Category: Nevin Manimala

Zh Vopr Neirokhir Im N N Burdenko. 2023;87(6):52-58. doi: 10.17116/neiro20238706152.

ABSTRACT

Methylation of the O-6-methylguanine-DNA methyltransferase (MGMT) gene promoter is currently the most important prognostic biomarker in therapy of IDH-wild-type glioblastoma. One can obtain information about this methylation from total DNA methylation profile.

OBJECTIVE: To analyze the DNA methylation signal intensity in the MGMT gene in samples of malignant gliomas and identify the most significant genomic positions for calculating the MGMT gene promoter status for further improvement of diagnostics and prediction of therapeutic options in patients with malignant gliomas.

MATERIAL AND METHODS: The study is based on 43 samples (frozen tissue or paraffin blocks) from patients with malignant gliomas. Tumor DNA samples were prepared using the Illumina Infinium MethylationEPIC BeadChip Kit and the Illumina Next-Seq 550 Sequencing System platform. DNA methylation profiles were analyzed using computational algorithms in the R language, specialized libraries minfi and mgmtstp27, as well as basic statistical functions in the Rstudio environment.

RESULTS: We established the MGMT gene promoter status in 43 samples of malignant gliomas considering total DNA methylation profile. In 24 samples (55%), the MGMT gene promoter was methylated. We compared methylation signal in certain CpG islands in groups with methylated and unmethylated MGMT gene promoters and identified the most significant positions for further improvement of data analysis algorithm.

CONCLUSION: These data demonstrate the possibilities and prospects for further improvement of algorithm for analysis of the MGMT gene promoter status based on total DNA methylation profile in patients with malignant gliomas as an alternative to methyl-specific PCR. Our results are consistent with data of other neuro-oncology researchers. Indeed, computational methods like MGMT-STP27 are quite powerful and can be used in scientific and clinical practice to assess prognosis and make decisions about chemotherapy with alkylating agents.

PMID:38054227 | DOI:10.17116/neiro20238706152

Zh Vopr Neirokhir Im N N Burdenko. 2023;87(6):43-51. doi: 10.17116/neiro20238706143.

ABSTRACT

Glioma cell cultures are used in basic researches of tumor processes, personalized medicine for selecting treatment regimens depending on individual characteristics of patients and pharmacology for assessing the effectiveness of chemotherapy. Suppression of glioma culture growth without reduction of malignancy grade is common. Drug cancellation may be followed by substitution of precursor cells by more malignant clones. Therefore, analysis of culture cell malignancy grade is important. In the future, intraoperative analysis of glioma cell malignancy grade can be used to select individual therapy.

OBJECTIVE: We analyzed the relationship between expression of marker genes TUBB3, CD133, CDK4, CDK6, CIRBP, DR4, DR5, EGFR, FGFR, FSHR, GDNF, GFAP, L1CAM, LEF1, MAP2, MDM2, MELK, NANOG, NOTCH2, OCT4, OLIG2, PDGFRA, PDGFA, PDGFB and SOX2 and glioma cell malignancy grade, as well as created appropriate prognostic model.

MATERIAL AND METHODS: We analyzed expression of 25 marker genes in 22 samples of human glioma cultures using quantitative real-time PCR. Statistical analysis was performed using the IBM SPSS Statistics 26.0 software. We used the Kolmogorov-Smirnov and Shapiro-Wilk tests to assess distribution normality. Nonparametric Jonckheere-Terpstra and Spearman tests were applied.

RESULTS: We obtained a prognostic model for assessing the grade III and IV glioma cell malignancy based on expression of marker genes MDM2, MELK, SOX2, CDK4, DR5 and OCT4. Predictive accuracy was 83% (Akaike information criterion -55.125).

PMID:38054226 | DOI:10.17116/neiro20238706143

JBI Evid Synth. 2023 Dec 6. doi: 10.11124/JBIES-23-00043. Online ahead of print.

ABSTRACT

OBJECTIVE: This review update aimed to determine the best strategies for assisted bathing or showering for older adults with dementia.

