Category: Nevin Manimala

J Perinat Med. 2022 May 10. doi: 10.1515/jpm-2021-0139. Online ahead of print.

ABSTRACT

OBJECTIVES: Congenital heart defects (CHD) are the most common inherited abnormalities. Intrapartum cardiotocography (CTG) is still considered a “gold standard” during labor. However, there is a lack of evidence regarding the interpretation of intrapartum CTG in fetuses with CHD. Therefore, the study aimed to compare intrapartum CTG in normal fetuses and fetuses with CHD and describe the association between CTG and neonatal outcomes.

METHODS: The present study is a retrospective analysis of the CTG of 395 fetuses. There were three study groups: Group 1: 185 pregnancies with a prenatal diagnosis of CHD, Group 2: 132 high-risk pregnancies without CHD, and Group 3: 78 low-risk pregnancies without CHD.

RESULTS: Abnormal CTG was present statistically OR=3.4 (95%CI: 1.61-6.95) more often in Group 1. The rate of the emergency CS was higher in this group OR=3 (95%CI: 1.3-3.1). Fetuses with CHD and abnormal CTG were more often scored ≤7 Apgar, with no difference in acidemia. The multivariate regression model for Group 1 does not show clinical differences between Apgar scores or CTG assessment in neonatal acidemia prediction.

CONCLUSIONS: CTG in fetuses with CHD should be interpreted individually according to the type of CHD and conduction abnormalities. Observed abnormalities in CTG are associated with the fetal heart defect itself. Preterm delivery and rapid cesarean delivery lead to a higher rate of neonatal complications. Health practitioners should consider this fact during decision-making regarding delivery in cases complicated with fetal cardiac problems.

PMID:35534874 | DOI:10.1515/jpm-2021-0139

Orphanet J Rare Dis. 2022 May 10;17(1):101. doi: 10.1186/s13023-022-02261-5.

ABSTRACT

BACKGROUND: Relapsing polychondritis (RP) is a rare inflammatory disease characterized by recurrent inflammation and destruction of cartilaginous tissues. RP has characteristics of autoimmune disease and some reports have noted co-occurrence with autoimmune thyroid disease (AITD), consisting of Graves’ disease (GD) and Hashimoto thyroiditis (HT). However, there have been no detailed studies on the co-occurrence of RP and AITD. In this study, we aimed to determine whether patients with RP tend to be complicated with AITD. We also analyzed the clinical and genetic profiles of patients in whom these diseases co-occur.

METHODS: We recruited 117 patients with RP and reviewed their medical records. Furthermore, we genotyped Human Leucocyte Antigen (HLA)-A, B Cw, DRB1, DQB1, and DPB1 alleles for 93 of the 117 patients. The prevalence of AITD among the patients with RP was compared with that among the general Japanese population. We also analyzed the clinical and genetic features of the patients with both RP and AITD.

RESULTS: The prevalence of GD among the patients with RP was 4.3% (5 among 117 patients), significantly higher than that among Japanese (0.11%) (p = 2.44 × 10^-7, binomial test). RP patients with GD tended to have nasal involvement (p = 0.023) (odds ratio (OR) 2.58) and HLA-DPB1*02:02 (p = 0.035, OR 10.41). We did not find significant enrichment of HT in patients with RP.

CONCLUSIONS: Patients with RP appear to be at elevated risk of GD. Nasal involvement and HLA-DPB1*02:02 characterize the subset of RP patients with GD, which may guide attempts to characterize a distinct subtype of RP for precision medicine.

PMID:35534869 | DOI:10.1186/s13023-022-02261-5

Trials. 2022 May 9;23(1):380. doi: 10.1186/s13063-022-06307-8.

ABSTRACT

BACKGROUND: Repeated or chronic stress is considered a major source of disease, in terms of both somatic and mental illnesses. The prevention of stress-related disease by interventions for relaxation has thus increased societal relevance. In this randomized controlled non-inferiority trial, we will compare a newly developed virtual reality (VR) environment for relaxation to an active control group applying a freely chosen relaxation method. To test if our VR environment supports relaxation in a situation of acute stress, a standardized stress induction protocol will precede the relaxation phase.

