Study Duration Research Articles

Effectiveness and Safety of Vildagliptin Sustained Release in the Management of Type 2 Diabetes Mellitus: Real-World Evidence in Indian Patients [NOVELTY Study

Vildagliptin sustained release (XR), a formulation that provides vildagliptin 100 mg with a once-daily dose administration, is a recent introduction to manage type 2 diabetes mellitus in India. This study aimed to evaluate the effectiveness and tolerability of vildagliptin XR in patients with type 2 diabetes in real-world clinical settings. This was an observational, prospective, multicenter, cohort study conducted in India, which included patients with type 2 diabetes uncontrolled on metformin XR monotherapy with glycated hemoglobin (HbA1c) >7.00%. Vildagliptin XR was added to their ongoing treatment. The primary endpoint was a change in HbA1c from baseline to 3 months. Secondary endpoints were changes in fasting plasma glucose, postprandial plasma glucose, percentage of patients achieving HbA1c <7.00% at 3 months, and assessment of efficacy, tolerability, and safety. A total of 1691 patients from 118 centers were enrolled in this study, having a mean (standard deviation) age of 53.10 (11) years and a mean (standard deviation) HbA1c of 8.44 (1.35) %. At the end of the study, vildagliptin XR significantly reduced the mean HbA1c by 1.02% points (95% confidence interval 0.93-1.12; p < 0.001) from baseline. The mean fasting plasma glucose and postprandial plasma glucose levels were significantly reduced by 28.44 mg/dL (95% confidence interval 26.64-30.25; p < 0.001) and 48.45 mg/dL (95% confidence interval 45.91-50.99; p < 0.001), respectively, with vildagliptin XR, at the end of study. During the study duration, 34.7% of patients achieved their glycemic target (HbA1c <7.0%) and there were three reported adverse events (all mild in severity). Results demonstrated that vildagliptin XR (100 mg once daily) significantly improved HbA1c and other glycemic parameters in Indian patients with type 2 diabetes and was well tolerated. The study was registered under the Clinical Trials Registry India (CTRI/2022/01/039112).

A descriptive study of fatal drownings among children and adolescents in the United States, with a focus on retention pond deaths, 2004-2020.

The objective of this study was to characterize fatal drownings among children and adolescents, with a focus on retention pond drownings, and identify risk factors for these fatalities using child death review data. We acquired 2004-2020 National Fatality Review-Case Reporting System data for drowning deaths among youth 0-19 years. Retention pond drownings were identified through case narratives. We analyzed demographics, primary caregiver, supervisor, death investigation, and drowning-related variables across age groups (<1, 1-4, 5-9, 10-14, and 15-19 years) using either the Chi-square test or Fisher's Exact test, as appropriate, with a p-value of <0.05 indicating statistical significance. Of 7,539 drowning deaths reported during the study duration, 265 deaths occurred in retention ponds. Children 1-4 years comprised a greater proportion of retention pond drowning deaths (59.3%) compared to overall drowning deaths (50.9%) in this age group. In 51.3% of retention pond drowning deaths among children <5 years, supervision was needed but not provided. Most (80.4%) retention pond-related deaths among children <5 years and 50.7% of deaths among children 5-19 years were attributed to child neglect, poor or absent supervision, or exposure to hazards. Among all decedents who drowned in retention ponds, 19.1% were found to have a disability or chronic illness. Most retention ponds lacked local ordinances regulating water access (83.5%) and did not have barriers or protection (66.1%) or warning signs (82.0%). Younger children with poor or absent supervision who cannot swim are at high risk of drowning. Retention pond drownings are not infrequent, and most locations lack ordinances regulating water access or requiring barriers, such as fences. Greater efforts are needed to address this common hazard and environmental and policy strategies should be implemented to prevent future deaths.

