Nevin Manimala

J Inj Violence Res. 2024 Nov 3;16(2). doi: 10.5249/jivr.v16i2.1842. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to investigate the effects of CPT on PTSD, depression, and anxiety symptoms in female victims of domestic violence.

METHODS: A two-arm randomized clinical trial was conducted in Bandar-Abbas involving 62 female victims of domestic violence referred from private gynecology and obstetrics clinics. Initial screening for domestic violence was based on the World Health Organization violence questionnaire. Participants were randomly assigned to either a control group (n=32) or an intervention group (n=28) for a study duration of six months in 2022. Twelve group CPT sessions were conducted. The domestic violence questionnaire, Beck’s Depression Inventory, Beck’s Anxiety Inventory, and the Impact of Event Scale-Revised were completed in three time points: pre-test, post-test, and follow-up.

RESULTS: There was a statistically significant difference in the mean scores of depression, PTSD, and domestic violence (P less than .001) between the two groups; however, no significant difference was found in anxiety scores (P greater than .050).

CONCLUSIONS: CPT is recommended for female victims of domestic violence to reduce symptoms of depression, PTSD, and domestic violence.

PMID:39488744 | DOI:10.5249/jivr.v16i2.1842

Chirurgia (Bucur). 2024 Oct;119(eCollection):1. doi: 10.21614/chirurgia.119.eC.3032.

ABSTRACT

OBJECTIVE: To compare the accuracy of arthroscopy with MRI in diagnosing ramp lesions associated with anterior cruciate ligament (ACL) injuries.

DESIGN: Prospective observational study. Material and Methods: We included 100 patients with complete ACL tear.

EXCLUSION CRITERIA: 1) Partial ACL tear, 2) ACL revision surgery or previous knee surgery, 3) Multi-ligamentous knee injury, 4) Extensive medial meniscus tear. Results: Nine patients were diagnosed with ACL-associated ramp lesions. All nine had magnetic resonance imaging (MRI) signs, but these were not statistically significant ( 2=1.884, FEp=0.348). Mean medial meniscal slope for patients with ramp lesions was 2.88 +- 0.46, without was 2.47 +- 0.55 (T=2.146, P=0.034), implying statistical significance as visualized by arthroscopy. Arthroscopy is superior in diagnosing ramp lesions.

CONCLUSION: Arthroscopy is superior in diagnosing ramp lesions due to cost-effectiveness, direct visualization, and immediate treatment capability. The absence of specific MRI signs for ramp lesions further supports this conclusion.

PMID:39488742 | DOI:10.21614/chirurgia.119.eC.3032

Cancer. 2024 Nov 2. doi: 10.1002/cncr.35608. Online ahead of print.

ABSTRACT

The study of prehabilitation and rehabilitation ([p]rehabilitation) to alleviate the sequelae of bladder cancer and its treatment has generated numerous opportunities to improve the quality of life of bladder cancer survivors. The authors conducted a scoping review of randomized clinical trials (RCTs) to identify knowledge gaps in and research directions for (p)rehabilitative support for those affected by bladder cancer. The authors systematically searched six databases and synthesized key findings from RCTs conducted from January 1, 2004, through March 15, 2022, that enrolled participants with bladder cancer, survivors, or caregivers in outpatient (p)rehabilitative programs (e.g., exercise, nutrition, or psychological support). Outcomes were characterized according to eight prespecified, clinically relevant categories. The search retrieved 10,968 records, 27 of which met the inclusion criteria, and 24 described unique RCTs with 2471 enrolled participants. Of 24 interventions, 17 (71%) yielded statistically significant results for the outcome of interest. Only one RCT included a cost-effectiveness analysis, and only two characterized the efficacy of interventions for caregivers. Of 11 RCTs involving psychological support, eight yielded statistically significant results, as did nine of 11 RCTs with physical exercise interventions, three of four RCTs with educational interventions, three of four RCTs with nutritional support interventions, one of two RCTs with pharmacologic medications, and zero of one RCT with physical therapy. The most promising interventions for inclusion in multimodal, personalized (p)rehabilitation programs included exercise, stress management training, cognitive training, smoking and alcohol cessation counseling, immunonutrition, stoma education, and penile rehabilitation. Further studies of the cost effectiveness and efficacy for caregivers of such interventions are needed. PLAIN LANGUAGE SUMMARY: In a scoping review of all randomized clinical trials involving prehabilitative or rehabilitative diet, exercise, and psychological support interventions for patients with bladder cancer, survivors, and their caregivers, 17 of 24 (71%) interventions yielded statistically significant improvements in the outcome of interest. Clinicians should consider implementing such interventions for those affected by bladder cancer.

PMID:39488730 | DOI:10.1002/cncr.35608

Sr Care Pharm. 2024 Nov 1;39(11):425-431. doi: 10.4140/TCP.n.2024.425.

