Clinical Research Directory

Comparative Effectiveness of Nursing Interventions: Using Buerger-Allen Exercises Versus Mechanical Compression Therapy on Lower Limb Perfusion and Peripheral Neuropathy Among Patients Undergoing Chemotherapy.

Chemotherapy-induced peripheral neuropathy (CIPN) and impaired lower-limb circulation are common adverse effects that can compromise patients' mobility, comfort, balance, functional independence, and quality of life and may increase the risk of falls. Although Buerger-Allen exercises and mechanical compression therapy are non-pharmacological approaches that may improve peripheral circulation and alleviate neuropathic symptoms, evidence directly comparing these interventions among patients receiving chemotherapy remains limited, particularly in Egypt. This study will address this gap and may inform feasible, nurse-led strategies for supportive oncology care. Aim of the study: This study will aim to compare the effects of Buerger-Allen exercises and mechanical compression therapy on lower-limb perfusion and peripheral neuropathy among patients undergoing chemotherapy. Randomized control trail research design will be used. Setting The study will be conducted in the inpatient chemotherapy department at Ayady Almostakbal Cancer Treatment Hospital, Alexandria Governorate, Egypt. The hospital is a specialized, non-governmental, charitable medical center that provides cancer treatment services to residents of Alexandria Governorate and surrounding areas. Subjects: A purposive sample of 100 eligible patients will be recruited and allocated equally to two intervention groups: the Buerger-Allen exercise group (n = 50) and the mechanical compression therapy group (n = 50). Inclusion criteria: • Adult male and female patients aged 20-60 years who have been receiving chemotherapy for at least six months and who are willing to participate will be eligible for inclusion. Exclusion criteria: * Patients with uncontrolled diabetes mellitus or other medical conditions that may affect lower-limb perfusion or peripheral nerve function will be excluded. * Patients with burns or extensive wounds of the lower limbs will be excluded. * Patients with a lower-limb amputation will be excluded. * Patients receiving another physical, pharmacological, or mechanical treatment regimen directed at the lower limbs will be excluded. Tools for data collection: Two principal assessment tools will be used for data collection. Tool 1: Lower-Limb Perfusion Assessment. This tool will be developed by the researchers following a comprehensive review of the relevant literature and will consist of three parts: * Part I: Patient Demographic Profile. This part will be used to collect data on age, gender, educational level, marital status, and occupation. * Part II: Clinical Data. This part will be used to assess the patient's past and current health history. * Part III: Lower-Limb Perfusion Assessment. This part will be adapted from Abouelala et al. (2022) Tool 2: Peripheral Neuropathy Assessment. This tool will be adapted from Abouelala et al. (2022) Proposed Study Procedures * The tools will be evaluated for content validity and relevance by a panel of five experts in medical-surgical nursing and oncology. Their recommendations will be considered when preparing the final versions. * A pilot study will be conducted with 10% of the calculated sample to assess the clarity, feasibility, and applicability of the study tools and procedures. Necessary modifications will be made accordingly. Participants included in the pilot study will be excluded from the main study sample and analyses. * Patients who meet the eligibility criteria will be allocated equally to the Buerger-Allen exercise group (n = 50) and the mechanical compression therapy group (n = 50). * Written informed consent will be obtained from each participant after the study purpose, intervention procedures, potential risks, and expected

Oral Flap Outline and Local Blood Supply After Surgical Removal of Lower Third Molar Teeth

Wisdom teeth in the lower jaw are frequently buried in bone and must be taken out surgically. To reach the tooth, the surgeon lifts the gum away from the bone as a flap, and the shape of that flap is left to the surgeon's judgement. Two outlines are in everyday use. The first runs only along the necks of the teeth, so the gum is lifted without any additional cut. The second adds a short downward cut in front, which opens the field more widely but also divides some of the small vessels that run within the gum. Because the tissues around a wound rely on a rich network of tiny vessels while they repair themselves, it is worth knowing whether these two outlines leave the local circulation in a different state. This project measured that circulation directly. A laser probe was placed against the tooth in front of the extraction site and against three points on the cheek-side gum, and the amount of moving blood beneath the probe was recorded. To make sure the probe returned to exactly the same spots at every visit, a thin clear plastic guide with prepared openings was made for each participant from a plaster model of the mouth. Measurements were taken before the operation and again on the third and the seventh day afterwards. Facial swelling and how widely the mouth could be opened were recorded on the same occasions. Participants were assigned to one of the two flap outlines in turn, and every operation was carried out by the same surgeon so that the comparison depended on the flap outline alone.