An Overview on Flavor Extraction, Antimicrobial and Antioxidant Significance, and Production of Herbal Wines

Wine has been utilized as a source for medicinal preparations, combined with various herbs, to treat particular ailments and disorders. By utilizing herb extracts, regular but limited consumption of these herbal wines helps to decrease the need for prescription medications to treat a variety of ailments. The diversity and the composition of the yeast micropopulation significantly contribute to the sensory characteristics of wine. A particular metabolic activity characterizes the growth of each wine yeast species, which determines the concentrations of flavor compounds in the final wine. Numerous herbs, such as tulsi, ginger, aloe vera, tea, amla, lemongrass, and peppermint, are used in the preparation of herbal wines, where either the herb or herbal blends are primarily used as the substrate. The variants provided improved accuracy, increased acceptability, and broader uses for the novel product. Herbal wines pave the way to provide nutraceuticals to consumers and protection against pathogenic microorganisms and inflammation through their richness in antioxidants. The existing herbal wines and their health advantages are discussed in this Review, along with some new directions for the herbal wine business.

Bodybuilders and high-level meat consumers' behavior towards rabbit, beef, chicken, turkey, and lamb meat: A comparative review

In bodybuilders' diets, protein plays a crucial role in supporting muscle growth and repairing damaged muscle tissue. These individuals meet their protein needs by combining dietary sources with supplements. Animal-based proteins are often preferred over plant-based proteins because they are believed to better support muscle protein synthesis. This review explores the meat consumption patterns of bodybuilders and high-level meat consumers, focusing on rabbit, beef, chicken, turkey, and lamb. We describe and compare the types of meat bodybuilders commonly consume and provide an overview of protein supplements, including meat-based options, plant-based alternatives, and whey-based products. Our aim is to gain insight into the dietary preferences of bodybuilders and high-level meat consumers, considering their nutritional requirements and the potential effect on the meat industry. We conducted an extensive search across various databases, including Scopus, Web of Science, PubMed, and Google Scholar. We found that individual choices vary based on factors such as attitudes, trust, taste, texture, nutritional content, ethical considerations, and cultural influences. Nutritional factors, including protein content, amino acid profiles, and fat levels, significantly influence the preferences of bodybuilders and high-level meat consumers. However, it is crucial to maintain a balance by incorporating other essential nutrients such as carbohydrates, healthy fats, vitamins, and minerals to ensure a complete and balanced diet. The findings from this review can inform strategies and product development initiatives tailored to the needs of bodybuilders and discerning meat enthusiasts.

A review on waste valorization, biotechnological utilization, and management of potato

One of the most popular, cost-effective crops that are consumed globally is the potato. Due to the expanding food crisis, there is an increase in the demand for potato-based agro-food items. At the same time, it is noted that this pathway of ecological pollution from large-scale wastes is challenging to manage. The food sector generates a lot of waste, which can be controlled better via biotechnological methods. The potato industry is one of the industries that generate a large amount of garbage that is harmful to the environment. Several by-products of industrial potato production, such as potato peels (PPs), starch, flakes, and granules, are disposed of despite being rich sources of nutrients and bioactive ingredients. These wastes can subsequently be used in biotechnological processing to produce microbial polysaccharides, yeast cellular biomass, lipids, protein, enzymes, organic acids, and carotenoids as components of the microbial medium. Similarly, food processing based on potatoes uses a lot of water, which is an issue because it pollutes wastewater. The most popular method for reducing trash that is both affordable and environmentally beneficial at the moment is biotechnology. The purpose of this review study is to illustrate the potential of applying biotechnological techniques to tackle the potato waste problem while simultaneously enhancing the economy. By discussing recent breakthroughs as well as current flaws in this method of controlling potato trash, this paper seeks to give a future vision of the justifiable use of biotechnological-based potato waste management and utilization strategies.

