Nevin Manimala

Georgian Med News. 2023 Oct;(343):44-49.

ABSTRACT

The aim of the study was to conduct approximate assessment of the prevalence of osteoporotic changes and evaluate quality of life (QoL) in postmenopausal women using ECOS-16 questionnaire in Yerevan city. The cross-sectional survey was conducted for data collection among 196 postmenopausal women. The research material about QoL was collected using ECOS-16 questionnaire. The sample was randomly selected through a two-stage cluster sampling from the population of women served by five policlinics of Yerevan. The majority of surveyed women (70.3%) were in age group under 60. Slightly more than half of the study participants (57.7%) had higher education and worked (59.2%). Almost two thirds of respondents were married (65.3%). Half of the respondents (51.0%) noted their income at the subsistence level. 71.9%±3.21 of women reported back pain for a long time. The scores of all the scales of ECOS-16, as well the total score were significantly higher in women who reported chronic back pain, indicating a lower quality of life for them. Women in age group under 60 years old, as well as women indicating absence of risk factors at workplaces, had significantly higher quality of life. A statistically significant difference was also observed between groups of women based on such social and demographic characteristics, as marital status, and average monthly income level. Pairwise comparison of groups based on these characteristics revealed a higher quality of life among married women compared to widows (p=0.043) and among women with income higher and at the subsistence level compared to the group of women with income below the subsistence level (p= 0.010). Poor QoL was associated with low self-reported health status and presence of chronic diseases in women. Pairwise post-hoc analysis showed lower level of QoL in the study participants with a below average/low level of health compared to both, those with above average (p<0.001) and average (p<0.001) level of health. QoL was also lower in women with four or more chronic diseases compared to both, women without chronic diseases (p=0.001) and the group of women with 1-3 diseases (p=0.001). The prevalence of chronic back pain, which was considered as one of the manifestations of undiagnosed osteoporosis in postmenopausal women, was quite high. The scores calculated for all dimensions of ECOS-16 questionnaire, as well the total score indicated lower quality of life among women reported chronic back pain compared to those who did not have such a health problem. Age older 60, spouse’s demise, income below the subsistence level, smoking, presence of risk factors at workplace, as well as poor self-reported health status, and presence of chronic diseases were the factors negatively affected the QoL of surveyed women.

PMID:38096514

Georgian Med News. 2023 Oct;(343):33-37.

ABSTRACT

Atopic dermatitis, despite its relatively wide distribution and low severity, was statistically often a disqualification condition for military service. The aim of our study is to determine correlations between characteristics of atopic dermatitis in military personnel. 144 people with atopic dermatitis were under our observation, 78 of them military personnel, 26 military family members and 40 civilians, 62 men and 82 women. We studied the following characteristics: gender, age, marital status, education, social status, place of service location, genetic anamnesis, recurrence during the year, laboratory indicators of attached infections, focus of localization, other skin diseases, comorbidities, compliance with hygienic conditions, wearing a military uniform, the frequency of changing bed linen. 3-5 times recurrence a year shows a reliable positive correlation with: wearing a uniform for 12-24 hours, SSA/eosinophilia, mycosis, pathology of the respiratory system, military personnel. Staphylococcus aureus is associated with other infections – St. hominis, fungus, also shows a reliable positive correlation: localization on the face and torso, wearing the uniform for 1 week and more. Staphylococcus hominis shows a reliable positive correlation: localization – torso, wearing uniform for 1 week or more,y. Shows a reliable positive correlation with fungus: localization scalp, neck, lower limb, military serviceman; reliable positive correlation with SSA/eosinophilia: increased IgE, localization on the upper limbs, mycosis, change of bed linen – once every 2 weeks; IgE – localization of dermatosis on the upper limbs and torso area, pathology of the digestive system, changing bed linen once every 2 weeks, military serviceman. It shows a reliable positive correlation with helminthiasis: Localization on the genitals, mycosis, pathology of the digestive system, change of bed linen once a month. Development and recurrence of atopic dermatitis in military personnel correlates with living conditions and infections. Determining the differences between civilian and military patient populations will allow clinicians to better investigate the risk factors that predispose to the manifestation of dermatitis in the military.

PMID:38096512

Georgian Med News. 2023 Oct;(343):6-13.

