Category: Nevin Manimala

Surg Technol Int. 2023 Jan 25;42:sti42/1550. Online ahead of print.

ABSTRACT

INTRODUCTION: The use of robotic-arm assistance for medial unicompartmental knee arthroplasty (RAUKA) has become an area of interest to overcome technical challenges, improve accuracy, and optimize patient outcomes. Due to the rise in osteoarthritis (OA) and robotic assistance, well-powered long-term studies are warranted. The aim of this study was to analyze midterm survivorship, radiographic changes, range of motion (ROM), and patient-reported outcome measurements (PROMs) of RAUKA.

MATERIALS AND METHODS: Patients who underwent RAUKA for medial compartmental OA were identified from April 2009 to May 2014. The query yielded 162 knees with a mean follow up of 6.5 years. Primary endpoints were to compare survivorship, final mechanical axis alignment, radiographic changes, mean ROM, and changes to the following PROMs: Knee Society Score (KSS), International Knee Documentation Committee (IKDC), and Oxford Knee Score (OKS). Statistical analyses were primarily descriptive. A p-value less than 0.05 was considered statistically significant.

RESULTS: There were no revisions of the primary implant, one case required exchange of polyethylene bearing and debridement for deep infection, and five cases required additional surgical intervention with implant retention. Overall survivorship was 100%. Radiographic assessment demonstrated no mechanical loosening or osteolysis surrounding the implant. Mean ROM was 3 to 121.9º. Patients demonstrated a mean functional KSS of 78.55, IKDC of 78.22, and OKS of 43.94.

CONCLUSIONS: The study supports excellent mid-term outcomes in patients undergoing RAUKA for medial compartment OA. Longer term follow-up studies are necessary to determine the efficacy of this technology for patients undergoing RAUKA for medial compartment OA.

PMID:36701812

J Phys Condens Matter. 2023 Jan 26. doi: 10.1088/1361-648X/acb67c. Online ahead of print.

ABSTRACT

A one-dimensional lattice model with mosaic quasiperiodic potential is found to exhibit interesting localization properties, e.g., clear mobility edges [Y. Wang et al., Phys. Rev. Lett. textbf{125}, 196604 (2020)]. We generalize this mosaic quasiperiodic model to a two-dimensional version, and numerically investigate its localization properties: the phase diagram from the fractal dimension of the wavefunction, the statistical and scaling properties of the conductance. Compared with disordered systems, our model shares many common features but also exhibits some different characteristics in the same dimensionality and the same universality class. For example, the sharp peak at $gsim 0$ of the critical distribution and the large $g$ limit of the universal scaling function $beta$ resemble those behaviors of three-dimensional disordered systems.

PMID:36701808 | DOI:10.1088/1361-648X/acb67c

Am J Speech Lang Pathol. 2023 Jan 26:1-16. doi: 10.1044/2022_AJSLP-22-00197. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to index cognitive resource usage for acquisition of initial targets of two common voice therapy techniques (resonant voice therapy [RVT] and conversation training therapy [CTT]) based on the theorized depletion effect (i.e., when an initial task requiring high cognitive load leads to poorer performance on a subsequent task).

METHOD: Eleven vocally healthy participants, ages 23-41 years, read aloud the Rainbow Passage and produced consonant-vowel resonant targets (/mi, ma, mu/) followed by a baseline computerized Stroop task and a 15-min washout. Following this baseline period, participants watched and interacted with two videos instructing them in RVT or CTT initial targets. After viewing each video and practicing the associated vocal skills, participants rated the degree of mental effort required to engage in the target vocal technique on a modified Borg scale. Participants recorded their attempts at RVT on /mi, ma, mu/ and CTT on the Rainbow Passage, which were later rated by three voice-specialized speech-language pathologists as to how representative they were of each respective target technique. Changes in fundamental frequency and average auditory-perceptual ratings from baseline were examined to determine if participants adjusted their technique from RVT and CTT baseline to acquisition.

