Nevin Manimala

Artif Organs. 2024 Aug 19. doi: 10.1111/aor.14841. Online ahead of print.

ABSTRACT

BACKGROUND: Ex vivo machine perfusion (EVMP) has been established to extend viability of donor organs. However, EVMP protocols are inconsistent. We hypothesize that there is a significant relationship between specific parameters during EVMP and perfusion outcomes.

METHODS: A meta-analysis of literature was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement. The search encompassed articles published before July 25, 2023. PubMed, Embase, and CENTRAL databases were screened using search terms “ex-vivo,” “ex-situ,” “machine,” and “perfusion.” Weight gain, an indicator of organ viability, was chosen to compare outcomes. Extracted variables included perfused organ, warm and cold ischemia time before perfusion, perfusion duration, perfusate flow, pressure, temperature, perfusate composition (presence of cellular or acellular oxygen carrier, colloids, and other supplements) and percent weight change. Data were analyzed using SPSS statistical software.

RESULTS: Overall, 44 articles were included. Red blood cell-based perfusates resulted in significantly lower weight gain compared to acellular perfusates without oxygen carriers (11.3% vs. 27.0%, p < 0.001). Hemoglobin-based oxygen carriers resulted in significantly lower weight gain compared to acellular perfusates (16.5% vs. 27%, p = 0.006). Normothermic perfusion led to the least weight gain (14.6%), significantly different from hypothermic (24.3%) and subnormothermic (25.0%) conditions (p < 0.001), with no significant difference between hypothermic and subnormothermic groups (24.3% vs. 25.0%, p = 0.952). There was a positive correlation between flow rate and weight gain (ß = 13.1, R = 0.390, p < 0.001).

CONCLUSIONS: Oxygen carriers, low flow rates, and normothermic perfusate temperature appear to improve outcomes in EVMP. These findings offer opportunities for improving organ transplantation outcomes.

PMID:39157933 | DOI:10.1111/aor.14841

Int J Gynaecol Obstet. 2024 Aug 19. doi: 10.1002/ijgo.15864. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the study was to analyze the association between de novo urethral hypermobility 6 months postpartum and stress urinary incontinence (SUI) symptoms at 6 months and 12 years after first delivery. Risk factors associated with the development of postnatal urethral hypermobility were also examined.

METHODS: A longitudinal cohort study was conducted on primigravid women, after excluding those with UI before pregnancy and/or urethral hypermobility (rotational angle ≥30°) at term. At 6 months postpartum, SUI was assessed based on symptoms and introital ultrasound performed to measure rotational angle (difference between urethro-pelvic angle at rest and at maximum Valsalva). Twelve years after delivery, women were sent a questionnaire including SUI assessment and questions on parity, current age, and body mass index. Continuous variables were compared using student’s t-test and qualitative variables using chi-squared tests. A logistic regression model was constructed including variables that reached statistical significance (P < 0.05) in the univariate analysis.

RESULTS: Of the 314 women who completed the 6-month follow-up, 265 (84.4%) were successfully contacted and completed the questionnaire at 12 years and these formed the study group. In 127 women (47.9%), de novo urethral hypermobility had developed by 6 months postpartum. There was no association between urethral hypermobility and SUI symptoms 6 months postpartum (OR: 1.17; 95% CI: 0.59-2.33). Twelve years after delivery, however, SUI was reported by 110 women overall (41.5%) and nearly half of the women who developed postnatal urethral hypermobility (61/127, 48.0%).

CONCLUSION: De novo urethral hypermobility 6 months postpartum constitutes a risk factor for SUI 12 years later.

PMID:39157930 | DOI:10.1002/ijgo.15864

Cancer Med. 2024 Aug;13(16):e7458. doi: 10.1002/cam4.7458.

ABSTRACT

OBJECTIVE: This study aimed to verify if intraoperative radiotherapy (IORT) can achieve the same survival outcome as whole-breast external beam radiotherapy (EBRT) in early breast cancer after breast-conserving surgery (BCS), and to explore the suitable candidates that can safely receive IORT after BCS.

METHODS: Eligible post-BCS patients who received IORT or EBRT were included in the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2018. Risk factors that affected 5-year overall survival (OS) or breast cancer specific survival (BCSS) were identified by Cox proportional hazards regression analysis. Clinical characteristics, OS, and BCSS were comparatively analyzed between the two treatment modalities.

