Clinical trials

this study aims to assess the ability of fibrinogen-to-albumin ratio to predict the development of Acute respiratory distress syndrome in traumatic brain injury patients.

purpose: to evaluate the postoperative pain incidence and intensity after three different obturation techniques (Cold lateral condensation technique (CLC), Vibration thermo-dynamic technique (Vibra-Tho) and Injection of thermo-plasticized gutta-percha (Fast Fill device)). Materials and Methods: Thirty patients with non-vital mature maxillary incisors requiring endodontic treatment will be randomly divided into three groups (n=10) according to the obturation technique used: Group I (CLC), Group II (Vibra-Tho) and Group III (Fast Fill device). Postoperative pain levels will be recorded using the visual Analogue Scale (VAS) immediately post operative and at 24 hours, 72 hours, one week and two weeks.

This study aims to compare the 3-needle and 5-needle of genicular nerve block on pain and quality of life in Knee osteoarthritis (KOA).

epsis is a life-threatening syndrome characterized by acute organ dysfunction resulting from a dysregulated host response to infection. Despite advances in antimicrobial therapy, source control, hemodynamic resuscitation, and organ-supportive strategies, sepsis continues to be associated with substantial morbidity and mortality. Current management is primarily supportive and does not directly target the interconnected processes of excessive inflammation, oxidative stress, endothelial dysfunction, and cellular injury that contribute to progressive organ dysfunction. Current international guidance emphasizes prompt antimicrobial therapy, source control, hemodynamic resuscitation, lactate assessment, and appropriate organ support as the foundation of management. Oxidative stress is an important component of sepsis pathophysiology. Excessive production of reactive oxygen species, together with impaired endogenous antioxidant defenses, can promote lipid peroxidation, mitochondrial dysfunction, cellular injury, and amplification of inflammatory signaling. Maladaptive activation of inflammatory pathways, including nuclear factor-kappa B (NF-κB), contributes to increased production of pro-inflammatory mediators such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). These processes may contribute to dysfunction of the kidney, liver, lungs, cardiovascular system, and other organs. Ursodeoxycholic acid (UDCA) is a hydrophilic endogenous bile acid with an established clinical safety record and established hepatobiliary therapeutic use. Beyond its conventional hepatoprotective effects, experimental evidence suggests that UDCA may exert antioxidant, anti-inflammatory, anti-apoptotic, cytoprotective, and mitochondrial effects. The rationale for investigating UDCA in sepsis is supported by several lines of evidence. Experimental work has demonstrated that UDCA can attenuate sepsis-induced acute kidney injury through activation of the Nrf2/HO-1 antioxidant pathway and inhibition of NF-κB signaling, accompanied by reductions in TNF-α, IL-1β, IL-6, and renal injury markers. Experimental studies have also demonstrated attenuation of sepsis-associated lung injury, pulmonary barrier dysfunction, oxidative stress, inflammatory cytokine production, and PANoptosis following UDCA administration. Importantly, emerging clinical evidence has begun to investigate UDCA in adult sepsis. A retrospective matched study of critically ill adults with sepsis/septic shock did not demonstrate significant improvement in day-3 SOFA score or vasopressor requirements, although improvement in the PaO₂/FiO₂ ratio and earlier extubation were observed among UDCA recipients. More recently, a small prospective pilot involving eight septic patients receiving UDCA explored its potential effects on sepsis-associated platelet dysfunction, while mechanistic studies implicated TREM2-linked signaling. Therefore, a randomized controlled trial is warranted to determine whether adjunctive UDCA can modify the biological abnormalities underlying sepsis, particularly oxidative stress and inflammation, and whether these effects are accompanied by improvement in organ dysfunction.

Pomegranate peel extract has demonstrated a range of potential uses in the biomedical industry in recent years because of its numerous benefits, which include anti-inflammatory, antibacterial, anti-apoptotic, antioxidant, and cell-regeneration-promoting qualities. Therefore, the purpose of this study will be to evaluate the clinical and radiographic efficacy of Pomegranate peel extract as a pulpotomy agent in primary teeth.

Primary dentition is the most suitable space maintainer for permanent teeth. However, as infants often lose their primary teeth too soon, using a space maintainer is the most efficient, long-lasting, and economical way to prevent malocclusions and function impairment in the future. Regarding personalized appliances, space maintainers in digital pediatric dentistry have made significant progress. Digital technology decreases the manual manufacturing stages that take a long time and increases the reliability and durability of digital fabrication procedures.