INTRODUCTION: Assisted bathing is a high-risk activity, as it can trigger agitated behaviors. Assisted bathing of older adults with dementia can create caregiver challenges and stress.

INCLUSION CRITERIA: This review update considered quantitative, qualitative, and mixed methods studies that investigated, firstly, older adults with dementia who required assistance in bathing and, secondly, their caregivers and family members who provided this assistance. The quantitative component considered randomized controlled trials and quasi-experimental studies testing interventions for reducing agitated behaviors in older adults with dementia during bathing, as well as perceived confidence or satisfaction in caregivers. The qualitative component considered studies that reported on experiences of clients or caregivers during the bathing process.

METHODS: A JBI mixed methods review was conducted following the convergent segregated approach. The review considered studies published between 1990 and March 11, 2022. The databases searched were PubMed, CINAHL, and Embase. Gray literature was also searched. Two independent reviewers screened titles and abstracts. Full texts were retrieved for studies that met the inclusion criteria and were assessed further for eligibility. Two reviewers independently assessed the quality of included studies and extracted data using the standardized JBI tools. Due to methodological and clinical heterogeneity, the results were presented in narratively in the quantitative section. For the qualitative component, meta-synthesis was conducted following the JBI approach of meta-aggregation. Finally, evidence from the 2 components was integrated following the convergent segregated approach.

RESULTS: Ten quantitative and 4 qualitative studies were included. The methodological quality was poor to moderate in the quantitative studies and moderate to high in the qualitative studies. Results from 3 quantitative studies suggested that providing training to caregivers on person-centered bathing reduced agitated behaviors in older adults with dementia. Other interventions did not show conclusive evidence of their effectiveness in any outcomes of interest. Two synthesized findings highlighted i) the importance of working within each person’s reality by having the skills and knowledge required to deliver person-centered assistance and ii) the challenges experienced by caregivers, such as lack of support, time pressure, and safety-related fears. The integrated evidence showed that the quantitative and qualitative components complemented each other to promote the training of caregivers to deliver person-centered bathing.

DISCUSSION: Integrated findings can help inform an evidence-based strategy utilizing a person-centered bathing approach to reduce agitated behaviors in older adults with dementia. Due to the limited number of eligible studies, and the clinical and methodological heterogeneity of included quantitative studies, no statistical pooling was possible. More studies are needed, particularly intervention studies with high methodological quality.

CONCLUSIONS: This review update suggests that providing caregivers with person-centered bathing training should be encouraged prior to bathing older adults with dementia. Caregivers should have knowledge and skills, such as relevant assessment and communication skills, enabling them to provide effective bathing experiences to older adults living with dementia. Organizations should provide caregivers with appropriate resources and training for bathing older adults with dementia.

REVIEW REGISTRATION: PROSPERO CRD42020208048.

SUPPLEMENTAL DIGITAL CONTENT: A Japanese-language version of the abstract of this review is available as Supplemental Digital Content 1, http://links.lww.com/SRX/A37.

PMID:38054221 | DOI:10.11124/JBIES-23-00043

Front Psychol. 2023 Nov 20;14:1272919. doi: 10.3389/fpsyg.2023.1272919. eCollection 2023.

ABSTRACT

OBJECTIVE: The present study aims to examine whether combining hatha yoga practice with self-compassion meditation could influence kinesiophobia, emotions, perceived stress, and perceived disability among individuals with chronic low back pain when compared with hatha yoga alone.

METHODS: The randomized controlled study included 70 participants with chronic low back pain (CLBP) who were randomly assigned to a Hatha yoga group (HY; n = 35) or a Hatha yoga group plus self-compassion meditation (HYSCM; n = 35). Participants followed a protocol for 8 weeks, and the assessments were carried out before and after the intervention, with a follow-up evaluation conducted after one month. The participants completed the PANAS, PSS, TSK, and RMQ questionnaires. A Generalized Estimating Equation was used to explore the effect of interventions.

RESULTS: Both HY and HYSCM groups improved kinesiophobia, perceived disability, and stress at the follow-up. However, the HYSCM group shown a more significant reduction in kinesiophobia compared to the HY group. Moreover, significant improvement in positive affect and a reduction in negative affect over time in the HYSCM group were observed.

