Category: Nevin Manimala

Inquiry. 2023 Jan-Dec;60:469580231161428. doi: 10.1177/00469580231161428.

ABSTRACT

In this westernized culture, maintaining a healthy lifestyle has become a major health concern internationally. Health literacy is an emerging concept and requires effective measures and reform to improve the health status and health of individuals at both national and international levels, and has become one of the important determinants of individual health and healthcare service. This study aimed to assess health literacy among adults in Saudi Arabia. A cross-sectional study was conducted among a randomly selected population using a structured validated questionnaire over 4 months in 2021. The questionnaires designed for the study included 26 items divided into 5 domains assessed on a five-point Likert scale. Data were analyzed using IBM SPSS Statistics 26 (IBM Inc., Chicago, IL, USA) and IBM SPSS 26 (IBM Inc.). The mean score for reading, access to information, understanding, appraisal, and decision-making was 12.01 ± 4.37, 20.16 ± 7.17, 24.84 ± 8.37, 11.85 ± 4.90, and 36.94 ± 10.41 respectively. The mean scores of reading and understanding domains were found to have significant differences concerning gender (P < .05). Additionally, participants’ age was significantly associated with the mean score of reading and decision-making (P < .006 and P < .049). The findings reported a prevalence of inadequate HL in the population of Saudi Arabia was 54.4%, and the determinants associated with the scores of HL were age, gender, and education.

PMID:36932856 | DOI:10.1177/00469580231161428

Biometrics. 2023 Mar 18. doi: 10.1111/biom.13857. Online ahead of print.

ABSTRACT

Many popular survival models rely on restrictive parametric, or semi-parametric, assumptions that could provide erroneous predictions when the effects of covariates are complex. Modern advances in computational hardware have led to an increasing interest in flexible Bayesian nonparametric methods for time-to-event data such as Bayesian additive regression trees (BART). We propose a novel approach that we call nonparametric failure time (NFT) BART in order to increase the flexibility beyond accelerated failure time (AFT) and proportional hazard models. NFT BART has three key features: 1) a BART prior for the mean function of the event time logarithm; 2) a heteroskedastic BART prior to deduce a covariate-dependent variance function; and 3) a flexible nonparametric error distribution using Dirichlet process mixtures (DPM). Our proposed approach widens the scope of hazard shapes including non-proportional hazards, can be scaled up to large sample sizes, naturally provides estimates of uncertainty via the posterior and can be seamlessly employed for variable selection. We provide convenient, user-friendly, computer software that is freely available as a reference implementation. Simulations demonstrate that NFT BART maintains excellent performance for survival prediction especially when AFT assumptions are violated by heteroskedasticity. We illustrate the proposed approach on a study examining predictors for mortality risk in patients undergoing hematopoietic stem cell transplant (HSCT) for blood-borne cancer, where heteroskedasticity and non-proportional hazards are likely present. This article is protected by copyright. All rights reserved.

PMID:36932826 | DOI:10.1111/biom.13857

J Pak Med Assoc. 2023 Mar;73(3):723-727. doi: 10.47391/JPMA.6200.

ABSTRACT

Epilepsy is the third most common neurological disease in the world associated with a high frequency in the paediatric age group. This study aims to evaluate the prevalence, types and aetiologies of epilepsy within the Pakistani population. A retrospective review of the charts of all patients, below the age of 18 years, presenting with epilepsy to the Department of Neurology at The Children’s Hospital and Institute of Child Health, Lahore, from January 2016 to December 2020, was carried out. Analysis was performed using SPSS Version 26. A p value of <0.05 was considered statistically significant. A total of 1,097 patients were studied, of which 644 (58.8%) were males and 451 (41.2%) females. a vast majority, i.e. 1,021 (96.1%), of the study participants, belonged to the province of Punjab. Afebrile seizures [n=798 (72.7%)] were more commonly reported than febrile seizures [n=299 (27.3%)]. Among seizure types, generalised seizures were the most common type of seizure reported in 520 (49.8%) patients. Refractory seizures were the least common type reported in 3 (0.3%) patients. Aetiology was mostly idiopathic [n=540 (49.2)], followed by congenital [n=228 (20.8%)]. The most frequently reported duration of seizure was between one and three minutes [n=116 (42.3%)]. The most common ictal features seen were a combination of up-rolling of eyes and frothing from the mouth [n=206 (34.9%)]. Results from this study can be used by health care providers to better formulate therapeutic interventions for a timely diagnosis and effective treatment of epilepsy.

