Category: Nevin Manimala

J Pak Med Assoc. 2023 Feb;73(2):328-332. doi: 10.47391/JPMA.6477.

ABSTRACT

OBJECTIVE: To measure the perception of medical students regarding different methods of active learning, and its association with the year of study.

METHODS: The analytical cross-sectional study was conducted at Shalamar Medical and Dental College, Lahore, Pakistan, from May to September 2020, and comprised medical students of either gender from first to final year of studies. Data was collected using an online questionnaire regarding different methods of active learning and e-learning. Perceptions and their association with the year of study were worked out. Data was analysed using SPSS 16.

RESULTS: Of the 270 subjects, 155(57.4%) were females and 115(42.5%) were males. Overall, 39(14.4%) students were from the first year of studies, 32(11.9%) second, 47(17.4%) third, 120(44.4%) fourth and 32(11.9%) were from the final year of medical studies. Most students preferred class lectures as the teaching method of choice 240(89%), followed by small group discussions 156(58%). Students showed positive perception of different learning methods except e-learning 78(28.89%). The association between perceptions and the year of study was statistically significant (p< 0.05).

CONCLUSIONS: Students apparently enjoyed using different interactive methods, but were apprehensive about online learning.

PMID:36800720 | DOI:10.47391/JPMA.6477

J Pak Med Assoc. 2023 Feb;73(2):290-293. doi: 10.47391/JPMA.5623.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of bleomycin in the treatment of lymphatic malformations, and the concordance between photographic and radiological assessments of the outcome.

METHODS: The retrospective study was conducted at the Vascular Anomalies Centre of Indus Hospital, Karachi, and comprised data of patients enrolled with diagnosis of macrocystic or mixed lymphatic malformations from January 2017 to November 2019. All patients had been treated with injection bleomycin 0.6-1mg/kg/session. Size and location of lesions, ultrasonographic findings, photographic documentation and post-procedure complications were reviewed. Photographic and radiographical assessment outcomes were categorised as excellent, good or poor, and compared for concordance. Data was analysed using Stata 14.

RESULTS: Of the 31 children, 22(68.8%) were boys. Mean age at presentation was 54.2±44 months (range: 2 months to 15.7 years). There were 32 lymphatic malformations; 29(90.6) macrocystic and 3(9.4%) mixed. Head and neck region was mostly involved 19(59.4%). Most lesions 23(71.9%) presented during the first year of life, and 29(90.6%) lesions were purely macrocystic. Excellent, good and poor response was seen in 16(50%), 15(46.9%) and 1(3.1%) lesions on photographic assessment, and 21(65.6%), 11(34.4%) and 0(0.0%) lesions on radiological assessment, respectively. Concordance in photographic and radiological outcomes was 22(69%). No complications were seen and no statistically significant difference was observed for photographic and radiographic assessment with respect to gender, malformation type, region involved, and number of sessions (p>0.05).

CONCLUSIONS: Intralesional bleomycin sclerotherapy was found to be effective in the treatment of lymphatic malformations. Clinical observation was reliable in assessing progress on routine follow-up, with additional radiology done when management decisions needed to be reviewed.

PMID:36800712 | DOI:10.47391/JPMA.5623

J Sports Med Phys Fitness. 2023 Feb 20. doi: 10.23736/S0022-4707.23.14441-0. Online ahead of print.

ABSTRACT

BACKGROUND: The main objective of this study was to assess the association between age and physical fitness and motor fitness components according to BMI levels, in men and women separately, and to test if this association is different between BMI levels.

METHODS: This cross-sectional study was based on a pre-existing database from the DiagnoHealth battery, a French series of physical fitness and motor fitness tests designed by the Institut des Rencontres de la Forme (IRFO; Wattignies, France). Analyses were perfomed on 6830 women (65.8%) and 3356 men (34.2%) aged from 50 to 80 years. In this French series several physical fitness and motor fitness components were measured: cardiorespiratory fitness (CRF), speed, upper muscular endurance, lower muscular endurance, lower body muscular strengh, agility, balance, and flexibility. From the results of these tests, a specific score named Quotient of Physical Condition was calculated. Associations between age and physical fitness and motor fitness components according to BMI levels were modelized using linear regression for quantitative components, and ordinal logistic regression for ordinal components. Analyses were performed separately for women and men.

