Infection and telomere length:A systematic review protocol

Introduction Telomeres are a measure of cellular ageing with potential links to diseases such as cardiovascular diseases and cancer. Studies have shown that some infections may be associated with telomere shortening, but whether an association exists across all types and severities of infections and in which populations is unclear. Therefore we aim to collate available evidence to enable comparison and to inform future research in this field.Methods and analysis We will search for studies involving telomere length and infection in various databases including MEDLINE (Ovid interface), EMBASE (Ovid interface), Web of Science, Scopus, Global Health and the Cochrane Library. For grey literature, the British Library of electronic theses databases (ETHOS) will be explored. We will not limit by study type, geographical location, infection type or method of outcome measurement. Two researchers will independently carry out study selection, data extraction and risk of bias assessment using the ROB2 and ROBINS-E tools. The overall quality of the studies will be determined using the Grading of Recommendations Assessment, Development and Evaluation criteria. We will also evaluate study heterogeneity with respect to study design, exposure and outcome measurement and if there is sufficient homogeneity, a meta-analysis will be conducted. Otherwise, we will provide a narrative synthesis with results grouped by exposure category and study design

Training in temporal bone surgery: A review of current practices

The temporal bone consists of complex anatomy, and the presence of various vital structures in close proximity makes the surgery of temporal bone highly challenging. Such a surgery requires years of training under the direct observation of trainers. Over the course of history, different training models have been adopted by experts to help train the young surgeons in this complex procedure. Cadaveric dissections of the temporal bone remains the gold standard in training of residents as the cadavers present the actual anatomical details which the surgeons encounter while operating on patients. However, due to scarcity of available cadavers, their one-time-only usage and high cost of involved in such trainings, experts have developed newer techniques of training, including three-dimensional reconstruction models and virtual reality simulators. Most of the literature on simulation in training of residents focuses on anatomical understanding and development of the surgical technique. There has been significant improvement in these techniques over time. With the addition of haptic feedback in the newer virtual simulation models, simulation has edged closer to basic modules of temporal bone dissection. the current review article was planned to have an overview of the different techniques in detail that are currently being in used

Quality characteristics, phytochemical analysis, and antioxidant of extract Cuscuta reflexa (Roxb.)

Cuscuta reflexa is an extensive leafless, parasitic climber that has been used since ancient times for various purposes and as a therapeutic plant in different areas of Pakistan. The phytochemical, antibacterial, antioxidant, and fatty acid investigations were carried out on the leaves, stems, and fruit extracts of C. reflexa. Preliminary phytochemical screening has shown the presence of various phytochemicals such as carbohydrates, protein, amino acids, alkaloids, flavonoids, phenols, glycosides, saponins, tannins, terpenoids, steroids, and phenolic compounds. The percentage variation of some components fluctuated like moisture (6.85-10.34%), ash (5.38-7.83%), acid insoluble ash (0.28-0.71%), water-soluble ash (0.78-0.96%), hexane extractives (1.23-1.91%), alcohol extractives (10.39-12.23%), water extractives (25.34-30.35%), loss on drying (1.16-1.47%) and crude fiber (15.04-18.26%) for leaves, stems, and fruits respectively. The level of free fatty acid was different as follows: leaves (2.37%), stems (2.16%), and fruits (2.94%); a high value of peroxide was observed in stems, followed by leaves and fruits. The iodine and saponification values in leaves, stems, and fruits were found in the range of 105-116 g I2/100 g, and 165-175 mg KOH/g. The antibacterial activity was carried out by the disc diffusion method against gram-positive Staphylococcus aureus and gram-negative Escherichia coli bacteria. It was found that all extracts of the selected plant were most active against E. coli with a zone of inhibition of 4, 4, and 6 at MIC 250 as compared to S. aureus, which showed a zone of inhibition of 3, 4, and 5 at MIC 250 µg/ml. The antioxidant potential of the leaves, stems, and fruit extracts, examined on the basis of their scavenging activity of free radicals, was found to be good. The result of the gas chromatography-mass spectroscopy (GC-MS) analysis reveals that linoleic acid (38.10–40.53%) is the most abundant fatty acid of C. reflexa and the smallest amount was found in tricosanoic acid (0.12-0.19%). In general, the isolated compounds were reported to possess anticarcinogenic, antitumor, antimicrobial, and anti-inflammatory properties. It was concluded that C. reflexa has a markedly therapeutic potential to heal wounds and may provide the pharmacological basis for its folk uses

COVID-19: Implications, reactions and future directions

Humanity has faced several foes over the centuries, a formidable one amongst them is the current pandemic of COVID-19. The symptoms of COVID-19 are more or less related to the nose and throat. Therefore, patients more often present to Ear Nose Throat (ENT) clinics with symptoms including cough, sore throat, fever and shortness of breath. In the management of head and neck pathologies, as the airway is a direct source of infection, the impact of COVID-19 holds special significance. This review has attempted to explain the various aspects of the disease itself, its diagnosis, the use of personal protective equipment (PPE) to provide an overview of the evolving recommendations in head and neck patients, the future outlook and the limitations faced in developing countries specifically for ENT patients

Parametric optimisation of friction stir welding on aluminium alloy (EN AW-1100) plates

