure, in combination with depression of consciousness. In order to compare across different condition severity degrees evaluated by physiological indicators, respective medians and dispersion measures were analyzed for each group. The analysis allowed to assess exacerbated severity of condition in our patients. This procedure requires further adjustment to pre-hospital emergency medical care.Conclusion. The performed statistical analysis allowed to assess the efficiency of severity assessment in victims of road accidents in prehospital setting.

Follitropin delta combined with menotropin in patients at risk for poor ovarian response during in vitro fertilization cycles: a prospective controlled clinical study

BackgroundThe maximum daily dose of follitropin delta for ovarian stimulation in the first in vitro fertilization cycle is 12 μg (180 IU), according to the algorithm developed by the manufacturer, and based on patient’s ovarian reserve and weight. This study aimed to assess whether 150 IU of menotropin combined with follitropin delta improves the response to stimulation in women with serum antimullerian hormone levels less than 2.1 ng/mL.MethodsThis study involved a prospective intervention group of 44 women who received 12 μg of follitropin delta combined with 150 IU of menotropin from the beginning of stimulation and a retrospective control group of 297 women who received 12 μg of follitropin delta alone during the phase 3 study of this drug. The inclusion and exclusion criteria and other treatment and follow-up protocols in the two groups were similar. The pituitary suppression was achieved by administering a gonadotropin-releasing hormone (GnRH) antagonist. Ovulation triggering with human chorionic gonadotropin or GnRH agonist and the option of transferring fresh embryos or using freeze-all strategy were made according to the risk of developing ovarian hyperstimulation syndrome.ResultsWomen who received follitropin delta combined with menotropin had higher estradiol levels on trigger day (2150 pg/mL vs. 1373 pg/mL, p < 0.001), more blastocysts (3.1 vs. 2.4, p = 0.003) and more top-quality blastocysts (1.8 vs. 1.3, p = 0.017). No difference was observed in pregnancy, implantation, miscarriage, and live birth rates after the first embryo transfer. The incidence of ovarian hyperstimulation syndrome did not differ between the groups. However, preventive measures for the syndrome were more frequent in the group using both drugs than in the control group (13.6% vs. 0.6%, p < 0.001).ConclusionsIn women with serum antimullerian hormone levels less than 2.1 ng/mL, the administration of 150 IU of menotropin combined with 12 μg of follitropin delta improved the ovarian response, making it a valid therapeutic option in situations where ovulation triggering with a GnRH agonist and freeze-all embryos strategy can be used routinely.Trial registrationU1111-1247-3260 (Brazilian Register of Clinical Trials, available at https://ensaiosclinicos.gov.br/rg/RBR-2kmyfm).

The role ovariectomies and/or the administration of artificial female sex hormones play in orthodontic tooth movement: A systematic review.

The objective was to assess how ovariectomy or the administration of artificial female sex hormones affects orthodontic tooth movement (OTM) with fixed appliances. An electronic search of indexed databases was completed without language or time restrictions up to June 2022. The following eligibility criteria were utilized: (i) prospective original controlled clinical studies; (ii) experimental studies on animal models; (iii) subjects undergoing orthodontic therapy with fixed appliances; (iv) clearly defined control groups not undergoing ovariectomy or administration of artificial female sex hormone; and (v) studies with experimental groups receiving the intervention of interest (ovariectomy or artificial female sex hormone administration). Review articles, letters to the editor, case reports, case series, commentaries, cross-sectional studies, retrospective studies, and studies with no well-defined control group were excluded. The quality of the available evidence and the risk of bias within the studies were assessed. All disagreements were resolved via discussion. Seven animal studies were included in the systematic review. Five studies reported that ovariectomy increased the rate of orthodontic tooth movement. Two studies reported that the administration of artificial female sex hormones decreased the rate of orthodontic tooth movement. There is an association between ovariectomies and OTM and between the administration of artificial female sex hormones and OTM. The full extent of the association remains unclear due to the biases that are present and the length of time of orthodontic therapy.

Is Topical Nasal Steroid Useful for Treatment of Otitis Media with Effusion in Children?