RESULTS: A significant association of age with physical fitness and motor fitness performance in each BMI levels were observed in women except for lower muscular endurance, muscular strength and flexibility in obese women. A significant association of age with physical fitness and motor fitness performance in each BMI levels were observed in men except for upper/lower muscular endurance and flexibility in obese men.

CONCLUSIONS: The present results shown that most of physical fitness and motor fitness decrease with age in women and men. Lower muscular endurance, muscular strength and flexibility did not change in obese women, thereas upper/lower muscular endurance and flexibility did not change in obese men. This finding is particularly revelant for guiding prevention strategies for maintaining physical fitness and motor fitness performance, which is one of the most important component of healthy aging and wellbeing.

PMID:36800688 | DOI:10.23736/S0022-4707.23.14441-0

Acta Orthop Belg. 2022 Dec;88(4):805-810. doi: 10.52628/88.4.9845.

ABSTRACT

We aimed to evaluate the intraobserver and inter- observer variations of the five primary classification systems for assessing tibial plateau fractures via standard X-Ray, biplanar and reconstructed 3D CT images. Using anteroposterior (AP) – lateral X-Ray, and CT images, one hundred tibial plateau fractures were evaluated and classified by four surgeons according to the AO, Moore, Schatzker, modified Duparc, and 3-column classification systems. Each observer evaluated the radiographs and CT images separately – listed each time randomly – on a total of 3 occasions: with an initial evaluation, and then subsequently in weeks 4 and 8. Intra- and interobserver variabilities were assessed using the Kappa statistics. Intra- and interobserver variabilities were 0.55 ± 0.03 and 0.50 ± 0.05 for AO, 0.58 ± 0.08 and 0.56 ± 0.02 for Schatzker, 0.52 ± 0.06 and 0.49 ± 0.04 for Moore, 0.58 ± 0.06 and 0.51± 0.06 for the modified Duparc, and 0.66 ± 0.03 and 0.68 ± 0.02 for the 3-column classification. Evaluation of tibial plateau fractures using 3-column classification in conjunction with radiographic classifications has higher levels of consistency compared to radiographic classifications alone.

PMID:36800667 | DOI:10.52628/88.4.9845

Acta Orthop Belg. 2022 Dec;88(4):739-747. doi: 10.52628/88.4.10833.

ABSTRACT

Although various surgical techniques have been reported for the treatment of advanced Kienböck’s disease (Lichtman stage IIIB and above), the ap- propriate operative treatment is still being debated. This study compared the clinical and radiological outcomes of combined radial wedge and shortening osteotomy (CRWSO) and scaphocapitate arthrodesis (SCA) in the treatment of advanced Kienböck’s disease (above type IIIB) with a minimum of 3 years of follow-up. We analyzed the data from 16 and 13 patients who underwent CRWSO and SCA, respectively. The average follow-up period was 48.6±12.8 months. Clinical outcomes were evaluated using the flexion-extension arc, grip strength, Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), and Visual Analogue Scale (VAS) for pain. The following radiological parameters were measured: ulnar variance (UV), carpal height ratio (CHR), radioscaphoid angle (RSA), and Stahl index (SI). Osteoarthritic changes in the radiocarpal and midcarpal joints were evaluated using computed tomography (CT). Clinically, both groups showed significant improvements in the grip strength, DASH, and VAS at final follow-up. However, regarding the flexion-extension arc, the CRWSO group showed a significant improvement, while the SCA group did not. Radiologically, compared to the preoperative values, the CHR results improved at final follow-up in the CRWSO and SCA groups. There was no statistically significant difference in the degree of CHR correction between the 2 groups. By the final follow-up visit, none of the patients in either group had progressed from Lichtman stage IIIB to stage IV. Considering restoration of wrist joint range of motion, CRWSO may be a good alternative for limited carpal arthrodesis for advanced Kienböck’s disease.

PMID:36800658 | DOI:10.52628/88.4.10833

Acta Orthop Belg. 2022 Dec;88(4):685-690. doi: 10.52628/88.4.01.