Nutritional, biochemical, and clinical applications of carob: A review

Carob is botanically called as Ceratonia siliqua and belongs to the Legumes family. The fruit is derived from hermaphrodite trees and hard in shape. The carob contains high sugar contents in pulp, fat in seed and minerals like potassium, calcium, and phosphorus are present in pods. Polyphenols and antioxidants are abundant in leaves and pods. It can be used for enhancing human health due to its high nutritional profile. Carob gum is used in the pharmaceutical industry in the form of pomades, anti-celiac ingredients, pills, and dental paste. The clinical carob can aid as an anti-cancer, anti-reflux, anti-diabetic, anti-diarrheal, anti-hyperlipidemia, anti-bacterial, anti-microbial, and anti-fungal. Nowadays, carob seeds are being used as an alternative to cocoa powder in food items whereas the leaves, pods, and seeds of carob are also historically used as food for animal feed. However, these parts of carob are available in markets with reasonable prices. Carob production, though with a rising contribution, contributes to the local economy. In this sense, we can incorporate knowledge on the chemical properties and the biological effect of carob fruits on human health. In this study, the supportive and health-promoting impacts of carob are discussed along with the clinical testing obtained from natural constituents of carob. In addition, further studies can be performed to extract and separate polyphenols and antioxidant potential for the development of functional that play a valuable role in pharmaceutical and food sectors.

Nutritional importance and industrial uses of pomegranate peel: A critical review

Pomegranate (Punica granatum L.), commonly known as a seeded or granular apple, is a delectable fruit eaten worldwide. Pomegranate is one of the healthiest fruits, with a high concentration of phenolic compounds. Large quantities of byproducts, such as seeds and peels, are produced during the pomegranate juice extraction process, which causes disposal problems and environmental contamination. Pomegranate peel (PoP), which accounts for around 30%-40% of the fruit component, is a byproduct of the fruit juice manufacturing industry. PoP is a rich source of polyphenols including phenolic acids, tannins, and flavonoids, especially anthocyanin. These peels offer several functional and nutraceutical qualities owing to their bioactive ingredients, including lowering blood pressure, reducing oxidative stress, lowering cholesterol levels, and restoring heart health. PoPs have a variety of biological effects, including the ability to resist pathogenic microbes effectively, and used as an additive in various food applications. The current review focuses on the PoP's nutritional and practical attributes, as well as their functions as food additives and functional food preparations.

Senna: As immunity boosting herb against Covid-19 and several other diseases

Introduction

A novel coronavirus outbreak in China (SARS-CoV-2) which began in December 2019, was proven major threat to global health. However, several results from clinical practices indicate that herbal medicine plays an important role in the prevention of COVID-19, which brings new hope for its treatment. The objective of this study is to check the effectivity of senna (Senna alexandrina Mill.) as an immunity-boosting herb against Covid-19 and several other diseases.

Method

The literature search was carried out using scientific databases comprising of Scopus, Science Direct, PubMed, Cochrane Library, Science Hub and Google Scholar, up to May 2020, using the following keywords: "senna", "senna makki", "Senna alexandrina", "senna nutrition value", "senna medicinal effect", "vitamins in senna", "mineral in senna", "bioactive compounds in senna", "laxiary components in senna", "senna against diseases", "senna enhance immunity", "covid_19″, "covid_19 symptoms". The authors also obtained data from primary and secondary sources as well.

Result

The results of different studies showed that senna was composed of a wide range of immunity-enhancing bioactive components like antioxidants, vitamins, minerals and laxatives. These bioactive components are effective against COVID-19 and other diseases.

Conclusion

Senna has medicinal and nutritional effects on the human body and has a key role in boosting immunity to prevent COVID-19 symptoms. Important nutritional components of senna include antioxidants, phytochemicals, vitamins and minerals that aids in reducing the risk of various diseases and also enhances the immune system.