RESULTS: The survival analysis after propensity score matching confirmed that patients who received IORT (n = 2200) had a better 5-year OS than those who received EBRT (n = 2200) (p = 0.015). However, the two groups did not differ significantly in 5-year BCSS (p = 0.381). This feature persisted even after multivariate analyses that took into account numerous clinical characteristics. Although there was no significant difference in BCSS between different subgroups of patients treated with IORT or EBRT, patients over 55 years of age, with T1, N0, non-triple negative breast cancers, hormone receptor-positive, and histologic grade II showed a better OS after receiving IORT.

CONCLUSION: In low-risk, early-stage breast cancer, IORT was not inferior to EBRT considering 5-year BCSS and OS. Considering the equivalent clinical outcome but less radiotoxicity, IORT might be a reasonable alternative to EBRT in highly selective patients undergoing BCS.

PMID:39157891 | DOI:10.1002/cam4.7458

Scand J Caring Sci. 2024 Aug 19. doi: 10.1111/scs.13293. Online ahead of print.

ABSTRACT

BACKGROUND: Preterm newborns face many health problems due to their incomplete intrauterine development and the immaturity of their systems. One of these problems concerns nutrition. This study aimed to determine the effect of online kangaroo care (KC) training provided post-discharge on breastfeeding self-efficacy in mothers with preterm infants.

METHODS: This research was conducted as an experimental study with a randomised control group. Two groups were formed: kangaroo care and control. The sample of the study consisted of 68 mothers of preterm infants. The mothers in the KC group were given online KC training after discharge from the hospital. The mothers were asked to perform KC regularly, at least once a day, for 20 min, 7 days a week. The Breastfeeding Self-Efficacy Scale was administered to the mothers before and after training.

RESULTS: The results of the study revealed that the difference between the pre-test and post-test breastfeeding self-efficacy scores was statistically significantly higher among the mothers who received online KC training compared with the controls (p < 0.001).

CONCLUSION: According to the results of our research carried out in this context, the mothers who received online KC training had increased breastfeeding self-efficacy compared to those in the control group.

PMID:39157886 | DOI:10.1111/scs.13293

J Oral Maxillofac Pathol. 2024 Apr-Jun;28(2):351-357. doi: 10.4103/jomfp.jomfp_540_23. Epub 2024 Jul 11.

ABSTRACT

BACKGROUND: Endless ink and pixel space have been spent to validate the use of cheiloscopy classification systems in the field of identification. It is becoming evident that lip-print patterns may provide indications about an individual’s gender, race, occupation, habits, blood type, and paternity. Over the course of time, much data have been collected on a substantial population in this field. In the present study, we strive to see how well a noble total lip scoring (TLS) system works in identifying a person’s gender among the College of Dentistry students. We also quantified the total groove score (TGS) and compared it with each quadrant for better authentication of the set study design.

MATERIALS AND METHOD: A cross-sectional descriptive study was conducted among 60 dental students (30 males and 30 females), with an age range of 18-30 years. Lip prints were recorded using the writing pad method and subsequently digitalized by capturing the images using Adobe Photoshop CS 6 Extended Version, counted and summed up, quadrant-wise, in both upper and lower lips. The TLS and TGS between males and females were statistically calculated using the Jamovi project.

RESULTS: The mean value for TLS for males (n = 402; SD ± 92.1) is higher than that for females (n = 348; SD ± 86.1). The correlation matrix applying a non-parametric test for non-continuous data using Spearman’s ratio inferred a statistically significant correlation (-0.354) with a P-value of 0.005 for TLS, whereas a correlation (-0.162) of TGS with gender was not so significant with a P-value of 0.217.

CONCLUSION: Our study proved the uniqueness of applying TLS as a novel approach to gender identification. The study revealed that males had a statistically higher lip score than females.

CLINICAL SIGNIFICANCE/FUTURE IMPLICATIONS: Being unique, our study inferred the importance of TLS, which needs to be explored in detail for applying, evaluating, and validating its accuracy in forensic research that can help for errorless investigations as full-proof evidence in court.

PMID:39157853 | PMC:PMC11329097 | DOI:10.4103/jomfp.jomfp_540_23

J Oral Maxillofac Pathol. 2024 Apr-Jun;28(2):226-231. doi: 10.4103/jomfp.jomfp_83_24. Epub 2024 Jul 11.

ABSTRACT

INTRODUCTION: Saliva enables the maintenance of oral and systemic health. Evaluation of saliva is very valuable for multiple parameters to be evaluated as they are easy to collect, allow easy and safe sample collection, are non-traumatic, can be repeated with ease, and are non-invasive in nature. Salivary enzyme systems have antimicrobial, antioxidant, and similar functions which aid in the maintenance of homeostasis in the oral cavity. Antioxidants scavenge free radicals from cells and prevent or reduce the damage caused by oxidation.