ABSTRACT

To analyze the correlation between the occurrence of vertebral artery ostium stenosis (VAOS) and the severity of osteoporosis in elderly patients with atherosclerosis (AS), and disclose the physiopathologic mechanism of the correlation between VAOS and osteoporosis. 120 patients were divided into two groups. The baseline data of both groups were collected. The biochemical indicators of patients in both groups were collected. The EpiData database was established to enter all the data into the database for statistical analysis. There were significant differences in the incidence of dyslipidemia among risk factors of cardia-cerebrovascular disease (P<0.05). LDL-C, Apoa and Apob were significantly lower than the control group (P<0.05). BMD, T-value and Ca in the observation group were significantly lower than the control group, while BALP and serum phosphorus in the observation group were significantly higher than the control group (P<0.05). The more severe the VAOS stenosis, the higher the incidence of osteoporosis, and there was a statistical difference in the risk of osteoporosis among different VAOS stenosis degrees (P<0.05). Apolipoprotein A, B and LDL-C in blood lipids are important factors affecting the development of bone and artery diseases. There is a significant correlation between VAOS and the severity of osteoporosis. The pathological calcification process of VAOS has many similarities with the process of bone metabolism and osteogenesis, and shows preventable and reversible physiological characteristics.

PMID:36800651 | DOI:10.52628/88.4.01

Medicine (Baltimore). 2023 Feb 17;102(7):e32933. doi: 10.1097/MD.0000000000032933.

ABSTRACT

BACKGROUND: Post-stroke cognitive impairment and dementia (PSCID) is the main source of morbidity and mortality after stroke worldwide. It is one consequence of ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Cognitive impairment and dementia after the clinical stroke may contribute to the clinical expression of PSCID, which are prevalent clinical symptoms, especially in the elderly. Current problems in the field of PSCID are related to a lack of harmonization of the classification and definition, deficiency of well-defined diagnosis, deficiency of standardized and objective treatment plans, etc. Auricular therapy can effectively improve the symptoms of patients with PSCID. However, there has been no systematic review of auricular therapy for PSCID. This study aimed to evaluate the efficacy and safety of auricular therapy in patients with PSCID.

METHODS: Before December 2022, a systematic literature search was conducted using the following databases: PubMed, Embase, SinoMed (previously called the Chinese Biomedical Database), Web of Science, Chinese National Knowledge Infrastructure, and Wanfang Database. Review Manager software (version 5.3) will be used for statistical analysis; otherwise, descriptive analysis or subgroup analysis will be conducted. The quality of evidence for outcomes will be assessed with the Grading of Recommendations Assessment, Development and Evaluation approach.

RESULTS: This meta-analysis further confirmed the beneficial effects of auricular therapy in patients with PSCID.

CONCLUSION: This study investigated the efficacy and safety of auricular therapy in patients with PSCID, providing clinicians and patients with additional options for this disease.

PMID:36800637 | DOI:10.1097/MD.0000000000032933

Medicine (Baltimore). 2023 Feb 17;102(7):e32857. doi: 10.1097/MD.0000000000032857.

ABSTRACT

BACKGROUND: Regular exercise has been shown to have a beneficial effect on primary osteoporosis (POP). However, current exercise prescriptions have limitations such as insufficient individualized features and low participant compliance, which in turn limit their application in clinical practice. In this study, we propose to establish a personalized exercise prescription based on the Chinese traditional exercise-Yi Jin Jing, combined with treadmill exercises and strength training, and then observe its effects on pain, muscle strength, balance, bone mineral density (BMD) and bone metabolic indexes in patients with POP.

METHODS: This trial is a single-center, randomized, assessor-blinded, controlled clinical study. We will recruit 40 patients with POP and assign them to the control group and the experimental group in a 1:1 ratio according to the intended protocol. The control group received 24 weeks of conventional medication and health promotion, and the experimental group received 24 weeks of personalized exercise prescription intervention (Yijinjing, treadmill exercises, and strength training). Outcome measures include pain (visual analogue scale), muscle strength (bilateral upper limb grip strength and isometric muscle strength of the trunk, hip, and knee), balance (Balance test with eyes open and closed while standing on one leg), and BMD (Lumbar spine 2-4 and femoral neck). In addition, bone metabolism indicators include parathyroid hormone, osteocalcin, 25-hydroxyvitamin D3 (1,25(OH) 2D3), type I procollagen aminoterminal peptide and type I collagen carboxy-terminal peptide. Outcome measures will be assessed before and after 24 weeks of intervention. Statistical analysis was performed by SPSS22.0.

