Category: Nevin Manimala

Dev Med Child Neurol. 2022 Apr 30. doi: 10.1111/dmcn.15252. Online ahead of print.

ABSTRACT

AIM: To identify 5-week pain intensity trajectories and their association with physical and psychological well-being in children/young people with cerebral palsy (CP).

METHOD: A cohort study was conducted with 101 Canadian children/young people with CP, of whom 49 were female, with an overall mean age of 12 years 11 months (SD 3 years 1 month), range of 8 to 18 years, and classified in any Gross Motor Function Classification System level. Self-reported pain intensity (Faces Pain Scale – Revised) was collected weekly for 5 weeks and physical and psychological well-being (KIDSCREEN-27) at baseline and 5 weeks. Statistical analyses included latent class growth and general linear models.

RESULTS: All Gross Motor Function Classification System levels were represented (I = 40.6%; II = 15.8%; III = 20.8%; IV = 13.9%; V = 8.9%). Five pain intensity trajectories were identified. Three trajectories had very low (35.4%), low (32.4%), or high (4.9%) mean stable pain. Two trajectories had moderate changing pain (16.8%) and high pain decreasing to moderate levels (10.5%) respectively. Trajectory participants with stable high pain had the lowest physical well-being (adjusted β = -10.01; 95% confidence interval [CI] = -19.37 to -0.66). Those in the three trajectories with the highest mean baseline pain intensity (>3 out of 10) had the lowest psychological well-being (adjusted β = -8.27, 95% CI = -14.84 to -1.70; β = -6.74, 95% CI = -12.43 to -1.05; β = -5.82, 95% CI = -15.34 to 3.71).

INTERPRETATION: Almost one-third of participants had moderate-to-high pain intensity trajectories. Membership in the higher pain intensity trajectories was associated with lower physical and psychological well-being.

PMID:35489074 | DOI:10.1111/dmcn.15252

Iran J Kidney Dis. 2022 Mar;16(2):88-95.

ABSTRACT

INTRODUCTION: Cardiovascular disease (CVD) may accompany chronic kidney disease (CKD), resulting in additional complications and increased death rate. This study was performed to evaluate cardiac structure and function and several risk factors in hospitalized CKD children.

METHODS: Seventy-four children with CKD were enrolled in this cross-sectional descriptive study. Two-dimensional and M-mode ultrasonography, Doppler flow velocity and Tissue Doppler Imaging (TDI) were used to evaluate cardiac chamber size, left ventricular mass (LVM) and echocardiographic indices of ventricular function.

RESULTS: Advanced stages of CKD showed statistically insignificant increased LVM and LVM indexed to height2.7 (LVMI), and mildly reduced diastolic function. Hypertensive patients had an insignificant increase in the incidence of left ventricular hypertrophy (LVH) defined as LVMI greater than 95th percentile for age and sex and LVH2 as LVMI2 more than 95 gr/m2 for girls and more than 115gr/ m2 for boys older than 8 years. Patients with LVH had lower left ventricular ejection fraction (LVEF) and abnormal right ventricular (RV) function based on the tricuspid valve systolic velocity (TV S’) survey. LVH2 cases, however, revealed decreased LV systolic function according to ejection fraction (EF) and abnormal mitral valve systolic velocity (MV S’).

CONCLUSION: LVH related to hypertension and mild systolic and diastolic dysfunction were more prevalent in advanced CKD cases, however TDI showed no statistically significant difference in the prevalence of MV S’ and TV S’. We recommend strict blood pressure control and prevention of renal function deterioration as effective tools for cardiac protection in CKD children. DOI: 10.52547/ijkd.6643.

PMID:35489077

J Med Entomol. 2022 Apr 30:tjac033. doi: 10.1093/jme/tjac033. Online ahead of print.

