2nd March Research Articles

Clinical Characteristics of Obstetric Patients Admitted in ICU During COVID-19 Pandemic and its Comparison with Pre-COVID Period: A Retrospective Analysis from North India.

It was initially believed that coronavirus disease-2019 (COVID-19) increased the risk of complications as well as mortality in obstetric patients. This study was done to analyze any difference in-patient admissions, indications and outcomes in the obstetric ICU before and during the COVID-19 pandemic. A retrospective study of obstetric cases admitted to the intensive care unit over a period of 6 years was done. The 6-year period was divided into 2 groups, pre-COVID-19 era (1st March 2017-1st March 2020) and the COVID-19 pandemic (2nd March 2020-2nd March 2023). The causes of admission, clinical characteristics, interventions required and outcomes of these patients were compared to see if there was any difference between the two periods and whether COVID-19 out obstetric patients at any additional risk as compared to patients admitted during the pre-COVID-19 period. It was found that there was no significant difference in the number of admissions, associated problems, interventions required and outcomes of patients between the two groups. The data seemed to suggest that the number of abortions have increased post COVID-19, but further studies would be required for that. Obstetric patients did not seem to be at an increased risk for ICU admission due to SARS-CoV-2. Furthermore, no additional increase in morbidity or mortality was observed in those patients in comparison to those admitted before the pandemic. Khan EA, Qadri A, Wani D, Gurcoo MS. Clinical Characteristics of Obstetric Patients Admitted in ICU During COVID-19 Pandemic and its Comparison with Pre-COVID Period: A Retrospective Analysis from North India. Indian J Crit Care Med 2024;28(10):912-916.

EP624 - Clavien Dindo system in general surgical patients at a district hospital in NHS

Abstract Aims To try and use the Clavien-Dindo system of grading of surgical complications to General Surgical patients at NMGH. To understand the predictors of grades of surgical complications. Propose the use of the CD system in regular mortality and morbidity meetings. Methods Retrospective cohort study. Total patients studied were 104. List of all elective and emergency general surgical patients at NMGH from 1st Feb to 2nd March 2023 collected from HIVE. Data collected included MRN, age, sex, BMI, ASA category, surgical time, blood loss, type of surgery, complication and CD grade. CD grade was calculated from the patient notes. Statistical analysis was performed on StatsDirect3 from MFT. Results 26.9 % (n = 28) of the patients developed CD grades complications overall. Mild complications (grade 1 and 2) were 18.2 %. Serious complications (grade 3 and 4) were 7.7 %. CD 5 was 0.96 % 51 % of emergency cases develop complications (Mild 29%, serious 20%, death 2 %) 11 % of elective cases develop mild complications and no serious complications. Age and ASA grade have no statistically significant relationship in the present study. Higher BMI is associated with lower grades of complications in this study. Conclusion Female patients in an emergency setting with a blood loss of greater than 100 ml and a surgical time of 150 minutes or greater developing grade 2 complications. Emergency cases carry 4.6 times more complication rates than elective cases. Blood loss of 50 ml or greater would give rise to CD 1 or greater. Surgical time of lesser than 125 minutes gives CD 1. Surgical time 125 to 200 minutes gives CD 2.

EP625 - Perioperative complications in general surgical patients at a district hospital in NHS

Abstract Aims To try and use the Clavien-Dindo system of grading of surgical complications to General Surgical patients at NMGH. To understand the predictors of grades of surgical complications. Propose the use of the CD system in regular mortality and morbidity meetings. Methods Retrospective cohort study. Total patients studied were 104. List of all elective and emergency general surgical patients at NMGH from 1st Feb to 2nd March 2023 collected from HIVE. Data collected included MRN, age, sex, BMI, ASA category, surgical time, blood loss, type of surgery, complication and CD grade. CD grade was calculated from the patient notes. Statistical analysis was performed on StatsDirect3 from MFT. Results 26.9 % (n = 28) of the patients developed CD grades complications overall. Mild complications (grade 1 and 2) were 18.2 %. Serious complications (grade 3 and 4) were 7.7 %. CD 5 was 0.96 %. 51 % of emergency cases develop complications (Mild 29%, serious 20%, death 2 %). 11 % of elective cases develop mild complications and no serious complications. Age and ASA grade have no statistically significant relationship in the present study. Higher BMI is associated with lower grades of complications in this study. Conclusion Female patients in an emergency setting with a blood loss of greater than 100 ml and a surgical time of 150 minutes or greater developing grade 2 complications. Emergency cases carry 4.6 times more complication rates than elective cases. Blood loss of 50 ml or greater would give rise to CD 1 or greater. Surgical time of lesser than 125 minutes gives CD 1. Surgical time 125 to 200 minutes gives CD 2.

