Adhere to the SPIRIT guidelines, a prospective, multi- center, large sample, randomized controlled trial with blinded assessments has been designed . This proto- col design has several strengths: (1) it is a multicenter trial that will be carried out in seven inpatient and out- patient stroke rehabilitation units, which enhances the study’s external validity and sample representativeness; (2) to guarantee quality, all staff in the study are re- quired to complete training on standard operating pro- cedures of the study protocol before recruiting; (3) this study is centrally randomized to guarantee adequate allocation concealment and blinded assessment of re- sults ; (4) a 12-week intervention and 24-week follow-up assessment can provide reliable long-term ef- fect evidence for a therapeutic regimen of TCM rehabili- tation treatment and its health economics in PSCI clinical practice.
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Background: Worldwide, hypertension affects approximately 25% of the adult population and diabetes about 8.5%. Lack of adherence to prescribed treatment regimen remains a problem among patients undergoing long-term treatment, showing high non-adherence rates, at estimated range of between 36 and 93%. In our city, patients with hypertension and diabetes in primary care are looked after mainly by doctors with little nursing support; also, there is no published dataset among Colombian populations on the effect of nursing intervention to increase adherence to therapeutic regimen. The aim of this study was to evaluate the efficacy of nursing intervention “ Teaching: Individual ” compared with usual care, to increase adherence to therapeutic regimen in people with hypertension and/or type-2 diabetes, and to analyze the impact to glycosylated hemoglobin and systolic blood pressure levels.
Drug-resistant TB poses a significant threat to humans and is a global cause for concern. It is said that one in three persons have dormant tuberculosis bacteria and the person develops TB when the bacteria are no longer dormant. According to Espinal et al., 2001, MDR-TB poses a serious problem in Eastern Europe (Estonia, Latvia and Russia), highly populated countries like Indian and China (which accounts for 39% of the TB cases) and countries in Africa. MDR-TB is associated with higher rates of failure and death, so countries should adopt programs that would be effective such as the Directly Observed Therapy (DOTS) and DOTS plus+ of the World Health Or- ganization. While usage of second line drugs is considered, it should be done in accordance with established tu- berculosis control programs. Although Rifampicin is the primary drug responsible for killing the bacilli, studies and research in the Americas where Rifampicin is eliminated in the continuation phase of the therapy has shown markedly low number of resistant cases . With such statistics, is essential to not only treat TB, MDR-TB and XDR-TB, but also work on preventing the further emergence of drug resistant bacteria. The combination therapy has been internationally approved, and this along with strict adherence to the drug regimen will help the Directly Observed Therapy (DOTS) and DOTS plus+ programs in treating MDR-TB and also the non-compliant patients. Further studies in assessing the mutation involved in resistance (particularly KatG) using new technology will help in understanding the different dimensions of the pathogenesis which will ultimately be useful for new drug
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PTX is a classical drug for the treatment of TNBC, while drug resistant and relapse are the major obstacles to the better prognosis. 26 For severe side effects occurring in patients with high dose of PTX, it is critical to reduce the dose while maintaining its cancer ﬁ ghting effect. 27 In our study, the combination of PIK3CG inhibitor (AS-605240) and PTX may provide new effectively therapeutic method of CLBC. On one side, PTX can help AS-605240 to kill the cancer cells. On the other side, the inhibition of PIK3CG activation may decrease the dose of PTX and increase cancer cells ’ susceptibility. Our results suggested that target PIK3CG potentiates the 2D and 3D grow inhi- bition by PTX. Moreover, the population of cancer stem cells deceases and the migration rate is signi ﬁ cantly
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Based on the study objective the semi structured questionnaire was used. The tool was divided in to two sections. The first section contained demographic data of the tuberculosis patients. The second section contained 17 questions; they were divided under certain factors which are as follows regimen factors containing 7 questions, socio cultural factors containing 3 questions, financial factors containing 3 questions and health services related factors containing 4 questions.
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Cochrane review . However, not all therapeutic cortico- steroids are the same. Even at dose equivalency, some cor- ticosteroids have more immunosuppressive properties (e.g., dexamethasone), and some have more mineralocor- ticoid and vasoreactive properties (e.g., hydrocortisone) . This, tied with the evidence that endogenous gluco- corticoids are secreted in a pulsatile manner in health , major surgery  and critical illness  warranted further analysis of the effects of the individual drugs and the dose regimens used. We performed a network meta-analysis (NMA) on the data used for the Cochrane review to estab- lish the likely effectiveness of each drug and therapeutic regimen in adults with septic shock.