Otitis media with effusion is a common and important pediatric clinical problem; it is the leading cause of hearing impairment in children. Medical treatment remains controversial. To evaluate the usefulness of using topical nasal steroids in the treatment of otitis media with effusion. Between November 2019 and October 2022, a prospective controlled clinical study was carried out in the department of otolaryngology at Al-Jerrahat Teaching Hospital in Medical City, Baghdad, Iraq. This study comprised 40 patients with bilateral otitis media with effusion (23 males, 17 females). Two groups were created for the patients. Patients in group A (20 patients) were treated with mometasone furoate nasal spray; 1 puff (50 µg) in each nostril daily for 2 weeks, while the 20 patients in group B were treated with saline nasal spray; 1 puff in each nostril daily for 2 weeks. At the end of the first and second weeks of treatment, otoscopic examination was used to monitor the patients. At the end of the second post-treatment week, pure tone audiometry and tympanometry were performed again. Normal otoscopic results, a type A tympanogram, and enhanced pure tone hearing threshold average to be ≤20 dB HL within 0, 5, 1, and 4 KHz were used to characterize resolution of OME. The association between two means was determined using an independent sample t-test, while the association between categorical variables was determined using an X2-test. At the end of 2nd post-treatment week, there was no significant difference regarding improvement of otitis media with effusion regarding otoscopic, audiometric, and tympanometric results in both groups (P-value >0.05). Topical nasal steroid is unuseful for the treatment of otitis media with effusion in the short-term.

Efficacy of ultrasound versus short wave diathermy in the treatment of chronic low back pain in patients with lumbar disk herniation: a prospective randomized control study

BackgroundLumbar disk herniation (LDH) is a cause of chronic low back pain (CLBP) treated using physical therapy (PT), including exercise and physical modalities such as ultrasound (US) and short wave diathermy (SWD). Despite the use of US and SWD, there is inconclusive evidence on their efficacy. The aim of this study was to investigate the efficacy of US and SWD in the treatment of CLBP in patients with LDH.MethodsA prospective randomized control clinical study. Individuals with radicular CLBP and LDH on magnetic resonance imaging, presenting to the Physical and Rehabilitation Medicine Department were randomized into 3 treatment groups. All participants received 10 sessions of hotpack, transcutaneous nerve stimulation (TENS) and therapeutic exercises. In addition, Group 1 received 10 sessions of therapeutic US (1 MHz, 1.5W/cm2, 10 min), Group 2 SWD (27.12 MHz, wavelength 11.06 m, induction technique, 20 min) to the lower back. Group 3 (control group) received hotpack, TENS and therapeutic exercises alone. Visual analogue scale (VAS) for LBP, Modified Oswestry Disability Index (MODI) and Short Form 36 (SF-36) were evaluated pre and post treatment and at one and three months follow up.ResultsIn all groups, VAS for LBP and MODI improved with treatment and at the one and three month follow up (p < 0.001). In Groups 1 and 2, MODI scores continued to reduce at 1 and 3 months (p < 0.001 and p = 0.012 respectively). SF-36 physical, social function and pain parameters reduced in all groups (p < 0.05). Role limitation due to physical and emotional problems, emotional well-being, vitality and mental health improved in Groups 1 and 2 (p < 0.05).ConclusionsDeep heating agents can be used as part of the physical therapy for CLBP in those with LDH with positive mid-term effects.Trial registrationNCT03835182, 02/04/2019.

Evaluation of hemodynamic changes and patient-reported outcome measures in surgical therapy with or without intravenous sedation: a prospective controlled clinical study.

To determine whether intravenous (IV) sedation would contribute to the stabilization of patients' hemodynamics during periodontal and oral surgical procedures, and to evaluate the patient-reported outcome measures (PROMs). Periodontal or oral surgery patients were recruited and distributed into two groups: (1) sedation group (SG): intravenous sedation plus local anesthesia; (2) control group (CG): local anesthesia only. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and oxygen saturation (SaO2), were monitored at 15-min intervals from sitting in the dental chair (baseline) until the end of the treatment. In addition, a subjective assessment of PROMs was obtained through a post-operative questionnaire. Forty-nine patients (25 in SG and 24 in CG) were included. The highest SBP and DBP were significantly higher in CG compared to the SG (141.1 ± 18.4 and 133.6 ± 15.1, respectively in SBP; and 85.5 ± 11.0 and 82.9 ± 10.1, respectively in DBP), but no mean significant differences were found between groups (P value of 0.85 and 0.72 for systolic and diastolic BP, respectively). HR and SaO2 did not show statistical intra- and inter-group differences. The overall patient satisfaction score was significantly higher in the SG group compared to CG. Intravenous moderate sedation seems to contribute to the stabilization of patient's hemodynamics, especially the systolic blood pressure, although small differences have been found. Intravenous sedation seems to contribute to stabilize the hemodynamic values, and enhances the patient satisfaction after periodontal and oral surgical treatment in the dental office.