The effectiveness of an exergame intervention for college students with subthreshold depression: protocol for a mixed methods study.

Subthreshold depression (StD) is a condition that significantly influences the mental health and quality of life of college students and increases the risk of developing major depressive disorder (MDD). Exercise therapy has been found to be effective, but may not be enjoyable for everyone. exergames, as a form of exercise therapy, address the limitations of traditional exercise by incorporating gaming elements to make physical activity more entertaining and interactive. Currently, the Nintendo Switch is one of the most widely used exergame devices. To explore the effectiveness of a Nintendo Switch-based exergame intervention on college students with StD compared to a control group, and to analyze their perceptions of the program. This study will employ an explanatory sequential design, starting with a quantitative evaluation using a randomized controlled trial (RCT), followed by a supplementary qualitative study. College students identified as having StD will be randomly allocated in a 1:1 ratio into the exergame intervention group (EIG) or the control group (CG). College students in the EIG will participate in a Nintendo Switch-based exergame program for 8 weeks, with 2-3 sessions per week, lasting 50-60 min each. Participant outcomes in both conditions will be assessed at pre-intervention (T0, week 0), post-intervention (T1, week 8), 1 month after the intervention (T2, week 12), and 2 months after the intervention (T3, week 16), and a generalized linear mixed model will be used for analysis. In the qualitative part of this study, interviews will be conducted with college students with StD from the EIG at T1 to explore their experiences of receiving the intervention, and content analysis will be applied to the data collected. Nintendo provides a user-friendly platform for college students with StD to engage in electronic gaming. Limited research has explored the mental health outcomes of interventions using this type of technology in young people with StD. If the exergame program proves to be effective, it could offer a convenient and feasible intervention for further enhancing the psychological well-being of college students. This study was registered in the Chinese Clinical Trial Registry (number: ChiCTR2300068970) on 2nd March 2023.

A qualitative evaluation of rural and provincial surgery wānanga to enhance cultural safety among surgical registrars in Taranaki, New Zealand.

The Royal Australasian College of Surgeons (RACS) recently instituted cultural safety and cultural competency as its 10th competency with formalized cultural safety training yet to be instituted. Wānanga are Indigenous Māori teaching institutions that can be used contemporarily for cultural safety training. In 2022, surgical registrars based at Taranaki Base Hospital (TBH) held in-hospital wānanga ranging from 1 to 3 h focussed on cultural safety, professionalism and wellbeing. This study explores the perspectives of these registrars who attended wānanga using a Kaupapa Māori aligned methodological stance and interpretive phenomenological analysis. Twenty-six wānanga were held from March 22nd 2022 to January 30th 2023. Six registrars provided their perspectives with four major themes emerging from their stories including: cultural safety; unity; time, place and person; and a new era. Registrars valued the wānanga which was scheduled for Friday afternoons after daily clinical duties. Wānanga facilitated unity and understanding with registrars being able to reflect on the context within which they are practicing - describing it as a new era of surgical training. 'Time' was the biggest barrier to attend wānanga however, the number of wānanga held was testament to the commitment of the registrars. Regular wānanga set up by, and for, surgical registrars cultural safety development is feasible and well subscribed in a rural or provincial NZ setting. We present one coalface method of regular cultural safety training and development for surgical registrars and trainees in NZ.

