Clinical Characteristics as Predictors of Early and Delayed Cerebral Infarction in Aneurysmal Subarachnoid Hemorrhage Patients: A Meta-Analysis of 4527 Cases.

BACKGROUND: Predictors of delayed cerebral infarction (DCI) and early cerebral infraction (ECI) among aneurysmal subarachnoid hemorrhage (aSAH) patients remain unclear. We aimed to systematically review and synthesize the literature on predictors of ECI and DCI among aSAH patients. METHODS: We systematically searched PubMed, EMBASE, Cochrane Library, and Scopus databases comprehensively from inception through January 2024 for observational cohort studies examining predictors of DCI or ECI following aneurysmal SAH. Studies were screened, reviewed, and meta-analyzed, adhering to PRISMA and Cochrane guidelines. The data were pooled as Odds ratios (OR) with 95% confidence intervals (CI) using RevMan 5.4 software. Methodologic quality was assessed with the Newcastle-Ottawa Scale. RESULTS: Our meta-analysis included 12 moderate to high-quality cohort studies comprising 4527 patients. Regarding DCI predictors, Higher severity scores (O.R.=1.49, 95%CI [1.12,1.97], P=0.005) and high Fisher scores (O.R.=2.23, 95%CI [1.28,3.89], P=0.005) on presentation were significantly associated with an increased risk of DCI. Also, the female sex and the presence of vasospasm were significantly associated with an increased risk of DCI (O.R.=3.04, 95%CI [1.35,6.88], P=0.007). In contrast, preexisting hypertension (p=0.94), aneurysm treatment (p=0.14), and location (p=0.16) did not reliably predict DCI risk. Regarding ECI, the pooled analysis demonstrated no significant associations between sex (P=0.51), pre-existing hypertension (P=0.63), severity (P=0.51), or anterior aneurysm location versus posterior (P=0.86) and the occurrence of ECI. CONCLUSION: Female sex, admission disease severity, presence of vasospasm and Fisher grading can predict DCI risk post-aSAH. Significant knowledge gaps exist for ECI predictors. Further large standardized cohorts are warranted to guide prognosis and interventions.

Characterization, anti-microbial, anti-oxidant and growth promoting effects of biogenically synthesized silver nanoparticles derived from Dicliptera bupleuroides Nees.

One of the most important areas of nanotechnology is the use of nanoparticles (NPs) for a variety of environmental and biological applications, with silver nanoparticles (Ag-NPs) gaining a lot attention due to their distinct properties. The current study deals with the synthesis of Ag-NPs from Dicliptera bupleuroides Nees leaf extract and to determine their antioxidant, antimicrobial potential and effects on wheat seed germination and growth. UV-Visible spectrum revealed a prominent absorption peak at 442 nm, elucidating the conformation of the Ag-NPs synthesis. Scanning electron microscopy (SEM) showed distinctive triangular, pyramidal, and irregular shape. X-ray diffraction (XRD) demonstrated their crystalline nature, with average crystallite size of the Ag-NPs measured at 20.52 nm. Fourier-transform infrared spectroscopy (FT-IR) further confirmed the presence of functional groups such as Phenols (O-H stretch), transition metal carbonyls N-H, ≡C-H, C ≡ N, C ≡ C, C-Cl, C-Br and O-H bonds on the surface Ag-NPs. The antibacterial activity of the Ag-NPs was most pronounced against Bacillus subtilis, with a zone of inhibition (ZOI) measuring 11 mm ± 0.57 at a concentration of 1000 µg/mL (45% inhibition). Likewise, Ag-NPs exhibited highest antioxidant potential (73.2%) at 100 µg/mL compared with standard (ascorbic acid) which showed (76%) at the same concentration. Furthermore, the effect of D. bupleuroides mediated Ag-NPs on wheat seeds growth and germination was recorded maximum at high concentrations (200-300 ppm). In conclusion, D. bupleuroides mediated Ag-NPs showed safe, cost effective and environmentally friendly synthesis which can be used as an antibacterial and antioxidant agent as well as for enhancing the growth and seed germination of crop seeds globally. RESEARCH HIGHLIGHTS: Nanotechnology is the study of nanoparticles for biological and environmental applications. Ag-NPs among other NPs have received broad attention because of their unique properties. D. bupleuroides Ag-NPs: 45% antibacterial, 73.2% antioxidant, enhance wheat germination. D. bupleuroides-mediated Ag-NPs are both cost-effective and environmentally beneficial.

