Category: Nevin Manimala

J Orthop Surg Res. 2023 Mar 2;18(1):157. doi: 10.1186/s13018-023-03605-y.

ABSTRACT

BACKGROUND: Little published data currently exist regarding the potential relationships between spondylolisthesis, mismatch deformity, and clinical outcomes following total knee arthroplasty (TKA). We hypothesize that preexisting spondylolisthesis will result in decreased functional outcomes after TKA.

METHODS: This retrospective cohort comparison of 933 TKAs was performed between January 2017 and 2020. TKAs were excluded if they were not performed for primary osteoarthritis (OA) or if preoperative lumbar radiographs were unavailable/inadequate to measure the degree of spondylolisthesis. Ninety-five TKAs were subsequently available for inclusion and divided into two groups: those with spondylolisthesis and those without. Within the spondylolisthesis cohort, pelvic incidence (PI) and lumbar lordosis (LL) were calculated on lateral radiographs to determine the difference (PI-LL). Radiographs with PI-LL > 10° were then categorized as having mismatch deformity (MD). The following clinical outcomes were compared between the groups: need for manipulation under anesthesia (MUA), total postoperative arc of motion (AOM) both pre-MUA or post-MUA/revision, incidence of flexion contracture, and a need for later revision.

RESULTS: Forty-nine TKAs met the spondylolisthesis criteria, while 44 did not have spondylolisthesis. There were no significant differences in gender, body mass index, preoperative knee range of motion (ROM), preoperative AOM, or opiate use between the groups. TKAs with spondylolisthesis and concomitant MD were more likely to have MUA (p = 0.016), ROM < 0-120 (p < 0.014), and a decreased AOM (p < 0.02) without interventions.

CONCLUSION: Preexisting spondylolisthesis by itself may not have adverse effect clinical results following TKA. However, spondylolisthesis increases the likelihood of developing MD. In those with both spondylolisthesis and concomitant mismatch deformities, patients had statistically and clinically significantly decreased in postoperative ROM/AOM and increased need for MUA. Surgeons should consider clinical/radiographic assessments of patients with chronic back pain who present for total joint arthroplasty.

LEVEL OF EVIDENCE: Level 3.

PMID:36864440 | DOI:10.1186/s13018-023-03605-y

J Orthop Surg Res. 2023 Mar 2;18(1):158. doi: 10.1186/s13018-023-03652-5.

ABSTRACT

BACKGROUND: Regarding the increasing adoption of oblique lateral interbody fusion (OLIF) for treating degenerative lumbar disorders, we aimed to evaluate whether OLIF, one of the options for anterolateral approach lumbar interbody fusion, demonstrate clinical superiority over anterior lumbar interbody fusion (ALIF) or posterior approach, represented by transforaminal lumbar interbody fusion (TLIF).

METHODS: Patients who received ALIF, OLIF, and TLIF for symptomatic degenerative lumbar disorders during the period 2017-2019 were identified. Radiographic, perioperative, and clinical outcomes were recorded and compared during 2-year follow-up.

RESULTS: A total of 348 patients with 501 correction levels were enrolled in the study. Fundamental sagittal alignment profiles were substantially improved at 2-year follow-up, particularly in the anterolateral approach (A/OLIF) group. The Oswestry disability index (ODI) and EuroQol-5 dimension (EQ-5D) in the ALIF group were superior when compared to the OLIF and TLIF group 2-year following surgery. However, comparisons of VAS-Total, VAS-Back, and VAS-Leg revealed no statistically significance across all approaches. TLIF demonstrated highest subsidence rate of 16%, while OLIF had least blood loss and was suitable for high body mass index patients.

CONCLUSIONS: Regarding treatment for degenerative lumbar disorders, ALIF of anterolateral approach demonstrated superb alignment correction and clinical outcome. Comparing to TLIF, OLIF possessed advantage in reducing blood loss, restoring sagittal profiles and the accessibility at all lumbar level while simultaneously achieving comparable clinical improvement. Patient selection in accordance with baseline conditions, and surgeon preference both remain crucial issues circumventing surgical approach strategy.

PMID:36864438 | DOI:10.1186/s13018-023-03652-5

BMC Public Health. 2023 Mar 3;23(1):282. doi: 10.1186/s12889-023-15180-2.

ABSTRACT

BACKGROUND: This study aimed to look at emotions perceived about the attributes, prevention, diagnosis, and treatment of infectious diseases related to coronavirus disease (COVID-19) that were widespread across the world and identify their relevance to knowledge about infectious diseases and preventative behaviors.

METHODS: Texts to measure emotional cognition were selected through a pre-test, and 282 people were chosen as participants based on the survey conducted for 20 days from August 19 to August 29, 2020, created with Google Forms. IBM SPSS Statistics 25.0 was used for the primary analysis, and the SNA package in R (version 4.0.2) was utilized to conduct the network analysis.

