Cureus

IntroductionIn recent time, developing countries of South Asia and Africa have seen significant increase in ingestion of Para-Phenylene Diamine (PPD), locally known as Kala Pathar, either accidental or for suicide. Through this study, we aim to study the clinical presentations and outcomes among patients who have ingested PPD. MethodThis retrospective case series study was conducted in a tertiary care hospital of Pakistan, from April 2013 to August 2017. Data of patients of PPD poisoning was archived from the hospitals medical records. Around 174 consecutive cases were included in the study. Patients were evaluated based on self-administrated proforma. ResultOut of 174 cases of PPD poisoning that were identified, 57(32.8%) were males and 117(67.2%) were females. The mean age {+/-} SD (range) of the patients was 24.16{+/-}9 (10 to 70) years. Approximately 170 (97.8%) patients used PPD for suicidal intention. The most common presentation was facial swelling which was present in 144(82.8%) patients followed by dysphagia in 143(82.2%) patients. Complications include metabolic acidosis in 50 (28.7%) patients and aspiration pneumonia in 36 (20.7%) patients. A total of 101 (58%) improved, while others were either referred or left against medical advice (LAMA). ConclusionIncreasing incidence of ingestion of PPD for suicide warrants the regulatory authorities to restrict the use of PPD in hair dyes and implement strict measures to educate masses and curtail the easy access of such poisonous substances among common people.

Burns are an important public health issue, related to 11 million cases annually around the world and up to 180 thousand direct or indirect deaths. Thus, it is vitally important to understand the effectiveness of the different products commercialized for the treatment of burn injuries. ObjectivesTo analyze the effectiveness of products used in the treatment of superficial-type partial-thickness burn injuries. MethodsThis is a systematic review, using the PICO strategy, with a search period between 2004 and 2020, consulting the COCHRANE Library, Lilacs, Medline, PubMed and Scielo databases. The inclusion criteria were studies that used commercialized products for the treatment of superficial-type partial-thickness burn injuries in humans. To assess the quality and risk of bias of the studies, the Oxford scale and criteria from the Cochrane Guidelines were used. Results19 eligible studies were selected, most of the products were presented as an alternative to the traditional treatment that involves the use of the silver sulfadiazine product. The methodological quality of the studies allowed performing a meta-analysis of only 2 studies, evaluating the healing outcome, the low number of studies included for statistical analysis suggests that it is not possible to conclude which product is more effective. ConclusionsThere is a limitation in the available studies that address the costs and outcomes of existing interventions for the treatment of burns. Future research should develop systematic, valid measures in order to obtain an analytically and statistically adequate result.

Tranexamic acid is a medication typically used to prevent excessive blood loss in the setting of trauma, surgery, and menstrual cycles. Administration of tranexamic acid within the first three hours of trauma has been shown to reduce blood loss and mortality in patients. [1] Tranexamic acid is also commonly used during heavy menstrual bleeding or postpartum hemorrhage cases in which administration has been shown to reduce bleeding in patients. [2] Although there have been studies conducted on the effects of tranexamic acid on blood loss during various surgeries, this systematic review aims to understand the effects specifically on patients undergoing coronary artery bypass grafting (CABG), a common procedure known to have significant blood loss. A systematic review using the PubMed database on the use of tranexamic acid in blood loss for patients undergoing CABG was conducted with the hypothesis that tranexamic acid administration reduces perioperative and postoperative blood loss. This systematic review includes 8 papers from the years 1997-2018 which report on a total of 712 patients. Although significant large, randomized, control studies on the topic are still pending, this systematic review of studies conducted thus far can conclude that tranexamic acid has a positive effect on reducing blood loss in patients undergoing CABG.