3D-printed polyether-ether ketone/carboxymethyl cellulose scaffolds coated with Zn-Mn doped mesoporous bioactive glass nanoparticles.

Patient-specific fabrication of scaffold/implant requires an engineering approach to manufacture the ideal scaffold. Herein, we design and 3D print scaffolds comprised of polyether-ether-ketone (PEEK) and sodium-carboxymethyl cellulose (Na-CMC). The fabricated scaffold was dip coated with Zn and Mn doped bioactive glass nanoparticles (Zn-Mn MBGNs). The synthesized ink exhibit suitable shear-thinning behavior for direct ink write (DIW) 3D printing. The scaffolds were crafted with precision, featuring 85% porosity, 0.3 mm layer height, and 1.5 mm/s printing speed at room temperature. Scanning electron microscopy images reveal a well-defined scaffold with an average pore size of 600 ± 30 µm. The energy dispersive X-ray spectroscopy analysis confirmed a well dispersed/uniform coating of Zn-Mn MBGNs on the PEEK/Na-CMC scaffold. Fourier transform infrared spectroscopy approved the presence of PEEK, CMC, and Zn-Mn MBGNs. The tensile test revealed a Young's modulus of 2.05 GPa. Antibacterial assays demonstrate inhibition zone against Staphylococcus aureus and Escherichia Coli strains. Chick Chorioallantoic Membrane assays also present significant angiogenesis potential, owing to the antigenic nature of Zn-Mn MBGNs. WST-8 cell viability assays depicted cell proliferation, with a 103% viability after 7 days of culture. This study suggests that the PEEK/Na-CMC scaffolds coated with Zn-Mn MBGNs are an excellent candidate for osteoporotic fracture treatment. Thus, the fabricated scaffold can offer multifaceted properties for enhanced patient outcomes in the bone tissue regeneration.

Functional and union outcome of combined column tibial plateau fracture treated with hybrid external fixator.

Objective: To determine the combined column tibial plateau fracture treated with a hybrid external fixator in terms of knee functionality, union outcome and complications. METHODS: The quasi-experimental study was conducted at the Department of Orthopaedic Surgery, Mayo Hospital, Lahore, Pakistan, from July 5, 2019, to December 31, 2021, and comprised patients of either gender aged 20-50 years who presented with 2-column or 3-column fractures of proximal tibia classified according to the 3-column classification system after being diagnosed using radiographs and three-dimensional computed tomography scan. Knee function, union and complications, like neural, vascular, infection, delayed union, nonunion, malunion and implant failure, were evaluated. The Knee Society Score was used to assess knee function, and modified Rasmussen score for the union, while complications were assessed clinically on the 2nd, 6th, 12th, 16th, 24th, 36th weeks and one year post-operatively. Data was analysed using SPSS 26. RESULTS: Of the 113 patients, 91(80.53%) were males and 22(19.47%) were females. The overall mean age was 35.56±9.00 years. From the 12th week to the 24th week 45(39.83%) patients had good and 59(52.21%) patients had excellent functional outcomes. Union outcome in the 16th and 24th week was good in 57(50.44%) patients and excellent in 47(41.59%) patients. No neurovascular injury was observed. Superficial pin tract infection was observed in 21(18.6%) cases that healed with wound debridement and antibiotics. No delayed union, malunion and implant failure was observed. CONCLUSIONS: Good to excellent functional and union outcomes with minimum complications were observed with the hybrid external fixator.

Systolic blood pressure reduction strategies in acute ischemic stroke patients following endovascular thrombectomy: a systematic review and meta-analysis.

