Category: Statistics

Afr J Reprod Health. 2024 May 31;28(5):39-46. doi: 10.29063/ajrh2024/v28i5.5.

ABSTRACT

The incidence of new cases of thyroid cancer worldwide is around 10.1/100.000 in woman dan 3.1/100.000 in men. Women with thyroid cancer are advised to avoid pregnancy while undergoing radioablation due to teratogenicity. Therefore, it is crucial to utilize contraception to avoid pregnancy during treatment. The purpose of this study was to determine the characteristics of contraceptive use patterns in women with thyroid cancer of reproductive age who underwent radioablation at Hasan Sadikin Hospital Bandung.Cross-sectional study conducted at Hasan Sadikin Hospital Bandung in May 2023. The research sample was all female thyroid cancer of reproductive age who underwent radioablation at the Nuclear Medicine polyclinic of Dr. Hasan Sadikin Bandung in January-December 2022 by purposive sampling. Data obtained from patient medical records and primary data from patients. A total of 450 patients fulfilled inclusion criteria, but only 329 analyzed with complete data. Majority of the patient was in age group 35-49 years (58.1%), parity >1 (55.9%), last education high school (39.2%), married (81.8%), type of papillary thyroid carcinoma (79.9%), sources of information about contraception from doctors (71.7%), and 75.4% use contraception. The most widely used type of contraception was intrauterine device (IUD), accounting for 28.6% patients. Approximately 75.4% patient use contraception. The most widely used type of contraception is the IUD. Contraception counselling is important for increasing contraceptive use rates among women with thyroid cancer. Further research in the form of analytical research is needed to assess the factors that influence contraceptive use in women with thyroid cancer of reproductive age.

PMID:38916057 | DOI:10.29063/ajrh2024/v28i5.5

Hosp Pediatr. 2024 Jun 25:e2023007125. doi: 10.1542/hpeds.2023-007125. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Current research implies overuse of diagnostic testing and overtreatment in children with tracheostomies. There are no guidelines for obtaining sputum cultures for these patients, yet they are commonly obtained without significantly affecting management or outcomes. The aim of our quality improvement project was to decrease rate of sputum cultures in this population by 50%, from 64% to 32%.

METHODS: This was a single-center quality improvement project conducted in a pediatric emergency department (ED). Key drivers included: Standardized decision-making, appropriate culture collection, knowledge regarding colonization versus clinically relevant growth, and viral versus bacterial infections in this population. The study team developed an algorithm, used modification to electronic medical records orders, and provided education to drive change. Six months of preintervention and 12 months postintervention data were collected. Run charts/statistical process charts were created for the rate of cultures, length of stay, and return to the ED.

RESULTS: There were 159 patient encounters and the rate of sputum cultures decreased from 64% at baseline to 25% without change in length of stay or increased rate at which patients returned to the ED, including during local coronavirus disease 2019 and respiratory syncytial virus surges. We observed nonrandom data patterns after introduction of algorithm resulting in centerline shifts.

CONCLUSIONS: The study team was able to introduce an algorithm coinciding with a reduction in number of sputum cultures obtained. Next steps would be determining safety and efficacy of such an algorithm over a larger population.

PMID:38916049 | DOI:10.1542/hpeds.2023-007125

Mol Biol Evol. 2024 Jun 25:msae131. doi: 10.1093/molbev/msae131. Online ahead of print.

ABSTRACT

Phylogenomic analyses of long sequences, consisting of many genes and genomic segments, infer organismal relationships with high statistical confidence. But, these relationships can be sensitive to excluding just a few sequences. Currently, there is no direct way to identify fragile relationships and the associated individual gene sequences in species. Here, we introduce novel metrics for gene-species sequence concordance and clade probability derived from evolutionary sparse learning models. We validated these metrics using fungi, plant, and animal phylogenomic datasets, highlighting the ability of the new metrics to pinpoint fragile clades and the sequences responsible. The new approach does not necessitate the investigation of alternative phylogenetic hypotheses, substitution models, or repeated data subset analyses. Our methodology offers a streamlined approach to evaluating major inferred clades and identifying sequences that may distort reconstructed phylogenies using large datasets.

PMID:38916040 | DOI:10.1093/molbev/msae131

Cureus. 2024 May 22;16(5):e60826. doi: 10.7759/cureus.60826. eCollection 2024 May.