Isolated Continuous Lumbar Plexus Block Infusion for Hip Fractures: Their Role as Sole Analgesic and Anaesthetic Modality—A Retrospective Observational Study

Background and Aims: India is one of the advancing ageing societies of the world; with this, the country’s demographic structure also changes. The incidence of lower limb fractures is high in this population, and it threatens their health both physically and mentally. Therefore, an effective anaesthesia and analgesia regimen is crucial for smooth and stable surgery and perioperative care. Methods: In this retrospective study, we aimed to describe the use of lumbar plexus block with an indwelling catheter as a sole anaesthetic technique intra-operatively and for providing peri-operative pain relief for 54 patients with intertrochanteric fracture posted for proximal femoral nailing or dynamic hip screw fixation from October 2020 to October 2023. Results: It was found that pain scores remained less than 1 for the majority of the study duration. Most patients underwent surgery within the first day of admission in our hospital and surgery lasted for one to two hours. All patients were discharged within five days of hospitalisation. There were no failures of the blocks before and during the surgical procedures. There were no records of any complications related to the technique. No supplement opioid was used during the procedure. Conclusion: With adequate monitoring, expertise, knowledge and familiarity with the procedure, lumbar plexus block with continuous infusion via a perineural catheter supplemented with periprocedural sedation can be used as a safe and effective anaesthetic technique for hip and proximal femur fracture reduction surgeries.

The effectiveness of play therapy on depression and anxiety in hospitalized children with cancer: a systematic review.

The presence of cancer and its treatment will induce anxiety and various effects, not only on a physical level but also on a psychological level. Play therapy can be used by children to articulate their emotions and foster proficient communication with healthcare professionals and caregivers. Play therapy emerges as a highly effective method for the management of illness in children diagnosed with cancer. A thorough search was conducted across multiple databases including PubMed, Web of Science, Scopus, Google Scholar, and Cochrane Library. Our review included only interventional studies published from inception to 1 March 2024 that investigated the impact of play therapy on depression and anxiety in hospitalized children with cancer. For each study, information was gathered regarding the study's objective, participant characteristics, conditions, intervention details, comparisons made, study duration, and outcome measures. Following the retrieval of 2158 records, 12 studies were found to meet the eligibility criteria and were thus selected to include in the synthesis. Play therapy has been explored in several studies using interventions like cognitive-behavioral-based play therapy, family-based play therapy, group-based play therapy, virtual reality-based play therapy, and play therapy combined with other therapeutic approaches. Specifically, six studies investigated the effects of play therapy on anxiety, two studies on depression, and four studies on anxiety and depression. Play therapy is highly recommended due to its simplicity, minimal requirement of tools and materials, ease of implementation, affordability, and suitability for hospitalized preschool and school-age children with cancer.

Effects of time-restricted eating with exercise on body composition in adults: a systematic review and meta-analysis.

The effects of time-restricted eating (TRE) with exercise on body composition in adults are not clear. This meta-analysis aimed to assess the effects of TRE when followed in combination with various forms of exercise, including aerobic, resistance, and combined aerobic and resistance [concurrent] training on body composition. Studies published up to May 2023 were searched in EBSCOhost (MEDLINE, CINAHL, SPORTSDISCUS), PubMed, and SCOPUS databases. Fifteen studies, including 338 participants, that evaluated TRE vs. unrestricted eating in individuals performing exercise were analyzed. A random-effects model was used to calculate the weighted mean effect sizes (ES) with 95% confidence intervals (95% CI's). According to the pooled results, TRE had a small but significant reduction of fat mass (FM) kg with an effect size of -0.20 (95% CI = -0.28 to -0.13, p < 0.001) and on body fat percent (BF%) with an effect size of -0.23 (95% CI = -0.35 to -0.11, p < 0.001). The prediction interval ranged from -0.48 to 0.08 for FM and from -0.64 to 0.18 for BF%, respectively. TRE did not significantly alter fat-free mass (FFM) kg compared to control (p = 0.07). Furthermore, age, body mass index (BMI), exercise type, study duration, and energy intake did not have a significant impact on the variation in effect sizes according to the subgroup analyses (p > 0.05). TRE with exercise may reduce fat mass compared to an unrestricted eating window exercise-matched control while preserving FFM. However, more studies are needed.

