Nevin Manimala

Am Surg. 2023 May 15:31348231175104. doi: 10.1177/00031348231175104. Online ahead of print.

ABSTRACT

The COVID-19 pandemic has had profound effects on the everyday behaviors of all patients. At the same time, the United States population is aging, and an increasing portion of traumatically injured patients are geriatric. Our study aims to examine the effects of the COVID-19 pandemic on the geriatric trauma population. We performed a retrospective review of the trauma database from our single institution level I trauma center examining pandemics impact on geriatric trauma demographics, mechanism of injury, injury severity, hospitalization characteristics, and alcohol use. Data during the pandemic was compared to the prior 3 years and controlled for seasonality. Statistical analysis demonstrated an increase in duration of mechanical ventilation and alcohol use during the pandemic while other factors remained stable. This shows the need for targeted alcohol assessment in the geriatric trauma population during periods of social isolation and additional research into the effects of the COVID-19 on trauma patients.

PMID:37183430 | DOI:10.1177/00031348231175104

Saudi Med J. 2023 May;44(5):486-491. doi: 10.15537/smj.2023.44.5.20220818.

ABSTRACT

OBJECTIVES: To understand the most common type and clinical manifestations of associated vasculitis (AAV) in the Saudi Arabia.

METHODS: This retrospective study was conducted at King Fahad Medical City and the Security Forces Hospital Program, Riyadh, Saudi Arabia, between January 2014 and May 2022. Patients aged ≥18 years were included in the study and diagnosed based on clinical manifestations, serology, or histopathology according to the EMA algorithm. Univariate analysis was carried out to compare different groups; a series of independent samples t-tests was applied for continuous data.

RESULTS: A total of 53 patients were enrolled: eosinophilic granulomatosis with polyangiitis (EGPA), granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA). Overall, proteinase-3 was the most prevalent (52.8%), and myeloperoxidase, myeloperoxidase MPO was the least prevalent antineutrophil cytoplasmic antibody (ANCA)-type (18.9%) among patients; other patients showed negative ANCA test results. The clinical manifestations differed significantly between EGPA and GPA groups in pulmonary, neurological, cardiological, and renal signs and symptoms (p<0.05); there was a higher incidence of the former 3 in the EGPA group. Although upper airway was predominant in all groups, there was no statistical difference between both groups.

CONCLUSION: This study validated international reports on AAV clinical manifestations in the Saudi population. The GPA was associated with more upper airway and pulmonary signs and symptoms. Further investigation is needed to understand the treatments and quality of life of patients with AAV.

PMID:37182925 | DOI:10.15537/smj.2023.44.5.20220818

Saudi Med J. 2023 May;44(5):498-499. doi: 10.15537/smj.2023.44.5.20230070.

ABSTRACT

OBJECTIVES: To investigate the clinical and pathological characteristics of extracranial germ cell tumors (GCTs) in children aged 0-168 months treated at the National Guard Hospital, Jeddah, Saudi Arabia from 1990 to 2020.

METHODS: In this retrospective analysis, the data for all cases of GCTs were collected from 1990 to 2020. Statistical analyses were carried out using JMP software. The data was divided into 4 main categories: demographics, pathological/clinical features, recurrence, treatment and outcome.

RESULTS: The study included 50 patients, with a mean age at diagnosis of 56.52 months. The median follow-up duration was 30 months. Most tumors were in the gonads, and among the extragonadal tumors, the sacro-coccyx was the most frequent site of the disease.The most common histological subtype of GCTs is yolk sac tumor, accounting for 28% of cases. Of the 50 patients, 46% received chemotherapy, and 54% underwent surgery without chemotherapy. Ten (20%) patients experienced recurrence after treatment. At the last follow-up, 96% of the patients were alive, and only 2 of the patients died due to advanced disease.

CONCLUSION: Our findings were comparable to international data, but improvement in surveillance is required for long-term survivors.

PMID:37182921 | DOI:10.15537/smj.2023.44.5.20230070

Saudi Med J. 2023 May;44(5):456-462. doi: 10.15537/smj.2023.44.5.20220833.

ABSTRACT

OBJECTIVES: To compare the subjective and objective visual quality more comprehensively after surgery of the commonly used multifocal intraocular lenses (IOL) and monolocal IOL implants through long-term systematic clinical observation, providing reference and basis for clinical application.

METHODS: Non-randomized controlled trial. A total of 91 (138 eyes) patients between June 2020 and December 2020 were implanted trifocal IOL or monofocal IOL after phacoemulsification in a tertiary class hospital in Wuhan. Monocular testing 3 months after surgery included best-spectacles corrected and uncorrected visual at distant, intermediate, and near vision; spherical equivalent (SE); defocus curve; modulation transfer function (MTF); dysfunctional lens index (DLI); Strehl ratio (SR); mesopic contrast sensitivity function; quality-of-life, spectacles independence, visual disturbance, and surgical satisfaction surveys 3 months post-surgery.