ABSTRACT

Background Chronic liver disease (CLD) is associated with a variety of consequences, including thrombocytopenia and esophageal varices, which significantly impact patient prognosis and management. Thrombocytopenia, frequently observed in patients with CLD, may correlate with the severity of esophageal varices, a critical complication leading to variceal bleeding. Methodology A cross-sectional study was carried out in the Department of Medicine and Gastroenterology, Pak Emirates Military Hospital, Rawalpindi, from October 2021 to March 2022. The study enrolled 94 patients, aged 18-70 years, diagnosed with CLD, regardless of the cause. These patients were categorized into four groups based on platelet count: <50,000/uL, 50,000-99,999/uL, 100,000-150,000/uL, and >150,000/uL. Pearson’s correlation was utilized to evaluate the association between the severity of thrombocytopenia and the grading of esophageal varices. Results A total of 94 patients were enrolled in the study, with 53 (56.4%) males and 41 (43.6%) females. The mean age of patients was 51.06 ±11.09 years. Seventeen (18.1%) had no esophageal varices, 16 (17.0%) were diagnosed with Grade I varices, 35 (37.2%) with Grade II varices, and 26 (27.7%) had Grade III varices. Most patients without varices had a platelet count above 150 x 10³ (17, 18.1%). Conversely, most patients with Grade III varices (19, 20.2%) had platelet counts below 50 x 10³. Patients with no esophageal varices had a mean platelet count of 173.70 ± 37.48 x 10³. Among the patients, those with Grade III esophageal varices exhibited the lowest mean platelet count, recorded at 78.54 ± 24.14 x 10³. These findings indicate a statistically significant difference in mean platelet counts across the various esophageal varices grades (P = 0.000). There was an inverse correlation of platelet count with the grading of esophageal varices (r = -0.645, P < 0.000). Conclusions A negative correlation was observed between the platelet count and the grading of esophageal varices, implying that as the severity of esophageal varices increased, the platelet counts proportionally decreased.

PMID:38916026 | PMC:PMC11195516 | DOI:10.7759/cureus.60826

Cureus. 2024 May 25;16(5):e61033. doi: 10.7759/cureus.61033. eCollection 2024 May.

ABSTRACT

Background and objective Procrastination, which refers to the act of unnecessarily delaying the beginning or completion of an assigned task, is a widespread but often neglected problem among college students. Postponing a task can impair academic performance or lead to stress and poor mental well-being. A knowledge gap exists in understanding the cyclical nature of the relationship between anxiety and procrastination, wherein anxiety leads to procrastination, which in turn exacerbates anxiety. In light of this, we aimed to assess the level of procrastination and anxiety among college students and to correlate the relationship between their procrastination and anxiety status. Methodology A cross-sectional analytical study was conducted among 347 graduate students from various disciplines at a tertiary care hospital in Puducherry, India. A convenient sampling technique was employed to recruit the participants, and data were collected using the validated Procrastination Assessment Scale for Students (PASS) and the Hamilton Anxiety Rating Scale (HAM-A). Results Our findings showed that about 124 (35.7%) participants reported weekly reading assignments as the most frequently procrastinated task, with a mean score of 3.15 ± 1.02, followed by studying for exams and writing term papers. The most commonly reported reason for procrastination was evaluation anxiety, followed by low self-esteem and perfectionism. A significant number of students (157, 45.2%) had mild anxiety, and 58 (16.7%) students were found to have severe anxiety. A Spearman correlation coefficient of 0.26 (95% CI: 0.16 – 0.36) was observed between the overall procrastination score and HAM-A score, which indicated a weak positive correlation and was statistically significant (p<0.05). Similarly, a weak positive correlation was found between task aversiveness, fear of failure, and anxiety levels. Conclusions Procrastination is positively related to anxiety but the relationship is weak. Understanding and addressing the underlying anxiety or stress can be a key to managing procrastination among college students.

PMID:38916017 | PMC:PMC11194534 | DOI:10.7759/cureus.61033

Cureus. 2024 May 25;16(5):e61041. doi: 10.7759/cureus.61041. eCollection 2024 May.

ABSTRACT

OBJECTIVE: To compare the bond strength of two types of resin cement to that of additive manufacturing (AM) or cast cobalt-chromium (Co-Cr) alloys.

MATERIALS AND METHODS: Two types of resin luting cement, composite resin and methyl methacrylate (MMA), were bonded to AM or cast Co-Cr alloys, and shear bond tests were performed after seven days of storage in distilled water at 37°C. Co-Cr alloy adhesive elements AM to the enamel surface of the labial aspect of a bovine mandibular central incisor crown were bonded with two types of resin luting cement and subjected to 1,000 cycles of storage in water for one day and 28 days or thermal cycling, followed by shear bonding tests. Residual cement on the metal and enamel surfaces after the bonding tests was evaluated using an optical microscope. The normality of the results was evaluated using statistical software Statcel4, analysis of variance, or Kruskal-Wallis test, depending on normality, and multiple comparison tests were performed using the Tukey-Kramer or Steel-Dwass tests.