DISCUSSION: This trial aimed to enrich the content and form of exercise rehabilitation prescriptions for patients with POP, which is conducive to improving the exercise rehabilitation effect and quality of life in this population.

PMID:36800636 | DOI:10.1097/MD.0000000000032857

Medicine (Baltimore). 2023 Feb 17;102(7):e32973. doi: 10.1097/MD.0000000000032973.

ABSTRACT

Breast cancer is the most commonly diagnosed cancer in women and the second leading cause of cancer-related death worldwide. Positive family history increases the likelihood of developing this disease. As late-stage presentation and poor survival rates are associated with a lack of knowledge about breast cancer and its screening methods, this study aimed to evaluate the knowledge of Lebanese women with first-degree relatives who were diagnosed with breast cancer. In this cross-sectional study, 200 women with a positive family history accompanying their relatives to oncology clinics or the infusion center at the American University of Beirut Medical Center, completed an online survey after institutional review board approval was granted. Demographic information and answers to questions related to breast cancer risk factors, warning signs, and screening techniques were collected and analyzed using descriptive statistics and chi-square tests. Eighty-one percent of the study participants agreed that a history of breast cancer is associated with a higher disease risk. The smaller portions were aware of other potential risk factors, such as hormone replacement therapy, alcohol consumption, late menopause, early menarche, and overweight and sedentary lifestyles. Also, 93% to 96.5% of the participants recognized breast self-examination and mammography as useful tools for early detection. Furthermore, younger participants who reached university level and were employed had more insights into breast cancer. Breast cancer knowledge and early diagnosis are key elements in preventing late presentations and reducing the associated morbidity and mortality. Further educational and awareness campaigns should be conducted in Lebanon to improve women knowledge of breast cancer.

PMID:36800620 | DOI:10.1097/MD.0000000000032973

Medicine (Baltimore). 2023 Feb 17;102(7):e32884. doi: 10.1097/MD.0000000000032884.

ABSTRACT

Transurethral enucleation and resection of prostate (TUERP), as one of the conventional surgical methods for patients with benign prostatic hyperplasia (BPH), usually resulted in pseudo urinary incontinence after surgery. The present study was thereby conducted to evaluate the feasibility of anterior lobe-preserving transurethral enucleation and resection of prostate (ALP-TUERP) on reducing the incidence rate of urinary incontinence after surgery in patients with BPH. Patients diagnosed with BPH underwent surgical treatment were enrolled in the present study within the inclusion criteria. Characteristics including age, prostate volume (before surgery), PSA level, maximum free flow rate, international prostate symptom score, and quality of life were reviewed and compared between the groups of ALP-TUERP and TUERP. Incidence rate of urinary incontinence on 24 hours, 3 days, 7 days, and 14 days after catheter drawing was deemed as main outcome, which was compared between the groups. In addition, secondary outcomes including surgery time, difference value of hemoglobin before and after surgery (∆Hemoglobin), catheter retaining time, catheter flushing time, and incidence rate of recurrent bleeding were also compared between the groups. There were 81 patients included in the present study within the inclusion criteria. There was no statistical difference on the baseline characteristics including age, prostate volume (before surgery), PSA level, maximum free flow rate (before surgery), international prostate symptom score, or quality of life between the 2 groups. Statistical superiority was observed on the incidence rate of urinary incontinence on day 1 (χ2 = 9.375, P = .002), and day 3 (χ2 = 4.046, P = .044) in the group ALP-TUERP, when comparing to group TUERP. However, the difference was not observed anymore after 7 days after catheter drawing (P = .241 for day 7, P = .494 for day 14) between them. In addition, no statistical differences were observed on surgery time, difference value of hemoglobin before and after surgery (∆Hemoglobin), catheter retaining time, or catheter flushing time between the group ALP-TUERP and TUERP (all P > .05). Results of the present study demonstrated a potentially statistical superiority of ALP-TUERP on the reduction of incidence rate of urinary incontinence comparing to conventionally TUERP.

PMID:36800610 | DOI:10.1097/MD.0000000000032884