Second Tanta

Researchers are evaluating the safety, compliance, and effectiveness of different bowel preparation methods before colonoscopy. This clinical trial compares a 4-liter split-dose polyethylene glycol combined with bisacodyl and docusate sodium regimen against a 2-liter split-dose polyethylene glycol plus oral simethicone regimen and the conventional 2-liter split-dose polyethylene glycol alone. Participants include adults aged 18 to 70 undergoing colonoscopy for various reasons, such as lower gastrointestinal bleeding or colorectal cancer screening. Participants are randomly assigned to one of three groups: one group receives 4 liters of polyethylene glycol mixed in water over 8 hours along with bisacodyl and docusate sodium tablets; another group receives 2 liters of polyethylene glycol mixed in water over 4 hours with oral simethicone tablets; the last group receives 2 liters of polyethylene glycol alone over 4 hours. Colonoscopy is performed 24 hours after starting the medication. During the study, participants undergo medical history review, physical exams, lab tests, and the colonoscopy itself. Researchers assess the quality of bowel cleansing using the Aronchick scale, record any side effects, and ask participants about how easy it was to take the preparation, how well they tolerated it, and whether they would be willing to use the same regimen again in the future. The primary outcome is a complete and successful colonoscopy, monitored through about one year of follow-up.

This research investigates how combining alveolar bone decortication with concentrated growth factor (CGF) injection affects the speed of moving teeth, specifically focusing on maxillary canine retraction. The study includes patients aged 16 to 22 years who need orthodontic treatment involving extraction of the maxillary first premolar and canine retraction due to certain types of malocclusion. The goal is to assess whether this combined procedure can accelerate tooth movement compared to standard methods. Participants will receive two different treatments on each side of their mouth. On the experimental side, after administering local anesthesia, a two-line flap will be made to expose the bone from the maxillary second premolar to the maxillary canine. The cortical bone will be perforated with multiple small holes, and 70 units of CGF will be injected near the maxillary canine. The flap will then be repositioned and sutured. On the control side, the maxillary canine will be retracted without any acceleration procedure. This allows comparison between accelerated and standard tooth movement techniques. During the study, researchers will monitor the rate of canine retraction over a period of four months. Participants will likely undergo regular orthodontic assessments and oral hygiene evaluations to ensure good periodontal health. The study aims to measure how much faster the tooth moves on the treated side compared to the control side, providing data on the effectiveness of the combined decortication and CGF injection method.

Researchers are evaluating the safety and effectiveness of three drugs—empagliflozin, acetazolamide, and metolazone—when added to loop diuretics for patients hospitalized with acute decompensated heart failure. The study aims to compare how well these add-on treatments help manage symptoms related to fluid overload in this condition. This is a Phase 2 clinical trial focused on improving treatment options for heart failure patients. Participants will receive one of the three study drugs in addition to their usual loop diuretic therapy. Empagliflozin is being studied for its ability to enhance the natural diuretic effects without causing typical electrolyte problems and has shown benefits in heart failure. Acetazolamide and metolazone are also being tested for their potential to boost the effects of loop diuretics. These treatments will be assessed during the hospital stay. During the study, researchers will monitor participants closely, measuring the total urine output over three days to evaluate the effectiveness of each drug combination. They will also assess safety and side effects throughout the treatment period. The study involves adults admitted with signs of fluid overload due to heart failure, with follow-up and monitoring occurring during their hospital stay.

This research aims to assess the effect of adding calcitonin to bupivacaine in an ultrasound-guided transversalis fascia plane block for women undergoing cesarean section. The study focuses on improving pain relief during and after cesarean delivery by evaluating this combination of medications. Participants receive an ultrasound-guided transversalis fascia plane block during their cesarean section, where calcitonin is added to bupivacaine to potentially enhance analgesic effects. The study compares this combination to the usual use of bupivacaine alone. During the 24 hours following the block, researchers monitor the time until participants require additional pain medication. This primary outcome helps determine how effective the combined treatment is in managing postoperative pain. Participant safety and comfort are maintained throughout the study period.

