]. They concluded that melatonin supplement was associated with a significant improvement in overall IBS severity, pain severity, and quality of life; however, there were no significant improvements in abdominal bloating and sleep quality.
The results of our trial showed that in both groups of patients with and without sleep disorders, receiving melatonin leads to a significant improvement in IBS score and GI symptoms, including the severity and the frequency of abdominal pain, the severity of abdominal bloating, satisfaction with bowel habits, disease's impact on patient's life, and stool consistency; however, there was no significant improvement in the frequency of defecations per week.
The differences between the results of our trial and other trials may be due to the difference in the trial duration, melatonin dosage, and scales used for evaluating the IBS symptoms, sleep parameters, and quality of life. In addition, they evaluated some parameters that we did not, such as psychological profile, colonic transit times, polysomnographic parameters, extracolonic parameters, and rectal sensory thresholds.
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The effect of intradialytic exercise on dialysis patient survival: a randomized controlled trial - BMC NephrologyBackground Patients with kidney failure have a high mortality rate. This study aimed to evaluate the effect of intradialytic exercise on survival in patients receiving hemodialysis (HD). Methods In this randomized controlled trial conducted in a HD center in Iran, adult patients receiving chronic HD were randomized to intradialytic exercise (60 min) in the second hour of thrice weekly dialysis for 6 months (intervention) or no intradialytic exercise (control). The primary outcome was survival rate at 12 months. Secondary outcomes were serum albumin, hemoglobin, hematocrit, red blood cell count, serum calcium, serum phosphorous, parathyroid hormone, physical function (6-min walk test) and nutritional status (Geriatric Nutritional Risk Index) during the first 6 months. The trial follow-up period was 12 months. Results The study included 74 participants (44 males) with an age average of 64 ± 12 years old and a dialysis history of 27 ± 12 months, randomized to intervention (n = 37) or control (n = 37). Compared with controls, 1-year survival was higher in the intervention group (94% vs 73%, P = 0.01). The hazard ratio in univariate analysis in intervention group was 0.17 (95% CI 0.04–0.8; P = 0.02) compared to that in control group. During the 6-month intervention period, significant between-group changes were observed in all secondary outcomes between the intervention and control groups. Conclusion Intradialytic exercise performed for at least 60 min during thrice weekly dialysis sessions improves survival in adult patients receiving HD. Trial registration ClinicalTrials.gov Identifier: NCT04898608. Retrospectively registered on 24/05/2021. Registered trial name: The Effect of Intradialytic Exercise on Dialysis Patients Survival.
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