Community- vs. hospital-based management of multidrug-resistant TB in Pakistan

BACKGROUND Multidrug-resistant TB (MDR-TB) treatment takes 18-24 months and is complex, costly and isolating. We provide trial evidence on the WHO Pakistan recommendation for community-based care rather than hospital-based care.METHODS Two-arm, parallel-group, superiority trial was conducted in three programmatic management of drug-resistant TB hospitals in Punjab and Sindh Provinces, Pakistan. We enrolled 425 patients with MDR-TB aged >15 years through block randomisation in community-based care (1-week hospitalisation) or hospital-based care (2 months hospitalisation). Primary outcome was treatment success.RESULTS Among 425 patients with MDR-TB, 217 were allocated to community-based care and 208 to hospital-based care. Baseline characteristics were similar between the community and hospitalised arms, as well as in selected sites. Treatment success was 74.2% (161/217) under community-based care and 67.8% (141/208) under hospital-based care, giving a covariate-adjusted risk difference (community vs. hospital model) of 0.06 (95% CI -0.02 to 0.15; P = 0.144).CONCLUSIONS We found no clear evidence that community-based care was more or less effective than hospital-based care model. Given the other substantial advantages of community-based care over hospital based (e.g., more patient-friendly and accessible, with lower treatment costs), this supports the adoption of the community-based care model, as recommended by the WHO.

Miso: A traditional nutritious & health-endorsing fermented product

Consumer demand for fermented foods with a well-balanced nutrient profile has been increasing owing to their ability to prevent chronic diseases as well as their functional, nutritional, and nutraceutical benefits. Among those functional foods, miso is a well-known traditional fermented food with a distinctive savory flavor and aroma that is most commonly used as a seasoning in miso soup. Among different fermented products, miso is derived from soybeans and grains as a result of the activities of Koji enzymes and beneficial microbes. Additionally, the microbial community of miso is thought to be crucial in enhancing its distinct flavor and texture as well as its nutritional properties. Despite the importance of microorganisms in the production of miso, there has been relatively little research done to characterize and describe the nutritional and medicinal potential of miso. In this review, the potential therapeutic properties, i.e., anticancer, antimicrobial, and antiobesity, of miso have been discussed comprehensively. This review envisions the production technology, its history, microbial population, nutritional properties, and the potential health benefits of miso associated with its consumption.

Effect of Cellulose–Chitosan Hybrid-Based Encapsulation on the Viability and Stability of Probiotics under Simulated Gastric Transit and in Kefir

Encapsulation comprises a promising potential for the targeted delivery of entrapped sensitive agents into the food system. A unique combination of cellulose/chitosan (Cl-Ch)-based hybrid wall material was employed to encapsulate L. plantarum by emulsion technique. The developed beads were further subjected to morphological and in vitro studies. The viability of free and encapsulated probiotics was also evaluated in kefir during storage. The developed beads presented porous spherical structures with a rough surface. A 1.58 ± 0.02 log CFU/mL, 1.26 ± 0.01 log CFU/mL, and 1.82 ± 0.01 log CFU/mL reduction were noticed for Cl-Ch hybrid cells under simulated gastro-intestinal and thermal conditions, respectively. The encapsulated cells were found to be acidic and thermally resistant compared to the free cells. Similarly, encapsulated probiotics showed better viability in kefir at the end of the storage period compared to free cells. In short, the newly developed Cl-Ch hybrid-based encapsulation has a promising potential for the targeted delivery of probiotics, as career agents, in gastric transit, and in foods.

Food grade nanoemulsions: promising delivery systems for functional ingredients

Nano-emulsions are receiving great attention in various industries, especially in the food sector. Peculiar properties of nano-sized droplets and high surface area are most suited for the development and delivery of functional ingredients. Nano-emulsions systems are suitable for encapsulation, protection, improving bioavailability, and target release of sensitive functional compounds. Nano-emulsions have promising potential for the delivery of nutraceuticals, probiotics, flavors, and colors. Nano-emulsions with active ingredients (antimicrobials) have a key part in ensuring food safety, nutrition, and quality of food. Nanoemulsions can also be used for biodegradable coating, packaging, antimicrobial coating, and quality and shelf life enhancement of different foods. The current review includes an overview of nanotechnology nano-emulsions, materials, techniques for formulation & production of nano-emulsions for food and nutrition. Furthermore, the analytical approaches used for the characterization of nano-emulsions and finally, the applications and limitations of nano-emulsions in the food industry are discussed in detail.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13197-022-05387-3.

