Nevin Manimala

Nucl Med Rev Cent East Eur. 2022 Dec 30. doi: 10.5603/NMR.a2022.0037. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the diagnostic accuracy of [18F]FDG PET/MR versus [18F]FDG PET/CT in the thoracic staging of patients with non-small cell lung cancer (NSCLS).

MATERIAL AND METHODS: The Preferred Reporting Items for Systematic Reviews (PRISMA) were followed in conducting the present study. All available research was collected through Embase (Elsevier), PubMed, as well as Cochrane Library databases up to June 2021. Only studies covering both [18F]FDG PET/MRI and [18F]FDG PET/CT techniques in the same group were included. Statistical analysis was done using Stata v.12.

RESULTS: The overall accuracy of [18F]FDG PET/CT in T and N staging was 92% (95% CI: 89-95 , I2 : 93.4%) and 78% (95% CI: 74-82 , I2 : 98.5%) respectively. While, the corresponding rates for [18F]FDG PET/MRI were 91% (95% CI: 88-94 , I2 : 96.5%) and 89% (95% CI: 84-94 , I2 : 88.1%) respectively.

CONCLUSIONS: The present meta-analysis showed that [18F]FDG PET/CT and [18F]FDG PET/MRI exhibit relatively the same performance in detecting N and T stages in patients with NSCLC. Thus, [18F]FDG PET/MRI can be a worthy alternative for [18F]FDG PET/CT in the diagnosis of advanced of NSCLC in the chest area, more specifically in N-staging, since it provides higher soft-tissue contrast. There is a need for more reliable research for comparing the diagnostic performance of these imaging techniques and various optimized [18F]FDG PET/MRI protocols.

PMID:36584217 | DOI:10.5603/NMR.a2022.0037

PLoS One. 2022 Dec 30;17(12):e0279631. doi: 10.1371/journal.pone.0279631. eCollection 2022.

ABSTRACT

Various low-volume bowel cleansing formulations that improve compliance have been approved and are being used in clinical practice. This study aimed to compare the effectiveness of 1 L polyethylene glycol (PEG) with ascorbic acid with that of sodium picosulfate (PICO) with magnesium citrate. This was a multicenter, randomized controlled, non-inferiority study. Patients were randomized into a 1 L PEG with ascorbic acid group and a PICO with magnesium citrate group according to the bowel cleansing agent used. Colonoscopy was performed as a single-blind study wherein the endoscopist had no information about any bowel preparation agent. The efficacy of bowel cleansing was assessed using the Harefield Cleansing Scale (HCS), and adverse events, preferences, and satisfaction were evaluated using a patient-reported questionnaire before colonoscopy. A total of 254 participants were randomly assigned to two groups: 115 in the 1 L PEG with ascorbic acid group and 113 in the PICO with magnesium citrate group. Overall bowel cleansing success was not statistically different between the two groups (97.4 vs. 97.3%), confirming that 1 L PEG with ascorbic acid was not inferior to PICO with magnesium citrate (lower confidence limit, -4.15%; p = 1.00). High-quality bowel cleansing was achieved in 87% of the 1 L PEG with ascorbic acid group and 77% of the PICO with magnesium citrate group (Lower confidence limit, 1.29%, p = 0.05). In terms of patient satisfaction, PICO with magnesium citrate was better, but compliance and side effects were similar in both groups. The 1 L PEG with ascorbic acid showed similar efficacy and adverse events as PICO with magnesium citrate. Although 1 L PEG with ascorbic acid is very effective in bowel preparation despite its small volume, it is necessary to increase satisfaction such as taste and feeling.

PMID:36584216 | DOI:10.1371/journal.pone.0279631

PLoS One. 2022 Dec 30;17(12):e0279889. doi: 10.1371/journal.pone.0279889. eCollection 2022.