RESULTS: After one day, the shear bond strength (SBS) was 25.9 MPa for Panavia V5 (PV; Kuraray Noritake Dental Corporation, Niigata, Japan) and 23.5 MPa for Super-Bond (SB; Sun Medical Corporation, Shiga, Japan), with no significant difference between the two cement types (P > 0.05). After 28 days, the SBS decreased to 4.1 MPa for PV and 6.7 MPa for SB, showing a significant difference between the two cements (P < 0.05). Following 1,000 thermal cycles, the SBS was 2.0 MPa for PV and 5.6 MPa for SB, with SB exhibiting a significantly higher value (P < 0.05). The adhesive strength was significantly lower after 28 days of storage and thermal cycling compared to after one day of storage (P < 0.05). The Co-Cr alloy exhibited more residual cement on the enamel surface due to interfacial fracture with the resin cement. The Co-Cr alloy showed more residual cement on the enamel surface due to interfacial fracture with the resin cement.

CONCLUSION: MMA-based resin cement showed optimal bond strength and may be suitable for clinical use in computer-aided design (CAD)/computer-aided manufacturing (CAM) orthodontic appliances.

PMID:38916016 | PMC:PMC11194759 | DOI:10.7759/cureus.61041

Cureus. 2024 May 25;16(5):e61040. doi: 10.7759/cureus.61040. eCollection 2024 May.

ABSTRACT

Background Knee osteoarthritis (KOA) is the most typical cause of knee pain and impairment worldwide. It is typified by slow and progressive degeneration of the articular cartilage of the knee joint. Although KOA is being managed with a variety of therapies, the comparison of the effectiveness of different intra-articular injections in KOA treatment in Pakistan is still not thoroughly investigated. Therefore, the purpose of this current study is to compare the efficacy of intra-articular administration of platelet-rich plasma (PRP) and corticosteroids (CSs) in the treatment of KOA. Methods This prospective comparative study was performed among one hundred patients diagnosed with KOA in Benazir Bhutto Hospital, Rawalpindi, for one year from April 2022 to March 2023. Specified inclusion and exclusion criteria were employed for patient enrollment. Patients were divided into two equal groups through simple random sampling. Group A patients received an intra-articular injection of PRP solution whereas group B patients received an intra-articular injection of CSs. Informed consent and ethical approval were also acquired prior to data collection. A self-designed proforma based on interviews was used to collect data. The data analysis in Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 25.0, Armonk, NY) was carried out via descriptive statistics and an independent t-test. Results Women (N=71, 71%) had a higher prevalence of KOA than men (N=29, 29%). The means of study variables like age, Visual Analog Scale (VAS) score, and Western Ontario and McMaster Universities (WOMAC) score were 56.10 ± 8.70 years, 8.08 ± 1.6, and 70.08 ± 8.76 respectively. The frequency of KOA on the right side was 62% (N=62) while it was 38% (N=38) on the left side. In the study population, 69% (N=69) patients had grade II KOA, and 31% (N=31) patients had grade III KOA. At the first-month, second-month, and third-month follow-up visits, there were statistically significant differences in the mean scores of the WOMAC and VAS between the study groups. However, at the first-month follow-up visit, mean scores of VAS and WOMAC were lower in group B than in group A while these were lower in group A as compared to group B, at the second-month and third-month follow-up appointments. Conclusions Intra-articular infiltration of both PRP and CSs was efficacious in the treatment of KOA-related pain and functional limitations; however, overall improvement in the PRP group was higher than CS group.

PMID:38916012 | PMC:PMC11194758 | DOI:10.7759/cureus.61040

Cureus. 2024 May 22;16(5):e60873. doi: 10.7759/cureus.60873. eCollection 2024 May.