Does adopting a healthy diet improve periodontal parameters in patients susceptible to periodontal disease? A systematic review.

The aim of this systematic review is to evaluate evidence relating to whether adopting a diet, associated with improved outcomes for chronic systemic diseases with an inflammatory component, can improve periodontal parameters in patients with periodontal diseases. Electronic databases and one platform were systematically searched; Medline, Embase, Web of Science and the Cochrane Library including references of relevant studies. 1220 studies were identified of which 9 studies were eligible; 4 RCT's, 1 controlled trial and 4 observational cohort studies DATA SYNTHESIS: 8 out of 9 studies found improved periodontal parameters associated with a diet that was low in refined carbohydrates, low in saturated fats, high in fibre and high in nutrition but the studies were low to medium quality of evidence and the diets, method of recording the diets and periodontal parameters varied between the studies as did the study duration and age of participants. Current evidence supports the hypothesis that adopting a healthy diet has the potential to positively impact periodontal parameters in patients with periodontal diseases, particularly in the older population but the effects may be negated by confounding factors such as smoking. 9 studies were included in the review which were rated moderate or low quality of evidence.

Inorganic Mercury Pharmacokinetics in Man: A Hybrid Model

A four-compartment model is presented that simulates inorganic mercury [Hg(II)] pharmacokinetics in blood, tissue, and excreta over a 70 day period. Simulations are validated against data collected from five human subjects, and previously analyzed (Farris, F.F., A. Kaushal, and J.G. Strom. 2008. “Inorganic Mercury Pharmacokinetics in Man: A Two-Compartment Model.” Toxicol Environ Chem. 90: 519-533). In the model, two compartments simulate Hg(II) in blood: one for mobile-Hg(II) and the other for immobile-Hg(II). Two corresponding compartments simulate Hg(II) in tissue. Mobile-Hg(II) represents Hg(II) available for transport across cell membranes. Immobile-Hg(II) represents Hg(II) that is not easily transported. Following dosing, blood total-Hg(II) drops rapidly in all subjects. Blood mobile-Hg(II) also drops rapidly with a concomitant rise in blood immobile-Hg(II). For four subjects, immobile-Hg(II) becomes the dominant Hg(II) species in blood by day 4. For subject five, mobile-Hg(II) remains dominant in blood for the study duration. Tissue mobile-Hg(II) declines rapidly for four of the subjects, with a simultaneous rapid rise in tissue immobile-Hg(II). In subject 5, tissue mobile-Hg(II) declines linearly, and immobile-Hg(II) accumulates slowly in tissue. For all subjects, tissue mobile-Hg(II) is the primary source of fecal Hg(II). The major source for Hg(II) excreted into the urine is immobile-Hg(II) from tissue.

How strong is the relationship between caregiver speech and language development? A meta-analysis.

A growing body of research has found that talking to young children is positively associated with language outcomes. However, there is tremendous heterogeneity in the design of these studies, which could potentially affect the strength and reliability of this association. The present meta-analysis, comprising 4760 participants across 71 studies, goes beyond prior research by including: 1) more recent studies, 2) non-English-speaking populations, 3) more fine-grained categorization of measures of input, 4) additional moderators, and 5) a multilevel model design allowing us to consider multiple effect sizes per study. We find a moderate association between input and outcomes (R2=0.04-0.07) across four input measures, with some evidence of publication bias. We find no differences in effect size across any of the input measures. Child age and study duration moderated some effects of input. Our findings suggest that language input-outcome associations remain robust but modest across a multitude of contexts and measures.

