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Aim of the study — to evaluate our own experience of the use of non-modular tapered stems in revision hip arthroplasty to determine the incidence and causes of repeated revisions, functional outcomes, and factors associated with subsidence of non-modular tapered stems. Methods. We retrospectively analyzed the results of using 78 non-modular tapered stems. The average follow-up period was 5.1 years. Results. There were repeated revisions accompanied by the removal of non-modular tapered stems in 14 (17.9%) cases. Significant subsidence was observed in 5 (6.4%) cases. Bicortical contact less than 2.0 cm (p = 0.017) was a risk factor for subsidence of non-modular tapered stems. The risk of having a bicortical contact of less than 2 cm was higher in patients with type IV femoral defect (p = 0.048). An improvement in functional parameters was found. Patients with significant subsidence of non-modular tapered stems had worse functional outcomes compared to patients without significant subsidence. Conclusions. The use of non-modular tapered stems in revision hip arthroplasty shows good results in terms of repeated revision rates and functional outcomes. Periprosthetic infection and aseptic loosening were the most frequent causes of repeated revisions with removal of non-modular tapered stems. All patients with significant subsidence of non-modular tapered stems underwent repeated revision due to aseptic loosening. Bicortical contact less than 2.0 cm was a risk factor for significant subsidence of non-modular tapered stems. The risk of bicortical contact less than 2.0 cm was higher in patients with type IV femoral defects. Therefore, it is recommended to use non-modular tapered stems with caution or consider other hip reconstruction options in this type of defect.

Background. The number of surgeries on the musculoskeletal system is increasing every year. Along with the increasing access to orthopedic care, the number of patients with orthopedic infection, the etiological agents of which can be from various taxonomic groups, is also increasing. Staphylococcus aureus and different types of coagulase-negative staphylococci (CoNS), including S. epidermidis and S. lugdunensis, together are the causative agents in 70% of cases. Aim of the study — to analyze the dynamics of the microbial spectrum isolated from patients of the septic surgery department for the period from 2011 to 2022. Methods. We performed a retrospective analysis of the microbial spectrum isolated from patients who were treated in the septic surgery department from January 1, 2011 to December 31, 2022. The leading pathogens were microorganisms whose share in the spectrum exceeded 3.5%. Of the isolated pathogens, 48.8% were the only etiological agents, and microbial associations were detected in 51.2% of the isolated pathogens. Results. A total of 10,327 bacteria strains were identified over the 12-year period. The leading microorganisms causing orthopedic infection were Staphylococcus spp., Enterococcus spp., Propionibacterium spp., Pseudomonas aeruginosa, Corynebacterium spp., Streptococcus spp., Klebsiella spp. and Acinetobacter spp. In the dynamics of isolated pathogens during the analyzed period, several trends were determined: a decrease in the shares of S. aureus, Enterococcus spp., P. aeruginosa, Acinetobacter spp. and an increase in the shares of CoNS and Corynebacterium spp. Conclusion. During 12 years, in the microbial spectrum of orthopedic infection in patients of the septic surgery department of our Center, Gram-positive bacteria, in the majority representatives of the genus Staphylococcus, prevailed. At the same time, a significant decrease in the share of S. aureus strains and an increase in the frequency of isolation of various species of CoNS were registered. A significant decrease in the number of non-fermenting Gram-negative bacteria was also revealed.

The second part of an interdisciplinary expert consensus on tissue banking is presented. An analysis and attempt was made to systematize some of the terms and definitions used by tissue bank specialists in the process of their work and presented in the Federal laws and orders of the Ministry of Health of the Russian Federation regulating medical activities in the field of tissue donation and their clinical use.

Khalid Mehmood,1 Aamir Suhail,2 Pradeep Kautish,3 Muhammad Mohsin Hakeem,4 Md Rashid5 1Research Center of Hubei Micro & Small Enterprises Development, School of Economics and Management, Hubei Engineering University, Xiaogan, People’s Republic of China; 2Department of Management and Leadership, Business School, Tecnologico de Monterrey, Guadalajara, Mexico; 3Department of Marketing, Institute of Management, Nirma University, Ahmedabad, India; 4NUCB Business School, Nagoya University of Commerce and Business, Nagoya, Japan; 5Department of Civil Engineering, Indian Institute of Technology, Kharagpur, IndiaCorrespondence: Md Rashid, Indian Institute of Technology, Kharagpur, India, Email rashidgeog@gmail.com Pradeep Kautish, Institute of Management, Nirma University, Ahmedabad, India, Email pradeep.kautish@nirmauni.ac.inPurpose: The overuse of internet-based technologies as a means of coping with the stress they generate has resulted in an alarming level of addiction, adversely impacting the quality of life and overall health of younger individuals. This social detachment, in turn, contributes to both physical and mental health deterioration. The potential remedy for this predicament lies in the application of social support as an antidote to internet addiction. In this context, our present study employs the Stress-Strain-Outcome model to explore the indirect effects of internet addiction and the moderating role of social support in relation to the influence of technostress on the quality of life of adults.Methods: We adopted a time-lagged design to collect data from university graduates and evaluated our study hypotheses using Mplus.Results: Our empirical findings highlight the significant influence of technostress on internet addiction, with the latter significantly mediating the relationship between technostress and quality of life. Furthermore, our results reveal that social support effectively moderates the indirect effects of technostress on quality of life through its impact on internet addiction.Conclusion: These findings can help researchers and educators better understand the underlying mechanisms between technostress and quality of life with social support as the silver lining. This form of social support holds the potential not only to alleviate internet addiction but also to positively enhance the quality of life and overall wellbeing of individuals facing these challenges. The implications of these findings and avenues for future research are also discussed.Keywords: internet addiction, quality of life, social support, technostress, social media, moderation-mediation

Intraventricular schwannomas are extremely rare, typically benign tumors originating from Schwann cells, which are not normally found within the ventricular system. Their presence challenges conventional understanding of tumor origins and complicates diagnosis and management. We report the case of a 19-year-old female presenting with a drop attack and headache, with no significant medical history. MRI revealed a heterogeneously enhancing lesion in the right lateral ventricle. Differential diagnoses included malignant tumors; however, histopathological examination post-surgical resection confirmed an intraventricular schwannoma. Postoperative outcomes were favorable, with successful CSF diversion via a right occipital ventriculoperitoneal shunt for isolated right temporal hydrocephalus. This case is notable for its atypical presentation in a young patient, challenging the conventional understanding that intraventricular schwannomas primarily affect older individuals. In addition, the correct diagnosis and successful management of a rare intraventricular schwannoma underscores the importance of considering this rare diagnosis in patients with nonspecific neurological symptoms and intraventricular lesions. This case, alongside the literature review, enriches the body of evidence on intraventricular schwannomas, highlighting the critical role of surgical intervention and the need for a comprehensive diagnostic approach.

