Category: Nevin Manimala

Eur Rev Med Pharmacol Sci. 2023 Nov;27(22):10958-10967. doi: 10.26355/eurrev_202311_34464.

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the protective effect of recombinant erythropoietin at different doses on brain injury in premature infants and the related effects on blood routine, liver function, intellectual development, mental development index (MDI), psychomotor development index (PDI), etc. PATIENTS AND METHODS: A total of 120 premature infants were divided into four groups, including experimental group A (n=30), experimental group B (n=30), experimental group C (n=30) and control group (n=30). The experimental group was treated with different doses of recombinant erythropoietin for brain injury protection of premature infants, while the control group with conventional methods.

RESULTS: There was no statistical significance in all test indicators of the four groups of patients before the intervention. After the intervention experiment, the S-100B index was p<0.05, and the erythropoietin (EPO) index was p<0.05. In the comparison of IL-6 indicators, the indicators of the experimental group were reduced after the comparison experiment, and there were significant differences, p<0.05. In neonatal behavior evaluation, there was a statistical difference between groups A and B and the control group (p<0.05), and no statistical significance was shown between group C and the control group (p>0.05). In the intelligence test comparison, the F value of the experimental group was 3.113 three months after treatment. After six months, the F value was 3.654. After nine months, the F value was 3.392 with p<0.05. In the comparison of blood routine indicators, the p-values of four indicators between groups were more than 0.05. In the comparison of liver function indexes, the indexes of groups A, B, and C were significantly changed before and after treatment, and the data after treatment were significantly different from those before treatment, p<0.05. In the comparison of development, there were no significant differences observed in the p-values of the two indicators of vigorous exercise and language in the experimental group.

CONCLUSIONS: Recombinant erythropoietin has a protective effect on infants with brain injury and can improve the intellectual development of premature infants, but has no significant effect on blood routine indicators. It can effectively improve the MDI, PDI, and related cytokines of premature infants, and has certain significance for the treatment of brain injury.

PMID:38039026 | DOI:10.26355/eurrev_202311_34464

Eur Rev Med Pharmacol Sci. 2023 Nov;27(22):10951-10957. doi: 10.26355/eurrev_202311_34463.

ABSTRACT

OBJECTIVE: This study aimed to investigate the level of perinatal anxiety in pregnant women who considered vaginal birth after a cesarean section (VBAC) and evaluate its effect on the type of delivery.

SUBJECTS AND METHODS: The study was planned as single-centered and analytical. It was performed with pregnant women planning VBAC, reached via Google Forms between February 23 and August 17, 2022. An online form consisting of the Patient Information Form and the Perinatal Anxiety Screening Scale-Turkish version (PASS-TR) was applied to the participants. The type of delivery was questioned by phone call.

RESULTS: Ages of 162 pregnant women ranged from 22 to 40 years (mean=31.08±3.75). 54.9% (n=89) had a gestational week of 37 or more. 83.3% (n=135) had a vaginal delivery, and 54.3% (n=88) had a score of >16 on PASS-TR. PASS-TR total and subscale scores were higher in patients with known gynecological diseases (p<0.001). The total score of PASS-TR was higher in those aged between 18-30 years (p=0.027). The total number of pregnancies was higher in those with a PASS-TR score of ≤16 (p=0.007). There was no statistically significant difference between the total and subscale scores of PASS-TR with the type of delivery after cesarean section.

CONCLUSIONS: Perinatal anxiety was determined in 54.3% of the pregnant women planning VBAC, and 83.3% had a successful vaginal delivery. Age, low gravida, and the presence of gynecological diseases were risk factors for anxiety. There was no relationship between the type of delivery after cesarean section and perinatal anxiety.

PMID:38039025 | DOI:10.26355/eurrev_202311_34463

Eur Rev Med Pharmacol Sci. 2023 Nov;27(22):10944-10950. doi: 10.26355/eurrev_202311_34462.

ABSTRACT

OBJECTIVE: Depression affects adolescents worldwide and often predicts more serious disease manifestations in later lifetimes. Peer victimization or bullying, another form of child abuse, increases symptoms of depression. In this paper, the relationship between peer bullying and depression in adolescence was investigated.

SUBJECTS AND METHODS: Each adolescent who was admitted to the adolescent unit completed forms referred to as the ‘Depression Scale For Children’ and the ‘Multidimensional Peer Victimization Scale’. Sociodemographic features and results of the scales’ evaluation were studied. SPSS 16.0 program was used for statistical analysis. The p-value below 0.05 was considered statistically significant.

