Improve Success Rates Research Articles

Genetic Algorithm-Enhanced Direct Method in Protein Crystallography

Direct methods based on iterative projection algorithms can determine protein crystal structures directly from X-ray diffraction data without prior structural information. However, traditional direct methods often converge to local minima during electron density iteration, leading to reconstruction failure. Here, we present an enhanced direct method incorporating genetic algorithms for electron density modification in real space. The method features customized selection, crossover, and mutation strategies; premature convergence prevention; and efficient message passing interface (MPI) parallelization. We systematically tested the method on 15 protein structures from different space groups with diffraction resolutions of 1.35∼2.5 Å. The test cases included high-solvent-content structures, high-resolution structures with medium solvent content, and structures with low solvent content and non-crystallographic symmetry (NCS). Results showed that the enhanced method significantly improved success rates from below 30% to nearly 100%, with average phase errors reduced below 40°. The reconstructed electron density maps were of sufficient quality for automated model building. This method provides an effective alternative for solving structures that are difficult to predict accurately by AlphaFold3 or challenging to solve by molecular replacement and experimental phasing methods. The implementation is available on Github.

Real-time lung extraction from synthesized x-rays improves pulmonary image-guided radiotherapy.


Lung tumors can be obscured in X-rays, preventing accurate and robust localization. To improve lung conspicuity for image-guided procedures, we isolate the lungs in the anterior-posterior (AP) X-rays using a lung extraction network (LeX-net) that virtually removes overlapping thoracic structures, including ribs, diaphragm, liver, heart, and trachea.
Approach:
73,965 thoracic 3DCTs and 106 thoracic 4DCTs were included. The 3D lung volume was extracted using an open-source lung volume segmentation model. AP digitally reconstructed radiographs (DRRs) of the full anatomy CT and extracted lungs were computed as the input and reference to train a network (LeX-net) to generate lung-extracted DRRs (LeX-net DRRs) from full anatomy DRRs, which adopted a Swin-UNet model with conditional GAN. Subsequently, the trained LeX-net on 3DCT was applied to 4DCT-derived DRRs. Lung tumor tracking was then performed on DRRs using a template-matching method on a holdoff 4DCT test set of 79 patients whose gross tumor volumes were smaller than 20 cm3.
Main results:
LeX-net successfully isolated the lungs in DRRs, achieving an SSIM of 0.9581 ± 0.0151 and a PSNR of 30.78 ± 2.50 on the testing set of 3DCT-derived DRRs. Its performance declined slightly when applied to the 4DCT but maintained useable lung-only 2D views. On the challenging test set including cases of organ overlap, high tumor mobility, and small tumor size, the individual tumor tracking error for LeX-net DRRs was 0.97 ± 0.86 mm, significantly lower than that of 3.13 ± 5.82 mm using the full anatomy DRRs. LeX-net improved success rates of using 5 mm, 3 mm, and 1 mm tracking windows from 88.1%, 80.0%, and 58.7% to 98.1%, 94.2%, and 73.8%, respectively.
Significance:
LeX-net removes overlapping anatomies and enhances visualization of the lungs in X-rays. The model trained using 3DCTs is generalizable to 4DCT-derived DRRs, achieving significantly improved tumor tracking outcome.&#xD.

Ultra-compact quintuple-band terahertz metamaterial biosensor for enhanced blood cancer diagnostics.

Cancer and its diverse variations pose one of the most significant threats to human health and well-being. One of the most aggressive forms is blood cancer, originating from bone marrow cells and disrupting the production of normal blood cells. The incidence of blood cancer is steadily increasing, driven by both genetic and environmental factors. Therefore, early detection is crucial as it enhances treatment outcomes and improves success rates. However, accurate diagnosis is challenging due to the inherent similarities between normal and cancerous cells. Although various techniques are available for blood cancer identification, high-frequency imaging techniques have recently shown promise, particularly for real-time monitoring. Notably, terahertz (THz) frequencies offer unique advantages for biomedical applications. This research proposes an innovative terahertz metamaterial-based biosensor for high-efficacy blood cancer detection. The proposed structure is ultra-compact and operates across five bands within the range of 0.6 to 1.2 THz. It is constructed using a polyethylene terephthalate (PET) dielectric layer and two aluminum (Al) layers, with the top layer serving as a base for the THz-range resonator. Careful design, architectural arrangement, and optimization of the geometry parameters allow for achieving nearly perfect absorption rates (>95%) across all operating bands. The properties of the proposed sensor are extensively evaluated through full-wave electromagnetic (EM) analysis, which includes assessing the refractive index and the distribution of the electric field at individual working frequencies. The suitability for blood cancer diagnosis has been validated by integrating the sensor into a microwave imaging (MWI) system and conducting comprehensive simulation studies. These studies underscore the device's capability to detect abnormalities, particularly in distinguishing between healthy and cancerous cells. Benchmarking against state-of-the-art biosensors in recent literature indicates that the proposed sensor is highly competitive in terms of major performance indicators while maintaining a compact size.