An approach to boost adherence to self-data reporting in mHealth applications for users without specific health conditions

BackgroundThe popularization of mobile health (mHealth) apps for public health or medical care purposes has transformed human life substantially, improving lifestyle behaviors and chronic condition management. The objective of this study is to evaluate the effect of gamification features in a mHealth app that includes the most common categories of behavior change techniques for the self-report of lifestyle data. The data reported by the user can be manual (i.e., diet, activity, and weight) and automatic (Fitbit wearable devices). As a secondary objective, this work aims to explore the differences in the adherence when considering a longer study duration and make a comparative analysis of the gamification effect.MethodsIn this study, the effectiveness of various behavior change techniques strategies is evaluated through the analysis of two user groups. With a first group of users, we perform a comparative analysis in terms of adherence and system usability scale of two versions of the app, both including the most common categories of behavior change techniques but the second version having added gamification features. Then, with a second group of participants and the best mHealth app version, a longer study is carried out and user adherence, the system usability scale and user feedback are analyzed.ResultsIn the first stage study, results have shown that the app version with gamification features has achieved a higher adherence, as the percentage of days active was higher for most of the users and the system usability scale score is 80.67, which is categorized as rank A. The app also exceeded the expectations of the users by about 70% for the app version with gamification functionalities. In the second stage of the study, an adherence of 76.25% is reported after 8 weeks and 58% at the end of the pilot for the mHealth app. Similarly, for the wearable device, an adherence of 74.32% is achieved after 8 weeks and 81.08% is obtained at the end of the pilot. We hypothesize that these specific wearable devices have contributed to a decreased system usability scale score, reaching 62.89 which is ranked as C.ConclusionThis study evidences the effectiveness of the gamification category of behavior change techniques in increasing the overall user adherence, expectations, and perceived usability. In addition, the results provide quantitative results on the effect of the most common categories of behavior change techniques for the self-report of lifestyle data. Therefore, a higher duration in the study has shown several limitations when capturing lifestyle data, especially when including wearable devices such as Fitbit.

Frequency and Patterns of Multidrug-Resistant Organisms among Ventilated Patients During the Coronavirus Disease-19 Pandemic.

To determine the frequency of multidrug-resistant (MDR) bacterial isolates in respiratory specimens obtained from ventilated patients admitted to critical care units at the National Institute of Cardiovascular Diseases (NICVD), along with COVID-19-positive cases. An observational study. Place and Duration of the Study: National Institute of Cardiovascular Diseases, between November 2021 and March 2022. Tracheal aspirate and bronchoalveolar lavage (BAL) samples received for culture and sensitivity were obtained from the critical and surgical intensive care units during the specified period. The prevalence of MDR organisms was compared between gram-negative and gram-positive bacteria using the chi-square test to determine any statistical significant differences in their occurrence. Throughout the study duration, 357 patients were admitted to critical care units, yielding 662 samples of tracheal aspirate and BAL. Among these samples, 229 bacterial isolates were identified, comprising 171 gram-negative rods (GNR) and 58 gram-positive cocci (GPC). The overall prevalence of MDR was determined to be 22% in GNR and 38% in GPC. Additionally, the prevalence of MDR among COVID-19 patients was observed to be approximately 11%. There was a notable frequency of MDR bacterial isolates in ventilated patients, particularly among GPC strains. Furthermore, the identified prevalence of MDR bacterial isolates in COVID-19 patients underscores the imperative for vigilant monitoring and intervention to address antibiotic resistance in this susceptible cohort. Ventilator-associated pneumonia, Bronchoalveolar lavage, Multidrug-resistant, Gram-negative rods, Gram-positive cocci, Coronavirus disease, Tracheal aspirate.

Modulation of Affective and Sensory Qualities of Acute Nociceptive Pain by Curcuma longa and Boswellia serrata Extract Formulation: A Randomized, Double-Blind, Placebo-Controlled Design in Subjects With Exercise-Induced Acute Musculoskeletal Pain.

