Research Committee Research Articles

COVID-19 pandemic: mental health (distress as depression) in orthodontists

ABSTRACT Objectives For health professionals, pandemic conditions impacted all societal aspects, including economic, wellness, and mental health. This study analysed sociodemographic factors, post-traumatic stress disorder symptoms (PTSD), and depression levels caused by the coronavirus disease 2019 (COVID-19) pandemic in orthodontists. Materials and Methods A sociodemographic questionnaire, the Impact of Event Scale (IES), and the Patient Health Questionnaire (PHQ-9) were used. Following data collection, multiple statistical analyses were applied: scores were compared using the Mann-Whitney and Kruskal-Wallis tests, followed by Dunnett's multiple comparisons. The association between variables was verified using Chi-square or likelihood ratio tests. Multiple logistic regression models were estimated after bivariate logistic regression tests (p < 0.10). The final models using the Stepwise backward selection method were assessed for variables at 5%. Results Of the respondents, 69.3% were women, and their mental health questionnaire scores were significantly higher (p < 0.001). The IES avoidance and PHQ-9 scores were statistically different between the age groups (p = 0.040 and p < 0.001, respectively). Subjective distress was associated with years of practice, monthly income, fear of contracting COVID-19 during dental care, transmitting COVID-19 to patients, and thinking about the future (p < 0.05). Depression was significantly associated with orthodontic practice type, self-confidence in providing dental care, pandemic impact on dental practice, remote care, monthly income, changes in financial expenses, fear of contracting COVID-19 and thinking about the future (p < 0.05). Conclusion Over half of the orthodontists experienced moderate-to-severe mental distress, and the same number suffered from mild-to-severe depression during the pandemic. Registration: Ethics and Research Committee (CEP) of the Faculty of Dentistry of the University of São Paulo (FOUSP): CAAE: 34223720.1.0000.0075 Protocol: 4.191.353

Effects of phrenic nerve magnetic stimulation on respiratory function in stroke patients: study protocol for a randomised controlled trial.

Respiratory dysfunction is a notable complication in stroke patients, in which the diaphragm, as the primary respiratory muscle, directly influences lung function. Repetitive peripheral magnetic stimulation (rPMS) is a new, non-invasive approach that is used to treat brain and nerve problems. Few studies have examined the effect of magnetic stimulation on the phrenic nerve, breathing and diaphragm in stroke patients. This study aims to assess the effect of magnetic phrenic nerve stimulation on respiratory muscle function and lung function in adults with stroke. The results of this study may provide a promising approach to managing respiratory dysfunction in stroke patients. This randomised controlled trial is designed to compare the effectiveness of bilateral magnetic phrenic nerve stimulation (rPMS) and conventional rehabilitation training in enhancing respiratory muscle strength, lung function indicators, diaphragmatic excursion and diaphragm thickness in patients with respiratory muscle weakness. Thirty patients admitted to the First Hospital of Fujian Medical University will be included in this study. Participants in the intervention group will undergo daily bilateral magnetic phrenic nerve stimulation for 2 weeks. Stimulation will be administered at a frequency of 25 Hz, with a pulse duration of 1.1 s and an inter-pulse interval of 5.9 s, for 5 days each week. Primary outcome measures will be assessed at baseline and after 2 weeks (end of the intervention) to evaluate the efficacy of rPMS compared with conventional rehabilitation techniques. Before commencing the study, all participants will receive a comprehensive explanation of the study procedures, including the assessments. They will also be provided informed consent forms for review, completion and signing. This study was approved by the Ethics Committee for Research at the First Affiliated Hospital of Fujian Medical University (No.: MRCTA, ECFAH of FMU [2021]641, dated 10 November 2023) (Appendix Ⅰ & Ⅱ). The trial protocol will strictly adhere to the Uniform Standards for Reporting of Trials (CONSORT) statement. The trial has been registered with the Chinese Clinical Trial Registry.Dissemination of individual findings for each participant will be available at the end of the study. The findings will be disseminated to different interest groups, participants or other patients with respiratory dysfunction through journal papers and/or conference presentations. The results of the primary trial will be submitted for publication in a peer-reviewed journal. ChiCTR2300075669, registered on 12 September 2023.

