Role of high resolution sonography and color Doppler flow imaging in the evaluation of scrotal pathology

Background: Scrotal swelling and pain are frequently encountered in clinical practice. Although to reach a diagnosis in some patients, history and physical examination are adequate, yet in a large percentage of patients, some additional studies are essential for complete evaluation of their symptoms. The clinical examination is often misleading or non-specific. The study shows the application of Gray-scale sonography, Color Doppler flow imaging (CDFI) and Power Doppler (PD) in the diagnosis of swelling, malposition, torsion, trauma, varicocele, hydrocele, cyst, mass, and atrophy.Methods: A total of 93 patients from all age groups with symptoms related to scrotal disease have been included in this study. Gray-scale sonography, CDFI and PD sonography of scrotal lesions were carried out.Results: A good correlation was seen in the comparison of scrotal lesions between sonography (gray scale, CDFI, and PD) and histopathology/ treatment response.Conclusions: High-resolution sonography, along with color Doppler flow imaging and power Doppler should be used as the first-line investigation in the evaluation of scrotal pathologies. Color Doppler flow Imaging and power Doppler add useful information and complement gray-scale sonography in reaching a correct diagnosis

A Cone Beam Computed Tomography (CBCT) evaluation of MB2 canals in endodontically treated permanent maxillary molars. A retrospective study in Indian population

Current technological advances have allowed application of different study designs and techniques for investigation of dental anatomy. Some clinical studies have provided evidence that Cone Beam computed tomography (CBCT) scanning is an important resource in assessment of root canal systems notably to identify MB2 canals in maxillary molars as CBCT scans allow in vivo dental investigation in axial, sagittal and coronal planes simultaneously. The current study was undertaken to detect and evaluate filled/unfilled MB2 canals in endodontically treated, asymptomatic maxillary molars utilizing cone beam computed tomography (CBCT). A retrospective study of 100 CBCTs of patients were underwent scanning for various treatment modalities, with asymptomatic endodontically treated permanent first and second maxillary molars were selected. History of root canal treatment varied from minimum of 1 year to a maximum of 10 years. Axial and paraxial images obtained were used to assess the presence of MB2 canal. Paraxial images were used to assess the periapical status. Of the 100 scans, 66 were of permanent maxillary first molar and 34 were of permanent maxillary second molar. The incidence of MB2 canal was 86.36% in maxillary first molars and 29.4% in maxillary second molars. 77.19 % of maxillary first molars and 90% of maxillary second molars had an unfilled MB2 canal. 72.7% of maxillary first molars and 88.8% of maxillary second molars showed significant periapical radiolucencies in unfilled MB2 canals. MB2 canals were present in majority of cases and most of the unfilled MB2 canals showed evidence of periapical radiolucencies

Corn distiller’s dried grains with solubles as a target for fermentation to improve bioactive functionality for animal feed and as a source for a novel microorganism with antibacterial activity

Plant-based bioenergy by-products such as corn distillers’ dried grains with solubles (DDGS) are widely utilized as animal feed sources and feed ingredients due to their balanced nutritional profile and animal health protective functional qualities. Bioprocessing of this bioenergy by-product using beneficial lactic acid bacteria (LAB)-based fermentation strategy to improve animal-health targeted functional qualities has wider relevance for animal feed applications. In this study, liquid extracts of corn DDGS were fermented with Lactiplantibacillus plantarum and Lactobacillus helveticus. The unfermented and fermented extracts were then analyzed (at 0, 24, 48 and 72-h) for their total soluble phenolic content (TSP), phenolic profile, antioxidant activity via ABTS and DPPH radical scavenging activity, and antimicrobial activity against the gut pathogen Helicobacter pylori using in vitro assay models. Statistical differences in antioxidant activity and phenolic content were observed among the unfermented and fermented extracts. The major phenolic compounds detected in corn DDGS were gallic, dihydroxybenzoic, p-coumaric, caffeic and ferulic acid, and catechin. Antimicrobial activity against H. pylori was observed for the unfermented extracts and the antimicrobial activity was attributed to the growth of a corn DDGS-endemic culture. The culture was isolated, sequenced, and identified as Bacillus amyloliquefaciens. Results of this study indicated that processing strategies of by-products such as LAB- based fermentation of corn DDGS could affect its bioactive-linked functional qualities due to microbial interaction with the phytochemicals. Furthermore, plant by-products can serve as novel sources of beneficial microflora that have relevance in wider agriculture, food safety, and therapeutic applications