Seasonal Incidence of Major Insect Pest of Chickpea and their Natural Enemies in Vindhaya Region of Madhya Pradesh

Field experiment carried out at the Entomology Instructional Farm, JNKVV-College of Agriculture Rewa, MP during rabi season 2018-19 revealed that incidence of the chickpea pod borer Helicoverpa armigera. Population range of pod borer during different weather weeks varied between 0.30 and 1.89 larvae/mrl (April 2nd week and March 2nd week respectively). Peak larval population of Helicoverpa armigera was recorded in 2nd week of March (11 standard weeks). A weak negative correlation was observed with the maximum relative humidity and minimum relative humidity correlation, -0.172 and -0.595 respectively and a non significant positive correlation with maximum temperature, minimum temperature and rainfall. The respective r was found to be 0.306, 0.391 and 0.269. In district Rewa, MP, India the insect-pests of chickpea and their natural enemies during rabi the total seven species was recorded in Chickpea in which six pests minor in nature and one major pest Chickpea pod borer (Helicoverpa armigera). Termite (Odontotermes obesus Ram.), White grub (Holotrichia consanguinea Bl.), Black aphid (Aphis craccivora Koch), Grasshopper (Chrotogonus trachypterus Blan.), Semilooper (Autographa nigrisigna L.), Cut worm (Agrotis ipsilon Huf.) are minor in nature. Seven natural enemies found during field investigation i.e. lady bird beetle (Chilomenes sexmaculata Fab.), lady bird beetle (Coccinella septempunctata L.), Praying mantis (Mantis religiosa), Dragon fly (Crocothemis servilia Drury), Campoletis parasitoid (Campoletis chlorideae Uch.), Indian mynah (Acridotheris tristis L.), King crow (Dicrurus macrocerus Vie.) in chickpea observed in low to medium population on the crop and to help in reduction of pest population.

To determine the frequency of triple vessel coronary artery disease in patients admitted with acute coronary syndrome.

Objective: To determine the frequency of triple vessel coronary artery disease in patients less than 40 years of age undergone diagnostic coronary angiography and were admitted with acute coronary syndrome Study Design: Cross Sectional study. Setting: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Period: 3rd Sep 2018 to 2nd March 2019. Methods: It was consisted of 90 patients Results: Total 90 cases were enrolled in the study. All presented with central or left sided chest pain clinically diagnosed to be having acute coronary syndrome. All patients undergo diagnostic coronary angiography for the first time. 36.7 % of the presenting cases included in the present study were females while 63.3 % were males who had acute coronary syndrome. Average age of patients included in present study was 30.1±5.9 Data was stratified according to age, gender, type of ACS present. Post stratification chi-square test was applied. It showed that 23.29 % patients had triple vessel coronary artery disease whereas 76.71% did not have triple vessel coronary artery disease. Conclusion: TVCAD was observed in 23.29% of patients presented with acute coronary syndrome in patients less than 40 years of age.

Efficacy of Sowing Dates in Growth and Yield of Hybrid Maize under Namsai Conditions

The study was conducted in the instructional and research farm during the period 10th February to 11th September 2023 in a randomized block design (RBD) method. The first sowing dates started on 10th February, followed by 20th February, 2nd March, 12th March, 22nd March, 1st April, 11th April, 21st April, 1st May and 11th May, respectively, at 10 days intervals. The growth parameters like seed germination, number of leaves per plant, plant heights, number of cobs per plant, number of grains per cobs, 100 grain seed index, leaf area index and grain yield per hectare has been observed and evaluated. On evaluation it was noted that maize sown on 1st April gave highest seed germination of 95.87%, tallest plant of 198.83 cm, maximum number of 20.33 leaves per plant, highest leaf area index of 582.56, maximum number of 8.00 cobs per plant, maximum number of 31.27 grains per cob, highest seed index of 41.33 and highest grains yield of 9.31 kg/plot when compared to all other sowing dates. The germination (r= 0.704), plant height (r= 0.641), number of leaves (r= 0.966), leaf area (r= 0.709), number of cobs per plant (r= 0.994), number of grains per cob (r= 0.698) and seed index (r= 0.968) are positively stimulated yield response in hybrid maize. Thus, sowing on 1st April has a paramount effect on the production of hybrid maize in Namsai conditions. Further study may be needed to investigate precise sowing dates of local maize in the Namsai region.

Dual-Task Specific Training or Conventional Physiotherapeutic Interventions, Which one is more Effective?

