Category: Nevin Manimala

Canine Med Genet. 2023 Jun 1;10(1):6. doi: 10.1186/s40575-023-00129-w.

ABSTRACT

BACKGROUND: The Boxer is a popular dog breed with a distinctive appearance. However, the breed has been linked with several health conditions, some of which have been associated with its moderately brachycephalic conformation and its white colouration. Anonymised primary-care veterinary clinical records were explored to extract data on the demography, common disorders and mortality of Boxers in the UK in 2016.

RESULTS: The study population of 336,865 dogs included 3,219 (0.96%) Boxers, of which 10.71% were recorded as white. The mean adult bodyweight was 30.43 kg (SD 5.73 kg). Annual disorder counts did not differ statistically between the sexes or between white and non-white Boxers. The most prevalent fine-level precision disorders were otitis externa (n = 230, 7.15%), epulis (188, 5.84%), corneal ulceration (161, 5.00%) and periodontal disease (149, 4.63%). Of the 34 most common fine-level disorders, none differed in prevalence between white and non-white dogs. The most prevalent disorder groups were skin disorder (n = 571, 17.74%), neoplasia (457, 14.20%) and ear disorder (335, 10.41%). White Boxers had higher prevalence than non-white Boxers for two disorder groups: dental disorder and brain disorder. The median longevity of 346 Boxers that died during the study was 10.46 years (IQR 9.00-11.98, range 2.76-18.00). Median longevity did not differ statistically between the sexes or between white and non-white Boxers. The most common grouped causes of death were death – unrecorded cause (n = 73, 21.10%), neoplasia (43, 12.43%) and brain disorder (33, 9.54%).

CONCLUSIONS: There was minimal evidence of substantial health differences between white and non-white Boxers. Among the four most common disorders recorded in Boxers, two were typically common across all types of dogs (otitis externa and periodontal disease) while two suggested strong predispositions for the Boxer breed (epulis and corneal ulceration), showing the value of eliciting breed-specific disorder patterns for insights for potential health reforms. The overall longevity of Boxer dogs was consistent with other breeds of similar body size.

PMID:37259166 | DOI:10.1186/s40575-023-00129-w

Contracept Reprod Med. 2023 Jun 1;8(1):34. doi: 10.1186/s40834-023-00233-z.

ABSTRACT

BACKGROUND: Adolescent girls, particularly in lower socioeconomic settings, lack adequate knowledge of menstrual hygiene management and have subpar hygiene habits. Likewise, the factors related to it have not been well addressed, and schoolgirls are facing a range of challenges. To develop effective intervention approaches, a context-specific assessment of menstrual hygiene practices is useful. Thus, this study aimed to assess menstrual hygiene management knowledge, practice, and associated factors among girls in the Boset district, Ethiopia.

METHODS: A school-based cross-sectional study was conducted at Boset district secondary schools among 629 randomly selected girls using the multi-stage sampling technique. Data were collected using a self-administered, structured questionnaire. The collected data were entered into Epi-info version 7 and analyzed by Statistical Package for Social Science (SPSS) version 26. Binary logistic regression analysis was used to model the association between dependent and independent variables. An adjusted odds ratio and 95% confidence interval were used to measure the strength of the association, and a p-value < 0.05 was used to declare statistical significance.

RESULT: Of the total study participants, 51.2% (95% CI: 46.6-55.8%) had an appropriate practice of menstrual hygiene and 57.9% (95% CI: 53.3-62.5%) had good knowledge status on menstrual hygiene management. Being an urban resident (AOR = 1.84, 95% CI: 1.20-2.80), having a mother with a secondary and above educational level (AOR = 3.4, 95% CI: 2.07-5.57), earning regular pocket money (AOR = 2.19, 95% CI: 1.45-3.313), and discussing menstrual issues with parents and friends (AOR = 3.65, 95% CI: 2.327-5.727) were associated with good practice of menstrual hygiene.

CONCLUSION: In this study, nearly half of the school girls had good practice and knowledge of menstrual hygiene management. Educating mothers and promoting discussion about menstrual hygiene management issues, especially in rural areas, should be priority actions.