RESULTS: It was found that universal negative emotions such as feeling “anxious” (65.5%), “afraid” (46.1%), and “scared” (32.7%) commonly appeared among most people. Also, they were found to be feeling both positive (“caring” [42.3%] and “strict” [28.2%]) and negative (“frustrating” [39.1%] and “isolated” [31.0%]) emotions about efforts to prevent and curb the spread of COVID-19. In terms of emotional cognition for the diagnosis and treatment of such diseases, “reliable” (43.3%) took the biggest ratio among the replies. The level of understanding about infectious diseases showed differences in emotional cognition, thereby affecting people’s emotions. However, no differences were found in the practice of preventative behaviors.

CONCLUSIONS: Emotions associated with cognition in the context of pandemic infectious diseases have been found to be mixed. Furthermore, it can be seen that feelings vary depending on the degree of understanding of the infectious disease.

PMID:36864419 | DOI:10.1186/s12889-023-15180-2

BMC Pregnancy Childbirth. 2023 Mar 2;23(1):134. doi: 10.1186/s12884-023-05438-3.

ABSTRACT

BACKGROUND: The outcome of in vitro fertilization-embryo transfer (IVF) is often determined according to follicle and estradiol levels following gonadotropin stimulation. In previous studies, although most of them analyzed the estrogen level from ovaries or the average estrogen level of a single follicle, there was no study on the ratio of estrogen increase, which was also correlated with pregnancy outcomes in the clinic. This study aimed to make timely adjustments to follow-up medication to improve clinical outcomes based on the potential value of estradiol growth rate.

METHODS: We comprehensively analyzed estrogen growth during the entire ovarian stimulation period. Serum estradiol levels were measured on the day of gonadotropin treatment (Gn1), five days later (Gn5), eight days later (Gn8), and on the trigger day (HCG). This ratio was used to determine the increase in estradiol levels. According to the ratio of estradiol increase, the patients were divided into four groups: A1 (Gn5/Gn1 ≤ 6.44), A2 (6.44 < Gn5/Gn1 ≤ 10.62), A3 (10.62 < Gn5/Gn1 ≤ 21.33), and A4 (Gn5/Gn1 > 21.33); B1 (Gn8/Gn5 ≤ 2.39), B2 (2.39 < Gn8/Gn5 ≤ 3.03), B3 (3.03 < Gn8/Gn5 ≤ 3.84), and B4 (Gn8/Gn5 > 3.84). We analyzed and compared the relationship between data in each group and pregnancy outcomes.

RESULTS: In the statistical analysis, the estradiol levels of Gn5 (P = 0.029, P = 0.042), Gn8 (P < 0.001, P = 0.001), and HCG (P < 0.001, P = 0.002), as well as Gn5/Gn1 (P = 0.004, P = 0.006), Gn8/Gn5 (P = 0.001, P = 0.002), and HCG/Gn1 (P < 0.001, P < 0.001) both had clinical guiding significance, and lower one significantly reduced the pregnancy rate. The outcomes were positively linked to groups A (P = 0.036, P = 0.043) and B (P = 0.014, P = 0.013), respectively. The logistical regression analysis revealed that group A1 (OR = 0.376 [0.182-0.779]; P = 0.008*, OR = 0.401 [0.188-0.857]; P = 0.018*) and B1 (OR = 0.363 [0.179-0.735]; P = 0.005*, OR = 0.389 [0.187-0.808]; P = 0.011*) had opposite influence on outcomes.

CONCLUSION: Maintaining a serum estradiol increase ratio of at least 6.44 on Gn5/Gn1 and 2.39 on Gn8/Gn5 may result in a higher pregnancy rate, especially in young people.

PMID:36864417 | DOI:10.1186/s12884-023-05438-3

BMC Health Serv Res. 2023 Mar 2;23(1):209. doi: 10.1186/s12913-023-09178-0.

ABSTRACT

BACKGROUND: Quality of care is fundamental to universal health coverage. Perceived quality of medical services is one of the most determining factors of modern health care service utilization. Between 5.7 and 8.4 million deaths are attributed to poor-quality care each year in low- and middle-income countries (LMICs), and up to 15% of overall deaths are due to poor quality. For instance, in sub-Saharan Africa (SSA), public health facilities lack basic facilities such as a physical environment. Hence, this study aims to assess the perceived quality of medical services and associated factors at outpatient departments of public hospitals in the Dawro zone, Southern Ethiopia.

METHODS: A facility-based cross-sectional study was conducted on the quality of care among outpatient department attendants of Dawro zone public hospitals from May 23 to June 28, 2021. A total of 420 study participants were included via a convenient sampling technique. An exit interview was used to collect data using a pretested and structured questionnaire. Then it was analyzed using the Statistical Package for Social Science (SPSS) version 25. Both bivariable and multivariable linear regressions were carried out. Significant predictors were reported at p < 0.05 with a 95% confidence interval.

