Category: Statistics

J Family Med Prim Care. 2024 May;13(5):2020-2025. doi: 10.4103/jfmpc.jfmpc_1796_23. Epub 2024 May 24.

ABSTRACT

AIM: Pakistan is in dire need of trained family physicians to enhance the quality of primary health care. To build capacity, there is a need to train the trainers on a large scale through a feasible and accessible program. Therefore, for the first time, a three-month online course was designed and piloted, in collaboration with national and international family medicine faculty. The aim of this study was to determine the gap between the pre-course expectations and the post-program perceptions of the participants for* a unique family medicine “Train the Trainers” course.

METHODS: A longitudinal-observational study was conducted at a private college of Karachi after approval from the Institutional Review Board. The expectations and perceptions of all (31) participants were recorded through a pre- and post-course questionnaire. Data were analyzed through descriptive and analytical statistics on SPSS-26. The responses to the open-ended questions were analyzed by content analytical approach.

RESULTS: Out of 20 quantitative items on the questionnaire, four were associated with a positive gap between the expectations and perceptions. One item showed a negative gap, while the rest did not show any significant difference. The majority of the participants expressed that they expected to see an improvement in their teaching skills because of the online course.

CONCLUSION: The online course was successful in meeting the participants’ expectations. The course delivery can be revisited to further improve its quality according to the participant’s feedback, including an opportunity to ask questions and incorporating some face-to-face sessions.

PMID:38948611 | PMC:PMC11213383 | DOI:10.4103/jfmpc.jfmpc_1796_23

J Family Med Prim Care. 2024 May;13(5):2111-2115. doi: 10.4103/jfmpc.jfmpc_1643_23. Epub 2024 May 24.

ABSTRACT

OBJECTIVE: To determine the association between vaccination status and mortality among critically ill patients admitted in a dedicated Covid hospital of Tripura who required invasive mechanical ventilation.

MATERIAL AND METHODS: This study was conducted at a dedicated Covid hospital of Tripura for a period of six months, i.e., from June 2021 to November 2021. A total of 304 patients were enrolled for this study. Baseline epidemiological, radiological data along with other information like heart rate, pulse rate, oxygen saturation (SpO₂), etc., were collected through patient record sheet in all cases during hospitalization. Statistical analysis was done by using SPSS 25 version.

RESULTS: Admission and mortality rates in hospital and advanced oxygen support like bi-level positive airway pressure (BiPAP), high-flow nasal cannula (HFNOC), and ventilator use incidences were higher in non-vaccinated patients (17.1%) in comparison to double-dose-vaccinated (0.98%) and single-dose (2.3%)-vaccinated patients.

CONCLUSION: This retrospective data analysis of Covid-19 positive patients admitted in the dedicated Covid Hospital of Tripura suggests that severe infection, need for invasive and non-invasive ventilation, and death were significantly less in the vaccinated patients as compared to the vaccine-naive one.

PMID:38948609 | PMC:PMC11213422 | DOI:10.4103/jfmpc.jfmpc_1643_23

J Family Med Prim Care. 2024 May;13(5):1688-1695. doi: 10.4103/jfmpc.jfmpc_1333_23. Epub 2024 May 24.

ABSTRACT

BACKGROUND: The elderly is defined as the person who is beyond middle age and approaching old age (60 or above), also called senior citizens. The number of older adults globally is expected to increase from 420 million in 2000 to 974 million in 2030. In 2017. The objectives of the study were to assess the existing level of knowledge regarding health promotion strategies and to determine the effectiveness of health education program on knowledge regarding health promotion among the elderly in old age home.

MATERIALS AND METHODS: The study employed one-group pretest and posttest preexperimental design without a control group. The sample size of 50 was selected using a non-probability convenient sampling technique. Baseline data were collected by a structured questionnaire, and a structured teaching program was given for 2 weeks, and after 15 days, a posttest was conducted with the same tool.

STATISTICAL ANALYSIS: Data collected were analyzed by using both descriptive and inferential statistics.

RESULTS: The knowledge score increased significantly from baseline. The mean score of the pretest was 18.38, the mean score of the posttest was 21.78, the mean improvement was 3.40, and the paired value obtained for knowledge was 17.36, which was found significant at 0.05 level (P < 0.05). There was a significant improvement in the knowledge regarding health promotion strategies in the geriatric population.

CONCLUSIONS: The result of the study concluded that health education program was effective in improving the knowledge regarding health promotion strategies in the geriatric population.

