Critical appraisal of the literature—its role in CPD

The information explosion has affected the medical as well as the lay press. Sources of literature have never been so diverse, and freedom of information legislation globally has empowered all and sundry to voice their views on all matters. This freedom is exercised with regard to medical literature in general and Women’s Health publications in particular. The implicit requirement for clinical practice to be informed by evidence (evidence-based medicine) has placed the onus on the readership of clinical literature to acquire skills in appraising such literature. The need to sift out relevant information from the burgeoning obstetrics and gynaecology literature has mandated the acquisition of skills in critical literature appraisal. This review outlines how to critically appreciate and evaluate literature generally, and as it relates to obstetrics and gynaecology.     

Recovery of FTO coated glass substrate via environment-friendly facile recycling perovskite solar cells

Organic–inorganic perovskite solar cells (PSCs) have recently emerged as a potential candidate for large-scale and low-cost photovoltaic devices. However, the technology is still susceptible to degradation issues and toxicity concerns due to the presence of lead (Pb). Therefore, investigation on ideal methods to deal with PSC wastes once the device attains its end-of-life is crucial and to recycle the components within the cell is the most cost effective and energy effective method by far. This paper reported on a layer-by-layer extraction approach to recycle the fluorine-doped tin oxide (FTO) coated glass substrate which is the most expensive component in the device architecture of mesoporous planar PSC. By adapting the sequential removal of each layer, chemical properties of individual components, including spiro-OMeTAD and gold can be preserved, enabling the material to be easily reused. It also ensured that the toxic Pb component could be isolated without contaminating other materials. The removal of all individual layers allows the retrieval of FTO conductive glass which can be used in various applications that are not only restricted to photovoltaics. Comparison of electrical, morphological and physical properties of recycled FTO glasses to commercial ones revealed minimal variations. This confirmed that the recycling approach was useful in retrieving the substrate without affecting its physicochemical properties.

Organic–inorganic perovskite solar cells (PSCs) have recently emerged as a potential candidate for large-scale and low-cost photovoltaic devices.     

Kinetic and isotherm studies on adsorptive removal of sulfates by cotton shell derived biochar: Recovery of sulfates from marcasite soil

This work illustrates the potential applications of the raw cotton shell (RCS) and cotton shell biochar (CSB) in the remediation of sulfate contaminants from aqueous solvents. Comprehensively, optimal batch and adsorption kinetics of sulfate by RCS and CSB were intensively analyzed and determined by varying the adsorption parameters. For RCS, the optimal series of parameters were at (pH-7, sulfate conc-150 mgL^?1, adsorbent dose- 0.5 g and time-150 min). While for CSB optimum conditions were at (pH-9.8, sulfate conc-100 mgL^?1, dosage- 0.1 g and time-90 min). The maximum adsorption efficiency for both RCS and CSB was achieved at 86.47% and 90.77%, respectively. Sulfate adsorption by RCS and CSB was examined by isotherm models and kinetic studies. The data are best suited to the Langmuir isotherm model with the highest RCS and CSB sulfate adsorption capability of 61.35 and 153.85 mg g^?1 and followed pseudo-second-order kinetics. Box-Behnken design (BBD) based response surface methodology (RSM) model-based analysis of variance test has demonstrated optimum conditions and sulfate adsorption by both RCS and CSB. The recovery studies on sulfates from marcasite soil were evaluated at different doses of RCS and CSB. This study provides insights into the usage of the developed process towards the circular economy of the sulfates.     

Autologous versus pooled human serum for articular chondrocyte growth

PURPOSE. To evaluate the effect of autologous human serum (AHS) versus pooled human serum (PHS) versus foetal bovine serum (FBS) for growth of articular chondrocytes and formation of chondrocytefibrin constructs. METHODS. Experiments with monolayer culture expansion of human articular chondrocytes were performed using basic culture media supplemented with 10% AHS, PHS, or FBS. Growth kinetics and specific phenotypic expression of the serially expanded chondrocytes were evaluated. Large-scale culture expansion was used to obtain about 30 million cells to form chondrocyte-fibrin constructs. All constructs were implanted subcutaneously at the dorsum part of athymic nude mice for 8 weeks. The in vivo constructs were evaluated using histological and gene expression studies. RESULTS. The morphology of primary cultured chondrocytes (P0) was polygonal and became more elongated and larger after serial passages (P1, P2, and P3). This was comparable for AHS, PHS, and FBS. Total cell yields accumulated for AHS (28 million) and PHS (41 million) were significantly higher than those for FBS (4 million). After 8 weeks of implantation, in vivo chondrocyte-fibrin constructs demonstrated a glistening white and firm texture, comparable to normal hyaline cartilage. All constructs exhibited histo-architectural characteristics of well-distributed cartilage-isolated cells embedded within basophilic ground substance. Presence of accumulated proteoglycans cartilage-rich matrix was indicated by positive orange-red Safranin O staining. During monolayer culture expansion, collagen type II gene expression was down-regulated, while collagen type I gene expression was up-regulated. Collagen type II--the specific chondrogenesis marker--was re-expressed in the in vivo chondrocyte-fibrin construct. CONCLUSION. AHS and PHS are better than FBS for in vitro cultivation of human articular chondrocytes.     

