Nevin Manimala

BMC Infect Dis. 2022 Nov 21;22(1):870. doi: 10.1186/s12879-022-07861-x.

ABSTRACT

BACKGROUND: This retrospective cohort study assessed benefits and risks of bedaquiline treatment in multidrug-resistant-tuberculosis (MDR-TB) combination therapy by evaluating safety, effectiveness, drug utilization and emergence of resistance to bedaquiline.

METHODS: Data were extracted from a register of South African drug-resistant-tuberculosis (DR-TB) patients (Electronic DR-TB Register [EDRWeb]) for newly diagnosed patients with MDR-TB (including pre-extensively drug-resistant [XDR]-TB and XDR-TB and excluding rifampicin-mono-resistant [RR]-TB, as these patients are by definition not multidrug-resistant), receiving either a bedaquiline-containing or non-bedaquiline-containing regimen, at 14 sites in South Africa. Total duration of treatment and follow-up was up to 30 months, including 6 months’ bedaquiline treatment. WHO treatment outcomes within 6 months after end-of-treatment were assessed in both patient groups. Longer term mortality (up to 30 months from treatment start) was evaluated through matching to the South African National Vital Statistics Register. Multivariable Cox proportional hazards analyses were used to predict association between receiving a bedaquiline-containing regimen and treatment outcome.

RESULTS: Data were extracted from EDRWeb for 5981 MDR-TB patients (N = 3747 bedaquiline-treated; N = 2234 non-bedaquiline-treated) who initiated treatment between 2015 and 2017, of whom 40.7% versus 80.6% had MDR-TB. More bedaquiline-treated than non-bedaquiline-treated patients had pre-XDR-TB (27.7% versus 9.5%) and XDR-TB (31.5% versus 9.9%) per pre-2021 WHO definitions. Most patients with treatment duration data (94.3%) received bedaquiline for 6 months. Treatment success (per pre-2021 WHO definitions) was achieved in 66.9% of bedaquiline-treated and 49.4% of non-bedaquiline-treated patients. Death was reported in fewer bedaquiline-treated (15.4%) than non-bedaquiline-treated (25.6%) patients. Bedaquiline-treated patients had increased likelihood of treatment success and decreased risk of mortality versus non-bedaquiline-treated patients. In patients with evaluable drug susceptibility testing data, 3.5% of bedaquiline-susceptible isolates at baseline acquired phenotypic resistance. Few patients reported bedaquiline-related treatment-emergent adverse events (TEAEs) (1.8%), TEAE-related bedaquiline discontinuations (1.4%) and QTcF values > 500 ms (2.5%) during treatment.

CONCLUSION: Data from this large cohort of South African patients with MDR-TB showed treatment with bedaquiline-containing regimens was associated with survival and effectiveness benefit compared with non-bedaquiline-containing regimens. No new safety signals were detected. These data are consistent with the positive risk-benefit profile of bedaquiline and warrant continued implementation in combination therapy for MDR-TB treatment.

PMID:36414938 | DOI:10.1186/s12879-022-07861-x

Environ Sci Pollut Res Int. 2022 Nov 22. doi: 10.1007/s11356-022-23959-w. Online ahead of print.

ABSTRACT

The quality of groundwater in the Jaunpur district of Uttar Pradesh is poorly studied despite the fact that it is the only supply of water for both drinking and irrigation and people use it without any pre-treatment. The evaluation of groundwater quality and suitability for drinking and irrigation is presented in this study. Groundwater samples were collected and analysed by standard neutralisation and atomic emission spectrophotometry for major anions (HCO₃^–, SO₄^2-, Cl^–, F^–, NO₃^–), cations (Ca²⁺, Mg²⁺, Na⁺, K⁺), and heavy metals (Cd, Mn, Zn, Cu, and Pb). The geographic information system (GIS) and statistical inferences were utilised for the spatial mapping of the groundwater’s parameters. The potential water abstraction (i.e. taking water from sources such as rivers, streams, canals, and underground) for irrigation was assessed using the sodium absorption ratio (SAR), permeability index (PI), residual sodium carbonate (RSC), and Na percentage. According to the findings, the majority of the samples had higher EC, TDS, and TH levels, indicating that they should be avoided for drinking and irrigation. The positive correlation coefficient between chemical variability shows that the water chemistry of the studied region is influenced by geochemical and biological causes. According to the USSL (United States Salinity Laboratory) diagram, most of the samples fall under the C2-S1 and C3-S1 moderate to high salt categories. Some groundwater samples were classified as C4-S3 class which is unfit for irrigation and drinking. This study suggests that the groundwater in the study area is unfit for drinking without treatment. However, the majority of the samples were suitable for irrigation.

PMID:36414896 | DOI:10.1007/s11356-022-23959-w

Eur J Orthop Surg Traumatol. 2022 Nov 21. doi: 10.1007/s00590-022-03442-5. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Since the description of the syndrome of the second intermetatarsal space, this is a common diagnosis among foot and ankle surgeons. However, no series have been published that consider this syndrome as its own entity. The objective of this study is to evaluate the clinical and radiological results of the release of the intermetatarsal ligament and minimally invasive distal metatarsal osteotomy in patients diagnosed with second space syndrome.