Background: Macular neovascular diseases can cause severe vision loss. A newly approved anti — VEGF drug Conbercept has shown good efficacy and safety in rigorous random controlled trials (RCT), however, it cannot fully reflect the clinical application of Conbercept in real world clinical practice. Moreover, anti-VEGF drugs are expensive and often require multiple treatments, and some patients have poor or even no response to the drugs,this resulted enormous waste of medical resources. Therefore, how to find out those patients who have good response, and how to develop individualized therapeutic regimen in real world need to be urgently investigated in the aspect of pharmacogenomics and
Age at diagnosis has been found to be a prognostic factor of outcomes in various cancers. However, the effect of age at diagnosis on nasopharyngeal cancer (NPC) progression has not been explored. We retrospectively evaluated the relationship between age and disease progression in 3,153 NPC patients who underwent radiotherapy, chemotherapy, or chemoradiotherapy between 2007 and 2009. Patients were randomly assigned to either a testing cohort or a validation cohort by computer- generated random assignment. X-tile plots determined the optimal cut-point of age based on survival status to be ≤61 vs. >61 years. Further correlation analysis showed that age >61 years was significantly correlated with the tumor progression and therapeutic regimen in both testing and validation cohorts (P <0.05). In the present study, we observed that older age (>61 years) was a strong and independent predictor of poor disease-free survival (DFS) and cancer-specific survival (CSS), in both univariate and multivariate analyses. Age was also found to be a significant prognostic predictor as well (P <0.05) when evaluating patients with the same disease stage. ROC analysis confirmed the predictive value of age on NPC-specific survival in both cohorts (P <0.001) and suggested that age may improve the ability to discriminate outcomes in NPCs, especially regarding tumor progression. In conclusion, our study suggests that older age at NPC diagnosis is associated with a higher incidence of tumor progression and cancer-specific mortality. Age is a strong and independent predictor of poor outcomes and may allow for more tailored therapeutic decision-making and individualized patient counseling.
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Following therapy mild cases showed slight improvement in appetite by 3 rd day and by 5 th day it was partially improved in moderate cases. In severe cases appetite was slightly improved by 7 th day of therapy. The general activity and alertness of the affected dogs was improved by 3 rd day in mild cases, by 5 th day of treatment in moderate cases and by the last day of therapeutic trial in severe cases. Emesis (in vomiting cases) was stopped by 2 nd day of therapy, hydration status in dehydrated dog was corrected by 3 rd day of therapy. The ascites was markedly reduced by 7 th day, but in icteric dog, there was not much improvement by 7 th day of therapy. The improvement in this group of dogs could be attributed to the therapeutic regimen of Liv.52, and supportive therapy.
Background: There have been reports of increased rates of multi-drug resistant VAP in the ICU of Zanjan Vali-e-Asr hospital. Suggesting an appropriate therapeutic regimen is of paramount importance, which is the main goal of this study. Method: This non-randomized uncontrolled semi experimental study was carried out with a total number of 45 patients who were selected from ICU of Zanjan Vali-e-Asr hospital. All patients were diagnosed with Serattia-positive multi-drug resistant VAP and treated with the suggested therapeutic regimen. The effectiveness of the regimen was evaluated through the CPIS before and after the treatment. Thereafter, the results were analyzed by SPSS and STATA software. Results: Our data indicate significant changes in body temperature with p value=0.004 (from 37.4±0.6 on the 1 st day to 37±0.3 on the 15 th day), pulse rate with p value=0.003(from 90.8±16.1 on the 1 st day to 83.7±9.1 on the 15 th day), systolic blood pressure with p value=0.009 (from 108.8±10.5 on the 1 st day to 107.1±8.8 on the 15 th day) and creatinine level with p value=0.005(from 1.4±1.3 on the 1 st day to 1±0.6 on the 15 th day). Although not statistically significant, radiologic changes and the pulmonary secretion both followed an overall improving pattern. The total cure rates on day 7 and day 15 were not statistically significant. Conclusion: Our study reports a positive response to our recommended therapeutic regimen in patients with VAP. Our findings also indicate that the antibiotic preference is not dependent on early or late VAP; especially in complicated cases such as patients admitted to ICU. We highly recommend a similar study conducted with the control group.