Background. It is known that the outcomes of patients treatment with periprosthetic joint infection (PJI) are significantly influenced by the state of the patient’s body, the nature of the pathogen, the state of tissues in the area of the infectious focus and the treatment tactics. However, topographic and anatomical features of the blood supply to the knee and hip joints, as well as the volume of soft tissues, can affect the spectrum of pathogens, manifestations of the infectious process and, as a consequence, the effectiveness of treatment. The aim of the study was to conduct a comparative analysis of the somatic status of patients, the etiology of the infectious process and the effectiveness of treatment of PJI depending on its localization. Methods. A single-center retrospective study was conducted. The cases of 337 patients were studied — 119 patients with knee and 218 patients with hip PJI who underwent treatment with a two-stage technique during the period from 2007 to 2017. A comparative analysis of the PJI pathogens structure and concomitant pathology between patients with hip and knee PJI was carried out. The frequency of infection relief in the groups following the first stage was counted. Results. Recurrence was diagnosed four times more frequently in patients with hip PJI compared to knee PJI. Risk factors for recurrence were gram-negative pathogens, microbial associations, and fistulous forms of the infectious process. Localization of the infectious process in the hip area was associated with a statistically significant greater volume of blood loss during the prolonged debridement surgery. Conclusion. Recurrences of PJI occur more frequently in the hip area compared to the knee joint. Further analysis of critical factors in recurrence development is necessary for potential intervention.

Background. Femoroacetabular impingement (FAI) is one of the most common causes of pain syndrome and limited mobility in the hip joint among young and middle-aged individuals. The aims of this study: 1) To evaluate the impact of the type of hip joint deformity in patients with FAI on treatment outcomes; 2) To identify the type of hip joint deformity that is optimal for correction using arthroscopy; 3) To determine the impact of the acetabular structure in conditions of borderline dysplasia on the treatment outcome. Methods. A retrospective uncontrolled single-center study was conducted, including 121 patients (135 hip joints), among them 49 (40.5%) women and 72 (59.5%) men. Patients were divided into four groups based on the type of deformity. The first group included 33 (24.4%) joints with cam-type FAI, the second group — 72 (53.4%) joints with mixed-type, the third group — 17 (12.6%) joints with dysplasia (LCEA-O25°) and cam-type deformity of the femoral head-neck junction, and the fourth group — 13 (9.6%) joints with a combination of dysplasia, cam-type deformity, and retroversion of the acetabulum. All patients underwent physical examination and radiographic diagnostics. In patients with borderline dysplasia, the version of the acetabulum was additionally assessed. The iHOT-33 and HOS scales were used to evaluate the preoperative status and postoperative results. Results. The best treatment outcome was achieved in the first group of patients, which was statistically significantly different from the results in the third group. The treatment outcomes in the second group of patients did not show statistically significant differences from the first group according to the HOS questionnaire, but differed according to the iHOT-33 scale. The treatment outcomes in the fourth group of patients were almost indistinguishable on the iHOT-33 scale from the first group and on the HOS scale from the second group. In the third group, a statistically significant result on the HOS-Sport subscale was achieved in only 30% of patients, while in other groups it was not less than 58%. Other scales showed a slight superiority of treatment results in the first and fourth groups compared to the second and third groups. In the first years after surgery, all groups of patients showed a significant improvement in sports activity, but after 2 years, there was a tendency for a decrease in patients in the second and third groups. Conclusion. The highest results of arthroscopic treatment were shown by patients in the first group with isolated cam-type deformity, slightly worse were results by patients in the second group (with mixed-type). In patients with borderline dysplasia, the effectiveness of arthroscopy depended on the structure of the anterior wall of the acetabulum. The worst result was observed in patients with borderline dysplasia and insufficiently developed anterior wall of the acetabulum — in that group of patients, it is worth preferring isolated periacetabular osteotomy or in combination with arthroscopy.

Studying the history of minorities in Iraq has been an important field of interest for many scholars. This study (The Role of British diplomats in Yazidis Affairs in Iraq1932- 1939) is an attempt to present and analyze the role of the British diplomats towards the affairs relating to Yazidi minority in Iraq during a very important period in the latter’s cotemporary history. The Yazidis who had been living in Sinjar a sub-district of Mosul in northern Iraq had been in continuous conflict with Ottoman authorities . This was partly due to their refusal to perform mandatory military service, (compulsory conscription,) and paying taxes. Ottoman campaigns were conducted against them to subjugate them by force to Ottoman rule. This was the reason for their isolating themselves in the mountainous area far from the city center. When British had developed an influence in Iraq an opportunity was presented to the Yazidis to defend themselves. Their leaders asked British authorities to defend their interests and to help them get rid of the oppression of the Ottomans. For the purpose of establishing British influence among the Yazidis , the former called the Yazidi leaders to hold a conference and issue a plea to the British authorities in Iraq to include them under British protection. Britain was planning to set up a Yazidi princedom in Sinjar to serve as a buffer between Iraq and Syria, kipping Frances away from oil field.

Background. According to the analysis of large arthroplasty registers we have noted the increase in the use of non-cemented implants, because the latter shows the same results of implant survival as well as cemented implants. On the other hand, they can affect the quality of the bone around the implant in different ways. These components differ in shape, length, and surface properties. According to the analysis of the arthroplasty register of the Vreden National Medical Research Center of Traumatology and Orthopedics, a significant decrease of the Alloclassic femoral stem using can be noted. In parallel the use of its SL-PLUS MIA modification has increased significantly. Aims of the study: 1) to determine the influence of changes in the design of the Zweymüller-type femoral stem on midterm and long-term outcomes and its survival; 2) to identify the characteristics of adaptive remodeling of periprosthetic bone tissue around these femoral stems; 3) to determine risk factors for aseptic loosening of these femoral stems. Methods. 492 cases of hip arthroplasty using the Alloclassic and SL-PLUS MIA femoral stems were observed, with an average follow-up 78.6 months. The patients were divided into 2 groups according to the type of femoral stem. The assessment the hip articulation condition was carried out using the HHS and OHS. The intensity of the pain syndrome was assessed by VAS, and the level of patient’s satisfaction. The dynamic analysis of X-rays was also performed visually. Results. A significant improvement in clinical and functional results was observed according to the HHS and OHS in both groups of patients, regardless of the type of femoral stem. Analysis of X-rays over time showed differences in the behavior of these two femoral component models. The radiolucent lines around the femoral stem are absent in SL-PLUS MIA group, in Alloclassic stem group radiolucent lines are present even at a minimal period (12 months). We also found that a tight fit of Zweymüller femoral stems in the distal shaft is a risk factor for severe stress-shielding syndrome, especially in the funnel channels. But ceteris paribus, a distal tight fit of SL-PLUS MIA stems despite similar geometry of the distal part does not lead to such frequent manifestation of severe stress shielding. Conclusion. The change in Zweymüller stem design from Alloclassic to SL-PLUS MIA improved the nature of adaptive remodeling in the periprosthetic area of the femur. It may improve the long-term results of primary hip arthroplasty, but these differences require closer observation.

Introduction Diagnostic algorithms are used for detection of periprosthetic joint infection (PJI) including sampling for histological evaluation (HE). The purpose was to assess the diagnostic significance of emergency HE of fresh-frozen intraoperative biomaterial as part of preoperative PJI screening of patients undergoing revision total knee arthroplasty (RTKA). Material and methods The prospective study included 83 patients who were admitted to two trauma and orthopaedic centers for RTKA. The European Bone and Joint Infection Society 2021 (EBJIS21) algorithm was used to detect PJI of the knee joint. The diagnostic value of screening PJI with/without regard to the results of an emergency HE was compared with the results of a microbiological study (MBI) of all types of biomaterials obtained from each patient. Subanalysis was additionally performed in patients with aseptic instability and antimicrobial spacer. Results Pathomorphological examination of freshly frozen and paraffin-embedded tissues showed the difference of 7.2 %, which did not significantly affect the interpretation of the results (p > 0.05). Diagnostically significant pathogens were identified in 83.3 % of cases with PJI confirmed by emergency HE (p < 0.001). A positive emergency HE result increased the chances of isolating diagnostically significant organisms by 34 times (95 % confidence interval (CI): 4.721 – 244.859) as compared with negative HE cases. The proportion of detected cases with emergency HE included in the screening increased from 2.4 to 8.4 %. The inclusion of emergency HE in the screening improved the diagnostic value both in the general cohort of patients and in the subanalysis of comparison groups due to a two-fold increase in sensitivity. Conclusion Relevance of the emergency HE results and the PJI criteria should be considered as a significant prognostic factor for an infectious process, however, this technique should be used only in a complex algorithm for PJI detection. Poor outcomes in 18.2 % of cases of probable PJI necessitated a change in the approach to managing this cohort of patients.