VITILIGO TREATMENT WITH MANIPULATED FORMULATION CONTAINING TOPICAL ANTI-INFLAMMATORY DRUGS: CASE REPORT

Introduction: Vitiligo is a dermatological condition that causes white patches on the skin due to the loss of melanocytes. Classified as an autoimmune disease, it is associated with genetic, environmental factors and oxidative stress. It occurs predominantly in people aged between 10 and 30 years, affecting the self-esteem and quality of life of patients. Objective: This study aimed to monitor a patient using a compounded formulation containing topical anti-inflammatories, regarding improvement in the pigmentation of the spots. Case Report: The volunteer presented vitiligo spots in the eye and eyelid region, leading to self-esteem problems because they are quite visible spots. The formulation containing topical anti-inflammatories was compounded in a Compounding Pharmacy in the city of Maringá (PR) and given to the volunteer, with instructions for use to apply once a day directly on the spots, always at night, after cleaning the affected area. The monitoring was carried out by the students weekly, through photos and application of a questionnaire to the volunteer. The treatment was carried out for 30 days, without any complications, discomfort or skin irritation. The patient reported having undergone the treatment without interruption, and after the total treatment time, there was a significant improvement in pigmentation. In the questionnaire applied, the volunteer reported that there was an improvement in the appearance of the spots, and the result can be seen in the weekly photos. This research was approved by the Ethics Committee for Research involving Human Beings of Uningá (CEP/Uningá), under protocol number 6,950,683.

Evaluation of the effectiveness of cognitive–behavioural therapy for insomnia delivered by nurses and physicians for patients in primary care (the NPD study): protocol for a cluster randomised controlled trial

IntroductionInsomnia is the most common sleep disorder, and it adversely impacts daily living and increases the risk of chronic and acute health problems. Of the few individuals who seek treatment...

Evaluation of Promising Lines of Lai Patta (Brassica juncea var rugosa L.) Suitable for Cultivation in North Eastern India

The present study was carried out with ten accessions of laipatta (Brassica juncea var rugosa L.) in Assam Agricultural University, Jorhat in order to identify suitable high yielding variety(s) with desirable quality characters. The accessions viz., JorMLG-1, JorMLP-2, MLG-3, MLP-4, MLG-5, MLP-6, ShLG-7, KjLP-8, ChL-9 (Check), and KL-10(Check) were collected from different districts of Assam and North East. They were evaluated consecutively for three years in station trials in the Dept. of Horticulture, AAU, Jorhat for plant yield and other quantitative and quality characters. The accessions were tested in Multilocation trials in five research stations. In these trials. among all genotypes JorMLG-1 and JorMLP-2 were found to be the best for plant yield and other component characters. The On Farm trials conducted in 12 farmers’ fields in Jorhat and Kokrajhar districts of the state exhibited average plant yield of 350.1 q/ha in JorMLG-1 and 318.2 q/ha in JorMLP-2 with 34 – 48% yield increase over the best check variety (ChL-9). JorMLG-1was a green leaf variety whereas JorMLP-2 was a greenish purple variety. The edible leaves could be harvested upto 60 days in JorMLG-1 and 55 days in JorMLP-2 after transplanting till the initiation of bolters. However, the best check variety ChL-9 showed bolting at 25 days after transplanting. Estimation of quality characters revealed 147.6 mg ascorbic acid, 186 mg calcium and 11.21 mg iron per 100g in JorMLG-1 whereas 145.2 mg ascorbic acid, 176 mg calcium and 10.61 mg iron per 100g in JorMLP-2. They have been recommended in the Zonal Research Committee Meeting and Annual Technical Committee Meeting held at Assam Agricultural University, Jorhat during 2019-20 for release in the state of Assam. In view of yield performance, consumer preference and taste, the varieties are spreading very fast and getting popularity throughout entire NE states. However, more study is required on quality traits, genetic parameters and molecular aspects.

The 2023 American Burn Association Research and Advocacy Summit: Our Roadmap.