PMID:38948606 | PMC:PMC11213379 | DOI:10.4103/jfmpc.jfmpc_1333_23

J Family Med Prim Care. 2024 May;13(5):1772-1779. doi: 10.4103/jfmpc.jfmpc_1169_23. Epub 2024 May 24.

ABSTRACT

INTRODUCTION: Cardiovascular diseases (CVDs) are a cluster of disorders of blood vessels and the heart. As a form of physical activity, yoga postures, and pranayama have been shown to be beneficial in various health conditions, i.e. hypertension, prediabetes, and diabetes among high-risk subjects. This study aimed to evaluate the impact of yoga and diet on the Framingham risk score (FRS) among high-risk cardiovascular subjects.

MATERIALS AND METHODS: The experimental interventional study was conducted at “RUHS College of Medical Sciences” and Associated Group of Hospitals”, Jaipur among high-risk cardiovascular subjects. FRS was used as a measurement for the outcome of interest at baseline and six months of yoga diet intervention in the study and control groups.

RESULTS: Mean age of participants was 48.43 ± 6.4 years. Baseline values (mean ± SD) of FRS 24.59 ± 10.15 after six months of yogic lifestyle 15.1 ± 7.05. After six months of yogic lifestyle FRS scores and estimated 10-year cardiovascular risk were statistically significantly (P < 0.0001) decreased. Pearson correlation analysis results depict that FRS correlation. There was a strong positive correlation between the FRS score and total cholesterol (r = 0.787; P < 0.001) and a negative strong correlation between the FRS score and high-density lipoprotein was observed (r =-0.621; P < 0.002).

CONCLUSION: The findings of this study conclude that six months of yoga and diet lifestyle intervention significantly decreased FRS among high-risk CVD subjects compared to the control group.

PMID:38948605 | PMC:PMC11213374 | DOI:10.4103/jfmpc.jfmpc_1169_23

Food Res Int. 2024 Aug;190:114575. doi: 10.1016/j.foodres.2024.114575. Epub 2024 May 28.

ABSTRACT

Plant-based proteins offer sustainable and nutritious alternatives to animal proteins with their techno-functional attributes influencing product quality and designer food development. Due to the inherent complexities of plant proteins, proper extraction and modifications are vital for their effective utilization. This review highlights the emerging sources of plant-based proteins, and the recent statistics of the techniques employed for pretreatment, extraction, and modifications. The pretreatment, extraction and modification approach to modify plant proteins have been classified, addressed, and the recent applications of such methodologies are duly indicated. Furthermore, this study furnishes novel perspectives regarding the potential impacts of emerging technologies on the intricate dynamics of plant proteins. A thorough review of 100 articles (2018-2024) shows the researchers’ keen interest in investigating novel plant proteins and how they can be used; seeds being the main source for protein extraction, followed by legumes. Use of by-products as a protein source is increasing rapidly, which is noteworthy. Protein studies still lack knowledge on protein fraction, antinutrients, and pretreatments. The use of physical methods and their combination with other techniques are increasing for effective and environmentally friendly extraction and modification of plant proteins. Several studies explore the effect of protein changes on their function and nutrition, especially with a goal of replacing ingredients with plant proteins that have improved or enhanced qualities. However, the next step is to investigate the sophisticated modification methods for deeper insights into food safety and toxicity.

PMID:38945599 | DOI:10.1016/j.foodres.2024.114575

Bone Joint J. 2024 Jul 1;106-B(7):646-655. doi: 10.1302/0301-620X.106B7.BJJ-2023-1113.R1.

ABSTRACT

AIMS: Proximal humeral fractures are the third most common fracture among the elderly. Complications associated with fixation include screw perforation, varus collapse, and avascular necrosis of the humeral head. To address these challenges, various augmentation techniques to increase medial column support have been developed. There are currently no recent studies that definitively establish the superiority of augmented fixation over non-augmented implants in the surgical treatment of proximal humeral fractures. The aim of this systematic review and meta-analysis was to compare the outcomes of patients who underwent locking-plate fixation with cement augmentation or bone-graft augmentation versus those who underwent locking-plate fixation without augmentation for proximal humeral fractures.

METHODS: The search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Articles involving patients with complex proximal humeral fractures treated using open reduction with locking-plate fixation, with or without augmentation, were considered. A meta-analysis of comparative studies comparing locking-plate fixation with cement augmentation or with bone-graft augmentation versus locking-plate fixation without augmentation was performed.