Markov model, we could identify the economic value of the improved response by patients on the single-tablet regimen versus those on a multipill regimen in terms of quality of life and cost per QALY gained. As a result of the better quality of life perceived by patients, the ICER was more favorable and came to € 4541.00 per QALY ( - 17%). In practice, assessment of the single-tablet regimen in the terms described here may indicate the range of cost reduction possible for a treatment regimen comprising various molecules (some of which may be nearing patent expiration) with a cost-effectiveness ratio equivalent to that of the corresponding single-tablet regimen. In our study, a 24% price decrease for the multipill regimen would make it comparable with that of the single-tablet regimen. Similarly, the results of our study could be used to identify a potential premium price to be assigned to a single- tablet regimen. In the proposed study, the maximum premium price could be about 29% of the corresponding noncombined therapeutic regimen.
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Chemotherapy is most of the time the standard second line treatment after surgery which prevents the relapse of the cancer and adds survival benefit in patients of stage II and Stage III cancer patients. The chemotherapy given after surgery is referred to as adjuvant chemotherapy. Different combinations with Fluorouracil were designed and studied in the past to serve as the most effective postoperative adjuvant regimen for CRC. 5FU in combination with Semustine and Vincristine were evaluated for effective therapy but the no significant survival benefit was noted in these combinations despite long term leukemogenic effect of Semustine 19,20 . Taylor et al., (1985) 21 tested the adjuvant efficacy of fluorouracil by infusion in the portal vein with no significant survival benefit. Levamisole which is an anthehelmintic agent with immunostimulation was combined with 5FU in 1989 which reduced the relapse rate of the disease with elevation of liver enzymes and neurotoxicity 22 .
This is to certify that the dissertation entitled “ SAFETY AND EFFICACY OF LOW DOSE MAGNESIUM SULPHATE REGIMEN IN ANTEPARTUM ECLAMPSIA AND A COMPARATIVE STUDY OF DHAKA REGIMEN WITH PRITCHARD REGIMEN IN ANTEPARTUM ECLAMPSIA” is a bonafide work done by Dr. M. NAGAMANI at K.A.P.Viswanathan Government Medical College, Trichy. This dissertation is submitted to Tamilnadu Dr. M.G.R. Medical University in partial fulfillment of University rules and regulations for the award of M.D. degree in Obstetrics and Gynaecology.
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Small dose flare-up regimens: This protocol is also known as ‘mini’ or ‘micro’ dose regimen. This protocol involves utilization of oral contraceptive (OC) priming followed by diluted doses of GnRH agonists, e.g. leuprolide acetate (LA) 40 μg, given twice daily. Two days later, stimulation is initi- ated by adding high doses of gonadotropins. En- hanced outcome was observed in a prospective controlled trial by Surrey et al. The patients had no pregnancies in previous IVF attempts with the long luteal regimen (8). Notable results using the same microdose protocol were also reported by Schoolcraft et al. on poor responders who were pretreated for 21 days with a combined oral con- traceptive (COC); on day 3 post COC, each pa- tient received leuprolide (40 μg twice daily) and growth hormone (GH, 4 IU/day intramuscularly) followed on day 5 post-COC by a high dose of go- nadotrophins (450 IU purified FSH) (9). Another retrospective study compared a microdose flare-up regimen with a long luteal protocol with de- creasing doses of GnRH agonist, and observed higher cancellation rates, lower clinical preg- nancies and decreased numbers of oocytes re- trieved per cycle with the microdose flare-up regi- men (10). Scott and Navot, used lower doses of leuprolide (ie. 20 μg b.i.d.) from cycle day 3, fol- lowed by high doses of FSH from cycle day 5, and reported a good number of retrieved oocytes (11).