ABSTRACT

Background Thyroidectomy is a routinely performed surgical procedure used to treat benign, malignant, and some hormonal disorders of the thyroid that are not responsive to medical therapy. Voice alterations following thyroid surgery are well-documented and often attributed to recurrent laryngeal nerve dysfunction. However, subtle changes in voice quality can persist despite anatomically intact laryngeal nerves. This study aimed to quantify post-thyroidectomy voice changes in patients with intact laryngeal nerves, focusing on fundamental frequency, first formant frequency, shimmer intensity, and maximum phonation duration. Methodology This cross-sectional study was conducted at a tertiary referral center in central India and focused on post-thyroidectomy patients with normal vocal cord function. Preoperative assessments included laryngeal endoscopy and voice recording using a computer program, with evaluations repeated at one and three months post-surgery. Patients with normal laryngeal endoscopic findings underwent voice analysis and provided feedback on subjective voice changes. The PRAAT version 6.2 software was utilized for voice analysis. Results The study included 41 patients with normal laryngoscopic findings after thyroid surgery, with the majority being female (85.4%) and the average age being 42.4 years. Hemithyroidectomy was performed in 41.4% of patients and total thyroidectomy in 58.6%, with eight patients undergoing central compartment neck dissection. Except for one patient, the majority reported no subjective change in voice following surgery. Objective voice analysis showed statistically significant changes in the one-month postoperative period compared to preoperative values, including a 5.87% decrease in fundamental frequency, a 1.37% decrease in shimmer intensity, and a 6.24% decrease in first formant frequency, along with a 4.35% decrease in maximum phonatory duration. These trends persisted at the three-month postoperative period, although values approached close to preoperative levels. Results revealed statistically significant alterations in voice parameters, particularly fundamental frequency and first formant frequency, with greater values observed in total thyroidectomy patients. Shimmer intensity also exhibited slight changes. Comparison between hemithyroidectomy and total thyroidectomy groups revealed no significant differences in fundamental frequency, first formant frequency, and shimmer. However, maximum phonation duration showed a significantly greater change in the hemithyroidectomy group at both one-month and three-month postoperative intervals. Conclusions This study on post-thyroidectomy patients with normal vocal cord movement revealed significant changes in voice parameters postoperatively, with most patients reporting no subjective voice changes. The findings highlight the importance of objective voice analysis in assessing post-thyroidectomy voice outcomes.

PMID:38916010 | PMC:PMC11195517 | DOI:10.7759/cureus.60873

Cureus. 2024 May 23;16(5):e60957. doi: 10.7759/cureus.60957. eCollection 2024 May.

ABSTRACT

Background and aim The majority of acne has the potential to transform into facial scars, which have a physical and psychological effect on the individual. There are plenty of treatment options to manage such scars. The aim of this study is to assess the comparative effect of the injection of platelet-rich plasma (PRP) alone, with that of the injection of PRP with microneedling, in the reduction of atrophic facial acne scars. Methods A total of 30 participants were included in this study, divided into two groups (n = 15). Patients in Group I received intradermal injection of PRP only, and Group II included patients receiving intradermal injection of PRP with microneedling. The scar appearance was evaluated at baseline, after one, two, and three months using Goodman Baron’s scar scale. The statistics were analysed using the Chi-square and Student’s t-tests. Results Patients in the PRP with microneedling group had lower acne scar scores on the Goodman Baron scale compared to those who received only PRP. The acne scores were statistically significant (p-value < 0.05) in the second and third months of treatment in Group II. Conclusion The addition of microneedling to PRP has proven to be effective in the reduction of facial acne scars. However, different types of scars require different modalities of treatment, and the final decision lies in the hands of the operator and the requirements of the patients.

PMID:38916005 | PMC:PMC11194131 | DOI:10.7759/cureus.60957

Cureus. 2024 May 24;16(5):e61028. doi: 10.7759/cureus.61028. eCollection 2024 May.

ABSTRACT

INTRODUCTION: The burden of chronic liver disease (CLD) is increasing globally and the ultimate treatment is a liver transplant. As Pakistan is a developing country, liver transplantation is not easily available due to limited resources. This study aims to assess the patients with CLD for liver transplantation and to find the frequency of eligible candidates for liver transplantation.

METHODS: A cross-sectional observational study was conducted on patients with CLD from June 2022 to December 2022. Total bilirubin, serum creatinine complete blood count, serum electrolytes, and international normalised ratio (INR) were done. The Model for End-Stage Liver Disease (MELD) score was calculated and the frequency of eligible patients for liver transplant was determined. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY, USA).

RESULTS: In our study, 149 patients were enrolled with a mean age of 46.81±15.7 years. There were 58.7% male and 41.6% female patients. The mean duration of liver cirrhosis was 18.22±11.7 months. The mean MELD score was 20.71±5.2. The common liver cirrhosis stages were stage II and stage II was found in 32.2% of each. Hepatocellular carcinoma (HCC) was present in 15.4% of patients. There were 25.5% of patients eligible for liver transplants.

CONCLUSION: In our study, we found that significant numbers of patients with CLD were eligible for liver transplantation.

PMID:38916000 | PMC:PMC11194463 | DOI:10.7759/cureus.61028