ABSTRACT

Host feeding patterns and the prevalence of infection with Rickettsia parkeri were determined for the primary vector, Amblyomma maculatum Koch as well as sympatric tick species A. americanum (Linnaeus) and Dermacentor variabilis (Say) collected from a reconstructed prairie in the Piedmont region of North Carolina during 2011 and 2012. The occurrence of R. parkeri among A. maculatum adults and nymphs was 36.9% (45/122) and 33.3% (2/6), respectively. Rickettsia parkeri was detected in a single male A. americanum 2.3% (1/43). A PCR-reverse line blot hybridization assay of a 12S rDNA fragment amplified from remnant larval and nymphal bloodmeals of host-seeking ticks was used to identify bloodmeal hosts. Of the tick samples tested, bloodmeal host identification was successful for 29.3% (12/41) of adult A. americanum and 39.2% (20/51) of adult D. variabilis. For A. maculatum, bloodmeal host identification was successful for 50% (61/122) of adults collected from vegetation and 100% (4/4) of nymphs removed from cotton rats (Sigmodon hispidus Say and Ord). The cotton rat was the most common bloodmeal host with 59.0% (36/61) identified for adult A. maculatum. No statistically significant association was observed, however, between bloodmeal host and pathogen prevalence for any tick species. While the cotton rat was an important bloodmeal host for A. maculatum nymphs, this vertebrate did not appear to be the primary source of R. parkeri infection for A. maculatum.

PMID:35489062 | DOI:10.1093/jme/tjac033

West Afr J Med. 2022 Apr 29;39(4):375-380.

ABSTRACT

BACKGROUND: Metabolic syndrome contributes to the burden of non-communicable diseases and is a growing public health problem in both developed and developing countries. We determined the prevalence and predictors of metabolic syndrome among adults in Benue State, North-Central, Nigeria to guide targeted interventions.

METHODS: We conducted a community-based cross-sectional study in Benue State, North-Central, Nigeria. Multistage sampling technique was used to recruit 823 respondents. We defined metabolic syndrome using the National Cholesterol Education Programme Adult Treatment Panel III guideline and adapted a component of the WHO Stepwise questionnaire for data collection. Prevalence of metabolic syndrome and the associated risk factors were estimated using Chi square test and logistic regression at 5% level of significance. Statistical analysis was done using SPSS version 23.0.

RESULTS: The mean age of the respondents was 40.1± 15.7 years. Most of the respondents were literate (86.8%) and married (67.0%). The prevalence of metabolic syndrome was 19.4%. One in every four of the respondents had pre-metabolic syndrome (25.6%) and this was more in females (28.2%) compared to males (22.9%). Thirty-four percent of the respondents had only one whereas 20.7% did not have any of the risk factors for metabolic syndrome. Age [aOR:10.3; 95%CI: 4.8-22.2], sex [aOR:2.4; 95% CI: 1.7-3.5] and education [aOR:2.9; 95%CI: 1.4-6.1] were significantly associated with metabolic syndrome among the respondents.

CONCLUSION: The prevalence of metabolic syndrome was high. The associated risk factors were age, gender and educational status. Therefore, interventions should be targeted at young adults to reduce the long-term impact of the disease.

PMID:35489039

West Afr J Med. 2022 Apr 29;39(4):388-393.

ABSTRACT

BACKGROUND: Adherence to standard precautions in hospitals is vital to control the spread of hospital-acquired infections (HAIs).

OBJECTIVE: To determine the level of compliance to standard precautionary measures by clinical students and doctors in a Nigerian tertiary hospital to curb spread of infectious diseases, with focus on uptake of Hepatitis B Virus (HBV) vaccine.

METHODS: This study which involved 228 participants used self-administered questionnaire to obtain data on respondents’ biodata, history of exposure to patient’s body fluids (PBF) in the last six months, HBV vaccination status, use and recapping of needles, handwashing, and use of Personal Protective Equipment (PPE). Data analysis was done using SPSS version18; associations were tested with Chi-square statistics, and p<0.05 was considered significant.