RESULTS: Performance on the Stroop task was, on average, worse post CTT than post RVT, but both post-CTT and post-RVT Stroop scores were poorer than baseline. These results suggest that both treatment techniques taxed cognitive resources but that CTT was more cognitively taxing than RVT. However, despite differences in raw averages, no statistically significant differences were found between the baseline, post-CTT, and post-RVT Stroop scores, likely due to the small sample size. Participant ratings of mental effort for CTT and RVT were statistically similar. Likewise, poorer post-RVT Stroop scores were associated with participants’ greater perceived mental effort with RVT acquisition, but there was no significant association between mental effort ratings for CTT acquisition and post-CTT Stroop scores. Significantly higher fundamental frequency and perceived ratings of the accuracy of technique from baseline to acquisition for both CTT and RVT were found, providing evidence of vocal behavior changes as a result of each technique.

CONCLUSIONS: Brief exposure to initial treatment tasks in CTT is more cognitively depleting than initial RVT tasks. Results also indicate that vocally healthy participants are able to make a voice change in response to a brief therapy prompt. Finally, participant-rated measures of mental effort and secondary measures of cognitive depletion do not always correlate.

PMID:36701805 | DOI:10.1044/2022_AJSLP-22-00197

Ocul Immunol Inflamm. 2023 Jan 26:1-6. doi: 10.1080/09273948.2022.2164729. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the vitreo-lenticular interface (Berger space) in Fuchs uveitis (FU).

METHODS: This cross-sectional study included 20 FU patients (Group 1), the fellow eyes of patıents (Group 2) and 20 healthy individuals (Group 3).

RESULTS: Berger space was detected in all, and hyperreflective spots were identified in Berger spaces in 65% of FU eyes through optical coherence tomography (OCT). The measurements of Berger space the distance in central, nasal, and temporal 2 mm were 715 ± 101μ, 620 ± 66μ, and 676 ± 76μ in group 1; 370 ± 40μ, 321 ± 41μ, 297 ± 39μ in group 2 and 290 ± 37μ, 267 ± 32μ, 227 ± 28μ in group 3. There was a statistical difference between groups 1, 2^nd, and 3^rd in all the values.

CONCLUSION: The detection of the Berger space is the crucial finding of this study. Visualizing the vitreolenticular area may reveal new insights for pathology and OCT-guided investigations.

PMID:36701791 | DOI:10.1080/09273948.2022.2164729

Georgian Med News. 2022 Nov;(332):113-117.

ABSTRACT

The aim of the study is to determine the single nucleotide polymorphism of the ADH3 gene, which is involved in the development of chronic alcoholic pancreatitis in the Azerbaijani population. Seventy patients (51 with chronic alcoholic pancreatitis, 19 with chronic non-alcoholic pancreatitis) and 90 healthy individuals (55 smokers and 35 non- drinkers) were included in the study. Genomic DNA was isolated from venous blood based on the kit protocol. Genotypes were determined on agarose gel using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) methods. To study the specificity of the ADH3 gene polymorphism in alcohol-dependent people, genotypes and alleles were compared in patients with chronic alcoholic pancreatitis (CAP) and “practically healthy ” alcohol abusers. It was found that in both groups, the ADH3*1/ADH3*2 genotype predominates. It was also found that in the Azerbaijani population the frequency of ADH3*1 and ADH3*2 alleles is equally divided. From the data obtained, it can be clearly stated that the correlation of the ADH3*1 allele of the ADH3 gene polymorphism with an increased risk of the disease is not detected (p=0.876). When comparing genotypes and alleles in patients with chronic pancreatitis of non-alcoholic origin and non-drinkers, the predominance of the heterozygous ADH3*1 gene in both groups was also revealed without statistical significance (p=0.777). In the Azerbaijani population, the association between the polymorphism of the ADH3 gene genotypes and the development of CAP was not revealed. The predominance of the ADH3*1/ADH3*2 genotype explains the low incidence of both CAP and alcohol-dependent people in the Azerbaijani population.

PMID:36701787

Georgian Med News. 2022 Nov;(332):76-84.