MATERIALS AND METHODS: In the present study, the pH and antioxidant capacity of the saliva were evaluated. Subjects were categorized as GROUP A: Vegetarians: Diets were entirely devoid of eggs or meat of any type (for more than 20 years). GROUP B: Non-vegetarians: Diets included both red and white meat, consumed either daily or frequently. GROUP C: Eggetarians: Otherwise vegetarian diets which includes eggs, consumed frequently. Ten samples of each group were collected. The pH profile and antioxidant activity of the samples were analysed. Each of the individuals was subjected to oral examination for grading of the status of oral hygiene, caries teeth, missing and extracted teeth, and the health of gingiva. For the same Oral Hygiene Index Simplified (OHIS), Decayed, Missing, and Filled Teeth (DMFT) and Gingival Status indices were used and the observations were noted.

OBSERVATIONS AND RESULTS: The average salivary pH for the vegetarians was 7 ± 0.5, that for eggetarians was 7.1 ± 0.5, and in the non-vegetarian group, the average pH was equal to 7.3 ± 0.5. Using the DPPH method, the percentage antioxidant activity of saliva in vegetarians was 20.9 ± 2.1%, while those of eggetarians and non-vegetarians were equal to 5 ± 0.6% and 11.4 ± 2%, respectively. Each individual was subjected to oral examination for grading of the status of oral hygiene (OHIS); decayed, missing, extracted teeth, filled teeth index (DMFT); and the health of gingiva (gingival status index). Overall, eggetarians had a high OHIS index (mean 1.08). The DMFT index was high in non-vegetarians with values ranging from 1 to 8. Statistical analysis using the T-test revealed that the antioxidant potential of the vegetarian group was significantly higher than those of the eggetarian and non-vegetarian dietary groups (P < 0.001). However, the eggetarian and non-vegetarian dietary groups did not significantly differ from each other with respect to this parameter.

CONCLUSION: The antioxidant capacity is markedly high in vegetarians, 20.9+/- 2.1%, as compared to non-vegetarians, 11.4+/- 2.1%, and was the lowest in eggetarians, 5+/- 0.6%.

PMID:39157847 | PMC:PMC11329075 | DOI:10.4103/jomfp.jomfp_83_24

J Oral Maxillofac Pathol. 2024 Apr-Jun;28(2):200-204. doi: 10.4103/jomfp.jomfp_310_23. Epub 2024 Jul 11.

ABSTRACT

CONTEXT: Caveolin-1 is a surface protein that is a major structural component of caveolae, which are vesicles of the plasma membrane integral to a variety of signal transduction molecules and transport functions. Caveolin-1 is a biomarker undergoing research & studies have shown an increased expression of Cav-1 in the stepwise carcinogenesis from the normal oral mucosa, hyperplastic mucosa, dysplastic mucosa, precancerous lesions to Oral Squamous Cell Carcinoma. In the present study Correlation between Caveolin-1 expression and grade of tumor was established statistically.

AIMS: To study immunohistochemical expression of Caveolin-1 in Oral Squamous Cell Carcinoma.

SETTINGS AND DESIGN: Cross sectional study carried out in a tertiary care hospital.

MATERIALS AND METHODS: A total of 90 cases of histopathologically diagnosed oral squamous cell carcinoma was evaluated. Grading of the cases into well, moderate and poorly differentiated carcinomas was done as per WHO guidelines . Margin and lymph node status were evaluated. Anti- Caveolin-1 antibody (E249)- Caveolae marker ab32577 was used in the dilution of 1:100. Results were expressed taking reference of the methodology used by Hung et al 2003.

STATISTICAL ANALYSIS USED: Statistical Package for the Social Sciences (SPSS 25.0).

RESULTS: Correlation of tumor grade and lymph node metastasis was statistically significant p=0.0006. There was a significant statistical correlation between tumor grade and immunohistochemical expression of Caveolin-1, p– value=0.00. Correlation between Lymph node metastasis and Caveolin-1 was statistically significant, p-value=0.008.

CONCLUSIONS: Caveolin-1 expression correlates with aggressive tumor behavior and poor prognostic outcome.

PMID:39157842 | PMC:PMC11329077 | DOI:10.4103/jomfp.jomfp_310_23

J Oral Maxillofac Pathol. 2024 Apr-Jun;28(2):178-181. doi: 10.4103/jomfp.jomfp_462_23. Epub 2024 Jul 11.

ABSTRACT

BACKGROUND: Stress is faced by every individual in their day-to-day life activities. During pandemic, most people have experienced multiple episodes of depression, anxiety, and insomnia. Several medical and dental problems are reported with stress and the fastest and easiest way to study and investigate is through body fluids, mainly saliva. Hence, we aim to study salivary α amylase in disabled individuals and hypothesize that salivary α amylase could be a reliable stress biomarker in disabled individuals.