ABSTRACT

OBJECTIVE: Type 2 diabetes mellitus(T2DM) is closely related to sarcopenic obesity(SO). Body composition measurement including body weight, body mass index, waist circumference, percentage body fat, fat mass, muscle mass, visceral adipose tissue and subcutaneus adipose tissue, plays a key role in evaluating T2DM and SO. The weight reduction effect of sodium-glucose cotransporter 2(SGLT-2) inhibitors has been demonstrated. However, there are warnings that SGLT-2 inhibitors should be used with caution because they may increase the risk of sarcopenia. The effect of SGLT-2 inhibitors on body composition in T2DM is inconclusive. In this work, a meta-analysis of randomized controlled trials was conducted to evaluate the effect of SGLT-2 inhibitors on body composition in T2DM.

METHODS: PubMed, the Cochrane Library, EMbase and Web of Science databases were searched by computer. All statistical analyses were carried out with Review Manager version 5. 3. Results were compared by weight mean difference(WMD), with 95% confidence intervals(CI) for continuous outcomes. A random effects model was applied regardless of heterogeneity. The I2 statistic was applied to evaluate the heterogeneity of studies. Publication bias was assessed using Funnel plots.

RESULTS: 18 studies with 1430 participants were eligible for the meta-analysis. SGLT-2 inhibitors significantly reduced body weight(WMD:-2. 73kg, 95%CI: -3. 32 to -2. 13, p<0. 00001), body mass index(WMD:-1. 13kg/m2, 95%CI: -1. 77 to -0. 50, p = 0. 0005), waist circumference(WMD:-2. 20cm, 95%CI: -3. 81 to -0. 58, p = 0. 008), visceral fat area(MD:-14. 79cm2, 95%CI: -24. 65 to -4. 93, p = 0. 003), subcutaneous fat area(WMD:-23. 27cm2, 95% CI:-46. 44 to -0. 11, P = 0. 05), fat mass(WMD:-1. 16kg, 95%CI: -2. 01 to -0. 31, p = 0. 008), percentage body fat(WMD:-1. 50%, 95%CI:-2. 12 to -0. 87, P<0. 00001), lean mass(WMD:-0. 76kg, 95%CI:-1. 53 to 0. 01, P = 0. 05) and skeletal muscle mass(WMD:-1. 01kg, 95%CI:-1. 91 to -0. 11, P = 0. 03).

CONCLUSION: SGLT-2 inhibitors improve body composition in T2DM including body weight, body mass index, waist circumference, visceral fat area, subcutaneous fat area, percentage body fat and fat mass reduction, but cause adverse effects of reducing muscle mass. Therefore, until more evidence is obtained to support that SGLT-2 inhibitors increase the risk of sarcopenia, not only the benefit on body composition, but also the adverse effect of the reduction in muscle mass by SGLT-2 inhibitors in T2DM should be considered.

PMID:36584211 | DOI:10.1371/journal.pone.0279889

PLoS One. 2022 Dec 30;17(12):e0279870. doi: 10.1371/journal.pone.0279870. eCollection 2022.

ABSTRACT

BACKGROUND: An estimated 22 million Ethiopian women between the ages of 15 and 49 are affected by cervical cancer each year, with 7095 cases and 4732 fatalities. Cervical cancer screening is one of the prevention methods, although Ethiopia has a low coverage rate. Furthermore, data on the use of cervical cancer screening services in the country is scarce. Therefore, we aimed to assess cervical cancer screening practices and its associated factors among females of reproductive age in Durame, Southern Ethiopia.

METHODS: A community-based cross-sectional study was conducted using a multi-stage sampling technique among 460 females of reproductive age from March to April 2020. Data were collected using interviewer-administered questionnaires and analyzed using the Statistical Package for Social Science (SPSS) Version 20. Bivariable and multivariable logistic regressions were carried out to determine the association between independent and dependent variables. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) and a P-value < 0.05 were used to declare the statistical association.

RESULTS: We found that cervical cancer screening practice in this study was 13.8% [95% CI:(10.4-17.2)]. Having a positive attitude [AOR = 5.2, 95% CI:(1.4, 20.0)], having a good knowledge [AOR = 5.4, 95% CI:(1.5,19.5)], being informed about cervical cancer by health professionals [AOR = 3.5, 95% CI:(1.3,9.8)], average monthly income greater than 3000 Ethiopian Birr (ETB) [AOR = 4.9, 95% CI:(1.1, 22)], and having a history of sexually transmitted infections [AOR = 4.2, 95% CI:(1.4,12.85)] were the factors associated with cervical cancer screening practice.