RESULTS: A total of 19 studies were included in the qualitative synthesis, and six comparative studies were included in the meta-analysis. Overall, 120 patients received locking-plate fixation with bone-graft augmentation, 179 patients received locking-plate fixation with cement augmentation, and 336 patients received locking-plate fixation without augmentation. No statistically relevant differences between the augmented and non-augmented cohorts were found in terms of the Disabilities of the Arm, Shoulder and Hand questionnaire score and Constant-Murley Score. The cement-augmented group had a significantly lower rate of complications compared to the non-augmented group.

CONCLUSION: While locking-plate fixation with cement augmentation appears to produce a lower complication rate compared to locking-plate fixation alone, functional outcomes seem comparable between augmented and non-augmented techniques.

PMID:38945543 | DOI:10.1302/0301-620X.106B7.BJJ-2023-1113.R1

J Dermatolog Treat. 2024 Dec;35(1):2367615. doi: 10.1080/09546634.2024.2367615. Epub 2024 Jun 30.

ABSTRACT

Purpose: Prurigo nodularis (PN) is a skin disease characterized by intensely itchy skin nodules and is associated with a significant healthcare resource utilization (HCRU). This study aimed to estimate the HCRU of patients in England with PN overall and moderate-to-severe PN (MSPN) in particular.

Methods: This retrospective cohort study used data from the Clinical Practice Research Datalink and Hospital Episode Statistics in England. Patients with Mild PN (MiPN) were matched to patients with MSPN by age and gender for the primary analysis. Patients were enrolled in the study between 1st April 2007 and 1st March 2019. All-cause HCRU was calculated, including primary and secondary care contacts and costs (cost-year 2022).

Results: Of 23,522 identified patients, 8,933 met the inclusion criteria, with a primary matched cohort of 2,479 PN patients. During follow up, the matched cohort’s primary care visits were 21.27 per patient year (PPY) for MSPN group and 11.35 PPY for MiPN group. Any outpatient visits were 10.72 PPY and 4.87 PPY in MSPN and MiPN groups, respectively. Outpatient dermatology visits were 1.96 PPY and 1.14 PPY in MSPN and MiPN groups, respectively.

Conclusion: PN, especially MSPN, has a high HCRU burden in England, highlighting the need for new and improved disease management treatments.

PMID:38945539 | DOI:10.1080/09546634.2024.2367615

Bone Joint J. 2024 Jul 1;106-B(7):680-687. doi: 10.1302/0301-620X.106B7.BJJ-2023-0943.R2.

ABSTRACT

AIMS: Robotic arm-assisted surgery offers accurate and reproducible guidance in component positioning and assessment of soft-tissue tensioning during knee arthroplasty, but the feasibility and early outcomes when using this technology for revision surgery remain unknown. The objective of this study was to compare the outcomes of robotic arm-assisted revision of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) versus primary robotic arm-assisted TKA at short-term follow-up.

METHODS: This prospective study included 16 patients undergoing robotic arm-assisted revision of UKA to TKA versus 35 matched patients receiving robotic arm-assisted primary TKA. In all study patients, the following data were recorded: operating time, polyethylene liner size, change in haemoglobin concentration (g/dl), length of inpatient stay, postoperative complications, and hip-knee-ankle (HKA) alignment. All procedures were performed using the principles of functional alignment. At most recent follow-up, range of motion (ROM), Forgotten Joint Score (FJS), and Oxford Knee Score (OKS) were collected. Mean follow-up time was 21 months (6 to 36).

RESULTS: There were no differences between the two treatment groups with regard to mean change in haemoglobin concentration (p = 0.477), length of stay (LOS, p = 0.172), mean polyethylene thickness (p = 0.065), or postoperative complication rates (p = 0.295). At the most recent follow-up, the primary robotic arm-assisted TKA group had a statistically significantly improved OKS compared with the revision UKA to TKA group (44.6 (SD 2.7) vs 42.3 (SD 2.5); p = 0.004) but there was no difference in the overall ROM (p = 0.056) or FJS between the two treatment groups (86.1 (SD 9.6) vs 84.1 (4.9); p = 0.439).

CONCLUSION: Robotic arm-assisted revision of UKA to TKA was associated with comparable intraoperative blood loss, early postoperative rehabilitation, functional outcomes, and complications to primary robotic TKA at short-term follow-up. Robotic arm-assisted surgery offers a safe and reproducible technique for revising failed UKA to TKA.