RESULTS: 239 adolescents, 120 of whom were male, were investigated. A positive relationship was determined among total and sub-scale scores of peer victimization-determining scale and depression scale scores. A negative relationship was determined between height, weight, age of the child, and sub-scale score of threat/intimidation. Both the total score of the peer victimization-determining scale and sub-scale scores of ridicule, open attack, and relational attack pertaining to patients with depression proved to be significantly higher than in those without depression.

CONCLUSIONS: The awareness of educators and parents, notably adolescents, must be raised in regard to peer victimization, and activities for increasing the communicative skills of adolescents and for allowing them to be able to express their emotions should also be performed. Identifying and preventing peer victimization, one of the causes of depression, and launching the treatment process for this are the first steps to be taken in terms of a healthy adulthood.

PMID:38039024 | DOI:10.26355/eurrev_202311_34462

Eur Rev Med Pharmacol Sci. 2023 Nov;27(22):10935-10943. doi: 10.26355/eurrev_202311_34461.

ABSTRACT

OBJECTIVE: In this study, we aim to estimate the prevalence of adult ADHD among Saudi adults, determine its demographic correlates, the impact of the disorder on school/work, social life, and productivity, and describe its association with other psychiatric disorders such as depression and anxiety.

SUBJECTS AND METHODS: A cross-sectional study involving 993 adult participants was carried out utilizing a validated online questionnaire that was given to the Saudi population between January 2022 and March 2022. Socio-demographic information, the adult ADHD Self-Report Scale, the Sheehan Disability Scale (SDS), and the Hospital Anxiety and Depression Scale (HADS) are among the data gathered from the questionnaire.

RESULTS: Participants’ median age group was 21-30 years (48.4%), with 77.8% being females. The prevalence of participants who were positive for ADHD symptoms was 46.6%. In univariate analysis, age group, marital status, depression, anxiety, Sheehan scale domains, day lost, and unproductive days were all significant risk factors for ADHD. In a multivariate regression analysis, anxiety, depression, symptoms that disrupted work/school work, family life/home responsibilities, and days unproductive remained statistically significant and determined as the significant independent predictors of positive ADHD.

CONCLUSIONS: Morbidity of adult ADHD symptoms appreciably existed among younger adults of Saudi Arabia, mostly students with no favorable genders. Adult ADHD symptoms were found to affect the quality of social life and work/schoolwork performance as they decreased the productivity rate and increased the absenteeism rate. Moreover, symptoms of depression and anxiety were in a profound correlation with Adult ADHD symptoms.

PMID:38039023 | DOI:10.26355/eurrev_202311_34461

Eur Rev Med Pharmacol Sci. 2023 Nov;27(22):10909-10916. doi: 10.26355/eurrev_202311_34458.

ABSTRACT

OBJECTIVE: Prognostic models proposed for cirrhotic patients’ survival have not been satisfactorily investigated in the Vietnam population, especially in the medium-term period.

PATIENTS AND METHODS: In this prospective study, we enrolled a total of 904 patients admitted to Hepato-Gastroenterology Center, Bach Mai Hospital from December 2019 to November 2021 and calculated their CP, MELD, MELD-Na score, IMELD, Refit MELD, and Refit MELD-Na after 2-year follow-up to compare their survival prognosis.

RESULTS: The mean age of the patients was 53.8 ±10.8 years, and males constituted 91%. Compared with the surviving group, deceased patients had statistically significant lower albumin, higher INR, serum bilirubin, and creatinine levels with higher means of all prognostic scores. RefitMELD score had the highest AUC (0.768), followed by MELD (0.766), and the lowest belonged to RefitMELDNa (0.669).

CONCLUSIONS: In conclusion, deceased patients had significantly higher values of Child-Pugh score and all MELD-based scores than survival. RefitMELD is the most reliable scoring system to predict 2-year mortality in patients with decompensated liver cirrhosis.

PMID:38039020 | DOI:10.26355/eurrev_202311_34458

Eur Rev Med Pharmacol Sci. 2023 Nov;27(22):10839-10844. doi: 10.26355/eurrev_202311_34450.

ABSTRACT

OBJECTIVE: This study aimed to demonstrate the relationship between thorax computed tomography (CT) findings at the time of admission and prognosis using a semiquantitative CT severity scoring system in patients diagnosed with coronavirus disease 2019 (COVID-19) who tested positive for reverse transcriptase polymerase chain reaction (RT-PCR).

PATIENTS AND METHODS: A total of 305 patients aged 18 years and older who were diagnosed with COVID-19 confirmed by RT-PCR and underwent thorax CT at the time of admission, were included in the study between March and July 2020. The demographic data of the patients, their presenting complaints at the time of admission, RT-PCR results, and thorax CT images were scanned retrospectively from electronic medical records. Lesions on thorax CT were evaluated for the presence of ground glass opacity, consolidation, and septal thickening and scoring.

