Kota Malang

Researchers are comparing two procedures, the superior hypogastric plexus block and the ganglion impar block, to manage pelvic and perineal pain caused by cervical and endometrial cancers. The study focuses on evaluating the effectiveness and safety of these treatments in patients who experience cancer pain resistant to standard medication methods. Both procedures aim to relieve pain by targeting specific nerve areas involved in pelvic and perineal sensations. The superior hypogastric plexus block is performed using a transdiscal approach at the L5-S1 vertebrae, where 5 ml of 1% lidocaine and 10 ml of 96% alcohol are injected, with placement confirmed by C-arm imaging. The ganglion impar block uses a trans-sacrococcygeal approach, injecting 4 ml of 1% lidocaine and 6 ml of 96% alcohol, also confirmed by C-arm. These procedures are compared to determine which provides better pain relief and safety for patients with cervical and endometrial cancer pain. Participants will be assessed on pain levels using a numerical rating scale, disability using the Oswestry Disability Index, and opioid use through morphine equivalent daily dose, all measured three months after treatment. Safety and treatment effects will be monitored throughout the study. The study requires participants to be involved in follow-up visits and assessments to evaluate outcomes and ensure their well-being over the course of the trial.

Researchers are evaluating different heart rate control strategies to improve outcomes for patients with atrial fibrillation related to rheumatic mitral stenosis. This study compares strict heart rate control (60-80 beats per minute) with lenient control (81-110 beats per minute) to see if lenient control is non-inferior in reducing hospitalizations, enhancing quality of life, and improving physical function. This research addresses a gap since patients with this specific heart condition have not been previously studied for these treatment approaches despite existing guidelines. Participants will receive standard medications according to Indonesian Heart Association guidelines, including beta-blockers, digoxin, or a combination, with dosages adjusted monthly to reach the targeted heart rate. After achieving the target, participants will have bi-weekly phone check-ins and monthly outpatient visits for three months to monitor hospitalizations, quality of life using the SF-36 questionnaire, and functional capacity with a 6-minute walk test. Echocardiograms will be done at the start and end of the study period. Throughout the study, participants will be closely monitored for symptoms and treatment effectiveness. The main outcomes measured include the number of hospitalizations within three months, quality of life at three months, and functional capacity measured by walking tests at three months. The study duration includes initial treatment adjustment, followed by ongoing monitoring and assessments to evaluate the safety and benefits of the heart rate control strategies.