Category: Nevin Manimala

Biotechnol Genet Eng Rev. 2023 May 8:1-13. doi: 10.1080/02648725.2023.2210448. Online ahead of print.

ABSTRACT

This study aimed to identify factors that affect the prognosis of children with pulmonary valve atresia and intact ventricular septum treated with transthoracic balloon dilation of the pulmonary valve. The study included 148 participants who were followed up for 5 years. Of these, 10 died, while 138 survived. Independent sample t-test and χ2 test were used to analyze clinical data of children in the death and survival groups. It was found that height, weight, body surface area, arterial oxygen saturation, degree of tricuspid regurgitation, pulmonary valve cross valve pressure difference, ICU length of stay, length of stay, reoperation intervention, and complications were statistically significant (P<0.05). ROC curve analysis of the measurement indicators with statistically significant differences showed that height, weight, body surface area, arterial oxygen saturation, ICU length of stay, and length of stay had AUCs ranging from 0.723 to 0.870. Logistic regression analysis revealed that the degree of tricuspid regurgitation, pulmonary valve cross valvular pressure difference, ICU length of stay, reoperation intervention, and complications were independent risk factors that affect the prognosis of patients with PA/IVS undergoing transthoracic balloon dilation of pulmonary valve. The study proposed a nomogram prediction model using R language software 4.0 “rms” package, which was validated using calibration curve and decision curve. The model had a C-index of 0.667 (95% CI: 0.643-0.786) and high degree of fit. This study provides clinicians with a prediction model to identify children with poor prognosis after treatment with transpulmonary valve balloon dilatation. .

PMID:37154016 | DOI:10.1080/02648725.2023.2210448

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):220-224.

ABSTRACT

PURPOSE: To integrate digital dynamic smile aesthetic simulation (DSAS) cognitive education in orthodontic practicum and evaluate the teaching effects.

METHODS: A total of 32 dental students during orthodontic practicum were randomly divided into two groups. One group received traditional teaching method to draft treatment plan, and another group was implemented with DSAS teaching method. Then two groups exchanged. Students were asked to grade both teaching methods and statistical analysis was performed on the scoring results with SPSS 24.0 software package.

RESULTS: The scores of the DSAS teaching method was much higher than traditional method, and the difference was statistically significant(P=0.012). Students considered that DSAS teaching method was more “novel and fascinating”, and also “convenient for comprehending of orthodontic treatment”. Students hoped to popularize the DSAS teaching method in future orthodontic practicum.

CONCLUSIONS: As a novel teaching method, DSAS is more intuitive and vivid to stimulate students’ interest in learning, and it is helpful to improve the effect of orthodontic practical teaching.

PMID:37154008

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):214-219.

ABSTRACT

PURPOSE: To evaluate the long-term clinical efficacy of short implants and analyze the influencing factors of the survival rate.

METHODS: A total of 178 patients who received implant therapy in the Department of Stomatology, the Fourth Affiliated Hospital of Nanchang University from January 2010 to December 2014 were selected, including 334 short implants of Bicon (implant length ≤6 mm). The basic condition, restoration design, short implant survival rate and complications were observed and analyzed. SPSS 24.0 software package was used for data analysis.

RESULTS: The average follow-up time of short implants was 96±17 months. During the observation period, 20 implants failed, 1 implant had mechanical complications and 6 implants had biological complications. Based on the analysis of implants and patients, the long-term cumulative survival rate of short implants was 94.0%(over 5 years survival rate was 96.4%) and 90.4% respectively. There was no significant difference between the survival rate of short implants and the patient’s gender, age, whether to use special operation and the type of jaw teeth(P＜0.05). Smoking and periodontitis were risk factors for failure of short implants(P＜0.05).The difference of short implant survival rate between short implants restoration with combined crowns and single crowns was statistically significant(P＜0.05). The survival rate of short implant in mandible was higher than that in maxilla(P＜0.05).

