Category: Nevin Manimala

Curr Eye Res. 2024 Aug 6:1-9. doi: 10.1080/02713683.2024.2381864. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to observe the macular pigment optical density (MPOD) and the relationship between MPOD and retinal thickness in Chinese primary angle-closure glaucoma (PACG) patients by the one-wavelength reflectometry method.

METHODS: This study was a prospective comparative observational study, including 39 eyes from 39 PACG patients (15 men and 24 women, mean age 61.89 ± 12.30) and 41 eyes from 41 controls (20 men and 21 women, mean age 63.24 ± 14.02). We measured the MPOD 7-degree area by the one-wavelength reflectometry method and analyzed both the max and mean optical density (OD). The central retinal thickness (CRT) and the total thickness of the macular ganglion cell layer (GCL), and inner plexiform layer (IPL)were measured by spectral-domain-optical coherence tomography (SD-OCT). Statistical methods such as Shapiro-Wilk test, Fisher’s exact test, chi-square test, two independent samples test and Spearman’s correlation coefficient were used to observe the differences in the MPOD between normal subjects and PACG patients and the correlation between the MPOD and retinal thickness.

RESULTS: The max optical density (Max OD) (PACG group: 0.302 ± 0.067d.u, control group: 0.372 ± 0.059d.u., p < .001) and mean optical density (Mean OD) (PACG group: 0.124 ± 0.035d.u., control group: 0.141 ± 0.028d.u., p < 0.05) were significantly reduced in PACG patients compared with control subjects. Significant decreases in GCL + IPL thickness (PACG group: 74.71 ± 39.56 μm, control group:113.61 ± 8.14 μm, p < 0.001) and CRT (PACG group: 254.49 ± 41.47 μm, control group:329.10 ± 18.57 μm, p < 0.001) were also observed in PACG eyes. There was no statistically significant correlation between the MPOD and GCL + IPL thickness (p = .639, p = .828).

CONCLUSIONS: MPOD was significantly lower in Chinese PACG patients than in the control group, potentially due to thinning of the GCL + IPL thickness. This study provides insights for the pathophysiology, assessment of PACG and potential guidance for lifestyle modifications.

PMID:39105271 | DOI:10.1080/02713683.2024.2381864

Appl Immunohistochem Mol Morphol. 2024 Aug 1;32(7):350-356. doi: 10.1097/PAI.0000000000001212. Epub 2024 Aug 6.

ABSTRACT

Lynch syndrome (LS) is a prevalent genetic condition associated with colorectal cancer (CRC). Accurate identification of LS patients is challenging, and a universal tumor screening approach has been recommended. We present the methodology and results of universal LS screening in our hospital’s Pathology Department. This retrospective study analyzed CRC tumors from a 5-year period (2017-2021). Immunohistochemistry was used to assess MMR protein expression, followed by BRAF V600E analysis and MLH1 promoter methylation. Statistical analysis examined associations between clinicopathologic variables MMR status and LS-suspected tumors. The study analyzed 939 colorectal carcinomas, with 8.7% exhibiting mismatch repair (MMR) deficiency, significantly lower than previous research. After applying the algorithm, 24 LS-suspected cases were identified, accounting for 2.6% of tested patients and 29.3% of MMR-deficient tumors. Our study establishes the feasibility of universal testing for all new cases of CRC in detecting individuals at risk for LS, even in the absence of clinical information. To gain a comprehensive understanding of the MMR status in our population, further investigations are warranted.

PMID:39105266 | DOI:10.1097/PAI.0000000000001212

J Obstet Gynaecol. 2024 Dec;44(1):2386975. doi: 10.1080/01443615.2024.2386975. Epub 2024 Aug 6.

ABSTRACT

BACKGROUND: The increasing awareness of women’s health issues, specifically pelvic organ prolapse (POP) and urinary incontinence (UI), has spurred a surge in patients seeking specialised advice for these conditions, necessitating modern diagnostic approaches for such issues. This study explored the diagnostic utility of translabial ultrasound for POP, emphasising its correlation with clinical assessments based on International Continence Society (ICS) criteria.

METHODS: Seventy-one patients with POP Quantification System (POP-Q) stage 0-IV with or without UI were prospectively enrolled at Jagiellonian University Medical College between 2014 and 2016. The study objectives included evaluating diagnostic accuracy and concordance across pelvic compartments, correlating the diagnoses with patient-reported symptoms, and identifying variables contributing to diagnostic discrepancies.