More than half of the fingertip injuries in children are due to door jamming injuries.1)2) There have been several studies on door crush injuries (DCI) but they pertain to either the paediatric age group or form a part of study of fingertip injuries in a large population. This article caters solely to studying the epidemiology, mechanism of injury, associated risk factors and suggests few simple techniques to avoid DCI. MaterialsComparative analysis of the epidemiological data of all the patients with door crush injuries who presented to the Emergencies and the Out Patient Department in the Tertiary care centre was obtained from the MRD. This is a retrospective cohort study between January 2021 to December 2021. Patients with serious concomitant injuries, machine crush injury, heavy falling objects, window crush injury were excluded from the study. ResultsOf the 34 patients, 27 were male and 7 females. In 33 patients DCI was in the hinge side while only 1 had lock-side, entrance door being the commonest. 35% had first-aid done in a local nursing home before arriving at the hospital. 4 patients left against medical advice, 4 were conservatively treated and 2 had double finger injury. DCI was most common in preschool children. Right side and middle finger were most susceptible. 25% of the injuries happened on Mondays. Of the 36 fingers injured, 69% had pulp, 58% had nailbed and 22% had bony involvement. Primary suturing, local flap cover and K-wiring were the main modalities of treatment. Complications included altered sensation, nail deformity and contracture. ConclusionDoor crush injury is a major contributor for finger crush injuries in both children and adults. Awareness among parents, the use of safety appliances to prevent accidental door closing, counselling by doctors and nurses greatly help to bring down the number of door crush injuries.

2.IntroductionPatients with acute renal failure requiring hemodialysis should use temporary hemodialysis catheters (THC) due to the urgency and potential reversibility of the condition. So far, three studies in North America indicate a higher risk of catheter-related issues in COVID-19 patients needing hemodialysis. This study examines the functionality and complications of temporary hemodialysis access in COVID-19 patients at a Brazilian hospital. MethodologyA prospective analysis was conducted at a COVID-19 referral center between May and July 2020. During this time, the Vascular Surgery team implanted temporary hemodialysis catheters in 107 patients. The patients were followed, and demographic and clinical characteristics that could be correlated with catheter malfunction were analyzed. ResultsOf the 107 patients studied, 22 (20,6%) experienced complications related to the catheter. Eighteen (16,8%) had malfunctions, and 4 (3,7%) had infections. Five patients evolved with unfavorable clinical conditions and did not undergo catheter replacement. Thirteen patients with malfunctions had catheter tip thrombosis as the cause of the malfunction. Among the variables analyzed, only the need for orotracheal intubation (p 0,009), deep vein thrombosis (p 0,01), and a history of a previous catheter (p 0,002) were found to be correlated with a higher risk of malfunctioning. ConclusionThe rate of temporary high-flow catheter malfunction in patients with COVID-19 is similar to that in patients without this disease. Previous catheter use, the necessity for OTI, and venous thrombosis were the main predictors of catheter malfunction.

IntroductionPeri-prosthetic Joint Infection (PJI) after total knee arthroplasty (TKA) is a devastating complication. Intra-wound vancomycin powder has been shown to reduce infection rates in spine surgery. Previous studies on the efficacy of local vancomycin powder in hip or knee arthroplasty are mostly retrospective case series. The aim of this prospective RCT was to evaluate the efficacy and safety of intrawound vancomycin in preventing PJI after primary TKA. MethodsThis study was a National Trial Registry-approved RCT of patients undergoing primary TKA. 1022 patients were randomized to the study group (n=507, received 2g intrawound vancomycin powder before arthrotomy closure) and control groups (n=515, no local vancomycin). The minimum follow-up was 12-months. The primary outcome was PJI rate. Secondary outcomes included surgical site infection (SSI) rates, incidence of revision for PJI/SSI, and incidence of wound complications. High-risk groups (Obesity and Diabetes) in both cohorts were also evaluated. ResultsThe overall infection rate in 1022 patients was 0.66%. There was no significant difference in PJI rate in the study group (0.2%) versus the control group (0.58%), p=0.264. Reoperation rates in the study group (N=4;0.78%) and Control (N=5;0.97%) and SSI rates in the study (N=1;0.2%) and control groups (N=2;0.38%) were comparable. The Vancomycin cohort however demonstrated a significantly higher number of minor wound complications (n=67;13.9%) compared to the control group (n=39;8.4%, p<0.05). There was no difference in PJI/SSI rates or minor surgical complications among high-risk groups and no cases of nephrotoxicity were reported in the study. ConclusionIntra-wound vancomycin powder does not appear to reduce PJI/SSI rate in primary total knee arthroplasties, including high-risk groups. Although safe from a renal perspective, intra-wound vancomycin was associated with an increase in postoperative aseptic wound complications such as persistent wound drainage. Intra-wound vancomycin may not be effective in reducing the rate of PJI in primary TKA.

