Category: Nevin Manimala

Reprod Female Child Health. 2022 Dec;1(2):99-110. doi: 10.1002/rfc2.15. Epub 2022 Sep 14.

ABSTRACT

AIM: To compare factors associated with exclusive breastfeeding (EBF) within 1 h of birth, within 3 days, and within the first 6 months post-birth.

METHODS: We used multivariate logistic regression models and data from “The Alive and Thrive Phase 2 Amhara Baseline Survey 2015” from Ethiopia (N = 3113).

RESULTS: Giving colostrum was strongly associated with EBF at all three time points, controlling for multiple confounders. Putting the baby to the breast before cleaning the baby and before cleaning the mother was significantly associated with EBF within 1 h and for the first 3 days. EBF within an hour of birth was more likely for girl babies than boy babies. Having a healthcare professional check whether the baby was sucking well was significantly associated with EBF 3 days post-birth.

CONCLUSIONS: The World Health Organization recommends breastfeeding within 1 h of birth and exclusively thereafter for 6 months, which can improve health outcomes for infants and children. In Ethiopia, many factors influence breastfeeding practices, but little is known about how these factors differ at various key timepoints in the 6 months after birth. Our study provides important information on correlates of EBF at three timepoints and shows that factors that are significantly correlated with EBF vary over time. Future research should assess the potential causal links among statistically significant associations between EBF and risk factors at various times between birth and 6 months of age. Ultimately, these findings have the potential to inform areas of intervention related to promoting EBF.

PMID:38047292 | PMC:PMC10691011 | DOI:10.1002/rfc2.15

Int J Dent. 2023 Nov 24;2023:2541243. doi: 10.1155/2023/2541243. eCollection 2023.

ABSTRACT

This study investigates the impact of brand experience (BE) on customer loyalty (CL) and examines the possible mediating effect of brand authenticity (BA) and the moderating effect of frequency of visits on the original relationship between BE and CL in dental practices. A descriptive, deductive, and quantitative research methodology was applied, with a self-administrated survey questionnaire over a cross-sectional convenience sample from dental clinics and centers in Erbil, Sulaymaniyah, and Duhok (Iraqi Kurdistan). Data were collected in July and August 2022. SPSS AMOS 26 was used for analyzing 952 patients’ responses. The results indicate that BE has a statistically significant positive effect on CL. However, only affective experiences, cognitive experiences, and behavioral experiences have a statistically positive effect on CL. BA has a significant direct mediation effect on the original relationship between BE and CL. In addition, a greater frequency of dental visits improves the BE and impacts CL. Discussion, recommendations, and future research orientation are provided.

PMID:38047272 | PMC:PMC10691884 | DOI:10.1155/2023/2541243

Skin Health Dis. 2023 Oct 14;3(6):e293. doi: 10.1002/ski2.293. eCollection 2023 Dec.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is one of the most common inflammatory skin diseases. It is associated with significant itch and impaired quality of life. Systemic treatments are efficient but associated with side effects. Novel topical treatments with a favourable safety profile are needed. SNG100 is a novel composition of hydrocortisone 1% in a cream base comprising sulphated polysaccharide (SPS; extracted from in-house cultivated Porphyridium Cruentum unicellular algae), a well-known hydrating, moisturising and a skin barrier repairing agent.

OBJECTIVES: To assess the safety, usability and efficacy of SNG100 cream in patients aged ≥6 years with moderate AD.

METHODS: In this proof of concept phase I, double-blind, randomised trial, participants received one of three treatments for 14 days: SNG100 twice daily (BID), hydrocortisone 1% BID or mometasone furoate once daily (QD). The primary endpoint was the safety and tolerability of SNG100 cream compared to hydrocortisone 1% and mometasone furoate. The secondary endpoint was the subject’s usability of SNG100. Exploratory efficacy endpoints included percent change from baseline in SCOring AD (SCORAD), Eczema Area and Severity Index, Patient-Oriented Eczema Measure, Dermatology Life Quality Index, pruritus Numerical Rating Score (NRS), peak pruritus-NRS and Investigator’s Global Assessment. Subjects were also followed up without any treatment for additional 14 days.

RESULTS: Overall, 66 participants were screened, and 60 patients were randomised. SNG100 demonstrated a high safety profile, similar to marketed products hydrocortisone 1% and mometasone furoate 0.1%, with no unanticipated drug safety related events. SNG100 and mometasone furoate 0.1% cream achieved almost similar and statistically significant greater percentage reductions from baseline in SCORAD as compared to hydrocortisone 1% cream. SNG100 demonstrated significant improvement in NRS as compared to hydrocortisone 1% cream. Remarkably, SNG100 led to a lasting effect with only 29.4% of subjects returning to IGA3 during the follow-up period compared to 50% and 38.9% in the hydrocortisone 1% and in mometasone furoate treatment arms, respectively.

