Category: Nevin Manimala

Seizure. 2023 Apr 12;108:24-32. doi: 10.1016/j.seizure.2023.04.008. Online ahead of print.

ABSTRACT

BACKGROUND: Women with epilepsy (WWE) are vulnerable in pregnancy, with increased risks to mother and baby including teratogenic risks, especially from valproate. The free EpSMon mobile-phone app allows self-monitoring to afford patient-centred feedback on seizure related risks, such as sudden death in epilepsy (SUDEP) to its users. We sought to generate insights into various seizure related risks and its treatments in WWE of childbearing age (16 to 60 years ) using EpSMon.

METHODS: The study utilizes a prospective real-world cohort of 5.5 years. Patient reported data on demographics, medication taken, diagnoses, seizure types and recognised biological, psychological, and social factors of seizure related harm were extracted. Data was stratified according to frequent and infrequent users and those scoring lower and higher risk scores. Multivariate logistic regression and different statistical tests were conducted.

FINDINGS: Data from 2158 WWE of childbearing age encompassing 4016 self-assessments were analysed. Overall risk awareness was 25.3% for pregnancy and 54.1% for SUDEP. Frequent users were more aware of pregnancy risks but not of SUDEP. Repeated EpSMon use increased SUDEP awareness but not pregnancy risks. Valproate was used by 11% of WWE, ranging from 6.5% of younger to 31.5% of older women.

CONCLUSIONS: The awareness to risks to pregnancy, SUDEP and valproate is low. Valproate is being used by a significant minority. It is imperative risk communication continues for WWE based on their individual situation and need. This is unlikely to be delivered by current clinical models. Digital solutions hold promise but require work done to raise implementation and acceptability.

PMID:37060628 | DOI:10.1016/j.seizure.2023.04.008

Psychiatr Danub. 2023 Spring;35(1):92-96. doi: 10.24869/psyd.2023.92.

ABSTRACT

BACKGROUND: Investigating the outpatient clinic admissions of children and adolescents significantly affected by the pandemic is crucial in developing policy and intervention methods in the future. The aim of this study is to analyze the admissions of child and adolescent psychiatry outpatient clinics, during the first year since the imposed rearrangements of the COVID-19 pandemic, compared to the one year before.

SUBJECTS AND METHODS: This study was conducted between March 2019 and March 2021 and the total number of 5833 patients referred to the hospital was 3168 in the pre-pandemic period (Pre-P) and 2665 in the pandemic (In-P) period. After excluding 78 not fulfilling inclusion criteria, these screened cases were randomized for 700 patients for Pre-P and 700 for In-P within each group.

RESULTS: Externalization Disorders and Neurodevelopmental Disorders were the most represented diagnoses categories between the two time periods and showed a statistically significant decrease in admission during the pandemic (p=0.002, p=0.024, respectively). Internalization disorders and the undiagnosed group showed a statistically significant increase during the pandemic (p=0.024, p<0.001, respectively). Significant differences were also shown in the treatment plan (need for pharmacological and psychotherapy) has increased.

CONCLUSIONS: This study stands out by providing data on the trend of diagnosis in a child and adolescent psychiatry outpatient clinic before and during the pandemic period. To dominate these trends would be important to provide a basis for policymakers to plan appropriate management methods and levels of support for children and adolescents with different mental disorders.

PMID:37060598 | DOI:10.24869/psyd.2023.92

Psychiatr Danub. 2023 Spring;35(1):73-79. doi: 10.24869/psyd.2023.73.

ABSTRACT

BACKGROUND: This research was conducted to objectively evaluate the level of brain fog that may develop due to many reasons.

SUBJECTS AND METHODS: This was a methodological study. This study was conducted in Turkey. Content validity ratio, EFA, CFA, Kaiser-Meyer-Olkin analysis and Bartlett’s test of sphericity, Item analysis, Cronbach’s alpha coefficient, Spearman-Brown, Guttman Analysis and test-retest correlations validity-reliability analysis were performed. The statistical meaningfulness level in all tests was determined as p<0.05.

RESULTS: As a result of context validity, factor analysis and item analysis, a 30 item scale with 3 subscale was obtained. The variance amount explained by the 3 subscale was on a very good level (77.43%). The fact that all of the Cronbach alpha, Spearman-Brown and Guttman internal consistency coefficients of the scale and all of its subscale are above 0.70. When the test retest reliability coefficients of the scale was examined, the scale was found to present consistent results in different applications and the scale was found to be reliable with regard to the constancy coefficient.

CONCLUSION: The Brain Fog Scale consists of 30 items and 3 subscales. It is a valid and reliable instrument.

PMID:37060595 | DOI:10.24869/psyd.2023.73

Hepatol Res. 2023 Apr 15. doi: 10.1111/hepr.13910. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: Data on the geoepidemiology and outcomes of primary biliary cholangitis (PBC) in Asia are limited; thus, we aimed to collect and assess this information for Taiwan.

