Category: Statistics

Niger J Clin Pract. 2024 Apr 1;27(4):489-495. doi: 10.4103/njcp.njcp_767_23. Epub 2024 Apr 29.

ABSTRACT

BACKGROUND: The preoperative prediction of intraperitoneal adhesion (IPA) before repeated cesarean deliveries (CD), which are becoming more prevalent, is crucial for maternal health.

AIM: The aim of the study was to preoperatively predict IPA in repeated CD with the stria gravidarum (SG) scoring system.

METHODS: A total of 167 patients with at least one previous CD at or beyond 37 weeks of gestation were analyzed. Preoperative SG was calculated according to the Davey scoring system: 0-2 score were defined as mild SG (Group 1; n: 94, 56.2%), and 3-8 score were defined as severe SG (Group 2; n = 73, 43.8%). Preoperative previous cesarean incision features were evaluated according to the Vancouver scar scale. IPA was evaluated according to the Nair’s and modified Nair’s scoring systems.

RESULTS: Parity, younger age at first pregnancy, higher body mass index, number of previous CDs, rate of scar symptoms, Nair’s and the modified Nair’s scores were statistically significant in Group 2 (P = 0.01; P = 0.04; P = 0.007; P = 0.004; P < 0.001; P = 0.007; P = 0.02, respectively). Davey score ≥3 and Vancouver score ≥4.5 were determined as the cut-off value to predict IPA (P = 0.1 and 0.07, respectively). According to multivariate analysis, both Davey and Vancouver scores are independent factors in predicting IPA (P = 0.02 and 0.04, respectively).

CONCLUSION: Evaluating the SG score through the Davey score in women with a history of previous CD may assist in predicting IPA status before the planning of a subsequent surgery.

PMID:38679772 | DOI:10.4103/njcp.njcp_767_23

Niger J Clin Pract. 2024 Apr 1;27(4):483-488. doi: 10.4103/njcp.njcp_706_23. Epub 2024 Apr 29.

ABSTRACT

BACKGROUND: The cuff is a complex structure with many factors affecting it. How much it is affected after repair is still being investigated.

AIM: The aim of this study was to analyze the functional results of individuals who received arthroscopic rotator cuff repair and assess the various factors that could impact these outcomes.

METHODS: The study included 57 patients with a mean age of 58.8 years (range: 39-71) who underwent arthroscopic rotator cuff repair between 2013 and 2020, with a minimum of 6 months after the operation. Functional and clinical outcomes of the patients were evaluated using preoperative and postoperative scores (QDASH, ASES, and VAS). The study also analyzed how demographic factors, type and duration of the tear, comorbidities such as diabetes mellitus (DM) and hypertension (HT), and other pathologies may have affected the patients’ scores.

RESULTS: The effect of the operation on the scores in rotator cuff tears was highly significant (P < 0.05). Age, gender, tear size, fatty degeneration, anchor configuration, comorbidities, and additional procedures presented variable values on postoperative scores, but were not statistically significant. The effect of DM and HT on VAS scores was statistically significant (P < 0.05).

CONCLUSION: The results of rotator cuff repair appear to be influenced by several factors, including the sex of the patient, type and duration of tear, comorbidities, and surgical procedures used. Although these factors had an effect on the scores, they were not statistically significant.

PMID:38679771 | DOI:10.4103/njcp.njcp_706_23

Niger J Clin Pract. 2024 Apr 1;27(4):467-474. doi: 10.4103/njcp.njcp_702_23. Epub 2024 Apr 29.

ABSTRACT

BACKGROUND: Tobacco smoking statistics are alarming and the oral mucosa is the first human part of the body that is exposed to the toxic substances of smoking.

AIMS: Considering the high prevalence rate of tobacco-associated problems in the oral cavity and few studies on the Iranian population regarding the effects of smoking on the oral cavity, this study aimed to evaluate the relationship between smoking and oral lesions in the Iranian population.

MATERIALS AND METHODS: Observational study. In this observational study, the oral cavities of 200 participants (smokers = 100 and non-smokers = 100) were examined by a trained dental student under the supervision of an oral and maxillofacial medicine expert, and the presence of coated tongue, leukoedema, leukoplakia, smoker’s palate, smoker’s melanosis, erythroplakia, frictional hyperkeratosis, acute pseudomembranous candidiasis, and erythematous candidiasis were recorded. Xerostomia was evaluated based on participants’ self-reporting through a questionnaire. All data were analyzed using T-test, Chi-square test, odd ratio, 95% confidence interval, Fisher’s exact test, and Spearman’s rank correlation coefficient.