Challenges of smoking cessation in users of non-invasive stimulation technologies in Iran: a parallel convergent mixed-methods study

ObjectivesIn recent years, non-invasive stimulation technologies such as repetitive transcranial magnetic stimulation, transcranial direct current stimulation, bioresonance and auriculotherapy have been used for smoking cessation. Individuals may face various challenges...

H1 Antihistamines-Promising Candidates for Repurposing in the Context of the Development of New Therapeutic Approaches to Cancer Treatment.

Despite significant progress in the field of clinical oncology in terms of diagnostic and treatment methods, the results of anticancer therapy are still not fully satisfactory, especially due to limited response and high toxicity. This has forced the need for further research to finding alternative ways to improve success rates in oncological treatment. A good solution to this problem in the context of rapidly obtaining an effective drug that works on multiple levels of cancer and is also safe is the global strategy of repurposing an existing drug. Research into other applications of an existing drug enables a precise assessment of its possible mechanisms of action and, consequently, the broadening of therapeutic indications. This strategy is also supported by the fact that most non-oncological drugs have pleiotropic effects, and most of the diseases for which they were originally intended are multifactorial, which in turn is a very desirable phenomenon due to the heterogeneous and multifaceted biology of cancer. In this review, we will mainly focus on the anticancer potential of H1 antihistamines, especially the new generation that were not originally intended for cancer therapy, to highlight the relevant signaling pathways and discuss the properties of these agents for their judicious use based on the characteristic features of cancer.

Improving Success Rates and Reducing Complications in Intravenous Cannulation: Knowledge and Practice on Peripheral Intravenous Catheterisation among Nurses of Armed Forces Hospital-King Abdulaziz Air Base in Dhahran, Saudi Arabia

Improving Success Rates and Reducing Complications in Intravenous Cannulation: Knowledge and Practice on Peripheral Intravenous Catheterisation among Nurses of Armed Forces Hospital-King Abdulaziz Air Base in Dhahran, Saudi Arabia

Relationship of difficult endoscopic retrograde cholangiopancreatography cannulation and visual characteristics of papilla.

Endoscopic retrograde cholangiopancreatography (ERCP) is commonly used to diagnose and treat bile duct and pancreatic disorders. Successful cannulation of the papilla is crucial for the effectiveness of ERCP; however, sometimes, it can be challenging to achieve. This study explores the relationship between net difficult ERCP cannulation with bile visibility, papilla orifice visibility, and papilla position and compares it with successful cannulation. These data were collected from the ERCP database at the Center for Liver Disease, Holy Family Hospital, Rawalpindi, between November 2019 and November 2022. IBM SPSS version 26.0 software was used for statistical analysis. The study included 329 patients, with 186 (56.6%) female and 143 (43.5%) male participants. Most patients were in the 39-48 age group (28.3%), with a mean age of 51 ± 1. Bile visibility was noted in 268 (81.5%) cases, papilla orifice visibility in 296 (90%) participants, atypical papilla in 20 (6.1%), and typical papilla in 309 (93.9%) participants. Bile visibility (P = 0.004) and papilla orifice visibility (P = 0.006) were significantly associated with successful cannulation, while papilla position (P = 0.116) was not. Significant associations were also found between difficult cannulation and bile visibility (P = 0.000), papilla orifice visibility (P = 0.000), and papilla position (P = 0.000). Understanding this relationship can improve success rates and reduce complications associated with difficult cannulation during ERCP procedures. Further research is needed to establish clear correlations and guidelines for endoscopists to plan appropriate strategies for challenging cases.

Wire Escalation And De-escalation Techniques in Antegrade and Retrograde Approaches to Chronic Total Occlusion Percutaneous Coronary Interventions.