BackgroundThe aim of this study was to evaluate the change in the position of totally implantable venous catheters (TIVC) tips in patients with mammary hypertrophy, comparing them to patients without this condition in both the supine and upright position. MethodsThis was a prospective study involving consecutive patients who underwent the implantation of totally implantable central venous catheters (TIVC) in internal jugular or subclavian veins with reservoir placement on the thoracic wall. Data were collected with regard to demographic and clinical features of the included patients, including: age (years), height (cm), weight (Kg), BMI, malignancy type, occurrence of previous non-deforming procedures to the breasts, presence of a Peripherally Inserted Central Catheter (PICC) during TIVC implantation, and history of DVT (punctured vein and laterality). The catheter tips position in an upright stance was documented through a routine postoperative chest X-ray, using a posterior-to-anterior incidence technique, also including a radiopaque ruler permitting the measuring of its distance from the carina in centimetres. The intraclass correlation coefficient between the intraoperative and postoperative distance variation recorded by Observers 1 and 2 was excellent (r =0.773). ResultsSignificant caudal TIVC tip displacement was determined by previous nondeforming surgery to the chest wall (p=0.002); and significant proximal displacement was calculated by the presence of PICC during TIVC implantation (p =0.042). The Sacchini index did not exhibit a significant association with changes in catheter tip locations after surgery. ConclusionSignificant caudal TIVC tip displacement was determined by previous non-deforming surgery to the thoracic wall (p=0.002); and significant proximal displacement was determined by the presence of a PICC during TIVC implantation (p=0.042). Mammary hypertrophy, as assessed by the Sacchini index, was not statistically correlated to catheter tip displacement (p=0.612).

The selective alpha-2 adrenoreceptor agonist medetomidine is commonly used as a component of combination solutions for general anesthesia in rodents and small animals. However, it has also been reported to increase the risk of obstructive uropathy in male mice. Here we report that in a recent cohort of mice undergoing two sequential surgical procedures using the anesthetic combination of fentanyl, midazolam and medetomidine (FMM) for general anesthesia, 60% of the male mice developed severe obstructive uropathy within 48 hours of the second surgery. We also report one case of an older male mouse developing severe obstructive uropathy after a single general anesthesia with FMM. In a subsequent pilot study involving five male mice undergoing similar surgical procedures, also with two sequential surgeries, but using xylazine as the alpha-2 adrenoreceptor agonist in the narcotic combination, none of the animals developed obstructive uropathy in the post-operative period or thereafter. We suggest that replacement of medetomidine with xylazine should be considered for general anesthesia in male mice undergoing multiple successive anesthesia events or in for procedures in older males.