Role of nitric oxide in hydroxyapatite-induced phagocytosis by murine macrophage cell line (RAW264.7)

The aim of this study was to determine the role of nitric oxide (NO) in hydroxyapatite (HA)-induced phagocytosis by a murine macrophage cell line (RAW264.7). The cells were incubated with HA particles at various incubation time and phagocytosis was assessed using phagocytic index (PI). NO production from the culture supernatants was determined by the Griess reagent. The inducible nitric oxide synthase (iNOS) expression was determined by Western blot. The particles were also incubated with cells pretreated with various concentrations of L-N(6)-(1-iminoethyl) lysine hydrochloride (L-NIL) or L-arginine. Latex beads were used as a control. Our results showed that macrophage phagocytosis induced by HA was higher than that induced by the beads. However, NO production by HA-stimulated cells was lower than that by bead-stimulated cells. iNOS expression in both bead- and HA-stimulated cells was observed expressed at 7, 15, 30, and 60 min. l-Arginine enhanced but l-NIL inhibited both phagocytosis and NO production by HA-stimulated cells. The results of the present study suggest that nitric oxide may play a crucial role in HA-induced phagocytosis by RAW264.7 cells.     

Measurement of nicotine withdrawal symptoms: linguistic validation of the Wisconsin Smoking Withdrawal Scale (WSWS) in Malay

Background  

The purpose of the linguistic validation of the Wisconsin Smoking Withdrawal Scale (WSWS) was to produce a translated version in Malay language which was "conceptually equivalent" to the original U.S. English version for use in clinical practice and research.     

Management of dry socket with low-level laser therapy

Objective

The aim of this study is to investigate the efficacy of delivering low-level laser therapy (LLLT) in the management of dry socket at University Dental Hospital Sharjah.

Materials and method

Forty-five patients with dry socket were divided into two treatment groups. Group I dry socket patients (n = 30) received conventional treatment while group II patients (n = 15) were irradiated with LLLT at a setting of 200-mW, 6-J, continuous-wave mode using an R02 tipless handpiece (Fotona Er:YAG, Europe), on the buccal, lingual, and middle surfaces of the socket for 30 s from a delivery distance of 1 cm. Pain score and quantification of granulation tissue in the socket were recorded at 0, 4, and 7 days post-dry socket treatment.

Results

Results showed that the LLLT-irradiated group II sockets showed a much lower VAS pain score of 1–2 as early as day 4, and a richer amount of granulation tissue compared to the conventional treated group I socket. The amount and rate of granulation tissue formation in the dry socket are inversely proportional to the pain score showing significant clinical effectiveness of LLLT on promoting the healing of the dry socket, with improvement in symptoms (P = .001). Conventionally treated dry sockets take at least 7 days to match the effective healing of an LLLT-irradiated dry socket.

Conclusion

LLLT irradiation influences biomodulation of dry socket healing by dampening inflammation, promoting vascularization, stimulating granulation, and controlling pain symptoms.

Clinical relevance

LLLT may be an additional effective tool for managing dry sockets in general dental practice.

     

Review article: Safety aspects of anesthesia in under-resourced locations

Purpose

Improving patient safety during anesthesia and surgery is the focus of much effort worldwide. Major advances have occurred since the 1980s, especially in economically advantaged areas. This paper is a review of some of the challenges that face those who work in resource-poor areas of the world.

Principal findings

There is a shortage of trained anesthesia providers, both physician and non-physician, and this is particularly acute outside urban areas. Anesthesia is still sometimes delivered by unqualified people, which results in expected high rates of morbidity and mortality. Residency training programs in low-income countries ought to increase their output as anesthesiologists must be available to supervise non-physician providers. All groups require continuing medical education. In addition, increased efforts are needed to recruit trainees into the specialty of anesthesia and to retain them locally. There is a well-recognized shortage of resources for anesthesia. Consequently, concerted efforts are necessary to ensure reliable supplies of drugs, and attention should be paid to the procurement of anesthesia equipment appropriate for the location. Biomedical support must also be developed. Lifebox is a charitable foundation dedicated to supplying pulse oximeters to low- and middle-income countries. Adoption of the World Health Organization’s Surgical Safety Checklist could further reduce morbidity and mortality.

Conclusions

Much time, effort, planning, and resources are required to ensure that anesthesia in low-income areas can reach internationally accepted standards. Such investment in anesthesia would result in wider access to surgical and obstetrical care, and the quality and safety of that care would be much improved.