CONCLUSION: Hatha yoga practice when combined with self-compassion meditation led to extra benefits by exhibiting a prolonged effect, especially on kinesiophobia positive and negative effects.

PMID:38054176 | PMC:PMC10694472 | DOI:10.3389/fpsyg.2023.1272919

Emerg Med Int. 2023 Nov 27;2023:6108057. doi: 10.1155/2023/6108057. eCollection 2023.

ABSTRACT

OBJECTIVE: This study aimed to investigate emergency nurses’ disaster nursing ability and psychological resilience, validate the effectiveness of a training system for disaster nursing ability based on psychological resilience, and verify the relationship between psychological resilience and disaster nursing ability among emergency nurses.

METHODS: A training system was developed to enhance psychological resilience and disaster nursing ability. A multicenter, randomized controlled experiment was conducted in five Grade III hospitals in Sichuan Province. A total of 93 emergency nurses were randomly assigned to the following three groups: the blank group, intervention group, and control group. The corresponding interventions were as follows: no intervention, psychological resilience, and nurses’ disaster nursing ability training. Personal information forms, the Connor-Davidson Resiliency Scale, and the Nurses’ Disaster Nursing Ability Assessment Scale were used in the survey.

RESULTS: There was no significant difference in the scores of psychological resilience and disaster nursing ability in the blank group in the pretest and posttest (P > 0.05). The disaster nursing ability of both the intervention and control groups significantly improved in the posttest (P < 0.05). Compared with the control group, the intervention group demonstrated significant improvement in psychological resilience in the posttest (P < 0.05). However, there was no statistical difference in psychological resilience scores in the control group in the pretest and posttest (P > 0.05).

CONCLUSION: The study concluded that the psychological resilience and disaster nursing ability of emergency nurses could be enhanced through the implemented training system.

PMID:38054165 | PMC:PMC10695688 | DOI:10.1155/2023/6108057

Cureus. 2023 Nov 4;15(11):e48259. doi: 10.7759/cureus.48259. eCollection 2023 Nov.

ABSTRACT

Background The COVID-19 pandemic has caused a devastating disruption in medical education worldwide. The influence on training, mainly for undergraduate MBBS pupils, has been noteworthy, especially the significant and unexpected shift to online learning. Materials and methods We performed a two-month, cross-sectional study from June to August 2022 at Kasturba Medical College in Mangalore, India. The study participants were second- and third-year MBBS students at Kasturba Medical College. The sample size was 319. We collected data using a pre-structured, validated, printed questionnaire, then coded and entered the data into SPSS Statistics for Windows, version 25.0, for interpretation. Results A total of 319 people took part in the study. Of these, 60.2% were females, 39.4% were males, 71.8% were from the batch of 2019-2020, and the remaining 28.2% were from the batch of 2018-2019. Among the participants, 90 students suffered from COVID-19, including 72.7% (n = 65) from the second year. Twenty-four percent of the population did not contract COVID-19, including 88 from the second year. A total of 153 participants were unsure whether they were infected with COVID-19, including 57.5% from the second year and 42.5% from the third year. The study group’s p-value of <0.0001 is statistically significant. On multivariate analysis, 54.5% of the study participants said the pandemic caused a significant disruption to their medical education. A majority of students (51.7%) agreed that the pandemic hampered practical/clinical work; 42.9% of participants somewhat disagreed that the pandemic hampered their interest in pursuing medical education in the future; and 21.9% of students said the pandemic hindered their interest in further studying medicine. Regardless of gender, a majority of the participants (78.1%) felt that online education negatively affected their time management skills and ability to cover the syllabus. Nearly half (46.4%) reported proficiency in using electronic devices. The medical students encountered multiple challenges: approximately 88% indicated that anxiety over the possibility of contracting the disease led to changes in personal behavior and interactions with family and friends. The study also revealed that 71% exhibited anxiety traits, and 11% displayed depressive symptoms, which may have been pre-existing. Furthermore, 77.1% of the participants experienced poor sleep quality, which, according to another study, is a significant predictor of depression and anxiety during COVID-19. Our findings show a significant correlation between undergoing COVID-19 testing and increased anxiety and stress levels among students, most of whom were infected during the pandemic’s second wave in India. Conclusion The study has shed light on the effect of the COVID-19 pandemic on MBBS scholars and the students’ reactions to this unparalleled situation. This aligns with Sustainable Development Goal 3, which focuses on “good health and well-being.” The medical community has been significantly impacted by the pandemic due to its frontline position, and medical students’ struggles to thrive academically. The knowledge gained from this study will assist facilitators and students of the medical fraternity in carrying out effective teaching modalities during this pandemic and any future outbreaks.