Клініко-лабораторні кореляції помірного ожиріння та дисбалансу вітаміну D з предикторами прееклампсії

There is a lot of evidence regarding the validity of various biomarkers as predictors of preeclampsia. However, despite the obviousness and necessity of such studies for women with obesity, such works are not numerous and their data are contradictory. Purpose - to investigate different predictors of preeclampsia in patients with moderate obesity, depending on vitamin D status. Materials and methods. A prospective controlled clinical study was conducted in which 101 pregnant women were included: the main group, consisting of women with moderate obesity (n=75), and the control group, consisting of almost non-obese pregnant women (n=26). The level of 25(OH)D in blood serum, markers of gestational endotheliopathy, blood flow in the uterine arteries of pregnant women, and markers of prenatal screening in the first trimester were studied. STATISTICA 10 software was used for statistical data processing. Results. Among the women in the main group, 85.3% had vitamin D insufficiency or deficiency in their serum. In such women in the first trimester of pregnancy, a significant increase in cases of microalbuminuria with a level of &gt;5.0 mg albumin/mmol creatinine and a decrease in cases of endothelium-dependent vasodilatation with an index of &lt;15.0%, a significantly higher resistance index in the uterine arteries, cases of early lateral and bilateral diastolic notch, as well as a statistically significantly lower level of β-hCG were observed. Conclusions. Moderate obesity and low vitamin D status were statistically significantly associated with predictors of preeclampsia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.

The accuracy of implant placement using a combination of static and dynamic computer-assisted implant surgery in fully edentulous arches: A prospective controlled clinical study.

To compare the accuracy of implant position, using a combination of static and dynamic computer-assisted implant surgery (CAIS), with either static, dynamic, or freehand implant placement, in fully edentulous arches. Twenty-one patients with a total of 88 fixtures were included. Implants were divided equally into four groups: a combination of static and dynamic CAIS (SD group), static CAIS (S group), dynamic CAIS (D group), and freehand placement (FH group). Angular deviation, as well as the 3D platform and apex deviations, were measured for all groups. Furthermore, the direction of implant deviation was recorded and compared. The FH group showed significantly more deviation compared to all groups, considering all the aspects, and at both the implant platform and apex. A significant difference in angular deviation between the SD and S groups (p < .001), and between the SD and D groups (p < .001) was noted, favoring the SD group. When evaluating implant distribution, the FH group showed a tendency towards the buccal, apical, and distal directions at platform and apex, while in the D group, implants shifted more to the buccal. In contrast, the SD group did not show a trend toward any specific direction. The S and SD groups did not show a statistical significance considering any direction. The combination of static and dynamic CAIS increases the accuracy of implant placement in fully edentulous arches when compared with either static or dynamic CAIS alone, as well as freehand placement.

Comparing the Efficacy and Safety of Treatment with Fixed Dose of Tadalafil Monotherapy versus Its Combination with Silodosin in Patients with Benign Prostatic Hyperplasia and Erectile Dysfunction

