Technologies, strategies and approaches for testing populations at risk of sexually transmitted infections: a systematic review protocol to inform prevention and control in EU/EEA countries.

OBJECTIVES: This protocol outlines a systematic review methodology, aiming to assess the recent evidence-base for the impact of testing strategies and approaches on access to testing, testing coverage, and linkage to care for populations at risk for specific curable sexually transmitted infections (STIs) (chlamydia, gonorrhoea, syphilis, trichomoniasis, and Mycoplasma genitalium infections). DATA SOURCES: These include MEDLINE, Embase, PsycINFO, Global Health, Cochrane Database, Epistemonikos, CINAHL Plus, and Web of Science Core Collection. REVIEW METHODS: Papers reporting primary data from 1 January 2012 onwards will be included. Titles, abstracts, and full texts will be reviewed for inclusion, and data will be extracted using a pre-specified and piloted data extraction form, by two independent reviewers. Experts in the field will be contacted and interviewed for further information about ongoing or unpublished studies. A narrative synthesis of the findings will be conducted. DISCUSSION: Outcomes of this study will inform policy makers, national and international programme coordinators, public health and clinical experts, and civil society organisations involved in STI prevention and control in EU/EEA countries and elsewhere. The review will provide a direction for future researchers and programmers seeking to improve STI testing services among key populations at high risk for STIs. SYSTEMATIC REVIEW REGISTRATION: In accordance with guidelines outlined in the PRISMA-P methodology, this protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 30 January 2019: CRD42019118261

Morphometric Study of Pterion in Dry Human Skull at Medical College of Eastern Nepal

Introduction: The pterion is defined as an H shaped sutural confluence present on the lateral side of the skull. This pterion junction has been used as a common extra-cranial landmark for surgeons in microsurgical and surgical approaches towards important pathologies of this region. Methods: This is an analytical cross-sectional study conducted at the Department of Anatomy, Birat Medical College & Teaching Hospital, Tankisinuwari, Morang, Nepal. Total enumeration technique was used to collect samples where 31 dry human skulls of unknown age and sex were taken. The sutural pattern and location of the pterion were determined and measured on both sides of each skull using a digital vernier caliper.  Results: Three types of sutural patterns of pterion were observed. Among them, the Sphenoparietal type was higher in frequency. The frequency was 26 (83.8%) on the right side and 24 (77.4%) on the left side. The distance between the center of pterion to the midpoint of the upper border of the zygomatic arch was 3.82±0.3 cm on the right side and 3.8±0.29 cm on the left side. The distance between the center of pterion to the postero-lateral aspect of fronto-zygomatic suture was 3.02±0.23 cm on the right side and 3.0±0.23 cm on the left side. Conclusion: The information of the sutural pattern and the location of the pterion from the different bony landmarks of our study may be useful for anthropologists and neurosurgeons.   Keywords: Frontozygomatic suture, Morphometric, Pterion, zygomatic arch DOI: https://doi.org/10.3126/jkahs.v2i3.2665

The impact of childhood malnutrition on mortality from pneumonia:a systematic review and network meta-analysis

IntroductionChildhood malnutrition is widespread in low-income and middle-income countries (LMICs) and increases the frequency and severity of infections such as pneumonia. We aimed to identify studies investigating pneumonia deaths in malnourished children and estimate mortality risk by malnutrition severity.MethodsWe conducted a systematic review of MEDLINE, EMBASE and Global Health databases to identify relevant studies. We used a network meta-analysis to derive ORs of death from pneumonia for moderately and severely underweight children using low weight-for-age, the most reported measure of malnutrition. We compared meta-estimates of studies conducted before and after 2000 to assess changes in mortality risk over time. We estimated the prevalence of underweight hospitalised children from hospital-based cohort studies and calculated the population attributable fraction of in-hospital pneumonia deaths from being underweight using our results.ResultsOur network meta-analysis included 33 544 underweight children from 23 studies. The estimated OR of death from pneumonia was 2.0 (95% CI 1.6 to 2.6) and 4.6 (95% CI 3.7 to 5.9) for children moderately and severely underweight, respectively. The OR of death from pneumonia for those severely underweight was 5.3 (95% CI 3.9 to 7.4) pre-2000 and remained high post-2000 at 4.1 (95% CI 3.0 to 6.0). Prevalence of underweight children hospitalised with pneumonia varied (median 40.2%, range 19.6–66.3) but was high across many LMIC settings. We estimated a median 18.3% (range 10.8–34.6) and 40.9% (range 14.7–69.9) of in-hospital pneumonia deaths were attributable to being moderately and severely underweight, respectively.ConclusionsThe risk of death from childhood pneumonia dramatically increases with malnutrition severity. This risk has remained high in recent years with an estimated over half of in-hospital pneumonia deaths attributable to child malnutrition. Prevention and treatment of all child malnutrition must be prioritised to maintain progress on reducing pneumonia deaths.</jats:sec

