Category: Statistics

Mymensingh Med J. 2023 Jan;32(1):35-38.

ABSTRACT

Myocardial infarction (MI) is one of the dangerous manifestations of coronary artery disease and one of the commonest causes of mortality. This cross-sectional study was carried out in the department of Biochemistry, Mymensingh Medical College in collaboration with the department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period of January 2018 to December 2018. A total of 120 subjects were included in this study. Among them 60 were diagnosed AMI patients denoted as case group and 60 were apparently normal healthy individuals denoted as control group. Biochemical values were expressed as Mean±SD (Standard deviation). Statistical analysis was done by using SPSS (Statistical package for social science) version 21.0 windows package. Serum uric acid determined by enzymatic colorimetric method using the test kit. Among the study groups the mean±SD values of uric acid were 6.61±2.62 and 5.38±1.16mg/dl in case and control group respectively. The analysis showed that, serum uric acid was statistically increased in case group compared with control group. The level of significance was 0.001. Statistical significance of difference between two groups were evaluated by using Student’s unpaired ‘t’ test.

PMID:36594297

Mymensingh Med J. 2023 Jan;32(1):18-21.

ABSTRACT

The oral contraceptive pill, ‘the pill’, was introduced in the starting of the 1960s. Presently, worldwide about 100 million women are current users of combined hormonal contraceptives (COC) most frequently used in the western world. The most frequently used agents are a combination of drugs containing both the estrogen and progesterone. This combination is considered to be highly efficacious, generally considered 99.9% and a use effectiveness of 97.0% to 98.0%. This study was done to evaluate the changes of Body Mass Index (BMI) and Blood pressure ( BP) in combined oral contraceptive pill users in comparison to non- users. This cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2021 to June 2022. Total number of 120 reproductive aged women, age ranged from 15-55 years was included in this study. Among them, sixty (60) combined oral contraceptive pill users subjects were taken as study group (Group II) and sixty (60) age matched oral pill non users subjects were taken as control group (Group I). Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired students’ ‘t’ test and Pearson’s correlation coefficient test. The mean±SD of BMI of control group (Group I) and study group (Group II) were 22.50±1.50 kg/m² and 27.64±1.28 kg/m² respectively. In study group (Group II) BMI was increased. Result is statistically highly significant (p<0.001). The mean±SD of systolic blood pressure of control group (Group I) and study group (Group II) were 111.17±8.51 mm of Hg and 127.50±6.14 mm of Hg respectively. In this study the mean±SD of diastolic blood pressure of control group (Group I and study group (Group II) were 75.58±5.05mm of Hg and 87.00±4.89 mm of Hg respectively. In study group (Group II) diastolic blood pressure was increased. Result is statistically highly significant (p<0.001). So the assessment of this parameter is important for early detection and prevention of complication related to combined oral contraceptive pill use for leading a healthy life.

PMID:36594294

Mymensingh Med J. 2023 Jan;32(1):3-9.

ABSTRACT

Polycystic ovary syndrome (PCOS) is a polygenic and multifactorial condition, regarded as the most common endocrine abnormality of women in reproductive period. It is commonly assumed that insulin resistance, hyperandrogenism and obesity significantly influence the pathophysiological process of PCOS. This study was designed to estimate hormonal parameters in different phenotypes of PCOS. The cross sectional descriptive type of observational study was carried out at Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2018 to June 2019. Data were collected from purposively selected 107 patients with PCOS by interview, clinical examination and laboratory investigations using a pretested case record form. Data were analyzed by computer software, SPSS-version 22.0. Hormonal parameters in different phenotypes of PCOS were compared with ANOVA test. Phenotype A was found in highest number (59.8%) followed by phenotype B (14.9%), phenotype D (14.0%) and phenotype C (11.2%). Biochemical hyperandrogenism was observed highest in phenotype A (57.8%) followed by phenotype B (36.4%) and phenotype C (6.1%). Biochemical or clinical hyperandrogenism was not observed among patients of phenotype D. Altered LH:FSH ratio was high in phenotype A (14.1%) and Phenotype B (2.8%). Increased serum prolactin level was found highest in phenotype A (10.3%) and increased serum TSH was found highest in phenotype D (4.7%). Statistically significant difference was observed among levels of serum testosterone of different phenotypes (p<0.001). Hormonal derangements among different phenotypes reflect the severity of reproductive dysfunction and metabolic aberrations. Screening for metabolic risks of diverse phenotypes is important to detect and prevent long term health consequences of PCOS.