This research aims to compare the safety, patient satisfaction, and efficiency of using propofol alone versus propofol combined with clonidine for sedation during colonoscopy. Colonoscopy is a common procedure performed to prevent, diagnose, and treat lower digestive tract conditions. Sedation helps reduce anxiety and discomfort, improving the procedure's tolerability and outcomes. While propofol is often used alone or with other drugs, higher doses may increase side effects. Clonidine, which acts on specific receptors in the nervous system, may enhance sedation and pain relief when added to propofol. Participants receive either continuous propofol infusion through a syringe pump with carefully controlled dosing or propofol combined with clonidine given intravenously before sedation. Propofol infusion starts at a rate of 25-75 micrograms per kilogram per minute initially and is then adjusted based on clinical response. Clonidine is administered 30 minutes before sedation at 2 micrograms per kilogram over 10 minutes. These treatments are compared to evaluate their effects during colonoscopy. Throughout the study, participants' satisfaction is measured 24 hours after the procedure. Researchers monitor safety and effectiveness by observing patient responses and side effects during and after sedation. The study includes adults aged 18 to 65 undergoing colonoscopy, with assessments ensuring appropriate sedation and overall experience. This approach helps determine if adding clonidine to propofol improves sedation outcomes.

Researchers are evaluating the effectiveness and safety of alpha-lipoic acid as an additional therapy to mesalamine in adults with mild to moderate ulcerative colitis. This condition involves inflammation of the colon, and alpha-lipoic acid is studied for its antioxidant and anti-inflammatory properties that may help improve the disease. Participants receive either mesalamine 1000 mg every 8 hours combined with alpha-lipoic acid 600 mg once daily or mesalamine with a placebo once daily, for a treatment period of 3 months. The study compares these treatments to assess any differences in health outcomes. During the study, patients' quality of life and disease severity are measured after 3 months from the start of treatment. Researchers monitor these changes to understand the impact of the treatments. The study involves regular assessments and follow-up over the 3-month treatment period.

Researchers are evaluating the pain relief effectiveness of two methods—multiple mid-transverse process to pleura (MTP) block and patient-controlled analgesia (PCA)—in adults with idiopathic scoliosis undergoing posterior spinal fusion surgery. This study addresses the challenges of managing postoperative pain and prolonged hospital stays by comparing these regional anesthesia techniques within a multimodal pain control approach. The trial is randomized and aims to improve strategies for postoperative care in this patient group. Participants will receive either multiple MTP blocks administered after anesthesia induction or morphine delivered through intravenous PCA. The PCA involves an initial morphine loading dose before surgery ends, followed by specific bolus doses, lockout intervals, and continuous background infusion tailored to body weight. These two approaches represent newer options compared to traditional epidural or paravertebral blocks, aiming to provide effective postoperative analgesia. During the study, participants will be closely monitored for pain levels 24 hours after surgery, which is the primary outcome measure. Additional assessments will likely include safety monitoring and evaluation of analgesic effectiveness throughout the postoperative period. The total duration of participation covers the surgery and immediate recovery phase, focusing on pain control efficacy and patient safety.

Researchers are evaluating the pain relief effects of two different nerve block techniques, the Quadro-Iliac Plane Block (QIPB) and the Erector Spinae Plane Block (ESPB), in patients undergoing total hip arthroplasty (THA). This study focuses on reducing postoperative pain without relying heavily on opioids, which can cause unwanted side effects such as nausea, vomiting, and respiratory problems. The trial is designed as a randomized non-inferiority study to compare these two approaches. Participants will receive one of two treatments during their surgery: either the QIPB or the ESPB. Both blocks involve injecting 20ml of 0.25% bupivacaine on the side of the body where the surgery is performed. QIPB combines techniques from posterior and anterior quadratus lumborum blocks, while ESPB is a newer method originally used to manage thoracic neuropathic pain. Both aim to block pain signals around the hip area. During the study, researchers will monitor how long it takes before patients need additional pain medication within the first 24 hours after surgery. Participants’ health status will be assessed before the surgery, and they will be carefully observed afterward to measure pain control and any side effects. The study includes adults aged 18 and older undergoing hip replacement under spinal anesthesia, and safety and effectiveness will be closely tracked throughout the postoperative period.

