A Systematic Review on the Effectiveness of Different Functional Treatments for Acute Ankle Sprains

Background: An ankle sprain is a very common sport-related injury and can reduce participation in sports and employment. It can also create further complications in the function of the joint. Purpose: To evaluate the effectiveness of different functional treatments and to ascertain which functional treatment is the most effective method for acute ankle sprains. Study Design: Systematic review. Methods: The design of this systematic review was developed in accordance with PRISMA-P 2015 statement and performed according to its guidelines. A computerized literature search was performed from PubMed Central, MEDLINE via OVID and Cochrane library. Randomized controlled trials or quasi-experimental studies, published within a ten-year period (2007 to 2017), in peer-reviewed journals, with full-text articles and written in English were included in this study. Any type of functional treatments being applied to treat acute ankle sprains were considered as an intervention and only adult participants were included in this review. Surgical methods, unpublished trials, not written in the English language or not experimental research were excluded. Results: From the pooled data of this review, the stocking was more effective at improving pain, swelling, functional outcomes, range of motion, and return to sport/work, and had higher patient satisfaction than the bandage. There was no evidence that the taping and lace-up brace were more effective than other functional interventions in the treatment of acute ankle sprains. Furthermore, the prevalence of complications was greatest for the taping and lace-up brace interventions. The semi-rigid or posterior rigid support group had a better functional recovery and higher patient satisfaction, but some complications were present. Conclusion: The semi-rigid or posterior rigid support group and stocking were the most effective functional interventions for acute ankle sprain treatment. What is known about this subject: The functional treatments are becoming popular due to being effective, inexpensive and simplistic to apply. Different types of functional interventions have been used according to the choice of clinicians and patients in the treatment of ankle sprains. According to the previous researches, semi-rigid support, ankle braces, bandage and lace-up supports have greater advantages than other functional treatments from different perspectives (Example. the elastic bandage had a slower recovery rate than semi-rigid brace but less complications than taping, the lace-up support was better in swelling management than other functional treatments). What this study adds to existing knowledge: This study found that the stocking is an effective treatment for managing acute ankle sprains. It is valuable for the patient because the cost of the stocking is considerably cheaper than other functional treatments and it is very easy to wear. Some popular functional treatments like lace-up support; taping and semi-rigid braces were shown to have some complications

Long-term outcomes of second-line antiretroviral treatment in an adult and adolescent cohort in Myanmar.

BACKGROUND: Myanmar has a high burden of Human Immunodeficiency Virus (HIV) and second-line antiretroviral treatment (ART) has been available since 2008 in the public health sector. However, there have been no published data about the outcomes of such patients until now. OBJECTIVE: To assess the treatment and programmatic outcomes and factors associated with unfavorable outcomes (treatment failure, death and loss to follow-up from care) among people living with HIV (aged ≥ 10 years) receiving protease inhibitor-based second-line ART under the Integrated HIV Care Program in Myanmar between October 2008 and June 2015. DESIGN: Retrospective cohort study using routinely collected program data. RESULTS: Of 824 adults and adolescents on second-line ART, 52 patients received viral load testing and 19 patients were diagnosed with virological failure. However, their treatment was not modified. At the end of a total follow-up duration of 7 years, 88 (11%) patients died, 35 (4%) were lost to follow-up, 21 (2%) were transferred out to other health facilities and 680 (83%) were still under care. The incidence rate of unfavorable outcomes was 7.9 patients per 100 person years follow-up. Patients with a history of injecting drug use, with a history of lost to follow-up, with a higher baseline viral load and who had received didanosine and abacavir had a higher risk of unfavorable outcomes. Patients with higher baseline C4 counts, those having taken first-line ART at a private clinic, receiving ART at decentralized sites and taking zidovudine and lamivudine had a lower risk of unfavorable outcomes. CONCLUSIONS: Long-term outcomes of patients on second-line ART were relatively good in this cohort. Virological failure was relatively low, possibly because of lack of viral load testing. No patient who failed on second-line ART was switched to third-line treatment. The National HIV/AIDS Program should consider making routine viral load monitoring and third-line ART drugs available after a careful cost-benefit analysis

Automatic Track Following System to Study Double Strangeness Nuclei in Nuclear Emulsion Exposed to the Observable Limit

