ANZCTR search results

The primary aim of this trial is to compare the outcomes and adverse events of two different physiotherapy treatment approaches for people with low back pain with or without sciatica. A secondary aim is to determine the perspectives of participants on the specific physiotherapy treatment program utilised in the trial.

In most labours, the baby is delivered head first, face downwards. When the baby is facing upwards, the labour may be more difficult, and assisted deliveries including suction cup, forceps, and caesarean section are more likely. When the mother is fully dilated, it is possible to perform an internal examination and to physically rotate the baby to the downwards (anterior) position, but it is unknown if this procedure reduces the chances of an assisted delivery. We plan to run a study looking at whether performing a procedure to turn the baby will reduce the risk of assisted delivery

This study seeks to determine the effect of application of cricoid pressure on the laryngoscopic view using a cMac video laryngoscope and secondly to assess if whether having the person applying the cricoid viewing the video feed assists in improving the laryngoscopic view.

Purpose of the study is to examine mother and baby outcomes following exposure to antidepressant medication during pergnancy. Patients will be asked to either continue antidepressant medication up until and after delivery; or to wean medication at 35 weeks of pregnancy and recommence at one week post partum. The primary hypothesis is the women who continue their medication through delivery will have fewer depressive symptoms. The secondary hypothesis is that babies exposed to antidepressant medication to term will be more likely to have discontinuation symptoms such as jitteriness and irritability

Achilles tendinopathy is a common condition that can cause marked pain and disability. Numerous non-surgical treatments have been proposed for the treatment of this condition, but many of these treatments have a poor or non-existent evidence base. This study is a randomised trial to evaluate the efficacy of customised foot orthoses to reduce pain and improve function in people with Achilles tendinopathy.

Effect of ventolin vs placebo in acute tetraplegic patients. Spirometric outcome measures

Many people who have a traumatic brain injury (TBI) - usually from a blow to the head such as in a vehicle collision or in a fall do not survive or, if they do, suffer from long-term disability. Previous studies have shown that about 1,000 people in Australia and New Zealand suffer a moderate or severe TBI every year. With current best available treatment and therapies many of these patients sustain loss of brain function and long term disability in varying degrees. When a patient sustains a traumatic brain injury there are two phases to the injury. First, the head-impact causes immediate damage to the brain. The secondary injury, which can evolve over hours or weeks, is a very complicated process. It involves many, linked, changes to the cells, brain chemistry, tissues or blood vessels that can destroy brain tissue. The treatment of brain injury focuses on trying to minimize the secondary injury and there is much research being done to try to find treatments that will prevent it. Erythropoietin (EPO) has recently emerged as a drug that may help reduce secondary injury and improve brain function. It has been found to offer some protection to the brain when brain cells are deprived of their normal oxygen supply causing cells to die or be impaired. The aim of this study is to determine if EPO reduces secondary brain injury and helps patients make a better recovery after traumatic brain injury. The investigators also plan to monitor the effect of EPO on the rate of deep vein thrombosis (DVT - blood clots in the large veins in lower extremity) in patients with moderate or severe TBI in the intensive care unit (ICU).

Studies in animals with retinal dystrophies shows benefit from light restriciton. In particular improvement in retinal function as measured by an elecroretinogram. This study is being undertaken to see if restricting light exposure in people with retinal dystrophies improves retinal function.

The aim of the proposed research is to determine the effectiveness of a comprehensive exercise program for chronic whiplash. Currently, for the majority of sufferers with chronic whiplash there are no proven therapies available to manage this personal and financially costly condition. Promising results have been identified in randomised controlled trials evaluating the effects of different exercise programs, graded activity and specific exercise. However, success rates from these studies were too low to represent a solution to the problem of chronic whiplash and further development was necessary. A comprehensive exercise program that combined both specific exercises and graded activity was developed. A small uncontrolled phase I/II trial provided evidence that this new exercise program had a much higher success rate with 56% of subjects having minimal or no disability at the end of the program. This success rate approximates that of radiofrequency neurotomy (58%) but avoids such invasive surgical techniques. Based upon the exciting results of the pilot study and the strong biological rationale for the superior results with the combined program we now propose to definitively establish the effectiveness of the new program in a large phase III randomised controlled trial.

Chloramphenicol is the commonest ophthalmic antibiotic ointment used by non-ophthalmologists in current practice. It is prescribed by general practitioners and emergency physicians in all cases of corneal abrasions, regardless of severity or mechanism of injury. However, there has been no evidence to determine whether chloramphenicol is the optimum therapeutic agent to treat corneal abrasions. It is uncertain whether the therapeutic effect of chloramphenicol is the antimicrobial agent (decreasing microbial infiltration) or the lubricating ointment (preventing micro-abrasions and speeding corneal re-epithelialization). Further, given the widespread use of chloramphenicol as a first line therapy for uninfected injuries, a serious risk and a major concern is the development of chloramphenicol resistant bacterial species. Thus the purpose of this study is to explore whether a simple lubricating ointment is a viable alternative to chloramphenicol ointment in the treatment of corneal abrasions. If proven correct, this study could potentially revolutionize the treatment of corneal abrasions, significantly decreasing the risk of antibiotic resistant bacteria while providing a cheaper alternative for both patient and hospital. We aim to conduct a double-blinded randomized control trial comparing chloramphenicol to a lubricating ointment with no antimicrobial properties. Both ointments will be prepared within the Pharmacy Department of Westmead Hospital (unblinded member). The labels for both ointments will be masked and each ointment will be placed in individually numbered envelopes. When a patient with a corneal abrasion presents to the emergency department at Westmead Hospital a detailed ocular examination would be undertaken. If the patient meets our inclusion criteria and informed consent is obtained, the medical officer treating the patient would be provided with a numbered envelope dictated by a randomized matrix and the masked ointment dispensed. The patient would be discharged home with an information leaflet and instructions for use of the ointment. After 2 days, the patient will be asked to represent to the emergency department for follow-up by a specialist trained by the Department of Ophthalmology to detect signs of infection, side effects to treatment and appropriate corneal re-epithelialization and healing. If any signs of infection are noted, the patient will be referred to the Westmead Eye Clinic to be seen by an ophthalmologist on the same day. The results from this study will be entered into a database and analysed by statisticians with the intension of publishing our findings in international peer-reviewed journals.