• Autism spectrum disorder
• Caregiver-mediated intervention
• Family psychological intervention
• Parenting sense of competence
• Parenting stress

• DPM
• Evidence-based medicine
• Journal
• PhD
• Podiatry
• Publish
• Research
• Science

• Humans
• Internship and Residency
• Podiatry/education

• Apicomarginal defect
• Consort randomized clinical trial
• Middle East and India
• Platelet-rich fibrin high (PRF High)
• Platelet-rich fibrin medium (PRF Medium)
• Quality of life
• Relative centrifugal force (RCF)

• clinical parameters
• gut microbiome
• moderate wine consumption
• oral microbiome
• phenolic metabolites
• polyphenols
• ulcerative colitis

• Humans
• Colitis, Ulcerative/microbiology
• Polyphenols/analysis
• RNA, Ribosomal, 16S/genetics
• RNA, Ribosomal, 16S/analysis
• Wine/analysis
• Microbiota
• Feces/microbiology

• Spanish Ministry of Science and Innovation

• Clinical trials
• Daily dose
• Infants
• Probiotics
• Statistical power

• Capsules
• Child
• Child Health
• Health Promotion
• Humans
• Infant
• Lacticaseibacillus rhamnosus
• Probiotics/therapeutic use

• Child & adolescent psychiatry
• MENTAL HEALTH
• PUBLIC HEALTH

• Autism Spectrum Disorder/therapy
• Caregivers/education
• Hong Kong
• Humans
• Parents
• Randomized Controlled Trials as Topic
• World Health Organization

• The Hong Kong Jockey Club Charities Trust

Randomized controlled trials (RCTs) are the most robust study design for evaluating the safety and efficacy of a therapeutic intervention. However, their internal validity are at risk when evaluating surgical interventions. This review summarizes existing expertise- based trials in surgery and related methodological concepts to guide surgeons performing this work. We provide caseloads required to reach the learning curve for various surgical interventions and report criteria for expertise from published and unpublished expertise-based trials. In addition, we review design and implementation concepts of expertise-based trials, including recruitment of surgeons, crossover, ethics, generalizability, sample size and definitions for learning curve. Several RCTs have used an expertise-based design. We found that the majority of definitions used for expertise were vague, heterogeneous, and inconsistent across trials evaluating the same surgical intervention. Statistical methods exist to adjust for the learning curve; however, there is limited guidance. We developed the following criteria for surgical expertise for future trials: 1) decide on the proxy to be used for the learning curve, and 2) assess eligible surgeons by comparing their performance to the previously defined expertise criteria.

• Apical periodontitis
• diabetes mellitus
• glycated hemoglobin

• Adult
• Dental Pulp Necrosis/complications
• Dental Pulp Necrosis/physiopathology
• Dental Pulp Necrosis/therapy
• Diabetes Mellitus, Type 2/complications
• Diabetes Mellitus, Type 2/physiopathology
• Female
• Glycated Hemoglobin/analysis
• Humans
• Male
• Mandible
• Middle Aged
• Molar
• Periapical Periodontitis/complications
• Periapical Periodontitis/physiopathology
• Periapical Periodontitis/therapy
• Prospective Studies
• Root Canal Therapy

• Biomechanics
• Knee sleeve
• Proprioception
• Review

• Anti-Bacterial Agents
• Antibiotic Prophylaxis
• Arthroscopy
• Humans
• Knee Joint/surgery
• Postoperative Complications
• Surgical Wound Infection

• Effect size
• Type 1 error
• Type 2 error
• power
• sample size

The statistical portion is a vital component of any research study. The research methodology and the application of statistical tools and techniques have evolved over the years and have significantly helped the research activities throughout the globe. The results and inferences are not accurately possible without proper validation with various statistical tools and tests. The evidencebased anesthesia research and practice has to incorporate statistical tools in the methodology right from the planning stage of the study itself. Though the medical fraternity is well acquainted with the significance of statistics in research, there is a lack of in-depth knowledge about the various statistical concepts and principles among majority of the researchers. The clinical impact and consequences can be serious as the incorrect analysis, conclusions, and false results may construct an artificial platform on which future research activities are replicated. The present tutorial is an attempt to make anesthesiologists aware of the various aspects of statistical methods used in evidence-based research and also to highlight the common areas where maximum number of statistical errors are committed so as to adopt better statistical practices.