PMID:36932799 | DOI:10.47391/JPMA.6200

J Pak Med Assoc. 2023 Mar;73(3):635-637. doi: 10.47391/JPMA.5288.

ABSTRACT

This cross-sectional study aimed to explore the relationship between perceived social support and psychological well-being in patients with epilepsy. The study was conducted, from January to December 2019, after ethical approval from the research ethical committee of FMU (Faisalabad Medical University, Faisalabad). A sample of 90 patients, attending free epilepsy camp in Mujahid Hospital Madina Town Faisalabad and psychiatry OPD of government General hospital G.M. Abad Faisalabad, was collected by using the Multidimensional Scale of Perceived Social Support (Urdu version). Moreover, Psychological well-being was assessed by Ryff Scale. Statistical analysis was done through data Correlation and T-test SPSS version 21. A positive correlation between psychological well-being and perceived social support in epileptic patients was established (p<0.001). This study concludes that on the one hand, strong social support enhances psychological well-being, while, on the other hand, both these factors collaboratively improve the mental health of PWE, thus promoting a better outcome.

PMID:36932769 | DOI:10.47391/JPMA.5288

J Pak Med Assoc. 2023 Mar;73(3):567-571. doi: 10.47391/JPMA.5008.

ABSTRACT

OBJECTIVE: To determine the difference in the marginal accuracy at buccal, lingual, mesial and distal margins of temporary crowns fabricated with bisacryl-based temporary crown material.

METHODS: The in-vitro, experimental, laboratory-based study was conducted at the Aga Khan University, Karachi, from September to December 2019, and comprised two bisacryl-based temporary crown material, Integrity and Protemp 4, which were used to fabricate a sample of 24 temporary crowns. A pre-operative polyvinyl siloxane impression served as a template for temporary crown fabrication. A right mandibular molar tooth on a typodont was prepared to receive a crown. The provisional crown material was syringed onto the template and was allowed to cure. All four surfaces of the crown were observed under a stereomicroscope equipped with digital single-lens reflex camera at 25.6x magnification. An image of each surface was captured and a photographic record was maintained. An image processing software was used for the measurement of marginal discrepancy. Marginal accuracy among the four surfaces was assessed. Data was analysed using SPSS 23.

RESULTS: Mean marginal discrepancy for provisional crowns fabricated with Protemp 4 and Integrity was 410±222μm and 319±176μm, respectively. The marginal discrepancy between the two groups was statistically significant (p=0.027), with buccal margin exhibiting the most discrepancy (p<0.01).

CONCLUSIONS: Integrity showed less microleakage than Protemp 4. Among all the walls, the buccal wall showed the most microleakage. Marginal accuracy was found to be dependent upon the type of provisional crown material and the side of the prepared axial wall.

PMID:36932761 | DOI:10.47391/JPMA.5008

J Pak Med Assoc. 2023 Mar;73(3):494-499. doi: 10.47391/JPMA.5312.

ABSTRACT

OBJECTIVE: To identify the mechanism of down-regulation of Lewis Y antigen caused by X-ray irradiation.

METHODS: The present original research study was conducted at Zhejiang University City College, Hangzhou, Republic of China, from 2020 to 2022. Western blotting, Co-immunoprecipitation (CO-IP), electrophoretic mobility shift assay and Cell Counting Kit-8 (CCK8) were performed to confirm the effect of X-ray irradiation on A549 cell proliferation and its mechanism. Data was analysed using Statistical Package for Social Sciences (SPSS) 11.5.

