Engagement With Sports After Solid Organ Transplant.

Introduction Transplant Games lend a unique opportunity not only by providing a platform for donors and recipients to engage in sports but also to counter the negativity surrounding organ donation and showcase to the world that transplant recipients can lead active lives. When the Transplant Games were held in Kochi, Kerala, India, for the first time, it provided a venue to engage with transplant recipients, donors, and the families of deceased donors. We aimed to understand the impact that engagement in sports brings on the lives of donors and recipients. Methods After obtaining permission from the organizers, we explained the objectives of the survey to the participants and encouraged them to participate. A survey, covering basic demographic information, transplantation details, and questions related to sports engagement was formulated. Participants could complete the survey electronically via a quick response code or in hard copy. They were fully informed about the objectives of the survey and had the right to withdraw at any stage without consequences. The survey was available for five hours during the games. The study received institutional ethics committee approval (ECASM-AIMS-2024-059). Results Among the approximate 150 participants, we received 78 respondents (52%). After the nine who withdrew consent were removed, we had a full response from 69 participants. Of these, 59 were males (85.5%), and 10 (14.5%) were females. The average age of the participants was 45 ± 13 years. Self-motivation was the most common factor in taking up sports for 30.4% of the responders, followed by family and friends in 23.2% and transplant doctors in 5.8%. Liver Foundation of Kerala (LIFOK), a self-help group of transplant recipients, played a major role in 4.3% of the responders. Bowling was the most popular sport with 23 mentions, followed by carroms and badminton with 27 and 20 mentions, respectively. Donors started to take an active role in sports earlier than recipients, 3.1 ± 1.89 vs. 5.7 ± 5.5 months. The most common reason cited for taking up sports was to become part of the transplant community, followed by a desire to embrace a healthier lifestyle and improve fitness levels. Although none had a personalized coach, most intensified their training and improved nutrition as part of their preparation for the games. Conclusion Our survey is limited by its small and self-selected sample size. Our study highlights the significant role of self-motivation, family support, and self-help groups in encouraging solid organ transplant recipients and donors to engage in sports after surgery. It also highlights the need for more proactive encouragement from doctors and better availability of sports facilities and support staff to help transplant recipients and donors engage in physical activities, which are crucial for their physical and emotional well-being.

Anti-inflammatory and Antioxidant Activity of Neem and Kirata-Induced Silver Nanoparticles Against Oral Biofilm: An In Vitro Study.

Introduction Silver nanoparticles have been the most commonly used nanoparticles which could be integrated with plant extracts. The mutually beneficial interaction between neutral plant extracts and nanoparticles reduced the chemical toxicity while promoting synthesis. Azadirachta indica, widely known as the neem plant, has diverse medicinal compounds encompassing antibacterial, antiviral, antiprotozoal, insecticidal, antifungal, and antioxidant properties. Swertia chirata, known as Chirayata in India, stands out for its dual roles as a laxative and appetiser with pronounced antimicrobial and anti-inflammatory qualities. Hence, this study aimed to evaluate the anti-inflammatory and antioxidant properties of silver nanoparticles synthesized using Neem and Kirata extract. Materials and methods The plant extracts of Neem (Azadirachta indica) and Kirata (Swertia chirata) were obtained in powder form. It was later formulated into an extract and stored in a refrigerator at 4 degrees Celsius. The formulated extract of Neem and Kirata was then incorporated with silver nitrate to form a modified silver nanoparticle using a green synthesis approach. The anti-inflammatory activity of Neem and Kirata extract was tested using Bovine Serum Assay and Egg Albumin Assay. The antioxidant activity of the new herbal-formulated Ag nanoparticles was determined by the DPPH ((2,2-diphenyl-1-picrylhydrazyl) assay. Results Based on the anti-inflammatory assays, the Neem and Kirata-induced nanoparticles showed increasing levels of inhibition, while the standard showed slightly higher inhibition at 10, 20 and 30 µL. At 40 µL and 50 µL, both Kirata and Neem (Ag) and the standard showed high levels of inhibition, nearing 75% and above, with the standard consistently showing a marginally higher inhibition percentage. Based on the DPPH assay, the Neem Kirata-induced Ag nanoparticle showed a comparable or slightly higher inhibition percentage compared to the standard. Conclusion The study underscores the potential of Neem and Kirata herbal-based silver nanoparticles as effective anti-inflammatory and antioxidant agents. Future research directions should focus on refining nanoparticle synthesis, investigating mechanisms of action, and exploring additional therapeutic applications in the biomedical and pharmaceutical sectors.