METHODS: One hundred healthy participants will be recruited from the University of Siegen and randomly assigned to the VR or the active control group that will be free to choose their own relaxation strategy. The multi-sensory VR includes visual, acoustic, and haptic features to induce a strong feeling of presence. The laboratory testing will comprise a baseline measurement, a stress induction, a relaxation intervention, and a recovery measurement. The primary outcomes are self-reported stress and relaxation measured with a visual analog scale (VAS) at pre- and post-baseline, at the start, middle, and end of the stress induction, at pre- and post-relaxation, at pre- and post-recovery, and in the evening of testing. Secondary outcomes are the physiological parameters, namely heart rate and heart rate variability, tonic skin conductance level as well as the number of non-specific skin conductance responses, systolic and diastolic blood pressure and respiratory rate recorded during the four experimental phases as well as state mood, and state rumination assessed at four time points (pre- and post-stress, post-relaxation, and in the evening of testing). Finally, post-event processing will be assessed after relaxation and in the evening of testing. Repeated measures ANOVAs will be performed to test for statistical effects of group, time, and group × time interaction.

DISCUSSION: The newly developed, multi-sensory VR offers an intervention for relaxation without prior training. Its immersive character might increase efficacy compared to other relaxation methods, especially in situations of acute stress. Future directions could be the development of a mobile version of the VR to enhance accessibility for users. To achieve a transfer of training effects to real life, VR components should successively be eliminated until relaxation is practiced without guidance by the VR.

TRIAL REGISTRATION: ISRCTN Registry ISRCTN11162338 . Retrospectively registered on January 22, 2021.

PMID:35534868 | DOI:10.1186/s13063-022-06307-8

BMC Health Serv Res. 2022 May 9;22(1):624. doi: 10.1186/s12913-022-07978-4.

ABSTRACT

BACKGROUND: Despite significant achievements made towards HIV testing, linkage to antiretroviral therapy treatment and viral load suppression, the Sub-Saharan region of Africa continues to be reported to have the highest prevalence of HIV/AIDS, with over 26 million people living with the disease. In light of the added burden on already overwhelmed health systems due to the Covid-19 pandemic, maintaining the reliability and accuracy of point-of-care diagnostics (POC) results is crucial to ensure the sustainability of quality service delivery. The integration of technology-based interventions into nurse education curricula is growing, to help prepare students for the current practice environment which requires access to large amounts of information. The aim of this study was to determine the effect of a Mobile Learning (mLearning) Curriculum on improving the quality of HIV rapid testing services in rural clinics of KwaZulu-Natal (KZN), South Africa.

METHODS: To achieve the aim of this study, pre-test and post-test audits were conducted in a quasi-experimental design. Eleven clinics of KZN, with the highest availability and usage of POC diagnostics were selected from a cross-sectional study survey to constitute the sample of this study. The World Health Organization On-site Monitoring Checklist-Assessment of Quality System was adapted and used as an audit tool to evaluate four key quality components. The effect of the mLearning curriculum on HIV testing quality improvement was determined through statistically comparing pre-audit and post-audit results. The independent samples t-test and the Levene’s test were employed to evaluate the equality of measured variables for the two groups. The relationships between variables were estimated using the Pearson pair wise correlation coefficient (p) and correlations were reported as significant at p < 0.05.

RESULTS: A total of 11 clinics was audited at the pretest and 7 clinics were audited post-piloting of the mLearning curriculum. The estimated level of compliance of the participating clinics to quality HIV rapid testing guidelines ranged between poor and moderate quality. The mLearning curriculum was shown to have no statistically significant effect on the quality of POC diagnostic services provided in rural clinics of KZN.

