JPMA. The Journal of the Pakistan Medical Association
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized effectiveness trial of methadone, TENS and methadone plus TENS in management of opiate withdrawal symptoms.
To compare effectiveness of methadone, TENS (Transcutaneous Electrical Nerve Stimulation) and methadone+ TENS in management of opiate withdrawal symptoms. ⋯ The results provide support for the use of methadone alone and methadone plus TENS for managing opiate withdrawal, but TENS by itself has no significant effect on withdrawal symptoms. However, TENS in combination with a moderate dose of methadone could reduce severity of withdrawal symptoms effectively.
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To identify prognostic determinants of survival in patients with non-resectable hepatocellular carcinoma (HCC), determine the effect of transarterial chemoembolization (TACE) on prognosis, compare hepatitis C related HCC with mixed etiologies and evaluate the prognostic value of different staging systems. ⋯ Hepatitis C as the etiology of HCC, female sex and multi-focality are associated with poor prognosis. HCV related HCC may differ in prognostic factors from non-HCV HCC. Simple staging system by Okuda predicts prognosis effectively in non-resectable.
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To report and discuss twelve cases of Valproate (VPA) induced hyperammonaemic encephalopathy without liver failure in subjects receiving VPA therapy. ⋯ In any patient on VPA therapy, who develops signs and symptoms suggestive of encephalopathy, even in the presence of normal liver function, VNHE should be suspected. Fortunately, it has a good prognosis and the early withdrawl of VPA leads to improvement in almost all cases.