Category: Nevin Manimala

Arch Physiother. 2022 May 16;12(1):14. doi: 10.1186/s40945-022-00137-2.

ABSTRACT

BACKGROUND: Establishing the biopsychosocial profile of patients with low back pain (LBP) is essential to personalized care. The Pain and Disability Drivers Management model (PDDM) has been suggested as a useful framework to help clinicians establish this biopsychosocial profile. Yet, there is no tool to facilitate its integration into clinical practice. Thus, the aim of this study is to develop a rating scale and validate its content, to rapidly establish the patient’s biopsychosocial profile, based on the five domains of the PDDM.

METHODS: The tool was developed in accordance with the principles of the COSMIN methodology. We conducted three steps: 1) item generation from a comprehensive review, 2) refinement of the scale with clinicians’ feedback, and 3) statistical analyses to assess content validity. To validate the item assessing with Likert scales, we performed Item level-Content Validity Index (I-CVI) analyses on three criteria (clarity, presentation and clinical applicability) with an a priori threshold of > 0.78. We conducted Average-Content Validity Index (Ave-CVI) analyses to validate the overall scale with a threshold of > 0.9.

RESULTS: In accordance with the PDDM, we developed a 5-item rating scale (1 per domain) with 4 score options. We selected clinical instruments to screen for the presence or absence of problematic issues within each category of the 5 domains. Forty-two participants provided feedback to refine the scale’s clarity, presentation, and clinical applicability. The statistical analysis of the latest version presented I-CVI above the threshold for each item (I-CVI ranged between 0.94 and 1). Analysis of the overall scale supported its validation (Ave-CVI = 0.96 [0.93;0.98]).

CONCLUSION: From the 51 biopsychosocial elements contained within the 5 domains of the PDDM, we developed a rating scale that allows to rapidly screen for problematic issues within each category of the PDDM’s 5 domains. Involving clinicians in the process allowed us to validate the content of the first scale to establish the patient’s biopsychosocial profile for people with low back pain. Future steps will be necessary to continue the psychometric properties analysis of this rating scale.

PMID:35570310 | DOI:10.1186/s40945-022-00137-2

BMC Public Health. 2022 May 15;22(1):979. doi: 10.1186/s12889-022-13392-6.

ABSTRACT

BACKGROUND: In India, there is currently a lack of data on socioeconomic inequalities in HIV testing on a national scale; thus, understanding socioeconomic inequalities in response to expanded HIV testing is critical for assessing and ensuring equity of HIV programmes in accordance with the Sustainable Development Goals. The specific objective of the study was to determine the factor associated with HIV testing during antenatal care and assess the socio-economic inequalities in HIV testing during antenatal care (ANC) among Indian women aged 15-49 years with a live birth in the two years preceding the survey.

METHODS: The results drawn from the state module of women data file of fourth round of National Family Health Survey (NFHS-4, 2015-16), considering HIV testing during antenatal care among women aged 15-49 who gave live birth in the two years preceding the survey and received the result of HIV test as a matter of fact. Method, such as, descriptive statistics, binary ogistic regression, concentration index were used in the analysis.

RESULTS: The findings of the study show that HIV testing during antenatal care was low (30%) among women in India. Our findings reveal that there were significant inequalities exist in HIV testing during ANC between richer and poorer quintile of women. Education, place of residence, comprehensive knowledge of HIV/AIDS, and regular exposure of mass media were substantially contributing to socioeconomic inequality in HIV testing during ANC among women in India.

CONCLUSIONS: The socioeconomic inequities in HIV testing during pregnancy should be monitored and addressed in order to ensure an equitable distribution of the benefits specially among children and accomplishments of HIV programs in India.

PMID:35570285 | DOI:10.1186/s12889-022-13392-6

J Egypt Natl Canc Inst. 2022 May 16;34(1):21. doi: 10.1186/s43046-022-00123-6.

ABSTRACT

BACKGROUND: Multiple myeloma (MM) predominantly affects older patients; many of whom do not undergo autologous hematopoietic stem cell transplant (AHSCT) despite the associated survival benefits. This study was conceived to investigate the patterns of AHSCT among MM patients with due regard to their age and standardized fitness assessments.

METHODS: Fitness scores as per the hematopoietic stem cell transplant-comorbidity index (HSCT-CI) and risk scores as per the revised-myeloma comorbidity index (R-MCI) of MM patients treated between January 2017 and December 2019 were analyzed to assess fitness for AHSCT. Proportions of patients who underwent AHSCT were calculated with regard to age and fitness for AHSCT.