Research is one of the American Burn Association's (ABA) strategic priorities. Advocacy is required not only to promote burn research, but also, the ABA's other strategic priorities (Prevention, Quality, and Education). The ABA convened a two-day Research and Advocacy (R&A) Summit in September 2023, to develop a roadmap for the organization's research and advocacy efforts. The in-person summit identified fourteen key R&A initiatives. A multidisciplinary workgroup then developed strategies to achieve each initiative. The initiatives and strategies were then approved by the ABA's Board of Trustees as our organization's roadmap for research and advocacy. The next task will be to implement the initiatives. This will require not only oversight from the ABA's Board of Trustees, but also, effort from and collaboration between several of the ABA's committees and panels, including the Burn Science Advisory panel (BSAP), the Research Committee, the Prevention Committee, The Governmental Affairs Committee, The Organization and Delivery of Burn care Committee, the Quality and Burn Registry Committee, the ad hoc Coding Committee, and the ABA's Central Office.

Bohccuid dálvebiebman – váikkuhusat bohccuid láhttenvieruide, boazodoalu geavadagaide ja birrasii

This report is based on the results from a Nordic network project funded by The Nordic Joint Committee for Agricultural and Food Research (NKJ) during the years 2021-2022. This network was created to encourage further cross-border discussions about the prospects of winter feeding of reindeer. In reindeer husbandry winter feeding has increased during the last decades due to competing land use activities and climate change. Herders in Norway, Sweden and Finland have previously raised concerns about the benefits and risks associated to the increasing need of winter feeding of reindeer in all three countries. The report, published in Swedish, Norwegian, Finnish and North Sámi, and covers the main findings from a series of preparatory workshops within each country and a main workshop in Arvidsjaur 8-9 June 2022. During the network activities, reindeer herders, researchers and managers discussed the effects of feeding on reindeer behaviour, herding practices and the environment. The two main topics discussed at the preparatory workshops were 1) the short- and long-term effects of winter feeding on reindeer behaviour, and 2) local to large scale effects of feeding on the environment and the natural pastures. During the main workshop, discussions were held about reasons for feeding of reindeer, the preconditions of feeding in the three countries, how winter feeding is usually performed, and best practices in relation to reindeer behaviour and the environment. The work aimed at promoting knowledge exchange on winter feeding of reindeer among all participants to help find solutions and mitigation actions to avoid changes in reindeer behaviour and negative effects of feeding on reindeer, reindeer herding and the environment. The report is aimed at herders, managers, as well as other land users, authorities and policymakers to give information on what was discussed and a summary of the challenges related to winter feeding and effects on reindeer behaviour and reindeer husbandry, and the environment. Rangifer Report No 23 is the North Sámi version of the report. The Swedish, Finnish and Norwegian versions have already been published (Rangifer Report No 18, 19 and 20 respectively).

Critical current characteristics and ampere force distribution of a novel HTS cable with different transposition lengths

Abstract Distribution characteristics of the current, ampere force and magnetic flux density (B [T]) of a novel high temperature superconducting (HTS) cable woven by transposed REBCO tapes under different transposition lengths are proposed, and these characteristics of the cable stacked with 3 REBCO tapes are also carried out in this paper for comparison. The objective is to enhance the current density and the compactness of the HTS tapes combination, and uniform the current, ampere force and magnetic flux density (B [T]) distributions. A 3D finite element model (FEM), based on Maxwell's equations without consideration of the displacement current, is established to describe the state of the system in the liquid nitrogen condition. The distributions characteristics, maximum and minimum values of current, ampere force and magnetic flux density (B [T]) show significant differences in the simulation results between the novel HTS cable woven by 3 transposed REBCO tapes and the cable stacked with 3 REBCO tapes. The simulated results show that the distribution characteristics are improved, with a more uniform distribution characteristic than that of the cable stacked with REBCO tapes. This is due to fully transposed REBCO tapes. In addition, the experimental E-I curve was also reached. The experimental results show that using a shorter transposition length in the cable can improve the critical current. However, A too small transposition length can cause significant damage to the HTS tape, resulting in deformation of the HTS tape and a reduction in the electromagnetic properties of the HTS tape. This affects the critical current of the HTS tape and, ultimately, the critical current of the cable. From the point of view of whether the production process is convenient, meets the requirements of economy and reduces costs, we need to find a suitable transposition length. The measured optimal transposition length is 95 mm for the cable woven by 3 REBCO tapes.&amp;#xD;Ethical Compliance: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.&amp;#xD;

