Category: Nevin Manimala

J Cardiothorac Surg. 2023 Apr 14;18(1):141. doi: 10.1186/s13019-023-02232-2.

ABSTRACT

OBJECTIVE: Most mitral valve repair techniques provide excellent surgical results by removing regurgitation, but all of these techniques simultaneously reduce posterior valve mobility. A comprehensive biometric study of the mitral valve apparatus will provide landmarks that would help improve this posterior valve mobility.

MATERIALS AND METHODS: Thirty one (31) human hearts have been studied, from 14 women and 17 men. The characteristics of the studied sample were analyzed descriptively. The difference in means of the variables between women and men were tested using a Student t test. Correlations between the different measures were determined by simple regression analysis. Mean values are shown with ± 1 standard deviation and the limit of significance was set at 0.05.

RESULTS: The mean weight of the hearts was 275.3 ± 2.4 g. The anteroposterior diameter of the mitral annulus was 29.3 ± 1.22 mm, the intertrigonal distance was 25.2 ± 3.50 mm and the anterior leaflet to posterior leaflet ratio was 1.9 ± 0.10, the length of the chordae A2 = 19.4 ± 1.15 mm and P2 = 14.5 ± 0.85 mm. The length of the anterior papillary muscle averaged 30.9 ± 7.20 mm and that of the posterior one 30.0 ± 8.75 mm. The comparison of the different values measured between women and men showed no statistically significant difference (p > 0.05). There was no correlation between these different measured values (p > 0.05).

CONCLUSION: A perfect knowledge of anatomy and biometry is therefore essential to offer alternative techniques that reproduce the real anatomy and physiology with a complete reconstruction of the mitral valve.

PMID:37060017 | DOI:10.1186/s13019-023-02232-2

BMC Musculoskelet Disord. 2023 Apr 14;24(1):295. doi: 10.1186/s12891-023-06393-y.

ABSTRACT

PURPOSE: This study aimed to compare total blood loss (TBL) and hidden blood loss (HBL) in patients undergoing single-level open transforaminal lumbar interbody fusion (O-TLIF) and unilateral biportal endoscopic transforaminal lumbar interbody fusion (ULIF).

METHODS: A total of 53 patients who underwent ULIF and 53 patients who underwent O-TLIF from March 2020 to July 2022 were retrospectively reviewed. The Nadler’s formula was employed to estimate the patient’s blood volume (PBV), Gross’s formula to estimate TBL, and Sehat’s formula to estimate HBL. The obtained data were then analyzed with independent t test, chi-squared test, and analysis of covariance.

RESULTS: TBL and measured blood loss (MBL) in ULIF group (326.86 ± 223.45 ml, 99.00 ± 72.81 ml) was significantly lower than O-TLIF group (427.97 ± 280.52 ml, 270.66 ± 102.34 ml). Nevertheless, the HBL in ULIF group was higher than that in O-TLIF group (227.86 ± 221.75 ml vs 157.31 ± 268.08 ml), however this was not statistically significant (p = 0.143). The HBL was 69.71 ± 23.72% of TBL in ULIF group and 36.76 ± 18.79% of TBL in O-TLIF group. Patients in ULIF group had lower TBL and MBL, shorter duration of drainage, lower postoperative anemia, and shorter postoperative hospital stay compared to those in O-TLIF group.

CONCLUSIONS: Perioperative HBL should not be neglected in patients undergoing ULIF or O-TILF, as it accounts for a large percentage of TBL in both groups. ULIF is associated with lower TBL and MBL, postoperative anemia, shorter postoperative hospital stays compared with O-TLIF.

PMID:37060012 | DOI:10.1186/s12891-023-06393-y

Cardiooncology. 2023 Apr 14;9(1):21. doi: 10.1186/s40959-023-00168-z.

ABSTRACT

BACKGROUND: Many ca. survivors exhibit signs of IR, an important risk factor for the development of CAD. CAC scans offer a risk assessment of CV disease before cardiac damage has occurred. We investigated how IR affects CAC scores in cancer survivors.

OBJECTIVES: The aim of this study was to show that CAC scores differ significantly between insulin-sensitive- and -resistant cancer survivors.

METHODS: We enrolled 90 cancer survivors of a large community hospital from March 2021 to January 2022 into this pilot study. Patients were subdivided into three groups: insulin-sensitive (IS), insulin-resistant/prediabetic and insulin-resistant/diabetic. All patients received a CAC scan.

RESULTS: 70% of asymptomatic survivors overall and 81% of asymptomatic IR patients show CAD on CAC scans. 17 CAC scans in the IS group, 6 CAC scans in the IR/prediabetic group and 5 CAC scans in the IR/diabetic group showed an Agatston score of 0. The p-value between the three groups was statistically significant (p = 0.005) whereas the IR/prediabetic- and the IR/diabetic group did not differ statistically from each other. The mean MESA 10-year CHD risk with CAC was 7.8. There was a highly significant difference between the 3 groups (p < 0.001). The two IR groups did not differ statistically (p = 0.076).