Hematite nanomaterial from a tropical freshwater ecosystem: Geological, environmental, and industrial implications.

Synthetic hematite (Fe2O3) nanoparticles are extensively explored for medicine, optics, and environmental remediation. However, natural iron nanoparticles in a freshwater ecosystem have not been well characterized. Here we report the presence of natural iron nanoparticles in a tropical freshwater ecosystem in southern India. These iron nanoparticles that exist as slime in the natural water system were characterized through a multiproxy investigation involving Field-Emission Scanning Electron Microscopy (FE-SEM), X-ray Diffraction (XRD), X-ray Fluorescence (XRF), X-ray Photoelectron Spectroscopy (XPS), and Raman spectroscopy and BET analyses. These nanoparticles exist as amorphous hematite (Fe2O3), with the XRD peaks matching that of the iron arsenate compound. Fe2O3 occurs as mesoporous hollow microspheres with a size range of 14.97 to 61.3 nm and a surface area of 48.45m2/g. Further, the identification of Bacillus cereus in the slime suggests its role in iron sequestration, indicating a biogeochemical origin, which we infer is a particularly common phenomenon in tropical river basins where lateritic soils prevail. This study is the first to describe natural iron nanoparticles in a tropical freshwater ecosystem. It identifies their amorphous hematite structure and biogeochemical origin, offering new insights into their ecological roles and potential applications. This discovery presents an opportunity for utilizing this slime as an important source of hematite nanomaterials, with potential industrial applications.

Evaluation of the impact of continuous Kangaroo Mother Care (KMC) initiated immediately after birth compared to KMC initiated after stabilization in newborns with birth weight 1.0 to < 1.8 kg on neurodevelopmental outcomes: Protocol for a follow-up study.

BACKGROUND: Preterm birth or low birth weight is the single largest cause of death in newborns, however this mortality can be reduced through newborn care interventions, including Kangaroo Mother Care (KMC). Previously, a multi-country randomized controlled trial, coordinated by the World Health Organization (WHO), reported a significant survival advantage with initiation of continuous KMC immediately after birth compared with initiation of continuous KMC a few days after birth when the baby is considered clinically stable. Whether the survival advantage would lead to higher rates of neurodevelopmental morbidities, or the immediate KMC will also have a beneficial effect on cognitive development also, has not been investigated. We therefore propose to test the hypothesis that low-birth-weight infants exposed to immediate KMC will have lower rates of neurodevelopmental impairment in comparison to traditional KMC-treated infants, by prospectively following up infants already enrolled in the immediate KMC trial for the first 2 years of life, and assessing their growth and neurodevelopment. METHODS: This prospective cohort study will enroll surviving neonates from the main WHO immediate KMC trial. The main trial as well as this follow-up study are being conducted in five low- and middle-income countries in South Asia and sub-Saharan Africa. The estimated sample size for comparison of the risk of neurodevelopmental impairment is a total of 2200 children. The primary outcome will include rates of cerebral palsy, hearing impairment, vision impairment, mental and motor development, and epilepsy and will be assessed by the age of 3 years. The analysis will be by intention to treat. DISCUSSION: Immediate KMC can potentially reduce low-birth-weight-associated complications such as respiratory disease, hypothermia, hypoglycemia, and infection that can result in impaired neurocognitive development. Neuroprotection may also be mediated by improved physiological stabilization that may lead to better maturation of neural pathways, reduced risk of hypoxia, positive parental impact, improved sleep cycles, and improved stress responses. The present study will help in evaluating the overall impact of KMC by investigating the long-term effect on neurodevelopmental impairment in the survivors. TRIAL REGISTRATION: Clinical Trials Registry-India CTRI/2019/11/021899. Registered on 06 November 2019. Trials registration of parent trial: ACTRN12618001880235; Clinical Trials Registry-India: CTRI/2018/08/015369.

