Obese people are susceptible to health complications and diseases, such as cardiovascular disorders, type 2 diabetes, hypertension, osteoarthritis, gallstone, hypoxia, certain cancers and even mental and intellectual and disabilities. Bariatric surgery is a prevalent weight loss approach, predominantly in situations where prior efforts towards weight reduction proved ineffective. It engages a modification in the digestive system by limiting food consumption, leading to decreased stomach capacity and physiological ability for nutrient absorption. Since obesity associates with morbidity, the pre, intra and post-operative care and post-discharge rehabilitation comprise key determining factors for a successful bariatric surgery. The process may involve short- and long-term recuperation in nursing homes and hospitals, which accord significant impact on patient’s well-being and psychology. Nursing care for these individuals with unique physiological and emotional problems is often an arduous task, requiring environmental modifications, mobility training facilities and bariatric program and care-related equipment. Special attention is required from nursing professionals towards minimum fall and injury, management of related problems, including arterial venous insufficiency, neuropathic ulcers, seromas, anastomotic leaks, abdominal wound dehiscence and post-surgery complications, together with increased hygiene and skin care. Through an interdisciplinary approach, regular monitoring of diet, nutritional parameters, including weight change, Body Mass Index, energy and protein requirement, medication, clinical complications, functional mobility, psychosocial issues, etc. can be essential. Overall, the current review enlightens the importance of bariatric surgery, and particularly offers critical assessment of nursing care systems and specialized rehabilitation services addressing physical and mental health care in obese and post-operative patients.

Backgrounds

The purpose of the meta-analysis was to evaluate and compare the effect of laparoscopy versus open appendectomy on wound infection in elderly subjects.

Methods

The results of this meta-analysis were analyzed, and the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random or fixed effect models.

Results

For the current meta-analysis, 6 examinations spanning from 2004 to 2021 were included, encompassing 42675 people; of them, 15486 had a laparoscopy, and 27189 had an open appendectomy.

Laparoscopy had a significantly lower surgical site infection (OR, 0.27; 95% CI, 0.22-0.32, p<0.001) and intra-abdominal abscess (OR, 0.36; 95% CI, 0.31-0.42, p<0.001) compared to open appendectomy in elderly subjects.

Conclusions

The information that was looked at showed that in older people, laparoscopy had a much lower rate of surgical site infections and intra-abdominal abscesses than open appendectomy. However, given the small number of studies included, attention should be given to their values.

Backgrounds

The purpose of the meta-analysis was to evaluate and compare the effects of negative-pressure wound therapy (NPWT) with conventional therapy (CT) on wound infection and graft take rates in split-thickness skin (STS) after grafting surgery (GS).

Methods

The results of this meta-analysis were analyzed, and the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random or fixed effect models. For the current meta-analysis, 16 examinations spanning from 2002 to 2023 were included, encompassing 1301 people with STSs after GS.

Results

NPWT had a significantly lower wound infection (OR, 0.29; 95% CI, 0.17-0.48, p<0.001), and higher graft take rate (MD, 8.70; 95% CI, 5.76-11.63, p<0.001) compared to CT in STSs after GS subjects.

Conclusions

The examined data revealed that NPWT had a significantly lower wound infection and a higher graft take rates compared to CT in STSs after GS subjects. However, given that several examinations had a small sample size, consideration should be given to their values.

The pyrrolizine nucleus is a bicyclic ring system that consists of a pyrrole ring fused to another pyrrolidin ring. It constitutes the basic skeleton in many natural and synthetic compounds with diverse biological activities such as the anti-inflammatory, nootropic, antiemetic, antibacterial, antiviral, anticonvulsant, antiarrhythmic, and anticancer activities. At least two of these derivatives, ketorolac and mitomycin C, have been approved for the treatment of inflammation and cancer, respectively. Licofelone, a dual inhibitor of COX and 5-LOX, was also evaluated in clinical trials for the treatment of osteoarthritis. On the other hand, a large number of the pyrrolizine-based derivatives have displayed anticancer activity against different types of cancer cells. In this review, the pyrrolizine-based derivatives with anticancer activity were classified based on their chemical structure into substituted, fused, and spiro-pyrrolizine. The mechanisms of action of these compounds included alkylation of the DNA, inhibition of COX, or alteration of the permeability of the cytoplasmic membrane in cancer cells. In addition, other pyrrolizines were found to act by inhibiting DNA replication, rRNA, Rac1 kinase, thioredoxin reductase, or oncogenic kinases. The last section of this review also focuses on the reported X-ray crystal structures of these compounds with different proteins. The binding modes and interactions of ketorolac and licofelone were illustrated in this review. To sum up, we anticipate that the data compiled in this review will be useful to researchers in the design of pyrrolizines with potent biological activities.