CONCLUSIONS: Under the standards clinical program and operation, short implant can be used to shorten the implant restoration cycle and avoid complicated bone augmentation which can achieve good long-term clinical effect. Short implant should be used to strictly control the risk factors that affect the survival of short implant.

PMID:37154007

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):198-202.

ABSTRACT

PURPOSE: To verify the efficacy and safety of calcined cattle bone grafting material in filling alveolar bone defect after tooth extraction.

METHODS: A randomized, bind, parallel, positive-control multicenter clinical trial was conducted. A total of 280 subjects were randomly assigned to either the experimental group (calcined cattle bone group) or control group (Bio-Oss group) equally. The main efficacy indicator was the imaging changes 24 weeks after material implantation. Secondary efficacy indicators were wound healing, rejection, bone metabolism, post-filling symptoms and signs of bone infection. The safety of material was assessed by the incidence of adverse events and serious adverse events. SAS 8.2 software package was used for statistical analysis.

RESULTS: A total of 280 cases were included, of them 267 cases completed the study while 13 cases fell off. The effective rate of FAS(PPS) was 90.58%(97.46%) in the experimental group and 87.05% (95.04%) in the control group. The difference of effective rate between the experimental group and control group (95%CI) was 3.53% (-3.88%, 10.94%) of FAS, 2.42% (-2.38%, 7.22%) of PPS, and there was no significant difference between the two groups. The incision healing of the two groups was good, and the incidence of rejection, bone infection signs, post-filling symptoms and bone metabolic changes was very low. The incidence of adverse events was similar in the two groups, and no serious adverse events related to the study materials occurred.

CONCLUSIONS: The efficacy of calcined cattle bone grafting material in filling alveolar bone defect after tooth extraction is not inferior to that of Bio-Oss, and it is safe and effective for alveolar bone defect repair.

PMID:37154004

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):188-192.

ABSTRACT

PURPOSE: To evaluate the effect of combination of auxiliary irrigation technology and root canal irrigation solution in the treatment of chronic apical periodontitis with fistula, and try to seek a more effective and minimally invasive therapeutic strategy.

METHODS: One hundred and fifty patients with fistulous chronic apical periodontitis who were diagnosed in Hefei Stomatological Hospital from January 2021 to January 2022 were randomly divided into 6 groups, 25 cases in each group. The 6 groups were as follows, group A: 0.5%NaOCl +ultrasonically activated irrigation; Group B: 1.0%NaOCl+ultrasonically activated irrigation; Group C: 2.0%CHX+ultrasonically activated irrigation; Group D: 0.5%NaOCl+sonic activation; Group E: 1.0%NaOCl+sonic activation; Group F: 2.0%CHX+sonic activation. The fistula healing time, treatment effect and postoperative pain were observed in each group. The data were analyzed with SPSS 20.0 software package.

RESULTS: In terms of fistula healing, the 10-day fistula healing rate of group E and group F was higher than that of group A and group D，and the difference was statistically significant(P＜0.05); but there was no significant difference between group E and group F (P＞0.05). The effective rate at 1 month after operation in group A was lower, and the difference was significant (P＜0.05). In terms of postoperative pain, the VAS score of group A was lower than that of group E and group F at all time points, and the difference was statistically significant(P＜0.05).

CONCLUSIONS: In the treatment of chronic apical periodontitis with fistula, 1.0% NaOCl or 2.0% CHX combined with ultrasonically activated irrigation or sonic activation obtain a better short-term effect，of which the sonic activation group can also obtain early healing of the fistula, but the incidence of postoperative pain is higher when sonic activation is used.

PMID:37154002

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):183-187.

ABSTRACT

PURPOSE: To analyze the use status and satisfaction of the follow-up patients, and explore the construction of internet medical service model and platform in stomatology.

METHODS: Patients who visited the internet clinic of stomatology from January to June, 2021 were selected. After diagnosis and treatment, they were followed up by AI intelligent voice with self-designed questionnaire. SPSS 21.0 software was used for statistical analysis.