Impact of COVID 19 on Surgical Practices among Maxillofacial Surgeons of Nepal

Introduction: Oral and maxillofacial surgeons come into contact with the saliva, mucus, blood during the examination of patients. Coronavirus disease (COVID-19) is believed to spread primarily via respiratory droplets that put oral and maxillofacial surgeons at high risk of contracting the infection. COVID 19 has led to changes in maxillofacial surgical practices. There is a gap in knowledge regarding its real impact. So, we conducted this study with the objective to evaluate the impact of COVID-19 on maxillofacial surgery practices in Nepal. Methods: A web-based cross-sectional study was conducted among all the members of the Nepalese Association of oral and maxillofacial surgeons (NAOMS) practicing in Nepal. The survey was conducted from 25 June 2020 to 25 July 2020.  The total enumeration sampling was used to collect information and 46 study participants enrolled in the study. A semi-structured questionnaire was developed and sent to study participants through a google form. Ethical clearance was taken from the Institutional Review Committee of Birat Medical College and Teaching Hospital and informed web-based consent was taken from study participants. Results: Only 46 participated among 70 invitations, with a response rate of 65.71%. Among the study participants, the majority (n=35, 76.08%) used personal protective equipment (PPE) for minor procedures and in the operating room. Most surgeons (n=37, 80.43%) asked to test their patients for COVID-19 prior to shifting to the Operating room. More than half of Surgeons were doing both elective and emergency surgeries (n=24, 52.17%). Almost all surgeons (n=44, 95.65%) responded that they have minimized aerosol-generating procedures. Almost two-thirds of surgeons (n=29, 63.04%) did not feel safe while working in a hospital. Conclusion: Despite the use of PPE by the majority of Maxillofacial Surgeons and asking their patients for the COVID- 19 test, they still did not feel safe to work at the hospital

Draft search strategies for: "Novel strategies and approaches for testing populations at risk for sexually transmitted infections: A systematic review protocol"

This draft search strategy covers two topics: curable Sexually transmitted infections (STIs) (chlamydia, gonorrhoea, syphilis, trichomoniasis, Mycoplasma genitalium) and novel strategies and approaches to diagnosis. The search strategy was developed in the OvidSP Medline database and tested in OvidSP Embase, OvidSP Global Health and OvidSP PsycINFO. Details of all four searches are provided

Endogenous fluctuations in cortical state selectively enhance different modes of sensory processing in human temporal lobe

Abstract The degree of synchronized fluctuations in neocortical network activity can vary widely during alertness. One influential idea that has emerged over the past few decades is that perceptual decisions are more accurate when the state of population activity is desynchronized. This suggests that optimal task performance may occur during a particular cortical state – the desynchronized state. Here we show that, contrary to this view, cortical state can both facilitate and suppress perceptual performance in a task-dependent manner. We performed electrical recordings from surface-implanted grid electrodes in the temporal lobe while human subjects completed two perceptual tasks. We found that when local population activity is in a synchronized state, network and perceptual performance are enhanced in a detection task and impaired in a discrimination task, but these modulatory effects are reversed when population activity is desynchronized. These findings indicate that the brain has adapted to take advantage of endogenous fluctuations in the state of neural populations in temporal cortex to selectively enhance different modes of sensory processing during perception in a state-dependent manner