ABSTRACT

Medical aspects of the organization of replenishment of the Armed Forces with healthy and physically strong personnel are of great importance, and the deficit in the number of conscripts and their low-quality condition have become one of the main and important problems for the Armed Forces. The aim of the study was to improve the medical care of male conscripts aged 18-27 years by revealing the regularities and peculiarities of the expert assessment of surgical diseases among this category of young men on the basis of mathematical modeling. The object of the research was the study of the names of surgical profile articles, according to which these people were recognized as unfit or restricted fit for service, and the results of military medical expertise. Descriptive, social, and statistical methods were applied in the course of the study. The final stage was to conduct a systemic multifactor analysis in order to obtain a mathematical model of the process under study. The values of the influence coefficients of the mentioned indicators for 2013-2019 on the obtained mathematical models from the point of view of military-medical expertise of young men with surgical diseases both in the Republic of Armenia as a whole and in its separate regions are presented. Summarizing, it can be stated that from the point of view of military-medical expertise of young men with surgical diseases it is impossible to consider Yerevan city and the regions of RA as separate parts of the Republic of Armenia. Yerevan and the regions of the Republic of Armenia as separate parts, as they appear as a single whole according to the results of systemic multifactor analysis with mathematical modeling.

PMID:38096507

West Afr J Med. 2023 Nov 30;40(11):1192-1198.

ABSTRACT

BACKGROUND: Sleep health indicates how well an individual or population sleeps. Good sleep health is characterized by subjective satisfaction, sustained alertness during waking hours, appropriate timing, high efficiency, and adequate duration. Poor sleep health is associated with many short-term and long-term health consequences. There are limited data on the pattern of sleep health in Nigeria. Against this backdrop, we embarked on this study to determine the Pattern of Sleep Health among patients attending the Adult Neurology clinic in a Federal Teaching Hospital, in Abakaliki, Nigeria.

METHODS: This is a cross-sectional observational hospital-based study undertaken at the Adult Neurology clinic of the Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria from July to September 2022.

RESULTS: Out of the 267 patients recruited for the study, 19% had good sleep health with SATED scores of 8 to 10 while 81% had poor sleep health. The absence of alcohol abuse, cigarette smoking, and neurological diagnosis were statistically associated with poor sleep health with no sex and age predilection. The mean sleep duration was 7.5± 1.5 hours (male = 7.6 hours, female = 7.3 hours, 18- 64 years= 7.4 hours, ≥ 65 years =7.9 hours). Timing of sleep (mean= 0.97) was the least rated while sleep satisfaction (mean= 1.54) was the best-rated sleep dimension.

CONCLUSION: Sleep health is very poor amongst patients attending the adult Neurology clinic at Abakaliki Nigeria and it is associated with smoking, absence of alcohol abuse, and neurological diagnosis.

CONTEXTE: La santé du sommeil indique à quel point un individu ou une population dort. Une bonne santé du sommeil se caractérise par une satisfaction subjective, une vigilance soutenue pendant les heures d’éveil, un timing approprié, une efficacité élevée et une durée adéquate. Une mauvaise santé du sommeil est associée à de nombreuses conséquences sanitaires à court et à long terme. Il existe des données limitées sur le schéma de santé du sommeil au Nigéria. Dans ce contexte, nous avons entrepris cette étude pour déterminer le schéma de santé du sommeil parmi les patients fréquentant la clinique de neurologie pour adultes dans un hôpital d’enseignement fédéral à Abakaliki, Nigeria.

MÉTHODES: Il s’agissait d’une étude observationnelle transversale réalisée à la clinique de neurologie pour adultes de l’hôpital universitaire fédéral Alex Ekwueme àAbakaliki, Nigeria, de juillet à septembre 2022.

RÉSULTATS: Sur les 267 patients recrutés pour l’étude, 19 % avaient une bonne santé du sommeil avec des scores SATED de 8 à 10, tandis que 81 % avaient une mauvaise santé du sommeil. L’absence d’abus d’alcool, de tabagisme et de diagnostic neurologique était statistiquement associée à une mauvaise santé du sommeil, sans prédilection pour le sexe et l’âge. La durée moyenne du sommeil était de 7,5 ± 1,5 heures (homme = 7,6 heures, femme = 7,3 heures, 18-64 ans = 7,4 heures, ≥ 65 ans = 7,9 heures). Le timing du sommeil (moyenne = 0,97) était la dimension la moins bien notée, tandis que la satisfaction du sommeil (moyenne = 1,54) était la dimension la mieux notée.

CONCLUSION: La santé du sommeil est très mauvaise chez les patients fréquentant la clinique de neurologie pour adultes à Abakaliki, au Nigéria, et elle est associée au tabagisme, à l’absence d’abus d’alcool et au diagnostic neurologique.

MOTS-CLÉS: :Santé du sommeil, Clinique de neurologie,Abakaliki, Nigeria.

PMID:38096460

J Hosp Palliat Nurs. 2023 Dec 14. doi: 10.1097/NJH.0000000000001005. Online ahead of print.