ABSTRACT

Background: Additional evidence is required to address the unintended consequences of medication use in older people and the required caregiver support. To inform priorities for future research efforts, different stakeholder perspectives are needed, including those of older people, caregivers, clinicians, and researchers. Objective: To develop a co-designed medication-related research agenda. Methods: A 12-member Advisory Council, half of which were older people and caregivers, designed the research. An 11-question survey to identify priorities for medication-related patient-centered outcomes research (PCOR) topics was administered to members of the Elder Care Medicine Network (ECMN) (ie, older people, caregivers, clinicians, and researchers). Respondents were categorized into two groups with hierarchical assignment to the clinician/research group over the older adult/caregiver group. Chi-square tests compared priority areas for medication-related PCOR between the two groups. Results: There were 53 responses (48% response rate) from the ECMN, with 39.6% (n = 21) from the clinician/researcher group and 60.4% (n = 32) from the older adult/caregiver group. The priority areas from both groups included safe ways to simplify medicines (62.2%), communicating with pharmacists and prescribers about medications (58.5%), and information about safe supplements with prescription medications (52.8%). Statistically significant differences existed between the two groups in the proportions choosing the priority areas. Conclusion: Co-design of a survey to identify priority areas for PCOR demonstrated successful engagement of older people and caregivers as research partners. While older people and caregivers may have differing perspectives on the importance of specific medication-related PCOR topics, simplifying medication regimen and health care communications were germane to both groups.

PMID:39488722 | DOI:10.4140/TCP.n.2024.425

Cardiovasc Diabetol. 2024 Nov 2;23(1):392. doi: 10.1186/s12933-024-02467-w.

ABSTRACT

BACKGROUND: There has been a concerning rise in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) following noncardiac surgeries (NCS), significantly impacting surgical outcomes and patient prognosis. Glucose metabolism abnormalities induced by stress response under acute medical conditions may be a risk factor for postoperative MACCE. This study aims to explore the association between stress hyperglycemia ratio (SHR) and postoperative MACCE in patients undergoing general anesthesia for NCS.

METHODS: There were 12,899 patients in this perioperative cohort study. The primary outcome was MACCE within 30 days postoperatively, defined as angina, acute myocardial infarction, cardiac arrest, arrhythmia, heart failure, stroke, or in-hospital all-cause mortality. Kaplan-Meier curves visualized the cumulative incidence of MACCE. Cox proportional hazard models were utilized to assess the association between the risk of MACCE and different SHR groups. Restricted cubic spline analyses were conducted to explore potential nonlinear relationships. Additionally, exploratory subgroup analyses and sensitivity analyses were performed.

RESULTS: A total of 592 (4.59%) participants experienced MACCE within 30 days after surgery, and 1,045 (8.10%) within 90 days. After adjusting for confounding factors, compared to the SHR T2 group, the risk of MACCE within 30 days after surgery increased by 1.34 times (95% CI 1.08-1.66) in the T3 group and by 1.35 times (95% CI 1.08-1.68) in the T1 group respectively. In the non-diabetes group, the risk of MACCE within 30 days after surgery increased by 1.60 times (95% CI 1.21-2.12) in the T3 group and by 1.61 times (95% CI 1.21-2.14) in the T1 group respectively, while no statistically significant increase in risk was observed in the diabetes group. Similar results were observed within 90 days after surgery in the non-diabetes group. Additionally, a statistically significant U-shaped nonlinear relationship was observed in the non-diabetes group (30 days: P for nonlinear = 0.010; 90 days: P for nonlinear = 0.008).

CONCLUSION: In this large perioperative cohort study, we observed that both higher and lower SHR were associated with an increased risk of MACCE within 30 and 90 days after NCS, especially in patients without diabetes. These findings suggest that SHR potentially plays a key role in stratifying cardiovascular and cerebrovascular risk after NCS.

PMID:39488717 | DOI:10.1186/s12933-024-02467-w

BMC Public Health. 2024 Nov 2;24(1):3038. doi: 10.1186/s12889-024-20514-9.

ABSTRACT

BACKGROUND: The social distancing measures associated with the COVID-19 pandemic had far reaching effects on sexual behavior worldwide. However, it remains unclear whether sexual contact with non-steady partners was a contributor to the spread of SARS-CoV-2. The aim of this study was to (i) describe risk factors for SARS-CoV-2 seropositivity after the first pandemic wave among people using HIV Pre-Exposure Prophylaxis (PrEP) in Zurich, Switzerland, including sexual contact with non-steady partners, and (ii) assess whether the SARS-CoV-2 seropositivity among PrEP users in this time period differed from that of a demographic matched population level comparison group.

