Category: Statistics

Niger J Clin Pract. 2021 Aug;24(8):1240-1246. doi: 10.4103/njcp.njcp_611_19.

ABSTRACT

BACKGROUND: The serum adiponectin level (AD), adiponectin resistance (AD-R) may reflect the degree of metabolic syndrome (MetS). The role parameter AD-R, The Homeostasis Model Assessment-Adiponectin (HOMA-AD) index on the coronary artery disease (CAD) severity is not still understood.

OBJECTIVE: To determine adiponectin concentration and HOMA-AD index in patients with CAD with/without MetS and to evaluate their prognostic importance on severity of CAD.

METHODS: This cross-sectional study involved selected 130 examinees which were divided into three groups: CAD+MetS, CAD-MetS, control group (no CAD/MetS). In all examinees values of biochemical and anthropometric parameters were determined. We analyzed the severity of coronary artery lesions from coronary angiography. Total serum adiponectin concentration was measured by ELISA. We calculated atherogenic Gensini scoring system, Duke prognostic index, and HOMA-AD-index.

RESULTS: Serum adiponectin level was significantly lower in the group with CAD+MetS (p < 0.001) and in CAD-MetS group (p < 0.01), compared to the control group. The HOMA-AD index showed statistically significant positive correlation with the key parameters of MetS, as well as with the parameters of CAD, number of CAD and modified Gensini score. After applying logistic regression analysis the best predictors for CAD were: adiponectin, blood pressure, HOMA-IR index, and HOMA-AD index. The cut-off values of adiponectin ≤1506.38 pg/mL, HOMA-IR index ≥3.91 and HOMA-AD index ≥0.67 were associated with a higher risk of CAD.

CONCLUSION: Patients with CAD with or without MetS had low adiponectin levels and this hypoadiponectinemia indicates that AD and HOMA-AD index may be a useful marker for identifying patients at risk for CAD.

PMID:34397037 | DOI:10.4103/njcp.njcp_611_19

Niger J Clin Pract. 2021 Aug;24(8):1247-1251. doi: 10.4103/njcp.njcp_92_21.

ABSTRACT

BACKGROUND: Chest injury remains a major source of morbidity and mortality in trauma as approximately two-thirds of all severe traumas involve the chest.

OBJECTIVE: To determine the changes in the profile management and outcome of severe chest injury in Jos University Teaching Hospital, Jos, Nigeria.

MATERIALS AND METHODS: This is an analysis of the Trauma Registry of Jos University Teaching Hospital-a prospectively gathered database. Patients’ entries with severe chest injuries for 7 years, from January 2012 to December 2018, were entered into a database and analyzed using the Epi Info Statistical Software, using simple statistics.

RESULTS: In all, 162 patients presented with severe chest injury over a 7-year period, of whom 78 (48.1%) had polytrauma, while 84 (51.9%) had isolated chest injury. There were 139 males and 23 females, giving male: female ratio of 6:1. Over 95 (58.6%) of them were between 20 and 39 years. Blunt injury was predominant, constituting 66.7%. Motor vehicular crash was the most common mechanism of injury constituting 87 (53.7%), while gunshot injuries were responsible for 34 (21%). In managing these severe chest injuries, 146 (90%) of the patients had closed-chest tube thoracostomy as the definitive treatment, while 16 (9.9%) had thoracotomy. The mean and median duration of hospital stay was 13.3 and 10 days, respectively. The commonest complication was wound infection in 8 (4.9%) patients and a mortality of 5.9%.

CONCLUSION: Blunt chest injury remains the commonest mechanism of chest injury but with an increasing proportion of penetrating injuries affecting predominantly young males. Most severe chest injury patients survive with simple interventions of resuscitation, and closed-chest tube thoracostomy for definitive treatment.

PMID:34397038 | DOI:10.4103/njcp.njcp_92_21

Niger J Clin Pract. 2021 Aug;24(8):1181-1187. doi: 10.4103/njcp.njcp_152_20.

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the expression level and clinical significance of inflammatory factors and biochemical markers in gingival crevicular fluid during different crown-binding styles in dental implant patients.

