Category: Statistics

J Nepal Health Res Counc. 2022 Mar 13;19(4):712-716. doi: 10.33314/jnhrc.v19i04.3797.

ABSTRACT

BACKGROUND: This study aimed to assess the distribution of fine-needle-aspiration-cytology or biopsy findings through cytopathological patterns of lymph nodes aspirations in different age groups of the population visiting a tertiary level hospital in Kathmandu.

METHODS: The retrospective study was conducted on the database of the 226 lymphadenopathy cases that underwent biopsy fine needle aspiration cytology from 1 January 2016 to 31 December 2019 at the Department of pathology of Helping Hand’s Community Hospital, Kathmandu. A descriptive analysis was performed yielding proportions and counts for the quantitative variables. Chi-squared test was used to compare the proportions. Point estimates and confidence intervals for measures of association were assessed with 95% confidence interval and p-value ?0.05 was considered statistically significant.

RESULTS: The 20-40 years were the most common age group undergoing biopsy fone needle aspiration cytology procedures. Males recorded majority of cases (68%, 153 of 226). The highest incidence of Reactive lymphadenitis was obtained (50%, 113 of 226) and it was the most common findings in the age group of <20 and 40-60 years. The Cervical lymph node (86%) was the most common anatomical location followed by axillary lymph nodes (8%). Squamous cell carcinoma and Adenocarcinoma accounted for more than half (53%, 20 of 38) of all the diagnosed malignancy. The incidence of Non-Hodgkin lymphoma and Hodgkin lymphoma were 8% (n = 3 of 38) and 5% (n = 2 of 38) respectively.

CONCLUSIONS: Lymph node enlargement is associated with a wide range of etiologies with Reactive lymphadenitis as the most common cause and cervical lymph node as the common site.

PMID:35615827 | DOI:10.33314/jnhrc.v19i04.3797

J Nepal Health Res Counc. 2022 Mar 13;19(4):688-692. doi: 10.33314/jnhrc.v19i04.3879.

ABSTRACT

BACKGROUND: Severe Acute Respiratory Syndrome Corona Virus 2019, a novel coronavirus first reported from China in 2019, is the causative agent of pandemic corona virus disease 2019. Antibody response and its dynamics may provide information about natural immunity conferred upon by corona virus disease 2019.

METHODS: A health-center-based follow up study of confirmed Severe Acute Respiratory Syndrome Corona Virus-2 infected patients was conducted from December 2020 to June 2021. Patients were followed up to period of 28 weeks during the study. An electrochemiluminescence immunoassay was used to test antibodies elicited by Severe Acute Respiratory Syndrome Corona Virus-2. Socio-demographic and clinical information was collected from each patient.

RESULTS: A total of 40 patients (18 males and 22 females) were enrolled in the study, with 90 % seropositivity of SARS-CoV-2 antibody. Antibody level was tracked up to 28 weeks following the infection, and persistence was observed till the end. Antibody level peaked on the 3rd to 4th month, after symptom onset. The male population was found to have higher antibody levels compared to females. Age-wise trend analysis showed lower antibody levels in the younger people (15-30 years) than those older (31-60 years).

CONCLUSIONS: We demonstrated that Severe Acute Respiratory Syndrome Corona Virus-2 specific antibodies in corona virus disease 2019 patients persist for at least 28 weeks, peaking at 13 to 20 weeks. Statistically, there was no correlation of antibody levels with the age and sex of individuals. Further study on a larger population is needed for determining long-term immunity.

PMID:35615823 | DOI:10.33314/jnhrc.v19i04.3879

J Nepal Health Res Counc. 2022 Mar 13;19(4):661-668. doi: 10.33314/jnhrc.v19i04.3524.

ABSTRACT

BACKGROUND: The accelerating rate of carbapenems resistance in Klebseilla pneumoniae isolates has put the treatment option worrisome. The effective strategy to ameliorate this alarming situation is possible through enhancing the combination therapy and appropriate laboratory diagnosis. Hence, the study was focused on identifying carbapenemase-producing K. pneumoniae and their antibiogram pattern.