BACKGROUND AND AIMS: There is no clear consensus on ideal systolic blood pressure (SBP) target post-endovascular thrombectomy (EVT) in patients with acute ischemic stroke. This study intends to investigate the relationship between reducing SBP and clinical outcomes and to determine the therapeutic efficacy of moderate and intensive SBP reduction post EVT. METHODS: A comprehensive search was conducted across five electronic databases to identify studies relevant to our analysis. Data from these studies were then analyzed using pooled relative risk (RR) along with their corresponding 95 % confidence intervals (CI) for our categorical outcomes. functional independence at 90 days post-EVT was defined as a modified Rankin score (mRS) 0-2. RESULTS: Our meta-analysis included eight studies with 2922 patients: 1376 patients were treated with intensive SBP reduction, 306 with moderate SBP reduction, and 1243 with standard SBP reduction. There was no difference in the risk of functional independence at 90 days post-EVT with both intensive-SBP reduction (target 120-140 mmHg, relative risk (RR) =1.05, 95 % CI 0.82, 1.34, p = 0.72) and moderate-SBP reduction (>160 mm Hg) (RR= 0.95, 95 % CI 0.69, 1.31, p = 0.76) compared with standard SBP reduction (>180 mm Hg). The risk of symptomatic intracranial hemorrhage (sICH) did not significantly differ between standard-SBP reduction and intensive-SBP reduction (RR = 0.93, 95 % CI 0.66, 1.31, p = 0.36) or moderate-SBP reduction (0.72 (95 % CI [0.28, 1.87], p = 0.50) groups, respectively. Intensive-SBP reduction significantly decreased the risk of hemicraniectomy. CONCLUSIONS: We did not identify any difference in functional independence at 90 days in acute ischemic stroke patients with either intensive-SBP reduction or moderate-SBP reduction compared with standard SBP reduction post-EVT.

Students' Perception of Online Versus Face-to-Face Learning: What Do the Healthcare Teachers Have to Know?

During the COVID-19 pandemic, educational institutions confronted the possibility of complete closure and took countermeasures by adapting e-learning platforms. The present cross-sectional study quantified the impact of the pandemic on medical education using a validated and reliable tool. The tool was used to explore the perceptions of 270 healthcare students about e-learning in comparison to traditional learning systems. Inferential statistics were employed using Pearson's chi-squared test. It was found that e-learning was advantageous because of its location flexibility (46.1%) and the ease of access to study materials (46.5%). However, in-person learning was found to lead to an increase in knowledge (44.9%), clinical skills (52.7%), and social competencies (52.7%). The study concluded that while e-learning offers flexibility, traditional face-to-face teaching is deemed more effective for skill development and social interaction. Hence, e-learning should complement rather than replace traditional methods due to limitations in replicating clinical environments.

Ticagrelor Versus Clopidogrel in Endovascular Therapy for Cerebral Aneurysms: A Systematic Review and Meta-Analysis.

BACKGROUND: Antiplatelet therapy is pivotal in endovascular treatment for intracranial aneurysms. However, there is a lack of studies comparing ticagrelor to clopidogrel in patients with aneurysms undergoing endovascular therapy. Additionally, the existing literature lacks adequate sample size, significant subgrouping, and follow-up, making our study important to cover these gaps. METHODS: We searched 5 databases to collect all relevant studies. Categorical outcomes were pooled as relative risk (R.R.) with a 95% confidence interval (CI). In the single-arm meta-analysis, outcomes were pooled as proportions and their corresponding 95% CI. RESULTS: This comprehensive analysis of 18 studies involving 2,427 patients. For thromboembolic events, the pooled (R.R.) did not show significant differences, whether considering overall events. A similar pattern was observed for thromboembolic events stratified by aneurysmal rupture status, with no significant differences in overall events. Hemorrhagic events did not also exhibit significant differences in previously mentioned stratifications. Furthermore, there were no substantial differences in death and mRS (0-2) on discharge between Ticagrelor and Clopidogrel. Single-arm meta-analyses for Ticagrelor demonstrated low rates of thromboembolic events, hemorrhage, death, and favorable mRS scores, with associated confidence intervals (CIs). Main line of endovascular treatment did not significantly affect either thromboembolic or hemorrhagic outcomes with Ticagrelor and Clopidogrel. CONCLUSIONS: We found no significant differences in key outcomes like thromboembolic events, hemorrhagic events, mortality rates, and favorable mRS (0-2) upon discharge in the studied patients between Ticagrelor and Clopidogrel. Moreover, the single-arm meta-analysis for Ticagrelor revealed low rates of thromboembolic events, hemorrhage, mortality, and high rates of favorable mRS scores.