RESULTS: Of the 228 respondents, 113(49.6%) were clinical students and 115 (50.4%) doctors with mean age of 27.61±7.48 years. A total of 140 (61.4%) respondents had been exposed to PBF: [89 (63.6%) doctors, 51(36.4%) students]. Age, student/doctor category, and number of years of practice all affected exposure to PBF (p<0.05). Recapping of needles was practiced by 167 (73.2%); hand-washing by 225 (98.7%), and lack of running water was the commonest reason for non-compliance. Also, 218 (95.6%) and 123 (53.9%) wore handgloves and face-masks respectively when attending to patients while 111 (48.7%) received at least a dose of HBV vaccine: [72 (64.9%) doctors, 39 (35.1%) students; p<0.05] but only 60.3% completed their doses.

CONCLUSION: Majority had good hand-washing practice, but only about half wore face-masks while working, and recapping of needles was prominent. Doctors had more occupational exposure to PBF but received more HBV vaccine although many were yet to complete their doses. With COVID-19 added to existing list of HAIs, there is need to scale-up compliance to infection control practices through sustained training programs and better health policies which would also drive vaccine coverage in this population.

PMID:35489043

West Afr J Med. 2022 Apr 29;39(4):369-374.

ABSTRACT

BACKGROUND: Globally, peripartum or puerperal infections account for about one tenth of maternal mortality, most of which occur in low income countries. Therefore, vaginal preparation with an antiseptic prior to a caesarean delivery could be considered an additional measure to prevent subsequent infectious morbidities.

OBJECTIVES: To evaluate vaginal preparation with 0.3% chlorhexidine solution in the prevention of endometritis, surgical site infection and post-operative fever following emergency caesarean section.

METHODS: This prospective randomized controlled trial (RCT) was conducted among 240 participants planned for emergency caesarean sections (CS) at term in the University of Medical Sciences Teaching Hospital Complex, Ondo State, Nigeria. Participants were randomised into either group “A” (study) or “B” (control). The former had vaginal preparation with 0.3% chlorhexidine gluconate immediately after anaesthesia while the latter received normal saline. Participants were followed up post-operatively during which clinical features of puerperal infectious morbidities were observed for each during admission as well as 8th and 14th days after delivery.

RESULTS: The rate and risk of endometritis were significantly lower in the study group compared to the control; 5.0% versus 13.3%, respectively (chi squared =5.004; p=0.042, RR = 0.38; 95% CI = 0.15-0.94; p = 0.042; RRR = 0.62). Post-operative fever and surgical site infection, were also lower in the study group compared to the controls, but the difference was not statistically significant.

CONCLUSION: When compared to placebo, pre-caesarean section vaginal preparation with 0.3% chlorhexidine solution significantly reduced only the rate and risk of post-operative endometritis among infectious morbidities.

PMID:35489037

Int J Cancer. 2022 Apr 30. doi: 10.1002/ijc.34057. Online ahead of print.

ABSTRACT

Skin damage is the most common and most important toxicity during and after radiotherapy. Its assessment and understanding of the factors influencing its occurrence, is a major issue in the management of patients irradiated for an early breast cancer CANTO is a prospective clinical cohort study of 10 150 patients with stage I-III BC treated from 2012-2017 in 26 cancer centers. In this study, we used CANTO-RT, a sub-cohort of CANTO, including 3480 patients who received RT. We are focus on specifical skin toxicities: Erythema, fibrosis, telangiectasia, and cutaneous pigmentation The prevalence of toxicities of interest varied over time, so at M3-6, 41.1% of patients had erythema while 24.8% of patients had fibrosis. At M12 and M36, the prevalence of erythema decreased respectively while fibrosis remains stable. The prevalence of telangiectasia increases from 1% to 7.1% from M3-6 to M36. After adjustments, we showed an association between the occurrence of skin erythema and obesity; the type of surgery; the presence of axillary dissection; the use of taxane-based CT and the 3DvsIMRT irradiation technique. Regarding fibrosis, an association is found, at M3-6, with age at diagnosis, obesity, tobacco, and the use of boost. Only obesity and the type of surgery received by the patient remained statistically significant at M12 and M36. In this study we identified several risk factors for acute and late skin. The use of a boost was mainly related to the occurrence of fibrosis while the use of IMRT-type technique decreased the occurrence of skin erythema.