MATERIALS AND METHODS: An observational, longitudinal, retrospective study was carried out in patients with a clinical diagnosis of second space syndrome operated on using a minimally invasive technique. For the clinical results, the visual analog scale (VAS) for subjective pain, the Manchester-Oxford Foot Questionnaire (MOXFQ) and the scale for minor metatarsals and interphalangeals of the American Orthopedic Foot and Ankle Society (AOFAS-LMTS) were used for clinical-functional assessment. Consolidation or not of osteotomies was recorded and complications were recorded.

RESULTS: Twenty-nine feet in 29 patients were included in the study. After a mean follow-up of 39 months (25-50), clinically and statistically significant improvement was obtained in the scores: pain VAS, scales and subscales of the MOXFQ and the AOFAS-LMTS (p < 0.0001). All osteotomies healed at the end of follow-up and no major complications were recorded.

CONCLUSIONS: Percutaneous or minimally invasive surgery, in patients with second intermetatarsal space syndrome, obtains good clinical, functional and subjective results, with few complications. Therefore, we consider it an effective, safe and recommended technique in the hands of experienced surgeons.

PMID:36414873 | DOI:10.1007/s00590-022-03442-5

Surg Endosc. 2022 Nov 22. doi: 10.1007/s00464-022-09770-1. Online ahead of print.

NO ABSTRACT

PMID:36414872 | DOI:10.1007/s00464-022-09770-1

Clin Rheumatol. 2022 Nov 21. doi: 10.1007/s10067-022-06452-0. Online ahead of print.

ABSTRACT

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are characterized by necrotizing inflammation of small and medium-size vessels that often manifest with devastating multi-organ effects. They present with a myriad of systemic features and require potent immunosuppression. Since they are uncommonly encountered in clinical practice, it is necessary to understand physicians’ knowledge and perceptions about this group of diseases. An online questionnaire was designed featuring 28 questions based on relevant global practice guidelines, recommendations, and previous online surveys on AAV. The questionnaire was validated by a core group of specialists with an interest in AAV. It was shared via social networking sites and entries were restricted to physicians. Only completed entries were analyzed with descriptive statistics. A total of 113 respondents from 21 different countries responded of whom the commonest were rheumatologists, internists, and general practitioners. Forty-five (40%) ran clinics dedicated to AAV patients as a part of their practice. They commented on organs involved in AAV; vasculitis secondary to infections, drugs or other rheumatic diseases; various tests useful for AAV diagnosis; and drug choices for induction and maintenance. They mentioned their experience regarding COVID-19 in AAV patients as well as vasculitic manifestations of COVID-19. Various methods to mitigate cardiovascular risks in AAV were mentioned. Finally, the respondents indicated how medical education needed to be strengthened to increase awareness and knowledge regarding AAV. This survey helped to inform about various perceptions regarding AAV across countries, including current practices and recent evolution of management. It also provided information on treatment of the COVID-19 in AAV patients. This survey showed that there is still a lack in understanding the prevalent definitions and there is gap between guidelines and current practice. Key Points • Perception about ANCA-associated vasculitis differ across countries. • The number of cases encountered across 21 different countries are limited implying a need for multi-national cooperation to study this disease further. • The COVID-19 pandemic has changed the approach towards ANCA-associated vasculitis by the various clinicians.

PMID:36414862 | DOI:10.1007/s10067-022-06452-0

Int Ophthalmol. 2022 Nov 21. doi: 10.1007/s10792-022-02573-2. Online ahead of print.

ABSTRACT

PURPOSE: To describe the findings and new interpretation methods of retinal thickness maps in the setting of hydroxychloroquine (HCQ) therapy.

METHODS: A case series of 27 patients with a history of HCQ intake of more than 5 years and 21 normal subjects as the control group were studied. Patients were tested using swept-source optical coherence tomography (OCT). Custom-made 10 × 10 retinal thickness pixel maps of the 6 mm⨯6 mm area centered on the fovea were created for the full, inner, and outer retina of each eye and normal values obtained from the control group were used to calculate the statistical significance of each pixel and highlight suspicious pixels. A pixel was shown with light or dark gray color if its p value was ≤ 0.05 or ≤ 0.01, respectively. Cross-sectional OCT images and visual fields were examined as well and used to confirm the diagnosis of HCQ retinopathy.

RESULTS: The pixel outer retinal thickness maps appeared accurate in detecting lesions even in eyes with unremarkable full retina thickness maps. The size and location of atrophic retinal defects were shown on pixel maps. Outer retinal thickness maps were able in differentiating outer retinal thinning from inner retinal thinning as the hallmark of HCQ retinopathy.

CONCLUSION: Outer retinal thickness pixel maps can be used for the screening of HCQ retinopathy.

PMID:36414851 | DOI:10.1007/s10792-022-02573-2

Reprod Sci. 2022 Nov 22. doi: 10.1007/s43032-022-01132-5. Online ahead of print.