METHODS: A nationwide population-based cohort study was conducted using data from the Taiwan National Health Insurance Research Database. PBC was defined by the International Classification of Diseases, Ninth Revision, Clinical Modification code 571.6 based on alkaline phosphatase and anti-mitochondrial antibody measurements and ursodeoxycholic acid treatment.

RESULTS: During 2002-2015, 2,737 patients (females: 2,137; mean age: 57.78 years) had PBC. The average annual age- and sex-adjusted prevalence and incidence rates of PBC were 8.092/10⁵ and 1.148/10⁵ , respectively. Prevalent cases peaked in patients aged 50-59 years; the female-to-male ratio was 4.21. Annual prevalence rates increased with time (average percentage change: 12.03%, p<0.0001). The annual incidence rates decreased with time (-7.39%, p=0.000011) in females (-8.94%; p=0.000003) but remained steady in males. Female-to-male and northern-to-southern relative risks of PBC incidence rates ranged from 2.2675 to 4.3318 and from 1.5707 to 3.1725, respectively. The 14-year hepatocellular carcinoma (HCC) cumulative incidence was 9.11%, and the mortality rate was 32.44%; the cumulative incidences of dyslipidemia, thyroid disease, and extrahepatic cancers were 65.13%, 24.40%, and 12.79%, respectively. Higher cumulative incidences of HCC (p=0.0064) and mortality (p<0.0001) were noted in male than female PBC patients; southern Taiwan PBC patients had higher cumulative incidences of mortality (p<0.0001) than their northern counterparts.

CONCLUSION: In Taiwan, decreasing trends in incidence rates and the female-to-male ratio of PBC patients and specific sex and geographic impacts on the incidence rates and outcomes of PBC demand further investigation. This article is protected by copyright. All rights reserved.

PMID:37060573 | DOI:10.1111/hepr.13910

Cell Rep. 2023 Apr 13;42(4):112386. doi: 10.1016/j.celrep.2023.112386. Online ahead of print.

ABSTRACT

The input-output transformation of individual neurons is a key building block of neural circuit dynamics. While previous models of this transformation vary widely in their complexity, they all describe the underlying functional architecture as unitary, such that each synaptic input makes a single contribution to the neuronal response. Here, we show that the input-output transformation of CA1 pyramidal cells is instead best captured by two distinct functional architectures operating in parallel. We used statistically principled methods to fit flexible, yet interpretable, models of the transformation of input spikes into the somatic “output” voltage and to automatically select among alternative functional architectures. With dendritic Na⁺ channels blocked, responses are accurately captured by a single static and global nonlinearity. In contrast, dendritic Na⁺-dependent integration requires a functional architecture with multiple dynamic nonlinearities and clustered connectivity. These two architectures incorporate distinct morphological and biophysical properties of the neuron and its synaptic organization.

PMID:37060564 | DOI:10.1016/j.celrep.2023.112386

Haemophilia. 2023 Apr 15. doi: 10.1111/hae.14790. Online ahead of print.

NO ABSTRACT

PMID:37060543 | DOI:10.1111/hae.14790

Forensic Sci Med Pathol. 2023 Apr 15. doi: 10.1007/s12024-023-00625-2. Online ahead of print.

ABSTRACT

Human skull has always been used for victim identification in forensic odontology. The gender-dimorphic bone of the skull is the mandible. The gonial angle has frequently been investigated for gender estimation with variable results and requires further exploration. We aim to compare the efficacy of gonial angle estimation by ancient methods of lateral cephalometric tracing compared with more recent digital analysis methods for gender estimation in the Indian population. Lateral cephalograms of 191 (96 M and 95F) cases above the age of 17 years were retrieved. Cephalometric analysis of gonial angle on radiographs was done using both manual cephalometric tracing method and digitally using Adobe Photoshop software. The results were subjected to statistical analysis for evaluation. The mean gonial angle was higher in females (125.05; 123.77 and 125.28) than in males (122.583; 121.715 and 122.008) using both manual and digital methods. On applying the logistical regression analysis (LRA), the digital method showed the highest gender estimation accuracy of 60.7% followed by Burstone’s analysis (57.1%) and manual conventional analysis (56.5%). Burstone’s analysis (57.9%) correctly identified increased females, whereas digital analysis (62.5%) and manual conventional analysis (59.4%) accurately recognised increased males. The present study showed a higher gender estimation accuracy using digital methods as compared to manual methods, but it still lacks the credibility to be used as a sole factor for predicting the gender of an individual. Hence, a cumulative factor must be taken into consideration for gender identification which would provide more promising results.

PMID:37060537 | DOI:10.1007/s12024-023-00625-2

Egypt Heart J. 2023 Apr 15;75(1):28. doi: 10.1186/s43044-023-00355-4.