RESULTS: A total of 372 valid questionnaires were collected. The male-to-female ratio of oral patients was 1.25:1, with an average age of 35.96 years. Most of them had a bachelor’s degree or above, and the patients were mainly from the Yangtze River Delta. 53.76% of patients needed doctors to prescribe drugs. 81.72% of the dental patients believed that the consultation process of internet clinic was convenient, and 79.83% of patients perceived that the system operation of internet clinic was convenient. Binary logistic regression showed that digital literacy, convenience of medical treatment process were significantly related to the satisfaction of internet outpatient service, while gender, education level, online medical treatment duration and convenience of system operation were not related.

CONCLUSIONS: Internet medical treatment in stomatology is feasible, but it is still necessary to break through limitations and further innovate service function. Internet outpatients are mainly young and middle-aged, but it is still necessary to care for the special group of the elderly. It is necessary to further optimize the process, upgrade the system and innovate management, strengthen policy support and incentive mechanism, and promote the transformation of medical service mode in stomatology.

PMID:37154001

Shanghai Kou Qiang Yi Xue. 2023 Apr;32(2):172-176.

ABSTRACT

PURPOSE: To investigate the changes of serum prealbumin (PA) expression level in patients with oral and maxillofacial space infections and its significance.

METHODS: Patients hospitalized at the Affiliated Hospital of Xuzhou Medical University from January 2020 to September 2021 were selected and divided into infected and non-infected group. One hundred and twenty-one patients with moderate to severe oral and maxillofacial gap infections were in the infected group, and 128 patients without infection were in the non-infected group. In the infected group, PA, high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) levels and related clinical parameters were measured at 1, 3 and 7 d of admission. In the non-infected group, PA, hs-CRP and WBC levels were measured at 1 d of admission. SPSS 23.0 software package was used to statistically analyze the relationship between PA levels and various laboratory and clinical parameters.

RESULTS: PA levels in the infected group were significantly lower than those in the non-infected group at 1 d of admission. PA levels in the infected group showed an overall increasing trend at different time points, and PA was negatively correlated with pain intensity and positively correlated with mouth opening(P＜0.05). The diagnostic sensitivity was 90.91% and the specificity was 92.97% for PA≤19.85 mg/dL, which can be used as the best diagnostic threshold. The diagnostic efficacy can be improved when combined with hs-CRP and WBC. Logistic regression analysis showed that low PA level was an independent risk factor for patients requiring intensive care after surgery (P＜0.05).

CONCLUSIONS: PA is an effective tool for the early diagnosis and evaluation of the efficacy of oral and maxillofacial interstitial infections, and can be used as a reference indicator to assess prognosis.

PMID:37153999

J Matern Fetal Neonatal Med. 2023 Dec;36(1):2208252. doi: 10.1080/14767058.2023.2208252.

ABSTRACT

BACKGROUND: Oxytocin is routinely administered after delivery for prophylaxis and treatment of postpartum hemorrhage, but it is associated with considerable cardiovascular side-effects. Carbetocin, a synthetic oxytocin analogue, has a myometrial contraction effect of 60 min when given IV, compared with 16 min for oxytocin.

OBJECTIVE: To investigate whether there are differences in cardiovascular effects between oxytocin and carbetocin up to 1 h after treatment.

METHODS: Sixty-one healthy pregnant women undergoing elective cesarean section in spinal anesthesia were randomized to receive an IV bolus of either five units (8.3 µg) of oxytocin or 100 µg of carbetocin after delivery of the baby. Heart rate (HR), mean arterial blood pressure, ECG ST index, oxygen saturation (SaO₂), and photoplethysmographic digital pulse wave analysis variables were recorded before and at 1, 5, 20, and 60 min after drug administration. Vasopressor use, uterine tonus, total bleeding, and need for additional uterotonics were also assessed. Repeated measurement ANOVA was used for statistical analyses.

RESULTS: The drugs had equal vasodilatory and hypotensive effects. Oxytocin, but not carbetocin, caused a decrease in HR at 1 min and a sustained decrease in cardiac left ventricular ejection time. Aggregate vasopressor use was higher in the carbetocin group. Neither drug caused any change in ST index, SaO₂, or subjective cardiac symptoms. Uterine tonus, need for additional uterotonics, or total bleeding did not differ significantly between the groups.