PMID:37259164 | DOI:10.1186/s40834-023-00233-z

J Med Case Rep. 2023 May 31;17(1):243. doi: 10.1186/s13256-023-03843-y.

ABSTRACT

BACKGROUND: Gastric cancer is the second highest cause of morbidity among malignant tumors of the gastrointestinal tract and fifth in overall cancer statistics. Diseases of the cardiovascular system are the leading causes of death in the world. Aneurysm of the abdominal aorta is the most common type of vascular aneurysm, while in 75% of the cases it is asymptomatic. The risk of rupture of aneurysm of the abdominal aorta increases progressively depending on its diameter and the age of the patient.

CASE PRESENTATION: A 56-year-old male patient underwent treatment for complaints of pain and discomfort in the epigastric region, general weakness and difficulty in passing food through the esophagus. The neoplasm extended to the esophagus up to 17-20 mm (pT3N3aM0 R0 stage IIIB TNM 8). The aortic diameter at the level of the renal arteries was 18 mm; lower than the main renal arteries, an expansion of up to 60 mm was visualized; the length of aneurysm was 105 mm extending to the bifurcation. A gastrectomy with a resection of the lower thoracic esophagus and application of a manual double-row Roux-en -Y esophagojejunal anastomosis with cholecystectomy and D2 lymphadenectomy was done along with longitudinal aneurysmectomy and thrombectomy. The proximal anastomosis between the aorta and the synthetic linear prosthesis of 18 × 9 × 9 mm in the end-to-end type was formed by a continuous winding suture with the “Prolene” 5-0 thread. The end-to-end distal anastomosis of the prosthesis and aorta branch was formed by continuous winding suture with the “Prolene” 6-0 thread. The postoperative period proceeded without features and complications. On the 7th day after the surgery, the patient was discharged home in satisfactory condition.

CONCLUSIONS: Performing a simultaneous operation allowed the patient to undergo rehabilitation after the treatment of two diseases during one hospitalization and, in the shortest possible time, to proceed to the next stage of gastric cancer treatment-chemotherapy, thereby improving the prognosis of life expectancy. Also, one-stage surgical treatment of concomitant aneurysm of the abdominal aorta and gastric cancer is well tolerated and can avoid financial costs, and patient anxiety involved in a second operation.

PMID:37259159 | DOI:10.1186/s13256-023-03843-y

Trials. 2023 May 31;24(1):369. doi: 10.1186/s13063-023-07330-z.

ABSTRACT

The placement of an endotracheal tube for children with acute or critical illness is a low-frequency and high-risk procedure, associated with high rates of first-attempt failure and adverse events, including hypoxaemia. To reduce the frequency of these adverse events, the provision of oxygen to the patient during the apnoeic phase of intubation has been proposed as a method to prolong the time available for the operator to insert the endotracheal tube, prior to the onset of hypoxaemia. However, there are limited data from randomised controlled trials to validate the efficacy of this technique in children. The technique known as transnasal humidified rapid insufflation ventilatory exchange (THRIVE) uses high oxygen flow rates (approximately 2 L/kg/min) delivered through nasal cannulae during apnoea. It has been shown to at least double the amount of time available for safe intubation in healthy children undergoing elective surgery. The technique and its application in real time have not previously been studied in acutely ill or injured children presenting to the emergency department or admitted to an intensive care unit. The Kids THRIVE trial is a multicentre, international, randomised controlled trial (RCT) in children less than 16 years old undergoing emergent intubation in either the intensive care unit or emergency department of participating hospitals. Participants will be randomised to receive either the THRIVE intervention or standard care (no apnoeic oxygenation) during their intubation. The primary objective of the trial is to determine if the use of THRIVE reduces the frequency of oxygen desaturation and increases the frequency of first-attempt success without hypoxaemia in emergent intubation of children compared with standard practice. The secondary objectives of the study are to assess the impact of the use of THRIVE on the rate of adverse events, length of mechanical ventilation and length of stay in intensive care. In this paper, we describe the detailed statistical analysis plan as an update of the previously published protocol.