PMID:36594292

Pediatrics. 2023 Jan 3:e2022057865. doi: 10.1542/peds.2022-057865. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: High-risk infant follow-up programs (HRIFs) are a recommended standard of care for all extremely low birth weight (ELBW) infants to help mitigate known risks to long-term health and development. However, participation is variable, with known racial and ethnic inequities, though hospital-level drivers of inequity remain unknown. We conducted a study using a large, multicenter cohort of ELBW infants to explore within- and between-hospital inequities in HRIF participation.

METHODS: Vermont Oxford Network collected data on 19 503 ELBW infants born between 2006 and 2017 at 58 US hospitals participating in the ELBW Follow-up Project. Primary outcome was evaluation in HRIF at 18 to 24 months’ corrected age. The primary predictor was infant race and ethnicity, defined as maternal race (non-Hispanic white, non-Hispanic Black, Hispanic, Asian American, Native American, other). We used generalized linear mixed models to test within- and between-hospital variation and inequities in HRIF participation.

RESULTS: Among the 19 503 infants, 44.7% (interquartile range 31.1-63.3) were seen in HRIF. Twenty six percent of the total variation in HRIF participation rates was due to between-hospital variation. In adjusted models, Black infants had significantly lower odds of HRIF participation compared with white infants (adjusted odds ratio, 0.73; 95% confidence interval, 0.64-0.83). The within-hospital effect of race varied significantly between hospitals.

CONCLUSIONS: There are significant racial inequities in HRIF participation, with notable variation within and between hospitals. Further study is needed to identify potential hospital-level targets for interventions to reduce this inequity.

PMID:36594226 | DOI:10.1542/peds.2022-057865

J Palliat Care. 2023 Jan 2:8258597221149402. doi: 10.1177/08258597221149402. Online ahead of print.

ABSTRACT

Objective: This study aims to evaluate the potential impact of addressing goals-of-care (GOC) with selected patients in the emergency department (ED), GOC documentation, hospital utilization, and patient satisfaction. Method: This is a single-center, retrospective, and prospective, observational convenience-sample study. ED registered nurses (ED RNs) received standardized GOC conversation training. Their selection criteria included a selection interview, a minimum of 3 years of ED clinical experience, and current employment in the ED. ED RNs used a standardized GOC questionnaire. Patient inclusion criteria included age ≥18 years and one or more of the following: chronic kidney disease ≥ stage III, congestive heart failure with an ejection fraction ≤ 40%, chronic obstructive pulmonary disease with home oxygen use, and/or malignancy with metastasis. GOC conversations were recorded in the electronic medical record (EMR). Physician Orders for Life-Sustaining Treatment (POLST) forms were completed as appropriate. Select individual patient data for the 12 months prior to the conversation were compared with the following 12 months. Results: Over 6 months, 94 of 133 patients who were approached consented to the GOC discussion with the RN. All 94 enrolled patients had their GOC recorded into the EMR. One-third already had a completed POLST form prior to ED arrival. 50% without a POLST on ED arrival left with a completed POLST. Eighty-four patients survived the index visit and 46 patients survived to study completion. Patient satisfaction with the interaction was high: In the cohort who survived past the index visit, 95% rated their experience at 4/5 or 5/5 (Likert scale, 5: strongly agree, 1: strongly disagree). In the survival-to-study completion cohort, 100% rated their experience as 4/5 or 5/5. Subsequent median ED visits decreased by 15% (1.0-4.0 interquartile range). There were no statistically significant changes in hospitalizations (both decreased by 25%, 0-3.0) or intensive care unit admissions (0%, 0-0). Conclusions: An ED RN-led GOC conversation had high patient satisfaction and 100% GOC documentation in the EMR. There was a significant increase in ED POLST form completion. There were no significant changes noted in subsequent hospitalizations, length of hospitalization, or intensive care unit utilization.

