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NCT ID: NCT02463721 Recruiting - Clinical trials for Primary Bacterial Peritonitis

Identification of Ascitic Fluid Bacterial Pathogens in Spontaneous Bacterial Peritonitis

Start date: January 2015
Phase: N/A
Study type: Interventional

Several studies have pointed out changes in the epidemiology of the causative bacteria in SBP and bacterascites and in their susceptibility to antibiotics. In particular, the development of beta-lactamase enzymes, which confer resistance to clavulanate, or extended spectrum beta-lactamases in Escherichia coli. The potential emergence of enterococci, methicillin-resistant S. aureus, or fluoroquinolone-resistant bacteria, following norfloxacin prophylaxis, is also a cause of concern since they may be associated with a higher risk of therapeutic failure. The microbial etiology of SBP remains relatively constant; however, the antibiotic resistance rate especially for third-generation cephalosporins (including cefotaxime and ceftazidime), ciprofloxacin, and ofloxacin increased dramatically

NCT ID: NCT02461979 Recruiting - Liver Cancer Clinical Trials

The Role of the Vitamin D Receptor Gene Polymorphisms in Hepatocarcinogenesis

Start date: February 2015
Phase: N/A
Study type: Interventional

Previous data have suggested that vitamin D levels may influence cancer development. In particular, several single nucleotide polymorphisms have been described in the Vitamin D receptor( VDR gene), and some polymorphisms are associated with tumor occurrence. For instance, VDR polymorphisms have been related to cancers of the breast, prostate, skin, colon-rectum, bladder and kidney, although with conflicting observations . VDR polymorphisms have also been investigated in the context of some chronic liver diseases, such as chronic hepatitis B, primary biliary cirrhosis and autoimmune hepatitis . In a recent published study, VDR polymorphism may be used as a molecular marker to predict the risk and to evaluate the disease severity of HCC in patients with chronic hepatitis B. A significant association of VDR (ApaI) polymorphism with the development of HCC in chronic HCV infection may help to identify those who are at high risk of developing HCC.

NCT ID: NCT02461875 Recruiting - OHSS Clinical Trials

Cabergoline Versus GnRH Antagonist Rescue and Cabergoline in the Prevention of Ovarian Hyperstimulation Syndrome

Start date: May 2013
Phase: Phase 2
Study type: Interventional

The aim of study is to compare the efficacy of GnRH antagonist rescue combined with cabergoline with cabergoline in the prevention of ovarian hyperstimulation syndrome in high risk patients undergoing ovarian stimulation for IVF-ET with long GnRH agonist protocol.

NCT ID: NCT02461173 Recruiting - Infertility Clinical Trials

Stimulated Intrauterine Insemination Cycles and Unstimulated Intrauterine Insemination Cycles in Couples With Unexplained Infertility

Start date: June 2015
Phase: Phase 3
Study type: Interventional

Four hundred and fifty women with unexplained infertility will be divided into 3 equal groups using computer generated random numbers: Group 1 will have up to 4 stimulated IUI cycles, group 2 will have up to 4 unstimulated cycles, women who do not become pregnant after the 4 cycles in groups 1 and 2 will be advised to have regular intercourse at the expected time of ovulation. Group 3 will be the control group will be advised to have regular sexual intercourse at the time of ovulation for 6 months

NCT ID: NCT02443285 Recruiting - Clinical trials for Primary Bacterial Peritonitis

Is Spontaneous Bacterial Peritonitis Still Responding to 3rd Generation Cephalosporins?

Start date: January 2015
Phase: Phase 3
Study type: Interventional

Current European and most other international guidelines recommend the use of a third-generation cephalosporin as the first choice, or amoxicillin-clavulanate acid or fluoroquinolones as an alternative choice . These recommendations are based mainly on clinical trials that were very often conducted a decade or more ago, and on the assumption that E. coli would be involved in nearly half of the cases. The microbial etiology of SBP remains relatively constant; however, the antibiotic resistance rate especially for third-generation cephalosporins (including cefotaxime and ceftazidime), ciprofloxacin, and ofloxacin increased dramatically .

NCT ID: NCT02440880 Recruiting - Pain Clinical Trials

Dexamethasone With TAP Block Increasing the Duration of the Peripheral Nerve Block in Caesarian Section

Start date: May 2015
Phase: N/A
Study type: Interventional

Nowadays Cesarean sections became the most popular surgery worldwide with the consumption of the hospital resources and the continuous need to decrease the costs, work load and medical stuff engagement. One of the most common problem is the need to control pain post operatively, this issue increase the work load over the pain management team and increase lead to patient in satisfaction. This study will test the usage of dexamethasone with different doses (4 and 8 mg) either locally or intravenously (I.V.) with the local anesthetics in TAP (transversus abdominis plane) block to prolong the duration of the block and decrease the need of post-operative analgesics.