Friction stir welding is a solid-state welding process used extensively for aluminium alloys. EN AW-1100 alloy is mostly used for its exceptional corrosion resistance, high ductility, high thermal and electrical conductivities, and cost-effectiveness. This study is focused on the optimisation of friction stir welding parameters to achieve enhanced mechanical properties of 5mm thick EN AW-1100 alloy plates welded with a single pass, using Taguchi L9 orthogonal array and ANOVA analysis. Experimental results revealed that maximum tensile strength of 79 MPa and percentage elongation of 38.87 % were achieved. The maximum Vickers hardness achieved in the stir zone was 34.15. These results were used for optimisation using Minitab and it was determined that 2000 RPM, 30 mm·min−1 traverse speed and square probe profile came out to be the best parameters for maximum tensile strength. 4000 RPM, 30 mm·min−1 traverse speed and square probe geometry were the best parameters for maximum hardness in the stir zone. ANOVA analysis showed that the most significant parameter for tensile strength was traverse speed. None of the considered parameters were influencing the hardness value in the stir zone at a 95 % confidence level

Infection and telomere length: a systematic review protocol

INTRODUCTION: Telomeres are a measure of cellular ageing with potential links to diseases such as cardiovascular diseases and cancer. Studies have shown that some infections may be associated with telomere shortening, but whether an association exists across all types and severities of infections and in which populations is unclear. Therefore we aim to collate available evidence to enable comparison and to inform future research in this field. METHODS AND ANALYSIS: We will search for studies involving telomere length and infection in various databases including MEDLINE (Ovid interface), EMBASE (Ovid interface), Web of Science, Scopus, Global Health and the Cochrane Library. For grey literature, the British Library of electronic theses databases (ETHOS) will be explored. We will not limit by study type, geographical location, infection type or method of outcome measurement. Two researchers will independently carry out study selection, data extraction and risk of bias assessment using the ROB2 and ROBINS-E tools. The overall quality of the studies will be determined using the Grading of Recommendations Assessment, Development and Evaluation criteria. We will also evaluate study heterogeneity with respect to study design, exposure and outcome measurement and if there is sufficient homogeneity, a meta-analysis will be conducted. Otherwise, we will provide a narrative synthesis with results grouped by exposure category and study design. ETHICS AND DISSEMINATION: The present study does not require ethical approval. Results will be disseminated via publishing in a peer-reviewed journal and conference presentations. PROSPERO REGISTRATION NUMBER: CRD42023444854

Ethical Dilemmas in the Management of Head and Neck Cancers in the Era of the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) has emerged as an unforeseen challenge for head and neck cancer care providers. A similar challenge is also faced by other oncological fields, but the severity of this challenge is highest in otolaryngology because of the need for additional precautionary measures and curbs on the possibility of aerosol forming interventions related to the upper aerodigestive tract. In this narrative review, provision of ethical and consistent care on moral and professional grounds to head and neck cancer patients during the pandemic are discussed for professionals who provide head and neck oncology care

COVID-19: Implications, Reactions and Future Directions

Humanity has faced several foes over the centuries, a formidable one amongst them is the current pandemic of COVID-19. The symptoms of COVID-19 are more or less related to the nose and throat. Therefore, patients more often present to Ear Nose Throat (ENT) clinics with symptoms including cough, sore throat, fever and shortness of breath. In the management of head and neck pathologies, as the airway is a direct source of infection, the impact of COVID-19 holds special significance. This review has attempted to explain the various aspects of the disease itself, its diagnosis, the use of personal protective equipment (PPE) to provide an overview of the evolving recommendations in head and neck patients, the future outlook and the limitations faced in developing countries specifically for ENT patients

Diagnostic Efficacy of MRCP and Ultrasound on Obstructive Jaundice-A Prospective Study

Background: Obstructive jaundice is a common pathological problem that occurs when there is an obstruction to the passage of conjugated bilirubin from liver cells to intestine. Bile, a digestive fluid secreted and produce by the liver. Most common cause of obstructive jaundice is due to gallstones. Objective: The aim of our study was to evaluate the diagnostic Efficacy of MRCP and Ultrasound on obstructive jaundice. Study design: A cross-sectional prospective study was performed. Material & Method: A cross-sectional prospective study was performed in 50 patients who came with the provisional diagnosis of obstructive jaundice were referred to ultrasound for primitive diagnosis and were then shifted to MRCP for a detailed diagnosis. The data was collected from the outpatient department facility of Pakistan Kidney and Liver Institute   Hospital, Lahore. After informed consent, data was collected from MRI GE 1.5 Tesla, Ultrasound Canon Xanio. Results: The results revealed that there are 50 patients of obstructive jaundice. 20 were females’ patients and 30 were males’ patients, with age raging from 20-40 years. There were 17 patients out of  50 in our study which ultrasound showed negative results that were positive on MRCP there were 28 patients that were positive on both ultrasound and MRCP. There were 3 patients that were positive on ultrasound but negative on MRCP and 2 patients that were negative on both modalities Conclusion: Our study concluded that higher ratio of males then females in our sample size, RHC was positive in all the patients with dominant cause of jaundice was stone with in biliary channel. We found that MRCP has better efficiency comparative to ultrasound to detect jaundice and its etiology i.e., 90% true positive. Keywords: Magnetic resonance cholangiopancreatography, Ultrasonography, Obstructive jaundice DOI: 10.7176/JHMN/91-03 Publication date:July 31st 202