Previous studies have shown that the use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with increased stress fracture risk, potentially due to diminished skeletal adaptation. This phenomenon has been studied predominantly in high-activity individuals like dancers, athletes, and soldiers, so current data regarding the general population is limited despite the substantial economic and resource burden of stress fracture injuries within the general US population. Furthermore, our preclinical studies demonstrate that regular use of NSAIDs also diminishes the intrinsic ability of bone to resist fracture. To determine the association of regular NSAID use with stress fractures in the general population, we surveyed subjects presenting with either stress fracture or uncomplicated ankle sprain to assess their use of NSAIDs over the three months before their injury. We hypothesized that subjects with stress fractures would have increased regular NSAID usage as compared to controls. Subjects diagnosed with a stress fracture (n=56) and subjects with uncomplicated ankle sprains (n=51; control) were surveyed about their NSAID use at the time of their diagnosis and in the previous three months using a questionnaire based on the National Health and Nutrition Examination Survey (NHANES). Subjects were surveyed in person on the day of their injury diagnosis or by phone within 30 days of their injury diagnosis. Fishers exact test was used to determine significant differences in NSAID usage between stress fracture and control subjects. Subjects diagnosed with stress fractures had a statistically significant increase in both current use (p=0.03) and regular use (p=0.04) of ibuprofen/naproxen/celecoxib as compared to control subjects. There were no significant differences in the use of aspirin, acetaminophen, or prescription medications containing acetaminophen between groups. Consistent with previous clinical reports, we observed a strong correlation between regular ibuprofen/naproxen/celecoxib use and stress fracture incidence in the general population. These results indicate that any patients at high risk for stress fracture should avoid regular use of ibuprofen, naproxen, or celecoxib. KEY POINTSO_LIThis retrospective case-control study found that use of ibuprofen, naproxen, and/or celecoxib by subjects within the general population three or more times per week for three months (regular use) was highly associated with stress fracture diagnosis. C_LIO_LINo significant correlation between stress fracture diagnosis and the use of acetaminophen, aspirin, or prescription drugs containing acetaminophen was found. C_LIO_LIPooled analysis of all surveyed drugs indicated a strong association between stress fracture diagnosis and NSAID or acetaminophen usage in the general population, consistent with previous work done in US Army soldiers and athletes. C_LIO_LIDue to the differences in mechanisms of action of the drugs surveyed in this study, future work is needed to conclude which NSAID, if any, is safest for regular use by those at higher risk of stress fracture formation. C_LIO_LIThe findings of this study highlight the need for future studies to include subjects from the general population in addition to high-activity subjects as they indicate that these individuals are also at higher risk of stress fracture formation with regular NSAID use. C_LI

BackgroundSacral dysmorphism refers to morphological variations found in the first two sacral segments that limit the safe placement of percutaneous sacral iliac screws. The prevalence is documented in European, North American and some Asian populations. However, studies within the African population including Kenya are lacking. The aim of the study was to describe the patterns of sacral dysmorphism in pelvic computerized tomography (CT) scans at a national referral hospital in Kenya. MethodsA cross-sectional study carried out at the Radiology Department, Kenyatta National Hospital from March 2020 to March 2021 involving the radiographic evaluation of 293 stored abdominal pelvic CT scans of patients. Sacral dysmorphism was identified based on the sacral dysmorphism score >70 and the presence of any of the six morphological features of sacral dysmorphism. ResultsA sacral dysmorphism score of more than 70 was found to in 64% of the population. The prevalence of dysmorphic sacra (based on the presence of at least one qualitative feature) was 100%. The most prevalent feature of sacral dysmorphism was the lack of recession of the S1 segment (82%) followed by an unfused sacral segment (76%). Of note is that some qualitative features of sacral dysmorphism were protective against a high sacral dysmorphism score. There was no statistical significance of gender in sacral dysmorphism. ConclusionThere is a high prevalence of sacral dysmorphism score in this population. There is a need for further studies to revisit the concept of dysmorphic sacra based on the presence of at least one qualitative feature as all our participants had at least one feature.

IntroductionCancer outcome is largely determined by stage at diagnosis. We hypothesised that people living in Low- and Middle-Income Countries may be reaching diagnosis at an early stage, reflecting growth in awareness of the disease and its symptoms. We examined stage at diagnosis for four common cancers presenting at a referral centre in Nigeria. MethodsA retrospective review of case-records from cases treated for four common cancers (colorectal, uterine cervix, breast and prostate) at University College Hospital, Ibadan over two epochs: 2012-2013 and 2017-2018. ResultsThere is no evidence that cases were diagnosed at an earlier stage in the later epoch. Seventy-five percent of cases were diagnosed at late stage (III or IV) in the second epoch, vs seventy percent in the first epoch. ConclusionThere is no evidence in the data that the problem of late presentation of common cancers is reducing in Oyo State, Nigeria.

