Category: Nevin Manimala

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2522-2534. doi: 10.26355/eurrev_202303_31786.

ABSTRACT

OBJECTIVE: The aim of this study was to assess the effects of epidural analgesia on the course of labor.

SUBJECTS AND METHODS: The material for the study was obtained from the analysis of 300 medical records of patients delivering under epidural analgesia in the period 2015-2019. A questionnaire by the authors was used as the research tool. Statistical analysis was performed using Fisher’s test, Pearson’s Chi-square test of independence, and Cramer’s V-test.

RESULTS: The first stage of labor in primiparas usually lasted six to nine hours, and in multiparas under five hours (p = 0.041). The second stage was shorter in multiparas (p < 0.001). Our five-year analysis demonstrated that the second stage of labor was longer from year to year (p = 0.087). The fetal station had an effect on the duration of the first stage of labor (p = 0.057). After administration of epidurals, the majority of the women bore the pain well (p = 0.052).

CONCLUSIONS: Epidural analgesia reduces labor pain, but may also disturb the natural rhythm of labor. This happens even if the moment of application of the analgesia is chosen with the guidance of obstetric indications, and may result in the necessity for surgical intervention.

PMID:37013770 | DOI:10.26355/eurrev_202303_31786

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2477-2484. doi: 10.26355/eurrev_202303_31781.

ABSTRACT

OBJECTIVE: The predictive value of body simplified indices needs to be evaluated properly for cardiovascular risk. This study aimed to assess and compare the relative relationship of arm circumference (AC), arm muscle circumference (AMC), body mass index (BMI), and waist-hip ratio (WHR) with Ultra-Sensitive C-Reactive Protein (US-CRP) in healthy male subjects and with type 2 diabetes mellitus (T2DM).

PATIENTS AND METHODS: We performed the study at the department of Physiology, College of Medicine & King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. It was a cross-sectional study with 93 healthy male subjects and 112 type 2 diabetic male patients who underwent body composition analysis by BIA and fasting venous blood samples were collected. US-CRP and body composition were determined for all subjects.

RESULTS: US-CRP is correlated positively with AC (0.378) and BMI (0.394) more than AMC (0.282) and WHR (0.253) which have lower correlation both in control and DM group. BCM has the lowest correlation with US-CRP (0.105). The association between US-CRP and AC, AMC, Body Fat Percent (BFP), and body fat mass (BFM) are statistically significant except for BFP in DM group. In control group, AC is noticed to be a better predictor for US-CRP, with area under curve (AUC) 64.2% (p=0.019), WHR with AUC 72.6% (p<0.001), and BMI with AUC 65.4% (p=0.011) but AMC is not a good predictor in control group with AUC 57.5% (p=0.213). In DM group, AC is noticed to be a better predictor for US-CRP, with AUC 71.5% (p<0.001), WHR with AUC 67.4% (p=0.004), BMI with AUC 70.9% (p=0.001), and AMC with AUC 65.2% (p=0.011).

CONCLUSIONS: Simplified muscle mass body indices like AC and AMC have significant predictive value for assessing cardiovascular risk in both healthy population and patients with T2DM. Therefore, AC could be used as a future predictor for cardiovascular disease in healthy and DM patients. Further investigations are needed to confirm its applicability.

PMID:37013765 | DOI:10.26355/eurrev_202303_31781

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2385-2393. doi: 10.26355/eurrev_202303_31773.

ABSTRACT

OBJECTIVE: The electromechanical window (EMW) was investigated as a new predictor of arrhythmia in the presence of long QT. However, the use of EMW to predict idiopathic frequent ventricular premature complexes (PVCs) in those with normal QT intervals has not been clarified.

PATIENTS AND METHODS: This single-center study included consecutive patients who presented to the Cardiology Clinic with palpitations and were found to have idiopathic PVC on 24-hour Holter monitoring. Those with a PVC/24-hour frequency of < 1% were defined as group 1, 1-10% as group 2, and > 10% as group 3. The EMW was defined as the time difference (in ms) between the aortic valve closure and the end of the QT interval, measured from an ECG on the concurrent echocardiogram.