岐阜大学(Gifu University)博士(工学)博士論文 (Doctoral dissertation)doctoral thesi

Sexually Transmitted Infections: Educational Settings

Background: Sexually transmitted infections (STIs) are a major public health concern in Canada and worldwide. Nearly two-thirds of STIs are seen among youth. Therefore, it is crucial to provide effective STI interventions to youth. Substance use is an important factor for STI acquisition among youth because of high prevalence and its ability to link proximal sexual risk behaviors and distal contextual factors. STI preventive behavioral interventions remain the gold standard due to the limitations in biomedical interventions. Educational institutions are recognized as ideal settings to target youth. Thus, it is essential to assess whether integrating substance use into STI prevention programs at educational settings is worthwhile as well as whether STI preventive interventions at educational settings are effective and how can they be improved. Objectives and Methods: The objectives and methodologies of this thesis include 1) determine the prevalence and association between substance use and STIs among Canadian post-secondary students (descriptive analysis and logistic regression of the ACHA-NCHA II Spring 2016 survey data and 2) assess the efficacy and effectiveness of STI preventive intervention programs at educational settings (a systematic review and meta-analysis). Results: Positive association exists between current cannabis use or other drug use and STIs among Canadian post secondary students. STI preventive interventions at educational institutions in developed countries show effectiveness. Interventions are more effective in promoting knowledge compared to enhancing motivational factors, behavioral skills and behaviors, and for female students. No significant difference in effectiveness is seen based on the type of provider (peer-involved and non-peer-involved) and type of intervention (face-to-face and technology-based). Recommendations: Based on our findings, it is recommended to integrate substance use preventive interventions into STI preventive interventions at Canadian post-secondary institutions. A potential framework for effective STI preventive interventions at educational settings which can possibly be inferred to the Canadian post-secondary institutions is presented based on our results. This thesis will help inform, evaluate and guide STI preventive interventions at educational settings to effectively reduce the burden of STIs among Canadian youth. Future research with more rigorous methodology should be undertaken to provide conclusive evidence

Relationship of EcologicalFactors and Commercial Bronze Featherback Fish,Notopterus notopterus(Pallas, 1769);Irrawaddy River, Myitkyina Segment, Kachin state, Myanmar

Nowadays, there are gradually decreasing the quality of water bodies of Rivers, among them, Irrawaddy River is also little impacts asunder the impact ofecological stress that is leading to be declining fisheries resources including Notopterus notopterus(Pallas, 1769) (here after target species, one of commercially importancefishesin Myanmar), therefore, this research work is conducted on the basis of assessing water quality, availability of target fish, its productivity rate, local indigenous groups participation for conservation, and to control illegal fishing methods and gears in order to sustain natural resource of fisheries as well as water bodies. It was observed some constraints such as poor stakeholder mapping, unclear understanding on ecologicalengagement, and weak environmental awareness.In doing so, it is focused on intervention with observation of actual target fish species population that is about 30 % of all fishes in the study area, Irrawaddy River, Myitkyina segment (Kachin state, Myanmar) according to survey versus aquatic ecosystem with respect to water quality monitoring assessment in which physico chemical indicator by comparing desirable as well as imperative of world health organization (W.H.O) standard, in doing so, all are chemically potable exceptcolor (units), turbidity (N.T U) concerning physical examination for pH (scale)= 6.8, color (units)= > 50, turbidity (N.T.U)= 52.1, conductivity (micromhos/cm)= 56; as well as chemical analysis for calcium as Ca= 8, total hardness (CaCO3)= 36, magnesium as Mg= 3, chloride as Cl= 5, total alkalinity= 36, total iron (Fe)= > 0.2, manganese (Mn)= 0.03, sulphate (SO4)= < 200. And the result of B.O.D (Biochemical Oxygen Demand)= 3.80, D.O (Dissolved Oxygen)= 5.60, C.O.D (Chemical Oxygen Demand)= -, pH value= 6.8, Salinity= 0.1, T.D.S (Total Dissolved Solids) = 29.6 (mg/l). Therefore, it leads toclearcomprehensiveunderstandingon ecological integrity,importance of fisheries resources with stakeholder mapping, compact information on conservation and monitoring fisheriesas well as water resource with capacity building engagement of stakeholders regarding community development and better livelihood of local indigenous group

Evaluation of the Yield of Bioethanol from Sterilized and Unsterilized Fruit Pulp of Waste Pineapple

In this research work, waste pineapple (Ananas comosus L.) was used as raw material for the production of bioethanol through direct fermentation by using baker’s yeast (Saccharomyces cerevisiae). Both unsterilized and sterilized fruit pulp were fermented with baker’s yeast (Saccharomyces cerevisiae) under anaerobic condition. Different fermentation conditions such as amount of substrate (100, 200, 300, 400, 500 and 600) g, amount of yeast (0.2, 0.4, 0.6, 0.8, 1.0 and 1.2 % w/w), temperature of fermentation (28, 30, 32, 34, 36 and 38) C, different pH (3.5, 4, 4.5, 5, 5.5 and 6) and period of fermentation (1, 2, 3, 4, 5 and 6) days were carried out to obtain the maximum strength of ethanol. The strength of the resultant bioethanol was measured by sp.gr and also analyzed by gas chromatography (GC). It was pointed out that the maximum strength of bioethanol 49.78 (%v/v) and 46.63 (%v/v) were obtained from sterilized and unsterilized pulp of pineapple respectively

Difficult cases of testoterone replacement therapy in male hypogonadism

Detailed formal protocol with illustrations and extensive bibliography.A recording of the protocol presentation is available on UT Southwestern’s Mediasite. Note: Access to the video is restricted to authorized UT Southwestern users only.UT Southwestern--Internal Medicin