Background. Today in our country, the follow-up of patients after arthroplasty is carried out in accordance with clinical guidelines, the wording of which is based on monographs from 2006, 2008, and 2014, in addition, clinical guidelines for follow-up do not take into account the results of treatment assessed by the patient himself. The purpose of this study was to examine existing systems and develop a proprietary follow-up system for patients after hip and knee arthroplasty. Results. A review of the literature revealed that follow-up of patients after arthroplasty is an unsolved problem, within which there is low coverage, reluctance or forgetfulness of the asymptomatic patient, the problem of accessibility of medical examinations, and an excessive financial burden on the health care system. Since 2022, fixed recommendations for follow-up after arthroplasty have been used in the clinical practice of our center in discharge epicrisis. Recommendations for the frequency of follow-up were formulated by experts based on a comprehensive review of the literature and their own experience. In the first three months, 221 hip and 235 knee evaluation questionnaires were collected through the proposed mechanism, with a progressive increase in the number of questionnaires based on weekly monitoring data. Conclusion. Unfortunately, the outpatient clinic system is not always able to provide qualitative monitoring of patients after arthroplasty due to various reasons, therefore, in our opinion, the implementation of the mechanism of remote monitoring of patients will allow detecting various complications at the stage of early diagnosis, which will contribute to prompt solution of these problems. The remote monitoring system is also an important source of scientific data.

Samrah Jamshaid,1,2 Noor Bahadar,3 Kamran Jamshed,4 Misbah Rashid,5 Muhammad Imran Afzal,2 Lv Tian,1 Muhammad Umar,6 Xuechao Feng,7 Imtiaz Khan,8 Minru Zong1 1Department of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China; 2School of Psychology, Northeast Normal University, Changchun, Jilin, People’s Republic of China; 3Department of Transgenic Animals, Changchun WISH Testing Technology & Service Co, Ltd, Building E11, Beihu Science Park B, Changchun, Jilin, People’s Republic of China; 4Business School, Bahria University Islamabad, Islamabad, Pakistan; 5Department of Psychology, Institute of Southern Punjab, Multan, Pakistan; 6Department of Orthopaedics, Shenzhen University General Hospital, Shenzhen, People’s Republic of China; 7Key Laboratory of Molecular Epigenetics, Institute of Genetics and Cytology, Northeast Normal University, Changchun, Jilin, People’s Republic of China; 8Department of Weed Science and Botany, The University of Agriculture Peshawar, Peshawar, KPK, PakistanCorrespondence: Minru Zong, Department of Rehabilitation, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, Jilin, 130033, People’s Republic of China, Email zongmr@jlu.edu.cnPurpose: International students are highly vulnerable to the risk of mental health worsening before and during the pandemic (COVID-19). This study investigated international students’ mental health pre- and post-pandemic (COVID-19).Methods: It is a longitudinal study, and data were collected online, pre-pandemic (N = 470) and during the pandemic (N = 420). Using a random sampling technique, a self-administered questionnaire was used to measure mental health, including depression and anxiety.Results: Findings show that international students’ mental health was good in pre-pandemic. Meanwhile, international students were found to be more depressed and anxious during the pandemic. Findings also investigated that in the pre-pandemic phase, young students’ and mainly females’ mental health was worsened.Conclusion: This study concluded that students’ mental problems are alarming, so the university should provide psychological services for the student’s mental health. Post-pandemic is leaving long-lasting psychological effects and will require further investigation.Keywords: Covid-19, anxiety, depression, international students, mental health

This review article focuses on issues of economic analysis in providing care to patients requiring total hip arthroplasty. A large number of factors affecting the final financial result force us to look at economic research in the field of arthroplasty with a certain degree of criticality. At the same time, the existing financing systems cannot fully take into account all the possible costs arising from total hip arthroplasty. For this reason, studies concerning revision total hip arthroplasty are of particular interest, where treatment costs can vary significantly depending on the etiology and complexity of the case. These differences are reflected in the works of authors from France, Germany and Great Britain, who compared the treatment costs of patients with septic and aseptic revisions. Very different data both between countries and within the same country well demonstrate the need for a critical approach to the results of cost-effectiveness studies, QALYs based on Markov and other models, as the quality of the original data can be highly variable and reproduce the error of the initially incorrect price structure. At the same time, the rapidly increasing number of operations of primary and revision hip arthroplasty and, accordingly, the increasing economic costs of these operations require clear and effective economic criteria for their evaluation. The formation and application of these criteria will be the purpose of further research.

Background. Femoroacetabular impingement (FAI) is one of the most frequent causes of hip pain and limited hip mobility in young and middle-aged patients. It is a result of repeated injury of hip structures, that leads to degenerative changes in hip labrum, cartilage and subchondral bone and provokes progressive development of hip osteoarthritis. Aim of study to analyze own experience of treating patients with femoroacetabular impingement and identify factors affecting its outcomes. Methods. Retrospective, uncontrolled, single-center clinical study included 128 patients with FAI which had 150 surgeries on 149 joints in in the period from 2013 to 2021. All patients underwent physical examination and X-ray diagnostics, their FAI type was identified. The alpha angle of external part of femoral head in anterior-posterior position and in the modified Dunn 45 position, as well as Tonnis angle, lateral central-marginal angle in Ogata modification and the height of articular gap along the lateral (LS) and medial edges (MS) of sclerosed acetabulum part were calculated. The i-HOT-33 and HOS scales were used to assess preoperative status and postoperative results. Results. The average follow-up period was 3.9 years (SD 1.71; min 1.05 and max 8.16). The study included 55 (43.0%) women and 73 (57.0%) men which underwent 64 (42.7%) and 86 (57.3%) surgeries respectively. The most common types of FAI, according to our data, were mixed type (53% of joints) and сam type (27.5% of joints). Insufficient coverage of the femoral head by the acetabulum (borderline dysplasia) in combination with the сam deformity of the femoral head was observed in 18.1%. Pincer-type FAI was observed in 1.4% of joints. We obtained the worst results with a combination of сam deformity and borderline dysplasia in comparison with cam- and mix-type FAI according to the i-HOT-33 and HOS scales. Patients age, deep cartilage damage, irreparable labrum damage and height decrease of the lateral part of the articular gap determined negative effect on treatment results according to the i-HOT-33 and HOS scales. Conclusion. Hip arthroscopy showed good short- and midterm outcomes in patients with FAI. Pain syndrome is most often manifested in patients with pathology of hip soft tissue structures concomitant to FAI. The combination of сam deformity and insufficient femoral head coverage, deep cartilage damage and a height decrease of the articular gap are important predictors of poor treatment results.