A systematic review and network meta-analysis of pharmaceutical interventions used to manage chronic pain

It is estimated 1.5 billion of the global population suffer from chronic pain with prevalence increasing with demographics including age. It is suggested long-term exposure to chronic could cause further health challenges reducing people’s quality of life. Therefore, it is imperative to use effective treatment options. We explored the current pharmaceutical treatments available for chronic pain management to better understand drug efficacy and pain reduction. A systematic methodology was developed and published in PROSPERO (CRD42021235384). Keywords of opioids, acute pain, pain management, chronic pain, opiods, NSAIDs, and analgesics were used across PubMed, Science direct, ProQuest, Web of science, Ovid Psych INFO, PROSPERO, EBSCOhost, MEDLINE, ClinicalTrials.gov and EMBASE. All randomised controlled clinical trials (RCTs), epidemiology and mixed-methods studies published in English between the 1st of January 1990 and 30th of April 2022 were included. A total of 119 studies were included. The data was synthesised using a tri-partied statistical methodology of a meta-analysis (24), pairwise meta-analysis (24) and network meta-analysis (34). Mean, median, standard deviation and confidence intervals for various pain assessments were used as the main outcomes for pre-treatment pain scores at baseline, post-treatment pain scores and pain score changes of each group. Our meta-analysis revealed the significant reduction in chronic pain scores of patients taking NSAID versus non-steroidal opioid drugs was comparative to patients given placebo under a random effects model. Pooled evidence also indicated significant drug efficiency with Botulinum Toxin Type-A (BTX-A) and Ketamine. Chronic pain is a public health problem that requires far more effective pharmaceutical interventions with minimal better side-effect profiles which will aid to develop better clinical guidelines. The importance of understanding ubiquity of pain by clinicians, policy makers, researchers and academic scholars is vital to prevent social determinant which aggravates issue.</p

A systematic review and bayesian meta-analysis of medical devices used in chronic pain management

Whilst. pharmacological therapies remain the cornerstone of pain management in chronic pain, factors including the current opioid epidemic have led to non-pharmacological techniques becoming a more attractive proposition. We explored the prevalence of medical device use and their treatment efficacy in non-cancer pain management. A systematic methodology was developed, peer reviewed and published in PROSPERO (CRD42021235384). Key words of medical device, pain management devices, chronic pain, lower back pain, back pain, leg pain and chronic pelvic pain using Science direct, PubMed, Web of Science, PROSPERO, MEDLINE, EMBASE, PorQuest and ClinicalTrials.gov. All clinical trials, epidemiology and mixed methods studies that reported the use of medical devices for non-cancer chronic pain management published between the 1st of January 1990 and the 30th of April 2022 were included. 13 studies were included in systematic review, of these 6 were used in the meta-analysis. Our meta-analysis for pain reduction showed that transcutaneous electrical nerve stimulation combined with instrument-assisted soft tissue mobilization treatment and pulsed electromagnetic therapy produced significant treatment on chronic lower back pain patients. Pooled evidence revealed the use of medical device related interventions resulted in 0.7 degree of pain reduction under a 0–10 scale. Significant improvement in disability scores, with a 7.44 degree reduction in disability level compared to a placebo using a 50 score range was also seen. Our analysis has shown that the optimal use of medical devices in a sustainable manner requires further research, needing larger cohort studies, greater gender parity, in a more diverse range of geographical locations

A systematic review and bayesian meta‑analysis of medical devices used in chronic pain management