Impact of emotional intelligence in resolving clinical conflicts among postgraduate residents of surgery.

Background & Objective: Emotional intelligence (EI) can become a vital tool for resolving clinical conflicts (CC) in surgery. The postgraduate residents focus on the technical skills and undermine the soft skills required for their better training. Our aim was to determine the EI of postgraduate resident (PGR) years one & two in General and Orthopedic Surgery. The CC in their workplace and how they use their EI to resolve these conflicts. Methods: This mixed-method study was conducted from March 10, 2019 to May 28, 2020 at Departments of General and Orthopedic Surgery, Mayo Hospital, Lahore. The study was conducted in two phases 1 & 2. In Phase-1, one hundred PGR years one & two were administered the Mayor-Salovey-Caruso Emotional Intelligence test (MSCEIT) to measure EI. In phase-2, semi-structured in-depth interviews of 10 PGRs five with high and five with low EI were conducted to determine the CC and use of EI to resolve the CC at the workplace. A thematic analysis was done. Results: Out of 100 PGR, the mean EI score was 46.25±14.8 with a maximum score of 75.4, and a minimum score of 18.16 (p-value =0.775). Ninety-one (91%) have not improving EI, and 09 (09%) have considered developing EI. Five themes in four settings, including emergency, ward, elective operation theatre, and outpatient department (OPD) were determined. The emerged themes for the CC were nepotism, gender biases, burnout, lack of professionalism, and toxic culture. The following were CC management strategies: self-study, deceit, gender affinity, performing attention-attaining work, aggrieved reaction and being disgruntled when alone. Conclusion: None of the PGR was emotionally intelligent in overall grades, as well as a particular aspect of MSCEIT.

Structural and molecular investigation of the impact of S30L and D88N substitutions in G9R protein on coupling with E4R from Monkeypox virus (MPXV).

Understanding the pathogenesis mechanism of the Monkeypox virus (MPXV) is essential to guide therapeutic development against the Monkeypox virus. In the current study, we investigated the impact of the only two reported substitutions, S30L, D88N, and S30L-D88N on the G9R of the replication complex in 2022 with E4R using structural modeling, simulation, and free energy calculation methods. From the molecular docking and dissociation constant (KD) results, it was observed that the binding affinity did not increase in the mutants, but the interaction paradigm was altered by these substitutions. Molecular simulation data revealed that these mutations are responsible for destabilization, changes in protein packing, and internal residue fluctuations, which can cause functional variance. Additionally, hydrogen bonding analysis revealed that the estimated number of hydrogen bonds are almost equal among the wild-type G9R and each mutant. The total binding free energy for the wild-type G9R with E4R was -85.00 kcal/mol while for the mutants the TBE was -42.75 kcal/mol, -43.68 kcal/mol, and -48.65 kcal/mol respectively. This shows that there is no direct impact of these two reported mutations on the binding with E4R, or it may affect the whole replication complex or any other mechanism involved in pathogenesis. To explore these variations further, we conducted PCA and FEL analyses. Based on our findings, we speculate that within the context of interaction with E4R, the mutations in the G9R protein might be benign, potentially leading to functional diversity associated with other proteins.Communicated by Ramaswamy H. Sarma.

Unmasking the Unforeseen: A Case of Radiological Tension Empyema Mimicking a Traumatic Hemothorax.

We present a case of a previously fit and well 28-year-old male who presented to the emergency department with respiratory distress and hypoxia four days after an alleged assault and blunt-force trauma to the chest wall. Initial clinical assessment and imaging suggested a likely diagnosis of delayed massive hemothorax associated with mediastinal shift. However, upon chest drain insertion, a large amount of pus was unexpectedly drained, leading to an immediate improvement in symptoms and restoration of mediastinal anatomy on repeat imaging. Our case illustrates that, although rare, empyemas can reach a significant volume before detection; they are capable of producing radiological and clinical intrathoracic tension configuration and can mimic hemothorax in the setting of trauma.

