Nevin Manimala

BMC Prim Care. 2022 Jun 30;23(1):166. doi: 10.1186/s12875-022-01766-z.

ABSTRACT

BACKGROUND: In organ transplantation, all patients must follow a complex treatment regimen for the rest of their lives. Hence, patients play an active role in the continuity of the care process in the form of self-management tasks. Thus, the main objective of our study was to investigate the pragmatic solutions applied by different studies to enhance adherence to self-management behaviors.

METHOD: A systematic review was conducted in five databases from 2010 to August 2021 using keywords. Eligible studies were all English papers that developed self-management programs to enhance patient care in solid organ transplantation. The interventions were analyzed using thematic analysis to determine the main descriptive areas. The quality of the included articles was evaluated using the research critical appraisal program (CASP) tool.

RESULTS: Of the 691 retrieved articles, 40 met our inclusion criteria. Of these, 32 studies were devoted to the post-transplantation phase. Five main areas were determined (e-health programs for telemonitoring, non-electronic educational programs, non-electronic home-based symptom-monitoring programs, electronic educational plans for self-monitoring, and Telerehabilitation) according to thematic analysis. Most studies (72.5%) declared that developed programs and applied solutions had a statistically significant positive impact on self-management behavior enhancement in transplant patients.

CONCLUSION: The results showed that an effective solution for improving organ transplantation needs patient collaboration to address psychological, social, and clinical aspects of patient care. Such programs can be applied during candidate selection, waiting list, and after transplantation by putting the patient at the center of care.

PMID:35773642 | DOI:10.1186/s12875-022-01766-z

BMC Public Health. 2022 Jun 30;22(1):1277. doi: 10.1186/s12889-022-13625-8.

ABSTRACT

BACKGROUND: We aimed to develop and validate a tool to identify which pregnant/lactating young South African women (≤ 24 years) are at risk of HIV infection.

METHODS: Data from three national South African Prevention of Mother-to-Child Transmission (PMTCT) evaluations were used to internally validate three HIV acquisition risk models for young postpartum women. We used univariate and multivariable logistic regression analysis to determine which risk factors were significant. Model coefficients were rounded and stratified into risk groups and the area under the receiver operating curve (AUROC) was computed. Models were developed to determine which risk factors provided the most predictive accuracy whilst remining clinically meaningful.

RESULTS: Data from 9 456 adult and 4 658 young pregnant and lactating women were included in the development and validation data sets, respectively. The optimal model included the following risk factors: age (20-24 years old), informal house structure, two or more pregnancies, mothers who had knowledge of when they received their last HIV test result, no knowledge of the infant’s father’s HIV status, no knowledge of breastfeeding as a mode of MTCT and knowledge of PMTCT programme. The mean AUROC was 0.71 and 0.72 in the development and validation datasets respectively. The optimum cut off score was ≥ 27, having 84% sensitivity, 44% specificity, and identifying 44% of high-risk women eligible for PrEP.

CONCLUSION: The optimal model to be used as a possible risk scoring tool to allow for early identification of those pregnant/lactating women most at-risk of HIV acquisition included both statistically as well as clinically meaningful risk factors. A field-based study is needed to test and validate the effectiveness of this targeted approach.

PMID:35773638 | DOI:10.1186/s12889-022-13625-8

BMC Pediatr. 2022 Jun 30;22(1):382. doi: 10.1186/s12887-022-03433-9.

ABSTRACT

BACKGROUND: The most common infection in children with the hepatic disease with or without cirrhotic ascites is spontaneous bacterial peritonitis (SBP), which occurs in the absence of an evident intra-abdominal source of infection. The present study aims to assess the value of calprotectin in ascitic fluid in the diagnosis of ascitic fluid infection in children with liver cirrhosis.

MATERIALS AND METHODS: In this cross-section study, 80 children with underlying liver disease who attended the Hepatology and Emergency Department in Shiraz University Hospitals were studied. All the patients were evaluated by a thorough history, clinical examination, laboratory investigations, diagnostic paracentesis with PMNLs count, and Calprotectin, which was measured in 1 mL ascitic fluid by ELISA.

RESULTS: Thirty-five patients (43.75%) were diagnosed with ascitic fluid infection. Of these children 6 cases had positive ascitic fluid culture (SBP). Calprotectin was high in AFI patients with a statistically significant difference in AFI patients compared to non-AFI patients. The cut-off levels were 91.55 mg /L and the area under the curve was 0.971. So it can serve as a sensitive and specific diagnostic test for detection of AFI in children with underlying liver disease.

CONCLUSION: Elevated ascitic calprotectin levels in cirrhotic patients are a diagnostic and reliable marker for the detection of AFI and are considered a surrogate marker for PMN.

