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NCT ID: NCT05235256 Recruiting - Clinical trials for Post-Dural Puncture Headache

Sphenopalatine Block Versus Greater Occipital Nerve Block in PDPH

Start date: January 10, 2022
Phase: N/A
Study type: Interventional

Management of postdural puncture headache (PDPH) has always been challenging for anesthesiologists. PDPH not only increases the misery of the patient, but the length of stay and overall cost of treatment in the hospital also increases. Although the epidural blood patch ( EBP ) is an effective way of treating the problem, the procedure itself could cause another inadvertent dural puncture (DP). Moreover, sometimes patients need to have a second EBP, if the first one is not completely effective. This can be difficult to explain to the patient who has already suffered a lot. Peripheral nerve blocks are well tolerated and effective as adjunctive therapy for many disabling headache disorder. Sphenopalatine ganglion is a parasympathetic ganglion, located in the pterygopalatine fossa. Transnasal sphenopalatine ganglion block ( SPGB ) has been successfully used to treat chronic conditions such as migraine, cluster headache, and trigeminal neuralgia, and may be a safer alternative to treat PDPH: It is minimally invasive and carried out at the bedside without using imaging. Besides that, it has apparently a faster start than EBP, with better safety profile. Another minimally invasive peripheral nerve block which has been used quite successful is greater occipital nerve block (GONB). The GONB has been in use for more than a decade to treat complex headache syndromes of varying etiologies like migraine , cluster headache and chronic daily headache with encouraging results. Greater Occipital Nerve (GON) arises from C2-3 segments, its most proximal part lies between obliqua capitis inferior and semispinalis, near the spinous process. Then, GON enters into semispinalis passing through it and after its exit; it enters into trapezius muscle. In distal region of trapezius fascia, it is crossed by the occipital artery and finally the nerve exits the trapezius fascia insertion into the nuchal line about 5-cm lateral to midline. Functionally, GON supplies major rectus capitis posterior muscle, and the skin, muscles, and vessels of the scalp, but is the main sensory supply of occipital region. Many providers believe that the local anesthetic produces the rapid onset of headache relief, like an abortive agent, and that the locally acting steroid produces the preventive like action of up to 6 weeks as dexamethasone possess potent anti inflammatory and immunosuppressive actions by inhibiting cytokine-mediated pathways .

NCT ID: NCT05234957 Recruiting - Clinical trials for Intermittent Exotropia

Symmetric vs Asymmetric BLR Recession in Management of Basic IXT With Ocular Dominance

Start date: April 17, 2022
Phase: N/A
Study type: Interventional

The study aims to investigate ocular motor and sensory outcomes of two different strategies of lateral rectus recession; symmetric and asymmetric, in management of basic type intermittent exotropia with ocular dominance.

NCT ID: NCT05234931 Recruiting - Clinical trials for Traumatic Anal Sphincteric Injury,Immediate vs Delayed Repair

Traumatic Anal Sphincteric Injury Immediate vs Delayed Repair

Start date: January 1, 2021
Phase:
Study type: Observational

comparison between immediate and delayed repair regarding the need for another technique ,pain score or repositioning and need for repair. We aim to evaluate the effects of immediate and delayed repair regarding the morbidity and mortalit - Objective 1: to assess the operative time and surgical field of both choices. - Objective 2: to estimate post-operative pain using pain score, to measure hospital stay and to assess short -term post-operative complications

NCT ID: NCT05233488 Recruiting - Clinical trials for Entrapment Neuropathies

Effect of Different Ultrasound Doses on Median Nerve Conduction Parameters

Start date: February 12, 2022
Phase: N/A
Study type: Interventional

The current study investigates the effect of different doses of pulses ultrasound therapy on different nerve conduction parameters of the median nerve in healthy volunteering subjects.

NCT ID: NCT05232981 Recruiting - Placenta Accreta Clinical Trials

Conservative Treatment of PAS With or Without IIL

PASIIL
Start date: May 1, 2022
Phase: N/A
Study type: Interventional

In the current study, the investigators aimed to compare the benefits of internal iliac ligation in placenta accreta spectrum

NCT ID: NCT05232318 Recruiting - Root Resorption Clinical Trials

Root Resorption Accompanied Clear Aligners and Fixed Orthodontic Appliance

Start date: April 1, 2022
Phase: N/A
Study type: Interventional

The aim of the study is to compare apical root resorption accompanied orthodontic treatment using clear aligners vs fixed appliances.