The coverage rate of different combinations of empiric antibiotics, as suggested by previous published articles (Gates 1983; Nagy et al 1997; Sakaguchi et al 1997; Chen et al 1998, 2000; Plaza Mayor et al 2001; McClay et al 2003) was com- pared based on the antimicrobial susceptibility of all cases in this study (Table 5). Regimen 5, penicillin and metronidazole, was less effi cacious than the other four regimens (p ⬍ 0.001), because penicillin and metronidazole could not adequately cover the gram-negative organisms, reducing the utility of the regimen. Among regimens 1–4, regimen 2 was found to be superior to regimens 1, 3, and 4. Regimens 2 and 4 differed signifi cantly (p ⬍ 0.001). Based on the drug sensitivity tests of the bacterial culture results, regimen 2 was more effective than regimen 4 by 13 patients. The cultured bacteria of these 13 patients were all susceptible to regimen 2 and resistant to regimen 4. The pathogens included viridans streptococci (11 isolates), S. aureus (1), S. intermedius (1), β -hemolytic Streptococcus group non-ABD (1), Salmonella enteritidis D (1), and Prevotella spp. (1), which were sensitive to ceftriax- one but not cefuroxime. The coverage rate of regimen 2 was better than regimens 1 and 3 but not signifi cantly.
The study was approved by our local Ethics commit- tee. All patients gave written informed consensus before starting chemotherapy with PEI regimen, and at the time of data analysis all living patients gave another written informed consent for the use of their personal data in the study analysis.
Background: Intra-abdominal infections are one of the most common infections encountered by a general surgeon. However, despite this prevalence, standardized guidelines outlining the proper use of antibiotic therapy are poorly defined due to a lack of clinical trials investigating the ideal duration of antibiotic treatment. The aim of this study is to compare the efficacy and safety of a three-day treatment regimen of Ampicillin-Sulbactam to that of a three-day regimen of Ertapenem in patients with localized peritonitis ranging from mild to moderate severity. Methods: This study is a prospective, multi-center, randomized investigation performed in the Department of General, Emergency, and Transplant Surgery of St. Orsola-Malpighi University Hospital in Bologna, Italy. Discrete data were analyzed using the Chi-squared and Fisher exact tests. Differences between the two study groups were considered statistically significant for p-values less than 0.05.
Table 2 shows that dental infections and procedures like tooth extraction were the most common causes for Iraqi patients to stop fasting. Tables 3 and 4 show that the majority of patients during Ramadan were prescribed antibiotics with a twice-daily regimen. There was no sta- tistical difference between the antibiotic-dosing regimens prescribed for fasting and nonfasting patients. In contrast to what was expected, the percentage of patients who were prescribed antibiotics with thrice daily regimen was higher among fasting patients than those in the non fasting state. Furthermore, physicians were less likely to ask the patient about fasting status when they prescribed two antibiotics with a thrice-daily regimen.
Restorative Emotion Scripts. Restorative emotion scripts enable emotional release that promotes well-being. The majority of respondents live in Scotland where the social order is “undemonstrative,” requiring a “stiff upper lip.” Respondents regard their home environments as being “emotionally straightjacketed,” you “don’t show emotion,” especially not in public and, for some, not even in private. James shares that “typically, where I’m from people are very introverted and don’t like to show their emotions but Lourdes brings it out and that is really quite profound.” These comments are reminiscent of Craig’s (2004) assessment of the dominance of logic over emotion within the Scottish culture and a national character that is fearful of drawing attention to oneself. The performance of sentiments (Gopaldas 2014) is largely absent within respondents’ home towns. This is why the Lourdes therapeutic servicescape is viewed as a “profound” opportunity to release emotional suffering:
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The nPCR test proved an insubstantial proportion of participants to have mixed malaria infection. However those entities of mixed malaria seemed inconsequential clinically as nPCR proven mixed malaria did not affect either the nature of illness or treatment/outcome and conclusions of the study. Notably, this inference of clini- cal inconsequentiality of merely nPCR-proven mixed malaria must be methodically evaluated further as it is beyond the scope of the current study. Lost to follow-up ensued in only three patients but seemingly they all had ACPR until their day 3 follow-up. However, we cannot rule out the possibility of treatment failure beyond day 3. Remarkably, this study did not assess the efficacy of CQ alone as per the WHO protocol , rather a permitted deviation from it i.e., assessment of CQ–PQ combined regimen as it was suitable in the respective study setting. Therefore, the findings of this study can only be applica- ble to population exempting any contraindications for PQ administration. Similar studies in future should with- hold PQ administration till day 28 as recommended pri- marily by the WHO .