Category: Statistics

Zhonghua Yi Xue Za Zhi. 2025 Jun 13;105:1-8. doi: 10.3760/cma.j.cn112137-20250415-00936. Online ahead of print.

ABSTRACT

Objective: To investigate the relationship between preoperative ultrasound-guided intra-articular local anesthetics injection at different time points and postoperative infection risk and inflammatory response after hip arthroscopy in femoroacetabular impingement(FAI). Method: This retrospective observational study enrolled FAI patients who underwent hip arthroscopy surgery at the General Hospital of the People’s Liberation Army from May 2017 to October 2023. According to the time interval between intra-articular injection and the surgery, the patients were divided into four groups: injection time≤30 days prior to surgery, injection time between 30-90 days prior to surgery, injection time>90 days prior to surgery, and non-injection group. The temperature and peripheral blood inflammation indicators of patients within one week before surgery and during hospitalization after surgery were collected. The international hip joint score (IHOT-12), visual analogue scale (VAS) of pain and the modified Harris Hip Score (mHHS) before and within 12 months after surgery were collected. The postoperative infection rates, clinical scores, temperature and inflammatory markers between groups were compared. Results: A total of 425 patients were included, with 264 males and 161 females, aged (37.2±12.9) years. There were 152 cases in the≤30 d group, aged (36.9±12.5) years; 58 cases in the 30-90 d group, aged (41.4±13.2) years; 28 cases in the>90 d group, aged (37.3±12.0) years; and 187 cases in the non-injection group, aged (36.2±13.0) years. No acute and chronic infections were found in the enrolled patients, and 8 cases of suspected acute infections were found: 5 cases (2.7%) in the non-injection group, 2 cases (3.5%) in the 30-90 d group, 1 case (3.6%) in the>90 d group, and 0 case in the≤30 d group, and the difference in the proportion of patients with suspected acute infections among the various groups was not statistically significant (P=0.061). There were 17 patients with maximum body temperature≥38.0 ℃ on postoperative day 1, 9 (4.8%) in the non-injection group, 2 (7.1%) in the>90 d group, 1 (1.7%) in the 30-90 d group, and 5 (3.3%) in the≤30 d group. There were 143 patients with mildly elevated body temperature (37.1-37.9 ℃), 74 (39.6%) in the non-injection group, 10 (35.7%) in the>90 d group, 17 (29.3%) in the 30-90 d group, and 42 (27.6%) in the≤30 d group, and the difference in the proportion of the number of people with different degrees of fever among the groups was not statistically significant (P=0.180). The peripheral blood leukocyte level was 10.6 (8.5, 12.2) x10⁹/L in the≤30 d group, 9.7 (7.8, 10.5) x10⁹/L in the 30-90 d group, 8.9 (8.0, 10.7) x10⁹/L in the>90 d group, 10.0 (7.9, 11.3) x10⁹/L in the non-injection group, and peripheral blood leukocytes in the≤30 d group were significantly higher than those in the other three groups (all P<0.05). The differences in neutrophil ratio, neutrophil-to-lymphocyte ratio, C-reactive protein, erythrocyte sedimentation rate were not statistically significant among the groups after the surgery (all P>0.05). The IHOT-12, VAS of pain and mHHS scores of patients in all groups improved at 12 months after surgery when compared with the values before the operation (all P<0.001). Conclusion: Preoperative ultrasound-guided intra-articular hip anesthetic injection performed with standardized sterile technique does not increase postoperative infection risk or inflammatory response in FAI patients.

PMID:40511480 | DOI:10.3760/cma.j.cn112137-20250415-00936

Zhonghua Yi Xue Za Zhi. 2025 Jun 13;105:1-6. doi: 10.3760/cma.j.cn112137-20250209-00290. Online ahead of print.