Background Benign prostate hyperplasia (BPH) is a histological diagnosis which is identified by non-malignant hyperplasia of prostatic tissue due to smooth muscle and epithelial cell proliferation in the prostatic transition zone. Aim of the Work To assess the efficacy and safety of fixed-dose of Tadalafil monotherapy versus its combination with Silodosin in treatment of BPH patient and erectile dysfunction (ED) by comparing IPSS score, PVR, Q max and The international Index of Erectile Function (IIEF questionnaire). Methodology This prospective randomized control clinical study was conducted at tertiary care hospital at Ain Shams University hospitals from June 2021 till January 2022 and performed on total 60 men patients which were 45 years old or older with a history of LUTS secondary to BPH of at least 6 months. Results Our study results revealed that there was no statistically significant difference found between the studied groups regarding IPSS and Q-max at baseline while there was statistically significant difference found in IPSS and Q-max at 1 month, 2 months and 3 months, with statistically significant decrease in IPSS and significant increase in Q-max through follow-up from baseline in each group. Conclusion This analysis suggested that the combination-therapy of tadalafil and Silodosin was more effective than tadalafil alone in improving subjective LUTS, but there was no significant improvement in sexual function.

The Effectiveness of Three-Dimensional Osteosynthesis Plates versus Conventional Plates for the Treatment of Skeletal Fractures: A Systematic Review and Meta-Analysis.

To assess the difference between preformed anatomically shaped osteosynthesis plates and patient-specific implants versus conventional flat plates for the treatment of skeletal fractures in terms of anatomical reduction, operation time, approach, patient outcomes, and complications. MEDLINE (1950 to February 2023), EMBASE (1966 to February 2023), and the Cochrane Central Register of Controlled Trials (inception to February 2023) databases were searched. Eligible studies were randomised clinical trials, prospective controlled clinical trials, and prospective and retrospective cohort studies (n ≥ 10). Inclusion criteria were studies reporting the outcomes of preformed anatomically shaped osteosynthesis plates and patient-specific implants versus conventional flat plates after treating skeletal fractures. Outcome measures included anatomical reduction, stability, operation time, hospitalisation days, patients' outcomes, and complications. Two independent reviewers assessed the abstracts and analysed the complete texts and methodologies of the included studies. In total, 21 out of the 5181 primarily selected articles matched the inclusion criteria. A meta-analysis revealed a significant difference in operation time in favour of the preformed anatomical plates and patient-specific implants versus conventional plates. Significant differences in operation time were found for the orbital (95% CI: -50.70-7.49, p = 0.008), upper limb (95% CI: -17.91-6.13, p < 0.0001), and lower limb extremity groups (95% CI: -20.40-15.11, p < 0.00001). The mean difference in the rate of anatomical reduction in the lower limb extremity group (95% CI: 1.04-7.62, p = 0.04) was also in favour of using preformed anatomical plates and patient-specific implants versus conventional plates. This systematic review showed a significant mean difference in surgery time favouring the use of preformed anatomical plates and patient-specific implants for orbital, upper, and lower limb extremity fractures. Additionally, preformed anatomical plates and patient-specific implants in the lower limb group result in a significantly higher rate of anatomical reduction versus conventional flat plates.

Intensive neurorehabilitation and allogeneic stem cells transplantation in canine degenerative myelopathy.

Degenerative myelopathy (DM) is a neurodegenerative spinal cord disease with upper motor neurons, with progressive and chronic clinical signs, similar to amyotrophic lateral sclerosis (ALS). DM has a complex etiology mainly associated with SOD1 gene mutation and its toxic role, with no specific treatment. Daily intensive rehabilitation showed survival time near 8 months but most animals are euthanized 6-12 months after clinical signs onset. This prospective controlled blinded cohort clinical study aims to evaluate the neural regeneration response ability of DM dogs subjected to an intensive neurorehabilitation protocol with mesenchymal stem cells (MSCs) transplantation. In total, 13 non-ambulatory (OFS 6 or 8) dogs with homozygous genotype DM/DM and diagnosed by exclusion were included. All were allocated to the intensive neurorehabilitation with MSCs protocol (INSCP) group (n = 8) or to the ambulatory rehabilitation protocol (ARP) group (n = 5), which differ in regard to training intensity, modalities frequency, and MSCs transplantation. The INSCP group was hospitalized for 1 month (T0 to T1), followed by MSCs transplantation (T1) and a second month (T2), whereas the ARP group was under ambulatory treatment for the same 2 months. Survival mean time of total population was 375 days, with 438 days for the INSCP group and 274 for the ARP group, with a marked difference on the Kaplan-Meier survival analysis. When comparing the literature's results, there was also a clear difference in the one-sample t-test (p = 0.013) with an increase in time of approximately 70%. OFS classifications between groups at each time point were significantly different (p = 0.008) by the one-way ANOVA and the independent sample t-test. This INSCP showed to be safe, feasible, and a possibility for a long progression of DM dogs with quality of life and functional improvement. This study should be continued.