Introduction Excessive repetitive physical activity most often leads to acute musculoskeletal pain. The management of acute pain is one of the primary concerns. The nociceptive pain has both sensory and affective qualities, patterns, and intensity. In this article, we focus on the effect of a turmeric-Boswellia formulation on that aspect at different locations of the body. Methods This multicentric study with a randomized, double-blind, placebo-controlled design enrolled 232 subjects in a male-to-female ratio of 1:1. The test dosage was 1,000 mg of turmeric-Boswellia extract (TBE) and a similar placebo in a parallel design allocation of 1:1 ratio. Healthy subjects with acute musculoskeletal pain of exercise-related origin with a numerical pain rating score of ≥ 5 were included in the study. The study duration was six hours, and the efficacy was analyzed using the short form of the McGill Pain Questionnaire, having subscales visual analog scale (VAS) and present pain index (PPI). Results There was a significant reduction in pain in the McGill total score (p < 0.001) of the TBE group, with a 98% change from the baseline compared to the placebo. The sensory and affective domains showed a significant reduction of 98% (p < 0.001) and 97% (p < 0.001) in pain in the TBE group from the baseline compared to placebo. The VAS had a 97% (p < 0.001), and PPI had 96% (p < 0.001) pain relief in the TBE group from the baseline compared to placebo. In the sensory domain, the most common pain descriptor reported by the participant was "tender," and in the affective domain, it was "tiring-exhaustive." The descriptor frequency of "tender" reduced from 65% in baseline to 1%, and "tiring-exhaustive" reduced from 61% to 3% at the end of six hours for the TBE group, while the placebo showed negligible change. The mean pain intensity of all pain descriptors in the TBE group showed more than 95% change from baseline. Conclusion It can be concluded that the turmeric-Boswellia formulation was very effective for exercise-induced musculoskeletal pain irrespective of location and had a significant reduction in pain intensity for sensory as well as affective pain sensations.

Factors associated with the evolution of digit health in Swiss dairy herds in a nationwide digit health program.

The purpose of this study was to investigate the evolution of digit health (DH) on Swiss dairy farms participating in a nationwide DH program and to identify risk factors associated with poor DH. Specially trained claw trimmers recorded disorders of the digits (DOD) electronically during routine trimmings between January 2020 and June 2023. The first part of the study was a non-randomized controlled implementation study, comparing the evolution of DH in 75 herds that received professional on-farm risk assessments as well as veterinary advice with 49 herds that did not. Overall DH improved over time in both groups, with no difference between the groups. Differences emerged when implementation rates of measures after on-farm risk assessment were considered: DH of farms implementing >50% of recommended measures improved significantly more compared with farms implementing £ 50%. Also, farms where cows predominantly suffered from infectious-related lesions improved significantly compared with farms where cows suffered predominantly from mechanical-metabolic-related lesions. The second part of the study consisted of a retrospective observational risk factor analysis with a larger population (498 farms). Here, greater improvement of DH on a farm over the study period was associated with a higher Farm-Claw-Score (FCS; index for decreased DH) at the beginning of the study and longer duration of participation in the DH program. Moreover, less improvement of DH was associated with freestalls, with "valley area" farm sites and with herds with Holstein Friesian cows as predominant breed. Our results suggest that, if implemented appropriately, measures issued by DH experts may improve DH. Furthermore, voluntary participation in a DH program in combination with routine electronic recording of DH data by claw trimmers seem to raise farmers' motivation to improve DH. Our results are useful for farmers and veterinarians as well as for establishing DH programs in other countries.

Unveiling the neuroprotective impact of virgin olive oil ingestion via the microbiota-gut-brain axis.

The gut-brain axis, a complex system of two-way communication between both organs, plays a key role in overall health. This comprehensive review explores the possible neuromodulatory effects upon consumption of virgin olive oil (VOO) via changes in the gut microbiota. The components found in VOO, such as polyphenols and monounsaturated fatty acids, and their function in influencing the composition of the gut microbiota, focusing on those known to possess neuroactive characteristics, based on a thorough analysis of the literature were investigated. Studies suggest that these compounds, such as hydroxytyrosol and ferulic acid, may protect against neuronal death and inhibit amyloid-β plaques (Aβ) formation. Furthermore, preclinical and clinical research indicates that VOO may promote the growth of beneficial bacteria, such as Lactobacillus and Bifidobacterium, and increase the production of short-chain fatty acids (SCFAs). These changes could be related to improved cognitive function, mood regulation, and neuroprotection. However, limitations of these studies (short duration of studies, the variability in VOO composition and the lack of standardized methodologies) need to be overcome. Furthermore, the limited number of human trials and incomplete understanding of the gut-brain axis make it difficult to establish causality and clinical application of the findings. For this reason, future research should focus on long-term clinical trials with larger cohorts, standardised characterisation of VOO and on exploring the synergistic effects with other dietary components. Furthermore, mechanistic studies should aim to uncover the molecular pathways involved in the gut-brain axis to develop specific dietary interventions for neurological and neurodegenerative disorders.

