Nevin Manimala

Saudi J Kidney Dis Transpl. 2022 Jul-Aug;33(4):574-581. doi: 10.4103/1319-2442.388192.

ABSTRACT

The risk of hospital-acquired acute kidney injury (HA-AKI) depends on a person’s intrinsic susceptibility, the presence of risk factors, and on the type and extent of exposure to kidney insults. Older cohort studies have focused on male-only or mostly male populations, assuming a lower incidence of HA-AKI in women. Insufficient statistical power suggested that female sex was a shared susceptibility factor for HA-AKI. It was included as a risk factor in risk prediction models of HA-AKI. With the inclusion of women in clinical research studies, this presumption was challenged. Recent meta-analyses of sex-stratified studies showed that the risk for HA-AKI was significantly higher in men. These results suggested a protective role of female sex hormones. However, these studies were complicated by the inclusion of women across an age spectrum that includes the menopausal shift. Preliminary clinical and basic research data suggest that postmenopausal women lose their protection from HA-AKI. The number, size, and quality of reported clinical studies are low. There is an unmet need to characterize the susceptibility factor sex, to assess its clinical relevance and to evaluate renoprotection by sex hormone administration.

PMID:37929551 | DOI:10.4103/1319-2442.388192

Saudi J Kidney Dis Transpl. 2022 Jul-Aug;33(4):553-558. doi: 10.4103/1319-2442.388190.

ABSTRACT

Systemic lupus erythematosus (SLE) is a disease of the immune system with an unknown etiology. It is a unique disease that has a wide range of clinical and laboratory findings according to the organ or system involved and the activity of the disease. Mean platelet volume (MPV) is a simple parameter of the blood and is widely and easily available. It has been evaluated as a sign of inflammation in many kinds of diseases recently. In this study, we retrospectively analyzed the laboratory parameters and clinical features of 36 SLE patients with renal involvement and nephrotic-range proteinuria in the active and remission periods of the disease between 2005 and 2013. We found that the mean MPV in the active disease of the period was statistically significantly higher than in the remission period (8.30 ± 1.09 and 7.88 ± 0.7, respectively, P = 0.007).

PMID:37929548 | DOI:10.4103/1319-2442.388190

Saudi J Kidney Dis Transpl. 2022 Jul-Aug;33(4):535-542. doi: 10.4103/1319-2442.388188.

ABSTRACT

Depression is common among patients undergoing dialysis. However, there is a dearth of data on depression and its predictors among patients at different stages of chronic kidney disease (CKD). This study assessed the prevalence of depression and the relationships between depression and sociodemographic and clinical factors among non-dialysis CKD patients. A convenience sample of 88 CKD patients was recruited using a cross-sectional study design. The Beck Depression Inventory-II (BDI-II) was used to assess the levels of depression among CKD patients, with a cutoff score of ≥11. Data on the sociodemographic factors and clinical factors were also collected. Inferential statistics were used to determine the characteristics of the sample and assess the prevalence and severity of depression. Multiple regression analysis was used to assess the associations between the characteristics of the sample and depression. The overall mean BDI-II score was 6.23 ± 6.13. With a cutoff score of ≥11, patients with major depressive episodes constituted 18.2% of the sample. Stages of the disease, comorbidities, and sex were independently associated with a high depression score. The model explained 39% of the variation in the depression score. Depression is common among non-dialysis CKD patients. Screening for depression with brief validated tools should be integrated into routine clinical practice at renal clinics because patients in the advanced stages of CKD and those with multiple comorbidities require close attention. Furthermore, large studies assessing the prevalence and predictors of depression among different stages of CKD are required.

PMID:37929546 | DOI:10.4103/1319-2442.388188

Saudi J Kidney Dis Transpl. 2022 Jul-Aug;33(4):526-534. doi: 10.4103/1319-2442.388187.

ABSTRACT

Patients with end-stage kidney disease (ESKD) are required to take multiple medications. Adherence to a complex regimen of medications is challenging and might lead to non-adherence. This study aimed to assess nonadherence to prescribed medications among patients with ESKD in Makkah City and determine the factors associated with a such behavior. A cross-sectional study was conducted at three governmental hospitals in Makkah City, Saudi Arabia. Descriptive statistics were performed to characterize participants, and a multivariable logistic regression analysis was used to determine factors associated with nonadherence to prescribed medications among patients with ESKD. In total, 358 patients have submitted completed surveys and were included in this study. A considerable number (45.25%) of participating patients were found to be nonadherent to prescribed medications. The factors: age, belief that taking medications as scheduled is important, adherence to dialysis sessions, and the number of comorbid diseases had significant and negative associations with nonadherence to prescribed medications. On the other hand, the factors: forgetfulness and having depression were significantly and positively associated with non-adherence to prescribed medications. Non-adherence to medications among patients on hemodialysis is a significant issue that leads to life-threatening complications. The factors identified as being significantly associated with nonadherence should be considered in designing future interventions to improve adherence to medications.

PMID:37929545 | DOI:10.4103/1319-2442.388187

Niger J Clin Pract. 2023 Oct;26(10):1568-1574. doi: 10.4103/njcp.njcp_278_23.