METHODS: A total of 944 clinical samples from patients attending Sahid Gangalal National Heart Center were processed from September 2019 to March 2020 to identify the possible bacterial pathogens following the standard microbiological procedures. K. pneumonaie isolates were further subjected to antibiotic susceptibility testing by the modified Kirby Bauer disc diffusion technique. Phenotypic confirmation of carbapenemase production was done by the modified carbapenemase inactivation method. The minimum inhibitory concentration of colistin was determined by the broth microdilution method.

RESULTS: Of the total 944 samples, 15.47% (146) samples showed bacterial growth, among which 23.97% (35) were K. pneumoniae. Out of 35 K. pneumoniae isolates, 45.71% (16) were multidrug-resistant followed by 42.86% (15) extensively drug-resistant. Fourteen isolates of K. pneumoniae were carbapenemase producers among which 20% (7) were serine carbapenemase while 20% (7) showed metallo-?-lactamase production. All the carbapenemase-producing K. pneumoniae were susceptible to colistin with <0.125µg/ml. Carbapenemase activity showed statistically significant with multidrug resistance (p=<0.05).

CONCLUSIONS: An increasing resistance to the carbapenem drugs showed a great problem in the management of K. pneumoniae infections among immunocompromised patients especially cardiac patients however, colistin can be still an ultimate choice of drug for disease management.

PMID:35615819 | DOI:10.33314/jnhrc.v19i04.3524

BMC Psychol. 2022 May 25;10(1):135. doi: 10.1186/s40359-022-00844-2.

ABSTRACT

The threat of COVID-19 outbreak in South Korea and around the globe challenged not only physical health but also mental health, increasing the chances of disorders such as posttraumatic stress disorder (PTSD). Such pandemic situation can be referred to a traumatic event for citizens. The present study aims to examine the psychometric properties of the PTSD Checklist (PCL-5), which is named the K-COVID-related-PTSD. The scale measures PTSD symptomology in the context of the COVID-19 pandemic in South Korea. A total of 1434 South Korean citizens were included in this study. The data were statistically analyzed using SPSS 21.0 and Mplus 8.0. The results of confirmatory factor analysis demonstrated a superior fit for the seven-factor hybrid model (x² = 1425.445 (df = 149), CFI = 0.950, TLI = 0.937, SRMR = 0.033, RMSEA = 0.077) consisting of re-experiencing, negative affect, anxious arousal, dysphoric arousal, avoidance, anhedonia, and externalizing behaviors. Furthermore, the K-COVID-related-PTSD showed a satisfactory level of internal consistency (α = 0.793 to α = 0.939) with good convergent and discriminant validity. Finally, concurrent validity was confirmed by the significant correlations with all the negative mental health outcomes, such as PTSD symptoms, somatization, depression, anxiety, anger, negative affect, job burnout, and suicidal ideation. Overall, the current results demonstrate the K-COVID-related-PTSD is a valid scale and therefore has important implications for future pandemic-related studies.

PMID:35614519 | DOI:10.1186/s40359-022-00844-2

AIDS Res Ther. 2022 May 25;19(1):21. doi: 10.1186/s12981-022-00447-2.

ABSTRACT

BACKGROUND: Viral suppression remains the most desired outcome in the management of patients with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and this can be achieved by an effective Antiretroviral Therapy (ART). However, some patients who achieve viral suppression may experience viral rebound with dire consequence. We evaluated viral suppression and rebound and their associated factors among adult patients on ART in Kumasi, Ghana.

METHODS: This hospital-based retrospective study was conducted at the Komfo Anokye Teaching Hospital in Ghana. We reviewed the medical records of 720 HIV patients on ART. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism version 8.0. p < 0.05 was considered statistically significant.

