Nevin Manimala

J Arthroplasty. 2023 Jun 2:S0883-5403(23)00570-3. doi: 10.1016/j.arth.2023.05.046. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study was to retrospectively examine the relationship between pre- and post-operative alignment in robotic unicompartmental knee arthroplasty and postoperative patient-reported outcome measures.

METHODS: A retrospective review of 374 patients who underwent robotic-assisted UKA was conducted. Patient demographics, history, and pre- and post-operative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) scores were obtained via chart review. Average follow-up period was 2.4 years (range: 0.4-4.5 years) to chart review and 9.5 months (range: 6-48 months) to latest KOOS-JR. Pre- and post-operative robotically-measured knee alignment was obtained from operative reports. Incidence of conversion to total knee arthroplasty was determined by review of a health information exchange tool.

RESULTS: Multivariate regressions showed no statistically significant relationship between preoperative alignment, postoperative alignment, or degrees of alignment correction and change in KOOS-JR score or achievement of KOOS-JR MCID (P > 0.05). Patients who had > 8 degrees of postoperative varus alignment had on average a 20% lower achievement of KOOS-JR MCID compared to patients who had < 8 degrees of postoperative varus alignment; however, this difference was not statistically significant (P > 0.05). There were three patients who required conversion to total knee arthroplasty in the follow-up period, with no significant relationship to alignment variables (P > 0.05).

CONCLUSION: There was no significant difference in KOOS-JR change for those patients who had a larger or smaller degree of deformity correction, and correction did not predict MCID achievement. The results of this study contributes to the ongoing discussion of expanding indications for UKAs.

PMID:37271235 | DOI:10.1016/j.arth.2023.05.046

Am J Emerg Med. 2023 May 24;70:119-126. doi: 10.1016/j.ajem.2023.05.010. Online ahead of print.

ABSTRACT

BACKGROUND: P2Y inhibitor and morphine are widely used in caring for patients with the acute coronary syndrome (ACS), but there are some concerns about the combination use due to interaction in metabolism. Therefore, this study aimed to examine whether using morphine with antiplatelets in patients with ACS affects the clinical outcomes based on currently available evidence.

METHODS: Three databases were searched for comparative studies on this topic by using relevant keywords of ACS and morphine. Two authors independently extracted study information, mortality, major adverse cardiac event (MACE), major bleeding, and length of hospital stay. Then, they evaluated the quality of evidence independently. Meta-analysis was planned to be conducted in random-effects model. Risk ratio (RR) was used for most outcomes except hospital stay, and Peto odds ratio (POR) was used if there were any zero cells. Pooled estimate was presented with 95% confidence interval (CI).

RESULTS: Fourteen studies (n = 73,033) met eligibility criteria, and there was non-significant difference in mortality between antiplatelet with and without morphine (RR = 1.13, 95%CI: 0.78 to 1.64). Antiplatelet therapy without morphine significantly reduced the risk of MACE (RR = 0.78, 95%CI: 0.67 to 0.89; I-square = 0%), but increased the odds of major bleeding (POR = 1.87, 95%CI: 1.04 to 3.35; I-square = 0%) as compared with the combined use of antiplatelet therapy and morphine.

CONCLUSION: In conclusion, there is no statistically significant difference in mortality in patients with ACS using morphine or not, but clinicians ought to make a trade-off between a lower risk of MACE and a higher risk of major bleeding before adding morphine to antiplatelet therapy.

PMID:37270851 | DOI:10.1016/j.ajem.2023.05.010

J Am Mosq Control Assoc. 2023 Jun 1;39(2):0. doi: 10.2987/22-7094.