Background: Physiotherapeutic interventions play a crucial role in motor re-learning and functional recovery for stroke patients with upper and lower limb motor impairments. Among these interventions, dual-task training (DTT) has demonstrated significant effectiveness in enhancing the functional recovery of stroke patients. Objective: This study aims to compare the effectiveness of DTT and conventional physical therapy in ambulating right-hemiplegic stroke patients.Material and Methods: A randomized control trial (RCT) was conducted at the Department of Rehabilitation Medicine, Saidu group of Teaching Hospital, 2nd March 2020 to 3rd August 2020. Chronic right-hemiplegic stroke patients meeting set inclusion criteria were randomly assigned to two groups: the treatment group (TG) receiving DTT and the control group (CG) undergoing conventional physical therapy. DTT interventions included walking forward, backward, and sideways on a smooth surface while holding an 80-gram sandbag. The CG received conventional physiotherapy involving mat activities, strengthening, stretching exercises, and ambulation/gait training. Pre- and post-tests collected clinical data analyzed on SPSS 22 included spatial and temporal variables, 10-Meter Walk Test (10MWT), Time Up & Go Test (TUG), step length, cadence, cycle time, and stride length. Results: Out of 18 patients, each group had 50%, comprising 5 males (28%) and 4 females (22%). The mean age in CG was 57.20± 5.20, and in TG, it was 57.27± 6.10 years. Baseline clinical parameters were nearly identical between groups (P>0.05). Post-test scores revealed significant improvements in spatial and temporal gait variables, 10MWT score, cadence, step length, stride, and cycle time in TG compared to CG (P<0.05). Conclusion: Dual-task training and conventional physical therapy both significantly enhance the functional ability of right-hemiplegic patients across all gait temporal and spatial parameters. Keywords: Conventional physical therapy, Dual task training, Gait & ambulation, Stroke.

COVID-19 Infection: A Mozambican Case Study

In China, the country of COVID-19 origin, until February 23rd, 2020, more than 77000 cases of COVID-19 infection were reported, and 60% of confirmed cases were reported in the city of Wuhan. Mozambique declared a state of emergency in March 2020, different prevention measures were implemented to control and respond in a timely manner to the pandemic, including the early diagnosis of cases of the disease. The present work reports some details about a larger project with the main objective of computing models of analysis and visualization of COVID-19 data in Mozambique. The topic falls within the area of Statistics with the purpose of providing evidence that explains the stage of the country regarding the evolution of COVID-19 cases, (from the notification of the first case of COVID-19 in Mozambique on March 22nd, 2020, until May 31st, 2022) with the focus on the provinces of Maputo, Nampula, Cabo Delgado and Niassa. The work considered qualitative and quantitative data to allow decision-making in the health area on measures to prevent the pandemic and the trend of cases and deaths from the disease.

ОТРЕЧЕНИЕ ИМПЕРАТОРА НИКОЛАЯ II ОТ ПРЕСТОЛА В СОВРЕМЕННОЙ ОТЕЧЕСТВЕННОЙ ИСТОРИОГРАФИИ

Based on available sources and modern scientific literature, the circumstances of the renunciation of Emperor Nicholas II are analyzed, which occurred on the 2nd March 1917. It is emphasized that this event is one of the most popular topics in our history, which has generated a huge amount of scientific literature. Attention is paid to the problems of historiography: analysis of various points of view existing in modern scientific literature. It is concluded that the renunciation of Emperor Nicholas II has not yet revealed a consensus: some are convinced that the renunciation was illegal, others blame the sovereign himself for everything, including the country’s slide into revolution

Influence of Planting Dates and Biohealth on Growth and Yield of Physalis peruviana L. Plant

An experiment was conducted to evaluate effect of planting dates and Biohealth on growth and yield of (Physalis Peruviana L.) plant at field of Directorate of Agriculture Research Center in Erbil, Kurdistan Region – Iraq. The experiment was laid out in Factorial Randomized Complete Block Design replicated three with nine treatments, and the experiment included three different Planting dates (2nd February, 17th February and 4th March) and Biohealth doses (0, 8, 16 g/1). The results of the experiment demonstrated that the first date of Planting (2nd February) produced early flowering and the greatest branch number. The maximum plant height and stem diameter were found from 4th March Planting. Moreover, the earliest flowering was recorded from the plant treated with 8 g/L Biohealth and control plant. The greatest numbers of branches and stem diameter were gained from the plant treated with Biohealth 8 g/l. The highest value of plant height was measured in the treatment (control plants + 4th March Planting), while the treatment of (Biohealth 8 g/l + 2nd February) was indicated the greatest number of branches. The shortest flowering period was recorded in the combination of (2nd February without Biohealth) and (2nd February with Biohealth 8 g/L). The best result of total Carotenoid in Physalis peruviana L fruits were gained from the first date (17th February) and third date (4th March) of Planting, while Biohealth 16 g/1 provided the best result of the total carotenoid. The best level of total carotenoid was investigated from the treatment (2nd February + Biohealth 16 g/l).