RESULTS: The results of this study showed smoking is significantly associated with an increased risk of coated tongue (OR: 1.80, 95% CI: 1.32-3.54, P = 0.005), smoker’s melanosis (OR: 6.176, 95% CI: 3.28-11.62, P = 0.00002), and frictional hyperkeratosis (OR: 1.33, 95% CI: 0.68-2.60, P = 0.005). However, no significant association was observed between smoking and leukoedema (OR: 1, 95% CI: 0.51-1.94, P = 1). None of the participants presented smoker’s palate, erythroplakia, and candidiasis.

CONCLUSIONS: This study’s results showed that smokers exhibited a greater chance of developing oral lesions compared to non-smokers.

PMID:38679769 | DOI:10.4103/njcp.njcp_702_23

Niger J Clin Pract. 2024 Apr 1;27(4):460-466. doi: 10.4103/njcp.njcp_696_23. Epub 2024 Apr 29.

ABSTRACT

BACKGROUND: Ultrasound scan (USS) in pregnancy has become a common diagnostic tool used in the assessment of pregnancy in recent time. In the course of routine pregnancy assessment using USS, some pregnant women will request to know the sex of their unborn babies. Their reasons for wanting to know the gender of their baby could be either for social reason like planning for an unborn child or their desire for a preferred gender.

AIM: The aim of the study was to evaluate gender preferences and disclosure of foetal sex at prenatal USS.

METHODS: This was a cross-sectional study conducted at the antenatal clinic of Central Hospital Agbor, Delta State, Nigeria. A total of 235 consecutive consenting women who came for antenatal care (ANC) registration were recruited for the study after obtaining their informed written consent. Questionnaire was used to seek for their sociodemographic characteristics, preference and desires for foetal gender disclosure, reasons for gender disclosure, and awareness of USS accuracy for gender determination.

RESULTS: The desire to know the sex of baby was high (99.6%). The major reason for wanting to know the sex of baby was to plan for the unborn child (47.7%) and maternal curiosity (37.0%). Majority of the women (57.4%) had no gender preference. Sixty percent (60%) were not aware that USS sex diagnosis could be wrong.

CONCLUSION: There is a strong desire by pregnant women to know the sex of their babies at routine USS. Considering the fact that many of the women were not aware that there could be wrong diagnosis at prenatal ultrasound, it is suggested that adequate counselling be given before fetal sex disclosure.

PMID:38679768 | DOI:10.4103/njcp.njcp_696_23

Niger J Clin Pract. 2024 Apr 1;27(4):455-459. doi: 10.4103/njcp.njcp_622_23. Epub 2024 Apr 29.

ABSTRACT

BACKGROUND: Traditional medicine is a constellation of practices, approaches, knowledge, and beliefs, which encompass material-based medicines, spiritual therapies, and manual techniques applied individually or combined.

AIM: This study seeks to determine the cost and visual status of traditional eye treatments users among new patients at a health facility.

MATERIALS AND METHODS: This is part of the study titled “Traditional eye practices: A facility-based study in North Central Nigeria.” It is a cross-sectional, facility-based study conducted between July 2013 and June 2014 on new patients seen in the eye unit of Church of Christ in the Nations Rehabilitation Center, Mangu. Interviewer-administered structured questionnaire was used to gather information on patient demographics; cost of traditional eye medication and manipulations and visual status of new patients were recorded.

RESULTS: The use of traditional eye treatment was reported by 134 (4.3%) of the 3113 new patients. Traditional operative couching of lens was more expensive than using traditional eye medications (P < 0.001). Payment modality varied, and poor visual status was significantly higher among traditional eye treatment users (P < 0.001).

CONCLUSION: Since most respondents who had their eyes couched or used traditional eye medicine were able to pay such high price with dissatisfaction and poorer visual status, they should be able to pay for modern cataract surgery with good outcome. There is a need for health education of the general public about the deleterious effects of traditional eye treatment.

PMID:38679767 | DOI:10.4103/njcp.njcp_622_23

Niger J Clin Pract. 2024 Apr 1;27(4):448-454. doi: 10.4103/njcp.njcp_559_23. Epub 2024 Apr 29.