RESULTS: A total of 148 patients were included in the study, 64% (n = 94) of which were female. The patients’ mean age was 50.11 ± 14.7. The groups were similar in terms of the patients’ age, BMI, and comorbidities. There was a statistically significant difference between the three groups in terms of the EMW measurements (group 1: 3.78 ± 19.6, group 2: -7 ± 30.9, group 3: -34.83 ± 55.2 ms: p < 0.001). In the multivariate regression analysis, the EMW (OR 0.971, p = 0.007) and every 10-ms decrease in the EMW (OR 1.254, p = 0.011) were thus determined to be independent predictors of PVC > 10%. An EMW value of ≤ -15 ms was associated with the frequency of 24-h PVC > 10%, with a sensitivity of 70% and a specificity of 70% (AUC 0.716, 95% CI: 0.636-0.787 p < 0.001).

CONCLUSIONS: The results showed that a negative increase in the EMW may be associated with frequent idiopathic PVCs.

PMID:37013757 | DOI:10.26355/eurrev_202303_31773

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2350-2357. doi: 10.26355/eurrev_202303_31770.

ABSTRACT

OBJECTIVE: Several studies have previously shown that some small leucine-rich proteoglycans (SLRPs) are associated with atherosclerotic plaque. We aim to investigate the relationship between circulating lumican levels and the severity of coronary artery disease (CAD).

PATIENTS AND METHODS: This study included 255 consecutive patients who underwent coronary angiography for stable angina pectoris. All demographic and clinical data were collected prospectively. The severity of CAD was assessed based on the Gensini score and a value >40 was defined as advanced CAD.

RESULTS: Eighty-eight patients were in the advanced CAD group; these are older and the frequency of diabetes mellitus, cerebrovascular accidents, reduced ejection fraction (EF), left atrium diameter was higher. Serum lumican levels were found as higher in advanced CAD group (0.4 ng/ml vs. 0.6 ng/ml, respectively, p<0.001). When the Gensini score increased, a statistically significant increase was observed in lumican levels with a good correlation (r=0.556 and p<0.001). In multivariate analysis, diabetes mellitus, EF and lumican were predictive for advanced CAD. Lumican level predicts CAD seriousness with a sensitivity rate of 64%, specificity rate of 65%.

CONCLUSIONS: In this study, we reveal a relationship between serum lumican levels and CAD severity. More research is warranted to determine the mechanism and prognostic values of lumican in the atherosclerosis.

PMID:37013754 | DOI:10.26355/eurrev_202303_31770

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2326-2331. doi: 10.26355/eurrev_202303_31767.

ABSTRACT

OBJECTIVE: The aim of this study was to analyze mortality-related factors and scoring systems in order to better manage the treatment process of patients monitored in the intensive care unit (ICU) due to Fournier’s gangrene (FG).

PATIENTS AND METHODS: The study included 28 male patients who were monitored in the surgical ICU with the diagnosis of FG between December 2018 and August 2022. The patients’ comorbidities, acute physiological and chronic health evaluation scoring system II (APACHE II), Fournier gangrene severity index (FGSI), sequential organ failure assessment (SOFA) scores, and laboratory data were evaluated retrospectively.

RESULTS: Of the patients, 67.9% (n=19) had diabetes mellitus, 78.6% (n=22) had hypertension, and 71.4% (n=20) had coronary artery disease. The mortality rate was 42% (n=11). There was no statistically significant difference between the patients who died and those who survived in terms of the SOFA score, comorbidities, and albumin, glucose, and procalcitonin values (p > 0.05), but age, APACHE II and FGSI scores, and the C-reactive protein (CRP) value were significantly higher in the non-survivor group. There was a positive correlation between the FGSI, APACHE II, and SOFA scores.

CONCLUSIONS: Older age, high CRP levels at the time of admission, and the presence of comorbidity are still determining factors in the prediction of mortality in patients with FG. We also determined that in predicting mortality in patients monitored in the ICU with the diagnosis of FG, in addition to the routinely used FGSI, the APACHE II score was also useful, but the SOFA score did not have significant predictive value.

