Category: Nevin Manimala

J Craniofac Surg. 2022 Jan-Feb 01;33(1):303-306. doi: 10.1097/SCS.0000000000007684.

ABSTRACT

PURPOSE: The authors compared facial scars after split-thickness skin grafts (STSGs) performed with a dermal substitute or after full-thickness skin grafts (FTSGs) in facial defect.

MATERIALS AND METHODS: The medical records of patients who had undergone FTSG or STSG with dermal substitute after skin cancer surgery between March 2016 and December 2018 were retrospectively reviewed. The scars resulting from skin grafts were assessed using the patient and observer scar assessment scales (PSAS and OSAS) in our clinic after a minimum of 6 months postoperatively.

RESULTS: Of the 50 study subjects, 35 patients (FTSG group) received FTSG only and 15 patients (STSG group) received STSG with the dermal substitute. The total scores of PSAS and OSAS were significantly lower in the FTSG group and it is suggested that both patients and observers thought that better scar outcomes were achieved when FTSGs were used. However, for defects smaller than 1.8 cm2 and defects located in the periorbital area, there was no statistically significant difference in the scores of PSAS and OSAS in the 2 groups. Interestingly, for defects located in the periorbital area, although there was no significant difference, PSAS and OSAS scores were lower in the STSG group than in the FTSG group. In other word, scar outcomes in the STSG group were better.

CONCLUSIONS: Although there was no significant difference, unlike what we usually know, our result shows that STSG with dermal substitute tended to produce comparable or rather better results than FTSG under some conditions.

PMID:34967526 | DOI:10.1097/SCS.0000000000007684

J Craniofac Surg. 2022 Jan-Feb 01;33(1):104-107. doi: 10.1097/SCS.0000000000008022.

ABSTRACT

BACKGROUND: Ectrodactyly, commonly referred to as cleft hand, is a rare pathology characterized by a deficiency and/or complete absence of the central ray in each hand. In order to customize treatment and improve the patient’s quality of life, a more detailed functional evaluation is required. Although several studies evaluate functionality in different types of cleft hands, there are only a few studies that show self-reported evaluations. The objective of this study is to assess the hand function of cleft hand patients.

METHODS: An observational retrospective study was performed on 12 cleft hand patients who were treated between 2008 and 2018. There were 8 male patients and 4 female patients. Patients were divided into 2 groups according to their ages: (Group 1) 6 patients between 1 and 7 years of age, and (Group 2) 6 patients between 8 and 18 years of age, respectively. Each group was sub-stratified into 5 subgroups according to the classification system created by Manske and Halikis.

RESULTS: Regardless of age, intragroup hand type comparisons within Groups 1 and 2 did not demonstrate statistically significant differences (P > 0.05) between hand outcomes according to Manske and Halikis classification. Comparison between cleft hand patients and their age matched controls demonstrated statistically significant differences (P < 0.05), as the patients in the control group had higher outcome scores.

CONCLUSIONS: Regardless of cleft hand type and patient age, patients with cleft hands experience impaired hand function and present lower outcome scores in comparison to their age matched controls.

PMID:34967517 | DOI:10.1097/SCS.0000000000008022

Pharmacotherapy. 2021 Dec 30. doi: 10.1002/phar.2657. Online ahead of print.

ABSTRACT

INTRODUCTION: Hormonal contraceptives have been used in perimenopausal women to manage a variety of symptoms and prevent unintended pregnancy. However, it is unclear what contraceptive regimen is best for these women.

OBJECTIVE: To evaluate hormonal contraceptive methods in women experiencing perimenopause using two prespecified outcomes: perimenopausal symptom management and long-term effects.

METHODS: A literature search of PubMed and EMBASE databases was performed (January 1990 to October 2021) using search terms “perimenopause” and “contraception.” Relevant full-text articles in English were included.

RESULTS: Fifteen clinical articles were reviewed. Fourteen were internationally-based and one study was conducted in the United States. Nine articles evaluated symptom resolution, and six of these nine reported statistically significant changes in favor of treating perimenopausal women with hormonal contraceptives compared with no treatment. Seven studies evaluated long-term outcomes including bone loss and metabolic parameters, and six of these seven showed statistically significant improvements with hormonal contraceptives. Based on limited data and a lack of comparative studies, the use of a levonorgestrel intrauterine device with supplemental low-dose menopausal estrogen has positive results for the management of disruptive perimenopausal symptoms and long-term outcomes.

CONCLUSION: Hormonal contraception in perimenopausal women improves symptom management and long-term outcomes if patients do not have contraindications. When selecting a contraceptive for women in perimenopause, clinicians and pharmacists need to address specific patient risk factors, symptom profiles, long-term risks and benefits, and patient preferences.

