Category: Nevin Manimala

Dent Traumatol. 2022 Apr 7. doi: 10.1111/edt.12750. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Approximately 20% of patients with maxillofacial trauma are women, but few articles have analysed this. The aim of this multicentric, prospective, epidemiological study was to analyse the characteristics of maxillofacial fractures in the female population managed in 14 maxillofacial surgery departments on five continents over a 1-year period.

METHODS: The following data were collected: age (0-18, 19-64, or ≥65 years), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment, and length of hospitalization.

RESULTS: Between 30 September 2019 and 4 October 2020, 562 of 2387 patients hospitalized with maxillofacial trauma were females (24%; M: F ratio, 3.2:1) aged between 1 and 96 years (median age, 37 years). Most fractures occurred in patients aged 20-39 years. The main causes were falls (43% [median age, 60.5 years]), which were more common in Australian, European and American units (p < .001). They were followed by road traffic accidents (35% [median age, 29.5 years]). Assaults (15% [median age, 31.5 years]) were statistically associated with alcohol and/or drug abuse (p < .001). Of all patients, 39% underwent open reduction and internal fixation, 36% did not receive surgical treatment, and 25% underwent closed reduction.

CONCLUSION: Falls were the main cause of maxillofacial injury in the female population in countries with ageing populations, while road traffic accidents were the main cause in African and some Asian centres, especially in patients ≤65 years. Assaults remain a significant cause of trauma, primarily in patients aged 19-64 years, and they are related to alcohol use.

PMID:35390219 | DOI:10.1111/edt.12750

J Cosmet Dermatol. 2022 Apr 7. doi: 10.1111/jocd.14978. Online ahead of print.

ABSTRACT

BACKGROUND: Onychomycosis, the most prevailing affliction of the nail, accounts for approximately 90% of the toenail infection worldwide. Owing to this infection, the affected patients experience reduced quality of their life as its awful appearance undermines their daily activities and social interactions. Onychomycosis is notoriously strenuous to cure. Systemic therapy, though effective, possess severe complication of toxicities, contra-indication, and drug-drug interaction. Albeit topical therapy is favorable to its localized effect, its potency relates to the effective concentration of the antifungal drugs achieved at the infection site. An approach to accomplish this goal would be acquiring benefits from the terpenes as penetration enhancers from natural sources. This investigation aimed to study the effectiveness of six terpenes, namely safranal, lavandulol, rose oxide, 3-methyl-2-butene-1-ol, linalool, and limonene, as potential penetration enhancers for improved nail permeation of fluconazole through the human nail.

METHODS: Ex vivo permeation experiments were carried out by soaking the nail clippings of human volunteers in control and working solutions containing fluconazole (5 mg/ml) per se and fluconazole (5 mg/ml) with 6% of each terpene, including safranal, lavandulol, rose oxide, 3-methyl-2-butene-1-ol, linalool, and limonene, respectively, for 48 hours. The amount of fluconazole in nail clippings was quantified using an HPLC method.

RESULTS: Statistical analysis showed that fluconazole transungual permeation was influenced by the studied terpenes in the following order: safranal > lavandulol acetate > limonene > rose oxide (P-value > 0.05) while the other terpenes showed no significant difference with the control group and safranal represents as the most effective permeation enhancer for the transungual delivery of fluconazole.

CONCLUSION: It is concluded that the safranal can be successfully used as a safe and potential permeation enhancer to enhance the transungual delivery of fluconazole for the treatment of onychomycosis.

PMID:35390220 | DOI:10.1111/jocd.14978

J Adolesc. 2022 Apr;94(3):422-434. doi: 10.1002/jad.12037. Epub 2022 Mar 7.

ABSTRACT

INTRODUCTION: While several studies have documented a declining-with-age trend in life satisfaction in adolescence, cross-national and nationally representative longitudinal evidence is needed to establish the normative trajectory of life satisfaction during this critical developmental period.

METHODS: The Health Behaviour in School-Aged Children (HBSC) study of 10-16-year-olds included the Cantril Ladder life satisfaction measure in surveys of 43 countries between 2001 and 2014 (N = 752,620, 51% females). The UK Household Longitudinal Study (UKHLS) was used to assess within-person changes in life satisfaction from age 10 to 15 years among young people sampled between 2009 and 2018 (N = 8952, Obs. = 30,278).

