Introduction: This study focuses on the treatment of painful crises in Sickle Cell Disease (SCD) patients using Paracoxib, a non-opioid, compared to Morphine. It addresses the need for alternative medications that reduce opioid dependency while providing effective analgesia.
Objectives:
Primary: Evaluate the analgesic effect of Paracoxib versus Morphine in SCD vaso-occlusive crises.
Secondary: Reduce opioid use/dependence, decrease the length of hospital stays, and monitor side effects related to Paracoxib.
Methodology: A double-blinded randomized controlled trial, conducted in a tertiary care emergency department. The study includes adult SCD patients with moderate to severe crises, excluding non-VOC pain, certain medications, and specific medical conditions. The sample size is 226 patients, split equally into two groups.
Intervention: Patients receive either Morphine or Paracoxib, with periodic assessment of vital signs and pain. Additional Morphine is administered if required. Data collection and analysis are meticulously planned.
Expected Outcomes: Improvement in SCD pain management, reduction in opioid usage, and potential benefits in terms of hospital stays and patient satisfaction.

开始日期2024-05-01

申办/合作机构

Armed Forces Hospital

NCT06522581 / Recruiting临床1期IIT

Role of Citicoline in Treatment of Neonates With Hypoxic Ischemic Encephalopathy

Hypoxic ischemic encephalopathy is an acute or subacute brain injury, due to asphyxia in neonates, leading to mortality and long-term morbidity. Its prevalence varies across regions, with developed countries reporting rates of 1.5 per 1000 live births, while developing nations experience a wider range from 2.3 to 26.5 per 1000 live births.
Infants afflicted with moderate HIE face a 10% risk of mortality, with surviving individuals encountering a 30% chance of developing disabilities. The prognosis is graver for severe HIE, with a mortality risk of 60%, and nearly all survivors experiencing some form of disability.

开始日期2024-01-01

申办/合作机构

Armed Forces Hospital

NCT04526847 / Not yet recruitingN/AIIT

Effectiveness of Intermittent Fasting Compared to Continuous Energy Restriction on Body Weight Loss Among Overweight/Obese Adults: a Randomized Controlled Trial

Obesity remains a major public health challenge. Intermittent fasting continues to gain popularity compared to continuous energy restriction as a weight-loss approach for cardiometabolic health. Studies to date comparing intermittent energy restriction (IER) and continuous energy restriction (CER) have not been investigated on weight loss and cardiometabolic risk markers in low-income countries like Nepal. The main objective of this study is to compare the effectiveness of IER versus CER diet on weight loss and cardiometabolic risk markers over the course of six months among overweight/obese Nepalese population.
This study will adopt a parallel arm, open-label, randomized control trial design. The study duration will be six months from baseline to endline. A total of 112 overweight and obese participants, aged 18-64 years, with waist circumference >90 cm (men) and >80 cm (women) will be enrolled in the study. Interested participants will be approached through social media and consecutively enrolled and assigned to either IER group (n=56) or CER group (n=56) randomly. Participants will be provided Mediterranean pattern dietary intervention including two groups: IER group will receive 5:2 diet pattern (5 day without energy restriction and 2 days with 75% energy restriction, net weekly energy deficit
25%), and CER group with a low-calorie diet (daily energy deficit
25%) over the course of six months. Both IER and CER group will be provided personalized diet plan, portion size, nutrition counseling focus on dietary guidance, motivational strategies, and personal goal setting for behavior change with educational materials. Baseline data will be collected using a structured questionnaire and the biochemical tests will be done. Baseline data will be collected at the time of enrollment, midline in three months, and end-line data collection in six months. The primary outcome of this study will be the change in weight loss between IER and CER groups. The secondary outcome measure will be to evaluate changes in nutritional composition, eating behavior, and cardiometabolic risk markers between IER and CER group over six months. Data will be entered using Epidata Software and transferred to the Stata/MP version 14.1 for further analysis. Data will be analyzed using an intention-to-treat basis. Independent t-test and, repeated measures ANOVA will be used to estimate changes between-group comparisons. The significance level will be assumed at p<0.05

开始日期2023-04-01

申办/合作机构

Armed Forces Hospital

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项与 Armed Forces Hospital 相关的文献（医药）