ABSTRACT

BACKGROUND: ST-segment elevation myocardial infarction (STEMI) is usually caused by a rupture in the atherosclerotic plaque, followed by platelet aggregation which ultimately leads to acute coronary artery occlusion. So far, few studies have investigated the effect of maintenance dose of Eptifibatide (glycoprotein IIb/IIIa inhibitor) in STEMI patients who underwent primary percutaneous coronary intervention (PPCI). Therefore, in this study, we investigated the effect of maintenance dose of Eptifibatide in patients with STEMI who underwent PPCI. 264 patients who had acute chest pain suggestive of STEMI were entered in the study. All patients received the same dose of bolus dose of Eptifibatide in the cardiac catheterization laboratory. Then the patients were randomly divided into two groups, one group (n = 147) received a maintenance dose of intravenous Eptifibatide (infusion of 2 μg/kg/min) and the other group (n = 117) did not receive this treatment. Standard medical treatment of STEMI after PPCI was performed based on guidelines and the same in both groups. All patients were evaluated 1, 2, and 3 months after the start of treatment in terms of predicted outcomes.

RESULTS: The occurrence of 3-month major adverse cardiovascular events (MACE) between the case and control groups did not have a statistically significant difference (28.6% versus 35.0%; P value: 0.286). Also, investigations showed that the rate of re-infarction (P value: 0.024) and target lesion revascularization (P value: 0.003) was significantly lower in the group that received Eptifibatide infusion.

CONCLUSIONS: Eptifibatide maintenance dose infusion in patients who undergo PPCI in the context of STEMI, does not significantly reduce MACE, although it does significantly reduce re-infarction and target lesion revascularization. It also does not increase the risk of bleeding and cerebrovascular events.

PMID:37060533 | DOI:10.1186/s43044-023-00355-4

Qual Life Res. 2023 Apr 15. doi: 10.1007/s11136-023-03420-2. Online ahead of print.

ABSTRACT

PURPOSE: To generate a normative profile for the EQ-5D-5L dimensions, EQ-5D-5L index, and EQ-VAS scores of the general Thai population and to examine the associations between sociodemographic characteristics and their norm-based scores.

METHODS: Data from 2019 general Thai samples were employed to estimate the norm-based scores elicited using the Thai EQ-5D-5L value set. Descriptive statistics were used to estimate the norm-based scores stratified by gender and six age bands to obtain the normative profile for the general Thai population. Multivariable logistic and Tobit regression models were used to investigate the relationships between sociodemographic characteristics and EQ-5D-5L dimensions, EQ-5D-5L index, and EQ-VAS scores.

RESULTS: The mean EQ-5D-5L index and EQ-VAS scores were 0.931 and 82.3, respectively. Approximately 88.9% of the participants reported 19 out of 3125 (3%) possible health states. The odds of having problems with mobility was greatest for the sample aged ≥ 65 years and declined with decreasing age. Women, samples with advancing age, and those with a household income of ≤ 10,000 Baht/month and fair and poor health perceptions were more likely to report a lower EQ-5D-5L index. Furthermore, advanced age and fair and poor health perception were significantly associated with lower EQ-VAS scores.

CONCLUSION: The EQ-5D-5L population norms were established as the benchmark for both EQ-5D-5L index and EQ-VAS scores for the general Thai population. This is expected to support the health service research and inform policymakers on the allocation of limited healthcare resources.

PMID:37060516 | DOI:10.1007/s11136-023-03420-2

Int Ophthalmol. 2023 Apr 15. doi: 10.1007/s10792-023-02693-3. Online ahead of print.

ABSTRACT

PURPOSE: To determine the keratometry measurement agreement using Sirius corneal topography and Scheimpflug camera, Tomey corneal topography, Topcon autokeratorefractometer, and Tomey OA-2000 optical biometry in eyes with different severity of keratoconus.

METHODS: In this retrospective study 115 eyes in different stages of keratoconus were divided into 2 groups of mild (stage 1), and moderate to severe keratoconus (stages 2, 3), according to the Amsler-Krumeich classification. Keratometry measurements were obtained using Sirius corneal topography and Scheimpflug camera (phoenix V3.7.01.08), Tomey corneal topography (Tms SW22C-200S-200), Topcon autokeratorefractometer (KR8900), and Tomey optical biometry (OA-2000 Opt-Meas V.4E).

RESULTS: In group 1 All devices demonstrated fair agreement in average keratometry values (95% LoA range > 1 D). However, it was poorer for group 2 (95% LOA range > 3 D). In group 1 Bonferroni test revealed statistically significant difference in average K readings among (Topcon autokeratorefractometer 8900 and Tomey OA-2000 biometry, p < 0.01), and between (Tomey topography and Topcon autokeratorefractometer, p < 0.05). Also in group 2 significant difference was observed in the average keratometry of the most instruments (p < 0.01) except for the (Tomey topography and Topcon autokeratorefractometer) and (Tomey topography and Tomey OA-2000 biometry.

CONCLUSIONS: According to our investigation in mild, moderate and severe keratoconus the agreement in K reading between Topcon autokeratorefractometer, OA-2000 optical biometry, Sirius topography and Tomey topography was poor. The agreement declines especially in the steep meridian and it was not acceptable clinically. These devices should not be applied interchangeably.

PMID:37060496 | DOI:10.1007/s10792-023-02693-3