Background. Resection arthroplasty with non-free muscle flap transfer allows to quickly eliminate the infection, but resulting in functional impairment of hip joint. To date, there are only a few publications with a small number of observations, where the proportion of patients who underwent the second stage of the revision hip arthroplasty (rTHA) is extremely small. The aim of the study was to evaluate the effect of resection arthroplasty on the functional outcomes and incidence of adverse outcomes in patients with difficult-to-treat (DTT) periprosthetic infection who had previously undergone resection arthroplasty with a non-free transfer of the axial flap fom the vastus lateralis muscle. Methods. The prospective study included 24 patients. During the period 20112021, at the first stage of the treatment for chronic recurrent DTT PJI of the hip, resection arthroplasty was performed with a non-free transfer of an island flap from the vastus lateralis muscle. Subsequent reimplantation of the endoprosthesis was performed in at least 1 year after the infection remission. The functional outcomes, degree of the lower limb shortening immediately before and in two or more years after revision arthroplasty (rTHA), the results of the microbiological cultures at the first and second stages of PJI treatment, technical aspects of the surgery as well as the postoperative period and long-term PJI remission were studied. Results. Revision arthroplasty resulted in a statistically significant improvement of the postoperative functional outcome and quality of life in patients. The average Harris score agter rTHA increased from 53 to 83 points after surgery, EQ-5D degree of the quality of life increased from 50 points to 80, the overall score from 0.61 to 0.74 and average intensity of pain via VAS decreased from 3 points to 1 point in 3.1 years after rTHA (p0.05). After reEP, complete restoration of the limb length was achieved in 29.1% of cases (n = 7) with an average compensation of the limb length for 4.5 cm. In 66.7% of patients (n = 16), the results of the intraoperative tissue biopsy microbiological analysis during reEP were culture negative. The recurrence rate of PJI was 12.5% (n = 3) up to 30 days after rTHA and 4.2% (n = 1) with a follow-up period of 3.1 years (IQR 2.14.1). With a single revision surgery performed without a delay, stable remission of DTT PJI was 95.8%. Conclusion. Complex two-stage surgical treatment using resection arthroplasty with a non-free muscle flap transfer at the stage of debridement and subsequent revision has demonstrated high efficiency in eliminating the infectious process as well as restoring weight-bearing capacity and extremity function. It could be recommended as a method of choice in the treatment of patients with DTT PJI of hip joint.

The guidelines describe modern approaches to the prevention, diagnosis, and treatment of thromboembolic complications in patients with injuries and after musculoskeletal surgery, in accordance with the interdisciplinary draft of the Clinical Guidelines (2022) Deep vein thrombosis of the extremities, which has passed public hearings and is being approved by the Russian Ministry of Health. The guidelines are designed for doctors of various specialties to provide medical care to specialized patients: orthopedic surgeons, anesthesiologists, resuscitators, clinical pharmacologists, health care organizers, medical students, residents, graduate students.

Abstract This study reports overall improvement in structural, morphological, and optoelectronic properties of Ruddlesden–Popper (RP) perovskites of type (BA)2(MA)n−1PbnI3n+1 by forming their bulk heterojunction hybrids with few‐layer MoS2 nanoflakes. RP perovskite–MoS2 hybrid thin films have shown significantly improved packing and crystallinity compared to pristine perovskites. The presence of MoS2 at RP perovskite interface has improved the quantum confinement effects and transport of photogenerated charge carriers from perovskite to MoS2, due to suitable conduction band of MoS2 and more number of decay channels. The optoelectronic properties of RP perovskite–MoS2 hybrids are studied for various MoS2 concentrations (4.2–25.6 × 10−3 m) and at optimum concentration (12.8 × 10−3 m) the photodetectors (n = 2, 4) have shown strong, sharp, and highly stable photocurrent response. At 0.0 V bias, the RP perovskite (n = 4) and MoS2 (12.8 × 10−3 m) hybrid‐based photodetectors, prepared without any encapsulation, have shown strong photocurrent density of ≈9.8 µA cm−2 under 1 sun illumination, which is ≈17 times higher compared to the pristine RP perovskites‐based photodetector (0.6 µA cm−2). Further transient photocurrent, performed over 200 cycles for hybrid (n = 4+MoS2) thin film photodetector under laser (λex ≈ 405 nm, ≈630 mW cm−2) illumination and ambient air conditions has shown highly stable photocurrent with only ≈9.6% reduction in the peak photocurrent density.

Introduction Custom-made acetabular componenents demonstrate a higher clinical efficiency in revision hip arthroplasty for 3A and 3B uncontained acetabular defects and pelvic discontinuity in comparison with serial implants. However, the cost of customized implants still outweighs the cost of serial implants. Accordingly, the level of economic feasibility of using different implants for various defects of the acetabulum seems to be interesting to investigate. Purpose To analyze the economic efficiency of using customized acetabular implants for 3A and 3B uncontained acetabular defects and pelvic discontinuity in comparison with serial implants. Materials and methods To assess the economic efficiency, the Markov model was applied. The model was built on the basis of 4-year survival data for aseptic loosening, infection, and dislocation in 133 cases of revision hip arthroplasty. Results According to the results of modeling, over a 5-year cycle, customized implants showed a reduction in costs by 11.7 % and an increase in the quality of life of patients by 0.2 QALY in the group of patients with 3A uncontained defects in comparison with serial implants. In patients with 3B uncontained defects and pelvic discontinuity, custom-made implants also showed a reduction in costs by 20.8 % and 41.1 %, and QALY values were also higher in the groups of patients who had custom-made implants at 0.6 and 1.4 QALY units, respectively. Conclusion The use of custom-made implants is a more cost-effective strategy in comparison with the implantation of serial acetabular components.

The relevance of the study is associated with the need to develop and improve technological methods for increasing oil production from the Bazhenov Formation in relation to the depletion of reserves in traditional granular reservoirs in the West Siberian oil and gas province. The features of the industrial development of these low-permeability rocks largely depend on their mineral-component composition. To identify different types of reservoirs of the Bazhenov Formation in wells that are not characterized by core material, it is necessary to develop a method for predicting its lithological composition. The main aim: to identify and study the relationships between the mineral component composition, and electrical rocks and radioactive properties of Bazhenov Formation in the central part of the West Siberian sedimentary basin for developing methods of calculating the content of basic rock-forming components in this formation section. The object of the research is the carbonate-argillaceous-siliceous rocks of the Bazhenov Formation, characterized by a large heterogeneity of the mineral-component composition along the section. Methods: identification of relationships between the mineral-component composition of the rocks of the Bazhenov Formation and its electrical and radioactive properties; statistical analysis of the obtained relations; calculation on their basis of the lithological composition of the Bazhenov rocks in the base, as well as in adjacent wells. Results. The article presents the results of an integrated lithological and geophysical interpretation of data from a wide range of electrical and radioactive logging and the results of analytical core studies, on the basis of which a methodological approach to calculating the concentrations of the main rock-forming components of the Bazhenov Formation has been developed. It is based on the identified relationships between the mineral-component composition of rocks and their physical properties. Satisfactory convergence of the calculated values ​​and core data is shown, volumetric lithological models are built for the wells of the Druzhnaya and Povkhovskaya areas. It is shown that the obtained dependences can be used to reliably calculate the lithological composition of the Bazhenov Formation in closely spaced wells that are not characterized by core material. The impossibility of using the proposed methodological approach in thin-layered sections is substantiated due to the fact that the thickness of the interlayers is much less than the resolving power of geophysical borehole probes.