RESULTS: There was statistically better uncorrected vision acuity with trifocal IOLs in all range, while monofocal IOL had statistically better mesopic contrast sensitivity at specific spatial frequencies and statistically worse defocus curves, spectacles independence, and surgical satisfaction. The trifocal IOL performed better in subjective quality of vision and life and spectacles independence questionnaires, and the objective quality of vision had no statistical significance.

CONCLUSION: Compared to monofocal IOL, trifocal IOL could provide a full range of clear vision for the majority of patients with simple cataracts, improve the rate of spectacles independence and patient satisfaction. And the objective quality of vision did not show any difference.

PMID:37182920 | DOI:10.15537/smj.2023.44.5.20220833

Saudi Med J. 2023 May;44(5):518-521. doi: 10.15537/smj.2023.44.5.20220031.

ABSTRACT

OBJECTIVES: To ascertain the use of draining the thyroid bed following surgery.

METHODS: Fifty four patients who underwent total thyroidectomy were enrolled in the study between March 2021 and July 2022 and randomly allocated into 2 groups – a drain group and a no drain group. The hospital stay, operating time, post operative pain, post operative complications, cosmesis, and patient’s perspectives were compared.

RESULTS: The mean duration of hospitalization was significantly shorter in the no drain group as compared to the drain group. The post operative pain, as assessed by the Mankoski Pain Scale (MPS) was significantly higher in the drain group than in the no drain group. The cosmetic evaluation undertaken using the Hollander Wound Evaluation Scale, noted that there was a statistically significant difference in scarring between the 2 groups. There was no statistically significant difference in the duration of surgery and post operative complications between the two groups. Patient satisfaction was also noted to be superlative in the no drain group.

CONCLUSION: The routine drain placement following thyroidectomy places the patient at a disadvantage in terms of longer hospitalisation, increased post operative pain and poor cosmetic outcome.

PMID:37182919 | DOI:10.15537/smj.2023.44.5.20220031

Saudi Med J. 2023 May;44(5):471-478. doi: 10.15537/smj.2023.44.5.20220872.

ABSTRACT

OBJECTIVES: To identify patients’ general comfort levels in percutaneous coronary intervention.

METHODS: This descriptive research included 2 hundred cardiac patients, whom were in the Medipol Mega University Hospital, Istanbul, during the period between May 2018 and May 2019. The data were obtained by General Comfort Questionnaire and evaluated using mean, standard deviation, percentage and t-test.

RESULTS: In this study reports that patients had the mean total comfort score as 3.03±0.3. They acquired the maximum score from the psychospiritual comfort subdimension and the minimum score from the physical comfort subdimension. Patients who experienced transradial percutaneous coronaryintervention had statistically higher general, physical, psycospiritual and environmental comfort levels than those who had transfemoral intervention (p<0.05). According to both access methods, relief and ease levels were significantly different.

CONCLUSION: Patients who experienced percutaneous coronary intervention have above medium general comfort levels. Their physical comfort scored lowest within the comfort dimensions investigated in this study. The comfort level of the patients to whom the transradial method was applied was found to be higher in comparison with the transfemoral method.

PMID:37182915 | DOI:10.15537/smj.2023.44.5.20220872

J Alzheimers Dis. 2023 May 5. doi: 10.3233/JAD-221242. Online ahead of print.

ABSTRACT

BACKGROUND: Microvascular dysfunction (MVD) may contribute to cognitive impairment and Alzheimer’s disease, but evidence is limited.

OBJECTIVE: To investigate the association of composite and organ-specific MVD burden with mild cognitive impairment (MCI) and cognition among rural-dwelling Chinese older adults.

METHODS: In this population-based cross-sectional study, we assessed MVD makers using optical coherence tomographic angiography for retinal microvasculature features, brain magnetic resonance imaging scans for cerebral small vessel disease (CSVD), and serum biomarkers for MVD. A composite MVD score was generated from the aforementioned organ-specific parameters. We used a neuropsychological test battery to assess memory, verbal fluency, attention, executive function, and global cognitive function. MCI, amnestic MCI (aMCI), and non-amnestic MCI (naMCI) were diagnosed following the Petersen’s criteria. Data was analyzed with the linear and logistic regression models.

RESULTS: Of the 274 dementia-free participants (age≥65 years), 56 were diagnosed with MCI, including 47 with aMCI and 9 with naMCI. A composite MVD score was statistically significantly associated with an odds ratio (OR) of 2.70 (95% confidence interval 1.12-6.53) for MCI and β-coefficient of -0.29 (-0.48–0.10) for global cognitive score after adjustment for socio-demographics, lifestyle factors, APOE genotype, the Geriatric Depression Scale score, serum inflammatory biomarkers, and cardiovascular comorbidity. A composite score of retinal microvascular morphology was associated with a multivariable-adjusted OR of 1.72 (1.09-2.73) for MCI and multivariable-adjusted β-coefficient of -0.11 (-0.22–0.01) for global cognitive score. A composite CSVD score was associated with a lower global cognitive score (β= -0.10; -0.17–0.02).