ABSTRACT

We compared the effectiveness of 4 different carbon dioxide (CO2) sources (sugar-fermented BG-CO2, sugar-fermented Fleischmann yeast, dry ice, and compressed gas cylinders) in attracting different mosquito species in 2 separate 4 × 4 Latin square trials. The CO2 generated by dry ice and the gas cylinders collected more Culex quinquefasciatus than the sugar-fermented BG-CO2 and Fleischmann yeasts during the 1st trial (16-h surveillance periods), but there was no significant difference in Aedes aegypti numbers. There were no significant differences between the different CO2 sources in collecting Cx. quinquefasciatus and Ae. aegypti mosquitoes in the 2nd trial (24-h surveillance periods). Catches for Culiseta inornata and Cx. tarsalis were too low in both experiments for formal statistical analysis. Data can be used to inform local mosquito surveillance programs, but the selection of a CO2 source will also depend on financial and logistical constraints.

PMID:37270849 | DOI:10.2987/22-7094

Neuroreport. 2023 Jun 7;34(10):521-525. doi: 10.1097/WNR.0000000000001918. Epub 2023 May 20.

ABSTRACT

In modern society, visual symbols such as logos, icons, and letters have become essential for communication and cognition, playing a crucial role in daily life. This study focuses on app icons, a frequently encountered type of symbol, and aims to investigate the neural mechanisms involved in their recognition. Specifically, our objective is to identify the timing and location of brain activity associated with this process. We presented participants with familiar and unfamiliar app icons and asked them to perform a repetition detection task while recording the event-related potentials (ERPs) elicited by these stimuli. Statistical analysis revealed a significant difference in the ERPs between familiar and unfamiliar icons, occurring around 220 ms in the parietooccipital scalp region. The source analysis indicated that this ERP difference originated in the ventral occipitotemporal cortex, specifically the fusiform gyrus. These findings suggest that the recognition of familiar app icons results in the activation of the ventral occipitotemporal cortex approximately 220 ms after exposure. Additionally, our findings, in conjunction with previous research on visual word recognition, suggest that the lexical orthographic processing of visual words is dependent on general visual processing mechanisms that are also involved in the recognition of familiar app icons. In essence, the ventral occipitotemporal cortex likely plays a crucial role in memorizing and recognizing visual symbols and objects, including familiar visual words.

PMID:37270845 | DOI:10.1097/WNR.0000000000001918

Technol Health Care. 2023 May 25. doi: 10.3233/THC-230074. Online ahead of print.

ABSTRACT

BACKGROUND: Undesirable effects of tooth bleaching can alter the biomechanical properties of enamel.

OBJECTIVE: To determine the influence of strontium fluorophosphate bioactive glass (Sr-FPG) on color, microhardness and surface roughness of enamel bleached with 35% hydrogen peroxide.

METHODS: The labial enamel of 36 extracted intact human anterior teeth were divided into 3 groups (n= 12), group 1 (HP): bleaching with 35% hydrogen peroxide only, group 2 (Sr-HP): bleaching with Sr-FPG incorporated 35% hydrogen peroxide and group 3 (HP-SrFPG): bleaching with 35% hydrogen peroxide followed by remineralization with Sr-FPG. Four consecutive eight-minute applications of the bleaching gel were done twice in all the groups. Color change (ΔE), microhardness and surface roughness were evaluated at baseline, post-bleaching and post-remineralization using spectrophotometer, Vickers hardness tester and profilometric analysis respectively.

RESULTS: The mean ΔE among the groups was statistically similar (p> 0.05). Bleaching with HP significantly reduced microhardness (p< 0.05), whereas bleaching with Sr-HP and HP-SrFPG did not (p> 0.05). Post-bleaching microhardness in Sr-HP was significantly higher than HP-SrFPG (p< 0.05). An increased surface roughness was seen in Sr-HP bleached samples (p< 0.05).

CONCLUSION: The addition of Sr-FPG to hydrogen peroxide significantly improved enamel microhardness than its use post-bleaching. An increase in surface roughness was seen post-bleaching with HP and Sr-HP.

PMID:37270825 | DOI:10.3233/THC-230074

Technol Health Care. 2023 May 25. doi: 10.3233/THC-230069. Online ahead of print.

ABSTRACT

BACKGROUND: Traditionally, alcohol sprays are used for disinfection of acrylic-base denture surfaces. A limited number of studies have assessed the role of antimicrobial photodynamic therapy (aPDT) in this regard; however, it remains debatable whether conventional alcohol sprays are superior to aPDT in terms of antifungal activity or vis versa.