The Use of Diagnostic Transcranial Magnetic Stimulation as a Predictor of the Functional Outcome in Ischemic Stroke

ABSTRACT. Determination of rehabilitation potential (RP) is necessary for optimal rehabilitation strategy and the best rehabilitation measures. Navigational transcranial magnetic stimulation (nTMS) has been proposed as a method for PR determination in after-stroke patients.THE AIM. was to study the importance of navigational diagnostic transcranial magnetic stimulation as a neurofunctional predictor of motor function recovery after ischemic stroke.MATERIAL AND METHODS. The study included 28 after-stroke patients, 19 men and 9 women, the mean age was 60.07±5.67 years, who underwent a course of inpatient medical rehabilitation at the Moscow Research and Practice Center for Medical Rehabilitation, Restorative and Sports Medicine named after S.I. Spasokukotsky in 2022–2023. Clinical examination and assessment were conducted before and after the rehabilitation course using validated scales and questionnaires — the Medical Research Committee (MRCs) scale, the Box and Block Test (BBT), the modified Rankin scale (mRS); the rehabilitation routing scale (RRS). The patients were also examined using nTMS at the N.V. Sklifosovsky Research Institute for Emergency Medicine with the determination of motor evoked potential (MEP) parameters from the muscles of the upper and lower extremities.RESULTS. In patients with preserved MEP, there was a significant increase in the strength of the paretic limb on the MRCs scale from 4.00 (2.94–4.06) to 4.22 (3.83–4.89) points (p &lt;0.001) for the upper limb and from 4.00 (3.67–4.00) to 4.44 (3.83–4.61) (p&lt;0.001) for the lower limb. Improvements were revealed according to the mRS scale — the number of patients with an mRS score of 2 points in the group of patients with defined MEP increased by 26.1%, reached values of 1 point — 13.0% of patients, and the number of patients with an assessment of disability and self-care ability of 4 points decreased by 8.7%.CONCLUSION. Navigational transcranial magnetic stimulation is one of the methods for assessing the rehabilitation potential in patients with ischemic stroke. But TMS should not be used as the only method of evaluating rehabilitation potential. The assessment of RP should be comprehensive and based on the complex data obtained.

The effect of role play prepared with video support on ethical decision-making and motivation levels of nursing students: A quasi-experimental study.

Background: Since the increasingly complex structure of health care services brings many ethical problems, it is important to use different instructional technologies in the ethical education of future nurses.Aim: The aim of this study was to determine the effect of role play prepared with video support on ethical decision-making and motivation levels of nursing students.Research design: A quasi-experimental study with pretest-posttest design.Participants and research context: The research was conducted in the Nursing Department of a University located in Istanbul, Turkey between October 15 and November 15, 2024. The sample of the research consisted of 3rd year nursing students. Data were collected using the Descriptive Characteristics Form, the Nursing Dilemma Test, and the Instructional Material Motivation Scale for Single-Use.Ethical considerations: Permission was obtained from Bezmialem Vakif University Non-Interventional Ethical Research Committee and the institution where the study was conducted for the implementation of the research. Written and verbal consent was obtained from all participants in accordance with the Helsinki Declaration.Findings: While there was no difference between the students' Ethical Dilemma Test Principled Thinking pre-test and post-test scores, their Practical Consideration (p = .005) and motivation levels (p = .037) post-test scores were found to be higher. There was a weak but significant negative correlation between academic achievement and pre-test teaching material motivation levels (r = -0.375, p = .041).Discussion: The use of different teaching methods and techniques in ethics education in nursing is important for future nurses to find more practical solutions to the ethical problems they will encounter during patient care.Conclusion: The results of the study indicate that the use of video-supported role play can be effective in teaching ethics courses in nursing education.