PMID:37259146 | DOI:10.1186/s13063-023-07330-z

J Transl Med. 2023 May 31;21(1):357. doi: 10.1186/s12967-023-04165-9.

ABSTRACT

BACKGROUND: Osteoarthritis (OA) is one of the most prevalent musculoskeletal diseases and is the leading cause of pain and disability in the aged population. However, the underlying biological mechanism has not been fully understood. This study aims to reveal the causal effect of circulation metabolites on OA susceptibility.

METHODS: A two-sample Mendelian Randomization (MR) analysis was performed to estimate the causality of GDMs on OA. A genome-wide association study (GWAS) of 486 metabolites was used as the exposure, whereas 8 different OA phenotypes, including any-site OA (All OA), knee and/or hip OA (knee/hip OA), knee OA, hip OA, spine OA, finger and/or thumb OA (hand OA), finger OA, thumb OA, were set the outcomes. Inverse-variance weighted (IVW) was used for calculating causal estimates. Methods including weight mode, weight median, MR-egger, and MR-PRESSO were used for the sensitive analysis. Furthermore, metabolic pathway analysis was performed via the web-based Metaconflict 4.0. All statistical analyses were performed in R software.

RESULTS: In this MR analysis, a total of 235 causative associations between metabolites and different OA phenotypes were observed. After false discovery rate (FDR) correction and sensitive analysis, 9 robust causative associations between 7 metabolites (e.g., arginine, kynurenine, and isovalerylcarnitine) and 5 OA phenotypes were finally identified. Additionally, eleven significant metabolic pathways in 4 OA phenotypes were identified by metabolic pathway analysis.

CONCLUSION: The finding of our study suggested that identified metabolites and metabolic pathways can be considered useful circulating metabolic biomarkers for OA screening and prevention in clinical practice, and can also serve as candidate molecules for future mechanism exploration and drug target selection.

PMID:37259122 | DOI:10.1186/s12967-023-04165-9

BMC Musculoskelet Disord. 2023 May 31;24(1):439. doi: 10.1186/s12891-023-06556-x.

ABSTRACT

BACKGROUND: Musculoskeletal (MSK) disorders are one of the main causes of disability among adults globally. The burden of MSK disorders varies greatly between different regions and is the highest in low- and middle income- countries. This study sought to investigate trends in the burden of MSK disorders across the MENA region, utilizing the GBD 2019 dataset.

METHODS: This ecological study utilized data from the Global Burden of Disease (GBD) to report on the burden of musculoskeletal (MSK) disorders in The Middle East and North Africa (MENA) region between 1990 and 2019. Our analysis involved descriptive statistics and sociodemographic trends and did not employ any specific statistical analyses. Using age-standardized rates of prevalence and disability-adjusted life-years (DALYs), we reported trends in the burden of MSK disorders, as well as national variation between different countries. Furthermore, we analyzed trends in risk factors contributing to MSK disorders by age and gender.

RESULTS: The longitudinal analysis from 1990 to 2019 showed an increase in the age-standardized rate for prevalence and DALYs of MSK disorders by 5% and 4.80%, respectively. Low back pain continued to be the most prevalent MSK condition, while RA and other MSK disorders had the largest percentage increase for DALYs between 1990 and 2019. The study found that Afghanistan had the lowest age standardized DALYs rate attributed to MSK disorders, while Iran, Turkey, and Jordan had the highest. Further, Syria showed the most dramatic decrease while Saudi Arabia had the most notable increase in age standardized DALY rates from 1990 to 2019. In 2019, occupational risks, high body mass index, and tobacco smoking were the main risk factors for MSK disorders, with occupational risks being the largest contributor, and between 1990 and 2019, there was a decrease in the contribution of occupational risks but an increase in the contribution of high body mass index as a risk factor.

CONCLUSION: This study highlights the significant burden of MSK disorders in the MENA region, with various risk factors contributing to its increasing prevalence in recent decades. Further research is needed to better understand the underlying factors and potential interventions that could improve health outcomes. Addressing MSK disorders should be a public health priority in the region, and efforts should be made to develop effective strategies to prevent and manage this debilitating condition.