ABSTRACT

Objective: To evaluate the clinical efficacy of the combined internal-external approach in establishing surgical portals for hip arthroscopy. Methods: A prospective analysis was conducted on patients who underwent hip arthroscopy at the General Hospital of the People’s Liberation Army from March 2021 to May 2023. The patients were divided into a trial group (using the combined internal-external approach) and a control group (using the traditional puncture method) based on their voluntary choices of surgical plans. All patients underwent imaging examinations before surgery. During the operation, the time taken to establish the anterolateral approach (AL approach), the time taken to establish the mid-anterior auxiliary approach (MA approach), and the total surgical time were recorded. After surgery, a 1-year follow-up was carried out. Indicators such as the visual analog scale (VAS) of pain, the modified Harris Hip Score (mHHS), the International Hip Outcome Tool-12 (iHOT-12) score, the Hip Outcome Score-Activities of Daily Living Subscale (HOS-ADL), and the Hip Outcome Score-Sports Subscale (HOS-SSS) were recorded and compared for the two groups. Results: A total of 77 patients were enrolled with a mean age of (37.9±12.6) years(48 males and 29 females). There were 37 cases in the trial group[ with a mean age of (38.0±11.8) years, 24 males and 13 females] and 40 patients in the control group[ with a mean age of (37.8±13.4) years, 24 males and 16 females]. All indicators in both groups demonstrated significant improvement postoperatively compared with the preoperative values (all P<0.001). No significant intergroup differences existed in the indicators preoperatively (all P>0.05). Postoperatively, there was no significant defferences in VAS of pain [(2.3±2.1) vs (2.4±1.9) points], mHHS [(83.3±7.4) vs (80.2±9.2) points], iHOT-12 [(72.8±15.5) vs (71.1±17.4) points], HOS-ADL [(81.4±16.9) vs (84.0±15.0) points] and HOS-SSS [(55.7±23.4) vs (56.1±19.1) points] or AL approach time [(5.3±0.5) vs (5.4±0.4) minutes] between the trial group and the control group(all P>0.05); however, the MA approach time [(9.0±0.6) vs (14.8±1.3) minutes] and total operative time [(105.2±8.8) vs (119.4±4.7) minutes] in the trial group were both shorter than those in the control group (both P<0.001). The trial group had a lower postoperative complication rate than the control group, but the difference was not statistically significant [5.4% (2/37) vs 15.0% (6/40), P=0.263]. Conclusion: Portal establishment using the combined internal-external approach significantly reduces operative time and postoperative complication rate when compared to the traditional puncture technique, representing a safer and more efficient method for hip arthroscopy.

PMID:40511479 | DOI:10.3760/cma.j.cn112137-20250209-00290

Zhonghua Yi Xue Za Zhi. 2025 Jun 13;105:1-4. doi: 10.3760/cma.j.cn112137-20250101-00006. Online ahead of print.

ABSTRACT

This study intends to compare the differences in psychological status of patients with chronic pain in different lower extremity joints. A retrospective cross-sectional study was used to assess patients with chronic hip, knee, and ankle pain hospitalized from June 2024 to December 2024 in the Sports Medicine Ward of the Department of Orthopaedic Medicine, General Hospital of the People’s Liberation Army. A total of 75 patients with chronic pain in the joints, 36 males and 39 females, aged (31.6±9.5) years, were included. General information such as age, gender, and body mass index (BMI) were recorded, and the pain status of patients with chronic pain in each joint was assessed and compared by visual analog scores (VAS) and pain sensitivity scale (PSQ), and the psychological status of patients was assessed by the Zong-type Anxiety Scale (SAS) and Beck Depression Inventory (BDI). A total of 25 patients each with chronic hip, knee, and ankle pain were included, and the differences in baseline data among the three groups were not statistically significant and were comparable. The results showed that the SAS scores in the hip group were higher than those in the ankle group (mean difference=0.101, 95%CI: 0.029-0.174) and the knee group (mean difference=0.164, 95%CI: 0.094-0.235); the BDI scores in the hip group were higher than those in the ankle group (mean difference=2.081, 95%CI: 0.848-3.314) and knee group (mean difference=2.044, 95%CI: 0.866-3.222). This study suggests that psychological disorders in patients with chronic hip pain are more significant compared to other lower extremity arthralgia patients, and psychological intervention support should be strengthened in this group of patients.