PMID:37013751 | DOI:10.26355/eurrev_202303_31767

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2320-2325. doi: 10.26355/eurrev_202303_31766.

ABSTRACT

OBJECTIVE: To our knowledge, there is no study in the literature so far to investigate the effect of silodosin therapy on the ureteric jet parameters. Therefore, the objective of this study was to investigate the effect of silodosin 8 mg/day for medical therapy of lower urinary tract symptoms (LUTS) on the color flow Doppler parameters and patterns of the ureteric jets.

PATIENTS AND METHODS: This prospective cohort study included 34 male patients who presented to our outpatient clinic with the complaint of lower urinary tract symptoms (LUTS) and received silodosin 8 mg once a day as medical therapy. In the color flow Doppler examinations, ureteric jets were observed and mean flow rate (JETave), maximum flow rate (JETmax), flow duration (JETdura), and flow frequency (JETfre) were examined. In addition, patterns of the ureteric jets (JETpat) were also evaluated.

RESULTS: There was no statistically significant difference in JETave; however, JETmax, JETdura and JETfre were significantly higher at post-silodosin treatment. The patterns of ureteric jet were significantly changed following a 6-week treatment with silodosin (p<0.001). One ureter in the monophasic pattern group (9.1%) and three in the biphasic group (13.6%) turned to polyphasic pattern after silodosin use. None of the patients developed side effects that would require discontinuation of the drug.

CONCLUSIONS: Six-week silodosin 8 mg/day therapy for the treatment of LUTS in men changed the parameters and patterns of ureteric jets at follow-up examination. Furthermore, comprehensive studies are needed on this issue.

PMID:37013750 | DOI:10.26355/eurrev_202303_31766

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2314-2319. doi: 10.26355/eurrev_202303_31765.

ABSTRACT

OBJECTIVE: We investigated the association between anxiety and depression and erectile dysfunction (ED) in patients who developed ED after coronavirus disease 2019 (COVID-19).

PATIENTS AND METHODS: This study included 228 men who were hospitalized in pandemic wards between July 2021 and January 2022 with positive reverse transcription-polymerase chain reaction test results for the severe acute respiratory syndrome coronavirus 2 RNA. All patients responded to a Turkish version of the International Index of Erectile Function (IIEF) questionnaire to determine erectile status. Patients were administered the Turkish version of the Beck Depression Inventory (BDI) and Generalized Anxiety Disorder 7-item scale (GAD-7) questionnaires the day after hospitalization and also during the 1st month after diagnosis of COVID-19 to compare the COVID-19 situation with the previous situation.

RESULTS: Patients’ mean age was 49.66 ± 13.3 years. The mean pre-COVID-19 erectile function score of 28.65 ± 1.33 decreased to a mean post-COVID-19 score of 26.58 ± 4.23, which indicates a statistically significant difference (p=0.03). Post-COVID-19 ED occurred in 46 (20.1%) patients; 10 (4.3%) patients had mild, 23 (10.0%) had mild-to-moderate, 5 (2.1%) had moderate, and 8 (3.5%) patients had severe ED. The mean pre-COVID-19 BDI score (which indicates depression) of 1.79 ± 2.45 increased to a mean post-COVID-19 score of 2.42 ± 2.89 (p<0.01). Additionally, the mean pre-COVID-19 GAD-7 score of 4.79 ± 1.83 increased to a mean post-COVID-19 score of 6.79 ± 2.52, which indicates a statistically significant difference (p<0.01). We observed a negative correlation between the increase in BDI and GAD-7 scores and the decrease in IIEF scores (r=0.426, p<.001, r=0.568, p<.001, respectively).

CONCLUSIONS: Our study highlights that COVID-19 can cause ED and that disease-induced anxiety and depression serve as primary contributors to ED.