BackgroundPatients with opioid use disorder are at a higher cardiovascular risk due to the effect of opioids on the cardiovascular system. Cardiac conduction abnormalities, electrical activity impairment, cardiac arrhythmias, and ventricular hypertrophy are reported in the opioid population. ObjectiveThis study aimed to assess the prevalence and factors associated with ECG abnormalities among adults with opioid use disorder attending the Itega addiction center for methadone-assisted therapy (MAT). MethodologyA cross-sectional analytical study was conducted among adult outpatients attending the Itega addiction center in Dodoma. A calculated sample size of 321was attained through a convenience sampling approach. A standard 12-lead ECG was recorded for each participant and interpreted by two independent cardiologists. Univariate and multivariable logistic regression was computed to determine the factors associated with ECG abnormalities. Under adjusted analysis, a p-value of less than 0.05 was considered significant for factors associated with ECG abnormalities after controlling for all the variables with a minimum p-value of 0.2 at univariate analysis. ResultsThe majority of 308 (95.95%) of the participants were males, 197 (61.37%) had attained primary education level, and the mean age of the participants was 35.44 {+/-} 6.54 years. The overall prevalence for any ECG abnormalities in this study was 26.47%, with Sinus bradycardia 59(18.4%) being the most observed ECG abnormality, followed by QTc prolongation 27(8.41%). A months increase in the duration on MAT and being a female were significantly associated with lower odds of ECG abnormalities (AOR =0.85, 95% CI =0.74-0.96 p =0.014) and (AOR = 0.05, 95% CI = 0.01-0.59, p = 0.017) respectively. ConclusionThe high prevalence of ECG Abnormalities implies high cardiovascular risk among a population with opioid use disorder. Given that majority of the ECG abnormalities are treatable, integrating cardiovascular care in the opioid addiction clinic would be beneficial for this population.

Background/ AimThis study is a prospective, randomized controlled clinical study investigating the effect of using a dichotomous pain scale on post-operative opioid use in patients undergoing anterior cruciate ligament (ACL) reconstruction compared with the standard of using a 10-pt VAS scale. The primary objective was to determine whether the use of a dichotomous pain scale would reduce the consumption of opioids within the first two weeks after surgery. MethodsTwenty-nine patients undergoing outpatient ACL reconstruction were randomly assigned to either the Binary (n=14) or Scale (n=15) group and completed a survey every day for two weeks after surgery. The Binary group was asked whether their pain was "tolerable" or "intolerable." The Scale group was asked to rate their pain on a scale from zero to ten, as per standard of care. ResultsPatients in the Scale group on average consumed approximately twice the number of morphine milligram equivalents per day than the Binary group (p=0.03). Two weeks after surgery, there was no significant difference between patient satisfaction nor average knee range of motion between groups (p=0.63, p=0.08). ConclusionsThe results from this study suggest that using a dichotomous tolerability-based pain scale instead of the NPRS could serve as one strategy to reduce opioid use in the post-operative period.

IntroductionProstatic malignancy is a major cause of morbidity and fatality among men around the globe. More than a million new cases of prostatic cancer are diagnoses annually. The incidence of prostatic malignancy is rising and it is expected that more than two million new cases of prostatic carcinoma will be diagnosed in 2040. The application of machine learning to assist the histopathologists could be a very valuable adjunct tool for the histological diagnosis of prostatic malignant tumors. Aim & ObjectivesTo evaluate the effectiveness of artificial intelligence for the histopathological diagnosis of prostatic carcinoma by analyzing the digitized pathology slides. Materials & MethodsEight hundred and two (802) images in total, were obtained from the anonymised slides stained with hematoxylin and eosin which included anonymised 337 images of prostatic adenocarcinoma and 465 anonymised images of nodular hyperplasia of prostate. Eighty percent (80%) of the total digital images were used for training and 20% for testing. Three ResNet architectures ResNet-18, ResNet-34, and ResNet-50 were employed for the analysis of these images. ResultsThe evaluation of digital images by ResNet-18, ResNet-34, and ResNet-50 revealed the diagnostic accuracy of 97.1%, 98 % and 99.5 % respectively. DiscussionThe application of artificial intelligence is being considered as a very useful tool which may improve the patient care by improving the diagnostic accuracy and reducing the cost. In radiology, the application of deep learning to interpret radiological images has revealed excellent results. In the present study, the analysis of pathology images by convolutional neural network architecture revealed the diagnostic accuracy of 97.1%, 98 % and 99.5 % with by ResNet-18, ResNet-34, and ResNet-50 respectively. The findings of the present study are in accordance with the other published series, which were carried out to determine the accuracy of machine learning for the diagnosis of cancers of lung, breast and prostate. The application of deep learning for the histological diagnosis of malignant tumors could be quite helpful in improving the patient care. ConclusionThe findings of the present study suggest that intelligent vision system possibly a worthwhile tool for the histopathological evaluation of prostatic tissue to differentiate between the benign and malignant disorders.