The local medicinal plant knowledge in Kashmir Western Himalaya: a way to foster ecological transition via community-centred health seeking strategies.

BACKGROUND: The mountainous region of Kashmir is a biodiversity hotspot, with diverse local communities and a rich cultural history linked to nature. Mountain ecosystems are highly vulnerable to climate change. This study emphasises the need to record the indigenous ethnoecological knowledge of wild plants used for the treatment of various ailments at higher elevations in remote areas where globalisation poses a threat to this traditional knowledge. METHODS: The field survey was carried out in 2020-2022, to collect data on wild medicinal plants. Informants were selected randomly to collect indigenous medicinal knowledge using semi-structured interviews and group discussions. Various quantitative indices were employed to evaluate ethnomedicinal data. RESULTS: A total of 110 medicinal plants belonging to 49 families were recorded in the study area. These medicinal plants are extensively used by local communities for the treatment of 20 major disease categories. Asteraceae was the dominant family contributing (9.09%) to medicinal plants, followed by Polygonaceae (8.18%), Apiaceae (7.27%), Lamiaceae (5.45%), and Ranunculaceae (5.45%). We observed 166 remedies were used for the treatment of various diseases in humans, and 9 remedies were used for animals. The most frequently used medicinal remedy was tea or decoction (30.91%). Among the medicinal plants, herbs (85.5%) were most frequently used by the local populations of Kashmir, whereas leaves (10.26%) were used for the treatment of various ailments. Out of 110 species, 31 were endemic, 15 of which are endemic to the Kashmir region and 16 to the Western Himalaya. The highest RFC value was reported for Allium humile (0.77), the highest UV value for Fritillaria cirrhosa (1.33), and the highest ICF value for gastro-intestinal/digestive disorders (0.85). CONCLUSIONS: Local communities still rely on wild medicinal plants for primary healthcare. These communities retained valuable indigenous knowledge, which needs to be preserved for the conservation and sustainable utilisation of natural resources. Further field exploration is required to fully explore indigenous knowledge in the mountainous regions of Kashmir, and this knowledge has the potential to support the ongoing ecological transition.

Effectiveness Of Neuro Mobilisation On Pain, Range Of Motion, Muscle Endurance And Disability In Cervical Radiculopathy: A Systematic Review.

Objective: To assess the effects of the neural mobilisation technique on mobility, pain and disability in cervical radiculopathy patients, and to assess the functional activity level. METHODS: The systematic review was conducted from January 5 to July 5, 2022, and comprised search on Medline, PEDro, Cochrane Library and Embase databases for randomised controlled trials involving patients diagnosed with cervical radiculopathy that were published in the preceding 10 years in the English language. The search terms were divided into four classes by using the guideline for systematic reviews of trials of interventions in the Cochrane neck and back groups and related spinal disorders. Data wasretrieved afterthe studies were subjected to quality assessment and risk of biasness. RESULTS: Of the 1563 studies initially found, 8 (0.51%)were reviewed.Nomatter the approach ordosage used,manual therapy was successful in treating cervical radiculopathy symptomsin all investigations. Conclusion: A multimodal strategy incorporating neural mobilisation appears to be the most successful short-term technique.

Lead Toxicity-Mediated Growth and Metabolic Alterations at Early Seedling Stages of Maize (Zea mays L.).

To investigate the toxic effects of lead (Pb) on key metabolic activities essential for proper germination and seedling growth of maize seeds, experiments were carried out with different levels of Pb (0 to 120 mg of Pb L-1 as PbCl2) applied through growth medium to two maize hybrids H-3310S and H-6724. The research findings indicated that growth and metabolic activities were adversely affected by increased Pb contamination in growth medium; however, a slow increase in these parameters was recorded with increasing time from 0 to 120 h. Protease activity decreased with an increase in the level of Pb contamination but increased with time; consequently, a reduction in seed proteins and an increase in total free amino acids were observed with time. Similarly, α-amylase activity decreased with an increase in Pb concentration in growth medium while it increased with increasing time from 0 to 120 h; consequently, reducing and non-reducing sugars increased with time but decreased with exposure to lead. The roots of both maize hybrids had higher Pb contents than those of the shoot, which decreased the uptake of nitrogen, phosphorus, and potassium. All these nutrients are essential for optimal plant growth; therefore, the reduction in growth and biomass of maize seedlings could be due to Pb toxicity that altered metabolic processes, as sugar and amino acids are necessary for the synthesis of metabolic compounds, rapid cell division, and proper functioning of enzymes in the growing embryo, but all were dramatically reduced due to suppression of protease and α-amylase by toxicity of Pb. In general, hybrid H-3310S performed better in Pb-contaminated growth medium than H-6724.