PMID:37259119 | DOI:10.1186/s12891-023-06556-x

Thyroid Res. 2023 Jun 1;16(1):15. doi: 10.1186/s13044-023-00156-6.

ABSTRACT

BACKGROUND: One of the common causes of suboptimal control of thyroid stimulating hormone (TSH) in levothyroxine-treated hypothyroidism is coadministration of proton pump inhibitors (PPIs). Morning administration of pantoprazole has been shown to suppress intragastric pH to a greater extent. We therefore aimed to determine the effect of pantoprazole at different time points of the day on thyroid function test (TFT) in levothyroxine-treated overt primary hypothyroidism.

METHODS: In this single centre, hospital based, prospective, two arm cross-over study (AB, BA), participants were randomized into 2 groups based on morning (6:00 am – 7:00 am simultaneously with the scheduled levothyroxine tablet) (group M) and evening (30 min before dinner) intake of 40 mg pantoprazole tablet (group N). After the initial 6 weeks (period 1), a washout period of 1 week for pantoprazole was given, and then both the groups crossed over for another 6 weeks (period 2). Patients were instructed to continue the same brand of levothyroxine tablet at empty stomach 1-hour before breakfast. Serum TSH was measured at baseline, week 6, and week 13.

RESULTS: Data from 30 patients, who completed the study with 100% compliance, were analysed. Mean TSH values of the study participants were significantly higher both at week 6 and week 13 compared to the baseline. Mean baseline serum TSH concentrations for groups M and N were 2.70 (± 1.36), and 2.20 (± 1.06) µlU/mL, respectively. Mean serum TSH concentrations at the end periods 1 and 2 for group M were 3.78 (± 4.29), and 3.76 (± 2.77) while the levels in group N were 3.30 (± 1.90), and 4.53 (± 4.590) µlU/mL, respectively. There was a significant rise in serum TSH concentration across periods 1 and 2 in both the groups (F_{2, 58} = 3.87, p = 0.03). Within group changes in TSH across periods 1 and 2 were not statistically significant. Similarly difference in TSH between the groups, either at 6 weeks or at 13 weeks, were also not statistically significant.

CONCLUSIONS: Concomitant use of pantoprazole, even for 6 weeks, leads to significant elevation in serum TSH in levothyroxine-treated patients who are biochemically euthyroid, irrespective of timing of pantoprazole intake. Early morning and night-time administration of pantoprazole have similar effect on TFT in these patients.

PMID:37259094 | DOI:10.1186/s13044-023-00156-6

Pediatr Rheumatol Online J. 2023 May 31;21(1):50. doi: 10.1186/s12969-023-00836-5.

ABSTRACT

OBJECTIVES: To determine the clinical and laboratory differences between leukemic arthritis (LA) and juvenile idiopathic arthritis (JIA) at the onset of the disease.

MATERIAL AND METHODS: Patients under 16 years of age, both genders, who presented for the first time to the pediatric rheumatology service with a diagnosis of probable JIA, with arthritis and without peripheral blood blasts, in which the final diagnosis was acute lymphoblastic leukemia (ALL) or JIA. The clinical and laboratory characteristics of the patients were compared, chi-square and relative risk were used for categorical variables, and the Mann-Whitney U and T-test for the comparison of means between groups. A binary logistic regression model was developed to differentiate leukemic arthritis from JIA.

RESULTS: A total of 76 patients, 14 with LA and 62 with JIA, were analyzed. The mean age at diagnosis was lower in the leukemic arthritis group, the female gender prevailed in the JIA group, and the time to onset of symptoms was lower in the leukemic arthritis group. Patients with leukemic arthritis showed increased pain intensity, fever, weight loss, nocturnal diaphoresis, lymph node enlargement, hepatosplenomegaly, and pain that did not improve with analgesic administration. Laboratory parameters with statistical significance were the presence of anemia, leukopenia, and neutropenia. The platelet count was significant but in a low normal value, compared to the JIA. A binary logistic regression model was developed to differentiate leukemic arthritis from JIA. The probability associated with the statistic (Chi-square) was 0.000, and the Cox and Snell R2 and Nagelkerke R2 values were 0.615 and 1, respectively. The developed model correctly classified 100% of the cases.