ABSTRACT

The high frequency of complicated forms of gastric cancer in young and middle-aged patients is associated with faster and more biologically aggressive tumor growth, as well as with a delay in diagnosis. The study aimed to evaluate the efficacy, safety, and technical feasibility of surgical interventions for complicated forms of gastric cancer in young and middle-aged patients. We studied 98 patients with complicated forms of gastric cancer from IIB to stage IV according to the TNM8 classification with a predominant lesion of the antrum and body of the stomach. We performed open, laparoscopic, or robot-assisted surgeries of various scopes (R0 or R1), mostly gastrectomy and subtotal distal resection of the stomach. We compared the clinical manifestations of the disease, the time of surgery, intraoperative blood loss, postoperative complications, survival, and quality of life in 2 groups of patients divided by age: 19 young patients (mean age 39.4±4.4 years) and 79 middle-aged patients (mean age 53.9±5.8 years). Clinical manifestations of gastric cancer were more pronounced in young patients. The number of postoperative complications in patients of Group 2 was significantly higher (7.8% to 5.26%) compared to Group 1 (p<0.05). Rehabilitation in patients who underwent laparoscopic surgery was significantly (p<0.05) faster than with the traditional method. The overall survival of young patients with IIB-IV stages of gastric cancer was 0.8 months less, and among patients with III-IV stages it was 2.4 months less than in the group of middle-aged patients and did not depend on the surgery scope. There were no statistically significant differences between the groups in terms of intraoperative blood loss, duration of surgery and hospital stay. Increased surgery duration of in middle-aged patients significantly correlated with the number of postoperative complications. Extended surgeries do not significantly increase the number of lethal, life-threatening complications. Combined surgeries in the R0 scope in patients with advanced gastric cancer (including with carcinomatosis) improved the quality of life of patients yet did not increase in overall survival, which determines the reasonable limits of surgical aggression.

PMID:36701781

Georgian Med News. 2022 Nov;(332):71-75.

ABSTRACT

The purpose of the study is to characterize irreparable facial disfigurement through the prism of medical science and from the perspective of legal criteria in the pre-trial investigation of criminal offenses. The practical basis of the research is the statistical and analytical materials of the Ministry of Internal Affairs of Ukraine and the National Police of Ukraine, the General Prosecutor’s Office, the State Judicial Administration of Ukraine for 2016 – 2021 regarding the commission of criminal offenses, namely infliction of grievous bodily harm on the grounds of irreparable facial disfigurement of the victim; summarized data of the study of 50 materials of criminal proceedings based on the specified facts (resolution on the appointment of forensic and other examinations, as well as relevant conclusions), materials of the mass media. As a result of the research, it was established that the medical criteria for irreparable facial disfigurement specified in the legal acts need to be improved due to the wide application and systemic nature of the problems, due to the wide application and systemic nature of the problems, which entail both complication of qualification of the committed act and other difficulties in the process of pre-trial investigation. The studied views of researchers in the area of medical and legal sciences made it possible to substantiate the essence and content of irreparable facial disfigurement not only as a legal criterion, but also as a primarily negative phenomenon in the provision of public health care.

PMID:36701780

Georgian Med News. 2022 Nov;(332):64-70.

ABSTRACT

In the context of global health challenges in the 21st century, against the background of a fundamentally changed pharmaceutical landscape, pharmaceutical sector needs to be newly understood and regulated. To assess how effective, the state is in managing pharmaceutical risks, how ready it is to curb the expansion of substandard drugs on the market, to ensure access to high quality and effective drugs. The aim of the preparation of above article was to analyze the legislative and legal norms of the Georgian pharmaceuticals market, their comparison with corresponding international standards. Identifying the main challenges in the sector and proposing recommendations. Legislations, Laws, and government orders for improving the supply of medicine to the population served as information bases for the study. During the work, reports from the Agency of the Regulation for Medical and Pharmaceutical Activities, Georgian Representatives of International organizations, the State Statistical Service, and industry experts were used. High prices for medicines, their irrational consumption and direct (out-of-pocket) payments, along with quality, safety, and efficiency, have been and remain the main challenge of the Georgian healthcare system. Georgia’s population spends an average of 3% of GDP annually on drugs each year, twice as much as the Organization for Economic Co-operation and Development (OECD) member states. It varies within. Thus, due to the urgency of the issue, we have made it a priority to work on drug policy issues in terms of containment of financial expenditures, both in terms of reducing the total cost of medicines and in terms of direct payments made by the population. To consider all the above, it can be said that the research of the pharmaceutical business policy was selected due to the high public interest, the challenges of the field and the scarcity of study in this regard. In order to highlight the shortcomings and deficits in the regulation, to suggest ways to correct them.