METHODS: A total of 38 patients with posterior tooth loss and implant repair were recruited and divided into two groups according to the different ways of crown bonding, including 19 prostheses (19 patients) in the adhesive retainer group and 19 prostheses (19 patients) in the modified adhesive retainer group. Moreover, the peri-implant gingival sulcus fluids of each group of patients were collected at 7, 15, 30, 60, and 90 d of post-treatment, and the expression level of each cytokine as well as biochemical marker were analyzed by enzyme-linked adsorption method, respectively.

RESULTS: Compared with the control group, the peri-implant plaque index and gingival bleeding index were decreased in the observation group. In addition, the secretion of peri-implant gingival crevicular fluid in the observation group was significantly higher than that of the control group. The level of IL-6, TNF-α expressions in peri-implant gingival crevicular fluid were gradually decreased with follow-up time, and the rate of decline gets slow at 15 h after operation. The TGFα in peri-implant gingival crevicular fluid in the two groups began to increase at 7 d, reached a peak at about 15 d, then slowly decreased and stabilized after 60 d. While the OCN was gradually increased during the whole detection process, slowly released before 30 d, then increasingly released and maintained at a peak state after 60 d. All the above differences were statistically significant (P < 0.05).

CONCLUSION: Different crown-binding patterns of implant teeth have a significant effect on the secretion amount of peri-implant gingival crevicular fluid and the expression level of inflammatory cytokines as well as biochemical markers.

PMID:34397028 | DOI:10.4103/njcp.njcp_152_20

Niger J Clin Pract. 2021 Aug;24(8):1188-1193. doi: 10.4103/njcp.njcp_687_20.

ABSTRACT

BACKGROUND: Helicobacter pylori (H. pylori) is a gram-negative ubiquitous bacterium affecting over half of the world’s population. Most infections are acquired in early childhood with highest prevalence in Africa and Asia. Infected individuals develop antibodies against H. pylori which persist up to 6 months after eradication. Low socioeconomic status, poor sanitation, poor personal hygiene, and absence of potable household water supply are prevalent in our environment and also linked with increased frequency of the disease with attendant health consequences.

AIMS: The aim of the study was to determine the seroprevalence of H. pylori infection and potential sociodemographic factors among children in Owerri.

METHODS: One hundred and twenty children aged 6 months to 15 years were studied from March to June 2016. Sociodemographic data was documented in a pretested structured questionnaire while rapid test kit that detects antibody to H. pylori by chromatographic flow was used to identify subjects with infection. Data were analyzed using SPSS version 20.0 with level of statistical significance at P < 0.05.

RESULTS: H. pylori infection prevalence was 20.0%, increased with age and highest in the 10-15 years age group (P = 0.001). Increasing age and low socioeconomic class (SEC) were found to be significant risk factors of H. pylori seropositivity among study subjects.

CONCLUSION: Prevalence of H. pylori infection was high, increased with age and lower SEC as well as highest among children aged 10 years and older. Efforts should be made to exclude H. pylori infection in children with suspected symptoms considering the high burden of the disease in our setting.

PMID:34397029 | DOI:10.4103/njcp.njcp_687_20

Niger J Clin Pract. 2021 Aug;24(8):1234-1239. doi: 10.4103/njcp.njcp_553_20.

ABSTRACT

AIMS: The aim of this study is to evaluate the multidisciplinary treatment relationship between the two specialties of Dentistry, Departments of Periodontology and Orthodontics, by examining consultation request notes between the two departments.

MATERIALS AND METHODS: The consultation request notes of 1685 patients who were treated at Erciyes University Faculty of Dentistry were included in the study. All notes were analyzed retrospectively and divided into categories. While the consultation request notes of 446 patients from the Department of Periodontology (DP) to the Department of Orthodontics (DO) were evaluated, the consultation request notes of 1239 patients from DO to DP were evaluated. Pearson’s Chi-Squared test was used in the cloud-based TURCOSA statistical software for the statistical analysis of the obtained data.

RESULTS: The highest number of requests for consultation from DP to DO was due to “Evaluation of the patient for orthodontic treatment (n = 203; 45.5%),” and the highest number of requests from DO to DP was “Gingival/Periodontal Treatment and Providing Motivation of Oral Hygiene (n = 558; 45.0%)”. It was observed that most patients for whom consultation was requested were women (P < 0.05).