RESULTS: The expressions of fucosyltransferase IV and Lewis Y were decreased after X-ray irradiation, thus inhibiting the proliferation of A549 lung cancer cells. Deoxyribonucleic acid damage caused by the irradiation caused higher level of poly- adenosinediphosphate-ribosylated Specific Protein 1(SP1), and translocation of SP1 from the nucleus, decreasing the expression of fucosyltransferase IV and Lewis Y.

CONCLUSION: There was a significant role of glycosylation in radiation therapy for lung cancer.

PMID:36932748 | DOI:10.47391/JPMA.5312

Urol J. 2023 Mar 18. doi: 10.22037/uj.v20i.7301. Online ahead of print.

ABSTRACT

PURPOSE: The most important point in cases of ureteropelvic junction obstruction (UPJO) is to decide on the need and timing of surgical treatment. Renal damage may become irreversible as the duration of the obstruction is prolonged. Worsening of hydronephrosis and decrease in renal parenchymal thickness after pyeloplasty may herald an irreversible renal damage. It is important to know at what age this damage begins. In this study, we aimed to determine the relationship between the age of the patients at the time of pyeloplasty performed for UPJO and parenchymal recovery.

MATERIALS AND METHODS: In our study, 156 patients (mean age: 43.5 months) who underwent pyeloplasty with the diagnosis of UPJO between 2007 and 2019 were evaluated retrospectively. Demographic characteristics, ultrasonographic (USG) and nuclear renal scintigraphy findings, previous surgeries ​of the patients were recorded.

RESULTS: Numerical variables were evaluated statistically, and the best cut-off point was determined. Parenchymal thickening was determined as the most important criterion in postoperative renal recovery which was more evident at early ages. Based on statistical assessments , the cut-off age for renal parenchymal recovery was determined as 38 months. While parenchymal recovery was inadequate after pyeloplasty performed in patients older than 38 months, the most significant improvement in renal functions was seen in children younger than 13 months of age.

CONCLUSION: Pyeloplasty should be performed in patients with UPJO before development of severe renal damage. Statistically, the best parameter to evaluate the recovery after pyeloplasty is the change in parenchymal thickness. With advancing age, it is impossible to reverse the obstructive nephropathy.

PMID:36932724 | DOI:10.22037/uj.v20i.7301

J Appl Gerontol. 2023 Mar 18:7334648231163430. doi: 10.1177/07334648231163430. Online ahead of print.

ABSTRACT

This mixed-methods study examined the health information-seeking behavior of Latino caregivers of people living with dementia. A structured survey and semi-structured interviews were conducted with 21 Latino caregivers in Los Angeles, California. For triangulation, semi-structured interviews were also conducted with six healthcare and social service providers. The interview transcripts were coded and analyzed via thematic analysis, while the survey data were summarized using descriptive statistics. The results show that caregivers sought information on what changes to expect as dementia progresses. Some desired detailed (limited) information to be better prepared (to worry less). The most common action to address their information needs was searching the Internet. However, those who did this tended to be concerned about the quality of information. Overall, this study sheds light on how much detail Latino caregivers desire in the information they need and the actions they take to obtain this information.

PMID:36932723 | DOI:10.1177/07334648231163430

J Hum Nutr Diet. 2023 Mar 17. doi: 10.1111/jhn.13168. Online ahead of print.

ABSTRACT

BACKGROUND: People with ileostomy are frequently advised to avoid specific foods and food groups, making it plausible that they are at risk of a range of nutrition-related adverse health consequences. Despite this there has been no recent study in the UK describing dietary intake, symptoms, and food avoidance in people with ileostomy or post-reversal.