PMID:38945538 | DOI:10.1302/0301-620X.106B7.BJJ-2023-0943.R2

Bone Joint J. 2024 Jul 1;106-B(7):720-727. doi: 10.1302/0301-620X.106B7.BJJ-2023-0778.R2.

ABSTRACT

AIMS: This study aimed to investigate the clinical characteristics and outcomes associated with culture-negative limb osteomyelitis patients.

METHODS: A total of 1,047 limb osteomyelitis patients aged 18 years or older who underwent debridement and intraoperative culture at our clinic centre from 1 January 2011 to 31 December 2020 were included. Patient characteristics, infection eradication, and complications were analyzed between culture-negative and culture-positive cohorts.

RESULTS: Of these patients, 264 (25.2%) had negative cultures. Patients with a culture-negative compared with a culture-positive status were more likely to have the following characteristics: younger age (≤ 40 years) (113/264 (42.8%) vs 257/783 (32.8%); p = 0.004), a haematogenous aetiology (75/264 (28.4%) vs 150/783 (19.2%); p = 0.002), Cierny-Mader host A (79/264 (29.9%) vs 142/783 (18.1%); p < 0.001), antibiotic use before sampling (34/264 (12.9%) vs 41/783 (5.2%); p＜0.001), fewer taken samples (n＜3) (48/264 (18.2%) vs 60/783 (7.7%); p＜0.001), and less frequent presentation with a sinus (156/264 (59.1%) vs 665/783 (84.9%); p < 0.001). After initial treatments of first-debridement and antimicrobial, infection eradication was inferior in culture-positive osteomyelitis patients, with a 2.24-fold increase (odds ratio 2.24 (95% confidence interval 1.42 to 3.52)) in the redebridement rate following multivariate analysis. No statistically significant differences were found in long-term recurrence and complications within the two-year follow-up.

CONCLUSION: We identified several factors being associated with the culture-negative result in osteomyelitis patients. In addition, the data also indicate that culture negativity is a positive prognostic factor in early infection eradication. These results constitute the basis of optimizing clinical management and patient consultations.

PMID:38945537 | DOI:10.1302/0301-620X.106B7.BJJ-2023-0778.R2

Bone Joint J. 2024 Jul 1;106-B(7):728-734. doi: 10.1302/0301-620X.106B7.BJJ-2023-0756.R2.

ABSTRACT

AIMS: Paediatric fractures are highly prevalent and are most often treated with plaster. The application and removal of plaster is often an anxiety-inducing experience for children. Decreasing the anxiety level may improve the patients’ satisfaction and the quality of healthcare. Virtual reality (VR) has proven to effectively distract children and reduce their anxiety in other clinical settings, and it seems to have a similar effect during plaster treatment. This study aims to further investigate the effect of VR on the anxiety level of children with fractures who undergo plaster removal or replacement in the plaster room.

METHODS: A randomized controlled trial was conducted. A total of 255 patients were included, aged five to 17 years, who needed plaster treatment for a fracture of the upper or lower limb. Randomization was stratified for age (five to 11 and 12 to 17 years). The intervention group was distracted with VR goggles and headphones during the plaster treatment, whereas the control group received standard care. As the primary outcome, the post-procedural level of anxiety was measured with the Child Fear Scale (CFS). Secondary outcomes included the children’s anxiety reduction (difference between CFS after and CFS before plaster procedure), numerical rating scale (NRS) pain, NRS satisfaction of the children and accompanying parents/guardians, and the children’s heart rates during the procedure. An independent-samples t-test and Mann-Whitney U test (depending on the data distribution) were used to analyze the data.

RESULTS: The post-procedural CFS was significantly lower (p < 0.001) in the intervention group (proportion of children with no anxiety = 78.6%) than in the control group (56.8%). The anxiety reduction, NRS pain and satisfaction scores, and heart rates showed no significant differences between the control group and the intervention group. Subanalyses showed an increased effect of VR on anxiety levels in young patients, females, upper limb fractures, and those who had had previous plaster treatment.

CONCLUSION: VR effectively reduces the anxiety levels of children in the plaster room, especially in young girls. No statistically significant effects were seen regarding pain, heart rate, or satisfaction scores.

PMID:38945536 | DOI:10.1302/0301-620X.106B7.BJJ-2023-0756.R2