Consent practices in midwifery: A survey of UK midwives

ObjectiveTo explore midwives’ knowledge and understanding of the law and practice of consent in the post-Montgomery world. DesignCross-sectional online survey. Descriptive statistical analysis of midwives’ survey responses. SettingsSocial media: Instagram, Facebook and Twitter. Survey distribution was via the UCL Opinio survey platform. ParticipantsA total of 402 midwives, surveyed over a four month period between 2nd March and 2nd July 2021. MeasurementsKnowledge of legal consent, ‘sureness’ of meeting current legal requirements and competence to gain consent. Findings91% of participants acknowledged correctly that consent must be voluntary. 91% reported that women must be informed of all the risks associated with their care, although 26% reported that women should be informed of some of the risks associated with their care. Most participants were ‘sure’ that their discussions of consent meet current legal requirements (91%). 21% rated their competence to gain consent as ‘excellent’, 71% rated themselves as ‘very good’, whilst 1% rated their competence as ‘poor’. Deficiencies in fundamental knowledge of consent were noted in some participants rating themselves highest in ‘sureness’ of meeting legal requirements and competence to consent. Key conclusionsFundamental gaps in midwives’ knowledge of legal consent were identified. Participants demonstrated uncertainty regarding the extent of risk disclosure and discussion of alternative care options. Participants generally rated themselves highly in their consenting practices, despite lacking in basic knowledge of legal consent, revealing a discrepancy between midwives’ self-perceptions and their actual knowledge. Implications for practiceThe overconfidence displayed by some participants is concerning for clinical midwifery practice. Professional education and guidance for midwives on legal consent in keeping with Montgomery is urgently required to ensure that midwives are legally compliant in their consenting practices.

Factors Associated with Road Traffic Accidents in Kathmandu, Nepal: A Cross-Sectional Study

Background: Road traffic accidents (RTAs) are a leading and disproportionately prevalent cause of mortality and disability, particularly burdening Nepal, primarily within the Kathmandu Valley.
 Methods: This cross-sectional study was conducted between March 22nd and April 24th, 2021, involving 185 victims admitted to the emergency department of a private hospital. Respondents were selected using purposive sampling, and data were collected through face-to-face interviews. Socio-demographic characteristics, human factors, and environmental factors data were analyzed using descriptive statistics, and all statistical tests were conducted using SPSS version 20.
 Results: Among the 185 RTA victims, the majority (36.8%) fell within the 21-30 age groups. Male victims (55.7%) outnumbered females (44.3%). Students (36.8%) experienced the highest accident rates, with most incidents (21.1%) occurring on Saturdays and 38.4% taking place between 12:00pm and 6:00pm.
 Human Factors and RTA: Of the total victims, 80 (43.2%) were drivers, with 43.75% of them reporting the use of emergency brakes. Furthermore, 77.61% indicated that accidents were caused by pedestrians not using zebra crossings when crossing the road.
 Environmental Factors and RTA: Rainy weather was associated with the highest number of accidents, accounting for 36.2% of cases. Additionally, narrow routes (28.6%) and slippery roads (25.9%) contributed to a significant number of accidents.
 Conclusion: Nepal faces a high rate of road traffic accidents, with critical factors including victim age, vehicle types, speed, road and weather conditions, and traffic rule violations. Authorities must consider these factors to effectively control and prevent RTAs.

Book Censorship in the United States: A Government Documents Story

In recent years, book bans and censorship have been serious topics of conversation in the United States. The American Library Association has been compiling data regarding censorship in libraries for more than twenty years. An announcement on March 22nd, 2023, reported 1,269 book censorship demands in 2022, the highest number yet recorded.According to the announcement, this data is compiled through reports given to ALA’s Office for Intellectual Freedom and challenges covered in the press. However, many censorship attempts are not reported, so this annual data is an incomplete overview of yearly trends. “Challenge” is defined as a complaint or attempt at removal; some challenges are resolved without removing the item from collections, while others do result in restriction or removal. Despite continual reports of challenges, ALA finds that most Americans are against book censorship and believe librarians make good decisions when building collections.