RESULTS: Translabial ultrasound identified POP in 74.5% of the patients, aligning closely with clinical evaluations. Concordance was the highest in assessments performed in the medial compartment (85.8%), while assessments performed in the anterior (29.6%) and posterior (29.6%) compartments showed higher rates of discrepancies. Correlation analyses showed varying associations, with the posterior compartment exhibiting the least pronounced correlation (R = 0.72, p < 0.0001). Self-perceive POP showed no discernible differences in relation to ultrasonographic and clinical assessments. Among the respondents, 55.9% reported experiencing the sensation of POP. Mean POP levels determined using the two approaches precisely matched in 46.5% of these cases. Discrepancies involved variables such as self-perceived POP, number of deliveries, child weight at birth, UI, and sexual activity.

CONCLUSIONS: Translabial ultrasound showed robust correlation with clinical assessments for evaluating POP, especially for defining defects and facilitating treatment-related decision-making. Our findings highlight the reliability of this method, particularly for assessments in the medial compartment. The evidence did not indicate the superiority of either method in detecting POP disorders for symptomatic versus asymptomatic patients. Significantly, a higher POP-Q measurement in clinical examination was correlated with greater sexual activity.

PMID:39105256 | DOI:10.1080/01443615.2024.2386975

Stat Methods Med Res. 2024 Aug 6:9622802241268654. doi: 10.1177/09622802241268654. Online ahead of print.

ABSTRACT

Biomechanical and orthopaedic studies frequently encounter complex datasets that encompass both circular and linear variables. In most cases (i) the circular and linear variables are considered in isolation with dependency between variables neglected and (ii) the cyclicity of the circular variables is disregarded resulting in erroneous decision making. Given the inherent characteristics of circular variables, it is imperative to adopt methods that integrate directional statistics to achieve precise modelling. This paper is motivated by the modelling of biomechanical data, that is, the fracture displacements, that is used as a measure in external fixator comparisons. We focus on a dataset, based on an Ilizarov ring fixator, comprising of six variables. A modelling framework applicable to the six-dimensional joint distribution of circular-linear data based on vine copulas is proposed. The pair-copula decomposition concept of vine copulas represents the dependence structure as a combination of circular-linear, circular-circular and linear-linear pairs modelled by their respective copulas. This framework allows us to assess the dependencies in the joint distribution as well as account for the cyclicity of the circular variables. Thus, a new approach for accurate modelling of mechanical behaviour for Ilizarov ring fixators and other data of this nature is imparted.

PMID:39105253 | DOI:10.1177/09622802241268654

Eur J Ophthalmol. 2024 Aug 6:11206721241272156. doi: 10.1177/11206721241272156. Online ahead of print.

ABSTRACT

PURPOSE: to investigate the existing practice patterns of immediate sequential bilateral cataract surgery (ISBCS) in Italy and to assess ophthalmologists’ attitudes towards performing ISBCS in the future for cataract treatment.

METHODS: It is a multicenter cross-sectional study. From February,1^st 2023 to March, 1^st 2023 the Members of the Italian Society of Cataract and Refractive Surgery (AICCER) as well as the attendees of its annual national congress were invited to anonymously complete an electronic 7-item questionnaire on their current ICBCS practice. Questions included the average number of procedures per month, the main indications for ICBCS, and the main reasons for performing and not performing ISBCS. Data were analyzed using descriptive statistics.

RESULTS: of the 2300 recipients, 246 (10.7%) completed the survey. Of the respondents, 156 (63.4%) replied to perform ISBCS, most of them (82%) occasionally (1 to 5 procedures per month). Fifty-three percent (130 ophthalmologists) considered adopting ISBCS as routine practice in the near future. The conditions most considered for ISBCS were age-related cataract surgery under general and topical anesthesia and congenital cataract surgery. The availability of separate instruments for the two eyes as well as patient and hospital advantages were the most important reasons for performing ISBCS. The risk of bilateral endophthalmitis and medicolegal issues were the main reasons for not performing ISBCS.

CONCLUSIONS: ISBCS remains controversial among Italian surgeons, despite growing evidence of its safety and efficacy. The risk of potentially blinding complications such as bilateral endophthalmitis, together with medicolegal concerns are the principal barriers to ISBCS implementation in routine practice.

PMID:39105233 | DOI:10.1177/11206721241272156

Eur J Ophthalmol. 2024 Aug 6:11206721241272182. doi: 10.1177/11206721241272182. Online ahead of print.