Coronary chronic total occlusions (CTO) are frequently identified during coronary angiography and remain the most challenging subset of coronary artery lesions to treat; however, advancements in techniques and materials have greatly improved success rates. Various crossing algorithms have been developed to standardise the approach to CTO interventions based on angiographic criteria. Antegrade wiring is typically the initial strategy of choice, particularly in cases of short and straight CTOs with tapered proximal cap. Similarly, retrograde crossing can be achieved through retrograde wiring, although this approach has a very low success rate. This review aims to outline how to perform a CTO analysis, clarify the fundamental features of guidewires and provide insights into both antegrade and retrograde wire-based approaches.

Experiencias de los pacientes en cuanto a inserción ecoguiada de un catéter intravenoso: estudio cualitativo

BackgroundPeripheral intravenous catheter (PIVC) insertion is the most performed invasive procedure in healthcare. However, it often presents challenges in patients with non-visible or non-palpable veins, leading to unsuccessful cannulation attempts and associated complications. Ultrasound-guided PIVC insertion is a promising solution for patients with difficult venous access (DiVA). However, there remains a gap in the literature regarding patient experiences with this technique. AimThis study aimed to describe the characteristics and experiences of patients referred to a specialised DiVA team for ultrasound-guided PIVC insertion and compare their experiences with previous traditional cannulation. MethodA qualitative study was conducted at an Australian 980-bed metropolitan tertiary referral centre. Thirteen patients were recruited through purposive sampling and interviewed post-ultrasound-guided cannulation. Data collection was conducted using one-on-one interviews followed by thematic analysis. ResultsThe study identified three major themes: the improved patient experience resulting from the expertise of the DiVA team with ultrasound cannulation; the impact of limited equipment and trained personnel on patient experience and outcomes; and the significance of acknowledging patients’ prior cannulation experiences. Participants reported a stark contrast in their experiences between ultrasound-guided and traditional cannulation, with the former significantly reducing physical discomfort, stress and anxiety and improving success rates. ConclusionsUltrasound-guided PIVC insertion by trained clinicians significantly enhances the experience for patients with DiVA. However, challenges remain, including the availability of equipment and trained staff. The study highlights the need for policy changes and training in ultrasound-guided cannulation to improve patient care and outcomes. Future research should focus on broader and more diverse populations to validate these findings.

Laparoscopic and Hysteroscopic Findings in A Selected Group of Women with Unexplained Infertility: A Cross-Sectional Study.

The role of laparoscopy and hysteroscopy in managing unexplained infertility (UI) is debatable because of the improved success rate of assisted reproductive technologies (ART). This study aims to assess the findings of laparoscopy and hysteroscopy in selected women diagnosed with UI to determine the frequency of such pathological conditions in order to manage them properly. The current cross-sectional study was conducted on 96 women who attended an infertility clinic at the educational hospitals of Isfahan University of Medical Sciences from March 2018 to February 2020. The participants had one or more of the following conditions: had failed to conceive after 2-3 cycles of ovulation induction with clomiphene citrate and intrauterine insemination (IUI), had a history of pelvic infection, pelvic surgery, or ectopic pregnancy (EP). Laparoscopy and hysteroscopic findings were recorded for all participants. Fifty-nine (61.4%) women had primary infertility, while 37 (38.6%) suffered from secondary infertility. In patients with primary and secondary infertility, 42.3 and 43.2% had laparoscopic abnormalities, respectively. Additionally, 33.8 and 21.6% of the participants had hysteroscopic abnormalities in the primary and secondary groups, respectively. The most common findings in the two groups of infertility who had done laparoscopy were endometriosis (21.8%, P=0.201) followed by tubal pathology (13.5%, P=0.952). Also, the most common intrauterine pathology found in both groups were uterine septum (7.2%, P=0.753) and endometritis (6.2%, P=0.241). Based on the findings of this study, laparoscopy is recommended in UI after three failed IUI and ovarian stimulation, a history of pelvic pain, pelvic surgery, or pelvic infection; however, it seems that further investigation is required to recommend universal hysteroscopy to all women with UI. Nonetheless, it is still emphasized that regional practice in one's local settings may also be effective concerning the prevalence of these pathologies.

REPRODUÇÃO ASSISTIDA: DESAFIOS E AVANÇOS DAFERTILIZAÇÃO IN VITRO E INSEMINAÇÃO ARTIFICIAL COM PERSPECTIVAS ATUAIS E FUTURAS

Assisted human reproduction (AHR) is a set of medical techniques that enable human reproduction with assistance, contributing to cases of infertility, advanced age, same-sex couples, independent gestation, and family planning. The main techniques are artificial insemination and in vitro fertilization (IVF). This exploratory-descriptive study investigates the challenges faced by these couples, as well as recent advancements and future perspectives of these techniques. The analysis includes a review of recent literature, focusing on advancements such as improved ovarian stimulation protocols and embryo selection, as well as the impact of emerging technologies. The study also addresses the variable success rates, procedure costs, and ethical issues involved. It is expected that ongoing innovations will improve success rates, reduce risks, and enhance the accessibility of these treatments. Currently, the technique of intracytoplasmic sperm injection (ICSI) is widely used. Despite the challenges, AHR has enabled infertile couples to realize their dream of parenthood. With scientific and technological advancements, it is anticipated that AHR techniques will continue to evolve to benefit more and more couples wishing to have children.