PMID:34967466 | DOI:10.1002/phar.2657

Psychooncology. 2021 Dec 30. doi: 10.1002/pon.5868. Online ahead of print.

ABSTRACT

OBJECTIVE: Globally, cancer incidence is on the increase and cancer care is complex, psychologically, physically and financially draining. Family caregivers of patients with cancer in low- and middle-income countries not only face enormous challenges in having their patients access comprehensive cancer treatment services but also the critical and complex roles that they play greatly predispose them to role strain. Role strain is multifaceted and encompasses physical, psycho-social and financial strain. Therefore, this study aimed to assess the level of role strain among the family caregivers of patients with cancer and ensure appropriate referral to care and support services.

METHODOLOGY: The study adopted cross-sectional design involving 255 systematically sampled family caregivers of adult patients attending Kenyatta National Hospital outpatient cancer treatment clinic. Quantitative data from Modified Caregiver Strain Index tool and questionnaire was analysed by deriving descriptive statistics and data was presented by use of tables and figures. SPSS software version 25 was utilized in data analysis.

RESULTS: From the study findings, the family caregivers who had mild, moderate and severe role strain were 25.9%, 44.3% and 29.8%, respectively.

CONCLUSION: Role strain was prevalent among family caregivers and this, therefore, calls for healthcare practitioners to assess all family caregivers of adult patients with cancer for role strain and appropriately refer those experiencing moderate to severe strain for psychological counselling, social and financial support.

PMID:34967495 | DOI:10.1002/pon.5868

J Environ Qual. 2021 Dec 30. doi: 10.1002/jeq2.20322. Online ahead of print.

ABSTRACT

Hydrogen sulfide (H₂ S) emissions from Midwestern United States dairy lagoons are episodic and seasonal. Emissions were determined using an inverse diffusion model in conjunction with measured upwind and downwind line-averaged H₂ S concentrations and turbulence. Mean daily H₂ S emissions from manure stored in earthen basins was 0.97 μg m^-2 s^-1 (σ = 1.35 μg m^-2 s^-1 ). Mean live animal basis daily emission from the basins was 1.1 g d^-1 hd^-1 (0.84 g d^-1 AU^-1 ). Daily emission was modeled using the van’t Hoff function with air temperature as a surrogate for slurry surface temperature and a linear function of friction velocity. The mean standard error of estimate of the model was 1.8 μg m^-2 s^-1 (2.0 g d^-1 hd^-1 , 1.6 g d^-1 AU^-1 ) and accounted for 60% of emissions variability. H₂ S emissions were enhanced for short periods during the year when the stored slurry was loaded onto trucks for removal. Emissions from the basins were not statistically different as barn manure handling changed from flushing to scraping. More measurements are needed to verify annual emissions estimates for these manure slurry storage basins and derive emission factors for these slurry storage systems.

PMID:34967465 | DOI:10.1002/jeq2.20322

J Popul Ther Clin Pharmacol. 2021 Dec 28;28(2):e7-e16. doi: 10.47750/jptcp.2021.859. eCollection 2021.

ABSTRACT

AIM: This study envisages understanding about the Oral Health-Related Quality of Life (OHRQoL) among groups of foundling and delinquent children and compares them with mainstream children in Riyadh, Saudi Arabia.

METHOD: This is a cross-sectional, observational study of a group of foundling and delinquent children aged 11 to 14 years, in care houses in Riyadh, Saudi Arabia, and mainstream school children. Variables measured for each group were demographic data (age, gender), subjective oral health condition, and OHRQoL. An interview-based questionnaire was used for collecting the relevant data. The questionnaire was divided into four parts, oral symptoms, functional limitations, emotional well-being, and social well-being, with each response scored as per the following codes: (0) never, (1) once or twice, (2) sometimes, (3) often, and (4) every day. The top possible score for the total scale was 144, and the lowest was 0. A comparison group of mainstream school children was recruited from public schools. Data were analysed using SPSS version 25.0 statistical software, and one-way ANOVA was used for the analysis of data when three levels or more were categorical, and the response was numerical. A chi-square test was used to assess the correlation between any two categorical variables.

RESULTS: Out of the total 99 children, 33 were delinquents, 33 were foundling, and 33 were mainstream children included as a comparative group in the study. It was noted that the delinquents compared to the other children had significantly higher scores in accordance with the data collected, with a mean overall score of 30.61 compared to the score for foundling, which was 19.48, and mainstream children had a meager score of 9.18. Individual factorssuch as the oral symptoms, functional limitations, and emotional and social well-being were scored separately, with delinquents having the highest scores and mainstream children the least.

CONCLUSIONS: Health, including oral health, is a right everyone is equally subjected to, and while the concept of OHRQoL is relatively new, delinquents and foundling are definitely subjected to poorer standards in terms of their oral hygiene, on-time treatment, and diagnosis, which further deteriorates their quality of life.