This review focuses on the mechanisms and methods involved in oral mucosal absorption, with a particular emphasis on drug delivery systems. It begins by discussing the protective role of saliva in the oral cavity, highlighting its importance in maintaining the health of the oral tissues and facilitating drug delivery. The review then delves into the mechanisms of oral mucosal absorption, including passive diffusion, which is the primary mechanism for drug transfer across the oral mucosa. It also explores the use of hydrophilic polymeric matrices as vehicles for oral transmucosal drug delivery systems, which are favored due to the water-rich environment of the oral cavity. The review further discusses the methods used to assess oral mucosal permeation, including both in vivo and in vitro approaches. In vivo methods, such as the buccal absorption test, are used to determine the bioavailability of drugs via this route, while in vitro methods are employed for high-throughput permeability screening. The review concludes by addressing the challenges and limitations associated with oral mucosal drug delivery, such as the difficulty in studying regional variation in drug absorption and the limitations of in vitro permeability models in predicting in vivo situations.

Background

Cardiac implantable electronic devices (CIED) represent established life-sustaining interventions for various cardiac conditions, but post-placement infections are associated with high morbidity and mortality. Although pre-procedural antibiotic prophylaxis effectively reduces CIED infection rates, limited data exist on post-procedural antibiotic use, especially beyond 24 hours. This study assesses the efficacy of post-procedural antibiotic usage in preventing CIED placement-related infections.

Methods

We conducted a systematic review and meta-analysis, including studies that examined the comparative outcomes among patients. The study cohorts were divided into two groups: (1) those who underwent preoperative antibiotic prophylaxis followed by a continuation of 24 hours or more postoperatively (intervention group); and (2) those who received either preoperative-only antibiotic prophylaxis or preoperative prophylaxis with a duration of less than 24 hours postoperatively (control group). Risk of bias was assessed with ROBINS-I and ROB-2 tools. Risk ratio (RR) was pooled using random-effect or fixed-effect meta-analyses with inverse variance method.

Results

Our analysis of ten studies, including four randomized controlled trials and six cohort studies with 27,375 participants, revealed no statistically significant differences in outcomes between two groups. These outcomes included (CIED) infection rates (RR 0.83, 95% CI 0.47, 1.44), mortality (RR 1.22, 95% CI 0.66, 2.25), pocket hematoma (RR 1.01, 95% CI 0.54, 1.92) and re-intervention (RR 0.71, 95% CI 0.20, 2.50). The larger randomized controlled trial had an obvious impact on the overall findings.

Conclusions

The present systematic review and meta-analysis found no advantage in extending postoperative antibiotic prophylaxis for more than 24 hours following (CIED) implantation. These findings align with prevailing guidelines which support antibiotic stewardship practices. This approach has the ability to reduce adverse drug events, curb the potential for antibiotic resistance and alleviate the financial burdens associated with prolonged postoperative antibiotic prophylaxis.

Backgrounds

The meta-analysis aims to estimate the effect of antibiotic prophylaxis (AP) on surgical site wound infection (SSWI) in third molar surgery (TMS).

Methods

Examinations comparing AP to placebo for TMS were utilized in the meta-analysis from various languages that met the inclusion criteria. Using dichotomous random or fixed effect models, the results of these investigations were examined, and the Odd Ratio (OR) with 95% confidence intervals was computed (CIs).

18 examinations from 2001 to 2023 were recruited for the current analysis including 4063 personals with TMS who were in the utilized examinations' starting point.

Results

AP had significantly lower SSWI (OR, 0.46; 95% CI, 0.33-0.65, p<0.001) with no heterogeneity (I² = 1%) compared to placebo in personals with TMS.

Conclusions

The examined data revealed that AP had significantly lower SSWI compared to placebo in personals with TMS. Nevertheless, caution should be exercised while interacting with its values since examinations were performed by different surgeons with different skills on different types of personals and the low sample size of numerous of the examinations selected for the meta-analysis.