RESULTS: Life satisfaction decreased by 0.61 SDs on average from ages 10 to 16 in the HBSC sample. A statistically significant decreasing-with-age trend was observed in each of the 43 countries examined. Females experienced a more pronounced decline in life satisfaction than males (0.75 SD vs. 0.46) on average, and a significantly larger decrease in life satisfaction among females was identified in 38 of 43 countries examined. Longitudinal analysis of adolescents from the UKHLS sample replicated this pattern: life satisfaction declined significantly by 0.5 SD between the ages of 10 and 15 and this decline was found to be steeper for females (0.76 SD) than for males (0.23SD).

CONCLUSIONS: The study findings enhance our understanding of the lifespan dynamics of life satisfaction and point to a potential universal decline in life satisfaction in adolescence. Understanding the developmental processes underlying this phenomenon will now be crucial.

PMID:35390206 | DOI:10.1002/jad.12037

BJS Open. 2022 Mar 8;6(2):zrac018. doi: 10.1093/bjsopen/zrac018.

ABSTRACT

BACKGROUND: External rectal prolapse (ERP) is a debilitating condition in which surgery plays an important role. The aim of this study was to evaluate the outcomes of abdominal approaches (AA) and perineal approaches (PA) to ERP.

METHODS: This was a PRISMA-compliant systematic review with meta-analysis. Studies published between 1990 and 2021 were retrieved. The primary endpoint was recurrence at the last available follow-up. Secondary endpoints included factors associated with recurrence and function. All studies were assessed for bias using the Newcastle-Ottawa Scale and Cochrane tool.

RESULTS: Fifteen studies involving 1611 patients (AA = 817; PA = 794) treated for ERP were included, three of which were randomized controlled trials (RCTs; 114 patients (AA = 54; PA = 60)). Duration of follow-up ranged from 12 to 82 months. Recurrence in non-randomized studies was 7.7 per cent in AA versus 20.1 per cent in PA (odds ratio (OR) 0.29, 95 per cent confidence interval (c.i.) 0.17 to 0.50; P < 0.001, I2 = 45 per cent). In RCTs, there was no significant difference (9.8 per cent versus 16.3 per cent, AA versus PA (OR 0.82, 95 per cent c.i. 0.29 to 2.37; P = 0.72, I2 = 0.0 per cent)). Age at surgery and duration of follow-up were risk factors for recurrence. Following AA, the recurrence rates were 10.1 per cent and 6.2 per cent in patients aged 65 years and older and less than 65 years of age, respectively (effect size [e.s.] 7.7, 95 per cent c.i. 4.5 to 11.5). Following PA, rates were 27 per cent and 16.3 per cent (e.s. 20.1, 95 per cent c.i. 13 to 28.2). Extending follow-up to at least 40 months increased the likelihood of recurrence. The median duration of hospital stay was 4.9 days after PA versus 7.2 days after AA. Overall, incontinence was less likely after AA (OR 0.32), but constipation occurred more frequently (OR 1.68). Most studies were retrospective, and several outcomes from RCTs were not consistent with those observed in non-RCTs.

CONCLUSION: The overall risk of recurrence of ERP appears to be higher with PA versus AA. Incontinence is less frequent after AA but at the cost of increased constipation. Age at surgery and duration of follow-up are associated with increased risk of recurrence, which warrants adequate reporting of future studies on this topic.

PMID:35390136 | DOI:10.1093/bjsopen/zrac018

Ann Work Expo Health. 2022 Apr 7;66(Supplement_1):i3-i22. doi: 10.1093/annweh/wxab107.

ABSTRACT

The GuLF Study is investigating adverse health effects from work on the response and clean-up after the Deepwater Horizon explosion and oil release. An essential and necessary component of that study was the exposure assessment. Bayesian statistical methods and over 135 000 measurements of total hydrocarbons (THC), benzene, ethylbenzene, toluene, xylene, and n-hexane (BTEX-H) were used to estimate inhalation exposures to these chemicals for >3400 exposure groups (EGs) formed from three exposure determinants: job/activity/task, location, and time period. Recognized deterministic models were used to estimate airborne exposures to particulate matter sized 2.5 µm or less (PM2.5) and dispersant aerosols and vapors. Dermal exposures were estimated for these same oil-related substances using a model modified especially for this study from a previously published model. Exposures to oil mist were assessed using professional judgment. Estimated daily THC arithmetic means (AMs) were in the low ppm range (<25 ppm), whereas BTEX-H exposures estimates were generally <1000 ppb. Potential 1-h PM2.5 air concentrations experienced by some workers may have been as high as 550 µg m-3. Dispersant aerosol air concentrations were very low (maximum predicted 1-h concentrations were generally <50 µg m-3), but vapor concentrations may have exceeded occupational exposure excursion guidelines for 2-butoxyethanol under certain circumstances. The daily AMs of dermal exposure estimates showed large contrasts among the study participants. The estimates are being used to evaluate exposure-response relationships in the GuLF Study.