Effect of pressure and time on bioactive content, PPO inactivation, physicochemical and sensory properties of aonla (Emblica officinalis) juice during hydrodynamic cavitation processing.

Physical and nutritional attributes of aonla juice treated with hydrodynamic cavitation (HC) at a pressure range of 5-15 psi and time between 5 to 30 min were evaluated. Based on maximum retention of bioactives, antioxidant activity, inactivation of polyphenol oxidase (PPO), and physicochemical properties, HC conditions were optimized at 10 psi for 15 min, based on retention of 92.19% antioxidant activity, 88.01% vitamin C, and 96.80% of total phenolic content. Improved sedimentation index and viscosity were noted due to HC processing. The color profile of HC-treated samples was improved with less browning (63.86) and yellowing index (14.79) than that of control (browning index 64.61). Thermally treated samples inactivated 100% of PPO at 95 ℃ for 3 min, however, formation of a dark color with a browning index value of 67.38 was noted. The retention of various bioactives in thermally treated juice samples was much lesser than that of HC-treated samples. Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-022-01164-2.

Cytotoxicity, Antimicrobial, Anti-inflammatory and Antioxidant Activity of Camellia Sinensis and Citrus Mediated Copper Oxide Nanoparticle-An In vitro Study.

Aim: Several applications of copper oxide nanoparticles (CuONPs) have been documented in various fields, including healthcare, dentistry, medication delivery, tissue and cancer imaging, biolabeling, and biosensing. Therefore, this study aimed to synthesize CuONPs using the plant extracts of Camellia Sinesis (CS) and citrus limon (CL). The nanoparticles were then evaluated for their cytotoxicity, antibacterial, anti-inflammatory, and antioxidant activities. Materials and Methods: CuONPs were prepared using CS and CL through the green synthesis method. The Zone of Inhibition (ZOI) test was used to assess the antibacterial activity against strains of Staphylococcus aureus, Enterococcus faecalis, Streptococcus mutans, and Candida albicans. The albumin denaturation assay was used to assess the substances' anti-inflammatory activity. The cytotoxicity was determined by conducting the brine shrimp lethality test. Additionally, the antioxidant nature was tested using the 1,1-diphenyl-2-picryl hydrazyl method. Results: CuONPs mediated by CS and CL were successfully synthesized. The nanoparticles demonstrated significant antimicrobial activity against the bacteria being studied, specifically S. aureus. The cytotoxic effect was observed to be the least when the concentrations were below 20 µL. A potent antioxidant effect, characterized by its maximum absorbance at 517 nm, was observed at a concentration of 50 µL. A significant anti-inflammatory effect was noted for all tested concentrations. Conclusion: The use of CS- and CL-mediated CuONPs demonstrates a favorable antimicrobial effect with reduced cytotoxicity, as well as improved anti-inflammatory and antioxidant effects at higher concentrations.

Morpho-physiological and biochemical responses of cotton (Gossypium hirsutum L.) genotypes upon sucking insect-pest infestations.

The effects of sucking insect-pests on the morpho-physiological and biochemical changes in the leaves of four cotton genotypes-Bio 100 BG-II and GCH-3 (highly tolerant); KDCHH-9810 BG-II and HS-6 (highly susceptible)-were examined. Compared to tolerant genotypes, susceptible genotypes showed a decrease in relative water content, specific leaf weight, leaf area, photosynthetic rate, and total chlorophyll content, with an increase in electrolyte leakage. Hydrogen peroxide and total soluble sugar content were higher in susceptible plants. In contrast, resistant plants had higher levels of total soluble protein, total phenolic content, gossypol content, tannin content, peroxidase activity, and polyphenol oxidase. The findings demonstrated that the Bio 100 BG-II and GCH-3 genotypes effectively offset the impact of sucking insect-pests by modifying the factors mentioned above. The KDCHH-9810 BG-II and HS-6 genotypes could not completely negate the effects of sucking insect-pests. Customized metabolites and total soluble protein are more efficient in protecting cotton plants from damage brought on by infestations of sucking insects and pests. Supplementary Information: The online version contains supplementary material available at 10.1007/s12298-022-01253-w.