Structural and nutritional portrayal of rye-supplemented bread using fourier transform infrared spectroscopy and scanning electron microscopy

In the present study, four different variants, namely Gp-1, Gp-2, Gp-3, and Gp-4, were characterized for their nutritional and fatty acid profile. Later on, the nutritionally superior variant was used for bread preparation. Purposely, composite flour was prepared with different ratios of wheat and rye (100:0; 90:10; 80:20). Furthermore, structural characterization of bread was done using Fourier transform infrared (FTIR) spectroscopy and scanning electron microscopy (SEM). Results showed that the Gp-2 was more nutritional among the four variants. Furthermore, the spectra of composite flour bread were scanned in the range of 4000-600 cm-1. All the bread samples presented almost similar spectra for major peaks corresponding to wavenumbers in the functional group. The SEM micrographs showed the presence of small and large starch particles with compact structures. Conclusively, rye flour supplementation has a significant impact on the nutritional and structural attributes of the bread.

Nutritional and ethnomedicinal scenario of koumiss: A concurrent review

Fermented foods are an essential source of nutrition for the communities living in developing areas of the world. Additionally, traditional fermented products are a rich source of various bioactive components. Experimental research regarding the functional exploration of these products is a way forward for better human health. Among fermented foods, Koumiss is rich in vitamins especially vitamin C and minerals, i.e., phosphorus and calcium. In addition, it is also rich in vitamins A, E, B2, B12, and pantothenic acid. High concentrations of lactose in milk favor bacterial fermentation, as the original cultures decompose it into lactic acid. Koumiss contains essential fatty acids such as linoleic and linolenic acid. Koumiss offers many health benefits including boosting the immune system and maintains blood pressure, good effect on the kidneys, endocrine glands, gut system, liver, and nervous and vascular system. The rich microflora from the fermented product has a pivotal role in maintaining gut health and treating various digestive diseases. The core focus of the current review paper is to highlight the nutritional and therapeutic potential, i.e., anticarcinogenic, hypocholesterolemia effect, antioxidative properties, antibacterial properties, antibacterial spectrum, intestinal enlargement, and β-galactosidase activity, of Koumiss as a traditional fermented product. Moreover, history and production technology of the Koumiss are also the main part of this review paper.

Heart rate variability and incident type 2 diabetes mellitus

Background

Hyperglycemia and autonomic dysfunction are bidirectionally related. The implications from former cross-sectional studies regarding the association of autonomic dysfunction and diabetes are limited due to the potential reverse causation. We aimed to investigate the association of longitudinal evolution of heart rate variability (HRV) with incident type 2 diabetes mellitus (T2D) among the general population.

Methods

Using data from the prospective population-based cohort study, 7630 participants with available repeated assessments of HRV, who were free of T2D and atrial fibrillation, were included. Measurements of HRV were analyzed from standard 10-s electrocardiograms records, including heart rate and two time-domain HRV markers: the heart-rate corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and heart-rate corrected root mean square of successive RR-interval differences (RMSSDc). Joint models with the Bayes approach were performed to assess the associations between longitudinal evolutions of heart rate and different HRV metrics with incident T2D during follow-up. Models were adjusted for age, sex, body mass index, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol, use of blood pressure-lowering or lipid-lowering medication, and prevalent cardiovascular disease. Spearmen correlation was used to examine the associations between HRV metrics and glycemic traits (fasting blood glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β)) at baseline.