PMID:35390131 | DOI:10.1093/annweh/wxab107

Am J Hypertens. 2022 Apr 7:hpac045. doi: 10.1093/ajh/hpac045. Online ahead of print.

ABSTRACT

Epidemiologic studies have consistently identified a strong, progressive relationship between blood pressure and cardiovascular disease events, in a range of systolic blood pressure (SBP) from as low as 90 mm Hg to as high as 180 mm Hg. Clinical trials have demonstrated greater prevention of cardiovascular disease with more compared to less intensive antihypertensive drug treatment. Meta-analyses of randomized controlled trials provides strong evidence for more intensive antihypertensive drug therapy down to an SBP of 130 mm Hg, and to an SBP 120-124 mm Hg in the meta-analysis with the greatest statistical power. In the Systolic Blood Pressure Intervention Trial (SPRINT) randomization to an SBP treatment goal of <120 mm Hg compared to <140 mm Hg in persons with high cardiovascular disease risk not only reduced the rate of cardiovascular disease but also all-cause mortality. These benefits were noted in all of the pre-stated subgroups of interest, including those ≥65 years of age at baseline. In addition, cognitive impairment was less common in those randomized to the intensive compared to standard treatment. Most clinical practice guidelines recommend an SBP treatment target <130 mm Hg in adults with a high risk of CVD, which is the norm for many patients seen in clinical practice, especially those who are older, have diabetes mellitus, or chronic kidney disease.

PMID:35390116 | DOI:10.1093/ajh/hpac045

PLoS One. 2022 Apr 7;17(4):e0266537. doi: 10.1371/journal.pone.0266537. eCollection 2022.

ABSTRACT

While the classical knapsack problem has been the object to be solved by optimization algorithm proposals for many years, another version of this problem, discounted {0-1} knapsack problem, is gaining a lot of attention recently. The original knapsack problem requires selecting specific items from an item set to maximize the total benefit while ensuring that the total weight does not exceed the knapsack capacity. Meanwhile, discounted {0-1} knapsack problem has more stringent requirements in which items are divided into groups, and only up to one item from a particular group can be selected. This constraint, which does not exist in the original knapsack problem, makes discounted {0-1} knapsack problem even more challenging. In this paper, we propose a new algorithm based on salp swarm algorithm in the form of four different variants to resolve the discounted {0-1} knapsack problem. In addition, we also make use of an effective data modeling mechanism and a greedy repair operator that helps overcome local optima when finding the global optimal solution. Experimental and statistical results show that our algorithm is superior to currently available algorithms in terms of solution quality, convergence, and other statistical criteria.

PMID:35390109 | DOI:10.1371/journal.pone.0266537

PLoS One. 2022 Apr 7;17(4):e0266670. doi: 10.1371/journal.pone.0266670. eCollection 2022.

ABSTRACT

BACKGROUND: The COVID-19 vaccination in Sudan launched in March 2021 but the extent of its acceptance has not been formally studied. This study aimed to determine the acceptance and hesitancy of the COVID-19 vaccine and associated factors among medical students in Sudan.

METHODS: A descriptive cross-sectional study was conducted using an online self-administered questionnaire designed on Google Form and sent to randomly-selected medical students via their Telegram accounts from 30th June to 11th July 2021. Data were analyzed using Statistical Package for Social Sciences software. Chi-square or Fisher’s exact test and logistic regression were used to assess the association between vaccine acceptance and demographic as well as non-demographic factors.

RESULTS: Out of the 281 students who received the questionnaire, 220 (78%) responded, of whom 217 consented and completed the form. Males accounted for 46. 1%. Vaccine acceptance was 55. 8% (n = 121), and vaccine hesitancy was 44. 2% (n = 96). The commonly cited reasons for accepting the vaccine were to protect themselves and others from getting COVID-19. Concerns about vaccine safety and effectiveness were the main reasons reported by those who were hesitant. Factors associated with vaccine acceptance were history of COVID-19 infection (adjusted odds ratio (aOR) = 2. 2, 95% CI 1. 0-4.7, p = 0. 040), belief that vaccines are generally safe (aOR = 2.3, 95% CI 1. 2-4.5, p = 0.020), confidence that the vaccine can end the pandemic (aOR = 7.5, 95% CI 2. 5-22. 0, p<0.001), and receiving any vaccine in the past 5 years (aOR = 2.4, 95% CI 1.1-5.4, p = 0.031). No demographic association was found with the acceptance of the vaccine.