Management of Cylindrical Battery Ingestion.

Presentation A female presented to the Emergency Department following ingestion of an unknown number of cylindrical batteries. Diagnosis Abdominal X-ray confirmed the presence of multiple batteries located throughout the abdomen. Treatment A trial of conservative management was pursued, and five AA batteries were successfully passed per rectum. Serial X-rays over three weeks revealed that the majority of batteries failed to pass. A decision was made to perform a laparotomy, and 46 cylindrical batteries were removed from the stomach through a small gastrotomy. Four batteries located in the colon were milked into the rectum and removed via the transanal route. Discussion Using daily clinical exams and weekly plain films of the abdomen, conservative management is possible if a small number of batteries are ingested and make it to the stomach. However, the potential of cylindrical batteries to result in acute surgical emergencies should not be underestimated.

Trivialization of Aggression Against Women in India: An Exploration of Life Writings and Societal Perception.

Purpose: Aggression, or an action that intend to harm, encompasses different forms with varying intensity, impact, and salient features. Globally and in Indian context specifically, aggression against women is often normalized if there is no physical aggression involved as the hurt caused tends to be invisible. The current study explored the perceived intensity of physical, verbal, and sexual aggression among south Indian adults. Method: Aggressive instances from the life writings of two south Indian women were chosen and were rated by five independent coders to check inter-coder reliability. The select narratives disclose instances of domestic aggression. Ten instances with highest ratings were chosen as the material for data collection. Adults (N = 145) from two southern states had reported the perceived intensity of aggression in each context. Textual analysis and ANOVA were the analytic techniques adopted. Results: The results indicate trivialization of verbal aggression compared to physical and sexual aggression. Further, the instances of verbal or more subtle aggression were perceived as even more trivial when the respondents got exposed to the instances of explicit physical and sexual aggressions first. Conclusions: The findings indicate trivialization of verbal and implicit forms of aggression, particularly when exposed along with physical and explicit forms of aggression. Consequences of different forms of aggression were not considered significant by the respondents. Suggestions for further studies, changes in policy-making, and law-enforcement were made based on the current results.

Effective adsorption of crystal violet onto aromatic polyimides: Kinetics and isotherm studies.

The motive of this work is to synthesis aromatic polyimides by a two-step poly condensation process and the prepared aromatic polyamides (APIs) is been used as an effective functionalized adsorbent for the removal of carcinogenic crystal violet (CV) from aqueous medium. The adsorption efficiency of the APIs was enhanced by incorporation different functional moieties (varying aromatic dianhydrides with -O-, -(CF3)2-, -(CH3)2-) in the polymer structure. The initial and final concentration of CV was measured using UV-Vis spectrometer. The adsorption process was optimized by varying the parameters such as the effect of solution pH, contact time, initial dye concentration, and adsorbent dosage. Kinetics and isotherms of the adsorption system were appraised using data obtained from effect of contact time and initial dye concentration with corresponding empirical modelling techniques respectively. The evaluated results of the adsorption kinetic studies confirmed that the adsorption of API onto CV is followed a pseudo-second-order kinetic model. The adsorption behaviour and their interactions between APIs and CV are well established. The experimental results of this research output could be confirmed that APIs is a very effective adsorbent for the removal of cationic dye from aqueous.

ATM technique - a novel radiographic technique to assess the position of buccal shelf implants.

