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Category: Trauma; Sports Introduction/Purpose: Platelet Rich Plasma (PRP) is known to exert multi-directional biological effects favouring tendon healing. However, conclusions drawn by numerous studies on its clinical efficacy for acute Achilles tendon rupture are limited. We performed a systematic review and meta-analysis to investigate this and to compare to those without PRP treatment. Methods: The Cochrane Controlled Register of Trials, Pubmed, Medline and Embase were used and assessed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria with the following search terms: ('plasma' OR 'platelet-rich' OR 'platelet-rich plasma' or 'PRP') AND ('Achilles tendon rupture/tear' OR' calcaneal tendon rupture/tear' OR 'tendo calcaneus rupture/tear'). Data pertaining to biomechanical outcomes (heel endurance test, isokinetic strength, calf- circumference and range of motion), patient-reported outcome measures (PROMs) and incidence of re-ruptures were extracted. Meta-analysis was performed for same outcomes measured in at least three studies. Pooled outcome data were analysed by random and fixed-effects models. Results: After abstract and full-text screening, 6 studies were included. In total there were 510 patients of which 256 had local PRP injection and 254 without. The average age was41.6 years, mean time from injury to treatment 5.9 days and mean follow-up at 61 weeks. Biomechanically, there was similar heel endurance, isokinetic strength, calf circumference and range of motion between both groups. In general, there were no differences in patient reported outcomes from all scoring systems used in the studies. Both groups returned to their pre-injured level at a similar time and there were no differences on the incidence of re- rupture (OR 1.13, 95% CI, 0.46 to 2.80, p = 0.79). Conclusion: PRP injections for acute Achilles tendon ruptures do not improve medium to long-term biomechanical and clinical outcomes. However, future studies incorporating the ideal application and biological composition of PRP are required to investigate its true clinical efficacy.

Objective: To determine the knowledge of undergraduate students of Sindh Medical College regarding Diabetes Mellitus (DM) Methodology: This cross sectional study was conducted at Sindh Medical College, Jinnah Sindh Medical University (SMC-JSMU). The participants were students of 3rd year, 4th year and 5th year M.B.B.S. The sample size was calculated to be 282, using open EPI software. The data was collected through a scientifically designed questionnaire which included questions about the over all knowledge, risk factors, complications, diagnosis, treatment, methods of prevention, and WHO criteria of Diabetes Mellitus. SPSS version 22.0 was used for data analysis. Results: About 275 (98%) students had knowledge of the site of insulin production and 255 (90%) knew exactly how insulin produces its effects. Regarding the clinical presentation of DM, 262 (93%) of them agreed that hunger, thirst, and urination present as the major symptoms of this disease (p=0.005). Family history was considered as the prime risk factor by 93 (98%), 83 (95%) and 86 (86%) of final year, fourth, and third year students respectively (p=0.003). Furthermore, 254 (90%) selected retinopathy (p=0.00), 239 (85%) preferred nephropathy (p=0.003) and 224 (79%) considered neuropathy (p=0.024) as the most significant complication of DM. Moreover, the recall of the WHO diagnostic criteria for DM was comparatively lower in final year students (p=0.003). Conclusion: The over all knowledge of undergraduate medical students of Sindh Medical College was found to be satisfactory. Most of the students considered medical education as an adequate source of knowledge in this regard. However, capability of diagnosing DM was found to be comparatively low among final year M.B.B.S. students.