Karbala

Researchers are evaluating the effectiveness of the I-arch system for aligning moderately misaligned teeth in patients seeking orthodontic treatment. This clinical trial compares the I-arch system with the MBT arch wire system to determine if the I-arch increases the rate of teeth alignment, produces significant changes in arch width and incisor inclination, and decreases patient-reported pain and root resorption. The study is a multicenter, randomized, blinded, parallel group trial designed to answer these questions during the initial stage of orthodontic treatment. The study uses a straight wire appliance with MBT prescription brackets and follows a standardized bracket bonding and arch wire placement protocol. Participants are randomly assigned to either the I-arch group, receiving a 0.016d70.014 copper nickel titanium arch wire placed at bonding and religated every four weeks, or the MBT group, receiving a 0.014-inch heat-activated nickel titanium arch wire initially, which is replaced by a 0.016-inch wire after eight weeks, both religated every four weeks. Elastomeric modules are used for ligation, and bracket rebonding is performed within 24 hours if needed. No deviations from the treatment protocol are allowed. Participants undergo digital scans of their upper and lower arches before treatment and at 4, 8, 12, and 16 weeks to measure teeth alignment and arch widths. Lateral cephalometric and periapical radiographs are taken before and after 16 weeks to assess incisor inclination and root resorption. Participants record their pain levels daily for seven days after wire placement using a visual analog scale. The primary outcome measured is the rate of teeth alignment over 16 weeks. After the trial, treatment continues as prescribed.

This clinical trial evaluates the effects of coughing exercises and incentive spirometry (IS) on postoperative respiratory outcomes and recovery in children undergoing elective cardiac surgery with cardiopulmonary bypass. The study aims to answer: How do coughing exercises and IS influence lung function and breathing after surgery? How do they affect overall recovery, including physical comfort, oxygenation, and prevention of pulmonary complications? Eligible children aged 6 to 18 years will be randomly assigned to one of three groups: Coughing exercises group Incentive spirometry group Standard care group Children in the intervention groups will perform the assigned exercises every 3 hours for the first 3 days after surgery. All participants will receive daily monitoring, including vital signs, oxygen saturation, lung function assessment, and observation of postoperative recovery indicators such as feeding tolerance and mobility. The study will assess primary outcomes such as postoperative respiratory function using a standardized respiratory score, and secondary outcomes including postoperative recovery indicators (quality of recovery scores), incidence of pulmonary complications, and length of stay in the pediatric intensive care unit (ICU). This research will help identify the most effective method for improving respiratory outcomes, reducing complications, and supporting faster recovery in children after cardiac surgery.

Peri-implantitis is an inflammatory condition caused by bacteria that affects the mucous membranes and bone around dental implants. This condition is characterized by inflammation, bleeding, increased pocket depth, and bone loss visible on X-rays. The study investigates the role of epithelial-mesenchymal transition (EMT), a process where epithelial cells change into motile mesenchymal cells, in the breakdown of the protective epithelial barrier around implants and its potential involvement in peri-implant disease development. EMT is influenced by bacterial products and inflammatory signals, and markers like E-cadherin and vimentin reflect changes in cell adhesion and motility associated with this process. The study compares peri-implant tissues from patients with peri-implantitis to those without the disease, examining EMT-related markers. Patients with peri-implantitis must have dental implants functioning over 12 months with specific clinical and radiographic signs of disease, while control patients have missing teeth but adequate bone and gum tissue for new implants. The study collects tissue samples and measures the depth of pockets around implants, bone levels via radiographs, and expression of EMT markers using immunohistochemical techniques. Participants undergo clinical exams, including measuring peri-implant probing depth and radiographic assessments before tissue sampling. The study evaluates the levels of EMT markers to understand their role in peri-implant inflammation and tissue changes. The results aim to clarify EMT's involvement in peri-implantitis, potentially guiding future treatments. Participants must consent to follow-up visits, and safety and disease progression are monitored throughout the study.

Researchers are studying how turoctocog alfa is used in everyday clinical practice for male patients with haemophilia A, a congenital bleeding disorder. This observational retrospective study aims to describe treatment patterns and provide baseline information for managing haemophilia A without changing participants' clinical care. The study focuses on patients who have previously received factor VIII (FVIII) replacement therapy and are now switching to turoctocog alfa. Turoctocog alfa, administered intravenously, is the drug being observed in this study. Data is collected from patients who switch from their previous FVIII therapy to turoctocog alfa. The study does not involve new treatments or interventions but relies on existing medical records uploaded to a special electronic database. Participants' baseline history is recorded at the time they switch to turoctocog alfa, and outcomes are tracked according to their regular clinic visits. The main outcome measured is the annual bleeding rate (ABR) over 12 months following the switch. This helps researchers understand how different turoctocog alfa treatment regimens affect bleeding events in these patients.