PMID:40511478 | DOI:10.3760/cma.j.cn112137-20250101-00006

Euro Surveill. 2025 Jun;30(23). doi: 10.2807/1560-7917.ES.2025.30.23.2500011.

ABSTRACT

IntroductionInfluenza A(H1N1)pdm09, A(H3N2) and B/Victoria viruses circulated in Europe in 2023/24, with A(H1N1)pdm09 dominance. First influenza infections in childhood may lead to different vaccine effectiveness (VE) in subsequent years.AimThe VEBIS primary care network estimated influenza VE in Europe using a multicentre test-negative study.MethodsPrimary care practitioners collected information and specimens from patients consulting with acute respiratory infection. We estimated VE against influenza (sub)type and clade, by age group and by year of age for A(H1N1)pdm09, using logistic regression.ResultsWe included 29,958 patients, with 3,054, 1,053 and 311 influenza A(H1N1)pdm09, A(H3N2) and B cases, respectively. All-age VE against influenza A(H1N1)pdm09 was 52% (95% CI: 44-59). By year of age, VE was 27% (95% CI: -2 to 47) at 44 years with peaks at 72% (95% CI: 52-84) and 54% (95% CI: 41-64) among children and those 65 years and older, respectively. All-age A(H1N1)pdm09 VE against clade 5a.2a was 41% (95% CI: 24-54) and -11% (95% CI: -69 to 26) against clade 5a.2a.1. The A(H3N2) VE was 35% (95% CI: 20-48) among all ages and ranged between 34% and 40% by age group. All-age VE against clade 2a.3a.1 was 38% (95% CI: 1-62). All-age VE against B/Victoria was 83% (95% CI: 65-94), ranging between 70 and 92% by age group.DiscussionThe 2023/24 VEBIS primary care VE against medically attended symptomatic influenza infection was high against influenza B/Victoria, but lower against influenza A(H1N1)pdm09 and A(H3N2). Clade- and age-specific effects may have played a role in the lower A(H1N1)pdm09 VE.

PMID:40511473 | DOI:10.2807/1560-7917.ES.2025.30.23.2500011

Euro Surveill. 2025 Jun;30(23). doi: 10.2807/1560-7917.ES.2025.30.23.2400682.

ABSTRACT

BackgroundDuring the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) such as social distancing, lockdowns and enhanced hygiene led to a decrease in respiratory pathogens. However, as NPIs were relaxed, a resurgence in several respiratory pathogens was observed including one local Chlamydia pneumoniae outbreak in Switzerland, prompting the need for a better understanding of C. pneumoniae epidemiology.AimTo assess temporal and geographical variations in C. pneumoniae detection before, during and after the COVID-19 pandemic.MethodsData on C. pneumoniae PCR detection ratios (number of positive tests/ total number of tests) across pre-pandemic (2018-2019), pandemic (2020-2022) and post-pandemic (2023) periods were collected via a global survey disseminated through various professional networks.ResultsC. pneumoniae detection ratios were analysed across 28 sites (27 in Europe, one in Taiwan) in 2023 (Dataset A, n = 172,223 tests) and 20 sites from 2018 to 2023 (Dataset B, n = 693,106 tests). Twenty-seven sites were laboratories (hospital or clinical) and one a surveillance system (Denmark). A significant decrease in detection ratios was observed during the pandemic period (from 1.05% to 0.23%, p < 0.001). In 2023, detection ratios increased to 0.28% (p < 0.002). Notable regional variations were found, with statistically significant increases in detection ratios at six sites located in Switzerland and Slovenia, where ratios ranged from 0.52% to 3.25%.DiscussionThe study highlights how NPIs influenced C. pneumoniae epidemiology, with reduced detection during the pandemic and partial resurgence afterwards. Regional variations suggest differing NPI impacts and underscore the need for continued surveillance.

PMID:40511472 | DOI:10.2807/1560-7917.ES.2025.30.23.2400682

Hong Kong J Occup Ther. 2025 Jun 10:15691861251339211. doi: 10.1177/15691861251339211. Online ahead of print.

