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Opioid analgesics are commonly used for acute low back pain and neck pain, but supporting efficacy data are scarce. We aimed to investigate the efficacy and safety of a judicious short course of an opioid analgesic for acute low back pain and neck pain. OPAL was a triple-blinded, placebo-controlled randomised trial that recruited adults (aged ≥18 years) presenting to one of 157 primary care or emergency department sites in Sydney, NSW, Australia, with 12 weeks or less of low back or neck pain (or both) of at least moderate pain severity. Participants were randomly assigned (1:1) using statistician-generated randomly permuted blocks to guideline-recommended care plus an opioid (oxycodone–naloxone, up to 20 mg oxycodone per day orally) or guideline-recommended care and an identical placebo, for up to 6 weeks. The primary outcome was pain severity at 6 weeks measured with the pain severity subscale of the Brief Pain Inventory (10-point scale), analysed in all eligible participants who provided at least one post-randomisation pain score, by use of a repeated measures linear mixed model. Safety was analysed in all randomly assigned eligible participants. The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615000775516). Between Feb 29, 2016, and March 10, 2022, 347 participants were recruited (174 to the opioid group and 173 to the placebo group). 170 (49%) of 346 participants were female and 176 (51%) were male. 33 (19%) of 174 participants in the opioid group and 25 (15%) of 172 in the placebo group had discontinued from the trial by week 6, due to loss to follow-up and participant withdrawals. 151 participants in the opioid group and 159 in the placebo group were included in the primary analysis. Mean pain score at 6 weeks was 2·78 (SE 0·20) in the opioid group versus 2·25 (0·19) in the placebo group (adjusted mean difference 0·53, 95% CI –0·00 to 1·07, p=0·051). 61 (35%) of 174 participants in the opioid group reported at least one adverse event versus 51 (30%) of 172 in the placebo group (p=0·30), but more people in the opioid group reported opioid-related adverse events (eg, 13 [7·5%] of 174 participants in the opioid group reported constipation vs six [3·5%] of 173 in the placebo group). Opioids should not be recommended for acute non-specific low back pain or neck pain given that we found no significant difference in pain severity compared with placebo. This finding calls for a change in the frequent use of opioids for these conditions. Australia's National Health and Medical Research Council, University of Sydney Faculty of Medicine and Health, and ReturnToWorkSA.

Background: Out-of-hospital cardiac arrest (OHCA) is a major cause of mortality in developing countries such as India. Most cardiac arrests happen outside the hospital and are associated with poor survival rates due to delay in recognition and in performing early cardiopulmonary resuscitation (CPR). Community CPR training and telephone CPR (T-CPR) in the dispatch centers have been shown to increase bystander CPR rates and survival. Objectives: The aim of this study is to identify the significance of T-CPR in OHCA and to discuss its implementation in the health system to improve OHCA outcomes in India. Materials and Methods: A descriptive research study methodology was adopted following a literature search. Results: The search criterion \"Cardiovascular diseases\" resulted in 162, \"Out-side hospital cardiac arrest\" in 50; For a comprehensive overview, these publications were evaluated looking for data on T-CPR incidence, criteria for detecting OHCA by emergency medical dispatchers, sensitivity and specificity, and BCPR. Conclusion: This current research stresses the scale and seriousness of the implementation of T-CPR in OHCA in India.

In this research work, an attempt was made to weld AA7075 alloy using the friction stir welding (FSW) technique. The experimental runs were designed using the Taguchi L18 orthogonal array and welds were obtained by varying tilt angle, tool rotation speed, tool feed rate, and axial load, whereas weld quality was accessed in terms of tensile strength and microhardness. The microstructure was examined using an optical microscope. The studies revealed that the tool angle was the most influential factor followed by the tool feed rate as both the parameters impacted the intensity of heat developed. It was observed that the tool tilt decreased the microhardness of the welds. The UTS values and macrostructure imply that the weld should be subjected to higher tool torque conditions. The material flow was not periodic nor coordinated, as seen by the tool-tilted weld's macrostructure. With a tool tilt, the weld pressure is lowered, and the lower pressure could not be enough to prevent volumetric defects. The reduced pressure at quicker welding rates may have had an effect on the development of flaws.