Category: Statistics

J Obstet Gynaecol Res. 2022 Jun 24. doi: 10.1111/jog.15343. Online ahead of print.

ABSTRACT

AIM: To evaluate the effectiveness of a preeclampsia (PE) screening program using the National Institute for Health and Care Excellence (NICE) guideline in pregnant Thai women.

METHODS: A total of 2552 pregnancies received antenatal care and were delivered at Songklanagarind Hospital between November 2016 and April 2020. PE screening with the NICE guideline was used to identify mothers at risk. In cases of positive screening results, a daily dose of 81 mg aspirin was prescribed. Pregnancy outcomes were compared with 2783 participants who had maternity care before the implementation of the screening program. The effectiveness of aspirin prophylaxis following the NICE guideline was assessed by a logistic regression model to compare the risk of PE development between before and after guidance.

RESULTS: The screening positive rate by NICE was 8.3%. Of these, 77.36% of the participants received aspirin prophylaxis according to the NICE recommendation. After the implementation of the PE screening program, the incidence of PE slightly decreased (from 4.31% to 3.72%, p = 0.274). The chance of PE in pregnancies who had high-risk factors was reduced after using low-dose aspirin prophylaxis, even though the difference was not statistically significant.

CONCLUSIONS: Screening with the NICE guidelines followed by prescription of low-dose aspirin (81 mg/day) was probably not an effective strategy for the prevention of PE in our population. Combining biophysical and biochemical markers to identify pregnant women who subsequently develop PE, concurrently with an increased dose of aspirin prophylaxis, may provide a better outcome in clinical practice.

PMID:35751401 | DOI:10.1111/jog.15343

ESC Heart Fail. 2022 Jun 24. doi: 10.1002/ehf2.14035. Online ahead of print.

ABSTRACT

AIMS: The analysis of heart rate (HR) changes, such as the HR variability or HR turbulence, has been reported as a marker of cardiovascular events during sinus rhythm; however, those relationships during atrial fibrillation (AF) remain controversial, and those parameters are not commonly used in AF patients. We sought to investigate the relationship between a simple index focused on the HR and heart failure (HF) events in patients with permanent AF.

METHODS AND RESULTS: We enrolled 198 patients with permanent AF and evaluated the HR range, defined as the maximum HR minus the minimum HR on 24-h Holter electrocardiogram recordings. The patients were divided into two groups, i.e., the larger (n = 101) and smaller (n = 97) HR range (HRR) groups, determined by the median value. The HF events were defined as hospitalizations for HF or urgent hospital visits due to exacerbations of one’s HF status. The observation period of this study was set at 5 years from registration. The median age was 73 (68-77) years, and 29% were female. The median HRR was 84 (63-118) beats per minutes (bpm). During the observational period of 1825 days (median), HF events occurred in 37 (0.047 per patient-year) patients. In a log-rank test, the larger HRR group had more frequent HF events than the smaller HRR group (P = 0.0078). In the adjusted Cox proportional hazards model using the significantly different factors from the univariate analysis (Model 1) and factors and medications associated with HF (Model 2), the larger HRR group had a higher prevalence of HF events than the smaller HRR group for both models [Model 1, adjusted hazard ratio = 3.21, 95% confidence interval (CI) 1.593-6.708, P = 0.0009; Model 2, adjusted hazard ratio = 3.12, 95% CI 1.522-6.685, P = 0.002]. When analysed using the time-dependent Cox proportional hazards model, the HRR was associated with HF with a statistically significant difference in both the univariate and multivariate analyses [hazard ratio = 1.01, 95% CI 1.006-1.020, P = 0.0002; Model 1, adjusted hazard ratio = 1.02, 95% CI 1.011-1.027, P < 0.0001; Model 2, adjusted hazard ratio = 1.01, 95% CI 1.008-1.021, P = 0.0003). There was no significant difference in the chronotropic medications between the two groups.

CONCLUSIONS: In patients with permanent AF, a larger HRR was associated with HF events.

PMID:35751389 | DOI:10.1002/ehf2.14035

J Pak Med Assoc. 2022 Jun;72(6):1250-1254. doi: 10.47391/JPMA.1782.

ABSTRACT

OBJECTIVES: To evaluate YAG capsulotomy rates following implantation of two types of trifocal intraocular lenses (IOLs).

METHODS: In this retrospective cohort study consecutive patients who underwent cataract surgery with a trifocal IOL from 1st May 2017 to 30th October 2019 at Aga Khan University Hospital, Karachi were included. Eyes which either had an AT Lisa Tri or Alcon PanOptix IOL implant were included. The primary outcome measure was Nd: YAG laser. Univariate analysis of all predictor variables was performed followed by a multivariate regression analysis of those which were significant. A p-value of < 0.05 was taken as significant.