Simulation-free prediction of atrial fibrillation inducibility with the fibrotic kernel signature

Computational models of atrial fibrillation (AF) can help improve success rates of interventions, such as ablation. However, evaluating the efficacy of different treatments requires performing multiple costly simulations by pacing at different points and checking whether AF has been induced or not, hindering the clinical application of these models. In this work, we propose a classification method that can predict AF inducibility in patient-specific cardiac models without running additional simulations. Our methodology does not require re-training when changing atrial anatomy or fibrotic patterns. To achieve this, we develop a set of features given by a variant of the heat kernel signature that incorporates fibrotic pattern information and fiber orientations: the fibrotic kernel signature (FKS). The FKS is faster to compute than a single AF simulation, and when paired with machine learning classifiers, it can predict AF inducibility in the entire domain. To learn the relationship between the FKS and AF inducibility, we performed 2371 AF simulations comprising 6 different anatomies and various fibrotic patterns, which we split into training and a testing set. We obtain a median F1 score of 85.2% in test set and we can predict the overall inducibility with a mean absolute error of 2.76 percent points, which is lower than alternative methods. We think our method can significantly speed-up the calculations of AF inducibility, which is crucial to optimize therapies for AF within clinical timelines. An example of the FKS for an open source model is provided in https://github.com/tbanduc/FKS_AtrialModel_Ferrer.git.

Research on Risk Management in Engineering Projects of Private Enterprises

In the modern market economy, private enterprises face multiple risks in engineering projects, including financial risks, management risks, and impacts from changes in the external environment. Based on the theory of engineering project risk management, this paper explores the risk characteristics, identification and assessment methods, as well as control and management strategies for engineering projects in private enterprises. Systematic risk identification and scientific assessment can effectively reduce project risks and improve success rates. The application of risk management theory provides scientific strategies for identification, assessment, and response, while emphasizing the importance of internal control and information communication. This paper also analyzes the application of big data and artificial intelligence in risk prediction and the advantages of information platforms in risk monitoring. Future research should focus on the application of digital technologies and the construction of risk management culture to address complex market environments and enhance enterprises' risk management capabilities.

A review of artificial intelligence applications in in vitro fertilization.

The field of reproductive medicine has witnessed rapid advancements in artificial intelligence (AI) methods, which have significantly enhanced the efficiency of diagnosing and treating reproductive disorders. The integration of AI algorithms into the in vitro fertilization (IVF) has the potential to represent the next frontier in advancing personalized reproductive medicine and enhancing fertility outcomes for patients. The potential of AI lies in its ability to bring about a new era characterized by standardization, automation, and an improved success rate in IVF. At present, the utilization of AI in clinical practice is still in its early stages and faces numerous ethical, regulatory, and technical challenges that require attention. In this review, we present an overview of the latest advancements in various applications of AI in IVF, including follicular monitoring, oocyte assessment, embryo selection, and pregnancy outcome prediction. The aim is to reveal the current state of AI applications in the field of IVF, their limitations, and prospects for future development. Further studies, which involve the development of comprehensive models encompassing multiple functions and the conduct of large-scale randomized controlled trials, could potentially indicate the future direction of AI advancements in the field of IVF.

An Adaptive Three-Arm Comparative Clinical Endpoint Bioequivalence Study Design With Unblinded Sample Size Re-Estimation and Optimized Allocation Ratio.

A three-arm comparative clinical endpoint bioequivalence (BE) study is often used to establish bioequivalence (BE) between a locally acting generic drug (T) and reference drug (R), where superiority needs to be established for T and R over Placebo (P) and equivalence needs to be established for T vs. R. Sometimes, when study design parameters are uncertain, a fixed design study may be under- or over-powered and result in study failure or unnecessary cost. In this paper, we propose a two-stage adaptive clinical endpoint BE study with unblinded sample size re-estimation, standard or maximum combination method, optimized allocation ratio, optional re-estimation of the effect size based on likelihood estimation, and optional re-estimation of the R and P treatment means at interim analysis, which have not been done previously. Our proposed method guarantees control of Type 1 error rate analytically. It helps to reduce the average sample size when the original fixed design is overpowered and increases the sample size and power when the original study and group sequential design are under-powered. Our proposed adaptive design can help generic drug sponsors cut cost and improve success rate, making clinical study endpoint BE studies more affordable and more generic drugs accessible to the public.