RESULTS: No significant relationship was found between mortality and CT score or other parameters. A significant relationship was found between admission to the intensive care unit and CT scoring (p=0.014), aortic diameter (p=0.032), chronic pulmonary disease (p=0.004), halo sign (p=0.031), mortality (p<0.001), fever (p=0.038), and dyspnea (p=0.031). A statistically significant difference was detected in the score parameter between discharged patients and intensive care unit patients who survived and those who died (p<0.001). In the parameter of the number of lobes, a statistically significant difference was found only between discharged patients and intensive care unit patients who survived (p=0.016).

CONCLUSIONS: Thorax CT is an advisor for early diagnosis, treatment, and prognosis assessment of the disease. Semiquantitative CT severity scoring can provide valuable information about the prognosis of the patient.

PMID:38039012 | DOI:10.26355/eurrev_202311_34450

JAMA Netw Open. 2023 Dec 1;6(12):e2340232. doi: 10.1001/jamanetworkopen.2023.40232.

ABSTRACT

IMPORTANCE: Optimizing insulin therapy for patients with type 2 diabetes can be challenging given the need for frequent dose adjustments. Most patients receive suboptimal doses and do not achieve glycemic control.

OBJECTIVE: To examine whether a voice-based conversational artificial intelligence (AI) application can help patients with type 2 diabetes titrate basal insulin at home to achieve rapid glycemic control.

DESIGN, SETTING, AND PARTICIPANTS: In this randomized clinical trial conducted at 4 primary care clinics at an academic medical center from March 1, 2021, to December 31, 2022, 32 adults with type 2 diabetes requiring initiation or adjustment of once-daily basal insulin were followed up for 8 weeks. Statistical analysis was performed from January to February 2023.

INTERVENTIONS: Participants were randomized in a 1:1 ratio to receive basal insulin management with a voice-based conversational AI application or standard of care.

MAIN OUTCOMES AND MEASURES: Primary outcomes were time to optimal insulin dose (number of days needed to achieve glycemic control), insulin adherence, and change in composite survey scores measuring diabetes-related emotional distress and attitudes toward health technology and medication adherence. Secondary outcomes were glycemic control and glycemic improvement. Analysis was performed on an intent-to-treat basis.

RESULTS: The study population included 32 patients (mean [SD] age, 55.1 [12.7] years; 19 women [59.4%]). Participants in the voice-based conversational AI group more quickly achieved optimal insulin dosing compared with the standard of care group (median, 15 days [IQR, 6-27 days] vs >56 days [IQR, >29.5 to >56 days]; a significant difference in time-to-event curves; P = .006) and had better insulin adherence (mean [SD], 82.9% [20.6%] vs 50.2% [43.0%]; difference, 32.7% [95% CI, 8.0%-57.4%]; P = .01). Participants in the voice-based conversational AI group were also more likely than those in the standard of care group to achieve glycemic control (13 of 16 [81.3%; 95% CI, 53.7%-95.0%] vs 4 of 16 [25.0%; 95% CI, 8.3%-52.6%]; difference, 56.3% [95% CI, 21.4%-91.1%]; P = .005) and glycemic improvement, as measured by change in mean (SD) fasting blood glucose level (-45.9 [45.9] mg/dL [95% CI, -70.4 to -21.5 mg/dL] vs 23.0 [54.7] mg/dL [95% CI, -8.6 to 54.6 mg/dL]; difference, -68.9 mg/dL [95% CI, -107.1 to -30.7 mg/dL]; P = .001). There was a significant difference between the voice-based conversational AI group and the standard of care group in change in composite survey scores measuring diabetes-related emotional distress (-1.9 points vs 1.7 points; difference, -3.6 points [95% CI, -6.8 to -0.4 points]; P = .03).

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of a voice-based conversational AI application that provided autonomous basal insulin management for adults with type 2 diabetes, participants in the AI group had significantly improved time to optimal insulin dose, insulin adherence, glycemic control, and diabetes-related emotional distress compared with those in the standard of care group. These findings suggest that voice-based digital health solutions can be useful for medication titration.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05081011.

PMID:38039007 | DOI:10.1001/jamanetworkopen.2023.40232

Ann Neurol. 2023 Dec 1. doi: 10.1002/ana.26839. Online ahead of print.