RESULTS: Of the 81 eligible patient records with a median age of 62 years, the HSCT-CI classified 79.6% and 77.8% of patients aged ≤65 years and >65 years as AHSCT eligible (p 1). Using the R-MCI, 96.3% and 81.5% of patients aged ≤65 years and >65 years, respectively, were classified as eligible for AHSCT (p 0.0381). Overall, patients aged ≤65 years underwent AHSCT with a greater frequency compared to those aged >65years (38.9 vs. 14.8%, p 0.0402). Irrespective of the age group, there was a statistically significant difference (p 0.0167) in terms of survival which favored those who underwent AHSCT.

CONCLUSIONS: Both the HSCT-CI and the R-MCI revealed that nearly 80% of patients aged >65 years were fit enough to receive AHSCT. However, far fewer patients of this age group underwent AHSCT. We propose that the routine inclusion of objective fitness assessment could ensure that fit older patients undergo AHSCT and thus do not miss out on the benefits of the same.

PMID:35570260 | DOI:10.1186/s43046-022-00123-6

BMC Geriatr. 2022 May 16;22(1):425. doi: 10.1186/s12877-022-03115-2.

ABSTRACT

BACKGROUND: The number of people with multimorbidity is surging around the world. Although multimorbidity has been introduced in policy and practice in developed countries, developing countries like Nepal have not considered it as a matter of public health urgency due to the lack of enough epidemiological data. Multimorbidity profoundly affects older adults’ wellbeing; therefore, it is crucial to estimate its prevalence and determinants. This study aimed to estimate the prevalence of multimorbidity among older adults in Eastern Nepal and identify its correlates.

METHODOLOGY: A community-based cross-sectional survey was conducted in three districts of Eastern Nepal. Data were collected between July and September 2020, among 847 Nepali older adults, aged 60 and older, where study participants were recruited through a multi-stage cluster sampling technique. Semi-structured interviews were conducted at the community settings to collect data. Logistic regression assessed correlates of multimorbidity. SAS 9.4 was used to run all statistical tests and analyses.

RESULTS: More than half (66.5%) of the participants had at least one of the five non-communicable chronic conditions; hypertension (31.6%), osteoarthritis (28.6%), chronic respiratory disease (18.0%), diabetes (13.5%), and heart disease (5.3%). The prevalence of multimorbidity was 22.8%. In the adjusted model, increased age (for 70-79 years, OR: 3.11, 95% CI: 1.87-5.18; for 80 + years, OR: 4.19, 95% CI: 2.32-7.57), those without a partner (OR: 1.52, 95% CI: 1.00-2.30), residing in urban areas (OR: 1.71, 95% CI: 1.16-2.51), and distant from health center (OR: 1.66, 95% CI: 1.04-2.64) were significantly associated with multimorbidity.

CONCLUSIONS: This study found one in five study participants had multimorbidity. The findings will assist policymakers and stakeholders in understanding the burden of multimorbidity among the older population and identifying the groups in most need of health promotion intervention. Future interventions may include developing horizontal multimorbid approaches and multisectoral strategies specifically tailored to meet the needs of those populations.

PMID:35570271 | DOI:10.1186/s12877-022-03115-2

Vet Res Commun. 2022 May 16. doi: 10.1007/s11259-022-09934-3. Online ahead of print.

ABSTRACT

Tumors are formed by various clones developed over a long time. This gives rise to a heterogeneous nature. This heterogeneity is the hardest challenge in the treatment of cancers because it is the main reason for drug resistance. This is a well-known fact in human cancer. Therefore, we have reasoned that if the tumor heterogeneity in canine mammary gland tumors (CMGTs) could be shown by an ex vivo assay, which will be used first time in veterinary oncology practice, this could be used further in clinics. To achieve this, twenty-six patients were included in the study. Tumor tissues were obtained from animals during routine surgery. Tumor cells were isolated and seeded ex vivo. The cells were exposed to anticancer drugs that are clinically used. Seven days after the treatment, chemosensitivity has luminometrically been assayed by ATP-tumor chemosensitivity assay (ATP-TCA). It has clearly been shown that all the tumor tissues have responded to treatment differently, implying that heterogeneity exists in mammary tumors. There has also been found that there was a weak to moderate statistically significant correlation between tumor size and drug index. However, there has been no correlation between drug index and metastasis to lymph nodes. Hyperplasic areas had relatively higher PCNA values. The results of our study demonstrate the heterogeneity in responses to in vitro drugs. Clinical trials based on test results and follow-up studies with large numbers of animals are needed to prove that such chemotherapeutic activity assessment tests can be clinically useful in predicting drug responses in CMGTs.

PMID:35570257 | DOI:10.1007/s11259-022-09934-3

Prog Orthod. 2022 May 16;23(1):17. doi: 10.1186/s40510-022-00409-4.