Antimicrobial resistance (AMR) is a serious global health issue highlighted by the World Health Organization. Research shows widespread improper use of antibiotics, including leftover use, non-adherence to prescriptions, pressure on clinicians, and self-prescribing. In Egypt, such misuse has led to high rates of multidrug-resistant bacteria. This study aims to assess how common antibiotic abuse is among medical professionals and the general public in Gharbia governorate, and to understand the factors driving misuse while evaluating awareness about antibiotic resistance. The study uses a cross-sectional design conducted by the Tropical Medicine and Public Health Departments at Tanta University Hospital from May to August 2024. About 1000 participants including physicians, pharmacists, medical students, nursing staff, and the general population will complete a detailed questionnaire available in Arabic and English, both in written and digital forms. The questionnaire covers demographics, socioeconomic status, antibiotic use behaviors, prescribing patterns, and laboratory testing related to antibiotic use. An awareness campaign will follow to educate participants on proper antibiotic use. Participants will provide informed consent before completing the questionnaire divided into sections on demographic data, socioeconomic information, and antibiotic use behavior. The study will monitor the prevalence of antibiotic abuse until August 2024. Data privacy will be strictly maintained using codes and anonymization. The research results will be used solely for scientific purposes. Safety measures include timely reporting of any unexpected risks to participants and ethical oversight by the Faculty of Medicine at Tanta University.

Success of root canal treatment is largely dependent on the elimination of harmful microorganisms and primarily bacteria from the root canal system through chemomechanical preparation and using intracanal medication in order to cure or prevent periapical disease and allowing the maintenance of the dental element. Failure of endodontically treated teeth is multifactorial; it is believed that the most important reason for endodontic treatment failure is the presence of microorganisms in the apical third of the root canal that survive after endodontic procedures. Enterococcus faecalis (E. faecalis) is among the most commonly isolated bacteria from the failed endodontically treated root canals. Enterococcus is a facultative anaerobic gram-positive coccus that invades dentinal tubules, can survive in alkaline environment, endure prolonged periods of starvation, and have certain virulence factors and lytic enzymes. Its prevalence in primary endodontic infection ranges from 4% to 40 % and secondary endodontic infection ranges from 24% to 77%. Moreover, anatomical complexity and diversity of root canals that hinders a complete disinfection of root canal space by chemo-mechanical instrumentation alone. So, the use of an intracanal medication remains an important adjunct to complete elimination of remaining bacteria by reaching areas that instruments and irrigation could not reach in addition to long-standing infections. So, using of intracanal medication is mandatory in infected endodontic cases as more thorough debridement is achieved because of the longer overall time used for the treatment.It prevents regrowth of the remaining microbiota within the root canal system and also to increase the level of disinfection. Chlorohexidine (CHX) is an intracanal medication that has an antibacterial effect plus high substantivity which leads to a prolonged action; however it isn't able to eradicate bacteria completely from root canals. Triple antibiotic paste (TAP) is a combination of metronidazole, ciprofloxacin, and minocycline. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. So, this allows disinfection, and possible sterilization of the root canal system. Introduction of nanotechnology in dentistry has been developed by using nanoparticles (NPs) exclusive features that include smaller sizes and increased surface area to volume ratio. They have higher chemical reactivity and charge density leading to greater interaction with the environment and negatively charged bacterial cells, compared to their bulk counterparts. These advantages may be used to design highly anti-microbial agents with maximal therapeutic efficacy and minimal side effects. Intracanal medications in the nano-form can achieve optimal therapeutic activity through their interaction with microorganisms at both the sub-cellular and molecular levels. Because of their small size, they can penetrate well into the complex anatomy of the root canal system. Chlorohexidine and triple antibiotic paste cannot be converted into nanosized forms, they can be loaded with other nanosized materials like silver and chitosan nanoparticles to gain the benefit of both materials and become nanoparticulate. The triple antibiotic was utilized together with chitosan as a vehicle to increase its stability and controlled release of the medicament. Triple antibiotic-loaded chitosan nanoparticles (tachnp) paved the way for the use of chitosan which has an excellent antiviral, antifungal and antibacterial properties. On the other hand, Chlorohexidine loaded by silver nanoparticles (Ag-np) had high antimicrobial efficacy which is due to the dual antibacterial effect of Ag-np and chlorohexidine, it also allowed the use of silver nanoparticles which are known for their ability to destabilize the bacterial cell membrane and increase its permeability which leads to bacterial death. According to the current knowledge, there is limited information concerning the efficacy of different new combinations of intracanal medications on bacterial count reduction of retreatment cases. Therefore, the purpose of the present study is to evaluate the antimicrobial effect of nano-based intracanal medications on Enterococcus Faecalis in secondary endodontic infection cases.