Antibiotic Susceptibility Pattern of Escherichia Coli at Tertiary Care Hospital, Islamabad

Objective: The objectives of this study are; 1. To comprehensively investigate the antibiotic susceptibility pattern of Escherichia coli, focusing on its virulence factors to understand its pathogenicity and address the challenges posed by antibiotic resistance. 2. To assess the prevalence of citrate and TSI in E. coli isolated from urine to evaluate the impact of antibiotics according to Clinical and Laboratory Standards Institute (CLSI 2023) guidelines. Study Design: Cross-sectional study. Study Place: Tertiary Care Hospital, Al Nafees Medical Hospital, Islamabad, Pakistan. Study Duration: March 2023 to October 2023. Methodology: Informed consent was obtained from the microbiology lab of Al Nafees Medical College. The study utilized biochemical tests, including citrate and TSI, for identification and differentiation of E. coli based on metabolic characteristics. A total of 50 urine samples were collected for isolation and identification of E. coli. The Kirby-Bauer disc diffusion technique was employed to determine antibiotic susceptibility, identifying nitrofurantoin and Fosfomycin as the most effective choices for bacterial infections. Results: Antibiotic efficacy assessments revealed nitrofurantoin as notably effective, surpassing other antibiotics according to CLSI guidelines. In contrast, ciprofloxacin demonstrated the lowest efficacy among the tested antibiotics. The research highlights the importance of judicious antibiotic selection for optimal therapeutic outcomes in clinical settings, emphasizing the need for continuous monitoring and optimization of antibiotic treatment strategies.

Optimizing SAQ performance in football atheletes exploring the influence of high-intensity interval training

Abstract Objectives. The major goal of this study was to investigate the impact of a twelve-week high-intensity interval training (HIIT) on male football players’ speed, agility, and quickness (SAQ) capabilities. Also, this study is to clarify the physiological and biomechanical mechanisms affected by HIIT. This work suggests the sustainability of this HIIT plan over a long period of time. Method. A total of thirty male college football players were split into two groups. One group underwent High-Intensity Interval Training (HIIT) and another group continued with their regular activities. This study was carried out for 12 weeks without changing the usual habits of the participants. The Illinois Agility Test, the Ruler Drop Test, and the Flying 30-meter Test were conducted both before and after the testing time. The T-tests were employed for statistical analysis by comparing both groups. Result. It was discovered that there were no significant gains in quickness (p &gt; 0.05), agility (p &gt; 0.05), or speed (p &gt; 0.05) by comparing the control group to the experimental group. The results of the t-test did not indicate any significant difference between the experimental and control group (p &gt; 0.05). Conclusion. The research shows the effectiveness of HIIT program for the improvement of Speed, Agility, and Quickness (SAQ) of male football players. While the current study did not find significant improvements in SAQ, further research is needed to explore the potential benefits of HIIT for football players. Factors such as sample size, study duration and individual differences might have influenced the results. Key words high intensity interval training, speed, agility, quickness, football players