CONCLUSIONS: The practice of cervical cancer screening was found to be very low, being influenced by women’s attitudes, knowledge, having health professionals as sources of information, monthly income, and history of sexually transmitted infections. Thus, it is necessary to increase awareness and knowledge about cervical cancer and improve attitudes toward cervical screening services to improve the uptake of the screening. Health professionals also have to play a pivotal role in properly addressing information about cervical cancer.

PMID:36584208 | DOI:10.1371/journal.pone.0279870

PLoS One. 2022 Dec 30;17(12):e0279741. doi: 10.1371/journal.pone.0279741. eCollection 2022.

ABSTRACT

The Extended Crosswise Model (ECWM) is a randomized response model with neutral response categories, relatively simple instructions, and the availability of a goodness-of-fit test. This paper refines this model with a number sequence randomizer that virtually precludes the possibility to give evasive responses. The motivation for developing this model stems from a strategic priority of WADA (World Anti-Doping Agency) to monitor the prevalence of doping use by elite athletes. For this model we derived a maximum likelihood estimator that allows for binary logistic regression analysis. Three studies were conducted on online platforms with a total of over 6, 000 respondents; two on controlled substance use and one on compliance with COVID-19 regulations in the UK during the first lockdown. The results of these studies are promising. The goodness-of-fit tests showed little to no evidence for response biases, and the ECWM yielded higher prevalence estimates than direct questions for sensitive questions, and similar ones for non-sensitive questions. Furthermore, the randomizer with the shortest number sequences yielded the smallest response error rates on a control question with known prevalence.

PMID:36584205 | DOI:10.1371/journal.pone.0279741

PLoS One. 2022 Dec 30;17(12):e0279733. doi: 10.1371/journal.pone.0279733. eCollection 2022.

ABSTRACT

BACKGROUND: Congenital rubella syndrome (CRS) is a recognised cause of childhood deafness and blindness caused by the transplacental transmission of rubella virus during pregnancy. Women in the reproductive age group, and by extension their unborn babies may therefore be at increased risk. The prevalence of Rubella virus specific IgM and IgG antibodies, including IgG avidity, was determined in pregnant women attending the antenatal clinic at a Teaching Hospital in Ghana.

METHODS: One hundred and forty-five women in their second and third trimesters of pregnancy from the outpatient clinic were recruited over a period of 2 months after written informed consent was obtained. Study participants completed a questionnaire and venous blood drawn for IgM, IgG, and avidity testing using SERION ELISA (SERION® Immunologics, Würzburg, Germany). Babies of mothers with positive or indeterminate IgM and low avidity IgG antibodies were offered specialist cardiological, ophthalmological or hearing assessment during follow up.

RESULTS: One hundred and twenty-eight (88.3%) had only IgG antibodies, 5 (3.4%) had IgM and IgG antibodies, while 12 (8.3%) had no antibodies. No patient had IgM antibodies alone. Ten women (6.9%) had indeterminate levels of IgM antibodies. Majority of the women had high avidity IgG antibodies, while 5 (3.4%) had low avidity antibodies. No patient had IgM with low avidity antibodies. There was no statistical association between socio-demographic factors and the presence of IgM, IgG (low or high avidity) antibodies. Of all the children followed, none had the clinical definition of CRS.

CONCLUSIONS: Consistent with the World Health Organization elimination strategy for measles and rubella viruses, non-immune women in the reproductive age group should be vaccinated. The immunization programme should be expanded to include teenagers and adults. Though Congenital Rubella Syndrome was not detected, the risk still remains.

PMID:36584202 | DOI:10.1371/journal.pone.0279733

PLoS One. 2022 Dec 30;17(12):e0279085. doi: 10.1371/journal.pone.0279085. eCollection 2022.

ABSTRACT

OBJECTIVE: While there is an emerging role of pancreatic fat in the aetiology of type 2 diabetes mellitus (T2DM), its impact on the associated decrease in insulin secretion remains controversial. We aimed to determine whether pancreatic fat negatively affects β-cell function and insulin secretion in women with overweight or obesity but without T2DM.