The goal of this prospective, single-arm clinical trial is to evaluate the speech performance of children with anterior dental crossbite before and after correction. Also, to assess the impact of early interceptive orthodontic treatment in the mixed dentition stage to correct the anterior dental crossbite on the quality of life of children. Fifty children of both sexes aged from 8 to 10 years were enrolled and evaluated using the study's inclusion \& exclusion criteria. before beginning interceptive orthodontic treatment, each child underwent full mouth treatment. then, using a removable anterior expansion screw along with posterior bite planes to treat the anterior crossbite. All children were subjected to the Protocol of speech evaluation before appliance insertion and after complete correction of anterior crossbite. Also, the Child Perceptions Questionnaire (CPQ 8-10) in the Brazilian version was used to gauge how the anterior crossbite affected the children's oral health-related quality of life.

the goal of this study is to evaluate the efficency of different activation techniques in removal of intracanal medication using cone beam computed tomography analysis

The primary goal of this cross-sectional study is to assess risk factors/predictors for dysphagia in RA. The secondary goals include demonstrating whether flexible fiberoptic pharyngolaryngoscopy can detect joint-affection-induced dysphagia in patients with rheumatoid arthritis (RA) and whether both oropharyngeal and esophageal dysphagia are present among these patients. The main questions it aims to answer are * What are the predictors that are associated with dysphagia via flexible fiberoptic pharyngolaryngoscopy in rheumatoid arthritis patients? * Whether flexible fiberoptic pharyngolaryngoscopy can detect joint-affection-induced dysphagia in patients with RA? * Whether both oropharyngeal and esophageal dysphagia are present in patients with RA?

Rheumatoid arthritis (RA) is a long-term inflammatory condition that leads to gradual damage of joints lined by synovial membranes, along with various potential effects outside of the joints. While RA can affect any joint, it typically involves the metacarpophalangeal, proximal interphalangeal, and metatarsophalangeal joints, as well as the wrists and knees. Symptoms related to the joints and surrounding tissues include swelling, tenderness upon touch, morning stiffness, and significant difficulty moving the affected joints

This crossover clinical study aims to evaluate the influence of three different intraoral scanning techniques on the scanning accuracy and passive fit of mandibular implant-supported fixed detachable prostheses in completely edentulous patients. Each participant will undergo digital implant scanning using three methods: splinted scan bodies, horizontal non-calibrated scan bodies (IO Connect), and auxiliary geometric devices.

It has been proposed that altered scapular muscle function can contribute to alterations in shoulder kinematics, which often lead to SD and are frequently associated with other shoulder pathologies. However, whether SD leads to the development of these diseases or is a consequence has yet to be clarified. Changes in scapular kinematics can be attributed not only to altered scapular recruitment patterns (e.g., altered serratus anterior muscle activity) or muscle performance (e.g., force imbalance in the upper and lower trapezius muscles) but also to flexibility deficits in the soft tissue surrounding the scapula, which may restrict normal scapular movement during daily activities and sport- specific movements. Although many studies have investigated the optimal management method, to date, there is no consensus. Conservative approaches involve not only physiotherapy but also other techniques, such as extracorporeal shockwave therapy.

The aim of the work is to evaluate the impact of Probiotics supplementation on prevention of ventilator associated pneumonia in critically ill children admitted at Pediatric Intensive Care Unit at Tanta University Hospitals.

This study is a prospective blind study of periscapular muscle thickness measured with MSUS and correlate it with EMG findings.

1\. Background and Rationale Breast cancer is one of the most common malignancies affecting women worldwide and represents a major health burden in Egypt. Anthracyclines, particularly doxorubicin, remain an important component of several breast cancer chemotherapy regimens. However, their clinical utility is limited by the potential development of anthracycline-induced cardiotoxicity. Doxorubicin-induced cardiac injury is multifactorial and involves oxidative stress, mitochondrial dysfunction, disturbances in myocardial energy metabolism, apoptosis, inflammation, and progressive myocardial structural damage. Cardiac injury may initially occur without symptoms or an obvious reduction in left ventricular ejection fraction (LVEF). Consequently, identification of early myocardial injury is important because intervention before clinically apparent heart failure may potentially reduce progression to overt cardiac dysfunction.

Background: Doxorubicin (DOX) remains a cornerstone in adjuvant and neoadjuvant therapy for breast cancer, but its utility is hindered by dose-dependent cardiotoxicity. Both SGLT2 inhibitors (Empagliflozin) and Biguanides (Metformin) have demonstrated off-target cardioprotective and metabolic properties in preclinical and clinical settings. Objective: To compare the cardioprotective efficacy, safety, and metabolic/oncologic outcomes of Empagliflozin versus Metformin in non-diabetic or controlled-diabetic women with breast cancer undergoing doxorubicin-based chemotherapy. Design: Prospective, 3-arm, open-label (or double-blind), randomized controlled clinical trial (RCT). Duration: 18 months

Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder caused by compression of the median nerve at the wrist. This study is a comparative study designed to evaluate the efficacy of three ultrasound-guided injection treatments for patients with mild to moderate CTS: hyaluronic acid (HA), corticosteroid, and 5% glucose (D5W). A total of 60 adult patients with clinically and electrophysiologically confirmed mild to moderate CTS will be enrolled and divided into three groups of 20 patients each. Participants will receive a single ultrasound-guided injection using one of the three study interventions. Clinical assessment will include Phalen's test and Tinel's sign. Electrophysiological assessment will include median nerve sensory and motor nerve conduction parameters, while ultrasonographic assessment will include measurement of the median nerve cross-sectional area. Participants will be reassessed three months after the intervention using the same clinical, electrophysiological, and ultrasonographic measures. The study will compare changes in these outcomes among the three treatment groups to evaluate their relative efficacy in the management of mild to moderate CTS.

This study aims to evaluate the postoperative outcomes of pyeloplasty in pediatric patients presenting with ureteropelvic junction obstruction and preoperative differential renal function less than 10%, focusing on: * Improvement or stabilization of renal function after surgery. * Radiological improvement in hydronephrosis. * Clinical outcomes such as symptom relief and complication rates.

Full-mouth dental rehabilitation under general anesthesia (GA) is frequently required for young children with extensive dental caries, behavioral challenges, or special healthcare needs. Although various restorative materials and treatment approaches are used during comprehensive dental rehabilitation, evidence regarding their long-term clinical performance and failure rates remains limited. Objective: This prospective cohort study aims to evaluate the clinical outcomes and failure rates of restorative materials and methods employed during full-mouth dental rehabilitation under general anesthesia in children over a two-year follow-up period. Methods: Children undergoing full-mouth dental rehabilitation under general anesthesia will be enrolled and followed prospectively for 24 months. Restorative procedures, including direct and indirect restorative treatments, pulp therapy-associated restorations, and full-coverage restorations, will be performed according to standardized clinical protocols. Clinical evaluations will be conducted at scheduled follow-up visits to assess restoration survival, integrity, recurrent caries, need for retreatment, and restoration failure. Failure rates and factors associated with restoration success or failure will be analyzed.

This randomized clinical trial aims to compare postoperative bite force following full-crown restoration with preformed Bioflx and zirconia crowns in children undergoing comprehensive dental treatment under general anesthesia. Children aged 4-7 years requiring full-coverage restoration of primary molars will be randomly allocated to receive either Bioflx or zirconia crowns. Occlusal bite force will be assessed before treatment and at predefined postoperative follow-up time points using a digital occlusal analysis system. The study will evaluate changes in occlusal function following placement of the two types of pediatric full-coverage crowns.

The success of pulpotomy in primary teeth is critical for preserving function and arch integrity in children and depends largely on the biological properties of the medicament used. Given the limitations of mineral trioxide aggregate, Pelargonium graveolens essential oil has emerged as a potential alternative; however, its clinical performance as a pulpotomy agent remains insufficiently investigated.

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology, with insulin resistance playing a central role in its pathophysiology. Hyperinsulinemia can enhance ovarian androgen production and reduce hepatic sex hormone-binding globulin synthesis, thereby aggravating hyperandrogenism and reproductive abnormalities. Vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, enhances endogenous incretin activity and may improve insulin sensitivity and glucose homeostasis. Emerging evidence suggests that DPP-4 inhibition may also influence body weight, androgen excess, inflammation, and reproductive function in women with PCOS.

This study aims to evaluate and compare the postoperative analgesic efficacy, opioid consumption, motor function preservation, and quality of recovery of ultrasound-guided Quadroiliac Plane Block (QIPB) versus transmuscular quadratus lumborum block (QLB) in patients undergoing THA under spinal anesthesia.

This study aims to evaluate the diagnostic accuracy of monocyte distribution width (MDW) as a novel biomarker for late-onset neonatal sepsis in preterm neonates and to assess its association with disease severity and short-term clinical outcomes

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by relapsing inflammation of the colonic mucosa. Despite advances in therapeutic options, many patients experience incomplete remission or treatment resistance. Emerging evidence suggests that intestinal barrier dysfunction, microbiota dysbiosis, and immune dysregulation play central roles in UC pathogenesis. Nitazoxanide is a broad-spectrum antiparasitic agent with demonstrated antimicrobial, anti-inflammatory, and immunomodulatory effects, including inhibition of NF-κB signaling and improvement of intestinal barrier integrity. Preclinical studies suggest potential benefit in experimental colitis models; however, clinical evidence remains limited. This randomized, double-blind, placebo-controlled trial aims to evaluate the efficacy and safety of nitazoxanide as an adjunct to standard therapy in patients with mild-to-moderate ulcerative colitis over a 12-week treatment period.