CONCLUSIONS: Survivors with IR including prediabetes have less frequent zero CAC scores than insulin-sensitive survivors. Our study also showed that IR including prediabetes significantly increases the MESA 10-yr. CHD Risk with CAC in cancer survivors. This trial highlights the importance of screening survivors for IR and draws attention to the association of IR to CAC not only in diabetes but also in prediabetes. The high fraction of asymptomatic survivors with CAD is concerning and calls for further investigation. CAC scans are an inexpensive and efficient way of screening asymptomatic cancer survivors for CAD.

PMID:37060010 | DOI:10.1186/s40959-023-00168-z

BMC Oral Health. 2023 Apr 14;23(1):214. doi: 10.1186/s12903-023-02893-4.

ABSTRACT

BACKGROUND: The purpose of this study was to compare the perception of upper dental midline deviation on the attractiveness of a smile among raters from different ethnicities, professions, genders, and ages and measure to what extent the presence or absence of the associated smiling structures influence the raters’ evaluations.

METHODS: A male subject (26 years of age) with adequate smile characteristics was selected by 3 experienced orthodontists, and 561 raters from 2 different ethnic groups (281 Chinese raters and 280 Black raters) rated the subject’s smile after the subject’s upper dental midline was digitally altered from 0 to 5 mm using a 5-point Likert scale on 12 smile photographs divided into two groups: group 1, in the presence of smile related structures, two-thirds of the nose, lips, and chin (NLC), and group 2, in the absence of smile related structures, the lips only (L).

RESULTS: There were statistically significant differences (p < 0.05) between the two ethnicities, in 2 mm and 4 mm in-group NLC and 5 mm in-group L, as well as the raters’ profession to each midline shift of both groups (NLC) and (L) for both ethnicities except for 0 mm. Regarding the role of associated smile structures, the smile photos were observed in the presence of smile-associated structures, and in its absence (NLC × L), statistically significant differences (p < 0.05) were found when the deviation was 5 mm among the Chinese raters; in 1 mm, and 4 mm among the Black raters. Among different genders, statistical differences were only reported (p < 0.05) for Chinese raters for 5 mm in NLC, while statistical differences were observed for 2 mm and 3 mm in NLC for Black raters. For age categories, differences were observed (p < 0.05) for 4 mm, 5 mm in NLC and 4 mm, and 5 mm in L for Chinese raters, while 5 mm in NLC and 1 mm in L for Black raters.

CONCLUSION: Perception of the upper dental midline deviations was influenced by the factors of ethnicity, profession, presence or absence of smile-associated structures, as well as the gender and age of the raters.

PMID:37060002 | DOI:10.1186/s12903-023-02893-4

BMC Nurs. 2023 Apr 14;22(1):122. doi: 10.1186/s12912-023-01295-9.

ABSTRACT

BACKGROUND: Promoting self-directed learning (SDL) among nursing undergraduates is crucial to meet the new requirements of the healthcare system and to adapt to online learning contexts during the COVID-19 pandemic. Therefore, identifying the classification features of SDL ability and developing targeted interventions are both critical. Professional identity (PI) may contribute to the cultivation of SDL ability, but their relationship remains relatively unknown. This study aimed to explore the subgroups of SDL ability and their differences in PI among nursing undergraduates during the COVID-19 pandemic.

METHODS: A total of 2438 nursing undergraduates at four universities in China were enrolled in this cross-sectional study from November 2021 to February 2022. The Self-Directed Learning Scale of Nursing Undergraduates (SLSNU) and the Professional Identity Scale for Nursing Students (PISNS) were administered. A latent profile analysis was performed to explore SDL ability latent profiles. Multinomial logistic regression analysis was conducted to examine the predictors of profile membership, and a one-way analysis of variance was applied to compare the PI scores in each latent profile.

RESULTS: Three latent profiles were identified and labeled ‘low SDL ability’ (n = 749, 30.7%), ‘low initiative of help-seeking’ (n = 1325, 54.4%) and ‘high SDL ability’ (n = 364, 14.9%). Multinomial logistic regression analysis suggested that nursing undergraduates who voluntarily chose a nursing major, had served as a student cadre, and had participated in clinical practicum were less likely to be included in the “low SDL ability” group. The average PI score was statistically different across the three profiles (F = 884.40, p < 0.001).

CONCLUSION: The SDL ability among nursing undergraduates was divided into three profiles, and results show that promoting PI may effectively foster SDL ability. This study highlights the importance of targeted interventions by considering their distinct SDL ability patterns, especially during the COVID-19 pandemic.