PMID:36701779

Georgian Med News. 2022 Nov;(332):44-55.

ABSTRACT

In spite of all clinical manifestation of undifferentiated dysplasia of connective tissue (UDCT) including joint hypermobility syndrome still there are no exact morphological characteristics of structural articular cartilage changes on the background of UDCT.

THE AIM: to determine the structural peculiarities of articular cartilage reactive changes in rats with an experimental undifferentiated dysplasia of connective tissue.

STUDY DESIGN: animal experience.

METHODS: The object of the study was 162 knee joints of white laboratory rats, which were divided into 3 groups: – The 1st one – intact animals; the 2nd group consisted of experimental animals, each of which at the 18th day of fetal development was injected by 0.05 ml of antigen in 0.9% NaCl; the 3rd group consisted of control rats, injected by 0.05 ml of 0.9% NaCl at the 18th day of dated pregnancy. Morphological structure of articular cartilage of knee joints was examined at days 1st, 11th, 14th, 21st, 30th, 45th, 60th, 90th, 120th after birth. Fixation of histological material was carried out in 10% neutral formaldehyde. Histochemical, histological methods, statistic methods were used in the work.

RESULTS: Experiencing aggressive exposure from osteoblasts of the subchondral bone, along with increasing mechanical stress, the articular cartilage of rats with experimental UDCT, first compensatory turns thicker, and then irreversibly thin down, which is a prerequisite for the development of primary osteoarthrosis.

CONCLUSIONS: In rats with experimental UDCT the articular cartilage is isolated on the 11th day during the formation of the subchondral bone, in contrast to control rats in which articular cartilage differentiates on the 14th day after birth. In rats with experimental UDCT, the content of sulfated glycosaminoglycans in the matrix of the articular cartilage decreases. There is an accelerated replacement of the deep zone of the articular cartilage by the subchondral bone and the thinning of the articular cartilage on the 90th day after birth.

PMID:36701776

Georgian Med News. 2022 Nov;(332):22-28.

ABSTRACT

It has been more than 34 months since the severe acute respiratory syndrome coronavirus 2 that causes the COVID-19 pandemic emerged. However, understanding of COVID-19 is still evolving, and COVID-19 statistics are dynamic. The purpose of this study was to investigate the pattern of distribution of COVID-19 in the six continents by the end of October 2022 and compare it to the end of 2020 and 2021. Online data of distribution was successfully recruited from the “Worldometer” website. By the end of October 2022, nearly 6.8 billion COVID-19 tests have been performed, resulting in around 636 million cases detected, while about 6.6 million deaths were registered. The year 2021 was worse than 2020, while the first 10 months of 2022 witnessed the largest number of detected cases (55% of all cases recorded). The distribution of deaths and cases has not been consistent between continents. The number of cases/deaths is proportional to the number of tests performed. The largest share of tests was carried out in Europe (41%), while fewer tests were conducted in Africa (1.6%), and therefore, fewer cases and deaths were recorded. In conclusion, between countries, as well as across continents, the number of COVID-19 cases/deaths/tests and the case-fatality rate vary significantly, and over time, which suggest considerable uncertainty over the exact COVID-19 statistics worldwide. The definition of suspected cases should be clear, appropriate, and internationally standardized. Only when an international standard is agreed upon will we be able to make fair comparisons.

PMID:36701773