Background
The purpose of the meta-analysis was to evaluate and contrast Chinese herbal medicine's effectiveness as a supplement to conventional treatment for diabetic foot ulcers.
Methods
The results of this meta-analysis were analyzed using dichotomous or contentious random or fixed effect models, and the odds ratio (OR) and mean difference (MD) with 95% CIs were calculated. 1140 individuals with diabetic foot ulcers were included in the 17 exams that were enlisted for the current meta-analysis, which ran from 2006 to 2021.
Results
When compared to standard treatment, Chinese herbal medicine significantly increased the overall effective rate (OR, 2.77; 95% CI, 1.89-4.07, p<0.001), reduced the size of the wound after treatment (MD, -2.44; 95% CI, -3.46- -1.43, p<0.001), decreased the number of patients who did not improve (OR, 0.26; 95% CI, 0.15-0.45, p<0.001), and shortened the time it took for diabetic foot ulcers to heal (MD, -10.46; 95% CI, -14.91- -6.37, p<0.001). The number of patients who experienced a 30% or greater decrease in the ulcer area of their diabetic foot ulcer did not, however, differ significantly between Chinese herbal medicine and standard treatment (OR, 2.69; 95% CI, 0.70-10.30, p=0.15).
Conclusions
According to the data analyzed, Chinese herbal medicine had a significantly higher overall effective rate, a smaller post-treatment wound, fewer patients who did not improve, and a shorter healing period for diabetic wound ulcers. However, there were no appreciable differences in the number of patients who experienced ulcer area reductions of 30% or more when compared to standard treatment for diabetic foot ulcers. However, given the majority of the chosen tests had small sample sizes and certain comparisons had few chosen studies, care should be taken when connecting to its values.

Background

We performed a meta-analysis to evaluate the influence of a phosphate-specific intake on serum phosphate levels in hemodialysis subjects.

Methods

A systematic literature search up to November 2021 was done and 14 studies included 1284 hemodialysis subjects at the start of the study; 671 of them were provided with phosphate-specific intake, and 613 were control. We calculated the mean difference (MD) with 95% confidence intervals (CIs) to evaluate the influence of phosphate-specific intake on serum phosphate levels in hemodialysis subjects by the contentious method with a random or fixed-influence model.

Results

Phosphate-specific intake had significantly better serum phosphate levels change (MD, -0.66; 95% CI, -0.95- -0.36, p<0.001) with moderate heterogeneity (I² = 71%) compared to control in hemodialysis subjects

Conclusions

Phosphate-specific intake had significantly lower serum phosphate levels change compared to control in hemodialysis subjects. Further studies are required.

Background:

A meta-analysis research was implemented to appraise gingival wound healing management by photobiomodulation as adjunctive management to periodontal treatments.

Inclusive literature research till April 2023 was done and 908 interconnected researches were revised. Methods

The 9 picked researches, enclosed 517 periodontal disease persons were in the utilized researchers' starting point, 258 of them were utilizing photobiomodulation, and 259 were control. Odds ratio (OR) and 95% confidence intervals (CIs) were utilized to appraise the consequence of photobiomodulation in treating gingival wound healing by the dichotomous, and contentious approach and a fixed or random model.

Results:

Photobiomodulation had a significantly higher Landry wound healing index (MD, 0.87; 95% CI, 0.40-1.34, p<0.001), and complete wound epithelialization (OR, 6.47; 95% CI, 2.05-20.44, p=0.001) compared to the control of gingival wound healing in periodontal disease persons. However, photobiomodulation and control had no significant difference in the remaining wound area (MD, -10.03; 95% CI, -22.83-2.77, p=0.12) of gingival wound healing in periodontal disease persons.

Conclusions:

Photobiomodulation had a significantly higher Landry wound healing index, and complete wound epithelialization, however, no significant difference was found in the remaining wound area compared to control of gingival wound healing in periodontal disease persons. However, caution needs to be taken when interacting with its values since there was a low sample size of most of the chosen research found for the comparisons in the meta-analysis and a low number of chosen investigations for some of the comparisons.

Backgrounds

A meta-analysis research was executed to appraise the effect of the continuous intervention for intraoperative pressure wound ulcers (IOPWUs) associated problems in breast cancer (BC) females.

Methods

Inclusive literature research till March 2023 was done and 436 interconnected researches were revised. The 8 picked researches, enclosed 1267 BC females were in the utilized researches' starting point, 636 of them were utilizing CI, and 631 were control. Odds ratio (OR) and 95% confidence intervals (CIs) were utilized to appraise the effect of CI for IOPWUs associated problems in BC females by the dichotomous, or contentious approaches and a fixed or random model.

Results

Continuous intervention had significantly lower IOPWUs (OR, 0.18; 95% CI, 0.13-0.24, p<0.001), higher Braden risk score (BRS) (OR, 2.11; 95% CI, 1.91-2.31, p<0.001), and higher quality of life (OR, 9.75; 95% CI, 6.90-12.60, p=0.02) compared to control in BC females.