ABSTRACT

BACKGROUND: Root coverage procedures are very technique sensitive and require patients’ compliance for successful treatment outcomes. Post operative complications can influence patients’ acceptance of treatment and compromise further periodontal maintenance.

AIM: The aim of this study was to evaluate the frequency and severity of complications after a modified coronally advanced flap procedure.

METHODS AND MATERIALS: A total of 78 modified coronally advanced flap procedures were performed in 42 patients for root coverage. Duration of surgical procedure, history of smoking, gender, and age were recorded for each patient. A questionnaire was given to every patient to fill in at first post operative week regarding their experience of postoperative pain, swelling, and bleeding.

RESULTS: Pain and duration of surgery had a correlation (OR: 1.05, P < 0.05). Post operative bleeding was significantly correlated with duration of surgery (OR: 1.03, P < 0.05). Current smokers experienced post operative swelling (P < 0.05). However, post operative pain in current smokers was not significantly different (P > 0.05) as compared to nonsmokers. Descriptive statistics were expressed as mean and standard deviations. Odd’s ratio was obtained to evaluate risk indicators for moderate to severe types of complications. P < 0.05 was considered as significant.

CONCLUSIONS: The duration of the surgery, long duration, and the presence of smoking can increase the frequency and severity of post operative complications.

PMID:38679766 | DOI:10.4103/njcp.njcp_559_23

Niger J Clin Pract. 2024 Apr 1;27(4):435-441. doi: 10.4103/njcp.njcp_499_23. Epub 2024 Apr 29.

ABSTRACT

BACKGROUND: Predisposing factors for otitis media with effusion are multifactorial, ranging from genetic and anatomical abnormalities to environmental factors and inflammation of the nose and adjacent structures.

AIM: The study determined the risk factors for otitis media with effusion (OME) among children in Calabar Municipality.

METHODS: This was a descriptive, cross-sectional, community-based study including children aged 1-10 years randomly selected from government and privately owned daycares, nurseries (preschool), and primary schools. The risk factors assessed included upper respiratory tract infection, allergic rhinitis, adenoid enlargement, acute otitis media, recurrent acute otitis media parental educational level, overcrowding (four children sleeping in a room), duration of breastfeeding, cleft palate, and Down’s syndrome. Allergic rhinitis was diagnosed when a child had at least two of the rhinological symptoms: nasal congestion, running nose, sneezing, itching of the eye or nose, and at least one of the following: history of allergy, family history of allergy, and positive history of asthma. The questionnaire was the research instrument used to assess the risk factors for OME. OME diagnosis was made with otoscopy and tympanometry. Data were collected and analyzed with IBM SPSS version 25, and a P value <0.05 was considered statistically significant.

RESULTS: A total of 24 daycare pupils, 141 nursery pupils, and 155 primary pupils were recruited into the study. The prevalence of otitis media with effusion was more in younger children than in older children and the relationship was statistically significant (P < 0.001). Female children were more statistically affected than male children (P = 0.007). Children with allergic rhinitis accounted for a higher proportion of those with OME than those without allergic rhinitis (26.7% vs. 11.6%), and the difference was statistically significant (P = 0.007). The association between OME and upper respiratory tract infection, acute otitis media, and recurrent acute otitis media was not statistically significant (P > 0.05). Multivariate binary logistic regression was used to identify predictors for the otitis media with effusion.

CONCLUSION: There are many endogenous and exogenous risk factors for OME, but notable risk factors in our study were age 1-2 years, female sex, and allergic rhinitis.

PMID:38679764 | DOI:10.4103/njcp.njcp_499_23

Niger J Clin Pract. 2024 Apr 1;27(4):430-434. doi: 10.4103/njcp.njcp_381_23. Epub 2024 Apr 29.

ABSTRACT

BACKGROUND: Various types of nasal tampons are used for packing after septoplasty. Intranasal splints are widely used as they are more advantageous than other materials regarding the lower complication rates of synechia, and lesser pain during removal. However, there is no consensus on the timing of intranasal splint removal after septoplasty operations.

AIM: In this study, we aimed to investigate the effects of removal time of intranasal splints on postoperative complications after septoplasty.