Investigating the aftermath of the Türkiye 2023 earthquake: exploring post-disaster uncertainty among Syrian migrants using social network analysis with public health approach.

On February 6th, 2023, a doublet earthquake struck Türkiye, impacting more than 15 million people including migrants, and resulting in over 50,000 deaths. The Syrian migrants experience multiple uncertainties in their daily lives which are further compounded by multifaceted challenges of the post-disaster environment. Social media was used intensively and with impunity in this environment and thereby provides a window into the explicit and implicit dynamics of daily life after a disaster. We aimed to explore how a post-disaster environment potentially generates new uncertainties or exacerbating pre-existing ones for migrants through social media analysis with an indirect perspective, in the context of 2023-Earthquake in Türkiye and Syrian migrants. Social network analysis was used to analyze Twitter-data with the hashtags 'Syrian' and 'earthquake' during a 10-day period beginning on March 22nd, 2023. We calculated network metrics, including degree-values and betweenness-centrality and clustered the network to understand groups. We analyzed a combination of 27 tweets with summative content analysis using a text analysis tool, to identify the most frequently used words. We identified the main points of each tweet and assessed these as possible contributors to post-disaster uncertainty among migrants by using inductive reasoning. There were 1918 Twitter users, 274 tweets, 124 replies and 1726 mentions. Discussions about Syrian migrants and earthquakes were established across various groups (ngroups(edges > 15) = 16). Certain users had a greater influence on the overall network. The nine most frequently used words were included under uncertainty-related category (nmost_frequently_used_words = 20); 'aid, vote, house, citizen, Afghan, illegal, children, border, and leave'. Nine main points were identified as possible post-disaster uncertainties among migrants. The post-disaster environment has the potential to exacerbate existing uncertainties, such as being an undocumented migrant, concerns about deportation and housing, being or having a child, inequality of rights between being a citizen and non-citizen, being in minority within minority, political climate of the host nation and access to education or to generate new ones such equitable distribution of aid, which can lead to poor health outcomes. Recognizing the possible post-disaster uncertainties among migrants and addressing probable underlying factors might help to build more resilient and healthy communities.

Best practices on adopting open-source and commercial low-cost devices in small satellites missions

The NewSpace approach of utilizing CubeSats and smaller satellites for complex LEO missions that once were reserved only for bigger platform, paired with the requirement of enduring reliability and quality assurance on batches of tens of satellites, is paving the way for the use of commercial-off-the-shelf (COTS) components in micro-satellite missions. The recent global supply chain issues and extended lead times in the procurement of micro-controllers, memories and passive electronic components, caused by the pandemic and factories shutdowns, have resulted in a forced procurement diversification of several key elements, even in partially assembled products.GAUSS has been designing, manufacturing, and launching Small Satellites since early 2000.Its tenth satellite, UNISAT-7, was launched by a Soyuz-Fregat LV on March 22nd, 2021. Thanks to the vast experience gained on the application of commercial components in all the subsystems developed by the company, the typical overall costs for a complete platform are substantially lower compared to competitors, while retaining similar reliability.UNISAT-7, developed using lean-satellite methodologies, included more than 28 independent subsystems with their own telemetry, and most of them were developed in-house using ground COTS components; no space-grade products were employed, to save on overall mission costs. Some systems were devised from the start using open-source hardware, to expedite the prototyping process, while having the benefit of using readily available software, generally included with these platforms. Raspberry embedded devices were employed on the flight model for two remote sensing systems, to test how such systems, duly adapted to sustain space conditions, may perform and show reliability similar to commercial space systems worth thousand times the value.All systems have been activated and successfully verified for an entire year in LEO. They were hardened for vacuum, extreme temperatures, radiation, and launch stresses using common items found in general hardware stores.This work will delve into the open-source/COTS components used, the process employed to strengthen them, and the programmed flight firmware routines for maximizing embedded devices’ reliability in space.