ABSTRACT

Local ischemic damage resulting from ovarian torsion is a common cause of decreased follicular activity and infertility. It was aimed to evaluate the effect of granulocyte colony-stimulating factor (G-CSF) protection on in vitro fertilization (IVF) results against experimental ischemic (I) and ischemic-reperfusion (I/R) injury in rat ovaries. The study consisted of 35 adult female Sprague-Dawley albino rats (sham, ischemia, I/R, I + G-CSF, and I/R + G-CSF) randomly assigned to 5 groups, each containing 7 rats. While bilateral adnexal torsion was applied to the ischemia groups for 3 h, detorsion was applied to the reperfusion groups. Intraperitoneal 100 IU/kg G-CSF was administered 30 min prior to ischemia (I + G-CSF) or reperfusion (I/R + G-CSF). After ovulation induction (intraperitoneal 150-300 IU/kg PMSG), the oocytes were collected and IVF was applied. Statistically significant differences were observed between the collected oocyte numbers in I and I + G-CSF, I/R, and I/R + G-CSF groups (P values were P = 0.001 for the I-I + G-SCF groups and P = 0.003 for I/R-IR + G-CSF, respectively). An increase in the number of MII oocytes obtained was observed in the I + G-CSF and I/R + G-CSF groups compared to the I and I/R groups. Grade 1 and grade 2 embryo numbers were statically different between the I/R and I/R + G-CSF groups (P values were P = 0.023 for grade 1 embryos and P = 0.045 for grade 2 embryos, respectively). G-CSF treatment was found to be effective in reducing I- and I/R-induced ovarian damage.

PMID:36414821 | DOI:10.1007/s43032-022-01132-5

Sci Rep. 2022 Nov 21;12(1):20056. doi: 10.1038/s41598-022-24532-8.

ABSTRACT

It has been a decade since the first extensive study on the internet’s adoption and use was conducted. Circumstances have changed in the last decade internet has become an essential need for every human being. Socio-psychological, economic, and personal factors play a significant role in shaping human behaviour. But their role in shaping consumer behaviour toward 5G is still unexplored. In order to determine the impact of socio-psychological elements on 5G technology adoption intention, the study integrated curiosity, perceived value, functional value, and environmental awareness into UTAUT2 and analyzed how they interact. Instead of relying on linear models, this study employed a dual-stage SEM-ANN approach because customers’ decision-making process to adopt new technology is complex. Valid responses from 840 respondents were collected, investigated, and ranked using the deep learning ANN approach. All predictors were found statistically significant except social influence. ANN sensitivity analysis revealed that newly integrated predictors (environmental awareness, curiosity) are surprisingly the most important predictors, followed by facilitating conditions and perceived satisfaction. SEM-ANN hybrid two-step deep learning approach explained 83.6% variance higher than the baseline model (UTAUT2). The study improved UTAUT2 by adding new variables and expanding its canvas to predict user technology adoption. This will show how consumers react to 5G services and help telecoms grow into new markets.

PMID:36414788 | DOI:10.1038/s41598-022-24532-8

PLoS One. 2022 Nov 22;17(11):e0278052. doi: 10.1371/journal.pone.0278052. eCollection 2022.

ABSTRACT

A meaningful engagement of learners is critical in the quality teaching and learning of mathematics at school level. Learner engagement has been an ongoing issue in mathematics classrooms in Nepal and elsewhere. In this context, this study aimed to examine the level of engagement (behavioral, social, emotional, and cognitive activities) and their association with learning mathematics through the virtual mode of instruction during the pandemic. The cross-sectional online survey design was employed among 402 secondary-level mathematics teachers in Nepal. Descriptive statistics, correlation, and structural equation modeling were the major statistical techniques used in research. The findings indicate that the level of behavioral, social, emotional, and cognitive engagement of students was found to be high in the online mode of instruction. Additionally, cognitive engagement has significant highest impact on social, behavior, and emotional engagement.

PMID:36413743 | DOI:10.1371/journal.pone.0278052

Clin J Oncol Nurs. 2022 Nov 18;26(6):636-642. doi: 10.1188/22.CJON.636-642.

ABSTRACT

BACKGROUND: &nbsp;For patients receiving chemotherapy, various oral care therapies are used to treat oral mucositis, but the use of black mulberry extract as an effective treatment has not been widely studied. .

OBJECTIVES: &nbsp;This study examined whether black mulberry extract is an effective treatment for oral mucositis, dry mouth, and weight gain compared to sodium bicarbonate in patients with cancer. .

METHODS: &nbsp;The control group (N = 20) received sodium bicarbonate, and the intervention group (N = 20) received black mulberry extract. Mucositis and weight gain were evaluated on days 1, 7, and 15 after oral care application. .

FINDINGS: &nbsp;For both groups, mean scores indicated a statistically significant decrease in mucositis and dry mouth at all three time points. Mean scores were significantly lower in the intervention group on days 7 and 15. At all three time points, increases in weight were statistically significant for the intervention group but not for the control group. Increased weight gain in the intervention group was statistically significant when comparing the two groups on days 7 and 15.

PMID:36413721 | DOI:10.1188/22.CJON.636-642