METHODS: One hundred patients who had septoplasty were randomly divided into two groups according to splint removal time. In group I, the splints were removed on the third postoperative day and in group II, splints were removed on the seventh postoperative day. Pain during splint removal was evaluated by visual analog scale (VAS). Complications of hemorrhage, septal hematoma, crusting, mucosal injury, and infection were recorded during splint removal and compared. In the first postoperative month, hemorrhage, crusting, mucosal injury, infection, synechia, and in the second postoperative month, synechia and perforation rates were compared between two groups.

RESULTS: Mucosal crusting was significantly higher in group II during splint removal. There was no statistically significant difference between the two groups regarding the complication rates and pain scores. Our findings showed no significant difference in pain scores during splint removal and postoperative complications between the two groups except for mucosal crusting.

CONCLUSION: Based on our findings, although there is no consensus on the optimal time for splint removal, earlier removal of splints can be considered a favorable option after septoplasty operations.

PMID:38679763 | DOI:10.4103/njcp.njcp_381_23

Niger J Clin Pract. 2024 Apr 1;27(4):415-423. doi: 10.4103/njcp.njcp_377_22. Epub 2024 Apr 29.

ABSTRACT

BACKGROUND: Cancer patients have high supportive care needs related to the nature of the disease and treatment methods. To meet these needs or reduce symptoms, patients can be expected to resort to alternative treatment methods.

AIM: To examine the relationship between the supportive care needs of cancer patients and their attitudes toward complementary and alternative medicine (CAM).

METHODS: This was a cross-sectional study involving 289 cancer patients at the Oncology Hospital in east of Turkey. Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF 29) and Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were standard instruments used for data collection. The association between supportive care needs and attitude toward CAM was determined.

RESULTS: The mean age of the study participants was 56.7 ± 12.7 years. There were 180 females (62.3%) and 109 males (37.7%). The mean score of the SCNS-SF 29 of the study participant was 101.19 ± 33.97. It was found that the patients’ psychological needs were the highest, followed by health services and information, daily life, and sexuality needs, respectively. The mean score of the HCAMQ was 27.16 ± 9.54. There was a weak, significant negative correlation between HCAM and psychological supportive care needs (r: -0.240, P: 0.003). However, there was no significant relationship between needs related to health services information, daily life sexuality, and attitudes toward CAM.

CONCLUSIONS: Cancer patients have high supportive care requirements. Those with high psychological needs have a positive attitude toward HCAM. Incorporation of HCAM in the care of cancer patients may improve their quality of care.

PMID:38679761 | DOI:10.4103/njcp.njcp_377_22

J Clin Endocrinol Metab. 2024 Apr 29:dgae277. doi: 10.1210/clinem/dgae277. Online ahead of print.

ABSTRACT

CONTEXT: Use of artificial intelligence (AI) to predict clinical outcomes in thyroid nodule diagnostics has grown exponentially over the past decade. The greatest challenge is in understanding the best model to apply to one’s own patient population, and how to operationalize such a model in practice.

EVIDENCE ACQUISITION: A literature search of PubMed and IEEE Xplore was conducted for English language publications between January 1, 2015 and January 1, 2023 studying diagnostic tests on suspected thyroid nodules that utilized AI. We excluded articles without prospective or external validation, non-primary literature, duplicates, focused on non-nodular thyroid conditions, not using AI, and those incidentally utilizing AI in support of an experimental diagnostic outside standard clinical practice. Quality was graded by Oxford level of evidence.

EVIDENCE SYNTHESIS: A total of 61 studies were identified; all performed external validation, sixteen studies were prospective, and 33 compared a model to physician prediction of ground truth. Statistical validation was reported in 50 papers. A diagnostic pipeline was abstracted, yielding five high-level outcomes: (1) nodule localization, (2) ultrasound risk score, (3) molecular status, (4) malignancy, and (5) long-term prognosis. Seven prospective studies validated a single commercial AI; strengths included automating nodule feature assessment from ultrasound and assisting the physician in predicting malignancy risk, while weaknesses included automated margin prediction and inter-observer variability.

CONCLUSIONS: Models predominantly used ultrasound images to predict malignancy. Of four FDA-approved products, only S-Detect was extensively validated. Implementing an AI model locally requires data sanitization and re-validation to ensure appropriate clinical performance.

PMID:38679750 | DOI:10.1210/clinem/dgae277