NOW HELPFUL IS PLASMAPHERESIS IN THE MANAGEMENT OF ACUTE LIVER FAILURE IN ADULTS

Objective: To compare the efficacy of plasmapheresis against other modalities of management in patients of acute liver failure Study Type: Cross-sectional Study Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from June 2023 to July 2024 Methodology: Patients of either sex between 18 years to 75 years of age meeting the acute liver failure criteria were enrolled into the study. Patients with liver failure due to pre-exiting liver disease, septicaemia, and heart failure were excluded from the study. The detailed history and clinical information were taken from all individuals after enrolment. The blood sample for serum alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, prothrombin time, international normalised ratio, bilirubin, and creatinine were taken pre- and post- plasmapheresis sessions. The plasmapheresis was done until clinical improvement was achieved. The data was analysed using the Statistical Package for Social Sciences (SPSS) Version 25.0. Results:A total of one hundred and seventy-six (n=176) were included in this study with median age of 47.00 (36.00-57.00) years. There were 53 (30.11%) females and 123 (69.89%) males. The median pre-plasmapheresis serum ALT was 602.00 (455.00-764.00) while post-plasmapheresis it was 324.00 (192.00-463.00). The median pre-plasmapheresis serum bilirubin was 34.00 (25.00-43.00) while post-plasmapheresis it was29.00 (21.00-39.00). The international normalised ratio was 24.00 (21.00-26.00) and 19.00 (15.00-20.00) pre and post plasmapheresis session. The improvement in liver markers was statistically significant (p&lt;0.001) post plasmapheresis. Conclusion:The plasmapheresis sessions were very effective in improving the outcome in patients of acute liver failure.

Breast Impact Discomfort Reduced with Customised Breast Protection for Amateur Female Soccer and Rugby League Players in New Zealand

BACKGROUND: The aims of this study were to survey amateur female domestic soccer and rugby league players on their sports bra use, to compare prior use of sports bra to wearing a custom fitted sports bra with polymer inserts over a competition season in New Zealand, and to compare breast injuries with different sports bra utilization over a competition season. METHODS: Players were invited to participate in a baseline survey of sports bra use. Players who completed the survey were provided with the opportunity to wear a sports protection bra and inserts and to complete post-match surveys reporting any breast injuries. The study duration was one competition season in 2023. RESULTS: 93 players (41 soccer open, 29 soccer U16, 23 league) completed the baseline survey. Of these 79 players (32 soccer open, 24 soccer U16, 23 league) utilised the sports breast protector during the season. There were 25 breast injuries over the study resulting in a pooled breast injury incidence of 41.3 (95% CI: 26.7 to 61.1) per 1,000 match-hrs. Eight of 25 injuries (32%) occurred to players wearing the sports protection bra (i.e., 5/79 =10% sports breast protector players; 9/14 = 64% other players; 14/93 = 15% all players). Of the 34 participants who reported a previous breast injury, there were 2.6 ±1.4 breast injuries per player in the previous year and, more than a third (37.5%) reported either wearing a padded bra or did not use strategies to prevent breast injuries. CONCLUSION: It is important that players, coaches, and team medical support associated with female sports are educated on the injury risk to breasts in training and competition enabling these players to be encouraged to report and seek treatment if necessary.

EFFECT OF DIFF. SUBS. AND SPRAYING WITH K2SIO3 ON THE ROOT AND VEGETATIVE GROWTH OF L. W. PLANTS IN BAGHDAD CITY

This study was aimed to investigate the response of two types of ornamental herbaceous plants (Wedelia trilobata and Jacobaea maritima 'Cirrus') to different agricultural environments and the application of potassium silicates to the living walls system LWS (Felt layer system) under the climate conditions of Baghdad city. Each experiment involved the cultivation of a different plant species, and the study duration was from September 15, 2021, to August 1, 2022. A Strip-Plot Design experiment was conducted using two factors: factor M with four levels of substrates (50% peatmoss and perlite (M1), 50% Vermicompost and perlite (M2), 50% Water hyacinth compost and perlite (M3), 50% wheat straw compost and perlite (M4)) and factor S with three levels of foliar spray of potassium silicate (0, 1.5, and 3 ml Lֿ ¹) S1, S2 and S3 respectively. The results differed according to the different substrates, and the study indicators were superior using potassium silicate concentrations compared to the comparison treatment.

