Damietta First

The etiology of tourniquet pain is complex, and the study team hypothesizes that blocking with Interscalene brachial plexus block (ISBPB) is more efficient in decreasing the incidence of tourniquet pain in comparison with other techniques. As there is a paucity of studies that evaluate the effect of intercostobrachial nerve (ICBN) block and ISBPB and Patient-Controlled Analgesia (PCA) with a supraclavicular brachial plexus block (SCBPB) on tourniquet pain in forearm surgery, Therefore, we established this randomized study to compare ISBPB and ICBN and PCA with fentanyl with SCBPB in terms of the incidence and severity of tourniquet pain in patients undergoing forearm surgery.

Nonalcoholic fatty liver disease (NAFLD) is a widespread health concern and the main cause of chronic liver disease in developed countries. It is defined by fat buildup in the liver not caused by alcohol, viruses, drugs, or autoimmune diseases. Diagnosis requires excluding significant daily alcohol intake, specifically more than 30 grams for men and 20 grams for women. This research evaluates the safety and effects of Cilostazol, a drug that may improve liver fat accumulation in NAFLD patients, through a combined Phase 1 and Phase 2 study. Participants are divided into groups receiving either standard therapy or Cilostazol. Standard therapy includes regular exercise such as walking or cycling for 30 to 45 minutes at least 5 days per week, along with calorie restriction tailored to gender and weight status (1200-1500 kcal/day for men and 1000-1200 kcal/day for women who are overweight or obese). Cilostazol is assessed as an additional treatment for its potential to reduce liver fat and improve liver health. During the 3-month study, researchers measure changes in liver fat content using ultrasound and assess fibrosis risk scores as primary outcomes. Participants undergo upper abdominal ultrasound to confirm fatty liver diagnosis. Safety and effectiveness are monitored throughout the study. The trial includes adults aged 18 to 60 years with fatty liver, excluding those with other liver diseases or certain health conditions. The overall goal is to determine how Cilostazol affects liver fat and fibrosis risk compared to standard therapy alone.

Ovarian hyperstimulation syndrome (OHSS) is a serious complication that can occur during controlled ovarian stimulation in assisted reproductive treatments. It is caused by the release of substances like vascular endothelium growth factor (VEGF) from overstimulated ovaries, which increases capillary permeability and leads to fluid leakage, blood thickening, and potentially serious complications. This clinical trial is a Phase 2 study evaluating whether cabergoline is effective compared to coasting in reducing the incidence of OHSS. The study compares two interventions: coasting, where patients stop human menopausal gonadotropin (hMG) injections for 1 to 3 days during their ICSI cycle while continuing agonist treatment until estradiol levels drop to a safer level; and cabergoline, a drug used to treat hormone-related conditions including fertility problems. Early OHSS is assessed at the day of embryo transfer and 7 days later, while late OHSS is assessed 14 days after embryo transfer. Participants will be monitored for one month to track the occurrence and severity of OHSS. Evaluations include measuring hormone levels and follicle counts to assess risk, and monitoring for symptoms of OHSS after treatment. The study involves women aged 20 to 35 years at high risk of OHSS undergoing ovarian stimulation with a long luteal protocol. Safety and effectiveness of the interventions will be closely followed throughout the study period.

Gout is a systemic condition caused by the buildup of monosodium urate crystals in tissues, mainly around the joints, leading to inflammation. This occurs when serum uric acid (SUA) levels exceed 6.8 mg/dl, which promotes crystal formation. The study aims to compare the effects of two drugs, Metformin and Febuxostat, on obese patients with gout who do not have diabetes, evaluating their impact on lowering SUA levels. The trial evaluates Febuxostat, a drug that inhibits xanthine oxidase to reduce uric acid production, and Metformin, an oral medication usually used for type 2 diabetes that activates AMP-activated protein kinase (AMPK). Both drugs are studied for their potential to lower serum uric acid in gout patients. The study is a Phase 2 clinical trial focusing on gouty obese non-diabetic adults, comparing the biochemical and clinical outcomes of these treatments. Participants will be monitored over a three-month period during which changes in serum uric acid levels will be assessed as the primary outcome. The study involves regular clinical and biochemical evaluations to measure how each drug affects uric acid in the body. Safety and effectiveness will be closely observed throughout the treatment period to understand the impact of these therapies on gout management.

Major depressive disorder (MDD) is a leading cause of disability and suicide worldwide. Despite significant research and improvements in mental health care, the nature of MDD remains unclear. Additionally, about two-thirds of patients with MDD do not respond well to standard treatments, and many suffer from treatment-resistant depression. This study evaluates the use of dapagliflozin, a medication originally for diabetes and heart conditions, as a potential antidepressant. It compares dapagliflozin with fluoxetine, a commonly used antidepressant. Both drugs will be administered orally to adults aged 18 to 60 years who have been depressed for at least two months. Participants will be monitored over three months, with depression severity measured using the 17-item Hamilton Depression Rating Scale (HDRS). The study includes assessments of treatment effects on depression symptoms and safety monitoring. The total participation period includes regular evaluations to track progress and response to the medications.