Nasogastric tube insertion in anesthetized, intubated adult patients: A comparison between combined lateral position with throat pack in situ and lateral position alone

Background: Although the proper placement of nasogastric tube (NGT) is usually a simple procedure, it may be challenging one in case of its placement in anesthetized intubated patients. At times, it may be tiresome even for the expert anesthesiologist. Different techniques have varying success rates. Many novel techniques are entering the avenue to be tested. Combinations of different techniques are showing improved success rates over individual techniques. Aims and Objectives: This interventional study primarily aimed at comparing the success rates of proper placement of NGT in the first attempt between the “combined lateral position with throat pack in situ” and “lateral position alone.” Materials and Methods: The present study was performed on 180 adults (≥18 years), posted for abdominal surgeries requiring NGT insertion. Patients received NGT placement using the “combined lateral position with throat pack in situ” technique (Group A, n=80) or lateral position alone (Group B, n=80). The proportion of patients in whom correct placement of NGT was possible in the first attempt using either of the techniques (primary outcome), the procedure time for successful placement of NGT, and the incidence of adverse events were compared between the groups. Results: Correct placement of NGT in the first attempt was possible in considerably higher proportions of patients using the combined technique over lateral position alone (87.5% vs. 68.75%, P=0.007). The procedure time was comparable in both groups (23.7±6.6 vs. 25.2±5.2, combined vs. lateral position alone, P=0.093). Coiling was found to be considerably reduced in the combined method compared with the “lateral position alone” (8.75% vs.17.5%, P=0.03). Conclusion: Combined lateral position with throat pack in situ technique can be a better alternative to “lateral position alone” for NGT insertion in anesthetized, intubated adult patients.

Impact of Either Trendelenburg or Reverse Trendelenburg Positioning for Ureteroscopy Lithotripsy Procedures: A Systematic Review and Meta-Analysis.

Urologists encounter multiple challenges in managing ureteral stones with ureteroscopic laser lithotripsy. This meta-analysis assesses the effectiveness of alternative surgical positioning, reverse Trendelenburg (RevTren) and Trendelenburg (Tren), in reducing stone migration and enhancing outcomes compared with standard dorsal lithotomy positioning. A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching MEDLINE, Embase, Scopus, Cochrane, and Web of Science up to March 2024. This review focused on studies evaluating RevTren or Tren positioning during ureteroscopic lithotripsy compared with standard dorsal lithotomy, analyzing end points such as stone migration, conversion rates, success rates, complications, and operative time. Of 137 studies identified, 8 met the inclusion criteria, encompassing 1374 patients. RevTren significantly reduced ureteral stone migration (odds ratio [OR], 0.20; 95% CI, 0.08-0.47), lowered the need for conversion to a flexible ureteroscope (OR, 0.28; 95% CI, 0.12-0.67), and improved success rates (OR, 2.90; 95% CI, 1.88-4.48). Tren increased migration of ureteral and calyceal stones toward upper renal calyces (OR, 2.12; 95% CI, 1.48-3.04) and achieved a higher success rate (OR, 3.56; 95% CI, 2.15-5.92). Complications were comparable across all positions. Adjusting patient positioning during ureteroscopic laser lithotripsy can enhance procedure outcomes. RevTren effectively reduces ureteral stone migration and the necessity for flexible ureteroscopes, whereas Tren facilitates ureteral and calyceal stone migration toward upper calyces, increasing success rates. Both positioning techniques offer significant advantages over standard positioning and can be safely adopted in clinical practice without compromising patient safety.