Effects of Prebiotics and Probiotics on Symptoms of Depression and Anxiety in Clinically Diagnosed Samples: Systematic Review and Meta-analysis of Randomized Controlled Trials.

The use of prebiotics and probiotics as a treatment for psychiatric conditions has gained interest due to their potential to modulate the gut-brain axis. This review aims to assess the effectiveness of these interventions in reducing symptoms of depression and anxiety in psychiatric populations. The aim was to comprehensively review and appraise the effectiveness of prebiotic, probiotic, and synbiotic interventions in reducing clinical depression and anxiety symptoms. Systematic searches were conducted across Embase, Medline, PsycINFO, CINAHL, Cochrane Library, and Science Citation Index from database inception to May 22, 2023. Randomized controlled trials investigating prebiotic, probiotic, or synbiotic interventions for treating clinical depression or anxiety symptoms in clinical samples were included. Data were extracted on study characteristics, intervention details, and outcome measures. The Cochrane Collaboration Tool was used to assess the risk of bias. The standardized mean difference (SMD) was calculated using Hedge's g as the metric of effect size. A random-effects model was applied to estimate pooled effect sizes with 95% CIs. Subgroup analyses were performed based on study characteristics, methodological factors, and intervention types. Sensitivity analyses excluded studies with a high risk of bias. Twenty-three RCTs involving 1401 patients met the inclusion criteria, with 20 trials providing sufficient data for meta-analysis. Of these, 18 trials investigated probiotics for depression, 9 trials assessed probiotics for anxiety, and 3 trials examined prebiotics for depression. Probiotics demonstrated a significant reduction in depression symptoms (SMD: -0.96; 95% CI: -1.31, -0.61) and a moderate reduction in anxiety symptoms (SMD: -0.59; 95% CI: -0.98, -0.19). Prebiotics did not show a significant effect on depression (SMD: -0.28; 95% CI: -0.61, 0.04). High heterogeneity was observed across studies, and subgroup analyses indicated that study duration and probiotic formulations contributed to the variation in effect sizes. Probiotics showed substantial reductions in depression symptoms and moderate reductions in anxiety symptoms. Prebiotics showed a nonsignificant trend toward reducing depression. An adjunctive mental health treatment approach that diagnoses, monitors, and treats the gut microbiome alongside traditional pharmacological treatment holds promise for clinical practice. PROSPERO registration no. CRD42023424136.

Leber congenital amaurosis: A clinical and genetic study from a tertiary eye care center.

To assess the clinical phenotypes and genetic mutations in patients with Leber congenital amaurosis (LCA) from a tertiary eye care center in India. Retrospective observational study. The study includes patients with a clinical diagnosis of LCA who underwent genetic testing from January 2016 to December 2021. The clinical exome of the patients was analyzed by targeted next-generation sequencing. The genetic variants found were classified as per standard American College of Medical Genetics and Genomics (ACMG) criteria and ClinVar database. There were 35 patients (19 females, 16 males) of LCA. Family history was positive in 29% (10/35) and a history of consanguinity was noted in 54% (19/35) of the patients. The mean presenting best-corrected visual acuity was 2.48 ± 0.59 logMAR. Retinal pigment epithelial abnormalities and macular involvement were seen in 83% (58/70) and 23% (16/70) of the eyes, respectively, at presentation. The most common causative genes for LCA in our cohort were: GUCY2D (20%, 7/35), CRB1 (14%, 5/35), RPE65 (11%, 4/35), RPGRIP1 (11%, 4/35), and LCA5 (9%, 3/35). Autosomal recessive inheritance was seen in 94% (33/35). Macular involvement at presentation was seen in CRB1 (3/5), NMNAT1 (2/2), and one each of RPE65, LCA5, and RDH12 patients. The genetic testing cost was reduced from 23,800 INR to 15,000 INR per test in the study duration. Genetic screening of LCA cases identified various genotypes, with GUCY2D being the most common. Increased awareness and reduced costs of genetic testing would benefit both patients and caregivers. With promising clinical trial outcomes, genotyping is crucial for better patient selection and treatment.