Results

During a median follow-up time of 8.6 years, 871 individuals developed T2D. Based on joint models, one standard deviation (SD) increment of heart rate (hazard ratio [HR], 1.21; 95% CI, 1.09–1.34), log(SDNNc) (HR, 1.10; 95% CI, 0.94–1.27), and log(RMSSDc) (HR, 1.15; 95% CI, 1.02–1.31) was associated with the risk of developing T2D in fully-adjusted models. Subgroup analyses suggested stronger associations among men. The HRs of incident T2D per SD increment were 1.25 (1.09, 1.43) for men and 1.16 (0.99, 1.35) for women for heart rate, 1.23 (1.01, 1.51) for men and 0.97 (0.78, 1.20) for women for log(SDNNc), and 1.24 (1.05, 1.48) for men and 1.09 (0.89, 1.31) for women for log(RMSSDc). Results did not change after excluding participants who were prediabetes at baseline or after exclusion of underweight participants. Spearmen correlation indicated that heart rate was significantly associated with baseline glycemic traits, while RMSSDc was only related to fasting blood glucose.

Conclusion

Our study suggests that both higher heart rate and heart rate variability are associated with an increased risk of T2D development, especially among men.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Erasmus MC and Erasmus University Rotterdam; Netherlands Organization for Scientific Research; Netherlands Organization for Health Research and Development (ZonMw); Research Institute for Diseases in the Elderly; Netherlands Genomics Initiative; Netherlands Ministry of Education, Culture and Science; Netherlands Ministry of Health, Welfare and Sports; European Commission; and Municipality of Rotterdam. We would like to thank the China Scholarship Council for the scholarship to K.W. Forest plot

Nutritional and end-use perspectives of sprouted grains: A comprehensive review

Scientific literature is evident that the germinated seeds possess a promising potential for essential nutrients, flavors, and textural attributes over nongerminated grain. In recent decades, sprouting has also been investigated as a potential green food engineering technique to boost the nutritive profile of grains. Sprouting grains have multifold applications in different fields such as baking, pharmaceutical, and cosmetic industries. During sprouting, shifting of molecular structures to macroscopic takes place. Sprouting reactivates the grain metabolism which leads to the catabolism and degradation of antinutrient and macronutrient compounds. These modifications have an effect on human health and on the nutritional content of the foodstuffs. Sprouting grains have high bioactivity against diabetes and cancer. Germination is also an outstanding green food development technique to increase the seed nutritive profile in terms of quality. The present review focuses on the sprouting of grains, changes in nutritional profile, and the technological exploration of sprouted grains.

Biochemical and nutritional profile of maize bran-enriched flour in relation to its end-use quality

The core objective of current research was determined to nutritional and bioactive profile of maize bran (MB)-enriched flour in relation to its end-use product quality. Furthermore, rheological properties of MB-enriched flour at different levels (5%, 10%, and 15%) were explicated through farinograph and mixograph. Moreover, bread was prepared with the addition of MB-enriched flour and was characterized for nutritional and textural properties. Results showed that MB-enriched flour having high water absorption and water retaining potential up to 4%-7% as compared to wheat flour (WF). Moreover, dough height gradually decreased with the addition of MB due to water-binding ability of bran which causes a decrease in gas retention during fermentation. This resulted in bread volume decrease (4%-7%) as compared to WF. Furthermore, the moisture content and hardness increased with the addition of MB. The water activity of bread slightly increased with the addition of maize bran after 4-day storage. Conclusively, MB-enriched flour improved nutritional, textural, and sensorial properties of final product.

Reinfection or relapse of COVID-19 in health care workers; case series of 2 patients from Pakistan

During an ongoing pandemic of severe acute respiratory syndrome coronavirus 2, main question which has arisen in everyone's mind is about the immune response that may protect from reinfection. Coronaviruses are known for short-term immunity. Their ability of mutations enables them to escape host immunity, thus increasing chances of reinfection. Here we report two cases of reinfection among health care workers who presented with symptoms of COVID-19 disease, after 3 months of first infectious course. Such documentations are necessary for epidemiological purposes and also to monitor response of virus on re-exposure.

789 Improving Compliance of The MUST Tool Through Multiple Interventions, Improves Documentation and Assessment of Nutritional Status in Trauma and Orthopaedic Patients Undergoing Surgery

Introduction

The Malnutrition Universal Screening Tool (MUST) is a nationally validated risk tool, used to identify adults who are malnourished. 40% of surgical patients are malnourished which significantly impacts the outcomes of elderly patients. The primary aim of this study was to ascertain its utilisation in elderly patients undergoing trauma and orthopaedic surgery in a district general hospital.