OBJECTIVE: The aim of the present in vitro study is to compare the antifungal activity of conventional alcohol sprays and aPDT on acrylic denture resin.

METHODS: Individuals wearing complete dentures at least on one arch were included. Dentures were randomly divided into three groups. Groups 1-3 were disinfected with an alcohol-based antiseptic spray and aPDT, respectively. Assessment of oral yeast growth was done using swab samples. The culture mediums were incubated at 37∘C for 72 hours and viewed through a microscope. The numbers of colony forming units (CFU/ml) were determined. P< 0.05 were considered statistically significant.

RESULTS: At baseline, the mean CFU/ml in Groups 1-3 were comparable. After disinfection, a statistically significant reduction in microbial CFU/ml was observed in Groups 1 (P< 0.05) and 2 (P< 0.05) compared with baseline. In Group 3, there was no difference in CFU/ml throughout the study. After disinfection, there was no difference in microbial CFU/ml in dentures in Groups 1 and 2.

CONCLUSION: Conventional alcohol sprays are as effective as aPDT towards reducing oral yeasts CFU/ml on acrylic denture resin.

PMID:37270824 | DOI:10.3233/THC-230069

Technol Health Care. 2023 May 25. doi: 10.3233/THC-220904. Online ahead of print.

ABSTRACT

BACKGROUND: Studies have shown that community-based group rehabilitation activities can have a positive impact on patients.

OBJECTIVE: This study attempted to improve schizophrenia patients’ social and self-cognition through short-term group-based cognitive behavioral therapy (G-CBT), break negative coping styles, and improve the patients’ quality of life.

METHODS: The patients with schizophrenia who participated in long-term community-based group rehabilitation were treated with G-CBT. Training on coping styles was conducted to improve their self-cognition and social cognition, and the rehabilitation effects of G-CBT on these patients were evaluated.

RESULTS: Compared with the control group, patient scores for self-esteem, self-efficacy, and positive coping in the G-CBT group increased, while patient scores for negative coping decreased. Compared with the control group, the differences in the total scores for mental health and the five dimensions of physical functioning, general health, vitality, social functioning, and emotional role function in the short-form (SF-12) survey were statistically significant. Compared with the baseline data, the differences in self-esteem, self-efficacy, positive coping, negative coping, and quality of life scores were statistically significant.

CONCLUSION: Short-term G-CBT had a good effect on patients with chronic schizophrenia who participated in community-based group rehabilitation for the long-term.

PMID:37270823 | DOI:10.3233/THC-220904

Technol Health Care. 2023 May 25. doi: 10.3233/THC-220742. Online ahead of print.

ABSTRACT

BACKGROUND: Juxta-papillary duodenal diverticula (JPDD) are common but are usually asymptomatic, and they are often diagnosed by coincidence.

OBJECTIVE: To analyse the anatomy and classification of JPDD and its relationship with biliary and pancreatic disorders, and to explore the diagnostic value of multi-slice spiral computed tomography (MSCT) in patients with JPDD.

METHODS: The imaging data of patients with JPDD, which was obtained via abdominal computed tomography examination and confirmed via gastroscopy and/or upper gastrointestinal barium enema, in our hospital from 1 January 2019 to 31 December 2020 were retrospectively analysed. All patients were scanned using MSCT, and the imaging findings, classification and grading were analysed.

RESULTS: A total of 119 duodenal diverticula were detected in 96 patients, including 73 single diverticula and 23 multiple diverticula. The imaging findings were mainly cystic lesions of the inner wall of the duodenum protruding to the outside of the cavity. The thin layer showed a narrow neck connected with the duodenal cavity, and the shape and size of the diverticula were different: 67 central-type cases and 29 peripheral-type cases. There were 50 cases of type I, 33 cases of type II, 19 cases of type III and six cases of type IV. Furthermore, there were seven small, 87 medium and 14 large diverticula. The differences in the location and size of the JPDD in MSCT grading were statistically significant (P< 0.05).