BackgroundHyperhidrosis (HH) is characterized by excessive sweating beyond thermoregulatory requirements and can significantly impair quality of life. Although oxybutynin has become an effective first-line therapy, video-assisted thoracic sympathectomy (VATS) remains the only definitive option for refractory cases. The availability of nationwide public and private healthcare datasets in Brazil enables a comprehensive assessment of national procedural trends on a continental scale. MethodsWe performed a retrospective nationwide analysis of all VATS procedures for HH conducted in Brazil between 2015 and 2023. Data were extracted from publicly available governmental databases covering both the public and private healthcare systems. Procedure rates were evaluated by year, geographic region, sex, and age group. Temporal patterns and differences between healthcare sectors were analyzed. ResultsA total of 26,980 VATS procedures were performed during the study period, with the private sector accounting for 75.25% of surgeries. Regionally, the Southeast (48.28%) and South (29.51%)--the most economically developed areas of the country--concentrated the majority of procedures. Women represented 64.5% of operated patients, and most surgeries were performed in individuals aged 15-39 years (82.74%). The mean cost per procedure in the private system was 4.2 times higher than in the public system (US$1,351.94 vs. US$351.27, p < 0.001), and the private sector accounted for more than 90% of total national expenditures. The overall mortality rate was 0.048%, with no significant difference between healthcare sectors. ConclusionsThis study provides the first nationwide evaluation of VATS performed for HH across Brazils public and private systems. Based on 26,980 procedures carried out between 2015 and 2023, most surgeries occurred in the private sector and predominantly involved women and young adults aged 15-39 years. Although mortality was low and similar across systems, procedure costs were substantially higher in the private sector, which accounted for the vast majority of national expenditures.

I.IntroductionScoliosis is defined as a deviation from midline in the frontal plane, and rotation of the apex of the curve from [&ge;]10{degrees} in AP radiography. Treatment of scoliosis is based in type of scoliosis, region of scoliotic curve, curve magnitude, bone maturity, gender, risk of scoliotic curve progression, other symptoms like and patients opinion about his spine shape. Treatment choices of AIS are observation, physical therapy, corsets and surgical treatment. PurposeResearch of patients with AIS focusing in its characteristics, clinical presentation, diagnosis and a detalized research in non-operative treatment of AIS focusing in treatment choices and criteria of treatment. Material and methodsThe study is based in retrospective research September 2018-March 2019 (7 months) in HUCSK- Specialized outpatient clinics of Orthopaedics. Data is taken with special permission from Personal Data Protection Office and Ethico-Professional Commity from specialized outpatient clinics of Orthopaedics systems archive for patients with AIS of 10-18 years old. ResultsDuring September 2018-March 2019 period in specialized outpatient clinics of Orthopaedics-HUCSK, 250 cases with AIS of 10-18 years old with Cobb angle [&ge;]10{degrees} are diagnosed and treated. The disease has a prevalence 1.40%. Based in gender women are more affected than men in a ratio 2.01:1. Most common form of AIS is the one that affects thoraco-lumbal region of spine with 60.8% of cases. Theres found a correlation between scoliosis and kyphosis in higher levels of spine.About 89.7% of cases are light scoliotic curves according to Cobb angle and the female\male ratio increases at women with increasement of Cobbs angle. Patients are treated with one or more forms of non-operative treatment: observation 10.4% of cases, observation and physical therapy 89.6% of cases and observation, physical treatment and corset TLSO 25.6% of cases. Cases that have undergone three forms of non-operative treatment are with Cobb angle [&ge;]20{degrees}. DiscussionThe results of this study are supported from many studies made in Germany, Singapor, Grece, Turkey and USA, from the earlier and later years, with data exactly or closely to this study results.

