Kafr Al Sheikh First

Researchers are evaluating the safety and effectiveness of a new drug delivery method using dexamethasone-loaded exosomes compared to standard intratympanic dexamethasone and exosome vehicle alone in adults with sudden sensorineural hearing loss SSNHL. This condition involves rapid hearing loss of 30 decibels or more over three frequencies within 72 hours, with causes often unknown but possibly related to infections, immune responses, or blood flow issues in the ear. The study aims to improve drug delivery to the inner ear and reduce systemic side effects. The trial includes three treatment groups one receiving standard dexamethasone injections into the middle ear, another receiving exosomes alone, and the third receiving exosomes loaded with dexamethasone. These treatments are given as a single course through intratympanic administration. The researchers will assess how well the treatments improve hearing and how the drugs distribute within the ear, using advanced imaging and hearing tests over several weeks. Participants will undergo hearing assessments including pure-tone average tests, auditory brainstem response, and otoacoustic emissions at baseline and follow-up visits at 1, 4, and 12 weeks after treatment. Safety and tolerability will be closely monitored. The main measurement is the change in hearing levels four weeks after treatment. The study will last up to six months for each participant, with detailed evaluations to understand the drugs effects and safety profile throughout this period.

Researchers are studying the safety and effectiveness of taking 4 grams of acetyl-leucine daily for three months in patients who have post-stroke ataxia following a posterior-circulation ischemic stroke. This clinical trial is designed as a double-blinded, placebo-controlled study to compare acetyl-leucine with a placebo in improving balance and movement issues after stroke. The study is conducted at Kafr-Elsheikh University and includes 200 patients who recently experienced this type of stroke. Participants are randomly assigned to one of two groups. One group receives 4 grams of acetyl-leucine daily along with aspirin and clopidogrel as part of their stroke treatment, while the other group receives a placebo with the same aspirin and clopidogrel regimen. The aspirin and clopidogrel are given as a loading dose during the first 24 hours after stroke, followed by a maintenance dose daily for 90 days. The interventions begin within 24 hours of stroke onset and continue for three months. During the study, participants will undergo brain imaging scans including CT and MRI to confirm stroke diagnosis and monitor progress. Researchers will assess balance and ataxia using the Berg Balance Scale BBS, Scale for the Assessment and Rating of Ataxia SARA, and Modified Rankin Scale mRS at 90 days. They will also monitor for any treatment-related side effects. The study lasts for three months, with detailed evaluations and safety assessments throughout this period.

Carpal tunnel syndrome CTS is a common nerve compression disorder affecting the wrist, caused by pressure on the median nerve within the carpal tunnel. Researchers are evaluating the use of ultrasound US and nerve conduction studies NCS as tools to help diagnose CTS, plan treatment, and monitor patients over time. This study focuses on how ultrasound can assist in understanding nerve changes and anatomical variations related to CTS. Participants will undergo high-resolution, real-time ultrasound imaging of both wrists using a 12 MHz linear array transducer. The ultrasound examinations will take place before surgery and again three months after surgery. This imaging approach aims to measure various nerve parameters such as size, blood flow, and movement, offering a non-invasive and quick method to support diagnosis and follow-up. During the study, patients will receive ultrasound assessments at specified times and clinical evaluations for CTS. Researchers will measure the sensitivity of ultrasound in diagnosing CTS during surgery. The study involves monitoring changes in the median nerve and surrounding structures to help improve diagnosis and management. Participation includes imaging visits and clinical follow-up over a period encompassing pre- and post-surgical assessments.

This research aims to understand how the length of time patients experience symptoms affects the results of lumbar spine surgery. It focuses on people with conditions such as degenerative disc disease, spinal stenosis, spondylolisthesis, and disc herniation who have not improved after 3 to 6 months of conservative treatment. Surgery is considered when neurogenic claudication and positive imaging findings are present, with previous studies showing surgery can improve disability and pain for at least four years compared to conservative care. The study includes patients undergoing lumbar spine surgery for symptoms like lower back pain, radiculopathy, neurogenic claudication, leg weakness, and bowel or bladder issues. There is one study group consisting of these patients who will have surgery. The trial does not involve a comparison group or placebo, as it is observational and focuses on monitoring outcomes after surgery. Participants will be followed for at least six months after surgery. Researchers will assess disability, pain levels, musculoskeletal conditions, and patient satisfaction at this time. Data will be collected to evaluate how symptom duration before surgery relates to these outcomes. The study is sponsored by Kafrelsheikh University and plans to start in July 2025 and end in January 2026.

Knee surgeries often cause significant pain after the operation, which can delay movement and recovery. This trial aims to compare how well blocking the nerve to the vastus lateralis muscle works against blocking the lateral femoral cutaneous nerve to manage pain and improve function after knee surgery. The study uses recent ultrasound-guided techniques to target these specific nerves for pain relief. Participants will be randomly assigned to receive either the vastus lateralis nerve block or the lateral femoral cutaneous nerve block. Both groups will receive an injection of 5 ml of bupivacaine 0.5% to block the respective nerves. These procedures are performed during the surgery under spinal anesthesia. The trial is double-blinded, meaning neither the patients nor the researchers know which nerve block is given to ensure unbiased results. During the study, researchers will monitor pain levels 24 hours after surgery, time until the first request for additional pain relief, total morphine use, block procedure time, patient satisfaction, hospital stay length, and any side effects during the first 24 hours. The hospital stay may last up to one week. Participants will undergo assessments related to pain and recovery, with close monitoring to evaluate the effectiveness and safety of each nerve block over this period.