PMID:37013749 | DOI:10.26355/eurrev_202303_31765

Eur Rev Med Pharmacol Sci. 2023 Mar;27(6):2241-2249. doi: 10.26355/eurrev_202303_31758.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate and compare the effect of different laser prototypes [Er, Cr: YSGG laser (ECYL), potassium titanyl phosphate laser (KTP), and Femtosecond laser (FSL)]and curcumin photosensitizer (CP) activated by Photodynamic therapy (PDT) on the bond strength of Pre-fabricated fiber reinforced composite (PFRC) post-bonded to radicular dentin.

MATERIALS AND METHODS: A total of fifty mandibular single-rooted closed apex teeth were extracted carefully, assembled, and decoronated up to the cementoenamel junction. The working length of all specimens was determined by using a 10 K patency file and later, were cleaned and shaped with Protaper NiTi system using the crown down approach, dried, and obturated with gutta-percha using an AH Plus sealer. Post space was prepared by guiding peeso-reamer. Based on the method of disinfection, the samples were allocated to five groups (n=10) at random: samples in group 1: curcumin photosensitizer (CP) activated by PDT, samples in group 2 disinfected using 5.25% NaOCl+17% EDTA, samples in group 3 disinfected using 5.25% NaOCl+17% EDTA+FSL, specimens in group 4 sterilized using 5.25% NaOCl+17% EDTA+KTP and samples in group 5 cleaned with 5.25% NaOCl+17% EDTA+ECYL. The fiber post was cemented via self-etch resin cement into the post space. All specimens with posts were dissected perpendicularly into apical, middle, and coronal dentin and subjected to the universal testing machine for push-out bond strength (PBS) testing. Statistical analysis was performed using a One-Way analysis of variance and Post Hoc Tukey multiple comparison tests.

RESULTS: The highest PBS was corroborated when the radicular canal was disinfected with 5.25% NaOCl +17% EDTA+ ECYL at all three root levels (coronal, middle, and apical) and the lowest was adjudicated by decontamination with CP activated by PDT at all inspected root levels. Intergroup comparison presented that specimens in group 2: 5.25% NaOCl+17% EDTA (control) and group 4: 5.25% NaOCl+17% EDTA+KTP revealed comparable PBS outcome to group 5 (p>0.05) while samples in group 3 revealed the equivalent PBS values to group 1 (p<0.05) at all three root levels.

CONCLUSIONS: Er, Cr: YSGG laser and potassium titanyl phosphate laser when used in combination with the conventional canal disinfection 5.25% NaOCl and 17% EDTA demonstrated the highest push-out bond strength values at coronal, middle, and apical levels of the root.

PMID:37013742 | DOI:10.26355/eurrev_202303_31758

Zhonghua Yan Ke Za Zhi. 2023 Apr 11;59(4):295-301. doi: 10.3760/cma.j.cn112142-20220801-00370.