CONCLUSIONS: Topical SNG100 is an effective, safe, and well-tolerated innovative treatment for moderate AD. Trial registration number: NCT04615962 (Topical Cream SNG100 for Treatment in Moderate AD Subjects).

PMID:38047249 | PMC:PMC10690700 | DOI:10.1002/ski2.293

Adv Radiat Oncol. 2023 May 6;8(6):101266. doi: 10.1016/j.adro.2023.101266. eCollection 2023 Nov-Dec.

ABSTRACT

PURPOSE: Patients with pancreatic cancer undergoing chemoradiation therapy may experience acute and chronic side effects. We conducted an exploratory analysis of patients with locally advanced pancreatic cancer (LAPC) undergoing definitive chemoradiation to identify factors influencing the occurrence of gastrointestinal (GI) bleeding, short-term radiation side effects, patterns of failure, and survival.

METHODS AND MATERIALS: Under an institutional review board-approved protocol, we retrospectively studied patients with LAPC treated with chemoradiation. Statistical models were used to test associations between clinical characteristics and outcomes, including upper GI bleeding, radiation treatment breaks, and weight loss during therapy.

RESULTS: Between 1999 and 2012, 211 patients were treated with radiation for pancreatic cancer. All patients received concurrent chemotherapy with either gemcitabine (174) or 5-fluorouracil (27), and 67 received intensity modulated radiation therapy (IMRT). Overall, 18 patients experienced an upper GI bleed related to treatment, with 70% of bleeds occurring in the stomach or duodenum, and among those patients, 11 (61%) patients had a pancreatic head tumor and 17 (94%) patients had a metallic biliary stent. IMRT was associated with decreased risk of postradiation nausea (odds ratio, 0.27 [0.11, 0.67], P = .006) compared with 3-dimensional conformal radiation. Regarding long-term toxicities, patients with a metallic biliary stent at the time of radiation therapy were at a significantly higher risk of developing upper GI bleeding (unadjusted hazard ratio [HR], 15.41 [2.02, 117.42], P = .008), even after controlling for radiation treatment modality and prescribed radiation dose (adjusted HR, 17.38 [2.26, 133.58], P = .006). Furthermore, biliary stent placement was associated with a higher risk of death (HR, 1.99 [1.41, 2.83], P < .001) after adjusting for demographic, treatment-related, and patient-related variables.

CONCLUSIONS: Metallic biliary stents may be associated with an increased risk of upper GI bleeding and mortality. Furthermore, IMRT was associated with less nausea and short-term toxicity compared with 3-dimensional conformal therapy.

PMID:38047228 | PMC:PMC10692286 | DOI:10.1016/j.adro.2023.101266

Adv Radiat Oncol. 2023 May 29;8(6):101277. doi: 10.1016/j.adro.2023.101277. eCollection 2023 Nov-Dec.

ABSTRACT

PURPOSE: In irradiating the prostate and pelvic lymph node regions, registration based on bony structures matches the pelvic lymph node regions but not necessarily the prostate position, and it is important to identify factors that influence prostate displacement. Therefore, we investigated factors influencing prostate displacement during volumetric modulated arc therapy after single-fraction high-dose-rate brachytherapy (HDR-BT) for prostate cancer and the trends in displacement for each fraction.

METHODS AND MATERIALS: Seventy patients who underwent pelvic volumetric modulated arc therapy of 46 Gy in the prone position 15 days after 13 Gy HDR-BT were included. Prostate displacement relative to bony structures was calculated using cone beam computed tomography. Systematic error (SE) and random error (RE) were evaluated in the right-left (RL), craniocaudal (CC), and anteroposterior (AP) directions. The association with clinical and anatomic factors on the planning computed tomography or magnetic resonance imaging was analyzed. Prostate volume change (PVC) was defined as the volume change at 2 days after HDR-BT. Displacement trends were individually examined from the first to 23rd fractions.

RESULTS: The mean SE in the RL, CC, and AP directions was -0.01 mm, -2.34 mm, and -0.47 mm, respectively. The root mean square of the RE in the RL, CC, and AP directions was 0.44 mm, 1.14 mm, and 1.10 mm, respectively. SE in the CC direction was independently associated with bladder volume (P = .021, t statistic = 2.352) and PVC (P < .001, t statistic = -8.526). SE in the AP direction was independently associated with bladder volume (P = .013, t statistic = -2.553), PVC (P < .001, t statistic = 5.477), and rectal mean area (P = .008, t statistic = 2.743). RE in the CC direction was independently associated with smoking (P = .035). RE in the AP direction was associated with PVC (P = .043). Gradual displacement caudally and posteriorly occurred during the irradiation period.