Clinical insights into Invasive Aspergillosis in Mexican children with cancer

Abstract Background In the last years Invasive Aspergillosis (IA) has become the most frequent invasive fungal infection (IFI) affecting children with hematological malignancies. This complication results in the delay of cancer treatment and/or poor prognosis mainly due to late diagnosis and late start of antifungal treatment. Therefore, antifungal prophylaxis and preemptive approaches have been proposed for these patients based on risk factors and local epidemiological data. For this reason, we performed a unicenter, descriptive and prospective study to determine the frequency and clinical course of IA in hospitalized cancer patients with fever and neutropenia. Methods we included events of fever and neutropenia of hospitalized patients with cancer and either with persistent febrile neutropenia (PFN: fever for &amp;gt;96h with total neutrophil count of &amp;lt;500cells/mm3) or profound prolonged neutropenia (PPN: total neutrophil count of &amp;lt;500cells/mm3 for &amp;gt;7 days). Informed consent was requested prior inclusion and follow up of these events was performed with weekly measurement of serum galactomannan antigen (until the recovery of neutrophil count), lung computed tomography (CT) and/or sinus and/or central nervous system (CNS) imaging, depending on clinical findings, and if feasible bronchoscopy to obtain bronchioalveolar lavage (BAL) samples. Clinical and laboratory data were obtained; with this information diagnosis of IA was classified as possible, probable, and proven, according to the EORTC/MSG guidelines. This protocol was approved by the hospital’s research and ethics committees (INP 041/2021). For data analysis categorical variables were presented as frequencies and numerical variables as median and range. Statistical analysis was made with X2 and U Mann Whitney tests. Results Seventy events were included, 14 (20%) had IA diagnosis; 2 possible, 11 probable and 1 proved. Median of age was 10.2y (5.5 – 17) and 64.3% were male. Acute lymphoblastic leukemia was the main oncologic diagnosis (71.4%), 35.7% during induction phase; followed by acute myeloblastic leukemia (21.4%). 92.9% of events with IA presented as PFN (p=0.001) with a fever duration of 3.5 days (1-8) (p=0.004). Pulmonary disease was evident in all events with IA, two had disseminated infection. In 5/14 events serum galactomannan antigen was positive in the first measurement. Only 8 events underwent bronchoscopy: BAL was positive in 6 and 4 had positive culture with Aspergillus spp. Lung CT scan showed different findings, lobar/segmental consolidation and nodule with halo sign were the most common; 85.7% of cases presented with more than one radiological sign (p=0.003). Voriconazole monotherapy was given to 78.5% of IA cases and 21.4% required combined antifungal therapy (added caspofungine or liposomal amphotericin B) due to disseminated disease or severe clinical course. Intensive care admission resulted with statistical significance for the events with diagnosis of IA (64.3% p= 0.019). Within the IA events survival at 60 days was of 78.6%. Conclusion Frequency of IA was high among our high risk cancer patients. This study demonstrates the importance of a complete work up for invasive fungal infection in high-risk patients with persistent febrile neutropenia. The information obtained is of great use for the implementation of pre-emptive approaches and antifungal prophylaxis in this patient population.

A Comparison of Conventional Root Canal Sealers With Ones That Use Green Synthesized Nanoparticles for Antimicrobial Activity: Protocol for a Systematic Review.

Root canal failure and secondary endodontic infection are frequent clinical scenarios in dentistry. The main microorganisms implicated in root canal therapy failure are persistent Enterococcus faecalis, Candida albicans, and Staphylococcus aureus. To combat the impact of disease resistance, scientists are concentrating on alternative antimicrobial root canal sealers. Nanomaterials are a recent development in endodontic materials that exhibit great antimicrobial properties, making them an ideal material choice for root canal sealers. This systematic review aims to compare the antimicrobial properties of conventional root canal sealers to those incorporating green synthesized nanoparticles between 2010 and 2024. A well-constructed protocol was established and registered with PROSPERO (CRD42021286373). Ethics approval was obtained from the Biomedical Research and Ethics Committee from the University of the Western Cape (UWC; BM22/1/4). PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) reporting guidelines were followed. The included criteria demonstrate the green synthesized nanoparticles studies where the nanoparticles (NPs) are incorporated in root canal sealers. MeSH (Medical Subject Headings) terms were used for the search strategy of the systematic electronic databases for articles published in English between 2010 and 2024. The selected databases included Scopus, PubMed, Web of Science, Science Direct, EBSCOhost, SpringerLink, and Wiley Online. A quality assessment tool for laboratory studies will be used to critically appraise the included studies. If applicable, statistical measures (mean, SD, etc) will be used for data analysis and presentation of the results. The protocol is registered with PROSPERO. A preliminary search was conducted using a determined search strategy across 8 electronic databases, and the review is now complete. It is anticipated that the results of this systematic review may reveal the increased interest and application for nanoparticle-enhanced root canal sealers. This will aid in the future development of root canal sealants and mitigate the risk of endodontic failure. PROSPERO CRD42021286373; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=286373. DERR1-10.2196/51351.