PMID:38054153 | PMC:PMC10694999 | DOI:10.7759/cureus.48259

Cureus. 2023 Nov 4;15(11):e48256. doi: 10.7759/cureus.48256. eCollection 2023 Nov.

ABSTRACT

Introduction Glaucoma can be considered a heterogeneous group of diseases with characteristic progressive optic neuropathy, which causes the development of visual field dysfunctions and irreversible blindness. Glaucoma is the most prevalent cause of irreversible blindness worldwide. Aim This study aimed to assess the awareness and knowledge of glaucoma and its associated risk factors among the adult population in Jazan, Saudi Arabia, in 2022. Methods A community-based cross-sectional study was conducted with 384 participants aged 40 years and above in the Jazan region. A convenience sampling technique was adopted to obtain the target sample size. Data were collected using a self-administered electronic questionnaire on Google Forms. Results A majority (73.1%) of the 387 respondents to the questionnaire were in the age group of 40-50 years, with the average age being 47.43 years. No statistically significant difference was found between different age groups’ level of knowledge (p=0.769). In addition, the difference between levels of knowledge based on participants’ residence was also statistically insignificant (p=0.387). Of the participants who were not diagnosed with glaucoma, 55% had poor knowledge of glaucoma; however, only 3.10% of the participants diagnosed with glaucoma had poor knowledge of the condition. Consequently, there was a statistically significant difference between participants’ levels of knowledge based on their diagnosis of glaucoma (p=0.04). Conclusion The study revealed low knowledge and awareness levels regarding glaucoma among adults aged 40 years and above in the Jazan region.

PMID:38054142 | PMC:PMC10694846 | DOI:10.7759/cureus.48256

Cureus. 2023 Nov 3;15(11):e48245. doi: 10.7759/cureus.48245. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: Effective and clear communication between the dentist and dental technician plays a vital role in rendering quality prostheses for patients. When fabricating a removable dental prosthesis, it is uncertain if the information received by the dental laboratory technician is clear and sufficient. This investigation aimed to assess dental technicians’ perceptions of the quality of dentists’ communication on the fabrication of removable partial dentures (RPDs) in Saudi Arabia.

METHODOLOGY: After obtaining the institutional review board (IRB) approval from Riyadh Elm University, Riyadh, Saudi Arabia, a cross-sectional survey on a convenient sample of 115 dental technicians registered with the Saudi Commission for Health Specialties was conducted in January 2022. The voluntary participation of 94 technicians fabricating RPDs was included. A 19-item online questionnaire was developed, including quality of written instruction, selection of impression trays, and impression materials for RPD fabrication, shared through Google Docs. Descriptive statistics were tabulated, and responses were displayed as a percentage of the total.

RESULTS: Of the 94 study subjects, 35% had less than five years of experience, 44% stated that they routinely receive work authorizations with clear instructions, 13% always used digital technology to fabricate prostheses, and 58% reported difficulty with communicated work authorization by dentists having less than five years of experience. Thirty-three respondents (35.1%) reported that 75% or more of the fabricated partial dentures were cast framework partials. Thirty-three respondents (35.1%) indicated that the master casts received for partial framework construction were usually accurate. Tooth alterations, however, were reported as usually adequate by only 28 respondents (29.8%). For creating the artificial gingiva portion of cast partials, 56 respondents (59.6%) preferred heat-cured acrylic resin. Furthermore, 40 respondents (42.6%) said that 75% or more of the requested partials were entirely made out of acrylic resin. Regarding case design discussions, 26 respondents (27.7%) always engaged with dentists, while 39 (41.5%) did so occasionally.