ABSTRACT

BACKGROUND: This study aimed to assess the distribution of non-carious cervical lesions (NCCLs) by tooth type, investigate the prevalence of NCCLs in patients undergoing orthodontic treatment, and identify the possible associated factors.

MATERIAL AND METHODS: A total of 160 patients were enrolled in this retrospective study. Data on the following variables were collected from pre-and post-orthodontic treatment records: age, sex, Angle’s malocclusion, facial pattern, number of activation sessions, compensatory treatment, and retreatment. Frontal, right and left lateral intraoral photographs of each patient were evaluated to identify the presence or absence of NCCLs in each tooth and assess the distribution of NCCLs in the 3840 teeth from the enrolled patients. Furthermore, patients were classified as NCCLs present, irrespective of the number of NCCLs on the teeth or NCCL absent. Bivariate and multivariate Poisson regression analyses with robust variance were used to assess the association between the NCCLs and each independent variable. Prevalence ratio and 95% confidence intervals were calculated and p < 0.05 was considered statistically significant.

RESULTS: The prevalence of NCCLs before and after orthodontic treatment was 22.71% and 30.91%, respectively. Premolars were the most affected teeth, followed by the first molars, canines, and incisors. After statistical analysis, age was found to be the variable factor that influenced the prevalence ratio, with NCCL being the most prevalent when orthodontic treatment was performed in adulthood.

CONCLUSIONS: Premolars were most commonly affected by NCCLs. Furthermore, age seemed to contribute to the increased prevalence of NCCLs in adults undergoing orthodontic treatment.

PMID:35570252 | DOI:10.1186/s40510-022-00409-4

Am J Cardiovasc Drugs. 2022 May 16. doi: 10.1007/s40256-022-00537-6. Online ahead of print.

ABSTRACT

BACKGROUND: The role of aspirin in cardiovascular primary prevention remains controversial. Moreover, evidence for the potential benefits of aspirin in patients with high cardiovascular risk remains limited.

OBJECTIVE: The aim of this study was to explore the role of low-dose aspirin in primary prevention.

METHODS: The PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases were searched for randomized clinical trials (RCTs) from the date of inception to August 2021. The efficacy outcomes were major adverse cardiovascular events (MACE), myocardial infarction (MI), ischemic stroke (IS), all-cause mortality, and cardiovascular mortality, whereas safety outcomes were major bleeding, intracranial hemorrhage, and gastrointestinal (GI) bleeding. Subgroup analyses were based on different cardiovascular risks and diabetes statuses. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using the fixed- and random-effects models, and trial sequential analysis (TSA) was conducted to determine the robustness of the results.

RESULTS: A total of 10 RCTs fulfilled the inclusion criteria. The use of aspirin was associated with a significant reduction in the risk of MACE (RR 0.89, 95% CI 0.84-0.93), MI (RR 0.86, 95% CI 0.78-0.95), and IS (RR 0.84, 95% CI 0.76-0.93); however, aspirin also increased the risk of safety outcomes, i.e. major bleeding (RR 1.42, 95% CI 1.26-1.60), intracranial hemorrhage (RR 1.33, 95% CI 1.11-1.59), and GI bleeding (RR 1.91, 95% CI 1.44-2.54). Subgroup analyses revealed that in the absence of a statistically significant interaction, a trend toward a net benefit of lower incidence of cardiovascular events (number needed to treat of MACE: high risk: 682 vs. low risk: 2191) and lesser risk of bleeding events (number needed to harm of major bleeding: high risk: 983 vs. low risk: 819) was seen in the subgroup of high cardiovascular risk. Meanwhile, the greater MACE reduction was also detected in the high-risk group of diabetes or nondiabetes patients. Furthermore, a post hoc subgroup analysis indicated a significant rate reduction in patients aged ≤ 70 years but not in patients aged > 70 years. TSA confirmed the benefit of aspirin for MACE up to a relative risk reduction of 10%.

CONCLUSION: The current study demonstrated that the cardiovascular benefits of low-dose aspirin were equally balanced by major bleeding events. In addition, the potential beneficial effects might be seen in the population ≤ 70 years of age with high cardiovascular risk and no increased risk of bleeding.

PMID:35570250 | DOI:10.1007/s40256-022-00537-6

Int Ophthalmol. 2022 May 16. doi: 10.1007/s10792-022-02346-x. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the characteristics and analyze the results of patients who underwent pars plana vitrectomy (PPV) as the first surgery due to rhegmatogenous retinal detachment (RRD) in pediatric age.

METHODS: The records of pediatric patients who underwent PPV alone due to RRD were reviewed retrospectively. The best corrected visual acuity (BCVA) values were recorded before and after the surgery. Complications during and after the operation, postoperative recurrences were followed-up.