Whilst. pharmacological therapies remain the cornerstone of pain management in chronic pain, factors including the current opioid epidemic have led to non-pharmacological techniques becoming a more attractive proposition. We explored the prevalence of medical device use and their treatment efficacy in non-cancer pain management. A systematic methodology was developed, peer reviewed and published in PROSPERO (CRD42021235384). Key words of medical device, pain management devices, chronic pain, lower back pain, back pain, leg pain and chronic pelvic pain using Science direct, PubMed, Web of Science, PROSPERO, MEDLINE, EMBASE, PorQuest and ClinicalTrials.gov. All clinical trials, epidemiology and mixed methods studies that reported the use of medical devices for non-cancer chronic pain management published between the 1st of January 1990 and the 30th of April 2022 were included. 13 studies were included in systematic review, of these 6 were used in the meta-analysis. Our meta-analysis for pain reduction showed that transcutaneous electrical nerve stimulation combined with instrument-assisted soft tissue mobilization treatment and pulsed electromagnetic therapy produced significant treatment on chronic lower back pain patients. Pooled evidence revealed the use of medical device related interventions resulted in 0.7 degree of pain reduction under a 0–10 scale. Significant improvement in disability scores, with a 7.44 degree reduction in disability level compared to a placebo using a 50 score range was also seen. Our analysis has shown that the optimal use of medical devices in a sustainable manner requires further research, needing larger cohort studies, greater gender parity, in a more diverse range of geographical locations

A systematic review and meta-analysis of gestational diabetes mellitus and mental health among BAME populations

BACKGROUND: Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with an increased risk of mental health (MH) disorders including antenatal and postnatal depression (PND), anxiety and post-traumatic-stress-disorder (PTSD). We hypothesized GDM and MH disorders will disproportionately affect individuals from Black, Asian and Minority Ethnic backgrounds.METHODS: A systematic methodology was developed, and a protocol was published in PROSPERO (CRD42020210863) and a systematic review of publications between 1st January 1990 and 30th January 2021 was conducted. Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random-effect models, subgroup analysis and sensitivity analysis. These were used to determine odds ratio (OR) and 95% confidence intervals (CI) to establish prevalence using variables of PND, anxiety, PTSD and stress to name a few.FINDINGS: Sixty studies were finalised from the 20,040 data pool. Forty-six studies were included systematically with 14 used to meta-analyze GDM and MH outcomes. A second meta-analysis was conducted using 7 studies to determine GDM risk among Black, Asian and Minority Ethnic women with pre-existing MH disorders. The results indicate an increased risk with pooled adjusted OR for both reflected at 1.23, 95% CI of 1.00-1.50 and 1.29, 95% CI of 1.11-1.50 respectively.INTERPRETATION: The available studies suggest a MH sequalae with GDM as well as a sequalae of GDM with MH among Black, Asian and Minority Ethnic populations. Our findings warrant further future exploration to better manage these patients.FUNDING: Not applicable.</p

Exploring the Efficacy of Hormone Replacement Therapy:A Network Meta-Analysis

Hormone Replacement Therapy (HRT), an FDA-approved treatment for menopausal conditions was found to be associated with increased risk of endometrial cancer and reduced oestrogen. Studies showing benefits of HRT in preventing chronic diseases lead to development of clinical guidelines by American College of Physicians. This study aims to assess effectiveness of HRT treatments across cardiometabolic measures including Triglycerides (TG), Follicle-Stimulating Hormone, LDL cholesterol, HDL cholesterol, and Estradiol in menopausal women. It reports gaps in scientific knowledge and clinical practice to enhance current guidelines and policies.Methods: A systematic methodology designed and published in PROSPERO (CRD42022346057) to report network meta-epidemiology analysis was utilised. We used databases by PubMed, Web of Science, ScienceDirect, EMBASE and MEDLINE for studies published between 30th of April 1980-2022. Effects of HRT treatments were explored using a mixed treatment comparison (MTC) model. Fixed and random-effects models were used to address heterogeneity in published studies. Publication bias was assessed and corrected using funnel plots and Egger’s test.Results: Of 45 eligible studies, our findings indicate a significant statistical heterogeneity between HRTs and reduction of TG, SFH, LDL-C alongside increase of HDL-C and Estradiol among menopausal women. The analysis suggests a lack of direct evidence to support their efficacy in reducing TG, SFH and LDL-C levels or to substantiate HRT’s effectiveness in increasing HDL-C and Estradiol. The results showed no significant publication bias in the meta-analysis of included studies.Conclusion: Our findings demonstrate that use of HRT interventions among menopausal women may reduce TG, FSH and LDL-C levels and increase levels of HDL-C and estradiol via oral and oral + transdermal administration. Our study reaffirms efficacy of HRT in supporting favourable lipid profile in menopausal women whilst highlighting the need for robust and inclusive epidemiology studies and clinical trials to further develop clinical guidelines and policies