Road traffic noise prediction model "ASJ RTN-Model 2023" proposed by the Acoustical Society of Japan - Part 2: Structure-borne noise of viaducts

The latest road traffic noise prediction model "ASJ RTN-Model 2023" was published by the Research Committee on Road Traffic Noise of the Acoustical Society of Japan (ASJ) in this April. In this new version, the method for predicting structure-borne noise from viaducts was also updated. Specifically, the calculation method was updated to separate direct sound and ground-reflected sound, and the sound power levels on structure-borne noise from viaducts have revised accordingly based on the latest research results. This paper describes the method for measuring structure-borne noise, the latest values of noise emission and its frequency characteristics, and the method for predicting structure-borne noise.

Road traffic noise prediction model "ASJ RTN-Model 2023" proposed by the Acoustical Society of Japan - Part 1: Framework of the calculation model

The Acoustical Society of Japan (ASJ) has had the Research Committee on Road Traffic Noise to develop a prediction model for road traffic noise for more than 50 years. As a result of the continuous research activities, a new version of model, "ASJ RTN-Model 2023", was published in this April. It is an upgrade version of the previous model, "ASJ RTN-Model 2018", proposed in 2019. In developing the latest version, existing knowledge was widely taken into account, in particular, the sound power levels of road vehicles under acceleration running conditions and calculation methods for sound propagation were improved in wide range. This new model is introduced in three papers with the same main title in this congress. In this paper, the framework of the model, the general procedure of prediction calculation, and the outlines of sound emissions and the calculation equations of sound propagation are presented.

Running shoe cushioning properties at the rearfoot and forefoot and their relationship to injury: study protocol for a randomised controlled trial on leisure-time runners

Previous work has demonstrated the protective effect of shoe cushioning on injury risk in leisure-time runners, but most models currently available on the market have greater cushioning than those investigated...

2024 IJSPT Orthopedic Summit Research Abstracts

The International Journal of Sports Physical Therapy is pleased to publish abstracts from the fourteenth Orthopaedic Summit (OSET) taking place in Las Vegas, September 13-18, 2024. The IJSPT hosted the third annual research forum and reception at OSET, sponsored by ATI Physical Therapy and Hyperice. The abstracts presented in the following pages were selected by the OSET Research Committee and editorial staff of the International Journal of Sports Physical Therapy. After careful review, a total of 18 research abstracts were accepted and presented at OSET 2024. Awards for outstanding abstracts were presented on September 14. The 2024 abstracts include contemporary orthopaedic and rehabilitation topics across various research designs. Each abstract presents only a brief summary of a research project / presentation and does not permit full assessment of the scientific rigor with which the work was conducted. While the abstracts offer only preliminary results that may require further refinement and future validation, they do serve an important role in sharing new research ideas and rehabilitation advancements. This sharing of ideas helps to encourage dialogue among researchers, clinicians, and educators that will ultimately contribute to the orthopaedic and rehabilitation body of knowledge. We strongly encourage authors to continue pursuing the publication of their research as a full manuscript. Thank you to all submitting abstracts for consideration. We look forward to another outstanding season of submissions for OSET 2025. _Phil Page PhD, PT, ATC Chuck Thigpen PhD, PT, ATC_ OSET Research Committee Co-Chairs