• Confidence interval
• research studies
• statistics
• study design
• type-I error
• type-II error

• Chlorhexidine
• periodontal attachment loss
• periodontal debridement
• root canal therapy wound healing, diffusion

• Orthopaedics
• Randomised Controlled Trials
• Study Design

Acutepostoperative pain is among the worst experience that patient scan undergo, and many analgesics have been used to suppress it; especially in chronic opium abusers. Ketamine is an N-methyl-D-aspartate antagonist analgesic, having both anesthetic and analgesic properties, which are not affected to the same extent in chronic opium abusers.

In this study, we assessed the analgesic effects of ketamine added to morphine as a patient-controlled analgesia method for acute pain management, compared with a placebo, inchronic maleopium abusers.

After institutional review board approval for ethical considerations, a randomized double-blinded placebo controlled clinical trial was conducted. A total of 140 male patients aged 18-65 years, undergoing orthopedic surgery, were entered into the study after matching inclusion and exclusion criteria. All patients received the same anesthesia method; while the first group received ketamine (1mg/mL) and morphine (0.5 mg/mL) as a patient-controlled analgesia (70 patients), the second group received morphine (0.5 mg/mL) plus normal saline (70 patients). P value less than 0.05 was considered statistically significant.

The ketamine and morphine group of patients experienced less postoperative pain and required less postoperative rescue analgesia. However, the unwanted postoperative side effects were nearly the same; although increased levels of postoperative nausea and vomiting were observed in the ketamine and morphine group

This study demonstrated improved analgesic effects after using intravenous patient controlled analgesia with ketamine on postoperative pain in opium abusers.

• Acute Pain
• Drug Users
• Ketamine
• Opium

In current practice, patients with chronic pancreatitis undergo surgical intervention in a late stage of the disease, when conservative treatment and endoscopic interventions have failed. Recent evidence suggests that surgical intervention early on in the disease benefits patients in terms of better pain control and preservation of pancreatic function. Therefore, we designed a randomized controlled trial to evaluate the benefits, risks and costs of early surgical intervention compared to the current stepwise practice for chronic pancreatitis.

The ESCAPE trial is a randomized controlled, parallel, superiority multicenter trial. Patients with chronic pancreatitis, a dilated pancreatic duct (≥ 5 mm) and moderate pain and/or frequent flare-ups will be registered and followed monthly as potential candidates for the trial. When a registered patient meets the randomization criteria (i.e. need for opioid analgesics) the patient will be randomized to either early surgical intervention (group A) or optimal current step-up practice (group B). An expert panel of chronic pancreatitis specialists will oversee the assessment of eligibility and ensure that allocation to either treatment arm is possible. Patients in group A will undergo pancreaticojejunostomy or a Frey-procedure in case of an enlarged pancreatic head (≥ 4 cm). Patients in group B will undergo a step-up practice of optimal medical treatment, if needed followed by endoscopic interventions, and if needed followed by surgery, according to predefined criteria. Primary outcome is pain assessed with the Izbicki pain score during a follow-up of 18 months. Secondary outcomes include complications, mortality, total direct and indirect costs, quality of life, pancreatic insufficiency, alternative pain scales, length of hospital admission, number of interventions and pancreatitis flare-ups. For the sample size calculation we defined a minimal clinically relevant difference in the primary endpoint as a difference of at least 15 points on the Izbicki pain score during follow-up. To detect this difference a total of 88 patients will be randomized (alpha 0.05, power 90%, drop-out 10%).

The ESCAPE trial will investigate whether early surgery in chronic pancreatitis is beneficial in terms of pain relief, pancreatic function and quality of life, compared with current step-up practice.

ISRCTN: ISRCTN45877994

In most areas in life, it is difficult to work with populations and hence researchers work with samples. The calculation of the sample size needed depends on the data type and distribution. Elements include consideration of the alpha error, beta error, clinically meaningful difference, and the variability or standard deviation. The final number arrived at should be increased to include a safety margin and the dropout rate. Over and above this, sample size calculations must take into account all available data, funding, support facilities, and ethics of subjecting patients to research.