METHODS: 20 women, with normo- or dysglycaemia based on fasting plasma glucose levels, and low (< 4.5%) vs high (≥ 4.5%) magnetic resonance (MR) quantified pancreatic fat, completed a 1-hr intravenous glucose tolerance test (ivGTT) which included two consecutive 30-min square-wave steps of hyperglycaemia generated by using 25% dextrose. Plasma glucose, insulin and C-peptide were measured, and insulin secretion rate (ISR) calculated using regularisation deconvolution method from C-peptide kinetics. Repeated measures linear mixed models, adjusted for ethnicity and baseline analyte concentrations, were used to compare changes during the ivGTT between high and low percentage pancreatic fat (PPF) groups.

RESULTS: No ethnic differences in anthropomorphic variables, body composition, visceral adipose tissue (MR-VAT) or PPF were measured and hence data were combined. Nine women (47%) were identified as having high PPF values. PPF was significantly associated with baseline C-peptide (p = 0.04) and ISR (p = 0.04) in all. During the 1-hr ivGTT, plasma glucose (p<0.0001), insulin (p<0.0001) and ISR (p = 0.02) increased significantly from baseline in both high and low PPF groups but did not differ between the two groups at any given time during the test (PPF x time, p > 0.05). Notably, the incremental areas under the curves for both first and second phase ISR were 0.04 units lower in the high than low PPF groups, but this was not significant (p > 0.05).

CONCLUSION: In women with overweight or obesity but without T2DM, PPF did not modify β-cell function as determined by ivGTT-assessed ISR. However, the salient feature in biphasic insulin secretion in those with ≥4.5% PPF may be of clinical importance, particularly in early stages of dysglycaemia may warrant further investigation.

PMID:36584200 | DOI:10.1371/journal.pone.0279085

PLoS One. 2022 Dec 30;17(12):e0279778. doi: 10.1371/journal.pone.0279778. eCollection 2022.

ABSTRACT

Polypoidal choroidal vasculopathy (PCV) with hemorrhagic complications is at higher risk for breakthrough vitreous hemorrhage (VH). This study aimed to evaluate the clinical features and outcomes of breakthrough VH secondary to PCV. Data of patients receiving pars plana vitrectomy for breakthrough VH secondary to PCV (VH group) were evaluated retrospectively and compared statistically to data of age and sex-matched PCV patients without breakthrough VH (control group). Among PCV patients, 36 eyes with breakthrough VH and 62 eyes without VH were included. Compared with baseline, best corrected visual acuity (BCVA) was worse in the VH group (P < 0.001), and improved postoperatively (P < 0.001). Percentages of pigmented epithelial detachment (PED), hemorrhagic PED, massive subretinal hemorrhage, hemorrhagic retinal detachment (RD), and hemorrhagic choroidal detachment (CD) (P = 0.007) were higher in the VH group (P < 0.001). Incidence of choroidal vascular hyperpermeability (P < 0.001), massive subretinal hemorrhage (P = 0.001), hemorrhagic retinal detachment (P = 0.001) and hemorrhagic type PCV (P = 0.001) was higher in patients with pachychoroid PCV, while fibrovascular type had lower incidence (P < 0.001). Better initial BCVA (P < 0.001), higher frequency of anti-VEGF treatment (P = 0.009), and previous photodynamic therapy (P = 0.017) showed better visual outcomes. Breakthrough VH risk is higher in PCV patients with massive subretinal hemorrhage, hemorrhagic PED and hemorrhagic RD. BCVA and hemorrhagic complications improve significantly postoperatively. Higher frequency of anti-VEGF treatment and previous photodynamic therapy are associated with better visual prognosis in PCV patients with breakthrough VH.

PMID:36584198 | DOI:10.1371/journal.pone.0279778

PLoS One. 2022 Dec 30;17(12):e0279081. doi: 10.1371/journal.pone.0279081. eCollection 2022.