NCT ID: NCT05231928 Recruiting - Pigmentary Glaucoma Clinical Trials

A Novel Argon Laser Iridoplasty for Pigment Dispersion Syndrome

Start date: December 1, 2021
Phase: N/A
Study type: Interventional

Pigment dispersion syndrome is a rare condition where anomalous iris configuration leads to posterior iris bowing with subsequent friction with the lenticulozonular unit resulting in dispersion of pigment from the back surface of the iris into the anterior segment as well as thinning with resultant transillumination defects in the mid iris segment. The released pigment is deposited in various parts of the anterior segment resulting in a constellation of clinical signs: Krukenberg Spindle: Back surface of the cornea Zentmayer ring: Back surface of the lens. Egger line: Anterior vitreous face. More importantly, pigment accumulated in the trabecular meshwork leading to visible hyperpigmentation of the trabeculum seen by gonioscopy. This leads to reduction of aqueous outflow which leads to ocular hypertension or even glaucoma which is known as pigment dispersion glaucoma which is considered one of refractory glaucomas. Current practice in the management of pigment dispersion syndrome revolves around the management of glaucoma when it develops by IOP lowering medication, Laser trabeculoplasty or peripheral iridoplastyor glaucoma surgery as a last resort. The only prophylactic measure in practice that is aimed at preventing the progression from mere pigment dispersion to pigment dispersion glaucoma is the long term use of miotic eyedrops e.g. Pilocarpine which comes with both risks and side effects i.e. the risk of retinal breaks and detachment which is even higher in a cohort which is predominantly myope, the constriction of visual field and ocular surface complications. In this interventional case series, the investigators assess the efficacy of a novel Argon Laser iridoplasty in the management of pigment dispersion through correcting the posterior iris bowing and hence halting the dispersion process so that glaucoma wouldn't develop in the first place instead of managing glaucoma after it sets in which proved refractory.

NCT ID: NCT05231148 Recruiting - Clinical trials for Infected Non Union and Delayed Union in Fractures of Both Long and Short Bones

Hardware Preservation in Management of Infected Non United or Delayed United Fractures of Long or Short Bones by Debridement and Local Calcium Sulfate Loaded by Antibiotics

Start date: December 12, 2021
Phase: N/A
Study type: Interventional

- Diagnosis of infection based on elevated serum markers of infection (ESR, CRP), discharging sinus, preoperative radiographs suggestive of bone infection and radiological findings . [6] - infected nonunion mean the bone has previous fracture , the bone not healed may be one of the reasons it didn't heal because there is sub-acute infection , there is low grade colonization into the bone or around the wound preventing the bone from healing , it different from infected fracture which occur fairly acutely. [6, 7] - Infected nonunion treated with systemic antibiotics alone, without using local antibiotic delivery systems associated with higher recurrence and reoperation rates. [7] - This led to the development and use of medical-grade calcium sulfate (CS), CS facilitates osseous healing in an osteoconductive fashion by filling the bone void and preventing fibrous tissue

NCT ID: NCT05230420 Recruiting - Pleural Effusion Clinical Trials

Urine Bag Usage Versus Chest Drain Clamping After Lung Resection Surgeries

Start date: January 1, 2022
Phase: N/A
Study type: Interventional

Investigators will compare two different approaches of postoperative drainage after the standard water-seal drain has been used efficiently; one is by using urine bag and check it get blown by the leaked air, two is by using clamping of the water seal drain. Investigators will compare them depending on several factors such as; cost effectiveness, hospital stay, duration of putting the drain and more, reinsertion of the chest tube and others.

NCT ID: NCT05228808 Recruiting - Clinical trials for Pancreatic Adenocarcinoma

Immunohistochemical Expression of PD-L1 in Pancreatic Ductal Adenocarcinoma

Start date: February 1, 2022
Phase:
Study type: Observational

Pancreatic carcinoma is ranked the 11th most common cancer worldwide. It is a highly lethal malignant tumor. In Egypt, the disease has traditionally been considered rare, but population in the East Nile Delta region exhibits an unusually high rate of young-onset pancreatic carcinoma. Pancreatic ductal adenocarcinoma is by far the most common histologic subtype of pancreatic malignancy. Programmed death ligand-1 (PD-L1) is a type I trans-membrane glycoprotein. It has an important prognostic and predictive value in various neoplasms. To date, few studies have addressed the potential prognostic role of PD-L1 in pancreatic carcinoma, so knowledge about its prognostic value needs further elucidation.