METHODS: The study was conducted between July 2020 and October 2020 as a nested cross-sectional study within two ongoing cohort studies, SwissPrEPared (all eligible PrEP users in Switzerland ≥ 18 years old) and Corona Immunitas (a series of cross-sectional and longitudinal studies measuring the SARS-CoV-2 seroprevalence across Switzerland, beginning in April 2020). All SwissPrEPared participants were recruited from Checkpoint Zurich (the main PrEP clinic in Zurich) and were men having sex with men or transgender women. Data were collected on participants’ SARS-CoV-2 antibody status, social characteristics and behavioral data after the first wave of the pandemic in Switzerland, and seroprevalence was compared with a propensity score-matched sample from the general Zurich population.

RESULTS: Of the 218 participants enrolled, 8.7% (n = 19, 95% CI: 5.5-13.5%) were seropositive for SARS-CoV-2 during the first pandemic wave, higher than that of the general male population in Zurich aged 20-65 (5.5%, 95% CI: 3.8-8.2%). Participants on average reduced their social outings, but the seronegative were more socially active before, during, and after the first lockdown period. In a logistic model, increasing mean sexual partner count was not associated with seropositivity (OR: 1.02, 95% CI: 0.95, 1.07). The estimated risk ratio for seropositivity for the participants compared to the general Zurich population after propensity score matching was 1.46 (95% CI: 0.53, 3.99).

CONCLUSIONS: Our study suggests that SARS-CoV-2 seropositivity was slightly elevated among people taking PrEP in Zurich during the first wave of the pandemic, but that socializing and sexual activity were less important than other factors in contributing to risk.

PMID:39488716 | DOI:10.1186/s12889-024-20514-9

BMC Public Health. 2024 Nov 2;24(1):3039. doi: 10.1186/s12889-024-20472-2.

ABSTRACT

BACKGROUND: Proper nutrition during early childhood is essential for healthy growth and development, yet many children, particularly in low and middle-income countries, fail to meet recommended intake levels of fruits and vegetables. This study aims to assess the factors associated with zero vegetable and fruit (ZVF) consumption among children aged 6-23 months in Tanzania, using data from the 2022 Tanzania Demographic and Health Survey (DHS).

METHODS: A weighted sample of 4582 children aged between 6 and 23 months were included in the study. Data cleaning, coding, and analysis were performed using STATA version 17 software. To address the hierarchical nature of the DHS data and the binary outcome variable, a multilevel mixed-effect binary logistic regression model was used. The deviance value served as a guide for determining the best-fitting model. In the subsequent multivariable multilevel binary logistic regression analysis, adjusted odds ratios were computed alongside their respective 95% confidence intervals to evaluate the strength of association, with statistical significance set at a p-value below 0.05.

RESULT: The overall proportion of ZVF consumption among children aged 6-23 months in Tanzania was 48.34% (95% CI: 46.87, 49.81). Current breastfeeding status, maternal educational status, household wealth index, sex of the household head, and community poverty level were associated with higher odds of ZVF consumption. Meanwhile, child age, maternal employment status, father’s educational status, and media exposure were associated with lower odds of ZVF consumption.

CONCLUSION: Child age, current breastfeeding status, maternal educational status, maternal employment status, father’s educational status, household wealth index, sex of household, media exposure, and community poverty level were significantly associated with ZVF consumption. Efforts should focus on educating mothers about the early introduction of fruits and vegetables in children’s diets, alongside supporting breastfeeding. Tailored economic empowerment initiatives are needed in impoverished communities to improve access to nutritious foods.

PMID:39488712 | DOI:10.1186/s12889-024-20472-2

Malar J. 2024 Nov 2;23(1):327. doi: 10.1186/s12936-024-05144-1.

ABSTRACT

BACKGROUND: Glucose-6-Phosphate Dehydrogenase deficiency (G6PDd) is a common genetic enzymopathy that can induce haemolysis triggered by various factors, including some anti-malarial drugs. Although many Point-of-Care (PoC) tests, such as Standard G6PD™ are available to detect G6PDd, its pooled diagnostic test accuracy (DTA) remains unknown.

METHODS: To estimate the DTA of StandG6PD-BS at various thresholds of G6PDd, a systematic review with a DTA meta-analysis were conducted, searching EMBASE, MEDLINE, and SciELO databases up to April 4, 2024.The included studies were those that measured G6PD activity using StandG6PD-BS (reference test) and spectrophotometry (gold standard) in patients suspected of having G6PDd. The risk of bias (RoB) of the studies was assessed using the QUADAS-2 tool and the certainty of evidence (CoE) with the GRADE approach. For the estimation of within-study DTA, a random-effect bivariate meta-analysis was performed to determine the pooled sensitivity and specificity for 30%, 70%, and 80% enzyme levels’ thresholds, and a graphical analysis of the heterogeneity using crosshair and Confidence Regions on receiver operating characteristic (ROC) space plots.