CONCLUSION: Single doses of oxytocin and carbetocin had similar dilatory effects on vascular tonus, where the difference in aggregate vasopressor use can be attributed to a more persistent hypotensive effect of carbetocin. A transient negative chronotropic and sustained negative inotropic effect occurred after oxytocin. Neither drug showed any alarmingly adverse effects. Differences in drug effects may be attributed to differences in oxytocin and vasopressin receptor signaling pathways.

PMID:37150593 | DOI:10.1080/14767058.2023.2208252

Air Med J. 2023 May-Jun;42(3):163-168. doi: 10.1016/j.amj.2023.01.009. Epub 2023 Feb 24.

ABSTRACT

OBJECTIVE: In May 2022, the Royal Flying Doctor Service Western Operations in Western Australia pioneered the introduction of the first organizational helicopter emergency service with 2 Eurocopter EC145 helicopters. This article describes the pilot study undertaken, assessing the implementation and flight crew confidence outcomes of the supplementation of video simulation training to standard clinical training for helicopter air medical retrieval.

METHODS: Survey assessments using a 5-point Likert scale provided anonymous demographic data with summarized results of the means and standard deviations. Nonparametric tests were used to compare responses between the control and experimental groups from pretraining to postintervention to postpractical.

RESULTS: The findings showed an increase in confidence rates after a classroom session and further increases after a practical session in the control group. The intervention group showed a small rise in overall confidence levels after being shown video simulations following the completion of their classroom session before commencing their practical session. This study established that regardless of the airframe, clinical staff, often with significant experience in air medical retrieval and critical care medicine, do not automatically have confidence in performing critical care procedures in a new aircraft type to which they have not previously been oriented. The results display a statistically significant increase in confidence levels in procedural performance after the classroom session compared with the pretraining questionnaire, with a subtle further rise when video simulations are included in the classroom session. When a classroom session is subsequently supplemented with a practical simulation session, confidence levels continue to rise.

CONCLUSION: Implementing a comprehensive educational strategy including classroom and practical elements for clinical staff in their orientation to new aircraft improves their confidence in performing critical care procedures if required in flight. The addition of in-flight prerecorded videos demonstrating these critical care procedures is a useful adjunct to simulation training for flight crew in air medical retrieval, and further analytical studies may indeed show a statistically significant improvement in staff confidence.

PMID:37150569 | DOI:10.1016/j.amj.2023.01.009

Air Med J. 2023 May-Jun;42(3):157-162. doi: 10.1016/j.amj.2023.01.004. Epub 2023 Feb 20.

ABSTRACT

OBJECTIVE: The current research was performed to assess professional quality of life; identify factors associated with secondary traumatic stress, burnout, and compassion satisfaction; and evaluate the effectiveness of a peer support pilot intervention among air medical crewmembers.

METHODS: Quantitative research methods were used to assess secondary traumatic stress, compassion satisfaction, and burnout among flight nurses and paramedics. Demographic variables and secondary traumatic stress, burnout, and compassion satisfaction scores using the Professional Quality of Life Scale were assessed. A comparison of survey scores obtained before and 16 months after the implementation of a piloted peer support program was performed.

RESULTS: Crewmembers with less experience within an air medical program and those without a support system are at the highest risk of developing secondary traumatic stress, burnout, and impaired compassion satisfaction. Observed scores for secondary traumatic stress, burnout, and compassion satisfaction suggest that peer support may be an effective intervention among air medical crewmembers. No statistically significant differences in secondary traumatic stress, burnout, or compassion satisfaction were observed by clinical role, marital status, or years in their profession.

CONCLUSION: Peer support after emotionally challenging or stressful transports may combat secondary traumatic stress, compassion fatigue, and burnout. This intervention would be most beneficial for crewmembers who are newer to the transport organization and lack social or familial support.

PMID:37150568 | DOI:10.1016/j.amj.2023.01.004