ABSTRACT

Objective: This study examined the associative relationships among age, cognition, anxiety, and participation in explaining the number of Assistive Technology Devices (ATDs) used by stroke survivors through path analysis. Methods: A cross-sectional study was conducted with 196 community-dwelling stroke survivors. Data on ATD usage, cognitive function (Montreal Cognitive Assessment), anxiety (Beck Anxiety Inventory), and participation (Utrecht Scale for Evaluation of Rehabilitation-Participation) were analyzed using SPSS 22.0 and Amos 24.0. Results: The modified path model demonstrated a good fit to the data. Age, anxiety, and participation had direct effects on the number of ATDs used, while cognition did not show a statistically significant effect. Anxiety also had an indirect effect through participation, indicating a dual role of participation in either increasing or reducing ATD reliance. Age influenced anxiety and participation both directly and indirectly. Conclusions: This study identified the pathways through which age, anxiety, and participation influence ATD usage among stroke survivors. Given the complexity of interplay of psychological and functional factors, ATD prescriptions should adopt a user-centered approach, considering participation levels, psychological responses, and environmental factors to optimize effectiveness and long-term use.

PMID:40511445 | PMC:PMC12151998 | DOI:10.1177/15691861251339211

Indian J Community Med. 2025 May-Jun;50(3):506-511. doi: 10.4103/ijcm.ijcm_834_23. Epub 2025 Jan 30.

ABSTRACT

BACKGROUND: Neck pain is characterized by symptoms of a nonspecific nature of the pain, which is of mechanical origin.[12] Frequently observed manifestations of neck discomfort encompass muscle pain, muscle spasms, headaches, facet joint pain, nerve pain, referred pain, and bone pain.[3] Instrument-assisted soft-tissue mobilization (IASTM) stands as a proficient myofascial intervention used for the treatment of soft tissues. Here, using instruments typically crafted from stainless steel featuring beveled edges and anatomically contoured designs to accommodate various body regions, this technique allows for enhanced depth of penetration.[4] Primarily used for the identification and therapeutic management of soft-tissue disorders, the approach involves the application of these specialized instruments.[5] Dry cupping, alternatively recognized as air cupping or suction cupping, constitutes a therapeutic methodology, wherein a vacuum is generated within cups and subsequently applied to targeted regions of the body. These cups, fabricated from diverse materials such as glass, silicone, or plastic, induce suction effects. Through the application of this suction, dry cupping serves to promote circulation, alleviate muscle tension, and facilitate the energetic flow within the treated areas.

MATERIAL AND METHODS: The purpose of the study to effectiveness of instrument-assisted soft-tissue mobilization versus dry cupping on pain and cervical range of motion in treatment of neck pain. The study is comparative in nature, and total subjects were 15 subjects in each group. The assessment of pain and range of motion of cervical flexion and lateral flexion were taken before starting the treatment of both the groups. The patients were randomly assigned by lottery method for both the groups, and assessments were taken on 0 day and at the end of 4^th week by VAS and ROM by a goniometer.

RESULTS: In IASTM treatment, the P value is 0.031. This suggests that there is a statistically significant difference between the pre-treatment and post-treatment values for the IASTM group. But, in dry cupping, the P value is 0.001. This indicates a highly significant difference between the precupping and postcupping values for this treatment group. The scores of variables VAS and ROM were improved significantly better in the subjects treated with dry cupping as compared to the group variables treated with instrument-assisted soft-tissue mobilization.

CONCLUSION: The study conclude that the dry cupping is more beneficial for the treatment of neck pain and range of motion.

PMID:40511444 | PMC:PMC12156098 | DOI:10.4103/ijcm.ijcm_834_23

Indian J Community Med. 2025 May-Jun;50(3):445-452. doi: 10.4103/ijcm.ijcm_469_23. Epub 2024 Oct 8.

ABSTRACT

BACKGROUND: Cancer is one of the leading causes of death worldwide, and in order to prevent it, it is vital to understand cancer patients’ health-seeking behavior that contributes to patient delays in receiving cancer treatment globally; however, no similar studies have been conducted in India. Therefore, this study made an effort to know health-seeking behavior among delayed cancer patients receiving treatment at a tertiary care hospital, Varanasi.