PMID:36594209 | DOI:10.1177/08258597221149402

J Intensive Care Med. 2023 Jan 2:8850666221149956. doi: 10.1177/08850666221149956. Online ahead of print.

ABSTRACT

BACKGROUND: Members of racial and ethnic minority groups have been disproportionately impacted by coronavirus-2019 (COVID-19). The objective of the study is to describe associations between race and ethnicity on clinical outcomes such as need for mechanical ventilation and mortality.

METHODS: Retrospective cohort study of patients with severe COVID-19 infection admitted within a large, not-for-profit healthcare system in the mid-Atlantic region between March and July, 2020. Patient demographic data and clinical outcomes were abstracted from the electronic health record. Logistic regressions were performed to estimate associations between race and ethnicity and the clinical outcomes.

RESULTS: The study population (N = 2931) was stratified into 1 of 3 subgroups: non-Hispanic White (n = 466), non-Hispanic Black (n = 1611), and Hispanic (n = 654). The average age of White, Black, and Hispanic patients was 69 ± 17.06, 64 ± 15.9, and 50 ± 15.53 years old, respectively (P < .001). Compared to White patients, Black and Hispanic patients were at increased odds of needing mechanical ventilation due to COVID-19 pneumonia (odds ratio [OR] Black = 1.35, 95% confidence interval [CI] = 1.04 to 1.75, P < .05; OR Hispanic = 1.43, 95% CI = 1.06 to 1.93, P < .05). When compared to White patients, Hispanic patients were at decreased odds of death (OR = 0.45, 95% CI = 0.32 to 0.63, P < .001). However, when adjusting for age, there were no statistically significant differences in the odds of death between these groups (adjusted OR [aOR] Black = 1.05, 95% CI = 0.80 to 1.38, P = .71; aOR Hispanic = 1.10, 95% CI = 0.76 to 1.60, P = .62).

CONCLUSION: Our analysis demonstrated that Hispanic patients were more likely require mechanical ventilation but had lower mortality when compared to White patients, with lower average age likely mediating this association. These findings emphasize the importance of outreach efforts to communities of color to increase prevention measures and vaccination uptake to reduce infection with COVID-19.

PMID:36594202 | DOI:10.1177/08850666221149956

Cleft Palate Craniofac J. 2023 Jan 2:10556656221149148. doi: 10.1177/10556656221149148. Online ahead of print.

ABSTRACT

OBJECTIVES: This study is performed to compare the paranasal sinus volumes in paediatric unilateral cleft palate (UCP) and healthy patients.

METHODS: Cone-beam computed tomography (CBCT) images of 80 patients (40 boys, 40 girls) with UCP and 80 healthy individuals (40 boys, 40 girls) were evaluated. Paranasal sinus volumes were segmented and measured using ITK-SNAP software. Descriptive statistics, Kolmogorov-Smirnov, paired sample t-test and student t-test were performed for statistical analysis.

RESULTS: The volumes of ethmoid, frontal and sphenoid sinus on the cleft side were not significantly different than the non-cleft side (p>0.05) in UCP patients. Maxillary sinus volume of the cleft side in UCP patients was significantly lower than the non-cleft side (p<0.05). Mean maxillary sinus volume in UCP patients was 11825.23±509.95 mm³ at the cleft side and 13497.85±358.07 mm³ at the non-cleft side. While the mean volumes of ethmoid and sphenoid sinuses of patients with UCP were not significantly different from healthy individuals (p>0.05), the mean volumes of maxillary and frontal sinuses were significantly lower than healthy individuals (p<0.05). The mean maxillary sinus volume in UCP patients was 25323±597.8 mm³ and 26666±874.3 mm³ in the control group. The mean frontal sinus volume in UCP patients was 5633±323.1 mm³ and 5735±315.2 mm³ in the control group.