RESULTS: Proportions of patients with viral suppression and viral rebound were 76.1% and 21.0% respectively. Being diagnosed at WHO stage I [aOR = 11.40, 95% CI (3.54-36.74), p < 0.0001], having good adherence to ART [aOR = 5.09, 95% CI (2.67-9.73), p < 0.0001], taking Nevirapine-based regimen [aOR = 4.66, 95% CI (1.20-18.04), p = 0.0260] and increasing duration of treatment (p < 0.0001) were independently associated with higher odds of viral suppression. However, being diagnosed at WHO stage II (aOR = 7.39, 95% CI 2.67-20.51; p < 0.0001) and stage III (aOR = 8.62, 95% CI 3.16-23.50; p < 0.0001), having poor adherence (aOR = 175.48, 95% CI 44.30-695.07; p < 0.0001), recording baseline suppression value of 20-49 copies/mL (aOR = 6.43, 95% CI 2.72-15.17; p < 0.0001) and being treated with Zidovudine/Lamivudine/Efavirenz (aOR = 6.49, 95% CI 1.85-22.79; p = 0.004) and Zidovudine/Lamivudine/Nevirapine (aOR = 18.68, 95% CI 1.58-220.90; p = 0.02) were independently associated with higher odds of viral rebound.

CONCLUSION: Approximately 76% viral suppression rate among HIV patients on ART in Kumasi falls below the WHO 95% target by the year 2030. Choice of ART combination, drug adherence, WHO clinical staging and baseline viral load are factors associated with suppression or rebound. These clinical characteristics of HIV patients must be monitored concurrently with the viral load.

PMID:35614510 | DOI:10.1186/s12981-022-00447-2

Harm Reduct J. 2022 May 25;19(1):53. doi: 10.1186/s12954-022-00633-5.

ABSTRACT

BACKGROUND: In Kyrgyzstan and other Eastern European and Central Asian countries, injection drug use and HIV-related intersectional stigma undermines HIV prevention efforts, fueling a rapidly expanding HIV epidemic. The Kyrgyzstan InterSectional Stigma (KISS) Injection Drug Use Cohort is the first study designed to assess the impact of drug use, methadone maintenance treatment (MMT) and HIV stigma experiences among people who inject drugs (PWID) on HIV prevention service utilization.

METHODS: Adult PWID were recruited from Bishkek city and the surrounding rural Chuy Oblast region in northern Kyrgyzstan via modified time location sampling and snowball sampling. All participants completed a baseline rapid HIV test and interviewer-administered survey. A subsample of participants were prospectively followed for three months and surveyed to establish retention rates for future work in the region. Internal reliability of three parallel stigma measures (drug use, MMT, HIV) was evaluated. Descriptive statistics characterize baseline experiences across these three stigma types and HIV prevention service utilization, and assess differences in these experiences by urbanicity.

RESULTS: The KISS cohort (N = 279, 50.5% Bishkek, 49.5% Chuy Oblast) was mostly male (75.3%), ethnically Russian (53.8%), median age was 40 years old (IQR 35-46). Of the 204 eligible participants, 84.9% were surveyed at month 3. At baseline, 23.6% had a seropositive rapid HIV test. HIV prevention service utilization did not differ by urbanicity. Overall, we found 65.9% ever utilized syringe service programs in the past 6 months, 8.2% were utilizing MMT, and 60.8% met HIV testing guidelines. No participants reported PrEP use, but 18.5% had heard of PrEP. On average participants reported moderate levels of drug use (mean [M] = 3.25; α = 0.80), MMT (M = 3.24; α = 0.80), and HIV stigma (M = 2.94; α = 0.80). Anticipated drug use stigma from healthcare workers and internalized drug use stigma were significantly higher among PWID from Bishkek (p < 0.05), while internalized HIV stigma among PWID living with HIV was significantly greater among PWID from Chuy Oblast (p = 0.03).

CONCLUSION: The KISS cohort documents moderate levels of HIV-related intersectional stigma and suboptimal engagement in HIV prevention services among PWID in Kyrgyzstan. Future work will aim identify priority stigma reduction intervention targets to optimize HIV prevention efforts in the region.

PMID:35614508 | DOI:10.1186/s12954-022-00633-5

BMC Med. 2022 May 26;20(1):186. doi: 10.1186/s12916-022-02382-5.