ABSTRACT

BACKGROUND: TURP remains the gold standard for simple prostatectomy presently. Different fluids have been used for irrigation while performing monopolar TURP. The choice of irrigation fluid depends on a lot of factors.

AIM: We sought to find out if the outcome of monopolar TURP using 5% dextrose water in our setting compares with findings in other studies using different fluids as irrigation fluid in monopolar TURP.

MATERIALS AND METHODS: This was a prospective study of 220 patients who had monopolar TURP using 5% dextrose water as irrigation fluid from 2015 to 2020.

RESULTS: The study was completed by 220 patients. The mean age was 66.25 yrs. The mean weight of prostate was 53.2 g, and mean resected weight was 30.10 g using a mean irrigation volume of 45.35 liters, 5% dextrose water over a mean resection time of 66.08 mins. The mean changes in International Prostate Symptom Score/quality of life score (IPSS/QOLS) were statistically significant. Early complications recorded were postoperative hematuria with clot retention (1.4%), urinary tract infection (UTI) (13.2%), and secondary hemorrhage (10%). TURP syndrome was not recorded. Late complications seen within 2 years follow-up were transient urinary incontinence (6.4%), urethral stricture (4.1%), and bladder neck contracture (2.3%). There was no repeat TURP for residual adenoma within this period.

CONCLUSION: TURP using 5% dextrose water has comparable outcomes to other irrigation fluids for monopolar TURP. It is a good alternative to any other irrigation fluid.

PMID:37929537 | DOI:10.4103/njcp.njcp_278_23

Niger J Clin Pract. 2023 Oct;26(10):1563-1567. doi: 10.4103/njcp.njcp_269_23.

ABSTRACT

BACKGROUND: The success of the treatment depends on the well-being of the parents in pediatric cancer patients. In addition, migrants need to deal with the consequences of war.

AIM: Our purpose was to compare the HRQoL of parents of Syrian and Turkish children followed in our bone marrow transplant and oncology units.

MATERIALS AND METHODS: One hundred SF 36 questionnaires, fifty from each group were collected between October 2019 and March 2020 in this cross-sectional study. Demographic characteristics of the patients (sex, age, cancer type, presence of relapse, duration of follow-up) and education level of parents were recorded. Analyses were performed using IBM SPSS Statistics version 20.0.

RESULTS: Turkish parents reported better results in physical functioning, emotional well-being, physical pain, general health, and physical health composite score (P < 0.05). There were more fathers in the Syrian group and education status was significant between the two groups (P = 0.01, P = 0.001, respectively). There was no correlation between QoL and education levels in the Turkish group. In Syrian parents, pain score was high in middle school graduates (P = 0.043). In the presence of relapse, although the physical function score decreased, the physical role function score increased in Turkish parents (P = 0.0035, P = 0.005, respectively). Syrian parents’ emotional role function and energy/fatigue score were both increased when children had relapses (P = 0.027for both).

CONCLUSION: Migration is a complex issue. Turkish parents were better in physical functioning, emotional well-being, physical pain, general health, and physical health composite score. Screening for parental burden, assisting them to find appropriate support services is essential in improving the health and QoL of both our patients and their parents.

PMID:37929536 | DOI:10.4103/njcp.njcp_269_23

Niger J Clin Pract. 2023 Oct;26(10):1505-1511. doi: 10.4103/njcp.njcp_131_23.

ABSTRACT

BACKGROUND: Gastric acid, which is among erosive substances, gradually rises to the mouth in individuals with reflux and bulimia nervosa disorders, and this causes various effects on dental restorations.

AIM: The objective of this study is in vitro investigation of gastric acid’s effect on flexural strength and hardness on aesthetic restorative computer-aided design and computer-aided manufacturing (CAD-CAM) materials.

MATERIALS AND METHODS: For this study, four materials have been used, namely Enamic (Vita), Superfect Zir (Aidite) Zirconia, IPS e.max CAD (Ivoclar Vivadent), and Mark II (Vita). From these four different materials, 24 samples with 14 × 4 × 1 dimensions in rectangular prism form are used, which makes a total of 96 samples. One group was separated as the control group, while the rest was allowed to wait at 37°C, 5 ml gastric acid for 96 hours. Hardness value and flexural strengths were measured as pre-exposure and post-exposure to gastric acid.

RESULTS: There is a statistically significant difference between the groups in terms of the amount of decrease in the mean hardness after exposure to gastric acid compared to pre-exposure values (p: 0,000; P < 0,05). There was no statistically significant difference between the groups in terms of the amount of decrease in the post-exposure average flexural strength compared to the pre-exposure value (p: 0.063; P > 0.05). There is a statistically significant difference between the groups in terms of the average flexural strength after exposure to the acid.

CONCLUSIONS: According to the data obtained, it was concluded that exposure to gastric acid affects the hardness and flexural strength properties of dental restorative ceramic materials.

PMID:37929527 | DOI:10.4103/njcp.njcp_131_23

Niger J Clin Pract. 2023 Oct;26(10):1491-1497. doi: 10.4103/njcp.njcp_91_23.