PMID:35489021 | DOI:10.1002/ijc.34057

Environ Sci Pollut Res Int. 2022 Apr 30. doi: 10.1007/s11356-022-20394-9. Online ahead of print.

ABSTRACT

We investigate the determinants of communicable diseases (CDs) and nexus of financial development, economic development, and renewable energy consumption to address the issues of ecological footprint level, the impacts of communicable diseases (CDs), and economic growth of the OECD countries throughout 2000-2019. The results from FMOLS and DOLS reveal that the levels of financial development, energy consumption, and trade volume significantly contribute to overcoming the death toll occurring due to CDs. As regards the growth function, the level of trade in the economy is significantly associated with economic growth. The findings reveal that the improvements and developments in the financial sectors and trading activities cause a reduction in the infection cases represented by COVID-19. In contrast, economic growth does have a negative but insignificant impact upon COVID-19. We conclude that sound financial development combined with economic and environmental regulations could be strategically helpful to cope with CDs.

PMID:35488993 | DOI:10.1007/s11356-022-20394-9

J Gastrointest Cancer. 2022 Apr 30. doi: 10.1007/s12029-022-00827-x. Online ahead of print.

ABSTRACT

PURPOSE: Worldwide, gastric cancer (GC) is the 5^th cancer with the highest incidence and the 4^th in mortality. To reduce it, one strategy is to diagnose preneoplastic lesions (PNL): atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia (DYS); to form risk groups on which to focus surveillance efforts as are first-degree relatives (FDR). The aim of this study was to determine prevalence of gastric PNL in FDR of patients with GC, and to study association with sex, age, and Helicobacter pylorii (Hp) infection.

METHODS: Cross-sectional study. One hundred and ten FDR, aged between 50 and 65 years, 54.5 female, obtained through convenience sampling, were studied. Biodemographic data survey and upper gastrointestinal endoscopy with histological study were applied according to Sidney protocol, and focal lesions found. Diagnosis of these lesions and condition of mucosa was carried out by applying OLGA and OLGIM systems. Descriptive statistics, estimation of prevalence, odds ratio (OR), and 95% confidence intervals (95CI) were calculated.

RESULTS: Median age of study group was 56.5 years. Prevalence of PNL, AG, IM, and DYS were 86.4%, 82.7%, 54.5%, and 12.7% respectively. Advanced stages of OLGA and OLGIM were verified in 18.0% and 16.3% respectively. No association with sex, age, and Hp infection were found ([OR 3.10; 95CI 1.0; 9.64]; [OR 0.74; 95CI 0.26; 2.14]; [OR 0.58; 95CI 0.12; 2.77]) respectively.

CONCLUSION: FDR of patients with GC have a high prevalence of PNL, which makes them a risk group in which endoscopic surveillance should be applied.

PMID:35488975 | DOI:10.1007/s12029-022-00827-x

Photochem Photobiol Sci. 2022 Apr 30. doi: 10.1007/s43630-022-00225-z. Online ahead of print.

ABSTRACT

The photon upconversion based on triplet-triplet annihilation (TTA) is a mechanism that converts the absorbed low-energy electromagnetic radiation into higher energy photons also at extremely low excitation intensities, but its use in actual technologies is still hindered by the limited availability of efficient annihilator moieties. We present here the results obtained by the synthesis and application of two new fluorinated chromophores based on phenazine and acridine structures, respectively. Both compounds show upconverted emission demonstrating their ability as TTA annihilator. More interesting, the acridine-based chromophore shows an excellent TTA yield that overcomes the one of some of best model systems. By correlating the experimental data and the quantum mechanical modeling of the investigated compound, we propose an alternative efficient pathway for the generation of the upconverted emissive states involving the peculiar high-energy triplet levels of the dye, thus suggesting a new development strategy for TTA annihilators based on the fine tuning of their high-energy excited states properties.

PMID:35488979 | DOI:10.1007/s43630-022-00225-z