جستجوی مقالات مرتبط با کلیدواژه "clinical trial study" در نشریات گروه "پزشکی"

Febrile seizure (FS) is the most common childhood seizure disorder that occurs in 3-4% of children .The aim of this study was to determine the effect of intermittent oral anticonvulsant Levetiracetam in prevention of the recurrence of febrile seizure (FS) in children.

This a randomized clinical trial study was conducted on 108 children with FS referred to the pediatric department of Mohammad Kermanshahi Hospital in Kermanshah in 2020. Then, eligible patients were divided into intervention (Levetiracetam; n= 72) and control (Acetaminophen; n= 36) groups using balanced block randomization. The intervention group received a dose of 30-60 mg/kg Levetiracetam during the febrile illness for prophylaxis for 9 months. In contrast, in the control group, only acetaminophen was prescribed just to reduce fever. Finally, the number of FS recurrences were studied in two groups. The data were analyzed using SPSS 26.

 The mean (±S.D) age were 2.37 (±1.01) vs. 2.30 (±0.95) years in the intervention and control groups; respectively. The number (%) of boys in the two groups under study was 39 (54.1) and 19 (52.7), respectively. The mean time to first seizure recurrence after the intervention was significantly longer in the intervention group (5.70 ± 0.82 months) than in the control group (2.32 ± 0.75 months) (P-Value<0.05). Also, the mean number of recurrences of FS in the intervention group (2.25 ± 0.80) was significantly lower than the control group (4.13 ± 0.79) (P-Value<0.05).

The administration of oral anticonvulsant Levetiracetam may be effective in the reduction of the recurrences of FS, however, detailed studies in this field is recommended.

 Due to its invasiveness and length, bimaxillary orthognathic surgery causes highly excruciating pain in the oropharyngeal area for the patient. There are several ways to reduce this pain, including prescribing painkillers and anti-inflammatory drugs. The aim of this study was to evaluate the effect of photobiomodulation by a 940-nm laser on reducing pain in the oropharyngeal area after bimaxillary orthognathic surgery.

 This randomized clinical trial study was performed on 40 patients aged 17-40 years who were candidates for bimaxillary orthognathic surgery referred to the Department of Oral and Maxillofacial Surgery of Besat hospital in 2021. All patients in the intervention group underwent the photobiomodulation of the oropharyngeal area with a 940-nm diode laser immediately after the end of bimaxillary orthognathic surgery. Sore throat, jaw pain, pain when swallowing, and stridor were recorded in the first to fifth days after surgery. Finally, changes in the mean score of indices were compared within and between the two groups using repeated measure analysis of variance.

 The mean age of patients in the intervention and control groups was 22.4±4.38 and 25.15±5.48 years, respectively (P=0.09). The pain score in the four areas studied in both intervention and control groups had a decreasing trend over time, which was statistically significant (P<0.001). In addition, the difference in the trend between the two groups was statistically significant so that in the intervention group, the decreasing trend was more severe (P<0.05). Eventually, a significant interaction was observed between the type of intervention and time in all four areas (P<0.05).

 The results showed that the use of a 940-nm diode laser led to a significant reduction in all four areas of sore throat, pain when swallowing, and stridor after bimaxillary orthognathic surgery.

Background :

Paracetamol and Pethidine are two prevailing analgesics prescribed for postoperative orthopedic patients, each having different side effects and impacts on fracture healing. The present study was conducted to compare the impacts of Paracetamol and Pethidine on postoperative pain relief of children with bone fractures.

Fifty children with orthopedic bone fracture surgery candidates were selected in a double-blinded clinical trial study. A random number table was utilized to classify children into two groups of Paracetamol or pethidine treatment. First, the pain intensity of each group was checked using the Visual Analog Scale (VAS). Six hours after the surgery, the first group received Pethidine (1mg/kg of body weight), and the second group received Paracetamol (1gr). Moreover, the VAS scales were checked for both groups 6, 12, and 24 hours later. Afterward, the pain intensity of both groups was assessed according to the VAS scale.

Independent t-test results revealed a significant difference between the pain intensity of paracetamol (44.24 ± 6.44), and Pethidine (52.68 ± 10.47) groups 6 hours after the surgery (p=0.03). Moreover, there was also a significant statistical difference between the pain intensity of two groups 12 and 24 hours after the surgery. 