CONCLUSIONS: UCP caused a significant reduction in maxillary and frontal sinus volumes. The results of the current study show that paranasal sinus volumes in patients with UCP should be examined in more detail to make more risk-free and effective treatment plans.

PMID:36594189 | DOI:10.1177/10556656221149148

BMJ. 2022 Dec 20;379:e072883. doi: 10.1136/bmj-2022-072883.

NO ABSTRACT

PMID:36593578 | DOI:10.1136/bmj-2022-072883

J Anim Sci Biotechnol. 2023 Jan 3;14(1):1. doi: 10.1186/s40104-022-00800-5.

ABSTRACT

BACKGROUND: Survival from birth to slaughter is an important economic trait in commercial pig productions. Increasing survival can improve both economic efficiency and animal welfare. The aim of this study is to explore the impact of genotyping strategies and statistical models on the accuracy of genomic prediction for survival in pigs during the total growing period from birth to slaughter. RESULTS: We simulated pig populations with different direct and maternal heritabilities and used a linear mixed model, a logit model, and a probit model to predict genomic breeding values of pig survival based on data of individual survival records with binary outcomes (0, 1). The results show that in the case of only alive animals having genotype data, unbiased genomic predictions can be achieved when using variances estimated from pedigree-based model. Models using genomic information achieved up to 59.2% higher accuracy of estimated breeding value compared to pedigree-based model, dependent on genotyping scenarios. The scenario of genotyping all individuals, both dead and alive individuals, obtained the highest accuracy. When an equal number of individuals (80%) were genotyped, random sample of individuals with genotypes achieved higher accuracy than only alive individuals with genotypes. The linear model, logit model and probit model achieved similar accuracy.

CONCLUSIONS: Our conclusion is that genomic prediction of pig survival is feasible in the situation that only alive pigs have genotypes, but genomic information of dead individuals can increase accuracy of genomic prediction by 2.06% to 6.04%.

PMID:36593522 | DOI:10.1186/s40104-022-00800-5

Eur J Med Res. 2023 Jan 2;28(1):1. doi: 10.1186/s40001-022-00965-9.

ABSTRACT

BACKGROUND AND PURPOSE: The implantation of carotid artery stents prevents recurrent ischemic stroke in patients with carotid stenosis. This study aimed to investigate associations between change of ophthalmic artery flow (COAF) post carotid stenting and recurrent ischemic stroke, as well as the link toward the anterior and posterior circulations and patients’ prognosis after carotid stenting.

METHODS: This retrospective, longitudinal cohort study recruited 87 left side carotid stenosed ischemic stroke patients undergoing left side carotid stenting between year of 2009 and 2013, and patients were followed up to 9 years after carotid procedures. Clinical data were derived from medical records. The primary outcome was stroke recurrence. Predictive factors were stenosis > 50% in one intracranial artery and ROAF. Kaplan-Meier and Cox regression analyses were used to identify risk factors associated with stroke recurrence.

RESULTS: Among 87 included patients undergone left side carotid stent treatment, 44 had stroke recurrence within 3 years after carotid stenting. The recurrence group had significantly greater proportions of COAF after stenting (p = 0.001), and middle cerebral artery (MCA) and basilar artery or vertebral artery (BA/VA) stenosis > 50% (all p < 0.001) than the no-recurrence group. Survival was significantly shorter in patients with COAF than in those without (p < 0.01). Regression analysis showed that COAF was associated with stroke recurrence (HR: 3.638, 95% CI 1.54-8.62, p = 0.003). The recurrence rate was highest in patients with bilateral MCA stenosis > 50% (100%), followed by left MCA stenosis > 50% plus BA/VA stenosis > 50% (83.33%) or COAF (82.14%). Patients with bilateral MCA stenosis < 50% had no recurrence within 3-year follow-up.

CONCLUSIONS: Prognosis after carotid stenting is poorer for patients with MCA stenosis > 50%, BA/VA stenosis > 50% and/or COAF. Carotid duplex and magnetic resonance angiography provide definitive information for prognosis prediction.

PMID:36593520 | DOI:10.1186/s40001-022-00965-9