Background. Protein-energy malnutrition (PEM) is an established risk factor of postoperative complications in orthopedic disorders, including arthroplasty of the large joints. The study aimed to evaluate PEM prevalence and its association with the early postoperative revision in patients with the difficult-to-treat (DTT) prosthetic joint infection (PJI) of the hip. Methods. The retrospective study included 132 patients with chronic DTT PJI of the hip. The patients underwent orthopedic implant removal, radical debridement of the infected tissues, and resection arthroplasty with non-free transplantation of an axial vastus lateralis muscle flap (n = 57) or installation of an antimicrobial spacer (n = 75). DTT PJI was defined as an infection caused by rifampicin-resistant staphylococcal strains, ciprofloxacin-resistant gram-negative bacteria, fungi of the genus Candida, and their associations. The assessment of the patients protein-energy status included the evaluation of reference laboratory parameters, such as levels of hemoglobin, total protein, and albumin and number of lymphocytes. The degree of PEM was determined by the number of laboratory markers below the threshold values. The statistical comparison was performed using Fishers test. The odds ratio (OR, 95% confidence interval [CI]) was calculated to assess the risk of PJI recurrence. Differences were considered significant at p0.05. Results. More than 70% of patients with chronic DTT PJI included in the study were diagnosed with preoperative PEM of varying degrees of severity. Hypoalbuminemia and decreased hemoglobin levels were diagnosed more often: 64.3% and 57.1% in the muscle flap plasty and 57.3% and 31.1% in the antimicrobial spacer group, respectively. In muscle plasty and antimicrobial spacer groups, a decrease in the values of three or more reference PEM markers was detected in 28.5% and 16.0% of patients, and this advanced impairment of the nutritional status increased the risk of early revision intervention by two (OR 2.0; CI 95% 0.478.56; p = 0.35) and six times (OR 6.11; 95% CI 1.0635.35; p0.04), respectively. Conclusion. In general, the analysis of publications and results of our study show that PEM is associated with the development of surgical site infection and recurrence of PJI after revision surgery. A decrease in the values of three or more reference PEM markers is a significant predictor of repeated revisions after debridement surgery with the installation of an antimicrobial spacer. PEM complicates the postoperative course in patients with resection arthroplasty. Given the high incidence of PEM in patients with DTT PJI of the hip joint, further research is needed to develop methods for nutritional status correction and assessment of their effect on the outcomes of debridement surgery.

Abstract. Introduction Current operations of elbow arthroplasty are accompanied by an extremely high rate of complications in the early and long-term periods. Therefore, along with the widespread growth of primary arthroplasty, there is a growing need for revision interventions. Purpose To study the age groups of patients at the time of primary and revision arthroplasty, to investigate the reasons of the first and repeated revisions, the scope of interventions, as well as the time since the previous AP. Materials and methods A retrospective analysis of 133 cases of elbow revision arthroplasty (111 patients) treated from 2003 to 2019 was conducted. The rate of re-revisions was 16.5 %. The study investigated the age of patients, reasons for the first and repeated revisions, the scope of interventions, as well as the time passed since the previous elbow arthroplasty. Results In the structure of primary and revision arthroplasty, there was a significant dominance of patients aged 51 to 60 years (25.4 % and 33.3 %, respectively). However, the total rate of patients under 40 years old in the group of primary arthroplasty was 33.5 %, and in the revision group it was 34.2 %. The most frequent reason in the first and repeated revisions was aseptic loosening: 47 % and 50 %, respectively, followed by PJI (23 % in both groups), dislocation (10 % and 18 %, respectively) and breaks of the implant's components (8 % and 4 %). Other complications were less common (12 % and 5 %, respectively). Most of the revisions for PJI were performed in the first year since the previous arthroplasty (56.7 %). In terms of aseptic instability, early and late periods were identified. The ratio of early revisions to the total number of primary arthroplasty during the entire time of the surgical team's work decreased from 19.4 % to 3.5 %. Discussion The observed number of young people in the age structure of primary and revision AP in the long term is likely to lead to an increase in the number of patients with severe bone defects. The data of our study demonstrate a significant decrease in the number of revisions over the past 5 years performed for early loosening, despite the general increase in the number of primary APs. Conclusion The study identified a considerable number of young patients, which could potentially lead to an increase in the number of repeated revisions and related problems, including pronounced bone defects and recurrent infection. All this actualizes the need to improve the technique of revision arthroplasty.

The aim of the study was to identify independent factors influencing the risk of death in patients with PJI after revision THA. Materials and methods The study included 51 lethal outcomes in patients with chronic PJI of the hip. Results and discussion In our cohort of 434 patients, 13 (2.99 %) patients died within the first year after surgery (p > 0.05), which is 2.2 times less than similar published data. The result of gender analysis showed no statistically significant differences in the risk of death between men and women (OR1.05 CI 0.59–1.89, p = 0.87). It was found that in patients over 70 years old, the risk of death was significantly higher (OR 2.05 CI 1.09–3.87, p = 0.031). Additional independent risk factors of death are diseases of the cardiovascular system. It was not possible to find a statistically significant effect of the nature of infection on the risk of death: no growth (OR 2.23, CI 0.52–9.61), monomicrobial infection (OR 1.98, CI 0.45–8, 73), polymicrobial infection (OR 3.2, CI 0.71–14.45, p > 0.05). Conclusion The mortality rate during the first year after revision THA in patients with PJI was 2.99 %, which is lower than the results of other researchers. In the next 2–3 years, the rate of death increases 3.9 times. The main independent risk factors are the age of patients and concomitant diseases of the cardiovascular system.

Abstract. Introduction The Covid-19 pandemic has led to quite significant changes in the length of hospital stay of orthopedic patients. Meanwhile, there has been a tendency for early discharge after arthroplasty for quite some time due to the increasing burden on health care systems that became possible due to the implementation of accelerated rehabilitation protocols. This study is dedicated to the effect of discharge terms on the incidence of postoperative complications. Material and methods A retrospective study of 1,837 patients who underwent primary/revision THA and TKA at our center in 2020 was carried out. The impact of the pandemic was assessed by comparing the duration of hospitalization, the incidence of complications and functional status in patients operated on before and after the introduction of epidemiological restrictions. Purpose of the study To assess the impact of the Covid-19 pandemic on the length of patients’ hospital stay after knee and hip arthroplasty. Results The total duration of hospitalization after primary THA was reduced by 35 % (from 11.8 ± 3.3 to 7.7 ± 2.6 bed-days), and by 38 % (from 19.9 ± 7.5 to 12.8 ± 6.3 bed-days) after revision THA. The overall readmission rate (for surgical and nonsurgical complications) after primary THA was 4.1 % before the pandemic and 4.3 % during the pandemic; for primary TKA it was 2.1 % and 5.1 %, respectively; for revision THA – 13.9 % and 4.5 %, revision TKA – 4.4 % and 9.8 %, respectively. Comparative assessment for each diagnosis separately did not show significant difference. Evaluation of the questionnaire survey using the Oxford hip/knee score also showed the absence of a statistically significant relationship between the time of discharge and the functional state of the operated joint. The interviewing of patients regarding the infection with coronavirus yielded positive answers in 22 % (n = 419). The onset of symptoms during hospitalization or within 14 days after discharge was noted by 4 % of respondents (n = 75). Conclusion The incidence of complications and unfavorable outcomes did not depend on the length of hospital stay after THA and TKA.

