Damietta First

Researchers are comparing different nerve block techniques and patient-controlled analgesia to reduce tourniquet pain during forearm surgery. The trial focuses on the effectiveness of interscalene brachial plexus block ISBPB, intercostobrachial nerve ICBN block, and supraclavicular brachial plexus block SCBPB combined with fentanyl for pain control. This randomized study aims to better understand which method lowers the incidence and severity of pain caused by a tourniquet used during surgery. All participants will receive a supraclavicular block as their primary anesthetic using 20 to 30 mL of 0.5% bupivacaine under ultrasound guidance. The study groups differ by additional treatments one group receives an interscalene brachial plexus block with 10 mL of 0.125% bupivacaine around the nerve roots another group receives an intercostobrachial nerve block with 10 mL of 0.5% bupivacaine near the second and third intercostal space the third group uses patient-controlled analgesia with fentanyl. Midazolam may be given on request, and fentanyl is administered if pain occurs during surgery. Participants will be monitored for tourniquet pain incidence within two hours after surgery, along with hemodynamic changes, adverse reactions, and patient satisfaction up to 24 hours. Pain quality and location will be documented if pain arises during surgery. The study involves patients aged 18 to 70 undergoing forearm orthopedic or plastic surgery with specific anesthesia eligibility. Safety and effectiveness data collected during and after surgery will help determine the best pain management technique for this setting.

Nonalcoholic fatty liver disease NAFLD is a common chronic liver condition characterized by excess fat buildup in the liver not caused by alcohol or other known factors. This condition is a major health concern worldwide, especially in developed countries. The study aims to evaluate the safety and effectiveness of cilostazol, a drug that may improve liver fat, in adults diagnosed with NAFLD. Participants will be randomly assigned to one of two groups. One group will receive standard therapy, which includes regular exercise and calorie restriction, along with a placebo for three months. The other group will receive the same standard therapy plus cilostazol at a dose of 100 mg twice daily. The study will last for three months to assess the effects of these treatments. During the study, researchers will monitor changes in liver fat levels using ultrasound and assess fibrosis risk scores. Participants will follow prescribed exercise routines and dietary plans. Safety and treatment effects will be closely observed throughout the study period, which lasts three months. This trial is sponsored by Tanta University and includes adults aged 18 to 60 years with diagnosed fatty liver disease.

Ovarian hyperstimulation syndrome OHSS is a serious complication that can occur during controlled ovarian stimulation in stimulated ovarian cycles. It is believed to result from the release of factors like vascular endothelial growth factor, which increase capillary permeability and cause fluid to leak from blood vessels. This leads to blood thickening and complications such as increased risk of blood clots and reduced blood flow to organs. This clinical trial evaluates the effectiveness of cabergoline compared to coasting in reducing the incidence of OHSS in women undergoing ovarian stimulation. The study involves two groups one group will receive cabergoline at a dose of 0.25 mg daily for 8 days starting from the day of HCG trigger, while the other group will undergo coasting, which means temporarily stopping human menopausal gonadotropin injections for 1 to 3 days while continuing agonist treatment until estradiol levels drop to a safer level. The coasting group may also receive cabergoline daily for 8 days in some cases. OHSS will be monitored early on the day of embryo transfer and 7 days after, with late OHSS assessed 14 days after embryo transfer. Participants will be closely monitored for OHSS occurrence and severity over one month. Assessments include hormone level measurements and follicle monitoring. The study uses a randomized, double-blind design to compare the treatments. Women aged 18 to 38 with a high risk of OHSS and specific hormone levels are eligible. Safety is monitored throughout, and the study is sponsored by Tanta University with a planned end date in November 2026.

Gout is a systemic condition caused by the buildup of monosodium urate crystals in tissues, especially around joints, resulting from high serum uric acid levels above 6.8 mgdl. This research aims to compare the effects of two drugs, Metformin and Febuxostat, on obese patients with gout who do not have diabetes. The study is a phase 2 randomized trial assessing how these treatments impact gout management by lowering serum uric acid levels. Participants will be randomly assigned to one of two groups. One group will receive Febuxostat 80 mg daily, a drug that inhibits uric acid production, for six months. The other group will take Metformin 1000 mg daily, a medication usually used for diabetes but being studied here for its potential effects on gout, also for six months. Both treatments are being compared under double-blind conditions to evaluate their effects on gouty obese non-diabetic patients. During the study, participants will have their serum uric acid levels measured, with the primary outcome being the change at three months. The study will monitor biochemical and clinical changes over the six months of treatment. Patients will be assessed to see how these medications influence gout symptoms and uric acid levels, with safety and effectiveness carefully observed throughout the trial period.

Major depressive disorder MDD is a leading cause of disability and suicide worldwide. Despite advances in mental health, many patients do not respond well to current treatments, and a large portion suffer from treatment-resistant depression. Researchers are studying the use of dapagliflozin, a drug originally for diabetes, as a potential antidepressant alongside fluoxetine for MDD treatment. Participants are randomly assigned to one of two groups for 3 months. One group receives fluoxetine 20 mg plus a placebo daily, while the other receives fluoxetine 20 mg plus dapagliflozin 10 mg daily. This double-blind study aims to compare these treatments to evaluate their effects on depression. During the study, participants will be regularly assessed using the 17-item Hamilton Depression Rating Scale HDRS to measure changes in depression severity over 3 months. Quality of life changes will also be evaluated. Safety and treatment adherence will be monitored throughout the trial, which is sponsored by Tanta University.