RESULT: with a 100% response rate. The overall perceived quality was 51.15%. Fifty-six percent of study participants rated perceived quality as poor, 9% as average, and 35% of participants rated it as good perceived quality. The highest mean perception result was related to the tangibility (3.17) domain. Waiting time less than one hour (β = 0.729, p < 0.001), availability of prescribed drugs (β = 0.185, p < 0.003), having information on diagnoses (illness) (β = 0.114, p < 0.047), and privacy maintained (β = 0.529, p < 0.001) were found to be predictors of perceived good quality of care.

CONCLUSION: A majority of the study participants rated the perceived quality as poor. Waiting time, availability of prescribed drugs, information on diagnoses (illness), and provision of service with privacy were found to be predictors of client-perceived quality. Tangibility is the predominant and most important domain of client-perceived quality. The regional health bureau and zonal health department should understand the issue and work with hospitals to improve outpatient service quality by providing necessary medication, reducing wait times, and designing job training for health care providers.

PMID:36864413 | DOI:10.1186/s12913-023-09178-0

BMC Anesthesiol. 2023 Mar 2;23(1):66. doi: 10.1186/s12871-023-02023-1.

ABSTRACT

BACKGROUND: Different anesthetics may have opposite effects on the immune system, thus affecting the prognosis of tumor patients. Cell-mediated immunity forms the primary defense against the invasion of tumor cells, so manipulation of the immune system to produce an enhanced anti-tumor response could be utilized as an adjuvant oncological therapy. Sevoflurane has proinflammatory effects, while propofol, has anti-inflammatory and antioxidant effects. Therefore, we compared the overall survival (OS) and disease-free survival (DFS) of patients with esophageal cancer under total intravenous anesthesia and inhalation anesthesia.

METHODS: This study collected the electronic medical records of patients undergoing esophagectomy from January 1, 2014 to December 31, 2016. According to the intraoperative anesthetics, the patients were divided into total intravenous anesthesia (TIVA) group or inhalational anesthesia (INHA) group. Stabilized inverse probability of treatment weighting (SIPTW) was used to minimize differences. Kaplan-Meier survival curve was established to evaluate the correlation between different anesthesia methods in overall survival and disease-free survival of patients undergoing esophageal cancer surgery.

RESULTS: A total of 420 patients with elective esophageal cancer were collected, including 363 patients eligible for study (TIVA, n = 147, INHA, n = 216). After SIPTW there were no significant differences between two groups in overall survival and disease-free survival. However, the adjuvant therapy was statistically significant in improving OS, and the degree of differentiation was correlated with OS and DFS.

CONCLUSIONS: In conclusion, there were no significant difference in overall survival and disease-free survival between total intravenous anesthesia and inhalational anesthesia in patients undergoing esophageal cancer surgery.

PMID:36864402 | DOI:10.1186/s12871-023-02023-1

J Med Virol. 2023 Mar 2. doi: 10.1002/jmv.28630. Online ahead of print.

ABSTRACT

SARS-CoV-2 infection leads to the accumulation of lipid droplet (LD), the central hubs of the lipid metabolism, in vitro or in type II pneumocytes and monocytes from COVID-19 patients and blockage of LD formation by specific inhibitors impedes SARS-CoV-2 replication. Here, we showed that ORF3a is necessary and sufficient to trigger LD accumulation during SARS-CoV-2 infection, leading to efficient virus replication. Although highly mutated during evolution, ORF3a-mediated LD modulation is conserved in most SARS-CoV-2 variants except the Beta strain and is a major difference between SARS-CoV and SARS-CoV-2 that depends on the genetic variations on the amino acid position 171, 193, and 219 of ORF3a. Importantly, T223I substitution in recent Omicron strains (BA.2-BF.8) impairs ORF3a-Vps39 association and LD accumulation, leading to less efficient replication and potentially contributing to lower pathogenesis of the Omicron strains. Our work characterized how SARS-CoV-2 modulates cellular lipid homeostasis to benefit its replication during virus evolution, making ORF3a-LD axis a promising drug target for the treatment of COVID-19. This article is protected by copyright. All rights reserved.

PMID:36861654 | DOI:10.1002/jmv.28630

Neurol India. 2023 Jan-Feb;71(1):44-48. doi: 10.4103/0028-3886.370484.

ABSTRACT

BACKGROUND AND OBJECTIVE: Superior turbinate manipulation is often required in cases of narrow cavities and expanded endonasal approaches with concern for olfaction. The objective of the study was to compare the pre- and postoperative olfactory function in patients undergoing endoscopic endonasal transsphenoidal pituitary excision with and without superior turbinectomy, using the Pocket Smell Identification Test and the quality of life (QOL) and Sinonasal Outcome Test-22 (SNOT-22) scores, irrespective of the extension (Knosp grading) of pituitary tumors. We also aimed to identify olfactory neurons in the excised superior turbinate with immunohistochemical (IHC) stains and correlate them with clinical findings.