This publication is the official report describing all total hip arthroplasty procedures registered in the database from 01.01.2007 to 31.12.2020. During this period, 74762 operations were performed: 67019 (89.64%) primary and 7743 (10.36%) revision. The proportion of males and females underwent primary arthroplasty was 41.1% and 59.0%, respectively. The age of patients with primary arthroplasty was 57.8 years (95% CI from 57.7 to 57.9), with revision 59.3 years (95% CI from 59.0 to 59.6). The absolute number of primary hip arthroplasty procedures added into the database increased annually from 2007 to 2012. Since 2015, there has been a trend towards a decrease in the number of hip arthroplasty, due to the more intensive growth in the number of knee replacements performed. The number of revision hip arthroplasty operations varies from year to year with a clear tendency to increase, except 2020. The large proportion of revisions are accounted for by early revisions performed in the first years after primary hip arthroplasty, as well as early re-revisions. The main types of implants fixation on primary arthroplasty during the reporting period were cementless (50.89%) and hybrid (32.33%). In patients of older age groups, there is a significant decrease in the proportion of cementless fixation, while the proportion of hybrid, reverse hybrid and cemented structures is increasing. There are significant fluctuations in the ratio of different types of implants fixation in different years.

Background. Since there is no national arthroplasty registry in the Russian Federation, the exact number of arthroplasty operations performed is unknown. Aim of the study to evaluate the epidemiology of primary, revision hip and knee arthroplasty and periprosthetic joint infection in Russian Federation. Materials and Methods. The inquires were made to 85 subjects, 73 federal state budget institutions and 30 private hospitals. Results. Answers were received from 76 subjects of Russian Federation, 41 federal and 18 private hospitals. The studied indicators revealed to be pretty much heterogenic. The decrease of operations number from 20% to 40% in subjects of Russian Federation due to SARS-CoV-2 pandemic forced us to make no analysis for these 2020 indicators in Russian Federation generally. 147 061 primary hip and knee arthroplasties were performed in 2019 in Russian Federaion. 7 770 revison hip and knee arthroplasties were done. 6 606 cases of severe orthopaedic implant-assosiated infection were cured including 4 282 cases post hip and knee arthroplasties that constitutes 2,91 % from primary arthroplasties. Conclusions. The frequency of periprosthetic joint infection in Russian Federation correlates to the world data. High complexity for patients routing with implant-assosiated infection and strong demand for Federal Center of implant-assosiated orthopaedic infection are revealed.

Abdulrhman Fahad Aljouie,1,2 Ahmed Almazroa,2,3 Yahya Bokhari,1,2 Mohammed Alawad,1,2 Ebrahim Mahmoud,4 Eman Alawad,4 Ali Alsehawi,5 Mamoon Rashid,1,2 Lamya Alomair,1,2 Shahad Almozaai,6 Bedoor Albesher,6 Hassan Alomaish,5 Rayyan Daghistani,5 Naif Khalaf Alharbi,2,7 Manal Alaamery,2,8– 10 Mohammad Bosaeed,2– 4 Hesham Alshaalan5 1Bioinformatics Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4Department of Medicine, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; 5Department of Medical Imaging, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; 6College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 7Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 8Department of Developmental Medicine, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 9KACST-BWH Center of Excellence for Biomedicine, Joint Centers of Excellence Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia; 10King Abdulaziz City for Science and Technology (KACST)-Saudi Human Genome Satellite Lab at Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi ArabiaCorrespondence: Mohammed AlawadBioinformatics Section, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaEmail malawad@sdaia.gov.saAhmed AlmazroaDepartment of Imaging Research, King Abdullah International Medical Research Center King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaEmail almazroaah@ngha.med.saBackground: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, in late 2019 and created a global pandemic that overwhelmed healthcare systems. COVID-19, as of July 3, 2021, yielded 182 million confirmed cases and 3.9 million deaths globally according to the World Health Organization. Several patients who were initially diagnosed with mild or moderate COVID-19 later deteriorated and were reclassified to severe disease type.Objective: The aim is to create a predictive model for COVID-19 ventilatory support and mortality early on from baseline (at the time of diagnosis) and routinely collected data of each patient (CXR, CBC, demographics, and patient history).Methods: Four common machine learning algorithms, three data balancing techniques, and feature selection are used to build and validate predictive models for COVID-19 mechanical requirement and mortality. Baseline CXR, CBC, demographic, and clinical data were retrospectively collected from April 2, 2020, till June 18, 2020, for 5739 patients with confirmed PCR COVID-19 at King Abdulaziz Medical City in Riyadh. However, of those patients, only 1508 and 1513 have met the inclusion criteria for ventilatory support and mortalilty endpoints, respectively.Results: In an independent test set, ventilation requirement predictive model with top 20 features selected with reliefF algorithm from baseline radiological, laboratory, and clinical data using support vector machines and random undersampling technique attained an AUC of 0.87 and a balanced accuracy of 0.81. For mortality endpoint, the top model yielded an AUC of 0.83 and a balanced accuracy of 0.80 using all features with balanced random forest. This indicates that with only routinely collected data our models can predict the outcome with good performance. The predictive ability of combined data consistently outperformed each data set individually for intubation and mortality. For the ventilator support, chest X-ray severity annotations alone performed better than comorbidity, complete blood count, age, or gender with an AUC of 0.85 and balanced accuracy of 0.79. For mortality, comorbidity alone achieved an AUC of 0.80 and a balanced accuracy of 0.72, which is higher than models that use either chest radiograph, laboratory, or demographic features only.Conclusion: The experimental results demonstrate the practicality of the proposed COVID-19 predictive tool for hospital resource planning and patients’ prioritization in the current COVID-19 pandemic crisis.Keywords: COVID-19, mortality, NIV, X-rays, CBC, random forest, SMOTE; machine learning

Background: The infection of Corona Virus Disease (Covid-19) is challenging health problems worldwide. COVID-19 pandemic is spreading all over the world with the number of infected cases increased to 54.4 million with 1.32 million deaths. Different types of statistical models have been developed to predict viral infection and multiple studies have compared the performance of these predictive models, but results were not consistent. This study aimed to develop and provide easy to use model to predict the Covid-19 infection severity in the patients and to help understanding the patient’s condition. Methods: This study analyzed simulated data obtained from the large database for 340 patients with an active Covid-19 infection. The study identified predictors of Covid-19 outcomes that may be measured in two different ways: the total T-cell levels in the blood with T-cell subsets and number of cells in the blood infected with virus. All measures are relatively unobtrusive as they only require a blood sample, however there is a significant laboratory cost implications for measuring the number of cells infected with virus. This study used methodological approach using two different methods showing how multiple regression and logistic regression can be used in the context of Covid-19 longitudinal data to develop the prediction models. Results: This study has identified the predictors of Covid-19 infection outcomes and developed prediction models. In the regression model of Total_T Cell, the predictors BMI, comorbidity and Total_Tcell were all associated with increased levels of infection severity (p < 0.001). For BMI, the mean % of unhealthy cells increased by 0.42 (95% CI 0.24 to 0.60) and comorbidity predictor has on average 8.3% more unhealthy liver cells than without comorbidity (95% CI — 2.9%–1.29%). The results of multivariate logistic regression model predicting the Covid-19 Infection severity were promising. The significant predictors were observed such as Age (OR 0.95, p = 0.02, 95% CI: 0.91–0.99), Helper T_cells (OR O.93, p = 0.03, 95% CI: 0.87–0.99), Basic_Tcell (OR 1.11, p = 0.001, 95% CI: 1.06–1.71) and Comorbidity (OR 0.41, p = 0.05, 95% CI: 0.16–1.07). Conclusions: In this study recommendation has been provided to clinical researchers on the best way to use the various Covid-19 infections measures along with identifying other possible predictors of Covid-19 infection. It is imperative to monitor closely the T-cell subsets using prediction models that might provide valuable information about the patient’s condition during the treatment process.