RESULTS: A total of 328 eligible eyes were identified. Nine eyes were excluded. Out of the 319 eyes of 177 patients included in this study, 180 received AT Lisa Tri while 139 of them received Alcon PanOptix Trifocal IOLs. The mean (SD) age of the patients was 52.29 years (±11.04). Gender was equally distributed with 91(51.4%). male patients. Median (IQR) time to laser capsulotomy was 8 months (3-16). Clinically posterior capsular opacification (PCO) was present in 75(23.5%) eyes. A total of 39(12.2%) eyes underwent Nd: YAG laser capsulotomy. Among the AT Lisa Tri group 29 (16.1%) eyes underwent laser capsulotomy compared to 10 (7.2%) (n=10) in Alcon PanOptix group (p=0.016). In both univariate and multivariate analyses, gender and IOL type were statistically significant.

CONCLUSIONS: Eyes implanted with AT Lisa Tri showed a significantly increased rate of YAG capsulotomy. A prospective randomized control trial is recommended to confirm these findings.

PMID:35751355 | DOI:10.47391/JPMA.1782

Indian Pediatr. 2022 Jun 11:S097475591600436. Online ahead of print.

ABSTRACT

OBJECTIVE: To study the association between serum magnesium level and migraine in children.

METHODS: This cross-sectional study enrolled children aged 5-18 years diagnosed with migraine, and age-and sex-matched controls without a headache disorder. International Classification of Headache Disorders 3 (ICHD-3) was used for the diagnosis of migraine. The association between serum magnesium level and migraine headache was analyzed.

RESULTS: A total of 35 children with migraine were enrolled with 35 control subjects. The median (IQR) serum magnesium levels were comparable among children with migraine and controls [2.0 (2.0,2.1) vs. 2.2 (1.9, 2.2) mg/dL; P=0.23], respectively. In adolescent sub-group, median (IQR) serum magnesium levels were significantly low among the children with migraine [2.0 (1.9, 2.1) vs. 2.2 (2.0, 2.2 mg/dL); P<0.045].

CONCLUSION: We found a statistically significant association between low serum magnesium levels and the occurrence of migraine in adolescents which needs further exploration as it may have treatment implications.

PMID:35751375

J Pak Med Assoc. 2022 Jun;72(6):1158-1165. doi: 10.47391/JPMA.3885.

ABSTRACT

OBJECTIVE: To determine the effectiveness of digital health technologies in the management of chronic pain.

METHODS: The systematic review comprised search for randomised controlled trials and controlled clinical trials involving patients with chronic pain published between 2010 and 2020. The search was conducted on PubMed, Google Scholar, MEDLINE, National Centre for Biotechnology Information, and National Library of Medicine databases. Risk bias tool was used to evaluate the biasness in the studies and Pedro scale was used to assess the quality of the included articles.

RESULTS: Of the 33 articles fully assessed, 14(42.42%) were analysed. All the studies analysed were randomised controlled trials and scored 6-10 on the Pedro scale which showed high quality of methodology. The studies typically reported statistically significant benefits of digital health technologies in the management of chronic pain. One of the main benefits was enhanced pain coping skills of the patients. Additionally, majority of the studies included increased adherence to exercise as an essential advantage.

CONCLUSIONS: All the studies analysed reported favourable conclusions regarding the use of digital intervention for chronic pain management.

PMID:35751328 | DOI:10.47391/JPMA.3885

J Pak Med Assoc. 2022 Jun;72(6):1123-1127. doi: 10.47391/JPMA.3368.

ABSTRACT

OBJECTIVE: To assess the diagnostic accuracy of haematoxylin-eosin staining in clinically suspected Hirschsprung disease, and to compare the findings with calretinin and S100 immunohistochemistry.

METHODS: The retrospective study was conducted at the AL-Khansaa Teaching Hospital, Nineveh, Iraq, and comprised data from January 2017 to October 2020 of rectal suction biopsies of patients with clinically and radiologically suspected Hirschsprung disease. Histopathology and immunohistochemistry were performed. Data was analysed using SPSS 16.

RESULTS: Of the 114 patients, 74(64.9%) were males and 40(35.1%) were females. Based on histology, 28(24.6%) cases were negative for ganglion cells, and, of them 25(89.2%) revealed nerve bundle hypertrophy. The diagnostic accuracy for the detection of ganglion cell and nerve hypertrophy using haematoxylin-eosin stain was 99.1% and 94.4%, respectively. Correlation of haematoxylin-eosin staining with calretinin and S100 was statistically near perfection (κ= 0.976 and κ = 0.923), respectively.

CONCLUSIONS: The mainstay to confirm or exclude Hirschsprung disease remains an accurate histopathological evaluation of the haematoxylin-eosin-stained sections of an adequate colorectal biopsy.

PMID:35751321 | DOI:10.47391/JPMA.3368

J Pak Med Assoc. 2022 Jun;72(6):1044-1047. doi: 10.47391/JPMA.800.

