Accuracy of Clinical and Imaging Tests for the Diagnosis of Hip Dysplasia and Instability: A Systematic Review.

BACKGROUND: Evidence concerning the accurate clinical or imaging methods to diagnose hip instability or hip dysplasia is currently scarce. OBJECTIVE: To summarize the diagnostic accuracy of clinical and imaging tests for the diagnosis of hip dysplasia and instability. METHODS: A computer-assisted literature search of the MEDLINE, CINAHL, and Embase databases, using key words related to diagnostic accuracy of the hip joint, was conducted on March 6, 2018. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the searching and reporting phases of the study. Quality assessment of bias and applicability was conducted using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Diagnostic accuracy, including sensitivity, specificity, likelihood ratio, and 95% confidence interval, was summarized. RESULTS: Out of 3109 citations, 7 articles were included. Two studies reported on 5 clinical tests for hip instability and 5 studies reported on 5 radiographic measures for hip dysplasia. Only 1 study was not of low methodological quality. The prone instability test moderately improved positive posttest probability by 38% to diagnose hip instability. The Shenton line moderately to highly improved posttest probability by 41% to 60% to diagnose hip dysplasia. CONCLUSION: This systematic review summarizes the diagnostic accuracy of various clinical tests and radiographic measures for hip instability and hip dysplasia. Further high-quality studies are necessary to examine the diagnostic accuracy of the clinical examination and radiography to assist in ruling in or ruling out the diagnoses of hip dysplasia and instability. Consensus is required to standardize the definitions of these diagnoses and their reference standards. The study was registered with the International Prospective Register of Systematic Reviews (CRD42018089019). LEVEL OF EVIDENCE: Diagnosis, level 3b. J Orthop Sports Phys Ther 2019;49(2):87-97. Epub 30 Nov 2018. doi:10.2519/jospt.2019.8476.

Assessment of Total Antioxidant Capacity and Antimicrobial Activity of Glycyrrhiza glabra in Saliva of HIV-Infected Patients.

OBJECTIVES: The objectives of this study were to evaluate the antimicrobial activity and total antioxidant capacity (TAC) of licorice in Saliva of HIV/AIDS patients. MATERIALS AND METHODS: Saliva specimens were collected from 20 people living with HIV infection, with CD4 count <500 cells/mm3 from people infected with HIV/AIDS in Mangalore city, India. A combination of amoxicillin-clavulanic acid and nystatin was taken as the positive control and normal saline as negative control. Results were compared using one-way analysis of variance followed by Tukey's post hoc analysis in SPSS 19. RESULTS: The TAC was evaluated spectrophotometrically at 695nm using the phosphomolybdenum method. Glycyrrhiza glabra showed a statistically significant reduction (P < 0.05) in total Candida count. The TAC of G. glabra was found to be 4.467 mM/L. CONCLUSIONS: G. glabra extracts showed good anticandidal activity and also high antioxidant property which reduces the oxidative stress of HIV-infected people.

Screening in Public Health and Clinical Care: Similarities and Differences in Definitions, Types, and Aims - A Systematic Review.

INTRODUCTION: The concept of screening can be many times misleading to many people. This may be partly due to the way screening is described and explained in textbooks and journal articles. AIM: To review prominent public health and epidemiology textbooks, dictionaries, and relevant journal publications for definitions and examples of screening, with the aim of identifying common usages and concepts, as well as sources of potential confusion. MATERIALS AND METHODS: Commonly available epidemiology and public health textbooks and peer reviewed journals were searched for definitions and examples of screening. The search located seven journal articles, 10 textbooks, and one dictionary. The search platforms used were Pubmed, BIOSIS, EMBASE, Medline-OVID and Scopus under the Epidemiology and Biostatics subject head listed with Life Sciences. RESULTS: Descriptions of screening give varying emphasis to whether it is a test or a program, the aims of screening, the setting in which it is conducted, eligibility criteria, who initiates and who is intended to benefit and whether the condition being screened is an infectious or chronic disease or a risk-elevated state. Four essentially different 'types' of screening are described, using seven terms and occasionally contradictory examples. The detection of asymptomatic infectious cases is gradually changing from screening to surveillance as part of infection control. CONCLUSION: Voluntary screening programs rely on high participation to be effective and support and trust of the public are essential for the continued success of the public health profession. Consistent terminology is important for patients, providers and policymakers to understand what screening is and is not. Clear definitions are needed if we are to evaluate and communicate the risks and benefits of screening in public health.