The use of Artificial intelligence in healthcare has evolved substantially in recent years. In medical diagnosis, Artificial intelligence algorithms are used to forecast or diagnose a variety of life-threatening illnesses, including breast cancer, diabetes, heart disease, etc. The main objective of this study is to assess self-management practices among patients with type 2 diabetes in rural areas of Pakistan using Artificial intelligence and machine learning algorithms. Of particular note is the assessment of the factors associated with poor self-management activities, such as non-adhering to medications, poor eating habits, lack of physical activities, and poor glycemic control (HbA1c %). The sample of 200 participants was purposefully recruited from the medical clinics in rural areas of Pakistan. The artificial neural network algorithm and logistic regression classification algorithms were used to assess diabetes self-management activities. The diabetes dataset was split 80:20 between training and testing; 80% (160) instances were used for training purposes and 20% (40) instances were used for testing purposes, while the algorithms’ overall performance was measured using a confusion matrix. The current study found that self-management efforts and glycemic control were poor among diabetes patients in rural areas of Pakistan. The logistic regression model performance was evaluated based on the confusion matrix. The accuracy of the training set was 98%, while the test set’s accuracy was 97.5%; each set had a recall rate of 79% and 75%, respectively. The output of the confusion matrix showed that only 11 out of 200 patients were correctly assessed/classified as meeting diabetes self-management targets based on the values of HbA1c < 7%. We added a wide range of neurons (32 to 128) in the hidden layers to train the artificial neural network models. The results showed that the model with three hidden layers and Adam’s optimisation function achieved 98% accuracy on the validation set. This study has assessed the factors associated with poor self-management activities among patients with type 2 diabetes in rural areas of Pakistan. The use of a wide range of neurons in the hidden layers to train the artificial neural network models improved outcomes, confirming the model’s effectiveness and efficiency in assessing diabetes self-management activities from the required data attributes.

The article presents the results of studying the geological structure of the Bazhenov Formation in the Nadym-Ob interfluve of Western Siberia with the aim of predicting the oil content of this black shale stratum. As a result of interpretation of a wide range of well logging represented by electric, radioactive and acoustic logging, with subsequent matching of these results with paleontological definitions of micro- and macrofauna, the distribution of the Salym, Nizhnevartovsky and Tarkosalinsky types of sections of the Bazhenov Formation was clarified, transitional areas between them were identified. It has been established that the Tarkosalinsky type is more widespread in the western direction than was shown earlier and is also distinguished in the Vengayakhinskaya, Yaraynerskaya and other areas. The Nizhnevartovsky type, on the contrary, has a narrower distribution and stands out directly within the same name arc and to the south by the Variegasky-Tagrinsky megahigh. On the basis of geological, geochemical, geophysical criteria and the results of an inflow test in deep wells, a map of the oil potential prospects of the “classical” sections of the Bazhenov Formation has been compiled. Regional prerequisites (high catagenesis of organic matter, significant modern concentrations of organic carbon, etc.) for the discovery of industrial accumulations of oil in the Bazhenov Formation in the southern regions of the Yamalo-Nenets Autonomous Area are identified. The results of the test for the inflow of the Bazhenov Formation in this area in the 70–90s XX century were analyzed; repeated, interval testing of these deposits using modern methods of stimulation of the inflow is recommended. The necessity of laboratory lithological, petrophysical, geochemical study of the core of the Bazhenov Formation in the southern part of the Yamalo-Nenets Autonomous Area is substantiated with the aim of determining its lithological composition, identifying oil source and oil productive intervals, studying the reservoir structure and the nature of saturation of its void space, developing recommendations for calculating oil reserves and creating technology for its cost-effective production.

Introduction Osteolysis is a common problem in the long-term outcome after total hip arthroplasty, since the wear of a polyethylene liner is an inevitable process. However, its pace depends on many factors and not all of them have been proven. In particular, many studies do not find a connection between the wear rate of the liner and the position of the acetabular component. The purpose of this publication is to demonstrate the importance of correct acetabular component positioning. Methods A clinical case of bilateral total hip arthroplasty with follow-ups after 17 and 19 years is presented. The patient was operated being 31 and 33 years old, respectively, by one surgeon. The same type of the acetabular component was installed with the same type of polyethylene and friction pair diameter. It eliminates implant or surgical approach factors and patient characteristics. The position of the implant components is then remains the most important factor. For analysis, there were radiographs before the operation, at different times after it, CT data and intraoperative photos during the revision surgery. Results At the time of the last examination, there were minor manifestations of retroacetabular osteolysis that were better seen in CT and were more pronounced on the right. CT radiometry data on the angles of inclination of the acetabular components were 50.6° and 46.7° on the right and left, respectively, and the anversion was 40.3° and 25.4°. Revision of the right total hip arthroplasty was performed and it was found that the liner wear extended till the metal layer. Given good fixation of the cup, only the liner was exchanged and osteolytic cavities were filled with allogenic bone chips. Discussion The case can be considered a very good result of primary arthroplasty as revision surgery in this young patient was performed only after 17 years. However, in the contralateral joint the implant with the same pair of friction has survived for 19 years and at the moment it is early to decide on its revision. In our opinion, this case is an excellent illustration of the importance of the correct positioning of implant components.

Background: Regional anesthesia and analgesia are being widely used nowadays, especially for lower-segment cesarean section (LSCS). However, according to some studies, as well as our observation, there is a high incidence of pruritus among patients undergoing LSCS under regional technique as compared to nonpregnant female patients. To enhance the quality of analgesia and increase the duration of spinal anesthesia, fentanyl is often added as an adjuvant drug. Till date, only few studies have reported the incidence of pruritus among this group after spinal anesthesia with added fentanyl, but none compared it to nonpregnant patients. Aim and Objective: The primary aim of this study was to estimate the magnitude of pruritus after intrathecal fentanyl in parturient patients. The secondary objective was to establish other pathophysiological mechanisms such as patient's body habitus and sex of the baby, which might influence the incidence and severity in this population as compared to nonpregnant patients. Materials and Methods: One hundred and sixty American Society of Anesthesiologists I and II female patients aged between 18 and 45 years were divided into two equal groups. Pregnant women group underwent LSCS, while nonpregnant patients had lower limb orthopedic surgery. Spinal anesthesia was administered using 20 mcg of fentanyl with 2.5 ml of 0.5% bupivacaine. Frequency and severity of pruritus were recorded in the patients of either group. Statistical analysis of the data was done using Chi-square test and logistic regression using SPSS version 22. A P < 0.05 was considered statistically significant. Results: The incidence of pruritus among pregnant women was noted to be 21.5%, which is significantly higher (P < 0.05) than that in the nonpregnant patients (3.75%). Pregnant patient's body habitus and gender of the baby were not found to influence the incidence or severity of pruritus (P > 0.05). Conclusions: Pregnancy is not only a risk factor for pruritus after intrathecal fentanyl but is also responsible for increasing the severity of pruritus.

Majority of Indian hospitals still lack the provision of acute postoperative pain relief service. In other parts of the world, field of acute pain management strategy has witnessed a surge in its implementation. Today, acute pain has begun to be recognized not merely as a distressing symptom but also as a precursor of chronic, debilitating pain. This development warrants that we in India address this issue on an urgent basis through the use of analgesic/narcotic combination via parenteral/oral/rectal route as well as by performing regional blocks, to meet the interpatient variability and available facility. In this review article, we have provided the organization and function of acute pain service (APS) program that can be adapted to a wide spectrum of Indian hospitals. We have outlined the role of APS team including the use of easily available analgesic/narcotic drug combinations for various categories of Indian hospitals dealing with different grades of surgical conditions, including those hospitals that are not sufficient in resources and funding. This article has also tabulated possible regional block techniques with their indications for treating acute postoperative pain in combination with parenteral/oral/rectal analgesics/narcotics in the more developed Indian hospitals. Staffing and equipment requirements have also been outlined.