METHODS: Cross-sectional study at different timepoints in people with ileostomy and reversal. Participants were recruited at 6-10weeks post-formation (n=17), and ≥12months with established ileostomy (n=16), and with reversal (n=20). In all participants, ileostomy/bowel-related symptoms in the previous week were assessed using a study specific questionnaire. Dietary intake was assessed using 3 on-line diet recalls or 3-day dietary records. Food avoidance and reasons for food avoidance were assessed. Data were summarized using descriptive statistics.

RESULTS: Participants reported few ileostomy/bowel-related symptoms in the previous week. However, over 85% of participants reported avoiding foods, particularly fruits and vegetables. At 6-10weeks the most common reason was being advised to do so (71%), although 53% avoided foods due to gas. At ≥12months the most common reasons were foods visible in the bag (60%) or advised to do so (60%). Reported intakes of most nutrients were comparable to population medians, apart from lower fibre in people with ileostomy. Intakes of free sugars and saturated fats were above recommendations in all groups, due to high consumption of cakes and biscuits and sugar-sweetened drinks.

CONCLUSION: After the initial healing period, foods should not be automatically excluded unless found to be problematic after reintroduction. There may be a need for healthy eating advice for people with established ileostomies and post-reversal, targeting discretionary high-fat, high-sugar foods. This article is protected by copyright. All rights reserved.

PMID:36932682 | DOI:10.1111/jhn.13168

J Magn Reson Imaging. 2023 Mar 17. doi: 10.1002/jmri.28690. Online ahead of print.

ABSTRACT

BACKGROUND: Cirrhotic patients with sarcopenia have poor prognoses and higher mortality. The third lumbar vertebra (L3) skeletal muscle index (SMI) is widely used to assess sarcopenia. However, L3 is generally outside the scanning volume on standard liver MRI.

PURPOSE: To investigate SMIs change between slices in cirrhotic patients and the relationships between SMI at the 12th thoracic vertebra (T12), the first lumbar vertebra (L1) and the second lumbar vertebra (L2) levels and L3-SMI and assess the accuracy of the estimated L3-SMIs in diagnosing sarcopenia.

STUDY TYPE: Prospective.

SUBJECTS: A total of 155 cirrhotic patients (109 with sarcopenia, 67 male; 46 without sarcopenia, 18 male).

FIELD STRENGTH/SEQUENCE: A 3.0 T, 3D dual-echo T1-weighted gradient echo sequence (T1WI).

ASSESSMENT: Two observers analyzed T12 to L3 skeletal muscle area (SMA) in each patient based on T1W water images and calculated the SMI (SMA/height² ). Reference standard was L3-SMI.

STATISTICAL TESTS: Intraclass correlation coefficient (ICC), Pearson correlation coefficients (r), and Bland-Altman plots. Models relating L3-SMI to the SMI at T12, L1, and L2 levels were constructed using 10-fold cross-validation. Accuracy, sensitivity, and specificity were calculated for the estimated L3-SMIs for diagnosing sarcopenia. P < 0.05 was considered statistically significant.

RESULTS: Intraobserver and interobserver ICCs were 0.998-0.999. The L3-SMA/L3-SMI were correlated with the T12 to L2 SMA/SMI (r = 0.852-0.977). T12-L2 models had mean-adjusted R² values of 0.75-0.95. The estimated L3-SMI from T12 to L2 levels to diagnose sarcopenia had good accuracy (81.4%-95.3%), sensitivity (88.1%-97.0%), and specificity (71.4%-92.9%). The recommended L1-SMI threshold of 43.24 cm² /m² in males and 33.73 cm² /m² in females.

DATA CONCLUSION: The estimated L3-SMI from T12, L1 and L2 levels had good diagnostic accuracy in assessing sarcopenia in cirrhotic patients. Although L2 was best associated with L3-SMI, L2 is generally not included in standard liver MRI. L3-SMI estimate from L1 may therefore be most clinically applicable.

EVIDENCE LEVEL: 1.

TECHNICAL EFFICACY: Stage 2.

PMID:36932680 | DOI:10.1002/jmri.28690