MATERIALS AND METHODS: Cross-sectional study was conducted including 200 individuals grouped into controls (100) and disabled individuals (100). Disabled individuals were further grouped into physically (50) and mentally (50) disabled. Stimulated and unstimulated saliva was collected from all the participants and were investigated for salivary α-amylase by direct substrate method. The enzyme activity was analyzed using a spectrophotometer and the obtained were analyzed statistically.

RESULT: Salivary α-amylase showed significant difference between controls and disabled group (p = 0.000). Salivary α-amylase was least in the mentally disabled group compared to physically disabled group. Age related comparison of salivary α-amylase was higher in physically disabled whereas gender related comparison showed females in physically disabled group to be more affected than controls.

CONCLUSION: Saliva, the easy and most researched fluid, is rich in salivary α-amylase. Salivary α-amylase is a potential biomarker to assess stress. Further diagnostic studies are required to know the salivary changes and their influence on individual general health status.

PMID:39157841 | PMC:PMC11329072 | DOI:10.4103/jomfp.jomfp_462_23

J Oral Maxillofac Pathol. 2024 Apr-Jun;28(2):247-252. doi: 10.4103/jomfp.jomfp_168_23. Epub 2024 Jul 11.

ABSTRACT

BACKGROUND: Nodal involvement in squamous cell carcinoma is an important feature directly associated with the poor prognosis in patients with head and neck squamous cell carcinoma (HNSCC). There are no clear cut indicators available currently to identify the lymph node metastases and overall prognosis in HNSCC. Thus, the current study was conducted to correlate the immunoexpression of cytokeratins (CK) 8, 10, and 14 with lymph node metastases and tumour differentiation in patients with HNSCC.

MATERIAL AND METHODS: The study population included 61 retrospective cases of HNSCC with lymph node metastases (n = 31) and without lymph node metastases (n = 30). Expression of CK 8, 10, and 14 was assessed by immunohistochemical staining procedure. Using Pearson’s Chi-square test and Spearman’s correlation coefficient, the correlation of these markers with lymph node metastases and tumour differentiation was statistically analysed.

RESULTS: The expression of CKs in HNSCC cases was higher than in controls. In nodal metastasis cases, CK 8 expression was noted in >50% of the tumour cells at the invasive tumour front (ITF) (P value 0.008), and in cases without nodal metastasis, <1% or negative expression was noted. CK 10 expression gradually decreased as the tumour grade increased. Association of CK 10 expression and tumour differentiation exhibited statistically significant results (P value 0.03). CK 14 expression was noted in the entire epithelium and at the ITF, strongly in most cases; however, CK 14 did not correlate with the lymph node metastasis and tumour differentiation as well.

CONCLUSION: We found a strong correlation of CK 8 expression with nodal metastasis in HNSCC, and it can be utilised as a reliable prognostic indicator.

PMID:39157840 | PMC:PMC11329098 | DOI:10.4103/jomfp.jomfp_168_23

J Oral Maxillofac Pathol. 2024 Apr-Jun;28(2):347-350. doi: 10.4103/jomfp.jomfp_454_23. Epub 2024 Jul 11.

ABSTRACT

BACKGROUND: Forensic odontology plays an important role in mass disasters, house fires, criminal deaths, identification of missing persons, and child abuse cases. Teeth are the most stable part of the human body and are resistant to thermal, mechanical, and chemical insults. The aim of this study was to evaluate the effectiveness of mandibular intercanine distance and mesiodistal width of mandibular first molar in gender determination.

MATERIALS AND METHODS: The study comprised 100 participants (50 males and 50 females) in the age group of 18-23 years. The mandibular impressions were made, and casts were prepared using dental stone. The intercanine distance and mesiodistal width of the right mandibular first molar were measured using digital vernier callipers. The data obtained was statistically analysed using SPSS software version 23.

RESULTS: The mean mandibular intercanine distance was found to be 27.2 ± 2.3 in males and 25.94 ± 1.76 in females (P = 0.03). There was no statistical difference in the mesiodistal width of the mandibular molar between males and females (P = 0.166). However, the mean mesiodistal width of males was higher when compared to females.

CONCLUSION: Males have a greater intercanine width and mesiodistal dimension when compared to females. This result will be helpful in forensic medicine, anthropology, orthodontic treatments, and clinical dentistry.

PMID:39157835 | PMC:PMC11329082 | DOI:10.4103/jomfp.jomfp_454_23