ABSTRACT

PURPOSE: To study cases diagnosed of myelinated retinal nerve fibres (MRNF) continuous with the optic disc and describe the plausible pathogenic mechanism for the ocular features in Straatsma syndrome.

METHODS: This retrospective observational study includes clinically diagnosed MRNF cases. MRNF, myopia, and amblyopia defined Straatsma syndrome. MRNF were classified into three types based on location: type 1 in the superior retina, type 2 in the superior and inferior retina, and type 3 in the inferior retina. MRNF size was measured on Optomap^® (Optos, Daytona, UK) images and posterior staphyloma location was noted. Demographics and best-corrected refractive error in logMAR units was recorded. Descriptive statistics and Spearman’s corelation test were used to analyse MRNF size’s relationship to refractive error and logMAR visual acuity.

RESULTS: The study included a total of 19 MRNF eyes from 18 patients. Seventeen (89%) eyes had Straatsma syndrome. Median age was 23.50 [range: 4-75] years. One (6%) patient exhibited bilateral presentation. The median logMAR visual acuity was 0.4 log units (interquartile range: 0.18-1.20) and mean refractive error was -7.21 ± 5.32. Type 2 MRNF (n = 14,74%) was the commonest. Average MRNF size was 34.37 ± 40.73 sq.mm. Posterior staphyloma was noted in 17 eyes, all in close MRNF association. Significant positive corelation was noted between logMAR visual acuity and MRNF size (r = 0.5, p = 0.028).

CONCLUSION: Large size MRNF corelated with poor visual acuity in the study. The paper explains the possible pathogenetic mechanisms for the ocular findings seen in MRNF.

PMID:39105228 | DOI:10.1177/11206721241272182

Expert Rev Pharmacoecon Outcomes Res. 2024 Aug 6. doi: 10.1080/14737167.2024.2390041. Online ahead of print.

ABSTRACT

BACKGROUND: As rheumatoid arthritis (RA) is a chronic and progressive disease that requires lifelong therapeutic intervention, it represents a considerable economic burden on those affected. This study investigated whether tofacitinib is a cost-effective therapeutic alternative to other DMARDs for treating moderate-to-severe RA.

RESEARCH DESIGN AND METHODS: All economic evaluation studies of tofacitinib compared to other DMARDs were identified. Using random-effects meta-analysis, we pooled incremental net benefit (INB) in (purchasing power parity) adjusted US$ with 95% confidence intervals. The modified economic evaluations bias checklist and Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) instrument for quality appraisal were used. The subgroup analysis was done based on the comparator regimen.

RESULTS: Of the selected 11 studies, the number of studies from high-, upper-middle- and lower-middle-income countries was 7, 3, and 1, respectively. The subgroup analysis showed that tofacitinib with an INB of -19180 US$ [95% CI, -34520 to -3840; p-value = 0.01] was not statistically cost-effective compared with cDMARDs (p-value > 0.0001). Compared to other DMARDs, the estimated pooled INB of tofacitinib was US$ 7260 [95% CI, 3030 to 11480; p-value < 0.001], but there was substantial heterogeneity among the included studies, and the observed publication bias.

CONCLUSION: While tofacitinib shows potential as a cost-effective treatment, tailored economic evaluations are needed to account for the diverse and evolving contexts of RA treatment.

REGISTRATION: PROSPERO: CRD42023405970.

PMID:39105220 | DOI:10.1080/14737167.2024.2390041

Eur J Ophthalmol. 2024 Aug 6:11206721241273631. doi: 10.1177/11206721241273631. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to compare the efficacy of topical 5% Sodium Chloride (NaCl) and 10% Mannitol agents in managing corneal edema following uncomplicated cataract surgery.

METHODS: Patients with postoperative corneal edema were enrolled, and they were divided into three groups for comparison. Anterior chamber depth (ACD), axial length (AL), intraocular lens (IOL) power, cumulative dissipated energy (CDE), best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC) were assessed among the groups.

RESULTS: Fifty-eight eyes of 58 patients were included. The study comprised the NaCl group (using topical 5% NaCl, n = 21), Mannitol group (using topical 10% Mannitol, n = 17), and a control group without osmotic agent use (n = 20). Age, gender, ACD, AL, IOL power, and CDE were similar across groups. Postoperative day-1 CCT values showed no significant difference between groups. Additionally, at postoperative 1 week, CCT values were [663.4 ± 100.2] microns in the NaCl group, [640.4 ± 68.9] microns in the Mannitol group, and [760.3 ± 76.7] microns in the Control group. Although CCT and BCVA values were better in the Mannitol group at postoperative 1 week, no statistically significant difference was found between the groups at 1 week and 1 month postoperatively. Furthermore, corneal edema positively correlated with CDE and negatively correlated with AL.