CONCLUSIONS: Anatomic characteristics of the bladder, rectum, and prostate predict SE. Smoking and PVC predict RE. In particular, whether PVC is ≥140% affects setting internal margins.

PMID:38047223 | PMC:PMC10692303 | DOI:10.1016/j.adro.2023.101277

Adv Radiat Oncol. 2023 May 27;8(6):101275. doi: 10.1016/j.adro.2023.101275. eCollection 2023 Nov-Dec.

ABSTRACT

PURPOSE: The purpose of this study was to identify factors associated with unanticipated radiation therapy (RT) replanning in stage III non-small cell lung cancer (NSCLC).

METHODS AND MATERIALS: Patients from a single institution with newly diagnosed stage III NSCLC treated with radical RT from January 1, 2016, to December 31, 2019, were retrospectively analyzed. The frequency and reasons for replanning were determined. Logistic regression analysis was used to identify factors associated with replanning.

RESULTS: Of 144 patients included in this study, 11% (n = 16) required replanning after the start of RT. The reason for replanning in these 16 patients was changes in the target detected by cone beam computed tomography (shift in 10 patients, shrinkage in 5 patients, and growth in 1 patient). Larger planning target volume (primary and nodal) was statistically predictive of replanning (odds ratio, 2.5; 95% CI, 1.2-5.4; P = .02). The actuarial median overall survival was 33.3 months (95% CI, 10.3-43.9) for the 16 patients who were replanned and 36.3 months (95% CI, 27.4-66.5) for the remaining 128 patients (P = .96). The median time to local recurrence was 25.0 months (95% CI, 10.3-41.3) for those patients who underwent replanning, which was similar to those patients who did not undergo replanning (19.5 months; 95% CI, 11.8-23.2; P = .28).

CONCLUSIONS: In this study, 11% of patients treated with radical RT for NSCLC required replanning due to changes in the target detected by cone beam computed tomography. A larger planning target volume predicts a higher likelihood of requiring adaptive RT. Overall survival and local control were similar between patients who were replanned compared with those who were not replanned.

PMID:38047222 | PMC:PMC10692281 | DOI:10.1016/j.adro.2023.101275

Indian J Occup Environ Med. 2023 Jul-Sep;27(3):226-228. doi: 10.4103/ijoem.ijoem_255_22. Epub 2023 Jul 14.

ABSTRACT

CONTEXT: In India fishing is a traditional occupation second only to agriculture. Fishermen are a marginalized group with high levels of occupational stress predisposing them to develop addictions to tobacco, alcohol, and areca nut chewing. These habits are well-established causes of developing oral potentially malignant disorders and oral cancer.

AIMS: To determine the prevalence of oral potentially malignant disorders among the fishermen population in and around Pondicherry.

SETTINGS AND DESIGN: Cross-sectional study.

METHODS AND MATERIAL: A descriptive cross-sectional study was conducted using a pre-designed and pre-tested questionnaire to assess the prevalence of oral potentially malignant disorders among the fishermen population in and around Pondicherry.

STATISTICAL ANALYSIS USED: Descriptive statistics were used with Pearson’s correlation.

RESULTS: The study showed 24.8% of fishermen consumed tobacco, and 7.3% consumed both tobacco and alcohol. Oral potentially malignant disorders were seen in 16.79% of the population.

CONCLUSIONS: The fishermen had a higher rate of addictions to tobacco, alcohol, and areca nut chewing and a higher prevalence of oral potentially malignant disorders.

PMID:38047179 | PMC:PMC10691522 | DOI:10.4103/ijoem.ijoem_255_22

Indian J Occup Environ Med. 2023 Jul-Sep;27(3):219-225. doi: 10.4103/ijoem.ijoem_190_22. Epub 2023 Jul 14.

ABSTRACT

CONTEXT: After the gas tragedy on the night of December 2/3, 1984, at Bhopal, the Indian Council of Medical Research (ICMR) started following up on four population cohorts with different levels of post-disaster mortality from December 3-6, 1984.

AIMS: The present study was undertaken to estimate the survival time of the cohort, and investigate the risk of mortality based on exposure, gender, and median age.

SETTINGS AND DESIGN: Survival analysis is generally used to evaluate factors associated with the time to an event of failure or death among any covered population.