CONCLUSION: Microvascular dysfunction, especially in the brain and retina, is associated with MCI and poor cognitive function among rural-dwelling older adults.

PMID:37182877 | DOI:10.3233/JAD-221242

Clin Hemorheol Microcirc. 2023 May 5. doi: 10.3233/CH-231780. Online ahead of print.

ABSTRACT

A usual practice in medicine is to search for “biomarkers” which are measurable quantities of a normal or abnormal biological process. Biomarkers can be biochemical or physical quantities of the body and although commonly used statistically in clinical settings, it is not usual for them to be connected to basic physiological models or equations. In this work, a normative blood velocity model framework for the exchange microvessels was introduced, combining the velocity-diffusion (V-J) equation and statistics, in order to define the normative range (NR) and normative area (NA) diagrams for discriminating normal (normemic) from abnormal (hyperemic or underemic) states, taking into account the microvessel diameter D. This is different from the usual statistical processing since there is a basis on the well-known physiological principle of the flow diffusion equation. The discriminative power of the average axial velocity model was successfully tested using a group of healthy individuals (Control Group) and a group of post COVID-19 patients (COVID-19 Group).

PMID:37182862 | DOI:10.3233/CH-231780

Work. 2023 May 9. doi: 10.3233/WOR-220621. Online ahead of print.

ABSTRACT

BACKGROUND: Professional rickshaw driving is a seemingly sedentary occupation and involves many risk factors for work-related musculoskeletal disorders (WMSD).

OBJECTIVE: To assess the prevalence of work-related musculoskeletal disorders and its associated risk factors among professional rickshaw drivers.

METHODS: 263 rickshaw drivers were voluntarily recruited from Aligarh, Uttar Pradesh, India. MSD symptoms in the past 12 months and last 7 days were assessed using a self-modified musculoskeletal questionnaire (Nordic Questionnaire). Chi-square tests and binary logistic regression were performed to analyze associations of MSD symptoms between study variables.

RESULTS: 155 (58.9%) study participants reported MSD symptoms in past 12 months, in lower back (n = 126, 81.3%), leg (n = 122, 78.7%), neck (n = 106, 68.4%) and knee (n = 105, 67.7%); and 121 (46.1%) in last 7 days, in leg (n = 107, 88.4%), lower back (n = 102, 84.3%), neck (n = 89, 73.6%), upper back and knees (n = 87, 71.9%). Binary logistic regression showed relationship between working hours, seat and road condition, average load per ride, rickshaw ride duration, and standing driving with MSD symptoms among rickshaw drivers, especially in the lower back, leg/calf muscles, neck and knees.

CONCLUSION: The results showed a high prevalence of MSD among all rickshaw drivers, with the neck, lower back, leg/calf muscles and knees being the most affected body parts. In order to avoid adverse effects on the occupational health of rickshaw drivers, ergonomic intervention training is necessary.

PMID:37182856 | DOI:10.3233/WOR-220621

Work. 2023 May 6. doi: 10.3233/WOR-220607. Online ahead of print.

ABSTRACT

BACKGROUND: High levels of mobbing are reported in Greek nurses, but the intraindividual and perceived group emotional correlates are little investigated.

OBJECTIVE: To determine the relationship between workplace mobbing (specifically in the nursing sector of a public rural hospital in Greece) and emotional correlates.

METHODS: Questionnaires measuring emotional aspects such as Negative Act Questionnaire – Revised (NAQ-R) for measuring perceived exposure to bullying and victimization at work, Maslach Burnout Inventory (MBI), Overall Job Satisfaction Scale (OJS), Job Affect Scale (JAS: positive and negative subscales), Perceived Cohesion Scale (PCS), Ethical Climate Questionnaire (ECQ), and Short General Health Questionnaire (GHQ-12) were administered. For the analysis of the data, descriptive and parametric tests were performed through the Pearson correlations and regression for the relationship between variables.

RESULTS: High mobbing levels were reported (M = 45.93) compared to already established cutoff scores. Statistically significant positive correlations were found for NAQ-R and MBI (Exhaustion subscale) (r = .569, p < .001), NAQ-R and JAS-negative affect (r = .610, p < .001), NAQ-R and GHQ-12 (r = .280, p = .002), and NAQ-R andeducational level (r = .196, p = .033). Statistically significant negative correlations were found for NAQ-R and ECQ (r = -.323, p < .001), NAQ-R and JAS-positive affect (r = -.556, p < .001), and NAQ-R and PCS (r = -.586, p < .001). Only burnout,negative affect, and perceived group cohesion predicted mobbing measured by NAQ- R.

CONCLUSION: As mobbing and its consequences are related to specific emotional variables, these perceived individual and group indices, could be targeted in future prevention initiatives.

PMID:37182854 | DOI:10.3233/WOR-220607