This research aims to evaluate the effect of kinetic control retraining on neck proprioception and functional outcomes in adults aged 40 to 55 years with cervical radiculopathy, a condition caused by degenerative changes like disc herniation and bone overgrowth. Cervical radiculopathy leads to neck pain radiating to the shoulder and significantly impacts physical and psychological well-being. The study also highlights the importance of physical exercise and movement control in managing pain and improving function. Participants will receive a selected physical therapy program including trans-cutaneous electrical nerve stimulation (TENS), moist hot packs, posture education, and strengthening exercises for deep neck flexors. This will occur for 30 minutes, three times a week, over eight weeks. The experimental group will additionally undergo kinetic control retraining for 30 minutes per session, three times weekly for eight weeks. This retraining involves assessing and improving motor control through specific tests tailored to each patient's symptoms. During the study, researchers will assess neck proprioception using a cervical range of motion device and measure neck muscle strength with a pressure biofeedback unit over the eight-week period. Patients will be evaluated through clinical tests and symptom-based screenings to monitor progress. The study will track functional outcomes and motor control improvements to better understand the impact of kinetic control retraining in this patient group.

Researchers are investigating the effectiveness and safety of adding either roflumilast or desloratadine to standard disease-modifying antirheumatic drug (DMARD) therapy in patients with rheumatoid arthritis, a chronic autoimmune disease causing joint inflammation, pain, and disability. This phase 2 randomized, double-blind, placebo-controlled study aims to improve disease control for patients who continue to have active disease despite standard treatment. Participants will be randomly assigned to receive oral roflumilast, desloratadine, or a matching placebo alongside their usual DMARD treatment for a period of three months. These medications are studied as add-on therapies to assess their potential anti-inflammatory and immunomodulatory effects. The study includes three parallel groups, each receiving one of the treatments during the trial. Throughout the study, participants will undergo clinical assessments including disease activity score measurements (DAS28), inflammatory biomarker evaluations, and patient-reported outcomes. Safety and tolerability will be closely monitored during the three-month treatment period. The main outcome measure is the change in disease activity score from baseline to 12 weeks, providing insight into the treatments' impact on rheumatoid arthritis symptoms and inflammation.

Diabetes affects hundreds of millions of people globally and often leads to diabetic neuropathy, a common and disabling complication characterized by symptoms like numbness, pain, and sensory changes in the feet. This trial is evaluating whether vagus nerve stimulation can help reduce neuropathic pain, improve nerve function, and enhance physical abilities in patients with diabetic peripheral neuropathy. The study aims to explore this non-drug treatment option and understand its effects on pain and nerve health in diabetic patients. Participants will receive transcutaneous auricular vagus nerve stimulation or a sham therapy, both combined with a conventional physical therapy program. The vagus nerve stimulation involves placing electrodes on specific parts of the ear with controlled electrical pulses for 30 minutes, while the sham group receives a similar setup without actual stimulation. Both groups also engage in exercises including stretching, muscle strengthening, aerobic activity, balance training, and gait improvement. Throughout the study, patients will be monitored for pain intensity at the start and after six weeks. Heart rates will be continuously checked during stimulation sessions to ensure safety. Researchers will assess symptom severity, nerve conduction, and functional outcomes to determine the treatment’s impact, aiming to improve quality of life and reduce chronic pain in diabetic neuropathy over the study period.

Researchers are conducting a prospective randomized study to compare two treatment methods for staghorn kidney stones: endoscopic combined intrarenal surgery and percutaneous nephrolithotomy (PCNL). The study aims to evaluate the effectiveness and safety of these procedures in treating urinary calculi, particularly focusing on patients with stones occupying the renal pelvis and extending into at least two major calyces. The study involves performing either endoscopic combined intrarenal surgery or PCNL on eligible patients. The effectiveness of each treatment will be assessed by measuring the stone-free rate three months after the procedure. Safety evaluations will include monitoring intra- and post-operative complications and using DMSA scans before and after the treatments to assess kidney function. Participants will undergo imaging to confirm the presence of staghorn stones and will be monitored throughout the study for complications. Researchers will collect data on stone clearance and kidney function changes to compare the two procedures. The study includes adult patients between 18 and 65 years old and excludes those with certain health conditions to ensure safety and reliability of results.

Researchers are evaluating two surgical methods, endoscopic and open lumbar discectomy, in patients with diabetes mellitus who have a herniated lumbar disc causing back pain and leg symptoms. Diabetes can affect many organs and increases the risk of complications during medical and surgical treatments. Open lumbar discectomy is widely used and considered the standard surgery for this condition, while endoscopic lumbar discectomy offers a minimally invasive alternative. The study compares patients undergoing either endoscopic lumbar discectomy or open lumbar discectomy to relieve pressure on the affected lumbar nerve root. Both procedures target a single-level herniation at either the L4-5 or L5-S1 spinal levels. The endoscopic method uses a small camera and instruments inserted through a small incision, while the open method involves a larger incision and direct access to the disc. Participants will be monitored for outcomes including the degree of low back pain measured 48 hours after surgery. The trial includes adults aged 18 to 75 years with specific disc herniation and symptoms who have not improved after 12 weeks of conservative treatment. Researchers will observe recovery, pain levels, and surgical success to better understand the benefits and risks of these two surgical options in diabetic patients.