The Efficacy and Safety of Ivabradine in Arrhythmias: A Systematic Review

Background: Treating arrhythmia adequately is crucial to prevent cardiac morbidity and mortality. Previous studies report that ivabradine may increase the risk of atrial fibrillation; however, emerging evidence shows that the drug may have beneficial effect in treatment of arrhythmia. Purpose: The present research explored the clinical evidence regarding the clinical efficacy and safety of ivabradine to treat arrhythmias. Method: A comprehensive literature search was conducted using MEDLINE, EMBASE, Scopus, Google Scholar and Web of Science databases. Full text articles that report on the use of ivabradine in human subjects with arrhythmia are included. Studies not written in English language and those not published in the period between 2016 and May 2021 were excluded. Results and discussion: Eight articles were included in the current review after screening a total of 1100 articles. The studies depicted that ivabradine is effective in improving ventricular rate, heart rate, and sinus rhythm in atrial fibrillation and has limited or no side effects. In addition, the findings indicate that combining ivabradine with other medications is more effective for improving the ventricular rate and maintain sinus rhythm than when used alone. Conclusion: Ivabradine alone or in combination with other medications can therefore be used as a potential treatment for arrhythmias. (AU)

Mechanical thrombectomy in patients with acute ischemic stroke in the USA before and after time window expansion.

BACKGROUND: In 2018, the time window for mechanical thrombectomy eligibility in patients with acute ischemic stroke increased from within 6 hours to within 24 hours of symptom onset. The purpose of this study was to evaluate the effect of window expansion on procedural and hospital volumes and patient outcomes at a national level. METHODS: We conducted a retrospective cohort study of patients with acute ischemic stroke undergoing mechanical thrombectomy using data from the National Inpatient Sample. We compared the numbers of mechanical thrombectomy procedures and performing hospitals between 2017 and 2019 in the USA, and the proportion of patients discharged home/self-care, those with in-hospital mortality and post-procedural intracranial hemorrhage (2019 vs 2017) after adjustment for potential confounders. RESULTS: The number of patients with ischemic stroke who underwent mechanical thrombectomy increased from 16 960 in 2017 to 28 120 in 2019. There was an increase in the number of hospitals performing mechanical thrombectomy (501 in 2017, 585 in 2019) and those performing ≥50 procedures/year (97 in 2017, 199 in 2019; P<0.001). The odds of in-hospital mortality decreased (OR 0.79, 95% CI 0.66 to 0.94, P=0.008) and the odds of intracranial hemorrhage increased (OR 1.18, 95% CI 1.06 to 1.31, P=0.003) in 2019 compared with 2017, with no change in odds of discharge to home. CONCLUSIONS: The window expansion for mechanical thrombectomy for patients with acute ischemic stroke was associated with an increase in the numbers of mechanical thrombectomy procedures and performing hospitals with a reduction of in-hospital mortality in the USA.

Synthesis, Characterization, and Antimicrobial and Nematicidal Activities of Chitosan-Based Silver-Doped Titanium Dioxide.