CONCLUSIONS: This study has revealed a high level of COVID-19 vaccine hesitancy among medical students. Efforts to provide accurate information on COVID-19 vaccine safety and effectiveness are highly recommended.

PMID:35390097 | DOI:10.1371/journal.pone.0266670

PLoS One. 2022 Apr 7;17(4):e0266700. doi: 10.1371/journal.pone.0266700. eCollection 2022.

ABSTRACT

Acid mine drainage (AMD) is one of the biggest environmental challenges associated with in the mining process. Most of the current research on AMD focuses on developed deposits, whereas there is almost no research on naturally-produced AMD from undeveloped deposits. In this study, river water and AMD were collected to analyze the distribution characteristics of heavy metals and the phytoplankton community. In addition, the environmental risks of heavy metals were evaluated by single-factor pollution index, Nemerow pollution index and health risk assessment model. The results show that the pH of the Rongna River water ranged from 6.52 to 8.46, and the average concentrations of Mn and Ni were 867.37 and 28.44 μg/L, respectively, which exceed the corresponding Grade III Environmental Quality Standard of Surface Water. The results of the environmental health risk assessment show that the river section of the Rongna River was seriously polluted by the heavy metal Mn after AMD confluence, and the health risk assessment indicates that oral ingestion of Mn posed a potential non-carcinogenic risk to children and adults. A total of 35 phytoplankton species were found in the Rongna River. The phytoplankton biomass was negatively correlated with the concentration of major heavy metals, indicating that the heavy metal concentration exceeded the tolerance limit of phytoplankton, thereby affecting their normal growth. Finally, statistical analysis shows that Cu, Zn, Ni, Mn and Cd in the Rongna River were mainly derived from AMD.

PMID:35390103 | DOI:10.1371/journal.pone.0266700

PLoS One. 2022 Apr 7;17(4):e0266681. doi: 10.1371/journal.pone.0266681. eCollection 2022.

ABSTRACT

BACKGROUND: Most childhood diarrheal illnesses are a result of the faeco-oral transmission of infected food, water, and unclean fingers. The present paper was conducted to estimate the prevalence of hygienic disposal of stools (HDS) and its associated factors, and further quantify the impact of HDS on diarrheal diseases among children under two years.

METHODS: A cross-sectional design was used to evaluate three rounds of the Ghana Demographic Health Survey (GDHS) from 2003-2014 involving 4869 women with children aged under two years. The outcomes were prevalence of HDS and diarrheal diseases. Poisson regression model was employed to assess risk factors associated with HDS and dominance analysis was used to rank the important risk factors. Inverse Probability Weighting Poisson Regression Adjustment (IPWPRA) with Propensity Score 1:1 density kernel-based matching was employed to assess impact.

RESULTS: The pooled prevalence rate of HDS was 26.5%(95%CI = 24.6-28.4) and it ranged from 18.7% (95%CI = 16.4-21.2) in 2014 to 38.8%(95%CI = 35.3-42.4) in 2003. Diarrhea diseases pooled prevalence was 17.9%(95%CI = 16.4-19.5) and ranged from 13.3%(95%CI = 11.1-15.9) in 2014 to 25.4%(95%CI = 22.2-28.9) in 2003. The overall growth rate for HDS and prevalence of diarrhea diseases, decreased by 21.6% and 11.4% respectively. The most important risk factors of HDS from dominance analysis included; age of the child, wealth index, and differences in region. From pooled data wealth index, increasing age of the child, and regional disparity constituted approximately 72% of the overall impact (Weighted Standardized Dominance Statistics (WSDS) = 0.30, 0.24, and 0.19 respectively). In 2014, they constituted approximately 79% (WSDS = 0.139, 0.177 and 0.471 respectively). The average prevalence of diarrheal diseases among children of women who practiced HDS reduced over the period of the GDHS compared to those whose mothers did not practice HDS [2008 ATE(95%CI) = -0.09(-0.16-0.02), 2014 ATE(95%CI) = -0.05(-0.09-0.01) and Pooled data ATE(95%CI) = -0.05(-0.09-0.02)].

CONCLUSION: This analysis has provided empirical evidence of the impact of practicing HDS in Ghana from a national household survey. Implementation of the WASH agenda in this low-income setting requires a synergy of interventions and collaborations of actors (government, private and development partners) to improve water and sanitation facilities and to increase hygiene education to prevent the spread of diseases including diarrhea by 2025.

PMID:35390094 | DOI:10.1371/journal.pone.0266681