This research aims to compare two surgical methods for patients with osteoporotic spines who need posterior instrumentation. It focuses on evaluating bone-cement-augmented transpedicular screw fixation versus cannulated pedicle screw fixation. The study examines implant stability, pain relief, functional recovery, and complication rates, addressing challenges caused by weak bone density that can lead to screw loosening and fixation failure. Participants will receive either bone cement augmented transpedicular screw fixation or cannulated pedicle screw fixation as part of their treatment. These procedures are designed to improve implant stability in weakened bones, with the cannulated screws allowing cement to flow through and reinforce the fixation. The treatments will be assigned randomly to compare their effects. During the study, researchers will monitor participants for wound infections six months after the procedure, along with other complication rates. The study involves clinical and radiological assessments to evaluate outcomes related to screw stability and recovery. Participants can expect follow-up visits and evaluations over a six-month period to track their progress and safety.

Researchers are evaluating the effect of combining intrathecal dexmedetomidine with an adductor canal block to manage pain after total knee arthroplasty TKA. This study aims to improve postoperative pain control, helping patients recover faster and reduce complications. The study focuses on analgesia after knee surgery, involving adults aged 18 to 75 years with specific health criteria. Participants are randomly assigned to one of three groups one receiving intrathecal dexmedetomidine with bupivacaine and a saline adductor canal block, another receiving bupivacaine intrathecally with an active bupivacaine adductor canal block, and a third group receiving both intrathecal dexmedetomidine and an active bupivacaine adductor canal block. All treatments are given at the end of surgery under spinal anesthesia. During the study, researchers will monitor total morphine use and pain levels for 48 hours after surgery, as well as heart rate and blood pressure in the first hour after anesthesia. Patient satisfaction and any side effects will also be assessed. The study uses a double-blind design and measures outcomes to better understand pain relief methods after knee replacement surgery.

Researchers are investigating the safety and effectiveness of combining aspirin with either cilostazol or clopidogrel in adults who have experienced a first-ever large-vessel minor ischemic stroke or transient ischemic attack TIA. This randomized controlled trial compares a 300 mg loading dose of clopidogrel plus 300 mg aspirin to a 200 mg loading dose of cilostazol plus 300 mg aspirin, focusing on stroke prevention and possible side effects. The study is conducted under ethical approval and involves careful monitoring of neurological outcomes and complications. Participants are randomly assigned to one of two treatment groups. One group receives clopidogrel with a 300 mg loading dose followed by 75 mg daily from day 2 to day 90, alongside aspirin starting with a 300 mg loading dose and then 75 mg daily maintenance. The other group takes cilostazol with a 200 mg loading dose within 24 hours of stroke onset, then 100 mg twice daily through day 90, plus the same aspirin regimen. Both groups undergo clinical assessments and brain imaging to track progress and safety. Throughout the study, patients have neurological evaluations using the NIH Stroke Scale NIHSS and the Modified Rankin Scale mRS at admission, day 7, and three months. Additional tests include echocardiography, ECG monitoring, carotid duplex, blood tests, and brain MRI scans. Researchers measure the rate of new strokes and bleeding complications at 90 days, along with secondary outcomes like stroke recurrence, heart attacks, deaths from vascular causes, and treatment side effects. Participants are followed for 90 days to monitor safety and effectiveness.

Researchers are evaluating the efficacy and safety of combining aspirin with either clopidogrel or cilostazol in adults who have experienced a minor ischemic stroke or transient ischemic attack TIA. This randomized controlled trial aims to compare a 300 mg loading dose of clopidogrel given within 24 hours of the first minor stroke or TIA to a 200 mg loading dose of cilostazol, measuring outcomes such as new stroke rates and adverse effects over 90 days. The study was approved by the ethics committee of Kafr el-Sheik University and involves patients aged 18 to 75 years who received antiplatelet treatment shortly after stroke onset.

Researchers are evaluating the safety and effectiveness of two different drug combinationsticagrelor with aspirin versus cilostazol with aspirinin adults who have experienced their first-ever large-vessel minor ischemic stroke or transient ischemic attack TIA. This phase 3 randomized controlled trial aims to compare these treatments in reducing the risk of new strokes and assess their safety regarding bleeding complications. The study is sponsored by Kafrelsheikh University and was approved by the ethics committee of the faculty of medicine at Kafr el-Sheik University. Participants are randomly assigned to one of two groups the ticagrelor arm receives a 180 mg loading dose within 24 hours of stroke onset followed by 90 mg twice daily from day 2 to day 90, along with a loading dose of 300 mg aspirin and a maintenance dose of 75 mg aspirin. The cilostazol arm receives a 200 mg loading dose within 24 hours followed by 100 mg twice daily from day 2 to day 90, also combined with aspirin given in the same manner. Both groups are followed up for 90 days to monitor treatment effects and safety. Throughout the study, participants undergo clinical assessments including history, neurological exams, and stroke severity scales such as NIHSS on admission and day 7, plus the Modified Rankin Scale at one week and three months. Imaging tests like brain CT and MRI, along with blood tests and heart monitoring, are performed as needed. Researchers measure outcomes including the rate of new strokes, bleeding events, and adverse drug effects, as well as overall functional recovery and vascular events over the 90-day follow-up period.