Relationship Between Anti-Mullerian Hormone (AMH) and Other Influencing Factors with in Vitro Fertilization (IVF) Outcome of Iraqi Infertile Women

The clinical application of Anti-Mullerian Hormone (AMH) measurement has been proposed in the prediction of qualitative and quantitative aspects of assisted reproductive technologies (ART). The aim of this study is to investigate the role of AMH level and other influencing factors in the outcomes of in vitro fertilization (IVF) treatment. The study focused on AMH and its association with infertile women undergoing IVF. The population included in this study was 131 infertile women who sought therapy for infertility at Kamal Al-Samarra'ay Specialized Hospital. They were divided into three groups according to the level of AMH hormone; group A (0.5-1.5 ng/mL, n=52), group B (1.6-4 ng/mL, n=70), and group C (> 4 ng/mL, n=9). Data collection was performed by means of a specially designed questionnaire, independent of demographic data. It included questions related to infertility. Statistical analysis was performed with SPSS 26. Clinical parameters of infertile women, infertility hormones and their relationship with AMH, as well as FMS-like Tyrosine kinase 1 levels, were all investigated. The study findings revealed a significant difference in the concentration of AMH between infertile women (p<0.01). Our analysis further demonstrated that the level of AMH reduces with advancing age in infertile women. Additionally, a positive correlation was observed between the number of oocytes obtained and AMH levels in infertile women. Furthermore, the study found that AMH levels had an effect on clinical pregnancy outcomes. Specifically, the highest success rates for IVF were observed in women with normal AMH levels falling within the ranges of group B (6-4 ng/mL(. Additionally, the study demonstrated significant differences in AMH and TSH levels among infertile groups (p<0.05). Our study concluded that there is a significant correlation between clinical parameters and IVF outcomes, which can provide information for future clinical interventions aimed at improving success rates. Our analysis highlighted the role of FMS-like Tyrosine kinase 1 in infertility, where higher FMS-like Tyrosine kinase 1 levels were associated with higher success rates in IVF. The results indicate that the FMS-like Tyrosine kinase 1 level is a valuable marker for confirming the success or failure of IVF and can help determine the appropriate treatment plan.

The Effects of Smoking on Dental Implant Failure: A Current Literature Update.

Background: This systematic review assesses the current literature (2020-2024) evaluating the impact of smoking on dental implant failure rates. Methods: A non-funded Pubmed database review was conducted according to PRISMA guidelines, and the results were tabulated to extract the study design, patient characteristics, follow-up time, comparison, outcome, and strengths and weaknesses, including risk of bias. This review included 33 studies with 29,519 implants placed in over 18,301 patients. We included prospective and retrospective clinical studies, randomized and non-randomized controlled trials, cohort studies, and observational studies that examined smoking's effects on implant failure rates. Studies had to classify individuals into two groups, smokers and non-smokers, with at least ten implants. Exclusions included reviews, case reports, experimental studies, guidelines, non-English publications, studies lacking comparative data on failure rates, those excluding smokers, and studies focusing on head and neck cancer patients or specialized implants. Results: Our findings indicate a significant correlation in 25 out of 33 studies between smoking and increased implant failure rates, affecting both early and late stages of implant integration and survival as well as revealing a dose-response relationship, with higher daily cigarette consumption significantly increasing the risk of implant failure. Conclusions: This review highlights the importance of smoking cessation efforts, patient education, and tailored patient care in dental implantology. Future research should explore the effects of smoking frequency and alternative tobacco products, such as e-cigarettes, aiming to improve success rates among smokers.

Modular component exchange has no advantage in Debridement, Antibiotics and Implant Retention (DAIR) for early onset hip and knee prosthetic joint infection.

Debridement, Antibiotics and Implant Retention (DAIR) has been the mainstay of treatment for early onset periprosthetic joint infection in spite of variable results. Modular component exchange is a widely recommended strategy to improve success rates with DAIR though very strong evidence to support its practice is still lacking. Eighty six patients underwent DAIR for early onset PJI following primary hip and knee arthroplasty were divided into two groups for this retrospective review. 45 patients (group 1) underwent DAIR with modular component exchange and 41 patients without exchange (group 2). We compared success rates based on infection eradication (primary outcome variable) and need for revision surgical procedures between these two groups. We also assessed differences in primary outcome based on type of arthroplasty, timing of DAIR and addition of local antibiotics. The overall success rate after DAIR was 71%. The outcome was similar in both groups (69% vs 74%, P = 0.66). The need for revision surgical procedures was 27% which was similar in both groups (P = 0.98) with 23% needing revision of prosthetic components. Type of arthroplasty (hip or knee) and addition of local antibiotics had no bearing on infection eradication after DAIR with or without modular component exchange. DAIR with in 45days of primary arthroplasty had significantly higher success rate compared to DAIR after 45days in both groups. We observed that modular component exchange did not improve infection eradication after DAIR for early onset PJI following hip and knee arthroplasty. Reasonable success rates can be expected after DAIR especially if the patient develops early clinical signs and the procedure is carried out as early as possible.