ABSTRACT

BACKGROUND: Telestroke (TS) service has been shown to improve stroke diagnosis timing and accuracy, facilitate treatment decisions, and decrease inter-facility transfers. Expanding TS service to inpatient units at the community hospital provides an opportunity to follow up on stroke patients and optimize medical management. This study examines the outcome of expanding TS coverage from acute ER triage to incorporate inpatient consultation.

METHODS: We studied the effect of expanding TS to inpatient consultation service at 19 regional hospitals affiliated with Promedica Stroke Network. We analyzed data pre- and post-TS expansion. We reviewed changes in TS utilization, admission rate, thrombolytic therapy, patient transfer rate, and diagnosis accuracy.

RESULTS: Between Jan-2018 and June-2022, a total of 9,756 patients were evaluated in our stroke network (4,705 in pre and 5,051 in the post-TS expansion). In the post-TS expansion period, stroke patients’ admission at the spoke hospital increased from 18/month to 40/month and for TIA from 11/month to 16/month. TS cart use increased from 12% to 35.2%. Patient transfers to hub hospital decreased by 31%. TS service expansion did not affect IV thrombolytic therapy rate or door-to-needle time. There was no difference in length of stay or readmission rate, and the patients at the spoke hospitals had a higher rate of home discharge 57.38% compared to 52.58% at hub hospital.

INTERPRETATION: Telestroke service expansion to inpatient units helped decrease transfers and retain patients in their communities, increased stroke and TIA diagnosis accuracy, and did not compromise patients’ hospitalization or outcome. This article is protected by copyright. All rights reserved.

PMID:38038962 | DOI:10.1002/ana.26839

Disabil Rehabil Assist Technol. 2023 Dec 1:1-9. doi: 10.1080/17483107.2023.2289547. Online ahead of print.

ABSTRACT

PURPOSE: In the Faroe Islands, an Assistive Technology (AT) Centre allocates and finances AT for all AT users. This study aimed to provide a preliminary evaluation of the Faroese AT services from a user perspective by using recommendations from the Horizontal European Activity on Rehabilitation Technology (HEART) study.

METHOD: The study enrolled 101 persons aged 8-95 (mean 69 years) using a study-specific questionnaire. The AT service delivery process (AT-SDP) questions included questions about the application and the implementation. User satisfaction was assessed with KWAZO and the service subscale of QUEST with seven and four questions, respectively. The sample and the steps in the AT-SDP were described with frequency distribution. The KWAZO and QUEST results were analysed item-by-item and grouped in “Satisfied” and “Not fully satisfied”. A threshold of 33% was used to identify items rated “Not fully satisfied”. Associations between items rated “Not fully satisfied” and the AT-SDP were assessed with statistical analysis.

RESULTS: The participants were mostly satisfied, but Instruction, Professional services and Follow-up were rated “not fully satisfied”. The AT centre helped with application and implementation in 9.6% and 12% of the cases, respectively, and other institutions in 62.3% and 43.7% of the cases. No contact had been with professionals in 28.7% and 37.6% of the cases.

CONCLUSIONS: There was a low degree of satisfaction in different quality parameters. The role of the AT-center seemed reduced to delivering AT and the whole service delivery process appeared to be fragmented and not in line with HEART recommendations.

PMID:38038955 | DOI:10.1080/17483107.2023.2289547

Environ Sci Pollut Res Int. 2023 Dec 1. doi: 10.1007/s11356-023-30763-7. Online ahead of print.

ABSTRACT

This analysis explores the complicated relationship between oil price fluctuations, the oil industry’s finances, and the resulting increase or decrease in carbon emissions. Oil price changes have far-reaching effects on the global economy because of its dependence on fossil fuels; therefore, understanding these patterns is essential for effective policymaking and long-term energy planning. The study uses a dataset built from secondary data collected in China over 15 years, starting in 2008 and ending in 2022. This information comes from a wide range of authoritative places, including public records, trade journals, university studies, and the records of international organizations, and provides a solid foundation for study. Oil prices on a global and national scale, oil sector financial performance indicators (such as revenues, earnings, and investment levels), and carbon emission statistics are all significant factors under investigation. As one of the world’s largest oil consumers, China has been singled out in this study to allow for a more comprehensive analysis of reactions within this crucial subset of the energy industry. To understand the complex interplay between oil price shocks, the financial dynamics of the oil sector, and carbon emissions, the research utilizes statistical and econometric methods, most notably time-series analysis and regression models. The results are meant to shed light on how oil price shocks consistently affect the monetary aspects of the oil business and, by extension, the patterns in carbon emissions. This study helps us understand these vital interrelationships more completely and nuancedly.

PMID:38038915 | DOI:10.1007/s11356-023-30763-7