CONCLUSION: The mLearning curriculum was shown to have no statistically significant effect on the quality of HIV rapid testing services provided in participating clinics; however, multiple barriers to the full adoption of the piloted curriculum were identified. The provision of reliable technology devices and improved internet connection were recommended to enhance the adoption of technology-based interventions necessary to improve access to relevant learning material and updated information.

PMID:35534859 | DOI:10.1186/s12913-022-07978-4

BMC Oral Health. 2022 May 9;22(1):169. doi: 10.1186/s12903-022-02064-x.

ABSTRACT

BACKGROUND: Owing to the reduced dental treatment infrastructure in the Tanzanian highlands, maintaining good oral health is a challenge for not only the general population but also individual professional groups. In this study, the caries prevalence and, subsequently, the prosthetic treatment needs of the nurses of the Ilembula Lutheran Hospital (ILH) and Ilembula Institute of Health and Allied Sciences (IIHAS), Tanzania, were investigated.

MATERIALS AND METHODS: One hundred and sixty-eight ILH and IIHAS nurses and nursing students (87 women, 81 men; age 23.1 ± 6.1 years, range 18-58 years) participated in this cross-sectional study conducted in February 2020. The participants were examined at the dental office of ILH. The Decayed, Missing, and Filled Teeth (DMF/T) Index, Simplified Oral Hygiene Index, and details regarding edentulism, nutrition habits, and socioeconomic factors were collected. Linear regression and binary logistic regression were used for statistical analysis.

RESULTS: The mean DMF/T-Index was 6.30 ± 4.52. In 7.14% of the investigated nurses, no dental plaque was detected. An enhanced prosthodontic treatment (Kennedy Class III) demand was identified in 31.50% of the participants, and 4.80% of the participants required treatment for acute malocclusion. Oral hygiene products were used by 99.4% of the patients.

CONCLUSIONS: The current oral health situation of the study participants showed a moderate restorative and prosthetic treatment demand in the rural area of Tanzania. The development of an interdisciplinary oral health prophylaxis system could be a means to remedy this situation.

PMID:35534856 | DOI:10.1186/s12903-022-02064-x

Parasit Vectors. 2022 May 10;15(1):105. doi: 10.1186/s13071-022-05205-x.

ABSTRACT

BACKGROUND: Cranial cruciate ligament rupture (CCLR) results from a multifactorial degenerative process that leads to rupture of the ligament. Vector-borne pathogens (VBP) in dogs can induce joint disease but their role in CCLR has not been previously investigated. The aim of the present work is to evaluate the prevalence of VBP in dogs with CCLR.

METHODS: This was a prospective study that included 46 dogs presented for CCLR surgical treatment and 16 control dogs euthanized for diseases unrelated to the joints. Specimens collected included blood, synovial fluid, and synovial membrane biopsy. Pathogen testing consisted of serology for Leishmania infantum (quantitative ELISA), Ehrlichia canis/ewingii, Borrelia burgdorferi, Anaplasma phagocytophilum/platys, and Dirofilaria immitis (4DX IDEXX test), and PCR for L. infantum, Ehrlichia/Anaplasma spp., Bartonella spp., piroplasms (Babesia spp. and Theileria spp.), and filariae (D. immitis, Dirofilaria repens, Acanthocheilonema dracunculoides, Acanthocheilonema reconditum, and Cercopithifilaria spp.) on both EDTA-whole blood (EB) and synovial fluid (SF) samples. SF cytology and histopathological evaluation of synovial membrane were also performed.

RESULTS: The prevalence of VBP was 19.6% in the CCLR group and 18.8% in the control group, with no statistical difference among them. The presence of synovitis was not more frequent in CCLR dogs (45.6%) than in control dogs (43.7%). Lymphoplasmacytic infiltration was the most common inflammatory pattern detected in the joints of both groups of dogs.

CONCLUSIONS: This study failed to demonstrate a role of canine VBP in CCLR or the presence or different pattern of joint inflammation in pathogen-positive dogs.

PMID:35534857 | DOI:10.1186/s13071-022-05205-x

BMC Public Health. 2022 May 9;22(1):918. doi: 10.1186/s12889-022-13173-1.