PMID:37059992 | DOI:10.1186/s12912-023-01295-9

BMC Infect Dis. 2023 Apr 14;23(1):232. doi: 10.1186/s12879-023-08212-0.

ABSTRACT

OBJECTIVE: This study aims to assess the clinical efficacy and safety of omadacycline for the treatment of acute bacterial infections.

METHODS: A search of PubMed, Embase, Cochrane Library, and Clinical Trials was conducted up to July 1, 2022. We included only randomized controlled trials (RCTs), in which omadacycline and other antibiotics were evaluated for treating acute bacterial infections in adults. The primary outcomes were clinical response and microbiological response, whereas the secondary outcome was the risk of adverse events (AEs).

RESULTS: A total of seven RCTs involving 2841 patients with acute bacterial infection were included. Overall, our study illustrated that the clinical cure ratio of omadacycline was similar to the comparators in the treatment of acute bacterial infections (OR = 1.18, 95%CI = 0.96, 1.46, I² = 29%). Omadacycline had a microbiological eradication rate similar to comparators in the treatment of acute bacterial infections (OR = 1.02, 95%CI = 0.81, 1.29, I² = 42%). No statistical differences were observed between omadacycline and the comparators in terms of infection caused by Staphylococcus aureus (OR = 1.14, 95%CI = 0.80, 1.63, I² = 0%), methicillin-resistant S. aureus (MRSA, OR = 1.28, 95%CI = 0.73, 2.24, I² = 0%), methicillin-susceptible S. aureus (MSSA, OR = 1.12, 95%CI = 0.69, 1.81, I² = 0%), and Enterococcus faecalis (OR = 2.47, 95%CI = 0.36, 16.97, I² = 7%). A significant difference was found between omadacycline and the comparators for the risk of any AEs and treatment related AEs. The risk of discontinuation of the study drug due to an AEs was lower for omadacycline than for the comparators.

CONCLUSION: Omadacycline is as good as comparators in terms of efficacy and tolerance in the treatment of acute bacterial infections in adult patients. Thus, omadacycline is an appropriate option for antibiotic therapy in adult patients with acute bacterial infections.

PMID:37059988 | DOI:10.1186/s12879-023-08212-0

BMC Pulm Med. 2023 Apr 14;23(1):120. doi: 10.1186/s12890-023-02414-7.

ABSTRACT

BACKGROUND AND OBJECTIVE: Studies linking early life exposure to air pollution and subsequent impaired lung health have focused on chronic, low-level exposures in urban settings. We aimed to determine whether in utero exposure to an acute, high-intensity air pollution episode impaired lung function 7-years later.

METHOD: We conducted a prospective cohort study of children who lived in the vicinity of a coalmine fire. Respiratory function was measured using the forced oscillation technique (FOT). Z-scores for resistance at 5 Hz (R₅), reactance at 5 Hz (X₅) and area under the reactance curve (AX) were calculated. Two sets of analyses were conducted to address two separate questions: (1) whether mine fire exposure (a binary indicator; conceived after the mine fire vs in utero exposed) was associated with the respiratory Z-scores; (2) whether there was any dose-response relationship between fire-related PM_2.5 exposure and respiratory outcomes among those exposed.

RESULTS: Acceptable lung function measurements were obtained from 79 children; 25 unexposed and 54 exposed in utero. Median (interquartile range) for daily average and peak PM_2.5 for the exposed children were 4.2 (2.6 – 14.2) and 88 (52-225) µg/m³ respectively. There were no detectable differences in Z-scores between unexposed and exposed children. There were no associations between respiratory Z-scores and in utero exposure to PM_2.5 (daily average or peak).

CONCLUSION: There was no detectable effect of in utero exposure to PM_2.5 from a local coalmine fire on post-natal lung function 7-years later. However, statistical power was limited.

PMID:37059986 | DOI:10.1186/s12890-023-02414-7

BMC Psychiatry. 2023 Apr 14;23(1):254. doi: 10.1186/s12888-023-04747-3.

ABSTRACT

BACKGROUND: Despite previous studies have recently shown Autism Spectrum Disorders (ASD) as having a strong genetics background, over a minimum environmental background, no study up to date has investigated the interplay between genetics and environment.

METHODS: We have collected data regarding Family History (FH) and Environmental Factors (EF) from 2,141 individuals with ASD and their caretakers throughout Brazil, based on an online questionnaire. Most of the ASD individuals were males (81%) and the average age was 02 years minimum for males and females, and the maximum age was 41 years for males and 54 for females. People from all states in Brazil have answered the questionnaire. Genetic inheritance was obtained based on the declared FH of Psychiatric and Neurological diagnosis. As for EF, exposure to risk factors during pregnancy was considered, like infections, diabetes, drugs/chemicals exposure, socioeconomic, and psychological factors. Respondents were invited to answer the questionnaire in lectures given throughout Brazil, and by the social networks of the NGO “The Tooth Fairy Project”. A Multiple Correspondence Analysis (MCA) was conducted to search vulnerability dimensions, and a Cluster Analysis was conducted to classify and identify the subgroups.