NCT ID: NCT02436525 Recruiting - Plaque Accumulation Clinical Trials

Microbial and Periodontal Changes Associated With Conventional Versus Self Ligating Brackets

Start date: March 2015
Phase: N/A
Study type: Interventional

Microbial and periodontal changes associated with conventional versus self ligating brackets. The aim of this study will be to compare microbial and periodontal changes associated with conventional versus self ligating brackets.

NCT ID: NCT02433418 Recruiting - Infertility Clinical Trials

Tubal Flushing Using Water Soluble Media for Unexplained Infertility

Start date: May 2015
Phase: Phase 3
Study type: Interventional

300 women with unexplained infertility will be randomly divided into 2 equal groups: Group 1 will be offered tubal flushing with water soluble media through hysterosalpingography (HSG) and group 2 will receive no intervention

NCT ID: NCT02429999 Recruiting - Clinical trials for to Evaluate Letrozole as a Modality for Minimal Ovarian Stimulation in ICSI Cycles .

Letrozole in Assisted Reproductive Technology

Start date: April 2015
Phase: Phase 2
Study type: Interventional

Infertility in not a health problem and that infertile couples are not really ill. However, this narrow interpretation of the problem is refuted by the world community. The WHO defines health as a "state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity". It has also been argued that overpopulation is the main problem in the developing countries and that helping infertile couples contradicts the interests of the countries and the world at large. However, this narrow approach contradicts human rights in general and reproductive rights in particular. In 1994, the United Nations International Conference on Population and Development in Cairo mentioned issues on future actions on 'prevention and appropriate treatment of infertility where feasible'. However, no guidelines or concrete actions and programmes were given for developing countries. Worldwide, more than 80 million couples suffer from infertility; the majority of this population are residents of developing countries. In September 2001, a meeting on 'Medical, Ethical and Social Aspects of Assisted Reproduction' was organized by the WHO. For the first time, major attention was paid to ongoing developments in assisted reproduction technology together with their social and ethical implications in developing countries . It was the first time that the WHO highlighted the issue of assisted reproduction in developing countries. ART in developed countries is highly expensive one of steps is ovulation induction the most common protocol for induction is the long gonadotrophin-releasing hormone (GnRH) agonist pituitary suppression regimen combined with relatively high doses of exogenous follicle-stimulating hormone (FSH) remains the most frequently used stimulation protocol which is expensive. in our study we will use a mild ovarian stimulating protocol letrozole adjuvant to gonadotrophins which is less expensive The use of aromatase inhibitor have only recently been introduced in infertility treatment, especially for ovulation induction. An aromatase inhibitor blocks the conversion of androgens to estrogens in the ovarian follicles, peripheral tissues, and in the brain. This result in two things: (a) Fall in circulating and local estrogens and (b) Rise in intraovarian androgens. Fall in estrogen levels, releases the hypothalamopituitary axis from the negative feedback of estrogens. Thus, there is a surge in follicle stimulating hormone (FSH) release, which results in follicular growth. Since, the feedback mechanism is intact; normal follicular growth, selection of dominant follicle, and atresia of smaller growing follicle occurs; and thereby facilitating monofollicular growth and ovulation.Another mechanism of action of the aromatase inhibitors is by the increasing intraovarian androgens. This increases the follicular sensitivity to FSH. Recent data shows the role of androgens in early follicular developments. by augmenting FSH receptors and stimulating insulin-like growth factor (IGF)-I; FSH and IGF-I act synergistically to promote follicular growth. This pharmacodynamics of letrozole ensures improved endometrial thickness, cervical mucus, monofollicular, and better folliculogenesis. So , these factors may lead to higher pregnancy rates and greater likelihood of singleton pregnancy. Letrozole has been tried for ovarian stimulation for assisted reproduction. With the concept of mild stimulation in IVF to improve implantation rate, letrozole is a potential agent. Letrozole has two potential uses in IVF: First, where it is used in the follicular phase usually with FSH/human menopausal gonadotropin (HMG) for ovulation induction; second, it has also been used in luteal phase of stimulated IVF cycle and to reduce circulating E2 levels; thus, potentially reducing ovarian hyperstimulation syndrome (OHSS) risk. A significant reduction in the total dose of gonadotrophins was found when aromatase inhibitor was added in controlled ovarian hyperstimulation (COH) cycles. Some studies evaluated the addition of letrozole in patients with normal ovarian response undergoing IVF or Intracytoplasmic sperm injection( ICSI). They showed higher implantation and ongoing pregnancy rates in the letrozole cotreatment group.

NCT ID: NCT02428777 Recruiting - Pain Clinical Trials

Tramadol Versus Diclofenac for Prevention of Pain in Operative Outpatient Hysteroscopy

Start date: April 2015
Phase: Phase 3
Study type: Interventional

The purpose of this study is to compare the effectiveness of Tramadol and diclofenac in reducing pain during operative outpatient hysteroscopy. Women undergoing operative hysteroscopy will be divided into 3 groups, the first group will receive Tramadol 100 mg 1 hour before the procedure, the second group will receive diclofenac 100mg 1 hour before the procedure and the third will receive a placebo. Pain will be assessed by a visual analogue scale