Conclusions

Continuous intervention had significantly lower IOPWUs, higher BRS, and higher quality of life compared to control in BC females. However, caution must be taken when interacting with its values since there was a low number of nominated research found for some comparison in the meta-analysis.

The COVID-19 pandemic practice of social distancing has led to an increased usage of social media, which has highlighted the importance and potency of social media for effective science communication. As a result, it is now just as crucial to educate and acquire the skills necessary to use social media for science communication in an accurate and efficient manner. In response, we created a task that models and develops 21st century science communication abilities using the social media site TikTok. During the COVID-19 outbreak, TikTok, a platform for sharing short videos, had a dramatic rise in popularity. We demonstrated efficient social media science communication strategies by employing the condensed, targeted video format of TikTok to instruct students in fundamental science ideas and lab procedures. Students were then given the task of practicing excellent science communication at the conclusion of the semester by making their own educational and entertaining TikToks about the research projects that their teams had been working on. Here, we provide our methodology, a number of TikTok best practices, and sample videos made throughout the process for science communication education that are both effective and interesting.

There isn't a COVID-19 vaccination or particular antiviral drug available yet. In order to preserve lives and stop the disease's spread, a readily available, efficient, and secure therapy is desperately needed. Acute respiratory distress syndrome plays a major role in COVID-19 death rates. The characteristic of acute respiratory distress syndrome is markedly elevated oxidative stress brought on by a fast release of free radicals and cytokines (cytokine storm), which can result in organ failure, cellular damage, and even death. We describe a case where the patient responded well to early administration of high dose intravenous vitamin C in addition to other nutrients and drugs.

Backgrounds:

This study aims to determine the relation between ABO and RhD and the prevalence and severity of COVID-19 disease.

Methods:

Data of 495 SARS-CoV-2 infected patients admitted to hospitals were collected. The ABO and RhD were determined for each patient to detect any possible relation between the prevalence of SARS-CoV-2 infection and each blood group. The patients were followed up to determine oxygen saturation and surveillance outcome (died or improved) to detect any possible relation between the severity of COVID-19 disease and each blood group.

Results:

A+ blood group was found to have a percentage of 32.3%, O+ to have a percentage of 30.3%, B+ to have a percentage of 21.2%, and AB+ to have a percentage of 10.1%. 19% of all the patients died. 20% of the dead patients were with O+ blood group, 60.5% were with A+ blood group, 10% with B+ blood group and 5% were with O- blood group.

The mean ± SD oxygen saturation on hospital admission was 94.2 ± 6.2% for the patients with O+ blood group, 91.06 ± 7.5% for the patients with A+ blood group, 92.8 ± 6.9% for the patients with B+ blood group, 93.4 ± 3.5% for the patients with AB+ blood group, and 94.5 ± 5.9% for the patients with O- blood group.

Conclusion:

Blood group A+ was the most common in the COVID-19 patients followed by O+ then B+ then AB+. Patients with blood group A+ had the worst oxygen saturation at hospital admission and had a higher mortality rate.

Backgroungs

Microemulsion is a clear thermodynamically stable dispersion of two immiscible liquids with carefully adjusted emulsifier(s). It can be used as a vehicle for many different drugs and dosage forms.

Methods

To formulate a microemulsion for topical use from cheap components a pseudoternary phase diagrams were constructed with formulae consisting of paraffin oil, cosurfactant (sorbitol or glycerol), surfactant (Brij97) and water. The existence of microemulsion regions was demonstrated.

Indomethacin was added to the best formulae, which produce microemulsions in gel form and evaluating them for their physical characters, release rate, physical and chemical stability and Pharmacodynamic.

Results

Fifty five formulae produce stable microemulsions in gel form. On incorporation of indomethacin only four formulae remain stable, clear formulae. They were used for further studies. Their order of drug release rate was first order. The four formulae were stable when stored at room temperature, or under stress. Shelf life of them would be minimum of 492 days and maximum of 712 days.

Indomethacin significantly inhibits edema, induced in rat paw by different percentage. Effect of the prepared microemulsions were between the effect of commercial injection form, highest effect, and commercial topical form, lowest effect.

Conclusions

The microemulsion formulae prepared with paraffin oil, brij97, sorbitol or glycerol and water showed acceptable physical properties, drug release, stability and Pharmacodynamic effect.