ABSTRACT

OBJECTIVE: To compare incubator and thermal blanket for thermoregulation in preterm and low birth weight neonates.

METHODS: The pilot study was conducted from January to March 2018 at the emergency department of the National Institute of Child Health, Karachi, and comprised preterm and low birth weight neonates without any co-morbidity who were randomised to control and interventional groups. Data was collected using a proforma about demographics, weight, gestational age and brief clinical history. Temperature, blood pressure and pulse were monitored along with other routine care after every 15 minutes in the incubator, and the same procedure was adopted for thermal blankets. Data was analysed using Statistical Package for Social Sciences (SPSS) Version 23.

RESULTS: Of the 38 subjects, 19(50%) each were cases and controls. The mean gestational age between the groups was not significantly different (p>0.05). Temperature for the first 60 minutes remained similar in the two groups, but at 75 minutes and onwards, the incubator showed a significantly better results (p<0.05).

CONCLUSION: Thermal blankets can sufficiently provide a hyperthermic environment to the neonates, but an incubator is a more reliable option to provide sustained temperature.

PMID:35751306 | DOI:10.47391/JPMA.800

J Pak Med Assoc. 2022 Jun;72(6):1035-1038. doi: 10.47391/JPMA.366.

ABSTRACT

OBJECTIVE: This study aims to evaluate the serological, radiological and epidemiological analysis of suspected cystic echinococcosis patients, and to assess the positivity rate in the region.

METHODS: The retrospective study was conducted at Bursa Uludag University Hospital, Turkey and comprised data from January 2009 to December 2017 related to patients of either gender with suspected cystic echinococcosis who underwent indirect haemagglutination testing. Demographic and clinical data of patients who tested positive were analysed. Statistical analysis was done using SPSS 23.

RESULTS: Of the 3910 patients with a mean age of 41.6±19.35 years (range: 0-93 years) who underwent indirect haemagglutination testing, 692(17.7%) tested positive; 390(56.4%) females, and 302(43.6%) males. The highest seropositivity rate 107(15.5%) was observed in 2011, followed by 104(15%) in 2016. Seropositive cases were predominantly seen in those aged 40-49 years 131 (18.9%), followed by those aged 50-59 years 124 (17.9%).

CONCLUSIONS: Cystic echinococcosis was found to be a public health problem in South Marmara region of Turkey.

PMID:35751304 | DOI:10.47391/JPMA.366

J Environ Manage. 2022 Sep 1;317:115464. doi: 10.1016/j.jenvman.2022.115464. Epub 2022 Jun 5.

ABSTRACT

Based on the panel data of 20 countries in EU during the period of 2007-2019, this paper study the effect of energy market integration (EMI) on renewable energy development (RED). We develop a general equilibrium model to explain how EMI affect the RED and the role of different mechanisms. The empirical results reports that the European EMI increased both the consumption and power generation of renewable energy, which proves a significant positive effect of EMI on the RED. In line with our expectations of theoretical model, our estimates show that the increase of renewable energy consumption is mainly due to the fossil energy cost increased, technology advancement and regional environmental regulation strengthening. And the fossil energy cost is the main driven force which plays a completely mediating role between EMI and RED. Furthermore, we also observe a negative effect of FDI and industry structure on RED.

PMID:35751265 | DOI:10.1016/j.jenvman.2022.115464

J Environ Manage. 2022 Sep 1;317:115484. doi: 10.1016/j.jenvman.2022.115484. Epub 2022 Jun 9.

ABSTRACT

Water conservation is vital to safeguard future water availability when natural resources like water become extremely scarce. It is fundamental to understand the significant determinants of water conservation activities which can also facilitate the implementation of appropriate policies for water demand management. Thus, the goal of this study was to determine the important social, psychological, and behavioral factors of water conservation behavior. A questionnaire survey was used to collect the data from 625 international students and employees from different universities in Japan. The structural equation modeling demonstrated that the proposed model explained 46% of the variation in water conservation behavior. Awareness of water issues was highly related to attitude, responsibility, and culture. Except for culture, attitude and responsibility were significantly connected with emotion. Finally, emotion, habit, culture and involvement were significantly and positively associated with water conservation behavior. These factors are incorporated for the first time in this study into a single model to better understand individual water conservation behavior. The sequential regression model showed that all determinants including demographic factors raised the variation’s proportion by 53% in water conservation. Female participants had a significantly higher positive attitude, emotion, and water conservation behavior than male participants. Older participants exhibited higher levels of awareness, habit, culture, and water conservation behavior when compared to younger people. Lastly, participants believed that the most dominant component in water conservation behavior was the awareness of water issues. These findings could assist policymakers in raising household awareness, accountability, and involvement towards water conservation efforts.

PMID:35751281 | DOI:10.1016/j.jenvman.2022.115484