Prospective Observational Study Of Hyperhomocysteinemia In Patients With Recurrent Pregnancy Loss In Teaching Hospital

Background: Spontaneous pregnancy loss can be physically and emotionally taxing for couples, especially when faced with recurrent losses. Recurrent pregnancy loss (RPL), also referred to as recurrent miscarriage or habitual abortion, is historically defined as 3 consecutive pregnancy losses prior to 20 weeks from the last menstrual period . RPL is also defined by two or more failed consecutive pregnancies. It is estimated that fewer than 5% of women will experience two consecutive miscarriages and only 1% experience three or more. At present, there exists a small number of accepted etiologies for RPL. Most of the diagnosed etiologies include endocrine abnormalities, autoimmune disorders, uterine anomalies, and genetic factors. After evaluation for these causes, approximately half of all cases will still remain unexplained. Hence the present study was taken up to investigate the association between hyperhomocysteinemia and recurrent pregnancy loss, evaluating prevalence, potential mechanisms and implications for management. Materials and Methods: The prospective observational study was conducted on 50 patients in the Department of OBG in Dr. B. R. Ambedkar Medical College and Hospital for a period of 18 months. Prior to the initiation of the study, Ethical and Research Committee clearance was obtained from Institutional Ethical Committee. Results: The majority of participants in both groups were aged 35 to 40 years (32.35% in Group A and 37.5% in Group B).Statistically significant differences were observed between the groups regarding hypertensive disorders of pregnancy, co-morbidities, adverse pregnancy outcomes, the nature of abortion (primary vs. secondary), fetal outcomes, APGAR scores at 1 and 5 minutes, neonatal birth weight, and NICU admissions, with p-values of 0.001 across these measures.Group B (with hyperhomocysteinemia) showed higher instances of hypertensive disorders, co-morbidities, adverse pregnancy and fetal outcomes, abnormal APGAR scores at 1 and 5 minutes, lower neonatal birth weight, and NICU admissions.The mean homocysteine levels were 13.28 ± 1.8 µmol/L in Group A and 73.98 ± 5.1 µmol/L in Group B, with a highly significant difference (p: 0.0001).Most subjects in Group B had intermediately severe hyperhomocysteinemia (50%), with 37.5% experiencing moderately severe hyperhomocysteinemia and 12.5% with severe hyperhomocysteinemia. All abortions in Group A were primary, whereas Group B had 60% primary and 40% secondary abortions. Conclusion: Hyperhomocysteinemia is a risk factor for recurrent pregnancy loss. About 1 in 3 patients of RPL have hyperhomocysteinemia and therefore as a routine workup for RPL serum homocysteine measurement should also be included. Treatment of hyperhomocysteinemia with folic acid and vitamin B12 decreases homocysteine levels significantly.

Prospective Observational Study Of Surgical Site Infections In Obstetrics And Gynaecological Operations In Teaching Hospital

Background: Surgical site infections (SSI) are defined as infections occurring upto 30 days after surgery or (upto one year in patients receiving implants) and affecting either the incision or deep tissue at the operative site. SSIs are potential complications associated with any type of surgical procedure. Even though SSIs are among the most preventable hospital acquired infections, they still symbolize a significant burden in terms of patient’s morbidity and mortality leading to prolonged hospital stay and increase the patient susceptibility to other nosocomial infections affecting the financial condition of patients. Risk factors for SSIs are grouped as patient related, preoperative or pre pregnancy, intraoperative or intrapartum, and postoperative. SSI causes a substantial risk to patients and financial loses for health system because the multi-factorial causes achieving a measurable and sustained reduction in SSIs. In this context it becomes important to determine the prevalence of SSI, assess the magnitude of problem and provide a rationale to set priorities in infection control in the hospitals. Materials and Methods: The present prospective observational study was conducted on 200 patients in the Department of Obstetrics and gynaecology, at Dr B R Ambedkar Medical College and Hospital for a period of 12 months. Prior to the initiation of the study, Ethical and Research Committee clearance was obtained from Institutional Ethical Committee. Results: There was a significant statistical difference in the incidence of SSIs basing on the body mass index of subjects (pvalue:&lt;0.001). SSI incidence was high in morbidly obese subjects. There was a highly significant statistical difference in the incidence of SSIs basing on the history of previous surgeries of subjects (p-value: &lt;0.0001). SSI incidence was low in subjects with no history of previous surgeries. There was a highly significant statistical difference in the incidence of SSIs basing on the type of surgery (p-value: 0.48). SSI incidence was high in caesarean and low in tubectomy surgeries. There was a significant no statistical difference in the incidence of SSIs basing on the type of incision (p-value: 0.70). There was a highly significant statistical difference in the incidence of SSIs basing on the methods of skin closure (p-value: 0.002). SSI incidence was high in mattress method of skin closure and low in subcuticular method of skin closure. There was a highly significant statistical difference in the incidence of SSIs basing on the class of wound (p-value: 0.00001). SSI incidence was high in dirty wounds and low in clean wounds of skin closure. Conclusion: Although several preoperative risk factors (e.g., age, morbid obesity, ability to pursue a minimally invasive approach, type of gynaecologic surgery, type of incision, methods of skin closure, class of wound) may not be within the surgeon’s control, several evidence based interventions can limit the incidence of SSIs.