 Conclusion:

 Given the effectiveness of Paracetamol and Pethidine on postoperative pain, both medications can be used for children with bone fractures.

Optimal surgical management of the neonate with imperforate anus (IA) depends on determining accurate location of muscle complex, pouch of rectum and urethral fistula. The aim of this study was to investigate a novel minimally invasive technique of anorectoplasty assisted by intraoperative sonography pull-through for repair of anorectal malformation and rectourinary fistula.
Patients and Eight male patients with imperforate anus aged under 48 h had undergone colostomy. Any associated anomalies were evaluated in cases. After 5-8 weeks, neonates were prepared for anoplasty. After catheterization, sonography of perinea was carried out. Patients were placed in lithotomy position. The accurate position of each required point was determined by this procedure.
In all cases, the pouch of rectum to skin distance was in range 1.5-1.8 mm and entrance distance of wire to fistula was maximally 6 mm, just in one patient this value was 7 mm. Anomalies associated with some patients were Down Syndrome, cardiac anomalies, kidney disease .6 out of 8 patients removed urinary catheter after two days and discharged home. Colostomy of all patients was closed after sonography of prinea. After one week and one month follow- up, all patients had an acceptable fecal frequency about 3- 5 times a day.
Intra-operative sonography is an applicable procedure to determine correct location of muscle complex, pouch of rectum and uretral fistula to treat IA patients non- invasively. Another interesting point of this study is the ability of non invasive surgery and novel procedure with perfect result.

BackgroundHydatidosis is a conventional health public problem in most parts of the world. Safe treatment of patients with hydatidosis has been a topic of debate for a long time. Surgical treatment always was associated with high morbidity and mortality. Medical treatment is also controversial. In this study, alternative procedure named Percutaneous, Aspiration and hypertonic Saline Instillation (PAHSI) was applied to treat patients with hydatidosis.
Materials and MethodsIn this single-blind clinical trial, thirty-eight patients, ranging in age between 6 months and 16 years, with 81 hepatic hydatid cysts underwent PAHSI treatment. The consecutive steps including sonographic guidance, aspiration of cyst content and injection of 15% saline hypertonic were carried out in this method. Patients with multiple cysts also were treated by this procedure.
ResultsParticipants were 18 boys (47.3%) and 20 girls (52.6%) with mean age of 8.08 3.92 years. Almost half of the patients had single cyst (52.63%). During 2- year follow- up, no recurrences were observed; therefore, re-hospitalization and possible complications reduced considerably. Furthermore, this method was applicable to cure multiple cysts.
Conclusion In PAHSI strategy, it seems that the complications of surgery (laparotomy and anesthesia) decreased since no complications observed after procedure, and cosmetic results in future are much better due to avoidance of incision.

Mini abstract: This study is an extended follow up of the original trial study (NCT00600197) that has been published in the clinical journal of pain. This trial aimed to explore if the proposed multidisciplinary program could improve quality of life and disability of the patients suffering from chronic low back up to 36 months.
Methods and Material: In this Clinical Randomized trial seventy percent (139 of 197) of the participants who had taken part in the original study including 66 patients in intervention group and 73 patients in control group were followed up to 36 months after intervention. The intervention group continued receiving monthly motivational consultation and booster classes plus oral medication but the other group received just medication. Data on measures of Short Form 36 (SF- 36), Quebec Disability Scale (QDS) and Ronald Morris Disability (RDQ) were collected at 3-,6- 12-, 18- 24-, 30-. and 36 - month follow ups and analyzed through RMANOVA.
The 2 groups were comparable regarding all baseline characteristics (P>0.05), except for education level that was better in intervention group (P = 0.01). Two groups were improved regarding all studied variables over time up to 36 month (P The proposed multidisciplinary program could improve quality of life and disability up to 36 months in chronic low back pain patients.
Key - Words: This study revealed the designed multidisciplinary program compared with medication group could reduce back pain up to 36-months among patients suffering from Chronic Low Back Pain.
This study showed the multidisciplinary program compared with medication group could reduce disability up to 36-months among patients suffering from Chronic Low Back Pain.
In total, the quality of life of patients who took part in multidisciplinary program would be improved better than medication group over 36- month follow up.