ABSTRACT

BACKGROUND: The purpose of this study is to assess the level of knowledge, attitudes, and willingness to organ donation among the general public in China.

METHODS: The study population consisted of 4274 participants from Eastern, Central and Western China. The participants’ knowledge, attitudes and willingness to organ donation were collected by a self-designed questionnaire consisting of 30 items. Knowledge is measured by 10 items and presented as a 10 point score, attitudes is measured by 20 items using a 5-step Likert scale and total score ranged between 0 and 80; while the willingness to donate is assessed as binary variable (0 = No; 1 = Yes). A logistic regression model was used to assess the association of knowledge and attitudes with willingness to organ donation, controlling for demographic and socioeconomic confounders.

RESULTS: The questionnaire response rate was 94.98%. The mean score (± SD) of the general public’s knowledge to organ donation was 6.84 ± 1.76, and the mean score (± SD) of attitudes to organ donation was 47.01 ± 9.07. The general public’s knowledge and attitudes were the highest in Eastern China, followed by West and Central China. The logistic regression model indicated a positive association between knowledge and the willingness to organ donation (OR = 1.12, 95%CI: 1.08, 1.17; P < 0.001); attitudes were also positively potential determinant of more willingness to organ donation (OR = 1.08, 95%CI: 1.07, 1.09; P < 0.001).

CONCLUSIONS: Knowledge and attitudes were found to be positively associated with the Chinese general public’s willingness to organ donation. Knowledge about the concept of brain death and the transplant procedure may help raise the rate of willingness to organ donation.

PMID:35534843 | DOI:10.1186/s12889-022-13173-1

BMC Gastroenterol. 2022 May 9;22(1):225. doi: 10.1186/s12876-022-02314-w.

ABSTRACT

BACKGROUND: Low-dose aspirin and clopidogrel have demonstrated potential chemoprevention for colorectal cancer (CRC). Proton-pump inhibitors (PPI) are commonly prescribed with anticoagulation drugs, but the relationship between PPI and CRC is unclear. Moreover, evidence of CRC risk under direct oral anticoagulant (DOAC) is limited. This study aimed to investigate the effects of anticoagulation drugs combined with or without PPI on the risks of CRC in Taiwan.

METHODS: A retrospective case-control study of 1,024,227 cases based on the Chang Gung Research Database from 2010 to 2017 was performed. Clinical characteristics, indications, duration of anticoagulation and PPI use, and CRC occurrence data were collected. Logistic regression was employed to adjust for known confounders of CRC risk.

RESULTS: Monotherapy of clopidogrel decreased the risk of CRC (AOR 0.70; 95% CI 0.60-0.83), while no protective effect was observed in aspirin alone or aspirin plus clopidogrel. DOAC did not affect CRC significantly. The risk of CRC increased in patients with PPI (AOR 1.38; 95% CI 1.28-1.49) and PPI plus DOAC (OR 3.91; 95% CI 1.49-10.27), while PPI plus aspirin decreased the risk of CRC (OR 0.48; 95% CI 0.32-0.73). PPI plus clopidogrel showed no significant effect on the CRC.

CONCLUSION: This study suggests clopidogrel alone and PPI plus aspirin offer a preventative benefit against CRC in the Taiwanese population studied. The same effect was not observed in DOAC. Moreover, a significant increase in CRC was observed in patients on PPI monotherapy and PPI plus DOAC, suggesting a possible risk.

PMID:35534834 | DOI:10.1186/s12876-022-02314-w

BMC Public Health. 2022 May 9;22(1):917. doi: 10.1186/s12889-022-13368-6.

ABSTRACT

INTRODUCTION: Uncontrolled blood pressure contributes a huge contribution to many hypertension-related complications and it is one of the unbeaten problems for patients taking antihypertensive drugs. The association of social support and other factors with uncontrolled blood pressure during the covid-19 pandemic is not well investigated. Therefore, this study explored the determinants of blood pressure control status during the COVID-19 pandemic among patients with hypertension who were on an antihypertensive treatment.