Chitosan (Cs)-based silver-doped titanium dioxide (Cs-AgTiO2) films were synthesized intending their end-use application in food packaging. AgTiO2 NPs were successfully prepared by using electrochemical synthesis. Cs-AgTiO2 films were synthesized by using the solution casting technique. Various advanced instrumental techniques such as scanning electron microscopy (SEM), X-ray diffraction analysis (XRD), transmission electron microscopy (TEM), and Fourier transform infrared spectroscopy (FT-IR) were used for the characterization of Cs-AgTiO2 films. Intending their food packaging applications, samples were further investigated to obtain varied biological results including antibacterial (Escherichia coli), antifungal (Candida albicans), and nematicidal activities. Ampicillin (E. coli) and fluconazole (C. albicans) were used as models. FT-IR and XRD confirm the structural modification of Cs. IR peak shifting was observed, which confirmed that AgTiO2 interacted with chitosan via amide I and amide II groups. This confirmed the stability of the filler in the polymer matrix. SEM also confirmed the successful incorporation of AgTiO2 NPs. Cs-AgTiO2 (3%) shows excellent antibacterial (16.51 ± 2.10 µg/mL) and antifungal (15.67 ± 2.14 µg/mL) activities. Nematicidal assays were also done, and Caenorhabditis elegans (C. elegans) was used as a model organism. Cs-AgTiO2 NPs (3%) exhibited excellent nematicidal potential (64.20 ± 1.23 µg/mL), which could make these films a suitable novel material to control nematode spread in food.

Corrigendum: Effects of breathing re-education on endurance, strength of deep neck flexors and pulmonary function in patients with chronic neck pain: A randomised controlled trial.

[This corrects the article DOI: 10.4102/sajp.v78i1.1611.].

Retrospective study on clinical efficacy of Evolocumab in highrisk ASCVD patients

Objective: This study evaluated the effectiveness of Evolocumab by measuring achievement target LDL-C among high-risk ASCVD patients in the UAE. Method: A retrospective observational study included 27 patients with high-risk ASCVD receiving Evolocumab 140 mg/mL SC injection every 2 weeks. The effectiveness of Evolocumab is measured by the mean reduction in LDL-C levels from baseline and achieving target LDL levels according to ECS/EAS guideline during average follow up period. Results: The average (SD) age of the patients is 52 (10) years. Majority of the patients were male (n=22), smokers (40.9%), overweight or obese (78%), had a history of hypertension (59.3%), MI (55.5%) and diabetes (40.7%). The patients were on Evolucomab therapy due to persistently elevated LDL-C (n=25) or statin intolerance (n=2). During the average follow up period of 42 weeks,14 patients (51%) achieved target LDL-C level. During this period, LDL-C and TC levels reduced from 3.51(1.3) mmol/L to 1.9 (1.2) mmol/L and from 4.97 (1.4) mmol/L to 1.62 (1.09) mmol/L, respectively post Evolocumab therapy. Conclusion: The reduction was statistically significant. However, the reduction of TG levels and the increase in HDL level was not significant. Evolocumab reduces LDL-C and TC levels significantly in high-risk ASCVD patients in a tertiary hospital in the UAE population. (AU)

Antibiotic prescribing and dispensing behavior among doctors and pharmacists working in UAE

Objectives: This study aims to determine the level of knowledge, attitude, and practice of doctors and pharmacists on antibiotic use in a group of Thumbay healthcare facilities in the UAE. Methods: This cross-sectional questionnaire-based survey included a convenience sample of doctors and pharmacists at Thumbay-related hospitals and clinics. The survey was sent online and it has a section on knowledge, attitude, and practice-related to antibiotics and barriers and facilitators of good antibiotic use. Results: This survey included 61 participants (doctors (n=27) and pharmacists (n=34)) with the age ranging between 26 to 60 years (mean age=37). More than half of the respondents were female (55.4%). Most of the participants (89%) agree that of antimicrobial resistance is a global problem. The majority of the participants agreed that antimicrobial stewardship programs can reduce antimicrobial resistance. Similarly, most of the participants feel confident about their knowledge and practice in the area of antimicrobial prescribing (81%), and they always or often (86.8%) use guidelines in their daily practice when prescribing or dispensing antibiotics. Similarly, 82% claimed that a policy that limits the prescribing of selected antibiotics to certain clinical indications via an approval process is introduced in their setting 82%. The top five cited barriers that hinder appropriate prescribing and dispensing of antibiotics include limited knowledge or confidence to discuss rational antibiotics use (72.1%), lack of incentives for appropriate prescribing or dispensing (68.9%), lack of interest by patients to receive counseling (68.9%), time limitations (62.3%) and presence of diagnostic uncertainties (62.3%). (AU)