Anthracyclines are a crucial component of chemotherapy regimens used to treat a range of malignancies in children and adults. However, cardiac dysfunction and heart failure frequently limit the therapeutic efficacy of anthracyclines. The risk of heart dysfunction increases with increasing doses of anthracycline. Cardiotoxicity is a challenging side effect of DOX, which is cumulative and irreversible; this necessitates assessing the cardiac functions in cancer patients before and after the use of    DOX to avoid permanent cardiac damage. Serial measurements of left ventricle ejection fraction (LVEF) are commonly used for cardiac monitoring during anthracycline treatment. In some studies, cardiotoxicity was defined as LVEF decrease by an absolute 10% and/or below 55%; in others, cardiotoxicity was defined as a decrease below 45%. A serious disadvantage of this test is radioactivity exposure and the low predictability of pre-symptomatic cardiac damage. Blood cardiac biomarkers, such as cardiac troponins and B-type natriuretic peptide (BNP), have been used in heart failure diagnostics. Susceptibility to DOX cardiotoxicity is largely individual, with some patients developing cardiomyopathy at low doses and others tolerating much higher cumulative doses, and this may suggest the presence of genetic predisposition factors. Genetic variations in CBR3 and ABCC1 genes were suggested to contribute to DOX adverse effects. This review highlights the genetic basis for anthracycline-related cardiac dysfunction, focuses on particular genes that have been implicated in innate predisposition to ACT, and assessment of cardiotoxicity.

Every academic institution is shaken by the recent development of Chat Generative Pre-trained Transformer, and although we still don't fully grasp all of its potential and hazards, it is worthwhile to offer some first analysis. Academic prospects for Chat Generative Pre-trained Transformer are unparalleled because of its remarkable human-like skills, which outperform the majority of recently released tools. Over the past few months, Chat Generative Pre-trained Transformer has received extraordinary interest from the news and academic community (as of 23/02/2023, there were 650,000,000 results in a Google search for the term). Since it is unlikely that the chatbot was designed with the intention of serving as a stand-in for academic writing, its use in academic writing is a byproduct of clever artificial intelligence. If given the chance, students everywhere would find a way around assessments, thus we are all worried that some students would take advantage of it despite its advantages. Although there isn't now a problem involving assessment integrity in academics, it is impossible to overlook the development of powerful artificial intelligence and tools that could facilitate cheating. Some of us think that the use of Chat Generative Pre-trained Transformer in assessments has some epistemic consequences; yet, these risks do not indicate that we will give up. Although we now know that certain university programs—like management studies and information technology—have a higher risk of academic dishonesty, educators are not new to the practice; rather, they are still learning about Chat Generative Pre-trained Transformer. I don't see any strong arguments in favor of allowing its usage in assessments, even though it is unavoidable in certain academic contexts. Instead than teaching students to "copy and paste," they teach them to "think and write critically." Therefore, the fact that Chat Generative Pre-trained Transformer passed the MBA and medical school exams should raise red flags.

An artificial intelligence-driven Chatbot called Chat Generative Pre-trained Transformer, created by Open artificial intelligence, is making waves in many industries. Its foundation in the Generative Pre-trained Transformer language model is where its name originates. The most promising aspect of Chat Generative Pre-trained Transformer is that, compared to other artificial intelligence models, it can provide responses to text input that are almost human-like through the use of deep learning techniques. The public's increasing reliance on artificial intelligence technology is indicated by its quick integration across a range of businesses. Therefore, it is crucial to assess Chat Generative Pre-trained Transformer's possible effects on clinical and translational medicine research in academic settings seriously.

Worldwide, medical education has been impacted by the coronavirus pandemic. As academic institutions endeavor to impart medical knowledge through innovative approaches, this ongoing education guarantees the future workforce of the National Health Service (NHS) is well-versed. When developing new medical curriculum, innovative approaches to online instruction and online delivery of practical skills to medical students should be taken into account.

Background: Meta-analysis research was implemented to appraise the effect of resident participation (RP) in ophthalmic surgery (OS) on wound dehiscence (WD). Methods: Inclusive literature research until April 2023 was done, and 645 interconnected researches were revised. The 7 picked researches, enclosed 4224 OS persons were in the utilized researchers' starting point, 2189 of them were utilizing RP, and 2035 were no RP. Odds ratio (OR) and 95% confidence intervals (CIs) were utilized to appraise the consequence of RP in OS on WD by the dichotomous approach and a fixed or random model. Results: RP had significantly higher WD (OR, 1.69; 95% CI, 1.04-2.76, p=0.03) compared to no RP in OS persons. Conclusions: RP had significantly higher WD compared to no RP in OS persons. However, caution needs to be taken when interacting with its values since there was a low sample size of some of the chosen researches and a low number of researches found for the comparison in the meta-analysis.