RESULTS: After screening 2496 reports, four studies were included with 7864 participants covering all thresholds. Two studies had high RoB in QUADAS-2 domains 2 and 3, and the others had low RoB, with low, moderate, and high heterogeneity at the 30%, 70%, and 80% thresholds, respectively. The pooled sensitivity was 99.1%, 95.7%, and 90% for 30%, 70%, and 80% thresholds, respectively. The pooled specificity was 97.4%; 92.9%; and 89.0% for 30%, 70%, and 80% thresholds, respectively.

CONCLUSION: StandG6PD-BS is a PoC test with high sensitivity and specificity to detect G6PDd at different thresholds.

PMID:39488711 | DOI:10.1186/s12936-024-05144-1

Malar J. 2024 Nov 2;23(1):326. doi: 10.1186/s12936-024-05157-w.

ABSTRACT

BACKGROUND: Pyrethroid-chlorfenapyr nets have shown significant epidemiological impact over pyrethroid-only and pyrethroid plus piperonyl-butoxide (PBO) in Africa. A non-inferiority evaluation of PermaNet^® Dual, a new chlorfenapyr plus deltamethrin net, compared to Interceptor^® G2, was conducted in experimental huts in Siaya, Kenya against free-flying pyrethroid-resistant Anopheles funestus.

METHODS: This study was an experimental hut trial, following a 7 by 7 Latin Square design. Seven treatments and seven sleepers were deployed in the experimental huts daily and rotated weekly and daily, respectively. Mosquitoes were collected every morning between 06:30 h and 08:30 h and were assessed for blood feeding and then monitored for immediate knockdown 1-h post collection and delayed mortality after 72 h. Differences in proportional outcomes were analysed using the blocked logistic regression model, while differences in numerical outcomes were analysed using the negative binomial regression model. Non-inferiority determination was performed based on World Health Organization (WHO) protocol.

RESULTS: Mortality at 72 h was 30.2% for PermaNet 3.0, 44.4% for the Interceptor^® G2 and 49.2% for the PermaNet^® Dual. Blood feeding was highest with PermaNet^® Dual at 15%, and least with PermaNet^® 3.0 at 10%. PermaNet^® Dual and Interceptor^® G2 had no significant differences in mortality (OR = 1.10, 95% CI 1.00-1.20) or blood feeding (OR = 1.18, 95% CI 1.04-1.33) and the lower confidence bounds were within the non-inferiority margins but for blood feeding, non-inferiority was relatively high to the upper 95% confidence bound. PermaNet^® Dual was non-inferior to the Interceptor^® G2 and superior to the PermaNet^® 3.0 nets in causing mortality but inferior to PermaNet ^®3.0 in blood feeding inhibition of the vectors.

CONCLUSION: PermaNet^® Dual met the WHO criteria for non-inferiority to Interceptor^® G2 and may be considered for deployment for public health use against pyrethroid-resistant Anopheles vectors of malaria.

PMID:39488707 | DOI:10.1186/s12936-024-05157-w

Malar J. 2024 Nov 2;23(1):325. doi: 10.1186/s12936-024-05134-3.

ABSTRACT

Malaria remains a significant global health challenge, with millions of cases and high mortality rates annually, especially in low-income countries. Africa bears a substantial burden, with direct costs of malaria among children under five reaching millions of dollars in countries like Ghana, Tanzania, and Kenya. In 2021, over 610,000 malaria-related deaths were reported, 96% of which occurred in sub-Saharan Africa. Despite existing interventions, such as long-lasting insecticidal nets, indoor residual spraying, and intermittent preventive treatment, the re-emergence of malaria underscores the need for innovative preventive strategies. This study explores the potential of utilizing mobile phone caller tunes to raise awareness and promote the uptake of the RTS,S malaria vaccine. The technology acceptance model (TAM) provides a framework for understanding how users perceive and adopt new technologies. Caller tunes, a mobile phone feature that plays audio for callers waiting to be connected, have been effective in health communication campaigns in Asia and Africa. This approach could be leveraged to enhance malaria vaccine awareness, particularly in low-income countries where vaccine hesitancy is prevalent and malaria endemic. Overall, mobile technologies have significantly improved healthcare delivery in Africa, facilitating communication, monitoring, and treatment adherence in remote areas. Integrating caller tunes with health messages about the malaria vaccine could address vaccine hesitancy and improve uptake. This would require collaboration with telecommunication companies, healthcare providers, and policymakers to design culturally and linguistically appropriate messages. However, the cost of caller tune services, the need for internet access, and cultural differences are the expected challenge that may occur in this approach. Therefore, strategic partnerships and intersectoral approaches can mitigate these issues, making caller tunes a viable tool for public health communication. Raising awareness through this innovative method could enhance the adoption of the RTS,S vaccine and support ongoing malaria control efforts in Africa.

PMID:39488704 | DOI:10.1186/s12936-024-05134-3