Osseointegration in additive-manufactured titanium implants: A systematic review of animal studies on the need for surface treatment

The objective of the systematic review is to find an answer to a question: “Do surface treatments on titanium implants produced by additive manufacturing improve osseointegration, compared to untreated surfaces?“. This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA 2020) and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022321351). Searches were performed in PubMed, Scopus, Science Direct, Embase, and Google Scholar databases on March 22nd, 2022. Articles were chosen in 2 steps by 2 blinded reviewers based on previously selected inclusion criteria: articles in animals that addressed the influence of surface treatments on osseointegration in implants produced by additive manufacturing. Articles were excluded that (1) did not use titanium surface, 2) that did not evaluate surface treatments, 3) that did not described osseointegration, 4) Studies with only in vitro analyses, clinical studies, systematic reviews, book chapters, short communications, conference abstracts, case reports and personal opinions.). 1003 articles were found and, after applying the eligibility criteria, 17 were used for the construction of this review. All included studies found positive osseointegration results from performing surface treatments on titanium. The risk of bias was analyzed using the SYRCLE assessment tool. Surface treatments are proposed to promote changes in the microstructure and composition of the implant surface to favor the adhesion of bone cells responsible for osseointegration. It is observed that despite the benefits generated by the additive manufacturing process in the microstructure of the implant surface, surface treatments are still indispensable, as they can promote more suitable characteristics for bone-implant integration. It can be concluded that the surface treatments evaluated in this systematic review, performed on implants produced by additive manufacturing, optimize osseointegration, as it allows the creation of a micro-nano-textured structure that makes the surface more hydrophilic and allows better contact bone-implant.

Frequency of diabetes mellitus in patients with chronic Hepatitis C Infection

Diabetes and hepatitis C infection are prevalent worldwide. The one chronic disease the later communicable disease is associated as far mortality is concern. People with hepatitis C infection are prone to develop type 2 diabetes. Objective: To find out the frequency of diabetes mellitus in chronic hepatitis C infected patients admitted to Department of Medicine, Khyber Teaching Hospital KPK. Methods: A cross-sectional Descriptive Study was conducted having 104 patients aged 15 years and above from both genders in department of Medicine for a duration of one year from 2nd March 2020 to 26th February 2021.The inclusion criteria were set for patients who were hepatitis C positive for at least two months investigated through detection of HCV antibodies by ELISA. Chronic hepatitis C was diagnosed on the basis of detecting HCV antibodies by ELISA, and confirmed by detecting HCV RNA by polymerase chain reaction (PCR). Diabetes mellitus was diagnosed on the basis of random blood sugar above 200 mg/dL, fasting blood sugar above 126 mg/dL on two occasions or HBA1C above 6.5 % (diagnostic criteria designed by ADA). Results: Only 21 (21%) were found to have newly diagnosed diabetes mellitus with a p value 0.37. Those with impaired glucose levels were found in 15(15%), and 59(59%) were with normal glucose level. Conclusions: Our study did not find any statistical significance in our result with p-value= (0.37).

Stakeholder’s perspectives and experiences of patient and public involvement (PPI) in clinical trials in maternal and neonatal healthcare: protocol for a qualitative evidence synthesis

Background: Patient and public involvement (PPI) has the potential to improve the relevance of trial outcomes and improve participant recruitment within clinical trials. However, the literature on PPI approaches, outcomes, and attitudes towards PPI in specific clinical research areas is limited. We are interested to know the current approaches to and views of PPI within maternal and neonatal clinical trials, from the perspective and experience of involved stakeholders. Methods: A qualitative evidence synthesis (QES) of stakeholders’ perspectives and experiences of PPI will be conducted. Stakeholders will include any individual involved in maternal or neonatal clinical trials with experience of PPI in the area or who expresses their views on PPI. The electronic bibliographic databases CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science and the Maternity and Infant Care (OVID) will be searched from inception. Qualitative studies, mixed-methods studies where the qualitative data can be extracted independently, and surveys with open-ended qualitative questions, will be included. Aims: The QES seeks to explore stakeholders’, including PPI contributors, trial participants and guardians, and trial researchers, perspectives and experiences of PPI in maternal and neonatal clinical trials. Discussion: THE QES will provide an understanding of how PPI is understood, operationalised and experienced by stakeholders in maternal and neonatal clinical trials, with the aim of identifying good practice and areas for improvement. PROSPERO registration: CRD42023383878 (2nd March 2023)