2024-11-01·European Urology Open Science

Development of the European Laparoscopic Intermediate Urological Skills LUSs2 Curriculum: A Delphi Consensus from the European School of Urology

Article

作者: Zondervan, Paticia J. ; Petrut, Bogdan ; Somani, Bhaskar ; de Vries, Anna H ; de Oliveira, Tiago Ribeiro ; Skolarikos, Andreas ; Alvarez-Maestro, Mario ; Greco, Francesco ; Sanchez-Salas, Rafael ; Tourinho-Barbosa, Rafael Rocha ; Carrion, Diego M. ; Pini, Giovannalberto ; Carrion, Diego M ; Veneziano, Domenico ; Silvestri, Tomasso ; Liatsikos, Evangelos ; Bujoreanu, Cristina E ; Baekelandt, Loic ; Rivas, Juan Gomez ; Bujoreanu, Cristina E. ; de Vries, Anna H. ; Socarras, Moises Rodriguez ; Zondervan, Paticia J ; Brinkman, Willem M ; Brinkman, Willem M.

Background and objectiveWhile programmes such as the European Basic Laparoscopic Urological Skills have made strides in foundational training, a significant gap exists for intermediate and advanced laparoscopy education. Our objective is to develop and validate the European laparoscopic intermediate urological skills (LUSs2) curriculum, which will establish uniformity in the training of urological laparoscopic procedures and facilitate proficiency among practitioners.MethodsThe study combines a literature review, cognitive task analysis development by a steering group, and a two-round Delphi survey involving international experts in urological laparoscopy. Consensus was defined as agreement of ≥70% among experts. The survey included statements on various laparoscopic procedures, assessed on a Likert scale from 1 (strongly disagree) to 9 (strongly agree).Key findings and limitationsThe Delphi process achieved consensus on 85% (235/275) of statements, indicating a strong agreement on the curriculum's content. Areas covered include renal hilum dissection, major vessel injury management, enucleation and renorrhaphy, vesicourethral anastomosis, and pyeloplasty. Limitations include the nonsystematic nature of the literature review and potential biases inherent in expert-based consensus methods.Conclusions and clinical implicationsThe LUSs2 curriculum significantly advances the standardised training of laparoscopic urological skills. It offers a detailed, consensus-validated framework that addresses the need for uniformity in surgical education and aims to enhance surgical proficiency and patient care.Patient summaryThis study presents the development of a new standardised training curriculum for urological laparoscopic surgery. We intend this curriculum to improve the quality of surgical training and ensure high-quality patient care.

2024-10-01·Pediatric Critical Care Medicine

Optimal Chest Compression Point During Pediatric Resuscitation: Implications for Pediatric Resuscitation Practice by CT Scans*

Article

作者: Huhndorf, Monika ; Eimer, Christine ; Sattler, Ole ; Jansen, Olav ; Grünewald, Matthias ; Reifferscheid, Florian ; Gräsner, Jan-Thorsten ; Seewald, Stephan ; Albrecht, Martin ; Feth, Maximilian ; Lorenzen, Ulf

OBJECTIVES:Current European guidelines for pediatric cardiopulmonary resuscitation (CPR) recommend the lower half of the sternum as the chest compression point (CP). In this study, we have used thoracic CT scans to evaluate recommended and optimal CP in relation to cardiac anatomy and structure.DESIGN:Analysis of routinely acquired thoracic CT scans acquired from 2000 to 2020.SETTING:Single-center pediatric department in a German University Hospital.PATIENTS:Imaging data were obtained from 290 patients of 3–16 years old.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:We measured and analyzed 14 thoracic metrics in each thoracic CT scan. In 44 of 290 (15.2%) scans, the recommended CP did not match the level of the cardiac ventricles. Anatomically, the optimal CP was one rib or one vertebral body lower than the recommended CP, that is, the optimal CP was more caudal to the level of the body of the sternum in 67 of 290 (23.1%) scans. The recommended compression depth appeared reasonable in children younger than 12 years old. At 12 years old or older, the maximum compression depth of 6 cm is less than or equal to one-third of the thoracic depth.CONCLUSIONS:In this study of thoracic CT scans in children 3–16 years old, we have found that optimal CP for CPR appears to be more caudal than the recommended CP. Therefore, it seems reasonable to prefer to use the lower part of the sternum for CPR chest compressions. At 12 years old or older, a compression depth similar to that used in adults—6 cm limit—may be chosen.