METHODS AND MATERIALS: To know the cause of death and mortality rate, a retrospective cohort analysis was conducted on the outcomes of 92,320 individuals with an exposed and non-exposed group from 1985 to 2015 in Bhopal, India.

STATISTICAL ANALYSIS USED: Basic survival analysis method, Kaplan-Meier method, and Cox proportional hazard regression model were used to analyze the mortality risk.

RESULTS: During the past 30 years, the survivability was 87.25%, and the mortality rate was 7.2% for the cohort population of Bhopal gas survivors. Cox regression analysis showed that exposed, males, and individuals above 21 years (at the time of the disaster) were at higher risk of mortality from 1985 to 2015.

CONCLUSIONS: During the initial two phases, the mortality was higher in the exposed group, but over time, their survival turned out to be the same in both groups.

PMID:38047177 | PMC:PMC10691511 | DOI:10.4103/ijoem.ijoem_190_22

Indian J Occup Environ Med. 2023 Jul-Sep;27(3):197-204. doi: 10.4103/ijoem.ijoem_354_21. Epub 2023 Oct 6.

ABSTRACT

INTRODUCTION: Employees are placed in various job rotations between two or more tasks or vocations at regular intervals to ensure that they are exposed to all elements of the company. Job rotation is a methodical approach that permits employees to avoid boredom while also allowing them to develop and grow. Both management and personnel objectives are met with this strategy. It aids in the identification of employee potential and abilities. Through job rotation, employees are exposed to all aspects of the company. Employee abilities and competencies are evaluated ahead of time to ensure that the employee is deployed in the best possible position. However, it does permit the pursuit of personal interests while gaining practical knowledge in a variety of industries or processes. The present study was undertaken with an aim to assess the effect of job rotation on the nursing staff in a private hospital of Vadodara.

METHODOLOGY: The study was cross-sectional in nature where the perception of the nursing staff was gathered through a structured questionnaire. The questionnaire assessed the perception of the staff on a five point likert scale from strongly agree to strongly disagree. The sample size of the study was 126. Mann Whitney Test and Kruskal Wallis test was used to assess the effect of job rotation with respect to gender and age, years of experience respectively. The statistical analysis was undertaken at 95% confidence level with statistical significance at a p value of less than 0.05.

RESULTS: The results depicted that there was no difference in the perception towards effect of job rotation with respect to gender and age group. However, with respect to job rotation not interrupting the employees’ work life and no effect on personal life, there was statistical significant difference with respect to the years of experience of the nursing staff as the p value was less than 0.05.

CONCLUSION: Job rotation, in their opinion, causes frequent interruptions in both the job and personal life of those who participate in it. The nurses working in the hospital came up with appropriate job rotation ideas that took into consideration their age and years of experience. It appears that most of the criteria indicate that the nursing staff members were satisfied with their job rotation, which lends support to the findings of the study.

PMID:38047175 | PMC:PMC10691525 | DOI:10.4103/ijoem.ijoem_354_21

Indian J Occup Environ Med. 2023 Jul-Sep;27(3):205-208. doi: 10.4103/ijoem.ijoem_57_22. Epub 2023 Oct 6.

ABSTRACT

INTRODUCTION: Burnout is often misconstrued for stress, whereas it is one of the consequences of stress when not managed prosperously. Stress leads to apprehensiveness, loss of energy, and the primary damage is physical. Whereas, burnout is characterized by disengagement where emotions are blunted thus fostering helplessness and hopelessness leading to detachment and despondence, loss of motivation and ideals with the primary damage being emotional.

OBJECTIVES: To find out the prevalence and severity of stress and burnout among bank officers in Meerut District and to find the correlation between the two parameters.

METHODS: Banks were selected by simple random sampling through computer random table method for our study. Further, officer grade bank employees were approached for data collection. A prevalidated seven-point Likert scale Shriom-Melamed Burnout Questionnaire was used for the assessment of burnout. Data were analyzed using appropriate statistical tests by EPI Info and Microsoft Excel 2013.

RESULT: 19.7% bank officers have pathological burnout followed by 55.1% of bank officers who are at the brink of developing burnout. Severe stress was found only among 7.9% bank officers, whereas burnout was present in 19.4%. A positive correlation was found between stress and burnout.

CONCLUSION: It was found that stress and job burnout are linked but do not entirely overlap, with individuals having a high risk of job burnout experiencing only moderate stress. Therefore, perceived stress cannot be taken as the only indicator of risk of burnout.

PMID:38047173 | PMC:PMC10691523 | DOI:10.4103/ijoem.ijoem_57_22