RESULTS: One hundred and six patients included in the study were followed-up for an average of 24.20 ± 11.38 months. The final mean BCVA showed a statistically significant improvement compared to the initial mean BCVA (p < 0.001). During the postoperative follow-up period, recurrent retinal detachment was seen in 31.1% of patients. Anatomical success was achieved at a rate of 68.9% after the first surgery and increased to 95.3% after repeated operations (in 78.3% without any tamponade). Both anatomical and functional success of patients with proliferative vitreoretinopathy (PVR) grade C or worse and patients with macula-off retinal status were poorer (each p value < 0.05). The effect of the etiological factor on anatomical and functional success was not significant (each p value > 0.05).

CONCLUSION: Satisfactory results can be obtained with PPV alone in pediatric RRD. However, it should be noted that postoperative complications and recurrences occur at a high rate and that repeated surgeries are often required. The presence of PVR and macular involvement are seen as negative prognostic factors to the success of surgery.

PMID:35570251 | DOI:10.1007/s10792-022-02346-x

Adv Ther. 2022 May 16. doi: 10.1007/s12325-022-02155-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Limited real-world data are available comparing multiple biologics on their adherence, persistence, and the use of concomitant biologics in the treatment of moderate-to-severe psoriasis in clinical practice. The objective was to compare persistence of and adherence to ixekizumab (IXE) treatment, as monotherapy or with concomitant medication, versus patients receiving other commonly prescribed biologics.

METHODS: Patients who newly initiated IXE, adalimumab (ADA), etanercept (ETN), secukinumab (SEC), or ustekinumab (UST) in IBM MarketScan^® databases with diagnosis of psoriasis were identified. Treatment comparisons on medication persistence, adherence, and monotherapy were based on balanced samples after inverse probability of treatment weighting (IPTW).

RESULTS: A higher proportion of patients receiving IXE had had previous biologic therapies (50.3%) versus other biologics (ADA: 9.1%, ETN: 10.9%, SEC: 33.9%, UST: 19.7%). Patients treated with IXE showed statistically (p < 0.001) greater persistence than patients treated with SEC, ADA, UST, or ETN at both 1-year follow-up and up to 3 years of follow-up. Adherence for patients treated with IXE was significantly (p < 0.001) higher compared to ADA, ETN, and UST at both 1-year follow-up and up to 3 years of follow-up. There was no significantly higher adherence in patients treated with IXE compared to those treated with SEC at 1-year follow-up, but IXE had higher adherence than SEC (p < 0.05) at 1-3 year follow-up. IXE showed longer time on monotherapy than ADA (p < 0.001), ETN (p < 0.001), SEC (p < 0.05), and UST (p < 0.001) for both 1-year and 1-3 year follow-up. Sensitivity analyses on persistence, adherence, and monotherapy with further model adjustments after IPTW confirmed the findings.

CONCLUSIONS: Patients treated with IXE were more persistent on and adherent to treatment and remained on monotherapy longer compared to those on all other commonly prescribed biologics combined or with individual biologics.

PMID:35570242 | DOI:10.1007/s12325-022-02155-9

Med Oncol. 2022 May 16;39(5):83. doi: 10.1007/s12032-022-01670-7.

ABSTRACT

Triple negative breast cancer (TNBC) is the most aggressive subtype of breast cancer. More and more studies have shown that the tumor immune microenvironment (TME) of TNBC is closely related to its poor prognosis and early metastasis. We try to explain how tumor-associate macrophages (TAMs), an important component of the TME, function in the matrix of TNBC. Therefore, we induced THP-1 cells to become M1-TAMs and M2-TAMs, investigated their influence on breast cancer cells. 82 TNBC paraffin samples were made into tissue microarrays. The expression of macrophages makers were measured by immunohistochemistry. Scratch assay, Transwell assay, CCK-8 cell proliferation assay were performed in the co-culture system of breast cancer cells lines and macrophages to observe the invasion and proliferation ability of breast cancer cell lines. Western Blot (WB) was performed to detect the expression of E-cadherin (CDH1) and N-cadherin (CDH2). M2-TAMs were more numerous than M1-TAMs in the matrix of TNBC cancer nests and associated with poor prognosis. M2-TAMs promoted the invasion, migration, and proliferation of TNBC cells. M1-TAMs had inhibitory effects. In MCF-7 cells, WB showed a decrease in CDH1 and an increase in CDH2. In MDA-MB-231 cells and BT549 cells, CDH2 expression was reduced and CDH1 expression was increased. All of the above results were statistically significant, p < 0.001. M2-TAMs were more numerous in TNBC and associated with poor prognosis. M2-TAMs promoted the invasion, migration, and proliferation of breast cancer cells. The mechanism may be related to the epithelial-mesenchymal transition.

PMID:35570226 | DOI:10.1007/s12032-022-01670-7