CONCLUSION: The MSCT method has an important diagnostic value for the classification of JPDD, and MSCT images are helpful in the clinical evaluation of patients with JPDD and the selection of treatment options.

PMID:37270822 | DOI:10.3233/THC-220742

Med Educ Online. 2023 Dec;28(1):2220175. doi: 10.1080/10872981.2023.2220175.

ABSTRACT

BACKGROUND: Faculty evaluation surveys in the frame of student evaluation of teaching (SETs) are a widely utilized tool to assess faculty teaching. Although SETs are used regularly to evaluate teaching effectiveness, their sole use for making administrative decisions and as an indicator of teaching quality has been controversial.

METHODS: A survey containing 22 items assessing demographics, perception, and factors for evaluating faculty was distributed to medical students at our institute. Statistical analyses were conducted using Microsoft Excel and R Software utilizing regression analysis and ANOVA test.

RESULTS: The survey received 374 responses consisting of 191 (51.1%) male students and 183 (48.9%) female students. In all, 178 (47.5%) students considered the optimal time for providing faculty evaluation to be after the release of the exam results, compared to 127 (33.9%) students, who chose the after the exam but before the release of exam results option. When asked what happens whenever the tutor is aware about the SETs data, 273 (72.9%) and 254 (67.9%) students believed that it would influence the difficulty of the exam and grading/curving of the exam results, respectively. Better teaching skills (93%, 348), being responsive and open to student feedback and suggestions (84.7%, 317), being committed to class time and schedule (80.1%, 300), and an easier exam (68.6%, 257) were considered important factors to acquire a positive evaluation by a considerable proportion of students. Fewer lectures (P < 0.05), decreased number of slides per lecture (P < 0.01), easier exam (P < 0.05), and giving clues to students about the exam (P < 0.05) were found to be very important to obtain a positive tutor evaluation by students.

CONCLUSIONS: Institutions ought to continue exploring areas of improvement in the faculty evaluation process while raising awareness among students about the importance and administrative implications of their feedback.

PMID:37270796 | DOI:10.1080/10872981.2023.2220175

Matern Child Health J. 2023 Jun 4. doi: 10.1007/s10995-023-03724-2. Online ahead of print.

ABSTRACT

BACKGROUND: According to the World Breastfeeding Trends Initiative, Sri Lanka ranked as number one and only country to achieve green status. Exclusive breastfeeding (EBF) for six months is current practice with a rate of 75.5% among 0-5 months.

AIM: Identify factors contributing early cessation of breastfeeding in a single centre of Eastern province Sri Lanka.

METHODS: A descriptive cross-sectional study conducted in Sammanthurai Medical officer of Health area. Consecutive mother-infant days with the infant ageing < 6 months were included from 25 public health midwife areas using an interviewer administered questionnaire. Missing values imputed using ‘missForest’ algorithm.

RESULTS: The mean age of the sample was 28.4(SD ± 5.6). Of the 257 mothers recruited, 15(5.8%) were teenagers and 42(16.3%) > 35 years. 251(97.6%) had children 1-5 and 86(33.5%) were first born. 140 (54.5%) had tertiary education, 28 (10.9%).31(12.1%) were employed. EBF rates 0-6 months was 79.8% (n = 205). 239(93.0%) started breastfeeding within an hour. EBF was not associated with maternal age, birth order or income. 18 employed mothers and 186 unemployed mothers continued EBF. Regarding the factors associated with EBF, having a tertiary education (p < .001), being employed (p = .004) and having less than 3 children (p = .03) were associated with non-exclusive breastfeeding. Tertiary education was the significant predictor of non-exclusive breastfeeding in this population with an odds ratio of 4.50 (95% CI 1.331-15.215).

CONCLUSION: Employment identified as a risk factor for early cessation of EBF needs well planned further research to overcome this practical issue. Also might need revision of workplace policies, establishment of lactation areas in office premises to overcome some of these issues.

PMID:37270754 | DOI:10.1007/s10995-023-03724-2