Method

We completed a closed-loop audit from October2019-June2020 over two, three-week periods Inclusion criteria was age ≥65 years, and patients undergoing surgery. Data collected included MUST score, nutritional support, pre-operative fasting time, and prescription of fluids. Our intervention included departmental teaching sessions, posters, and the addition of the MUST tool to clerking proformas.

Results

We included analysis of 70 patients. Following our intervention, admission MUST score calculation improved by 8%, and providing nutritional support increased by 21%. However, there was no improvement in reducing pre-operative fasting time and prescription of pre-operative fluids.

Conclusions

Through our intervention’s documentation and assessment of nutritional status in elderly patients has improved. However further work must be completed to reduce time spent ‘nil-by-mouth’ and prescribe fluids for maintenance before surgery. This requires better pre-operative planning and communication between the surgical and ward-based teams.

Exploring the amino acid profile and microbial properties of locally sweet preserved kachra hareer (Terminalia chebula)

The current research was designed to determine the amino acid profile and microbial properties of kachra hareer. For the purpose, kachra hareer was purchased with their brand names coded as S1, S2, S3, and S4 from five towns named as L1, L2, L3, L4, and L5. The samples were analyzed for their amino acid profile and microbial properties, while the water and alcohol extractive values were analyzed to obtain the different levels of purity during processing. The results explained that physicochemical analyses, that is, pH, moisture, acidity, and vitamin C, ranged from 4.67% to 9.44%, 22% to 40%, 0.054% to 1.44%, and 7.67% to 19.36%, respectively. However, essential amino acids histidine, isoleucine, leucine, methionine, phenylalanine, proline, threonine, and valine ranged from 470.3 to 484.5, 516.1 to 527.5, 805.5 to 817.4, 910.1 to 922.5, 240.2 to 250.5, 508.2 to 518.2, 1,160.5 to 1,172.6, 466.9 to 476.3, and 502.5 to 513.4 mg/kg, respectively, whereas nonessential amino acids alanine, arginine, aspartic acid cysteine, glutamic acid, serine, tyrosine, and glycine ranged from 612.7 to 628.2, 1,212.3 to 1,225.9, 7,254.2 to 7,258.8, ND, 1,561.2 to 1,575.2, 634.8 to 648.9, 618.4 to 630.4, and 712.8 to 723.7 mg/kg, respectively. Conclusively, sample S2 showed the maximum nutritional content and minimum microbial load.

Effect of adding Aloe vera jell on the quality and sensory properties of yogurt

This study was planned to investigate the effect of replacing milk fat with aloe vera gel addition on yogurt quality. Purposely, yogurt was prepared with different concentration of aloe vera gel and coded as AGY0, = Control (3.5% fat and no AG), AGY1 = (1% fat and 1% AG), AGY2 = (1% fat and 2% AG), AGY3 = (1% fat and 3% AG), AGY4 = (2% fat and 1% AG), AGY5 = (2% fat and 2% AG), and AGY6 = (2% fat and 3% AG). Aloe vera gel yogurt was analyzed for physicochemical, microbial, and sensory characteristics with defined interval (0, 7th, 14th, and 21st) days. All attributes of the yogurt were significantly (0.05) affected by the addition of aloe vera gel. Results showed that the pH (4.6-4.05), viscosity (46.4-4.3), WHC (32.8%-26.1%), fat (0.9%-3.48%), protein (3.14%-3.36%), lactose (4.07%-4.23%), ash (0.48%-0.63%), total solids (11.08%-17.18%), SNF (7.69-l5.21%), and TPC (2.36 × 107 to 1.02 × 107 CFU/ml) values of yogurt samples decreased with storage time. However, acidity and syneresis of yogurt increased with the passage of time ranging from 1.12%-1.67% and 0.9-5 ml, respectively. In conclusion, aloe vera improved the texture of the yogurt which leads to higher consumer acceptability. Addition of 3% aloe vera to 1% fat (AGY3) containing buffalo milk yogurt was found to best for physicochemical as well as organoleptic characteristics as well as organoleptic characteristics.