Antioxidant supplementation during treatment of outpatient dogs with parvovirus enteritis ameliorates oxidative stress and attenuates intestinal injury: A randomized controlled trial

A prospective randomized controlled clinical study was conducted to determine whether antioxidant supplementation as an adjunct therapy alters hemogram, oxidative stress, serum intestinal fatty acid binding protein-2 (IFABP-2) level, fecal viral load, clinical score (CS) and survivability in outpatient canine parvovirus enteritis (CPVE) dogs. The dogs with CPVE were randomized to one of the five treatment groups: supportive treatment (ST) alone, ST with N-acetylcysteine (ST+NAC), resveratrol (ST+RES), coenzyme Q10 (ST+CoQ10) or ascorbic acid (ST+AA). The primary outcome measures were reduction of CS and fecal HA titre, and enhancement of survivability. Secondary outcome measures were reduction of oxidative stress indices and IFABP-2 level from day 0 to day 7. The mean CS and HA titre were significantly (P < 0.05) decreased from day 0 to 7 in ST and all antioxidant groups. The supplementations of NAC, RES and AA along with ST markedly (P < 0.05) reduced the concentrations of malondialdehyde, nitric oxide and IFABP-2 on day 7 as compared to ST alone. Additionally, NAC and RES supplementations markedly (P < 0.05) improved the total leukocyte count and neutrophil count in CPVE-affected dogs. NAC and RES could serve as better antioxidants for the amelioration of oxidative stress in CPVE but, the antioxidants did not confer any additional benefits in reduction of CS, fecal HA tire, or survivability when compared with ST alone.

Depression, Anxiety, and Quality of Life in Patients with Cochlear Implant: A Case-Control Study.

It is known that there is a relationship between hearing loss, which is an important cause of disability, psychological symptoms, and low quality of life. The aim of this study is to evaluate the anxiety, depression levels, and quality of life analysis of adults with postlingual hearing loss and who have undergone cochlear implants and to compare them with the data of subjects who have never had a hearing loss. The prospective controlled clinical study included 53 subjects who had cochlear implants and 52 healthy controls in terms of hearing. Hospital Anxiety and Depression Scale and Short Form 36 were filled by all subjects to investigate their depression, anxiety, and quality of life levels. The mean age of subjects was 42.88 ± 18.04, and 44% (23) were women. There was no significant difference between the study and control groups in terms of Hospital Anxiety and Depression Scale scores. Short Form 36 physical role (P = .018) and SF-36 general health (P = .014) in quality of life assessment sub-scores were statistically significantly higher in the study group than in the control group. When the correlation between the time elapsed after surgery and Hospital Anxiety and Depression Scale scores and Short Form 36 scores was evaluated, no significance was observed. The fact that the patients evaluated after cochlear implant surgery had similar depression and anxiety levels and quality of life as the controls, and even physical role and being significantly better in general health compared to the controls reveal the importance of regaining the hearing ability.

Open-Labeled, Randomized, Prospective Controlled Clinical Study to Assess Efficacy of Rasayana Churna and Pranayama in the Management of Rajonivritti Lakshanas w. s. r. to Postmenopausal Syndrome

