BACKGROUND Chronic wounds affect mainly the productive age group in developing countries and stretch the limited healthcare facility. We aimed to establish the efficacy or otherwise of pawpaw dressing in management of common forms of wounds in resource-poor settings using the Nigerian pawpaw in humans. METHODS This study was a prospective research carried out at Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria between September 2019 and August 2020 using patients with lower extremity wounds. Thirty patients who had lower extremity wounds that required debridement were enrolled in the study after giving consent. They had wound dressing with unripe pawpaw as an enzymatic debriding agent to evaluate the rapidity of eschar separation and bacterial clearance. The data obtained with a proforma were analyzed using IBM SPSS. RESULTS There were 16 males and 14 females with an average wound size of 127. 13+ 103cm2. Eschar separation occurred earliest after 3 d of dressing and the latest after 14 d with a mean period of 5. 5+ 2. 255 days. A case had negative bacterial culture on the first test. Others had a variable period of clearance with a maximum of 18 d and a mean of 6. 73+3. 750 days. Both eschar separation and bacterial clearance correlated positively with the wound size. CONCLUSION Wound bed preparation with unripe pawpaw dressing showed promising outcomes with rapid eschar and slough separation, and bacterial clearance resulting in a faster wound healing. This is recommended for wounds needing debridement in which the patients are not fit for anesthesia or could not afford the cost of surgery.

Tehran prospective survey of lipid and sugar" is the first biggest epidemiologic study in Iran, conducted with the aim of determining the etiologic factors of cardiovascular disease in Tehran urban residents. This study, covering a vast majority of the population, was begun with society recognition and just like other prospective studies has paid more attention to social relations. Familiarizing the society with research objectives and encouraging them to active participation were among the most determining factors observed exactly in this survey. This was entrusted to the "group of social relations", composed of social workers and health assistants of East Health Services System. They have face to face communication with the studied society and have covered about 17000 cases within the first two years in Tehran 13th District. Despite being aware of weak points of therapeutic and health services and also employing previous experiments, we have faced numerous unpredictable problems. However, resolving these problems has brought us valuable experiences, steering us towards facilitated next steps. In this study we have taking advantage of voluntary "health assistants" and 3 Health Services Centers supervised by Shahid Beheshti University of Medical Sciences. Removing opposing tendencies towards public health services, spending adequate time for explaining and conducting the research, achieving strategies for cultural beliefs' concurrence, and finding ways of population excitement for participation were other activities performed in our study.

Oral feeding is the best means of nutrition in surgical patients. There are many reports on early oral feeding after lower gastrointestinal (GI) operations but data regarding upper GI procedures is rather scant. This limited study focuses on early removal of nasogastric tube and start of oral diet after transhiatal esophagectomy. We prospectively evaluated 13 consecutive patients (8 males, 5 females) with esophageal cancer who had undergone transhiatal esophagectomy from March 2001 to September 2003. Nasogastric tube was removed on post-op day 2 and clear liquids started on day 3. Diet was advanced to soft regular in the next 5 days if the patients tolerated it. Mean age of patients was 63 years. Mean body weight and serum albumin level were 57.9 kg and 3.73 gr/dL, respectively Tumor pathology was squamous cell carcinoma in 12 cases and adenocarcinoma in 1. Location of tumor was at the lower third of the esophagus in 12 cases and middle third in one. All patients in the study group tolerated the protocol well. Only one patient had nausea after oral intake, without vomiting. We had one neck wound infection and one pulmonary infection. There was no anastomotic leakage or fistula. A group of 10 esophageal cancer patients undergoing transhiatal esophagectomy in the same period were used as the control group. One anastomotic leakage occurred in control group. We had no significant complication. Early nasogastric tube removal and oral feeding seems to be safe in patients with esophageal cancer undergoing transhiatal esophagectomy.

While anterior cruciate ligament (ACL) injury prevention programs (IPP) have shown strong evidence of their effectiveness, their implementation rate is low. Knowledge translation (KT) model is a proactive and evolving strategy designed to close the disconnect between proven research and practical application; therefore, this research aimed to examine the effectiveness of a KT-based ACL-IPP on the movement quality of young female soccer players. Eight female soccer players participated in a preliminary prospective study. The mean age, height, and weight of the participants were 13.3 (standard deviation [SD]=0.7) years old, 1.68 (SD=0.03) m, and 57.3 (SD=4.9) kg, respectively. The IPP was performed throughout a soccer season. Biomechanical analyses were performed before and following the IPP. Subjects were instrumented with motion capture markers and instructed to perform the following tasks: step down, drop jump, lateral shuffle, cutting, deceleration, and triple jump. Sagittal thigh angle, knee valgus angle, pelvic drop angle, and frontal trunk angle at maximum knee flexion were calculated. Paired t-tests were used to compare each movement performance in each task over time. The results revealed that sagittal thigh angle (mean difference=7.6 (SD=9.8)°, P=0.004) and knee varus (mean difference=3.5 (SD=5.8)°, P=0.014) were found to increase in drop jump. Sagittal thigh angle also increased in lateral shuffle (mean difference=2.1 (SD=4.8)°, P=0.047). However, pelvic drop angle was found to increase in deceleration (mean difference=2.6 (SD=3.7)°, P=0.006). The study demonstrated potential effectiveness of a KT-based ACL-IPP in showing improvement in shock absorption and knee stability among a group of youth female soccer players, both of which are critical in reducing risk of ACL injury. This preliminary prospective study provides a foundation for future research to explore the long-term benefits and feasibility of KT-based ACL-IPPs in a larger scale and diverse populations.