Withdrawal StatementThe authors have withdrawn their manuscript owing to 1. The paper needs structural changes. 2. Some of the data were found to have errors that need to be corrected after the previous submission. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.

Background & objectivesAssociation between serum vitamin D levels and lipid levels has been focus of research in recent times. The relationship of 25(OH)D and Atherogenic Index of Plasma is not well established among Indian population. We investigated the prevalence of vitamin D deficiency, its relation with serum lipids and AIP among IT employees. MethodsA retrospective observational study was conducted among employees of multiple IT firms in Bangalore, India. Participants were selected by convenient sampling from annual comprehensive health screening at work place. Serum lipid levels were assessed auto-analyser (ADVIA1650; Siemens, NY, USA). Serum 25(OH)D was assessed by Chemiluminescent microparticle immunoassay. AIP was calculated as log [Triglycerides/HDL-Cholesterol]. ResultsAmong 533 subjects included final analysis, mean of age was 33.18{+/-}6.6 with Male: female ratio of 1.8:1. Vitamin D deficiency and AIP > 0.15 was observed in 405 (75.98%) and 450 (84.43%) participants respectively. Median HDL-cholesterol was significantly lower (42 Vs 45.5, P value 0.004) and LDL cholesterol was significantly higher (90 Vs 52, P value <0.001) among people with vitamin-D deficiency. LDL (Spearman Rho=-0.18, P <0.001) had weak negative correlation, Total cholesterol (Spearman Rho=-0.1, P Value <0.01) and VLDL (Spearman Rho=-0.18, P Value <0.001) had weak positive correlation with 25(OH)D. No statistically significant association was observed between AIP and vitamin-D. ConclusionsMore than two thirds of IT employees were deficient in vitamin D. Vitamin D deficiency was associated with significantly higher LDL, lower HDL and VLDL levels. No statistically significant association was observed between vitamin D and AIP.

BackgroundOrofacial cancer is a malignant neoplastic proliferation of epithelial and ectomesenchymal tissue of oral and maxillofacial origin. The late presentation of patient, aggressive nature of orofacial malignancy and the anatomic site closure to vital organ make orofacial cancer management challenging. ObjectiveThe goal of this was to assess the patterns and risk factors of primary orofacial malignancy among patients visited Tikur Anbessa comprehensive specialized hospital. Patients and methodsA cross sectional descriptive study with retrospective data collection was conducted on 175 patients diagnosed with primary oral and maxillofacial malignancies at Tikur Anbessa comprehensive specialized hospital over a period of January 2020 to December 2021. Data were collected by chart review. The collected date were entered to SPSS 25.0 for statistical analysis and results were presented with table, figures and charts. Percentage and frequency were employed for categorical data while mean was used for continuous variables. ResultsOut of 175 primary orofacial cases analysed, male were 57.1 %(n=100) with male to female ratio 1.48: 1, mean age of (48.21 {+/-} 16.93 years) and range (12-91 years). Squamous cell carcinoma was the commonest cancer (52.0%) followed by mucoepidermoid carcinoma. About 34 % of patient had known risk factor. Majority of the patient (65.7%) were diagnosed as stage IV. Distance metastases were identified in 8.6 % of the patients and 41.7% of patients were treated surgically. ConclusionThe study showed squamous cell carcinoma was the most prevalent orofacial cancer. Majority of patients were presented with advanced stage of disease. Surgery was the main means of treatment modality given to orofacial cancer patients.

Olecranon fractures in young people are commonly treated surgically. When a transverse pattern is presented the most used method to fix the fracture is the Tension Band Wiring. The AO Foundation proposed a theory for the mechanism of action of this device. It could transform the tensile forces on the posterior side into compression forces on the joint side during flexion of the elbow. Our objective is to systematically review the available literature in order to confirm or not this hypothesis. We will include biomedical research studies evaluating Tension Band Wiring function. We are planning to search on Medline, Embase and other sources including grey literature. The studies will be selected and the data extracted. Results will include a descriptive analysis and a meta-analysis to compare the observed compression force before and after the flexion of the elbow. Our findings will be discussed having in mind the potentially clinical implications of results.