ABSTRACT

BACKGROUND: There is limited knowledge regarding the process of deprescribing psychotropic drugs to people with dementia (PwD) conducted by general practitioners (GP). We investigated the impact of a multicomponent intervention, emphasizing medication reviews, on psychotropic drugs and behavioral and psychological symptoms (BPSD) in home-dwelling PwD and quantified change in patient-GP communication evaluated by their informal caregivers.

METHODS: [email protected] is a stepped-wedge closed-cohort cluster randomized controlled trial for people with mild to moderate dementia aged ≥65 and their informal caregivers (dyads) in Norway. Complementary to health care as usual (control condition), municipal coordinators implemented the multicomponent LIVE intervention: Learning, Innovation, Volunteer support, and Empowerment (including medication review by the PwD’s regular GPs). Block-randomization was used to allocate dyads in three groups receiving the intervention sequentially in periods of 6 months duration. Prepandemic data from the first period is reported, resulting in a 1:2 intervention-to-control ratio. Primary outcome was change in psychotropic drug use. Secondary outcomes were changes in BPSD by Neuropsychiatric Inventory and Cornell Scale of Depression in Dementia and patient-GP communication by an adaption of the Clinical Global Impression of Change.

RESULTS: Four hundred thirty-eight dyads were screened, 280 included, and 237 participated at 6 months (intervention group n=67; control condition n=170). At baseline, 63% used psychotropic medication regularly: antidementia drugs (47%), antidepressants (13%), hypnotics/sedatives (13%), antipsychotics (5%), and anxiolytics (2%). At 6 months, medication reviews were more frequently conducted in the intervention group compared to control (66% vs 42%, P=0.001). We found no differences regarding a change in drug use and BPSD. Patient-GP communication enhanced in the intervention group (mean score 0.95 [standard deviation 1.68] vs 0.41 [1.34], P=0.022). In the intervention group, control group, and overall sample, the informal caregivers of those who had their medications reviewed reported improved patient-GP communication compared to those who did not.

CONCLUSIONS: Change in psychotropic drug use and BPSD did not differ, even though patient-GP communication improved with medication reviews. Restricted psychotropic drug use among PwD likely reflects more judicious prescribing practices in recent years. Nevertheless, medication reviews could be cultivated to optimize pharmacologic treatment for this complex population.

TRIAL REGISTRATION: ClinicalTrials.gov : NCT04043364 ; registered 15/03/2019.

PMID:35614509 | DOI:10.1186/s12916-022-02382-5

BMC Med Educ. 2022 May 25;22(1):402. doi: 10.1186/s12909-022-03462-z.

ABSTRACT

BACKGROUND: This pilot study aimed to investigate the effects of developing scenario learning (DSL) on team efficacy, systems thinking, and proactivity in problem-solving in a fundamental nursing course.

METHODS: A total of 53 second-year nursing students were enrolled in the study; the DSL nursing education program was implemented for 15 weeks from March 4 to June 17, 2021. Data on team efficacy, systems thinking, and proactivity in problem-solving were measured before and after the DSL-based nursing education program. The collected data were analyzed using the IBM SPSS Statistics version 22.0.

RESULTS: The results demonstrated that nursing students’ team efficacy (t = – 8.228, p < .001, Cohen’s d = 1.079), systems thinking (t = – 9.757, p < .001, Cohen’s d = .731), and proactivity in problem-solving (t = – 8.635, p < .001, Cohen’s d = .992) significantly increased after the program.

CONCLUSIONS: The findings of this study can contribute to the development of nursing competency in nursing students without experience in nursing practicum. The authors recommend incorporating DSL in the nursing curriculum to promote early adaptation in clinical settings.

PMID:35614507 | DOI:10.1186/s12909-022-03462-z

BMC Nurs. 2022 May 25;21(1):128. doi: 10.1186/s12912-022-00915-0.