OBJECTIVES: Success of the buccal shelf implants depends on its proper placement. Radiographic techniques like cone beam computed tomography (CBCT), posteroanterior cephalogram (PA cephalogram) have been used to evaluate the position of buccal shelf implant placement. However, these techniques have disadvantages like increased radiation exposure, metal artifact, less availability in dental offices and are more expensive.The aim of Arvind's Trans Mandibular (ATM) technique is to overcome this drawback by using an intraoral periapical radiograph (IOPA) film or radiovisiography (RVG) sensor to assess the post-operative placement of buccal shelf implants. METHODS: Radiographs were taken for four patients after the placement of buccal shelf implants. The IOPA sensor was placed beneath the lower border of the mandible using this modified extraoral technique to assess the position of the buccal shelf implants in relation to the adjacent molars. The findings from the IOPA image were verified with CBCT images. RESULTS: The radiographic images taken using ATM technique were compared with the gold-standard CBCT technique. The ATM technique was able to accurately assess the postoperative buccolingual position of the implant with respect to the roots of molars in all the four cases. The proximity of the implant to the roots of the molar can be clearly visualized in all the cases. CONCLUSIONS: ATM is a novel radiographic technique using IOPA radiographic film or RVG sensor to assess the post-operative buccolingual placement of buccal shelf implants in relation to lower molar roots.

Association of severity of malocclusion with socioeconomic status in the South Indian population.

Malocclusion has been linked to various factors out of which certain dietary patterns and unhealthy habits are the most overlooked. The dietary patterns and unhealthy habits vary according to socioeconomic status. The present research was aimed to perform an association of malocclusion severity with socioeconomic status. This study was done in a retrospective manner and was conducted at Saveetha Dental College. A total of 241 clinical case records of the participants with malocclusion reporting for orthodontic therapy were selected and enrolled for the study. Data on the socioeconomic status and the severity of malocclusion as assessed with the Index of Orthodontic Treatment Needs (IOTNs) index were noted. All these records were collected and entered into Excel and then analyzed through statistics. Descriptive statistics and nonparametric Chi-square tests were performed. From the analysis, the proportion of IOTN Grade 1 malocclusion (30%) was found to be the highest. The highest number of patients with Grade 1 malocclusion belonged to the lower socioeconomic class. Socioeconomic status and the severity of malocclusion were significantly associated with each other. Malocclusion prevalence and severity were more among participants belonging to lower socioeconomic groups.

Association of vertical growth pattern with canine impactions in Dravidian subjects.

Canine impaction, ectopic canines, canine transposition, canine transmigration, and agenesis are all caused by disturbances during development and eruption of the teeth. The position of the canines is of utmost importance, and they should be carefully inspected as they follow the longest path during eruption in the oral cavity and their shape and position play a major role in occlusal guidance. The prevalence of canine impaction may also be connected to the pattern of facial growth. The objective of this study was to analyze the association of vertical growth pattern and canine impaction in Dravidian population. The dental records were consulted for information. The patient information was gathered from the outpatient data records of patients who were treated with fixed orthodontic treatment at the private dental setup. Patients with canine impactions were shortlisted. Malocclusion, growth pattern, and type of impaction were recorded. The data obtained were tabulated and analyzed using statistical software. Out of 1385 subjects, 35 patients had impacted canines. Among 35 patients with impacted canines, 23 (65.71%) have a vertical growth pattern, 6 (17.14%) have an average growth pattern, and 6 (17.14%) have a horizontal growth pattern. According to the findings of this investigation, there was no gender-related difference in canine impaction. The canine impaction prevalence in Dravidian subjects was found to be 2.53%. Most of them with impacted canines had a vertical growth pattern.

Severity of mandibular arch crowding in different sagittal malocclusions.

Mandibular anterior crowding is caused by a variety of factors. Mandibular incisor crowding can be caused by a number of causes including incisor and molar inclination, early loss of deciduous molars, mandibular growth, and oral musculature. The study was aimed to perform an association of the lower anterior crowding severity with gender and type of malocclusion. The current study was performed in a hospital setup and data about mandibular arch crowding patients were collected from the Records management system of a Private Dental Hospital in Chennai city. All the patient data on Mandibular arch crowding were sourced and tabulated after which statistical analysis with SPSS-IBM was done. Data collection was done over a period from June 2019 to February 2021. The entire study sample size was 634 case records. The result obtained from the statistical analysis was found that nearly 46% of the patients were found to have Mandibular arch crowding with female predilection (50%). The most commonly associated age groups were children than adults (63.2%) associated with mild type of crowding (65.1%). The most commonly involved malocclusion was found to be Class 1 (88.4%) Mild imbrications of the lower arch were common and were seen mainly in subjects with Class I malocclusion. Female subjects presented with more prevalence of mandibular arch crowding when compared to male subjects. Children were more affected by crowding than adults.