Researchers are investigating how kinetic control retraining affects neck proprioception and functional outcomes in patients with cervical radiculopathy, a condition caused by degenerative changes like cervical disc herniation and bone overgrowth. This condition leads to neck pain and pain radiating to the shoulder, affecting quality of life and daily function. The study aims to add important information about the benefits of this specific physical therapy approach compared to standard care. Participants will be randomly assigned to one of two groups. One group will receive kinetic control retraining combined with a selected physical therapy program, while the other group will receive only the selected physical therapy program. Both treatments will last for 30 minutes each session, conducted three times per week for eight weeks. The physical therapy program includes trans-cutaneous electrical nerve stimulation, moist hot packs, posture education, and exercises to strengthen deep neck flexors. The kinetic control retraining involves tailored exercises based on motor control tests related to the patients symptoms. Throughout the eight weeks, participants will be assessed on cervical proprioception using a cervical range of motion device and deep neck flexor strength measured by a craniocervical flexion test with a pressure biofeedback unit. Additional evaluations will include neck pain intensity using a visual analogue scale and neck-related functional performance via the Arabic version of the Neck Disability Index. These measures will help researchers understand the effects of the interventions on neck function and pain.

Rheumatoid arthritis is a chronic autoimmune disease causing joint pain, swelling, and disability despite treatment with standard disease-modifying antirheumatic drugs DMARDs. Researchers are evaluating whether adding roflumilast or desloratadine to standard DMARD therapy can better control disease activity and inflammation in patients with persistent symptoms. This phase 2 randomized, double-blind, placebo-controlled trial aims to assess the safety and effectiveness of these add-on treatments for rheumatoid arthritis over a three-month period. Participants will be randomly assigned to one of three groups receiving roflumilast, desloratadine, or placebo, each added to their usual DMARD therapy. Treatments are given orally and continue for three months. The studys design includes parallel groups to compare each add-on treatment against placebo while patients maintain their standard care. During the study, participants will undergo clinical assessments including disease activity scoring DAS28, blood tests to measure inflammatory markers, and patient-reported outcome questionnaires. Safety and tolerability will be monitored throughout the 12-week treatment. Researchers will track changes from baseline to 12 weeks to determine the impact of the treatments. Participation lasts about three months, with regular evaluations to monitor progress and safety.

This research aims to evaluate the combined effect of task-oriented training and functional electrical stimulation on improving ankle muscle strength and balance in children with hemiparesis. Hemiparetic cerebral palsy often causes children to favor their non-paretic side, leading to uneven walking and balance challenges. Muscle weakness affects motor function, so the study focuses on strength training alongside balance improvement to address these difficulties. Participants are divided into two groups one receives a conventional exercise program for 60 minutes, while the other group receives task-oriented training with functional electrical stimulation applied to the affected ankle muscles for 20 minutes, combined with 40 minutes of conventional exercises. The electrical stimulation uses specific parameters to activate ankle dorsiflexion, and training occurs three days a week on non-consecutive days. This combined approach targets strength and balance over an 8-week period. During the study, children undergo assessments of balance and muscle strength at the start and after 8 weeks to measure changes. The study uses tools like electrical stimulation devices and involves various exercises designed to improve balance, gait, and muscle control. Researchers monitor progress through physical evaluations and measure outcomes focused on balance and ankle muscle strength to understand the effectiveness of the combined therapy.

Diabetic peripheral neuropathy is a common and often disabling complication affecting many people with diabetes, characterized by symptoms such as numbness, pain, and sensory changes in the feet that can spread upward. Researchers are evaluating the potential benefits of vagus nerve stimulation to reduce neuropathic pain, improve nerve function, and enhance daily activities in patients aged 45 to 60 with diabetic peripheral neuropathy. This study aims to explore a non-drug treatment option that might improve quality of life and reduce the burden of chronic pain in diabetes. Participants will be randomly assigned to one of two groups. One group will receive traditional physical therapy combined with 30 minutes of transcutaneous auricular vagus nerve stimulation five times per week for six weeks. The other group will receive the same physical therapy along with a placebo sham vagus nerve stimulation for the same duration and frequency. The vagus nerve stimulation involves using a device that delivers mild electrical pulses to specific areas of the ear, with heart rate monitored during sessions to ensure safety. During the study, participants will undergo assessments at the start and after six weeks, including measures of pain intensity, sensory and motor nerve conduction, nerve signal speed and latency in the lower limbs, and functional ability in daily activities. Researchers will monitor safety and treatment effects throughout. The total study participation lasts six weeks, with evaluations focusing on changes in neuropathic pain and nerve function to determine the impact of vagus nerve stimulation.

Researchers are comparing two surgical techniquesendoscopic and open lumbar discectomyin patients with diabetes mellitus who have a prolapsed lumbar disc causing low back pain and radiculopathy. Diabetes is a common disease that can affect many organs and increase risks during medical and surgical treatments. The study aims to determine differences in outcomes between the less invasive endoscopic method and the traditional open surgery approach. Participants will be randomly assigned to one of two groups. One group will receive endoscopic lumbar discectomy, a minimally invasive surgery using an endoscope to relieve nerve pressure. The other group will undergo the conventional open lumbar discectomy, which is considered the standard technique. Both methods target herniated discs at a single spinal level L4-5 or L5-S1. During the trial, researchers will assess pain levels 48 hours after surgery, including low back and radicular pain. They will also measure operative factors such as blood loss, procedure duration, wound length, and hospital stay length up to one week postoperatively. Participants will be monitored closely to collect these outcomes, ensuring thorough evaluation of each surgical approach over the course of recovery.