RESULTS: Regarding EF, social and psychological exposures contributed to the first two dimensions. Concerning FH, the first dimension represented psychiatric FH, while the second represented neurological FH. When analyzed together, EF and FH contributed to two new dimensions: 1. psychiatric FH, and 2. a psychosocial component. Using Cluster Analysis, it was not possible to isolate subgroups by genetic vulnerability or environmental exposure. Instead, a gradient of psychiatric FH with similar contributions of EF was observed.

CONCLUSION: In this study, it was not possible to isolate groups of patients that correspond to only one component, but rather a continuum with different compositions of genetic and environmental interplay.

PMID:37059985 | DOI:10.1186/s12888-023-04747-3

BMC Psychiatry. 2023 Apr 14;23(1):251. doi: 10.1186/s12888-023-04745-5.

ABSTRACT

BACKGROUND: The methodological choice of aggregated estimates for meta-analysis may be notable for some common drawbacks, including variations in the cut-off values of depression, and lower statistical power for analyzing the associated factors. The study aimed to refine the precision of previous findings on the prevalence of depressive symptoms among medical students, through gathering individual participant data (IPD) as identified from our previous reviews.

MATERIAL AND METHODS: In the present study, we searched MEDLINE, EMBASE, PsycINFO, WanFang, Scielo and LILACS to identify published systematic reviews and meta-analyses up to March 2018, then individual data was requested for further analysis (PROSPERO registration: CRD42018091917). The participants’ age, sex, year of study, scores for depressive symptoms, and other predictor variables were requested. To pool the prevalence from the included studies, random-effects model (two-step method) was used. Multiple linear regression was used to examine the associated factors on the depression z-scores (one-step method).

RESULTS: Of the 249 studies, the datasets of 34 studies were included. The crude prevalence was 19.4% (95% CI: 18.8%, 19.9%) by one-step method and the pooled prevalence was 18.1% (95% CI: 14.1%, 22.1%) by two-step method. Multiple linear regression revealed that being a female, older age, and senior year of study were significantly associated with the z-score.

CONCLUSION: The pooled prevalence of depressive symptoms from the Individual Participant Data (IPD) meta-analysis was lower than the previous meta-analyses using aggregated data. Age, sex, and year of study were significantly associated with the depression z-score. IPD meta-analysis may provide a more accurate estimation of disease burden, and allow verification of associated factors.

PMID:37059978 | DOI:10.1186/s12888-023-04745-5

BMC Public Health. 2023 Apr 14;23(1):699. doi: 10.1186/s12889-023-15661-4.

ABSTRACT

INTRODUCTION: Unmanaged Type 2 diabetes mellitus (T2DM) substantially contributes to the multi-morbidity of the elderly. Fewer research has concentrated on understanding the determinants of treatment utilization among older people, with even lesser concerns about missing data in outcome variables leading to biased estimates. The present study intends to evaluate the epidemiology of T2DM in the elderly in India and explore the socioeconomic and behavioral risk factors determining the treatment utilization among the elderly > 60 years in India by addressing the missing data to generate robust estimates.

METHODS: The secondary analysis used data from the Longitudinal Ageing Study in India. The key dependent variables were the presence or absence of T2DM and treatment utilization. Descriptive statistics were used to understand the differences in the prevalence of diabetes and the utilization of treatment across various socio-demographic characteristics. Heckman’s statistical technique evaluated the predictors of T2DM and treatment utilization. Analysis was done using STATA software version 14.0.

RESULTS: Almost 14% elderly reported to be living with T2DM. The odds of living with T2DM increased with non-working status, a sedentary lifestyle, and a higher BMI. A higher proportion of the elderly was on oral drugs than insulin and had been practicing lifestyle modifications to control their disease. The probability of developing T2DM was lower among females than males, but females had better odds for treatment utilization of health medication than males. Lastly, treatment utilization was significantly affected by socio-demographic characteristics like education and monthly per capita expenditure.

CONCLUSIONS: Treatment utilization by the elderly living with T2DM is significantly affected by socio-demographic characteristics. Keeping in mind the increasing proportion of the geriatric population in our country, it is pertinent to tailor-made counseling sessions for the elderly to improve medication utilization and adherence and realize our goals concerning non-communicable diseases.

PMID:37059974 | DOI:10.1186/s12889-023-15661-4