ABSTRACT

BACKGROUND: Corona (COVID-19) is an infectious disease caused by a newly discovered corona virus. The World Health Organization has recommended several preventive measures for COVID-19 and African countries, including Ethiopia had accepted and engaged in the recommended preventive measures. Adherence to COVID-19 prevention measure is still a big problem; however, the level of adherence to preventive measures had not reported in Ethiopia among students and there is an information gap, therefore, this study conducted to fill the information gap on level of adherence to COVID-19 preventive measures among students.

OBJECTIVE: This study aimed to assess the level of adherence to COVID-19 preventive measures and its associated factors among high school students in Jimma Town public High Schools in southwest Ethiopia, 2021.

METHODS SAND MATERIALS: An institution-based cross-sectional study was conducted among 404 systematically selected high school students from Jimma town from July 15 to August 2, 2021. The sample size was determined using a single-population proportion formula, and data were collected through face-to-face interviews using a structured and pretested questionnaire. Data were entered into Epi-data manager 4.4.2.1 then exported to Stata 14 for cleaning and analysis. Bivariate and multivariable ordinal logistic regression analyses were declared to identify significant variables. Finally; significant factors were determined at a significance level of <0.05.

RESULTS: Of 388 students included in the analysis, approximately 14.7% (95%CI: 11.51-18.60) of students had good level of adherence to COVID-19 preventive measures.Only 6.9%of participants had good knowledge where as approximately half of the respondents had favorable attitude toward COVID-19 preventive measures. Factors such as Female gender (AOR = 1.03(95%CI: 1.01-1.74), access to water and soap (AOR = 2.11(95%CI: 1.06-4.19) andattitude (AOR = 4.36(95%CI: 2.69-7.08)) were found to have a statistically significant association with level of adherence to COVID-19 preventive measures.

CONCLUSION: Adherence to COVID-19preventive measures among students wasunexpectedly lower than in other studies. Female gender, lack of access to water and soap, and attitudes were factors associated with adherence to COVID-19 preventive measures. Therefore, to ensure maximal adherence to preventive measures for COVID-19, special messages and efforts targeting males, increasing access to water and soap, trainingto improve attitude toward COVID-19 preventive measures should be implemented at schools.

PMID:36584185 | DOI:10.1371/journal.pone.0279081

PLoS One. 2022 Dec 30;17(12):e0272131. doi: 10.1371/journal.pone.0272131. eCollection 2022.

ABSTRACT

BACKGROUND: Adolescent pregnancy and motherhood have been linked to several factors stemming from social, cultural and to a large extent economic issues. This study examined the socio-economic factors associated with adolescent pregnancy and motherhood in Ghana.

DESIGN: This was a secondary analysis of the 2017 Ghana Maternal Health Survey, which was a nationally representative cross-sectional survey. Data from 4785 adolescents aged between 15-19 years were included in the analysis. Adolescent pregnancy was defined as adolescents who have ever been pregnant, whiles adolescent motherhood was defined as adolescents who have ever given birth. Weighted logistic regression was used to assess the association between the socio-economic variables and adolescent pregnancy and motherhood.

RESULTS: Of the 25062 women aged between 15 and 49 years included in the 2017 maternal health survey, 4785 (19.1%) were adolescents between 15-19 years. Adolescent pregnancy was reported in 14.6% (CI:13.2% -16.1%) of the respondents, whereas 11.8% (CI: 10.5% -13.1%) of the respondents had ever given birth. In the multivariate regression analysis, zone (p<0.001), wealth index (p<0.001), age (p<0.001), marital status (p<0.001) and level of education (p<0.001) were all significantly associated with adolescent pregnancy and motherhood. The odds of pregnancy and motherhood were significantly higher in the Middle and Coastal zones (p<0.001), and among older adolescents (p<0.001). However, the odds of pregnancy and motherhood was significantly lower among adolescents from households with the highest wealth index (p<0.001), among those who were never married (p<0.001) and among adolescents who had secondary/higher education (p<0.001).

CONCLUSION: Several socio-economic variables including education, household wealth, marital status and zone of residence were significantly associated with adolescent pregnancy and adolescent motherhood. Sexual and reproductive health education should be intensified among these populations. Adolescent friendly corners should be made available and accessible to all adolescents in Ghana irrespective of where they live or their age.

PMID:36584169 | DOI:10.1371/journal.pone.0272131