The efficacy and application of tranexamic acid in emergency medicine: Emergency Medicine Association of Türkiye clinical policy- 2024

Abstract The clinical policy of the Emergency Medicine Association of Türkiye (EMAT) provides guidance on the use of tranexamic acid (TXA) in emergency settings. TXA, an antifibrinolytic drug, is used to control bleeding by inhibiting plasminogen. Its applications have expanded from hemophilia and severe menstrual bleeding to include various forms of trauma and surgery-related bleeding. Despite its potential benefits, the use of TXA in emergency settings must be carefully evaluated due to its associated risks, including venous thromboembolism. This policy aimed to offer evidence-based recommendations on the indications and contraindications of TXA in different clinical scenarios encountered in the emergency departments. The guidelines were developed using the “Grading of Recommendations, Assessment, Development, and Evaluations” approach, incorporating systematic literature reviews, and expert consensus from the EMAT Research Committee. This document focuses on critical clinical questions regarding the efficacy and safety of TXA in situations such as gastrointestinal bleeding, multitrauma, traumatic brain injury, nontraumatic intracranial hemorrhage, hemoptysis, and epistaxis. By addressing these issues, the policy seeks to assist emergency physicians in making informed decisions about the use of TXA, ultimately aiming to improve the patient outcomes.

Patterns of Care for Brain Metastases in Asia: A Real-World Survey Conducted by the Federation of Asian Organizations for Radiation Oncology.

To report the patterns of care for brain metastases (BMs) in the Federation of Asian Organizations for Radiation Oncology (FARO). Overall, 37 questions were prepared. The survey was conducted online using Google Forms, and the URL was distributed to members of the FARO research committee. Radiation oncologists associated with FARO responded to the questionnaire between May 2023 and June 2023, and their answers were analyzed. Responses were received from 32 radiation oncologists in 13 countries participating in FARO. Twenty-six physicians (81.3%) were affiliated with academic centers, and 22 (68.8%) were able to perform stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (fSRT) for BMs at their institution. The most typically used prognostic index for BM was the recursive partitioning analysis classification (17 physicians, 53.1%). The maximum number of BMs indicated for SRT/SRS was ≤three (11 physicians, 34.4%), whereas eight (25.0%) physicians answered for 6-10 BMs. The maximum size of BMs considered for SRS/fSRT was ≤3 cm (14 physicians, 43.8%), whereas nine (28.1%) answered that SRS/fSRT was preferred if the maximum size was >4 cm. When whole-brain radiotherapy (RT) was indicated, hippocampal avoidance and memantine usage were limited to 50.0% and 25.0% of patients, respectively. The most typical RT modality after BM resection was SRS/fSRT alone, regardless of whether the margin was positive (19 physicians, 59.4%) or negative (13 physicians, 40.6%). We report the survey results of the patterns of care for BMs in the FARO. This survey was conducted only among a limited number of FARO members. Since many respondents were affiliated with relatively large-scale academic centers, large-scale surveys, including community hospitals, are warranted for future initiatives.