METHODS: A cross-sectional study was conducted at the Department of Surgical Oncology OPD, Sir Sunder Lal Hospital, IMS, BHU, Varanasi. Randomly selected 440 registered patients were interviewed with the help of semi-structured questionnaire. Binary logistic regression analysis and 2-test were used in this study.

RESULTS: Out of total 440 patients included in this study, 207 (47.05%) were males and 233 (52.95%) were females. The majority (59.32%) of patients were more than 45 years of age group. Most (80%) of the patients had delay in cancer treatment of more than 60 days from onset of symptoms. Only 29.55% of patients were aware of any symptoms of Cancer. Those patients who were doing self-medication (P=0.03) and did not attend any cancer screening program (P=0.04) showed a statistically significant association with delayed initiation of treatment. Patients referred from another centre (P = 0.03) also show a significant association with delayed treatment initiation. Cancer patients who visited the screening program (AOR= 0.22, P=0.003) were significantly associated with a lower likelihood of delayed treatment initiation.

CONCLUSION: The study showed that 80% of patients were delayed in seeking treatment for Cancer and highly influenced by low awareness, self-medication and visiting multiple health centres for diagnosis and treatment. Therefore, there is a strong need to address the reasons for the delay in seeking treatment.

PMID:40511434 | PMC:PMC12156084 | DOI:10.4103/ijcm.ijcm_469_23

Indian J Community Med. 2025 May-Jun;50(3):530-534. doi: 10.4103/ijcm.ijcm_772_22. Epub 2024 Oct 8.

ABSTRACT

Malignant non-odontogenic tumors of the oral cavity remain understudied in India, despite their global prevalence. This retrospective analysis examined cases from a single institution in Maharashtra between 1990 and 2021, focusing on patient demographics, clinical presentations, and histopathological features. Oral squamous cell carcinoma (OSCC) emerged as the predominant malignancy, with epithelial malignancies accounting for 98.6% of cases. A slight male predominance was observed. Buccal mucosa was the most frequent site of occurrence, with tobacco chewing identified as the primary risk factor. This study underscores the need for increased attention to oral malignancies in routine medical examinations and calls for more comprehensive statistical analysis to inform clinical practice and public health strategies.

PMID:40511429 | PMC:PMC12156099 | DOI:10.4103/ijcm.ijcm_772_22

Indian J Community Med. 2025 May-Jun;50(3):428-436. doi: 10.4103/ijcm.ijcm_810_23. Epub 2025 Feb 1.

ABSTRACT

INTRODUCTION: Quality antenatal care (QANC) is an important health care indicator of the public health structure of the country. Causal mediation analysis is a statistical model that can model the complex path that determines the QANC received by women. The objective of the study was to assess the proportion of women receiving QANC in India and to ascertain its determinants using causal mediation analysis.

METHODOLOGY: The dataset for study was obtained from the NFHS-4 survey. The outcome variable QANC was formulated based on a set working definition. The potential determinants of QANC at individual and population levels were identified by literature search, expert opinion, and availability in the NFHS dataset. The effect estimates of the determinants were estimated by multiple logistic regression. The potential determinant variables were categorized as independent and mediating variables. A schematic path analysis model was conceptualized by plausibility and expert opinion. The direct, indirect, and total effects of independent and mediating variables were estimated by generalized causal path analysis.

RESULTS: We found that region, education, wealth, religion, working status, husband’s education, and age were significant independent factors influencing QANC. Additionally, we found that husband’s alcohol status, pregnancy awareness month, presence of husband during antenatal care (ANC) visit, pregnancy registration month, emotional violence, and timing of the first ANC visit were significant mediating variables.

CONCLUSION: Understanding the factors associated with QANC is statistically more robust using causal path analysis, which would help us better shape policies for improved maternal health care in India.

PMID:40511427 | PMC:PMC12156105 | DOI:10.4103/ijcm.ijcm_810_23