CONCLUSIONS: This study determined the most common reasons for consultation requests between DP and DO and the sex which was the most prevalent. It was concluded that requests were made for the expertise of the other department for problems that could not be solved by the first department.

PMID:34397036 | DOI:10.4103/njcp.njcp_553_20

Natl Med J India. 2021 Jan-Feb;34(1):4-9. doi: 10.4103/0970-258X.323446.

ABSTRACT

BACKGROUND: . Diabetes-related health education promotes patient efficacy for diabetes self-management. However, sub-optimal knowledge of diabetes in people with diabetes is recognized as a challenge in overcrowded public health facilities in India. We aimed to determine the effect of health education through mobile phone text messages (short messaging service [SMS]) on diabetes-related knowledge of patients with diabetes.

METHODS: . From February 2016 to February 2017, we recruited adult patients with diabetes for this quasi-experimental study done in the outpatient setting of a major tertiary care government hospital in Delhi, India. Participants in the intervention group received a text message on diabetes self-care practices every alternate day for 90 days. We evaluated the patients’ knowledge of diabetes using the Spoken Knowledge in Low Literacy in Diabetes (SKILL-D) questionnaire and a self-designed diabetes knowledge questionnaire.

RESULTS: . We enrolled 190 men and 160 women, of whom 52 (13.7%) were lost to follow-up. At baseline, mean diabetes knowledge scores were higher in the intervention group compared to the control group. After the intervention period of 3 months, the diabetes knowledge scores for SKILL-D and the patient diabetes knowledge questionnaire showed a statistically significant increase in the intervention group (mean difference 0.7 and 0.5, respectively; p<0.001, but there was no increase in the control group).

CONCLUSION: . The use of mobile phone technology for diabetes-related health education through mobile text-message (SMS) technology is an effective method for health promotion.

PMID:34396996 | DOI:10.4103/0970-258X.323446

Niger J Clin Pract. 2021 Aug;24(8):1159-1163. doi: 10.4103/njcp.njcp_574_19.

ABSTRACT

OBJECTIVE: Our aim was to compare the efficacy of two triggering method one with dual triggering with gonadotropin-realising hormon (GnRH) agonist plus standard dosage human chorionic gonadotropin (hCG) and the other with hCG only for final oocyte maturation on oocyte/follicle ratio and pregnancy rates in normoresponders in GnRH antagonist cycles in invitro fertilization-intrastoplasmic sperm injection (IVF-ICSI).

MATERIAL METHODS: In this retrospective study, all patients underwent GnRH antagonist protocol. When at least ≥3 follicles reached ≥17 mm diameter, 116 patients received dual trigger with GnRH agonist plus hCG (1mg Leuprolide acetate plus 10.000 IU uhCG) and 178 patients received uhCG (10.000 IU u hCG) for final oocyte maturation. All follicles ≥10 mm diameter were aspirated. Number of oocytes and metaphase II oocytes retrieved per aspirated follicles, implantation rate, and clinical pregnancy rate per cycle was recorded.

RESULTS: There was no statistically significant difference in terms of metaphase II oocyte ratio per aspirated follicle, implantation rate and clinical pregnancy rate between the dual trigger group and hCG only group (45.7% vs. 51%; 35.4% vs.30.3% and 45%vs. 40% respectively). Oocyte/ follicle ratio was significantly higher in dual trigger group (68.2%vs 63.8% p=0,028).

CONCLUSIONS: Dual triggering in normal responders with a GnRH-agonist and a standard dosage of hCG is superior to hCG only protocol in terms of oocyte/follicle ratio but does not improve metaphase II oocyte, implantation and clinical pregnancy rates in GnRH-antagonist cycles. Dual triggering method may be beneficial in patients with immature oocytes and emty follicle syndrome.

PMID:34397024 | DOI:10.4103/njcp.njcp_574_19

Disaster Med Public Health Prep. 2021 Aug 16:1-6. doi: 10.1017/dmp.2021.193. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is to assess the impact that natural disaster response has on local health departments’ (LHD) ability to continue to provide essential public health services.

METHODS: A web-based survey was sent to all North Carolina Local Health Directors. The survey asked respondents to report on LHD functioning following Hurricanes Florence (2018) and Dorian (2019).