ABSTRACT

BACKGROUND: With the COVID-19 outbreak in China, the Chinese government took measures to prevent and control the spread of the virus. In-person teaching was replaced by distance learning, which was an unknown challenge for students. In this context, little is known about the perceived distress of nursing students and the relationship between psychological capital, perceived distress, and psychological stress. This study examined the relationship between psychological capital, psychological distress, and perceived stress, and the mediating role of psychological capital in the relationship between perceived stress and psychological distress among nursing students.

METHODS: This cross-sectional survey was conducted between January and December 2020 using a convenience sampling method involving 359 undergraduate and specialist nursing students at a tertiary hospital in Shandong Province. Standardised instruments were used to measure psychological capital, psychological stress, and perceived stress. We used SPSS 24.0 and PROCESS macro to analyse the data.

RESULTS: There was a statistically significant difference in perceived stress among students based on whether they liked the nursing profession (P < 0.01). Relative to nursing college students, undergraduates experienced significantly higher levels of perceived stress (P < 0.01). Nevertheless, there were no significant differences in perceived stress according to gender, place of residence, and being an only child. Psychological distress was positively correlated (r = 0.632, p < 0.001) with perceived stress (r =-0.662, p < 0.001), whereas it was negatively correlated with psychological capital. Psychological capital played a potential mediating role in the relationship between psychological distress and perceived stress.

CONCLUSIONS: Psychological distress was negatively correlated with psychological capital, and positively correlated with perceived stress. Mediation analyses indicated that psychological capital partially mediated the relationship between perceived stress and psychological distress. Educators should therefore heed students’ perceived stress and develop appropriate mental health counselling programmes for students in the curriculum that could help them reduce their psychological distress. In clinical practice, nursing managers must take effective measures, such as skills training, to improve the psychological capital of nursing students and reduce the negative impact of their psychological distress.

PMID:35614502 | DOI:10.1186/s12912-022-00915-0

Arthritis Res Ther. 2022 May 25;24(1):124. doi: 10.1186/s13075-022-02808-8.

ABSTRACT

INTRODUCTION: Foot involvement is a significant concern in psoriatic arthritis (PsA) as it can lead to severe levels of foot pain and disability and reduced mobility and quality of life. Previous studies have shown moderate efficacy for custom-made foot orthoses (CFO) in reducing foot pain and disability in people with rheumatoid arthritis. However, evidence on the efficacy of CFO in people with PsA is lacking.

OBJECTIVES: To explore the effects of CFO on foot function, foot and lower limb pain, gait function, and free-living walking activities (FWA) in people with PsA.

METHODS: A pre-experimental study including twenty participants with PsA (mean age: 54.10 ± 9.06 years and disease duration: 11.53 ± 10.22 years) was carried out. All the participants received and wore CFO for 7 weeks. Foot and lower limb pain and foot function were measured before and after the intervention using the numerical rating scale (NRS) and the foot function index (FFI). Gait function was assessed by recording spatiotemporal parameters (STPs) during a 10-m walk test using an instrumented gait analysis system (Mobility Lab). Free-living walking activities (step count, free-living cadence, time spent in different ambulatory physical activities (APA)) were recorded over 7 days using an accelerometer-instrumented sock.

RESULTS: The FFI reported scores demonstrated severe baseline levels of foot pain (54.46 ± 14.58 %) and disability (46.65 ± 16.14%). Statistically and clinically significant improvements in foot pain and foot function and large effect sizes (Cohen’s effect size > 1, p < 0.005) were observed after the intervention period. A strong correlation (r = -0.64, p < 0.01) between the CFO wearing time and foot function was demonstrated. However, no significant changes were found for gait STP or free-living walking activities after 7 weeks of CFO use.

CONCLUSION: Results support the clinical and biomechanical plausibility of using CFO in people with PsA to reduce pain and improve foot function. Large-scale and controlled studies are needed to confirm these findings. Moreover, a multidisciplinary approach including the prescription of exercise therapy and physiotherapy combined with CFO could be required to improve STP and promote APA in people with PsA.

TRIAL REGISTRATION: ClinicalTrials.gov , NCT05075343 . Retrospectively registered on September 29, 2021.

PMID:35614481 | DOI:10.1186/s13075-022-02808-8