CONCLUSION: The obtained assessments pointed to the fact that dental technicians expressed a perception of inadequacy regarding the work authorizations provided by dentists for the fabrication of RPDs, where they seemingly felt that the instructions conveyed by the dentists were not sufficiently comprehensive or clear.

PMID:38054138 | PMC:PMC10694483 | DOI:10.7759/cureus.48245

Cureus. 2023 Nov 3;15(11):e48241. doi: 10.7759/cureus.48241. eCollection 2023 Nov.

ABSTRACT

INTRODUCTION: Depression is one of many comorbid conditions associated with diabetes. The rationale for this study is to examine the prevalence of depressive symptoms in adults with diabetes mellitus type II. Furthermore, the association between depressive symptoms and glycemic control will also be analyzed.

MATERIALS AND METHODS: A chart review of 59 diabetes mellitus type II patients from a family practice clinic in San Juan, Texas was performed. These patients were screened for depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) during their annual physical exam. Since many of these patients have been treated in this clinic for many years for their multiple comorbidities, it is possible to evaluate their responses to the PHQ-9 over consecutive years and compare them with their glycemic control using a HbA1c level. Data was evaluated by using biological parameters, such as age and gender, and the clinical parameter of a HbA1c level. Inferential statistics, such as prevalence, frequency, correlation, and p-value, were also used in analyzing the data.

RESULTS: Depressive symptoms were analyzed using the PHQ-9. In 2016, 2017, and 2018, female diabetics were found to have a higher prevalence of depressive symptoms. When comparing diabetes and age, in 2016, those who were between the ages of 65 and 74 and 75 and older had a higher incidence of depressive symptoms. Furthermore, in 2017 and 2018, patients 75 and older also had a higher frequency of depressive symptoms. The controlled diabetic population was also found to have a greater rate of depressive symptoms. However, after careful analyzation, there was no significant relationship between glycemic control and depressive symptoms.

CONCLUSION: Many diabetics have comorbid depressive symptoms. Even though this study showed no relationship between depressive symptoms and glycemic control, the treatment of depressive symptoms in diabetics may help to prevent the multiple life altering complications that diabetes can cause.

PMID:38054137 | PMC:PMC10694021 | DOI:10.7759/cureus.48241

Cureus. 2023 Nov 2;15(11):e48190. doi: 10.7759/cureus.48190. eCollection 2023 Nov.

ABSTRACT

Background In Andhra Pradesh, India, tribal communities face unique nutritional challenges due to limited access to healthcare and a predominantly plant-based diet. Maternal undernutrition is a significant concern, impacting the well-being of both mothers and their offspring. This study focuses on assessing the prevalence of undernutrition among tribal mothers in Andhra Pradesh using the BMI-for-age criterion. Objectives The aim of this study was to comprehensively evaluate the prevalence of undernutrition among tribal mothers, explore associations with demographic factors, and assess the impact of a nutritional intervention program. The ultimate goal was to contribute to targeted interventions and policies for improving the health and well-being of these communities. Materials and methods A cohort study was conducted in the Guntur district of Andhra Pradesh, involving 340 lactating mothers and their infants. Data collection and anthropometric measurements were performed. Results The study found that 67 (19.71%) of tribal mothers were underweight at baseline. There were statistically significant associations with the Yenadi tribe, low educational status of the mother, and history of lower segment Caesarean section with a high prevalence of being underweight. No significant associations with age, occupation, or socioeconomic status were observed. Undernutrition was more common among mothers with older children and was associated with specific obstetric factors. Conclusion While the prevalence of undernutrition is lower than in some previous studies, it remains a critical concern, particularly within disadvantaged communities. These undernourished mothers face health risks, including anemia. Urgent policy interventions and nutritional programs are needed to address this issue and enhance the well-being of tribal communities in Andhra Pradesh.

PMID:38054136 | PMC:PMC10694381 | DOI:10.7759/cureus.48190