2024-09-01·Current Problems in Cardiology

Advancements and challenges in cardiac amyloidosis imaging: A comprehensive review of novel techniques and clinical applications

Review

作者: Hovseth, Chad ; Al Hajri, Ruqaya ; Albulushi, Arif ; Jawa, Zabah ; Al-Mukhaini, Mohammed ; Sallam, Mansour ; El Hadad, Mohamed Gamal

Cardiac amyloidosis, characterized by amyloid fibril deposition in the myocardium, leads to restrictive cardiomyopathy and heart failure. This review explores recent advancements in imaging techniques for diagnosing and managing cardiac amyloidosis, highlighting their clinical applications, strengths, and limitations. Echocardiography remains a primary, non-invasive imaging modality but lacks specificity. Cardiac MRI (CMR), with Late Gadolinium Enhancement (LGE) and T1 mapping, offers superior tissue characterization, though at higher costs and limited availability. Scintigraphy with Tc-99m-PYP reliably diagnoses transthyretin (TTR) amyloidosis but is less effective for light chain (AL) amyloidosis, necessitating complementary diagnostics. Amyloid-specific PET tracers, such as florbetapir and flutemetamol, provide precise imaging and quantitative assessment for both TTR and AL amyloidosis. Challenges include differentiating between TTR and AL amyloidosis, early disease detection, and standardizing imaging protocols. Future research should focus on developing novel tracers, integrating multimodality imaging, and leveraging AI to enhance diagnostic accuracy and personalized treatment. Advancements in imaging have improved cardiac amyloidosis management. A multimodal approach, incorporating echocardiography, CMR, scintigraphy, and PET tracers, offers comprehensive assessment. Continued innovation in tracers and AI applications promises further enhancements in diagnosis, early detection, and patient outcomes.

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2021-06-08

·GlobeNewswire

Armed Forces Entertainment Brings Big Name Talent to Three

Joint Base Andrews, MD, June 08, 2021 (GLOBE NEWSWIRE) -- Armed Forces Entertainment (AFE) has an amazing lineup of Country musical talent for their upcoming summer concert series, Heat Wave. Three virtual concerts will stream free across AFE’s website, YouTube, and Facebook Watch beginning June 15, allowing military personnel and their families around the world to enjoy top-tier performances on their own schedules in their respective time zones. Created exclusively by AFE for military audiences, the 2021 Heat Wave series features top Country artists up close and personal. On June 15, singer-songwriter Rodney Atkins is joined by fellow singer-songwriters Lee Brice, Josh Turner and Jennifer Smestad, plus American Idol winner Scotty McCreery and hit vocal band Parmalee. The June 25 show features the silky voice of Brian McKnight, who rose to fame with hit song and album Anytime, which went double platinum in 1997. Then he exceeded his own success with the triple-platinum album/single Back at One in 1999 on the Motown Records label. Soulful and deep, the song resonated with country artist Mark Wills who covered it that same year. The final show in the Heat Wave series will be released June 29, just in time for Independence Day. The Grand Ole Opry Salutes America’s Heroes show, features a sparkling lineup of popular artists including the powerhouse band Lady A, multi-platinum award-winner Luke Combs, legendary country star Lee Greenwood, singer-songwriter Carly Pearce, American Idol star Lauren Alaina and Nashville Star winner Chris Young. The musicians have prepared special sets to perform for this unique audience of dedicated Americans deployed or stationed overseas. “This exciting lineup of popular American musical artists starts the summer off with upbeat music and a heartfelt message of gratitude to our military members across the globe,” said Brian Burke, AFE Marketing & Business Analyst. The full artist lineup and schedule is available at the Heat Wave hub. About Armed Forces Entertainment: Armed Forces Entertainment (AFE) is the official agency of the Department of Defense providing quality entertainment to U.S. military personnel serving overseas, primarily at contingency operations and in remote and isolated locations. Now in its 70th year, AFE brings a touch of home through music, sports and comedy entertainment to more than 400,000 troops annually, providing our dedicated military members much-needed downtime. For more information, schedules, and downloadable images, visit: , Facebook, Instagram, Twitter or YouTube Attachments

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