METHOD: A cross-sectional study was done from March to May 2021 among adults aged 18 or more patients with hypertension for three months or more on treatment in Dessie City. An interview-administered questionnaire was done using simple random sampling from hypertension follow-up register for 380 patients with hypertension. Blood pressure measurement was taken from their arm using a stethoscope and mercury sphygmomanometer at a sitting position with 90-degree back support. Uncontrolled blood pressure was also computed either the systolic or diastolic blood pressure greater than or less than the limit of uncontrolled blood pressure with regarding the age and diabetic status of patients. The perceived social support-related questionnaire was adopted from the Multidimensional Scale of Perceived Social Support (MSPSS) -12 item checklist. It was sum-up and transformed into three categories using tertile of their computed raw scores. The adjusted prevalence ratio with a 95 percent confidence interval (CI) was used to calculate the strength of the association between uncontrolled blood pressure and independent predictors using log-binomial regression analysis. A P-value less than 0.05 was declared as statistically significant in multivariable log-binomial regression analysis.

RESULT: A total of 360 study participants were included in this study. The prevalence of uncontrolled blood measures in patients with hypertension with a 95% CI was 55.8(50.7, 61.0). In a multivariable analysis adjusted prevalence ratio with 95% CI for poor medication adherence 1.86(1.59,2.19), being male 1.35(1.11,1.64), secondary education 0.52(0.35,0.77), and low social support 1.24(1.01, 1.54) were the predictors of uncontrolled blood pressure.

CONCLUSION: Uncontrolled blood pressure for patients with hypertension on treatment is higher during the COVID-19 pandemic. Being male, poor medication adherence, educational status and low social support are factors that contribute to uncontrolled blood pressure.

PMID:35534831 | DOI:10.1186/s12889-022-13368-6

BMC Public Health. 2022 May 9;22(1):916. doi: 10.1186/s12889-022-13329-z.

ABSTRACT

BACKGROUND: Temporomandibular disorders (TMD) are common and affect approximately 10% of the adult population. TMD is usually associated with headache, pain in the masticatory muscles and/or the temporomandibular joint, clicking or crepitations during mandibular movement as well as painful and/or reduced mouth opening. This study aimed to investigate the level TMD-patients use social insurance benefits before and after their first time of diagnosis or first surgical event, compared to the general population. Furthermore, the aim was to investigate the differences in the use of social insurance benefits between surgically and non-surgically treated TMD-patients that were diagnosed in a hospital setting.

METHODS: All Swedish citizens aged 23-59 diagnosed with TMD in a hospital setting and/or surgically treated for the condition during 1998-2016 were identified via the Swedish National Board of Health and Welfare. A non-exposed comparison cohort was collected via the Total Population Registry. Outcome and sociodemographic data were collected via Statistics Sweden. Main outcome was annual net days on sick leave and disability pension five years before (-T5) and five years after (T5) diagnosis and/or surgical treatment (T0). Regression analysis was conducted with generalized estimated equations.

RESULTS: The study included 219 255 individuals (73% female) – 19 934 in the exposed cohort and 199 321 in the comparison cohort. The exposed group was classified into three subgroups: non-surgical, surgically treated once, and surgically treated twice or more. The mean annual net days of sick leave and disability pension combined during the ten-year follow-up was 61 days in the non-surgical group, 76 days in the surgically treated once group, and 104 days in the surgically treated twice or more subgroup. The corresponding number for the non-exposed comparison cohort was 32 days.

CONCLUSION: Patients diagnosed with TMD in a hospital setting are 2-3 times more dependent on the use of social benefits than the general population. The reliance on sick leave and disability pension is seen as early as five years before diagnosis, and the reliance remains after surgical treatment. The reliance is stronger in patients with several surgical interventions. These findings indicate that patients diagnosed with TMD constitute a patient group with a high burden of health issues causing long-term dependence on social security benefits.

PMID:35534826 | DOI:10.1186/s12889-022-13329-z