PMID:34965641 | DOI:10.47750/jptcp.2021.859

Zhongguo Gu Shang. 2021 Dec 25;34(12):1152-7. doi: 10.12200/j.issn.1003-0034.2021.12.012.

ABSTRACT

OBJECTIVE: To study the clinical efficacy and complications of Endobutton titanium plate and clavicle hook plate in the treatment of acromioclavicular dislocation.

METHODS: Total 48 patients with Rockwood Ⅲ to Ⅴ acromioclavicular joint dislocation from March 2015 to May 2019 were retrospectively divided into two groups according to different surgical methods. Among the patients, 23 patients were treated with Endobutton loop titanium plate fixation (observation group), including 15 males and 8 females, ranging in age from 23 to 59 years old, with an average of(36.2±8.1) years old;Rockwood type Ⅲ in 6 cases, type Ⅳ in 11 cases and type Ⅴ in 6 cases. Twenty-five patients were treated with clavicular hook plate(control group), including 17 males and 8 females, ranging in age from 22 to 54 years old, with an average of (34.7±6.4) years old; Rockwood type Ⅲ in 6 cases, type Ⅳ in 14 cases and type Ⅴ in 5 cases. The operation time, intraoperative bleeding, hospitalization time, visual analogue scale (VAS) of pain, Constant-Murley score of shoulder function and postoperative complications were compared between the two groups.

RESULTS: All the patients were followed up, and the duration ranged from 24 to 51 months, with a mean of (30.5±6.5) months. The amountof bleeding and hospitalization time in the observation group were (71.9±4.0) ml and(8.2±1.6) d respectively;and those in the control group were (97.6±13.4) ml and (12.8±1.2) d respectively. There was significant difference between the two groups (P<0.05). There was no significant difference in operation time between the two groups(P>0.05). The VAS scores of the observation group immediately after operation and 12 months after operation were 4.00±0.39 and 1.58±0.13 respectively, which were statistically significant compared with 7.32±0.43 and 3.09±0.23 in the control group (P<0.05). The Constant-Murley scores of shoulder function in the observation group were 59.65±0.15 and 85.97 ±0.73 immediately and 12 months after operation, which were significantly different from those in the control group 52.77±0.19 and 55.78±0.19(P<0.05). In the observation group, there were 1 case of shoulder pain and 1 case of ectopic ossification; in the control group, there were 1 case of internal fixation failure, 3 cases of acromion impact, 3 cases of shoulder pain and 3 cases of ectopic ossification. There was significant difference between the two groups (P<0.05).

CONCLUSION: Compared with clavicular hook plate internal fixation in the treatment of acromioclavicular joint dislocation, Endobutton loop titanium plate internal fixation technology has the advantages of less surgical bleeding, shorter hospitalization time, less postoperative pain, good recovery of shoulder joint function and less complications.

PMID:34965634 | DOI:10.12200/j.issn.1003-0034.2021.12.012

Zhongguo Gu Shang. 2021 Dec 25;34(12):1114-20. doi: 10.12200/j.issn.1003-0034.2021.12.005.

ABSTRACT

OBJECTIVE: To explore the influencing factors of the postoperative effect of arthroscopic treatment of symptomatic discoid lateral meniscus (DLM).

METHODS: From September 2008 to September 2015, patients with symptomatic DLM treated by arthroscopic surgery were retrospectively analyzed. The knee function was evaluated by Lysholm scoring system. According to the scoring results, it was divided into excellent (≥90 points), good (80 to 89 points), fair (70 to 79 points) and poor (<70 points). Sixteen research factors were collected, namely gender, operation age, body mass index, work intensity, symptom duration, history of knee injury, involved knee side, DLM classification, DLM injury type, DLM injury site, medial meniscus injury, knee cartilage injury site and degree, Kellgren-Lawrence (K-L) classification, operation method, and latest follow-up time. According to the data type, Kruskall-Wallis rank sum test or χ² test was used for univariate analysis, and ordinal Logistic regression model was used for multivariate analysis. Univariate analysis showed that the statistically significant factors were included in the multivariate analysis model, and the independent risk factors influencing the curative effect of symptomatic DLM were obtained.

RESULTS: According to the inclusion and exclusion criteria, 502 patients were included. Lysholm functional grade at the latest follow-up was higher than that before operation (P<0.001). Univariate analysis showed that there were significant differences in gender, body mass index, work intensity, history of knee injury, age of operation, duration of symptoms, medial meniscus injury, K-L grade, operation method, location and degree of knee cartilage injury among Lysholm functional grades(P<0.05). Ordinal logistic regression analysis showed that female was an independent risk factor for postoperative efficacy (P=0.002, OR=0.370);body mass index (P=0.007, OR=0.894), work intensity(P=0.004, OR=0.525), age of operation(P<0.001, OR=0.953), duration of symptoms(P<0.001, OR=0.989), degree of cartilage damage (P=0.016, OR=0.631) were negatively correlated with Lysholm knee function classification.