CONCLUSION: Topical 5% NaCl and 10% Mannitol agents are effective and reliable agents that showed faster recovery of corneal edema during the early postoperative period after uncomplicated cataract surgery. The choice between these agents may depend on factors such as patient tolerability, cost, and availability.

PMID:39105213 | DOI:10.1177/11206721241273631

Cureus. 2024 Aug 5;16(8):e66176. doi: 10.7759/cureus.66176. eCollection 2024 Aug.

ABSTRACT

OBJECTIVE: There are various treatment modalities for bony Bankart lesions following glenohumeral joint dislocations. In this research, we aimed to compare the radiological and clinical results of patients who underwent the Latarjet procedure and iliac crest bone graft transfer.

MATERIALS AND METHODS: Clinical and radiological data of 15 patients were retrospectively evaluated. Inclusion criteria were a history of at least two dislocations, being between 18-65 years of age and having at least 10% glenoid bone loss. The exclusion criteria were defined as follows: patients who underwent only soft tissue procedures, patients who did not attend the follow-up, patients with other pathology in the upper extremity (fracture, cuff tear, etc.), and patients with a follow-up period of less than 12 months time. Nine patients underwent the Latarjet procedure and six underwent iliac crest bone graft transfer. Clinical evaluation, age, gender, body mass index, range of motion, Quick Disabilities of the Arm, Shoulder and Hand (QDASH) score, Constant score, and Visual Analogue Scale (VAS) score were evaluated. Radiographic evaluation was performed with preoperative and postoperative direct radiographs and computed tomography. Mann-Whitney U test, t-test, and Fisher exact tests were used for group comparisons.

RESULTS: The mean age of the patients was 32.6 years and the mean follow-up period was 24.9 months. When the two groups were compared, no statistical difference was found in terms of age, gender, body mass index, range of motion, Constant score, VAS score, glenoid cartilage stepping, and bone defect (p>0.05). The operation time was longer in the iliac crest bone graft transfer group compared to the Latarjet group (p<0.05).

CONCLUSION: Latarjet and iliac crest bone graft transfer can be used successfully in the treatment of bony Bankart in recurrent anterior shoulder dislocations. The operation time is longer in iliac crest bone graft transfer compared to the Latarjet procedure.

PMID:39105204 | PMC:PMC11299470 | DOI:10.7759/cureus.66176

Cureus. 2024 Aug 5;16(8):e66154. doi: 10.7759/cureus.66154. eCollection 2024 Aug.

ABSTRACT

Background and objective Comprehensive health literacy and prevention have been the key methods to reduce the spread of human papillomavirus (HPV) and HPV-associated disease development. Raising awareness among young individuals about the risk factors and the ways to prevent the infection is often the starting point of primary prevention. In light of this, we aimed to assess the awareness of midwifery students at Medical University-Pleven about (HPV) and HPV-associated diseases. Material and methods We conducted a survey-based study among first-year students at Medical University-Pleven in the period spanning January to March 2020, which involved a direct group survey. We initially reached out to 445 students and 284 (63.8%) of them responded; 12 of them were midwifery students. In the period from May through November 2022, the same type of survey was repeated among 75 midwifery students, and 47 (62.7%) responded. A set of classic statistical methods were used to present and analyze the collected quantitative and qualitative data. The responses in the questionnaires were reviewed and recoded according to the requirements of the statistical program. The significance of the results, the findings, and the conclusions was set at p<0.05. A comparative analysis was employed to statistically compare the results to present the differences between the groups of traits studied. Data processing was performed using MS Office Excel 2019 and SPSS Statistics v.28 (IBM Corp., Armonk, NY). Results Over half (70.6%) of the first-year midwifery students were aware of the infection caused by HPV. Among them, 10 students (29.4%) were familiar with the risk factors for HPV and HPV-associated diseases, and all of the fourth-year respondents knew about the studied issue. The majority of the respondents – 61.8% of the freshmen and 100% of the fourth-year students- were aware of HPV vaccine availability. Conclusions In the course of their training, the midwifery students at Medical University-Pleven acquired enough knowledge about the risk factors of HPV-associated diseases and the availability of vaccines to prevent them.

PMID:39105201 | PMC:PMC11298953 | DOI:10.7759/cureus.66154