Background: In modern science, hormonal replacement therapy (HRT) is the only alternative for postmenopausal syndrome whereas non-hormonal pharmacologic therapies have been shown to be less effective than hormonal therapy. So, it was assumed that Rasayana Churna along with Pranayama would be effective in relieving postmenopausal symptoms. Objective: to assess the clinical efficacy of Rasayana Churna and Pranayama in the management of   Rajonivritti Lakshanas w. s. r. to Postmenopausal Syndrome. Methods: The present open-labeled, randomized, prospective controlled clinical study was conducted after IEC approval. Total 60 female patients suffering from Postmenopausal Syndrome were enrolled in the study and randomized into two groups i. e. Group A &amp; Group B. 30 patients in Group A were given Rasayana Churna orally with daily practice of Pranayama was advised. 30 Patients in Group B were advised daily practice of Pranayama for consecutive 12 weeks. The results were assessed by using Menopausal Rating Scale (MRS) and Menopause-Specific Quality of Life Questionnaire (MENQOL). Results: The significant difference was observed in MRS-Total score and MENQOL scores after treatment in both the groups. Out of four scales of MENQOL, the vasomotor, physical and psychological scales showed significant improvement in the group received regimen of Rasayana Churna along with Pranayama as compared with only Pranayama. Only change in sexual scale score was found to be similar in both the groups’ patients. Conclusion: It can be inferred that regimen of Rasayana Churna along with Pranayama was more efficacious in treatment of post-menopausal syndrome as compared with only Pranayama.

Evaluation of molecular signatures in the urinary bladder and upper tract urothelial carcinomas: a prospective controlled clinical study

BackgroundUrothelial carcinomas (UC) can be either in the upper or in the lower urinary tract or both. Urothelial bladder cancer (UBC) is more common than upper tract urothelial carcinoma (UTUC). This research was designed to study the difference between UBC and UTUC using the molecular pathways including (MAPK/ERK) pathway, cell cycle regulating genes, and oncogenic genes.MethodsTo study the discrepancy between UBC and UTUC, a prospective trial was carried out for 31 radical cystectomy and 19 nephrouretrectomy fresh-frozen specimens of UBC and UTUC patients, respectively. The expression level of mRNA of eight genes namely EGFR, ELK1, c-fos, survivin, TP53, RB1, FGFR3, and hTERT was assessed in normal adjacent tissues, UTUC, and UBC by RT-PCR.ResultsComparison between UTUC and UBC regarding the expression level of mRNA of the EGFR, ELK1, c-fos, survivin, TP53, and FGFR3 had significant difference (p-value < 0.001), while the expression level of RB1 and hTERT level had no significance. Sensitivity/specificity of EGFR, Elk1, c-fos, survivin, TP53, and FGFR3 was 0.78/0.90, 0.84/0.90, 0.84/0.80, 0.84/0.96, 0.94/0.93, and 0.89/0.93, respectively, to differentiate between UTUC and UBC.ConclusionsDespite the fact that UTUC and UBC share the same origin, there is a clear evidence that there is a molecular difference between them. This molecular difference could be the reason that UTUC is more aggressive than UBC.

Time efficiency and efficacy of a centralized computer-aided-design/computer-aided-manufacturing workflow for implant crown fabrication: A prospective controlled clinical study

ObjectiveTo assess time efficiency and the efficacy of the prosthetic manufacturing for implant crown fabrication in a centralized workflow applying computer aided design and computer aided manufacturing (CAD-CAM). Material and MethodsFifty-nine patients with one posterior implant each, were randomly allocated to either a centralized digital workflow (c-DW, test) or a laboratory digital workflow (l-DW, control). Patients were excluded from efficiency and efficacy analyses, if any additional restoration than this single implant crown had to be fabricated. A customized titanium abutment and a monolithic zirconia crown were fabricated in the c-DW. In the l-DW, models were digitalized for CAD-CAM fabrication of a monolithic zirconia crown using a standardized titanium base abutment. Time for impression, laboratory operating and delivery time were recorded. The efficacy of the prosthetic manufacturing was evaluated at try-in and at delivery. Data was analyzed descriptively. Statistical analyses using student's unpaired t- and paired Wilcoxon were performed (p < 0.05). ResultsAt impression taking, 12 patients (c-DW) and 19 patients (l-DW) were included. The impression time was 9.4±3.5 min (c-DW) and 15.1 ± 4.6 min (l-DW) (p < 0.05). The laboratory operating time was 130 ± 31 min (c-DW) and 218.0±8 min (l-DW) (p < 0.05). The delivery time was significantly longer in the c-DW (5.9 ± 3.5 1 days) as compared to the l-DW (0.5±0.05 days). At try-in and at delivery, efficacy of prosthetic manufacturing was similar high in both workflows. Clinical relevanceThe c-DW was more time efficient compared to the lab-DW and rendered a similar efficacy of prosthetic manufacturing.