ABSTRACT

BACKGROUND: E-max is a more aesthetic material than traditional zirconia. In addition, the bond strength of traditional zirconia with adhesive cements is lower. There are not enough studies on how the aesthetic values and bond strength of 5-YZP, the new generation zirconia, compare to e-max and traditional zirconia. Can 5-YZP be an alternative to e-max in terms of aesthetics and bond strength?

AIM: The aim of the study is to compare the translucency property and bonding ability of 5y-zp zirconias with previous generation zirconias and lithium disilicate.

MATERIALS AND METHODS: Two types of zirconia Katana UT and Katana HT for measuring translucency values; and using a type of lithium disilicate IPS e.max CAD LT, three groups were formed (n = 10). Translucency specimens were fabricated (n = 10). Their L*a*b* values were measured against a black-and-white background with a spectrophotometer, and DE00 was calculated. To perform micro-shear tests, a cylinder design was made from zirconia and IPS e.max CAD blocks (n = 20). After the samples were aged by thermal cycle, the micro-shear test was applied to specimens cemented to teeth extracted with two different adhesive cement systems.

RESULTS: According to the results of one-way analysis of variance, a statistically significant difference was found between the translucency parameter (TP) values of the groups. According to Tukey’s honestly significant difference (HSD) multiple comparisons, the values of the three groups are statistically different from each other. Although IPS e.max CAD group has the highest TP values, the Katana HT group has the lowest values.

CONCLUSION: 5Y-PZ has a TP intermediate to those of 3Y-TZP and lithium disilicate. Long-term bond strength of 3Y-TZP and 5Y-ZP were similar to those of lithium disilicate. To be an alternative to glass ceramics in the anterior region, translucency and bond strength values need to be improved.

PMID:37929525 | DOI:10.4103/njcp.njcp_91_23

Niger J Clin Pract. 2023 Oct;26(10):1483-1490. doi: 10.4103/njcp.njcp_26_23.

ABSTRACT

PURPOSE: This study aims to assess the efficacy of implementing a novel technique of reinforcement of gastric pouch and remnant stomach staple line with Double Omentopexy (DO) in patients undergoing One-Anastomosis Gastric Bypass (OAGB) surgery and evaluate its impact in reducing the early postoperative complications.

MATERIALS AND METHODS: The 123 patients were allocated into two groups: 61 in the standard OAGB group and 62 in OAGB with DO group. The primary outcomes are postoperative complications (including early postoperative bleeding, leakage, gastric twist, reflux, etc.) and hospital stay. The secondary outcome is excess body weight loss. Follow-up visits were planned after discharge: at two weeks, two months, and three months postoperatively.

RESULTS: Postoperative complications were significantly lower, 3 (4.84%) in OAGB with DO compared with 10 (16.39%) in standard OAGB (P =0.037). There was no statistically significant difference in the incidence of early postoperative bleeding, deep vein thrombosis, biliary reflux, and gall bladder stone (P >.05). No patient had leakage in either group. The mean operative time was significantly longer (68.66 ± 6.68 min) in OAGB with the DO group when compared with the standard OAGB group (62.16 ± 7.54 min) (P <.001).

CONCLUSION: Applying the DO technique may be a good measure to be added during OAGB to decrease the incidence of potential postoperative complications, especially the rate and severity of bleeding.

PMID:37929524 | DOI:10.4103/njcp.njcp_26_23

Niger J Clin Pract. 2023 Oct;26(10):1472-1482. doi: 10.4103/njcp.njcp_23_23.

ABSTRACT

AIM: The study aims to compare the short-term outcomes of reduced ports sleeve gastrectomy versus conventional five ports sleeve gastrectomy in postoperative weight loss, morbidity rate, pain, and resolution of obesity-related diseases.

MATERIALS AND METHODS: One hundred forty patients were equally allocated to reduced ports (n = 70) and conventional ports (5 ports) Laparoscopic Gastrectomy groups. The primary outcomes are postoperative pain by numeric rating score, cosmetic visual analog score, satisfaction visual analog score, operative time, and hospital stay. The secondary outcomes are postoperative complications and comorbidity resolution.

RESULTS: The numeric rating score for pain assessment was statistically significantly lower in the reduced ports group compared with the conventional ports group at 2, 6, 12, and 24 hours, postoperatively (P < .001). Cosmetic visual analog score was statistically significantly higher in the reduced ports group compared with conventional ports group at 2 and 3 months follow-up (P < .001 and P = .008, respectively). Patient satisfaction visual analog score was statistically significantly higher in the reduced ports group than the conventional ports group at 2 and 3 months follow-up (P < .001 and P = .032, respectively).

CONCLUSION: Reduced ports laparoscopic sleeve gastrectomy is safe and feasible in patients with body mass index (BMI) up to 50 kg/m². It is cosmetically well appreciated with noticeable patient satisfaction. It should be practiced with regularity. Further trials should be considered in patients with high BMI (>50 kg/m²).

PMID:37929523 | DOI:10.4103/njcp.njcp_23_23