RESULTS: After Hurricane Florence, the positions who most frequently had regular duties postponed or interrupted were leadership (15 of 48; 31.3%), and professional staff (e.g., nursing and epidemiology: 11 of 48; 22.9%). Staffing shelters for all phases – from disaster response through long-term recovery – was identified as a burden by LHDs, particularly for nursing staff. Approximately 66.6% of LHD jurisdictions opened an Emergency Operations Center (EOC) or activated Incident Command System in response to both hurricanes. If an EOC was activated, the LHD was statistically, significantly more likely to report that normal duties had been interrupted across every domain assessed.

CONCLUSIONS: The ability of LHDs to perform regular activities and provide essential public health services is impacted by their obligations to support disaster response. Better metrics are needed to measure the impacts to estimate indirect public health impacts of disasters.

PMID:34396948 | DOI:10.1017/dmp.2021.193

Am J Clin Nutr. 2021 Aug 16:nqab262. doi: 10.1093/ajcn/nqab262. Online ahead of print.

ABSTRACT

A double-blind controlled trial initiated in 1944 has led to the common narrative that a 10-mg daily vitamin C intake is adequate to prevent and treat impaired wound healing, and by inference, other collagen-related diseases such as heart disease or stroke. The WHO relies on this narrative to set the recommended nutrient intake for vitamin C. This narrative, however, is based on what is known as the eyeball method of data assessment. The 1944 trial published individual participant data on scar strength providing an opportunity to statistically probe the validity of the 10-mg narrative, something which has not yet been done. The findings show that a vitamin C intake that averages to 10 mg/d over a mean follow-up of 11.5 mo was associated with a 42% weakened scar strength when compared with 80 mg vitamin C intake/d (P < 0.001). The observed dose-response curve between scar strength and vitamin C intake suggests that the daily vitamin C intake needed to prevent collagen-related pathologies is in the range recommended by the National Academy of Medicine and the European Food Safety Authority (75 to 110 mg/d), not the WHO recommendation (45 mg/d). The findings also show that a vitamin C intake that averages to 65 mg/d over a mean follow-up of 6.5 mo failed to restore the normal wound-healing capacity of vitamin C-depleted tissues; such tissues had a 49% weaker scar strength when compared with nondepleted tissues (P < 0.05). Thus, average daily vitamin C intakes ∼50% higher than the WHO recommends may fail to treat existing collagen-related pathologies. It is concluded that the prior lack of statistical analyses of a landmark trial may have led to a misleading narrative on the vitamin C needs for the prevention and treatment of collagen-related pathologies.

PMID:34396385 | DOI:10.1093/ajcn/nqab262

J Infect Dis. 2021 Aug 16;224(Supplement_2):S64-S71. doi: 10.1093/infdis/jiab149.

ABSTRACT

BACKGROUND: Chlamydia trachomatis (Ct) infection ascending to the upper genital tract can cause infertility. Direct association of genetic variants as contributors is challenging because infertility may not be diagnosed until years after infection. Investigating the intermediate trait of ascension bridges this gap.

METHODS: We identified infertility genome-wide association study (GWAS) loci using deoxyribonucleic acid from Ct-seropositive cisgender women in a tubal factor infertility study and Ct-infected cisgender women from a longitudinal pelvic inflammatory disease cohort with known fertility status. Deoxyribonucleic acid and blood messenger ribonucleic acid from 2 additional female cohorts with active Ct infection and known endometrial infection status were used to investigate the impact of infertility single-nucleotide polymorphisms (SNPs) on Ct ascension. A statistical mediation test examined whether multiple infertility SNPs jointly influenced ascension risk by modulating expression of mediator genes.

RESULTS: We identified 112 candidate infertility GWAS loci, and 31 associated with Ct ascension. The SNPs altered chlamydial ascension by modulating expression of 40 mediator genes. Mediator genes identified are involved in innate immune responses including type I interferon production, T-cell function, fibrosis, female reproductive tract health, and protein synthesis and degradation.

CONCLUSIONS: We identified Ct-related infertility loci and their potential functional effects on Ct ascension.

PMID:34396400 | DOI:10.1093/infdis/jiab149