Background: Shivering is an undesirable, unpleasant experience after spinal anesthesia. Injecting cold bupivacaine has been incriminated as a contributory factor. Aims and Objective: In this prospective study we evaluated the efficacy of warming the heavy bupivacaine to body temperature for prevention of shivering and if it influences analgesic quality of spinal anesthesia. Materials and Methods: In this double blind, randomized controlled study, 100 patients aged 20-35 years of American Society of Anesthesiologist physical status I and II undergoing elective or emergency Caesarean sections were included and allocated to either Room temperature group (RT Group, n= 50), or Body temperature group (BT group, n = 50). A standard spinal anesthetic of 2ml of 0.5 % heavy bupivacaine plus 20 microgram of fentanyl was administered using 25G pencil point spinal needle in the sitting position. Besides the incidence and intensity of shivering and effect on intraoperative analgesia, effect on hemodynamics, nausea, vomiting, blood loss, pruritis and Apgar scores were recorded. Data was analyzed using SPSS (The Statistical Package for Social Sciences) version 22.0 software (International Business Machines Corporation, Armonk, New York, USA). P < 0.05 was considered significant. Results: The patients were comparable in terms of demographic variables. Shivering was present in 31 (62%) and 7 (14%) patients respectively in RT and BT Groups, which was statistically significant (P = 0.0001). Intensity of shivering ≥3 was observed in 15 (30%) patients of RT group and 5 (10%) patient in BT group. We did not note any difference in the analgesic status intraoperatively nor any difference in the duration of analgesia. Surprisingly, the incidence of pruritis was significantly reduced in the BT group as compared to RT group (P = 0.037). Conclusions: Warming the heavy bupivacaine to body temperature is effective in preventing shivering and reducing pruritis secondary to spinal anesthesia without affecting analgesia.

Objective This study aimed at assessing the self-management activities of type 2 diabetes patients using Structural Equation Modeling (SEM) which measures and analyzes the correlations between observed and latent variables. This statistical modeling technique explored the linear causal relationships among the variables and accounted for the measurement errors. Methods A sample of 200 patients was recruited from the middle-aged population of rural areas of Pakistan to explore the self-management activities of type 2 diabetes patients using the validated version of the Urdu Summary of Diabetes Self-care Activities (U-SDSCA) instrument. The structural modeling equations of self-management of diabetes were developed and used to analyze the variation in glycemic control (HbA1c). Results The validated version of U-SDSCA instrument showed acceptable psychometric properties throughout a consecutive reliability and validity evaluation including: split-half reliability coefficient 0.90, test-retest reliability (r = 0.918, P ≤ .001), intra-class coefficient (0.912) and Cronbach’s alpha (0.79). The results of the analysis were statistically significant (α = 0.05, P -value

Objective: The English version of the Summary of Diabetes Self-Care Activities (SDSCA) measure is the most frequently used self-reporting instrument assessing diabetes self-management. This study is aimed at translating English SDSCA into the Urdu version and validating and evaluating its psychometric properties. Methods: The Urdu version of SDSCA was developed based on the guidelines provided by the World Health Organization for translation and adaptation of instruments. The panel of experts examined the content validity, reliability, and internal consistency of the instrument. The translation process from the English version to the Urdu version revealed excellent results at all the stages. Results: The instrument showed promising and acceptable results. Of particular mention are the results related to split-half reliability coefficient 0.90, test-retest reliability ( r = 0.918, P < .001), intraclass coefficient (0.912), and Cronbach’s alpha (.79). The factor analysis (exploratory and confirmatory) was not performed in this study due to the small sample size (n = 30) as the objective was to validate the Urdu version of the SDSCA instrument. Conclusions: This study provided evidence for the reliability and validity of the Urdu Summary of Diabetes Self-Care Activities (U-SDSCA) instrument, which may be used in the future for the patients of diabetes in order to assess type 2 diabetes self-management activities in the rural area of Pakistan and other Urdu-speaking countries.

The present study aims at understanding the reality of teacher research in the Sultanate of Oman, how to benefit from such research in the improvement of teacher development and the teaching-learning process, who should do that, as well as informing current literature with updates on teacher research, a topic that is not yet given adequate attention in Oman. The study implemented a qualitative approach for data collection and analysis of 50 researches done by school-teachers and 22 interviews with research teachers, school head-teachers and educational specialists. The study revealed that teachers are interested in doing research. Teachers, school administration and supervisors benefit from teacher research. Teachers use their own ways to take advantage from their own research and to share it with other teachers and help them value its results and recommendations. The study recommends that a culture of teacher research should be founded in schools, teachers should be supported to do research and more research should be done to explore the extent to which teacher research meets the criteria of educational research so that it can be trustworthy and useable for schooling improvement.

Sixty seven healthy growing goat kids of three Omani breeds, born and raised in Sultan Qaboos University Agricultural Experiment Station, were used to study the effects of age, breed and sex on haematological parameters. Blood samples were collected at several times from the first to 25 weeks to study the following parameters: Red Blood Cells (RBCs), White Blood Cells (WBCs), Packed Cell Volume (PCV), Haemoglobin (Hb), Mean Cell Volume (MCV), Mean Cell Haemoglobin Concentration (MCHC) and Mean Cell Haemoglobin (MCH). At birth, MCV and MCH levels were significantly higher in Batina (BAT) kids than both Jabal Akhdar (JA) and Dhofari (DOF), but there were no breed differences in the rest of the haematological values. There were significant breed differences in RBC, MCH, WBC, MCV at different ages, with Hb and PCV being highly significant at all ages. All blood parameters changed with time but showed different patterns in all breeds. There was no effect of sex on RBC, MCHC, PCV, Hb or WBC, but female kids had significantly higher MCH and MCV values at week 12. This study indicates that haematology parameters in Omani goat kids could be affected by age, breed and sex.

Patients with cancer are known to have a poor prognosis when infected with SARS-CoV-2 infection. We aimed in this study to assess health outcomes in COVID-19 patients with different cancers in comparison to non-cancer COVID-19 patients from different centers in the United States (US). We evaluated medical records of 1,943 COVID-19 Cancer patients from 3 hospitals admitted between December 2019 to October 2021 and compared them with non-cancer COVID-19 patients. Among 1,943 hospitalized COVID-19 patients, 18.7% (n=364) have an active or previous history of cancer. Among these 364 cancer patients, 222 were African Americans (61.7%) and 121 were Caucasians (33.2%). Cancer patients had significantly longer hospitalization compared to controls (8.24 vs 6.7 days). Overall, Lung cancer is associated with high mortality. Patients with a previous history of cancer were more prone to death (p=0.04) than active cancer patients. In univariate and multivariate analyses, predictors of death among cancer patients were male sex, older age, presence of dyspnea, elevated troponin, elevated AST (0.001) and ALT (0.05), low albumin (p=0.04) and mechanical ventilation (p=0.001). Patients with a previous history of cancer were more prone to death when compared to active cancer COVID-19 patients. Early recognition of cancer COVID-19 patients death-associated risk factors can help determine appropriate treatment and management plans for better prognosis and outcome.