Synthesis, characterization, and antimicrobial activity of silver nanoparticles derived from Mentha X piperita + Ocimum tenuiflorum: An in vitro study.

The objective of the study was to synthesize silver nanoparticles using Mentha X Piperita (Mint) + Ocimum tenuiflorum (tulsi) and to confirm its size and shape. 0.5 mg of tulsi and 0.5 mg mint were diluted in distilled water (100 ml). The dissolved formulation was heated for 15 min at 70°C and filtered. The filtrate was homogeneously combined with 0.9 mg of silver nitrate to prepare nanoparticles of silver (AgNPs). The characterization of the obtained nanoparticle was done using transmission electron microscopy. Using agar disc diffusion assay, the antibacterial property was evaluated against common oral microbes at different concentrations. Silver nanoparticles showed excellent antimicrobial activity against Streptococcus mutans at 100 µL concentration. At 25 and 50 µL, all microbes showed similar extent of antimicrobial activity when quantified. Tulsi and mint prove to be effective in synthesizing silver nanoparticles that have good antimicrobial activity against oral microbes.

Association of crossbite with vertical skeletal growth patterns: A retrospective study.

Crossbite is a type of malocclusion in which teeth are positioned more buccally or lingually than their corresponding opposing tooth in the upper or lower dental arch, resulting in a lateral mismatch of the teeth in the dental arches. Crossbite can be unilateral or bilateral, and it can be anterior or posterior. The link between crossbite and skeletal growth pattern remains uncertain. The current study aimed to find the prevalence of crossbite in subjects visiting a private dental hospital and evaluate if there is any association between crossbite and skeletal growth pattern. Data required for the study were procured from the dental information archiving software. The data were sorted and entered into an Excel spreadsheet. IBM SPSS software version 23 was used to conduct the statistical analysis. Graphs and tables were used to interpret the findings. the prevalence of crossbite was found to be 6.4%. Subjects with horizontal growth pattern commonly had crossbite, but no statistical significance (P = 0.07), standard deviation (1.011), was noted. There was no statistically significant association between different skeletal growth patterns however subjects with horizontal growth pattern reported more commonly with crossbite.

Assessment of anterior open bite prevalence in children visiting a dental hospital - A retrospective evaluation.

Anterior open bite (AOB) is the insufficient vertical overlapping between the maxillary and mandibular anteriors when the teeth are in centric occlusion. The purpose of this study was to determine the prevalence of AOB in children and adolescents who visited a private dental hospital. In this study, subjects aged between 16 and 18 years with AOB were included. Data about orthodontic examination of patients were taken from preentered dental records of the hospital. Data of patients with AOB regarding age, gender, and intraoral and extraoral features were collected from the case records of the subjects, and statistical analysis was performed (Chi-square test and nonparametric correlations). The prevalence percentage of open bite in the anteriors was 2.7%, with more prevalence in Class 1 subjects (81.5%). Subjects with AOB had competent lips (81.8%), straight nasolabial angle (86.8%), and shallow palatal vault (49.5%). AOB had no significant relationship with the type of malocclusion, palatal vault, and lip competency, according to the Chi-square test. AOB and the nasolabial angle had a significant association. Both acute and right-angled nasolabial angles were commonly seen in adolescent patients with AOB. In children and adolescents visiting a private dental hospital in Chennai, the prevalence of AOB was found to be 2.7%. A significant association was observed between AOB and nasolabial angle.

Preoperative Serum Albumin Level as a Predictor of Abdominal Wound-Related Complications After Emergency Exploratory Laparotomy.