MATERIALS AND METHODS: The study was a prospective, randomized study performed in a tertiary center. Two groups A and B, with superior turbinate preserved and resected, respectively, during endoscopic pituitary resection, were compared using pre- and postoperative Pocket Smell Identification Test and QOL and SNOT-22 scores. The superior turbinate was subjected to IHC staining to identify the presence of olfactory neurons in patients with tumors of pituitary gland requiring endoscopic trans-sphenoid resection.

RESULTS: Fifty patients with sellar tumors were enrolled. The mean age of patients in this study was 46.15 years. The minimum age was 18 years and the maximum was 75 years. Of the 50 patients in the study, 18 were female and 32 were male. Eleven patients had more than one presenting complaint. Loss of vision was the commonest and altered sensorium was the rarest symptom.

CONCLUSION: Superior turbinectomy is a viable option to gain wider access to sella without affecting the sinonasal function, quality of life, and olfaction. There was doubtful presence of olfactory neurons in superior turbinate. The extent of tumor resection and postoperative complications were unaffected and statistically nonsignificant in both the groups.

PMID:36861573 | DOI:10.4103/0028-3886.370484

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):453-458. doi: 10.4103/jisppd.jisppd_398_22.

ABSTRACT

BACKGROUND: Pit and fissure sealing is an evidence-based preventive measure against dental caries, especially in primary teeth which possess high caries risk, and to give the required benefits of the sealant, a good adaptation, and sealing ability should be present.

PURPOSE: This study aimed to assess and compare the microleakage score of Ionoseal^® pit and fissure sealant, when used either alone or with prior surface treatment of erbium-doped yttrium aluminum garnet (Er: YAG) laser, acid etching, or their combination, in primary teeth.

MATERIALS AND METHODS: Forty healthy human molar teeth were randomly chosen and allocated into four study groups according to the surface pretreatment: group I, no surface pretreatment; Group II, 2W Er: YAG laser etching, Group III, combined laser etching and acid etching group, and Group IV, 37% phosphoric acid etching. After surface pretreatment procedures were conducted, the teeth were sealed with Ionoseal^®. Subsequent microleakage was assessed through dye penetration under a stereomicroscope. One sample from each group was randomly selected, and scanning electron microscopy (SEM) was carried out on the central slice of the three obtained slices of the samples.

RESULTS: Chi-square test revealed a high statistically significant difference between groups (P = 0.00). Similarly, all pairwise comparisons revealed a statistically significant difference. Group I showed the greatest mean of microleakage score (1.5), followed by Group IV (1.4), Group II (0.7), and Group III which showed the least microleakage score (0.6). These findings were supported by the SEM examination results.

CONCLUSIONS: Using Ionoseal with prior surface treatment by combined 2 W Er: YAG laser etching and 37% phosphoric acid etching can result in the best sealing ability which would significantly enhance the long-term success of pit and fissure sealing in primary teeth.

PMID:36861564 | DOI:10.4103/jisppd.jisppd_398_22

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):437-444. doi: 10.4103/jisppd.jisppd_382_22.

ABSTRACT

CONTEXT: Early childhood caries is a major health problem affecting children worldwide. Although incorrect feeding practices hold a prime position in the etiology, there are gaps in the literature pertaining to the physical properties of milk.

AIM: To assess the viscosity of human breast milk (HBM) versus infant milk formulae, with and without the addition of sweetening agents.

MATERIALS AND METHODS: All commercially available infant milk formulae (60 samples) and breast milk from 30 donor mothers were assessed for viscosity using Brookfield DV2T viscometer. The study period was from April 2019 to August 2019. Viscosity of infant milk formulae sweetened with sugar, honey, and brown sugar was further investigated and compared with that of HBM.

STATISTICAL ANALYSIS: Inter-group and intra-group mean viscosity was compared using independent t-test and repeated-measures ANOVA.

RESULTS: Viscosity of HBM ranged from 18.36 centipoise (cP) to 91.30 cP, the mean viscosity being 45.7 cP. Viscosity values varied for each formula group, the least being as low as 5.1 cP and the highest being 89.3 cP. The mean viscosities of each group were in the range of 33 to 49 cP.

CONCLUSIONS: HBM was found to have a tendency toward higher viscosity than most of the infant milk formulae. Also, varied viscosity values were obtained when commonly used sweetening agents were added to infant milk formulae. Greater viscosity of HBM might increase its adherence to enamel surface leading to prolonged demineralization and potentially altering the caries risk, needs to be investigated further.

PMID:36861562 | DOI:10.4103/jisppd.jisppd_382_22