ABSTRACT

Objective: To investigate the clinical features of dry eye disease in patients with graft-versus-host disease (GVHD) and to identify the correlative factors that contribute to its severity. Methods: It was a retrospective case series study. A total of 62 patients with dry eye disease caused by GVHD after allogeneic hematopoietic stem cell transplantation (HSCT) were recruited from the First Affiliated Hospital of Soochow University between 2012 and 2020. The study population comprised 38 males (61%) and 24 females (39%), with an average age of (35.29±11.75) years. Only the right eye of each patient was evaluated. The patients were divided into two groups based on the severity of corneal epitheliopathy: a mild group (15 eyes) and a severe group (47 eyes). Demographic information, including gender, age, primary disease, type of allogeneic HSCT, donor-to-recipient information, source of hematopoietic stem cells, systemic GVHD, and the time from HSCT to the first visit, was collected. Ophthalmologic assessments, including the Schirmer Ⅰ test, tear breakup time, corneal epithelial staining, and eye margin assessment, were performed during the first visit to the ophthalmology department and compared between the two groups. Results: The average time from HSCT to the first visit to the ophthalmology department among the 62 patients was (20.26±13.09) months. The median corneal fluorescein staining score was 4.5 points. In the mild group, the main characteristic of corneal staining was scattered punctate staining in the peripheral region in 80% of cases, while in the severe group, corneal staining fused into clumps in both the peripheral region (64%) and the pupillary zone (28%). Results of the Schirmer Ⅰ test were significantly lower in the severe group compared to the mild group (P<0.05). The median total eyelid margin score in the severe group was higher than that in the mild group [9 (7, 12) points vs. 6 (5, 8) points] (P<0.05). The median eyelid congestion score in the severe group was, also higher than that in the mild group [2 (1, 3) points vs. 1 (0, 2) points] (P<0.05). The compatibility between the blood types of the donor and recipient was found to be statistically significant (P<0.05). There was no significant difference in gender, age, family relationship, human leukocyte antigen matching, gender consistency, source of hematopoietic stem cells, or the occurrence of systemic GVHD between the two groups (P>0.05). Conclusions: Patients in the mild group had scattered punctate corneal staining in the peripheral region, while those in the severe group showed fusion of corneal staining into clumps in both the peripheral and pupillary zones. The severity of dry eye disease caused by GVHD was strongly correlated with eyelid margin lesions. A higher degree of eyelid margin lesions indicated more severe dry eye disease caused by GVHD. Additionally, compatibility between the blood types of the donor and recipient may play a role in the development of GVHD-associated dry eye.

PMID:37012593 | DOI:10.3760/cma.j.cn112142-20220801-00370

Zhonghua Yan Ke Za Zhi. 2023 Apr 11;59(4):272-278. doi: 10.3760/cma.j.cn112142-20220813-00400.

ABSTRACT

Objective: To compare the point-of-care assays for tear matrix metalloproteinase 9 (MMP-9) using domestic and InflammaDry kits, and to evaluate the feasibility of diagnosing dry eye with the domestic kit. Methods: It was a cross-sectional study. Thirty dry eye patients and 30 age-and sex-matched normal volunteers were continuously enrolled in this cross-sectional study from June 2022 to July 2022. Both domestic and InflammaDry kits were used to detect the tear MMP-9 levels. The positive rates were recorded for qualitative analysis, and the gray ratios of bands (the gray value of detection bands to that of control bands) were collected for quantitative analysis. The correlations of MMP-9 levels with age, ocular surface disease index, fluorescence tear break-up time, tear meniscus height, Schirmer’s Ⅰ test score, corneal fluorescein staining score, and meibomian gland dropout were analyzed. The Mann-Whitney U test, paired Chi-square test, Kappa test, and Spearman’s correlation coefficient were used for statistical analysis. Results: There were 14 males and 16 females (30 eyes) in the control group, and their age was (39.37±19.55) years. In the dry eye group, 11 males and 19 females (30 eyes), aged (46.87±17.85) years, had moderate to severe dry eye. The positive rates of MMP-9 in tear fluid were significantly different between dry eye patients (InflammaDry: 86.67%; domestic kit: 70.00%) and controls (InflammaDry: 16.67%, P<0.001; domestic kit: 6.67%, P<0.001). Although the sensitivity of the domestic kit was lower than that of the InflammaDry kit (70.0% vs. 86.7%, P=0.001), the specificity was higher (93.3% vs. 83.3%, P=0.001). In dry eye patients, the positive coincidence rate was 80.7% (21/26), the negative coincidence rate was 100% (4/4), and the total coincidence rate was 83.3% (25/30), with no significant difference between the two kits (McNemar test: χ²=3.20, P>0.05), and the results of both kits were consistent (Kappa=0.53, P=0.001). The Spearman’s correlation coefficient showed the gray ratios using both kits were positively correlated with the corneal fluorescein staining score (InflammaDry: ρ=0.48, P<0.05; domestic kit: ρ=0.52, P=0.003). Conclusion: The performances of the domestic and InflammaDry kits are consistent in the point-of-care assay for tear MMP-9, and the domestic kit has lower sensitivity but higher specificity.

PMID:37012590 | DOI:10.3760/cma.j.cn112142-20220813-00400