Background Serum albumin is generally considered to be a predictor of patients' nutritional status. Previous studies have used serum albumin to assess postoperative morbidity, mortality, and various other surgical outcomes in cardiac surgeries and elective gastrointestinal surgeries. In this study, we used preoperative serum albumin levels to assess postoperative surgical site wound complications in patients who underwent emergency exploratory laparotomy. Methodology Preoperative serum albumin level was observed in 60 patients who underwent emergency exploratory laparotomy due to various pathological conditions and were divided into those with hypoalbuminemia (serum albumin level <3.5 g/dl and >3.5 g/dL). Postoperative surgical site infections, wound dehiscence, and various complications, such as duration of hospital stay, prolonged ileus, the incidence of enterocutaneous fistula, the incidence of anastomotic leak, and 30-day mortality, were assessed. Results In our study, about 65% of the patients had hypoalbuminemia. Among them, 56.4% of the patients had surgical site infections according to the Southampton grade, with a statistically significant p-value of <0.001. Moreover, 87.2% of the patients had wound dehiscence according to the World Union Wound Healing Societies Surgical Wound Dehiscence wound grading, with a statistically significant p-value of <0.001. In addition, statistical significance was noted between preoperative hypoalbuminemia and increased postoperative hospital stay, with a p-value of <0.001. Conclusions Preoperative serum albumin value is a formidable predictor of postoperative surgical site infections, wound dehiscence, and duration of hospital stay in patients who underwent emergency exploratory laparotomy.

Assessment of Prescription Adherence to Secondary Prevention Guideline Recommendations and Patient Adherence to Pharmacotherapy and Lifestyle Modifications in Acute Coronary Syndrome and Chronic Coronary Syndrome Patients.

BACKGROUND: Coronary artery diseases (CADs) contribute to the majority of deaths and disabilities worldwide. People who have suffered an acute myocardial infarction (AMI) are at a higher risk of having a further attack. Hence, prolonged secondary prevention is necessary following index myocardial infarction (MI) for long-term cardiovascular protection as it reduces the morbidity and mortality associated with reinfarction, improves the quality of life, and is cost-effective. METHODS: An observational, ambidirectional study was carried out in a tertiary care hospital for 6 months. A total of 200 patients above 18 years of age with a confirmed diagnosis of acute coronary syndrome (ACS) or chronic coronary syndrome (CCS) were included in the study. Prospective data were collected using a self-designed patient profile form and by interviewing patients in the cardiac outpatient department while retrospective data were collected from the medical records department of the hospital. RESULTS AND CONCLUSION: Sex-wise distribution showed that males and females constituted 79 and 21% of the study participants, respectively, while the age-wise distribution revealed that the majority of patients were in the age-group of 60 years and above (63.5%). Hypertension and diabetes mellitus were the most common comorbid conditions, while dyslipidemia was the least observed comorbidity. Prescription adherence to secondary prevention guideline recommendations was studied, which revealed that 26.5% of the prescriptions were adherent to all four guideline recommendations. On evaluating adherence to pharmacotherapy, the maximum proportion of patients demonstrated moderate adherence (45%).

Two-Stage Primary Arthroplasty in the Infected Native Knee: A Systematic Review and Pooled Analysis.

INTRODUCTION: The knee is the commonest native joint to develop an infection. A two-stage primary knee replacement, with an interim stage of debridement and cement spacer application, modelled after two-stage revision for periprosthetic joint infections (PJI) has been reported for the management of chronic infections. AIMS: To systematically review the literature to find the infection-free survival and outcomes of this operation and explore its indications. METHODS: PRISMA guidelines were followed for this review. A systematic search of 4 online databases was conducted on 9/8/2020. After reviewing 226 abstracts and applying our selection criteria, 10 papers were selected for full-text review, and 9 included in the final synthesis. RESULTS: On pooled analysis, an infection-free survival of 95.6% (CI 94.7-96.4) was found at 2 years in 139 knees, which was unchanged over the remainder of the follow-up (Mean 3.9 years). The complication rate after final implantation was 6% in those that did not develop reinfection. The mean pooled Knee Society Score (KSS) and KSS Function score among 70 patients (4 papers) was 83.4 (80.1-89.0) and 76.8 (71.5-78.0), respectively. The mean range of motion among 82 patients (6 papers) was more than 100°. CONCLUSIONS: Two-stage primary knee replacement is a safe, effective and reliable procedure with good results in the short to medium term. Further studies are required to lay down precise indications and cost-effectiveness of this procedure, in comparison to other strategies for chronic infection. All joint registries should develop methods to identify patients undergoing two-stage procedures, to understand their long-term survival and outcomes.