CONCLUSIONS: The diagnosis of acute lymphoblastic leukemia should be ruled out in patients who present with arthritis and hematological alterations, mainly leukopenia and neutropenia, with joint pain disproportionate to the degree of arthritis, predominantly at night and that does not improve with the use of analgesics, fever, lymph nodes, and hepatosplenomegaly. Criteria are suggested to differentiate both diseases.

PMID:37259088 | DOI:10.1186/s12969-023-00836-5

BMC Nurs. 2023 May 31;22(1):186. doi: 10.1186/s12912-023-01348-z.

ABSTRACT

BACKGROUND: Nurses’ effective handover communication is vital for patient safety and quality of care. Few studies have empirically tested how certain factors influence the quality of handover in the Saudi context.

METHODS: A descriptive correlational design was used with a convenience sample of all nurses (N = 201) working in Saudi hospital CCUs in 2022. Demographics and handover quality instruments were used to collect the necessary data in addition to two open-ended questions that asked about perceived barriers and facilitators to handover. The analysis was conducted using descriptive statistics and regression analysis.

RESULTS: The majority of nurses reported good-quality handover. The regression analysis showed that staffing, cognitive capacity, the focus of attention, relationships, and safety climate factors contributed positively to the variance of handover quality. In contrast, intrusions, distractions, anxiety, time stress, and acute and chronic fatigue factors negatively affected the prediction of handover quality (p < 0.05). Nurses added types of shifts and languages as barriers to handover while emphasizing training and the use of standardized tools for handover as facilitators.

CONCLUSION AND RECOMMENDATIONS: Nursing handover is a multidimensional phenomenon. By understanding the determinants that contribute to or hinder handover quality, it is possible to develop targeted interventions aimed at improving communication and the quality of shift handover in CCUs. The current study’s findings highlight the need for nurses to work in a more supportive environment, receive better training, and follow a standardized handover protocol. Additionally, nurse managers should pay more attention to nurses’ well-being to control or mitigate the effect of psychological precursors on the quality of nurses’ handover. Future research should investigate handover practices and outcomes on units that have both good and bad practice environments.

PMID:37259086 | DOI:10.1186/s12912-023-01348-z

BMC Public Health. 2023 May 31;23(1):1031. doi: 10.1186/s12889-023-15856-9.

ABSTRACT

BACKGROUND: According to the minority stress theory, stigma affects the health of marginalized populations. Previous stigma research has focused on the health effects of individual and interpersonal stigma, paying less attention to structural factors. Laws on legal gender recognition affect the lives of transgender individuals in unique ways. The fact that these laws and population attitudes vary greatly between European countries, offer a unique opportunity to study the role of structural stigma in the lives of transgender individuals. Little is known about how transgender specific structural stigma relates to individual health determinants. Consequently, the aim of this study was to explore the association between structural stigma and access to gender affirming care, gender identity disclosure in health care, and experiences of discrimination in health care across 28 European countries.

METHODS: By using multilevel regression, we combined data on health seeking behavior, transgender identity disclosure to health care providers, and experiences of discrimination in health care from 6,771 transgender individuals participating in the 2012 European Union Lesbian, Gay, Bisexual and Transgender survey with a structural stigma measure, consisting of population attitudes towards transgender individuals as well as national legislation on gender recognition. Reasons to refrain from seeking care and discrimination in health care were assessed by categorizing countries as low or high in structural stigma and using Chi-square statistics.

RESULTS: Country-level structural stigma was negatively associated experiences of seeking gender affirming care and positively associated with concealment of being transgender to health care providers. Identity concealment was associated with a lower likelihood of exposure to discrimination in the health care setting across countries regardless of their level of structural stigma. The most prevalent reasons to forgo gender affirming care were shared between low and high structural stigma country groups and centered around fear.

CONCLUSION: The results highlight the importance of changing stigmatizing legislation and population attitudes to promote access to gender affirming care as well as openness of being transgender towards providers. Measures to decrease discrimination in the health care setting are warranted in high as well as in low structural stigma countries.

PMID:37259082 | DOI:10.1186/s12889-023-15856-9