ABSTRACT

Palliative care is traditionally delivered by specialty-trained palliative care teams. Because of a national workforce shortage of palliative care specialists, there is an urgent need to explore alternative models of palliative care delivery to meet the needs of patients living with serious illness. As part of a multisite randomized controlled trial, 2 registered nurses without previous palliative care experience were trained to deliver a primary palliative care intervention to patients with newly diagnosed lung cancer. The intervention focused on assessing and managing symptoms, psychosocial needs, education, and initiating goals-of-care discussions. The primary outcome, improved symptom burden and quality of life, was not statistically significant. Despite this finding, nurses addressed 5 of the 8 National Consensus Project Guidelines domains of quality palliative care: structure and processes of care; physical, psychological, and social aspects of care; and ethical and legal aspects. Patients’ engagement in goals-of-care discussions, a measure of high-quality palliative care, increased. Clinical recommendations offered by the nurses to the patients’ clinicians were addressed and accepted on a timely basis. Most patients rated satisfaction with the intervention as “very or extremely” satisfied. These findings may inform future nurse-led palliative care interventions on the specific quality domains of palliative care.

PMID:38096450 | DOI:10.1097/NJH.0000000000001005

Stomatologiia (Mosk). 2023;102(6. Vyp. 2):37-43. doi: 10.17116/stomat202310206237.

ABSTRACT

AIM: Studying the duration of treatment in patients with temporomandibular joint pain dysfunction syndrome, and the relationship of the duration of treatment with the age of the patient at the beginning of therapy.

MATERIALS AND METHODS: The study was carried out using information from medical records of dental patients, information from additional examinations of patients who were treated at the National Medical Research Centre for Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia from 2016 to 2022. Statistical research methods: to evaluate the normality of the distribution, graphical methods were used, as well as the Shapiro-Wilk criterion.

RESULTS: The duration of splint therapy in patients with temporomandibular joint pain dysfunction syndrome varied from 4 to 27 months. The average duration of treatment of patients using occlusive splints was 10.5±5.3 months. Without abnormal observations, the average duration of splint therapy in patients with TMJ pain syndrome was 9.6±4.1 months. The obtained data allow stating the absence of a correlation between the age of patients and the duration of splint-therapy.

CONCLUSION: The majority of patients (68.4%) complete the splint therapy stage within 1 year, and a very small part (1.8%) are treated for more than 1.5 years. The duration of treatment of patients with temporomandibular joint pain dysfunction syndrome does not depend on age or gender.

PMID:38096393 | DOI:10.17116/stomat202310206237

Blood. 2023 Dec 14:blood.2023021231. doi: 10.1182/blood.2023021231. Online ahead of print.

ABSTRACT

Extreme disease phenotypes can provide key insights into the pathophysiology of common conditions, but studying these patients is challenging due to their rarity and the limited statistical power of existing methods. Herein, we used a novel approach to pathway-based mutational burden testing, the rare variant trend test (RVTT), to investigate genetic risk factors for an extreme form of sepsis-induced coagulopathy, infectious purpura fulminans (PF). In addition to prospective patient sample collection, we electronically screened over 10.4 million medical records from four large hospital systems and identified historical cases of PF for which archived specimens were available to perform germline whole exome sequencing. We found a significantly increased burden of rare, putatively function-altering variants in the complement system in patients with PF compared to unselected patients with sepsis (p=0.01). A multivariable logistic regression analysis found that the number of complement system variants per patient was independently associated with PF after controlling for age, sex, and disease acuity (p=0.01). Functional characterization of PF-associated variants in the immunomodulatory complement receptors CR3 and CR4 revealed that they result in partial or complete loss of anti-inflammatory CR3 function and/or gain of pro-inflammatory CR4 function. Taken together, these findings suggest that inherited defects in CR3 and CR4 predispose to the maladaptive hyperinflammation that characterizes severe sepsis with coagulopathy.

PMID:38096369 | DOI:10.1182/blood.2023021231

PLoS One. 2023 Dec 14;18(12):e0296017. doi: 10.1371/journal.pone.0296017. eCollection 2023.

ABSTRACT

BACKGROUND: Circulating cytokines have been associated with colorectal cancer (CRC). However, their causal correlation remains undetermined. This investigation uses genetic data to evaluate the mechanism that links circulating cytokines and CRC via Mendelian Randomization (MR).

METHODS: A two-sample MR evaluation was carried out to investigate the mechanism associating circulating cytokines and CRC in individuals of European ancestry. The Genome-wide association studies statistics, which are publically accessible, were used. Eligible instrumental SNPs that were significantly related to the circulating cytokines were selected. Multiple MR analysis approaches were carried out, including Simple Mode, inverse variance weighted (IVW), MR-Egger, Weighted Mode, Weighted Median, and MR pleiotropy residual sum and outlier (MR-PRESSO) methods.