CONCLUSION: Arthroscopy is a safe and effective method for the treatment of symptomatic DLM. The gender, body mass index, work intensity, age of operation, duration of symptoms and degree of knee cartilage injury are independent influencing factors for the postoperative efficacy of symptomatic DLM.

PMID:34965627 | DOI:10.12200/j.issn.1003-0034.2021.12.005

Zhongguo Gu Shang. 2021 Dec 25;34(12):1126-31. doi: 10.12200/j.issn.1003-0034.2021.12.007.

ABSTRACT

OBJECTIVE: To compare the femoral and tibial tunnel positions of anterior cruciate ligament reconstruction using the modified transtibial (MTT) technique and anteromedial (AM) portal technique.

METHODS: Between January 2017 and September 2020, 78 patients with anterior cruciate ligament rupture underwent single-bundle reconstruction with the modified transtibial technique in 39 cases (group MTT) and through anteromedial approach in 39 cases (group AM). There were 25 males and 14 females in group MTT, with an average age of (37.0±2.3) years old; 27 males and 12 females in group AM, with an average age of (37.5±2.2) years old. CT scan of the affected knee was conducted one week after the surgery to measure and compare the femoral tunnels positioning (Fx, Fy), tibial tunnels positioning in the frontal plane(Tx1), tibial tunnels positioning in the sagittal plane (Ty1), and tibial tunnels positioning in the axial plane (Tx2, Ty2) in patients undergoing anterior cruciate ligament reconstruction through Mimics software.

RESULTS: Three-dimensional CT reconstruction after the surgery showed that the average Fx and Fy were(25.2±2.1)% and (34.9±3.0)% respectively and the Tx1 and Ty1 were (45.5±3.3)% and (44.7± 3.0)% respectively, while the Tx2 and Ty2 were (47.0±3.0)% and (39.9±4.2)% respectively in group MTT. In group AM, the average Fx and Fy were (26.0±2.0)% and (36.1±3.9)% respectively and the Tx1 and Ty1 were (46.5±3.1)% and (45.6± 3.1)% respectively, while the Tx2 and Ty2 were (47.4±2.5)% and (39.6±3.9)% respectively. There were no statistically significant differences in the femoral and tibial tunnels between the two groups (P>0.05). Patients in both two groups obtained anatomic anterior cruciate ligament reconstruction.

CONCLUSION: Both the MTT and AM technique can achieve good anatomical positioning of the femoral and tibial tunnels, without significant differences in the positioning of the bone tunnels.

PMID:34965629 | DOI:10.12200/j.issn.1003-0034.2021.12.007

Zhongguo Gu Shang. 2021 Dec 25;34(12):1108-13. doi: 10.12200/j.issn.1003-0034.2021.12.004.

ABSTRACT

OBJECTIVE: To explore the potential related factors of falls and provide a reference plan for preventing falls for the middle-aged and elderly people.

METHODS: From November 2017 to July 2018, a total of 1 642 middle-aged and elderly people from 10 communities in Chaoyang District and Fengtai District of Beijing were interviewed by questionnaires. The contents of the questionnaire included the subjects basic information, life style, basic diseases and eating habits. The relationship between various factors and falls was preliminarily analyzed by t-test and Chi-square test. The possible influencing factors of falls in the surveyed population were further analyzed by Logistic regression.

RESULTS: A total of 1 540 subjectswere included, including, 415 men and 1 125 women. Their average age was(63.02±7.15) years. The incidence of falls in recent one year was 12.14%(187 / 1 540). According to Chi-square test, there was a statistically significant difference in bone mineral density, age, fracture history and other factors between the two groups (P<0.05 ). According to Logistic regression analysis, age (OR= 1.048, 95%CI=1.015-1.082), hips size (OR=1.034, 95%CI=1.001-1.067), heavy drinking (OR=29.422, 95%CI=5.226-189.378) may be a risk factor for falls. And edible eggs(OR=0.423, 95%CI=0.184-0.972), beef (OR=0.064, 95%CI=0.006-0.634) and better muscle strength(OR=0.936, 95%CI=0.906-0.992) may be a protective factor for falls. In addition, suffering from diabetes(OR=1.461, 95%CI=1.006-2.213) may also increase the risk of falls in this population.

CONCLUSION: For middle aged and elderly people, avoiding heavy drinking, eating more eggs, vegetables, and active strength exercise can effectively prevent falls. And people with family history of fracture and diabetes should pay more attention to the prevention of falls.

PMID:34965626 | DOI:10.12200/j.issn.1003-0034.2021.12.004