Decontamination and Reuse of N95 Masks: A Narrative Review

BACKGROUND

The COVID-19 pandemic has presented an unprecedented strain on healthcare supplies. Currently there is a global shortage of personal protective equipment (PPE), especially N95 masks. In order to safeguard healthcare personnel in this critical time and to mitigate shortages of N95 respirators, reuse of N95 respirators has to be considered.

METHODS

Using PubMed and Science Direct, a literature search was conducted to find and synthesize relevant literature on decontamination of N95 respirators for their subsequent reuse. Peer-reviewed publications related to methods of decontamination from January 2007 to April 2020 in the English language are included in this narrative review. Bibliographies of articles for relevant literature were also scrutinized. Findings. A total of 19 studies are included in this narrative review. The appraised methods include ultraviolet germicidal irradiation (UVGI), moist heat incubation (MHI), ethylene oxide (EtO), hydrogen peroxide vapor (HPV), microwave steam bags (MSB), microwave-generated steam (MGS), dry microwave oven irradiation, hydrogen peroxide gas plasma (HPGP), dry heat, liquid hydrogen peroxide, and bleach and alcohol.

CONCLUSION

In light of the COVID-19 pandemic, reuse of N95 respirators, although suboptimal, can be considered. Evidence reveals that UVGI, MHI, and HPV are amongst the safest and efficacious methods for decontamination of N95 masks. More research is needed to establish the safety and effectiveness of MGS, MSB, dry heat, EtO, liquid hydrogen peroxide, and HPGP. Alcohol, microwave irradiation, and bleach are not recommended because they damage N95 respirators.

How well can step-off and gap distances be reduced when treating intra-articular distal radius fractures with fragment specific fixation when using fluoroscopy

INTRODUCTION

Although fragment specific fixation has proved to be an effective treatment regime, it has not been established how successfully this treatment could be performed using fluoroscopy and what the added value of arthroscopy could be. Establish gap and step-off distances after in intra-articular distal radius fractures that have been treated with fragment specific fixation while using fluoroscopy.

MATERIAL

Forty-four patients with an intra-articular distal radius fracture were treated with fragment specific fixation while using fluoroscopy.

METHODS

After the treatment of the intra-articular distal radius fracture with fragment specific fixation and the use of fluoroscopy, but before the completion of the surgical intervention, all gap, and step-off distances were determined by using arthroscopy. In addition, the joint was checked for any other wrist pathologies.

RESULTS

Arthroscopy after the surgical intervention showed that in 37 patients no gap distances could be detected, while in six patients a gap distance of≤2mm was found and in one patient, a gap distance of 3mm. Similarly, arthroscopy revealed no step-off distances in 33 patients, while in 11 patients a step-off distance of≤2mm was found. Although additional wrist pathologies were found in 48% of our population, only one patient needed surgical intervention. Three months after the surgical intervention wrist flexion was 41±10°, wrist extension 51±17°, ulnar deviation 19±10°, radial deviation 32±12° while patients could pronate and supinate their wrist to 85±5° and 74±20°, respectively.

CONCLUSION

Intra-articular distal radius fractures can be treated successfully with fragment specific fixation and the use of fluoroscopy. As almost all gap and step-off distances could be reduced to an acceptable level, the scope for arthroscopy to further improve this treatment regime is limited. The functional outcome scores that were found 3 months after the surgical intervention were similar to what has been reported in other studies using different treatment option. These findings suggest that fragment specific fixation is a good alternative for treating intra-articular distal radius fractures. As in most cases, only fluoroscopy is needed for fragment specific fixation, this treatment technique is a good treatment option for resource-limited hospitals, setting who do not have access to arthroscopy.

LEVEL OF EVIDENCE

III, case-control study.