RESULTS: The evidence supporting the association of genetically predicted circulating levels with the increased risk of CRC was revealed; these included vascular endothelial growth factor (OR = 1.352, 95% CI: 1.019-1.315, P = 0.024), interleukin-12p70 (OR = 1.273, 95% CI: 1.133-1.430, P = 4.68×10-5), interleukin-13 (OR = 1.149, 95% CI: 1.012-1.299, P = 0.028), interleukin-10 (OR = 1.230, 95% CI: 1.013-1.493, P = 0.037), and interleukin-7 (OR = 1.191, 95% CI: 1.023-1.386 P = 0.024). Additionally, MR analysis negative causal association between macrophage colony stimulating factor and CRC (OR = 0.854, 95% CI: 0.764-0.955, P = 0.005). The data from Simple Mode, Weighted Median, MR-Egger, and Weighted Mode analyses were consistent with the IVW estimates. Furthermore, the sensitivity analysis indicated that the presence of no horizontal pleiotropy to bias the causal estimates.

CONCLUSION: This investigation identified a causal association between circulating cytokines levels risk of CRC and may provide a deeper understanding of the pathogenesis of CRC, as well as offer promising leads for the development of novel therapeutic targets for CRC.

PMID:38096329 | DOI:10.1371/journal.pone.0296017

PLoS One. 2023 Dec 14;18(12):e0289880. doi: 10.1371/journal.pone.0289880. eCollection 2023.

ABSTRACT

This study aims to investigate socioeconomic disparities in nutritional status among ever-married women in Bangladesh and to break down urban-rural differences in the underlying causes of undernutrition. We utilized data from the Bangladesh Demographic and Health Survey 2017-18, a sample size of 18328 ever-married women, including 5170 from urban residences, and 13159 from rural residences. To explore socioeconomic inequality, we employed a concentration indexing measure, while a multiple binary logistic regression model was carried out to identify the determinants associated with the outcome variable. A Blinder-Oaxaca decomposition analysis was performed to decompose the urban-rural gap in women’s nutritional status using associated factors. The prevalence of undernutrition among ever-married women in Bangladesh was 12 percent. Notably, this percentage varied by region, with urban residents accounting for 8.6% and rural residents accounting for 13.3%. Our findings confirmed that undernutrition was more prevalent among women with lower wealth indexes in Bangladesh, as indicated by the concentration index (CIX = -0.26). The multivariable analysis investigating the determinants of undernutrition status among ever-married women, with a focus on residence revealed significant associations with respondent age, education, marital status, mass media access, wealth status, and division. According to the Blinder-Oaxaca decomposition and its extension, the prevalence was significantly higher in rural residences of Bangladesh than in urban residences, and the endowment effect explained 86 percent of the total urban-rural difference in undernutrition prevalence. The results of this study indicate that the factors that influence women’s nutritional status in rural areas play a significant role in the gap, and the majority of the gap is caused by education and economic position. In order to effectively promote maternal health policies in Bangladesh, intervention techniques should be created that are aimed at the population, that is, the poorest and least educated.

PMID:38096318 | DOI:10.1371/journal.pone.0289880

PLoS One. 2023 Dec 14;18(12):e0296039. doi: 10.1371/journal.pone.0296039. eCollection 2023.

ABSTRACT

BACKGROUND: The global population of individuals with gender diversity or LGBTQ+ people is on the rise. However, negative attitudes towards LGBTQ+ individuals persist, even among healthcare professionals, creating barriers to healthcare access. These attitudes are influenced by cultural variations worldwide and necessitate investigation across diverse cultures and settings.

OBJECTIVES: This study aimed to evaluate the attitudes towards LGBTQ+ people and describe associated factors with being LGBTQ+ among Thai medical students.

METHODS: During the 2021 academic year, a survey was conducted at a medical school in Bangkok, Thailand, collecting demographic data and attitudes measured by a standardised Thai questionnaire. Descriptive statistics as well as bivariate and multivariable logistic regression analyses were used to describe characteristics and association.

RESULTS: A total of 806 medical students participated, with a neutral attitude being the most prevalent (72.2%), followed by a positive attitude (27.2%), and a minority reporting a negative attitude (0.6%). Bivariate and multivariable logistic regression analyses revealed significant associations between positive attitudes and female sexual identity (aOR 2.02, 95%CI 1.45-2.81, p-value < 0.001), having LGBTQ+ family members (aOR 3.57, 95%CI 1.23-10.34, p-value = 0.019), having LGBTQ+ friend (aOR 1.46, 95%CI 1.02-2.11, p-value = 0.040), and coming from areas outside of Bangkok (aOR 1.41, 95%CI 1.01-1.97, p-value = 0.043).

CONCLUSION: Positive attitude towards the LGBTQ+ community are essential for physicians, emphasising the need to study factors that contribute to positive attitudes in order to foster an LGBTQ+-friendly environment for both patients and medical students.

PMID:38096311 | DOI:10.1371/journal.pone.0296039