PMID:35773636 | DOI:10.1186/s12887-022-03433-9

BMC Prim Care. 2022 Jun 30;23(1):165. doi: 10.1186/s12875-022-01772-1.

ABSTRACT

BACKGROUND: The caregivers of patients with covid-19 face constant responsibilities such as providing personal, health, and social care to family, which can be physically, and emotionally exhausting resulting in a considerable stress burden. Therefore, given the importance of the subject, this study aimed to investigate the burden of disease dimensions (time-dependent, developmental, physical, social and emotional) among family caregivers with covid-19 patients in Iran.

METHODS: This cross-sectional study was conducted one year after the onset of the Covid-19 outbreak in Iran. Family caregivers of Covid-19 patients discharged from the hospitals in Kerman city, Iran, were chosen by simple randomization (n = 1500). Data were collected utilizing a demographic characteristics inventory created by the researcher as well as the Novak and Guest Caregiver Burden Inventory. Descriptive statistics such as mean and standard deviations, frequency, and percentages and analytical statistics such as Kolmogorov-Smirnov, T-test, ANOVA, and Multivariate Linear Regression were used for data analysis using the 20, SPSS Inc., Chicago, IL Software at the level of P < 0.05.

RESULTS: The results demonstrated that the mean score of family caregiver burden was 2.61±0.6 and the severity of this burden was in a moderate range. The finding showed a statistical difference was seen between the family caregiver burden mean score of participants in terms of gender, duration of treatment, age and employed status. The multivariable linear regression model showed demographic variables of caregivers included (female, married, employed, elderly, low income and poor education) had a beneficial influence on family caregiver burden.

CONCLUSION: The findings of this study can increase the awareness of health managers, about the level of burden of disease among family caregivers from the covid-19 patients and can help to provide economic, social and psychological support programs for improvement and reducing the burden of disease of caregivers during the covid-19 outbreaks.

PMID:35773628 | DOI:10.1186/s12875-022-01772-1

BMC Cardiovasc Disord. 2022 Jun 30;22(1):300. doi: 10.1186/s12872-022-02736-0.

ABSTRACT

BACKGROUND: Mounting evidence indicates an association between endothelial dysfunction and the coronary slow flow phenomenon (CSFP). In the present study, we aimed to evaluate the possible role of endothelial nitric oxide synthase (eNOS) 894G/T and interleukin-1β (IL-1β) 315C/T polymorphisms as possible risk factors for CSFP.

METHODS: This prospective study enrolled patients with CSFP and individuals with normal coronary arteries. Genotypes were assessed using regular polymerase chain reaction and direct Sanger-sequencing techniques.

RESULTS: The study population consisted of 267 individuals: 180 patients with CSFP (49 women [27.2%]) at a median age of 55 (48-62) years and 87 controls with normal coronary arteries (56 women [64.4%]) at a median age of 47 (41-58) years. The allelic distribution of eNOS 894G/T was significantly associated with CSFP (odds ratio [OR], 1.58; 95% confidence interval (CI), 1.04-2.42; P = 0.03). This polymorphism increased the risk of CSFP under the dominant model (OR 1.73; 95% CI I.02-2.95; P = 0.04). However, the allelic frequencies (1.05; 95% CI 0.68-1.59; P = 0.83) and genotypic frequencies (0.88; 95% CI 0.52-1.49; P = 0.63) of the IL-1β 315C/T polymorphism were not associated with the incidence of CSFP in the Iranian population.

CONCLUSIONS: The CSFP and control groups were statistically different regarding the eNOS 894G/T polymorphism. Our findings also demonstrated that the IL-1β 315C/T polymorphism was not a risk factor for CSFP.

PMID:35773625 | DOI:10.1186/s12872-022-02736-0

Expert Opin Drug Saf. 2022 Jun 30. doi: 10.1080/14740338.2022.2094914. Online ahead of print.

ABSTRACT

BACKGROUND: Studies on the efficacy of prescription omega-3 polyunsaturated fatty acids to reduce cardiovascular events have produced conflicting results.

RESEARCH DESIGN AND METHODS: This 3-year prospective post-marketing surveillance study evaluated the effect of omega-3-acid ethyl esters (O3AEE; usual dosage 2 g/day) on cardiovascular events in high-risk statin-treated Japanese patients with hypertriglyceridemia. Statin-treated patients not receiving O3AEE were included as a reference cohort. The composite primary endpoint was cardiovascular death, myocardial infarction, stroke, angina requiring coronary revascularization, or peripheral arterial disease requiring surgery or peripheral arterial intervention.

RESULTS: At 3 years, Kaplan-Meier estimated cumulative incidence of the primary endpoint was 2.5% (95% confidence interval, 2.1%-2.9%) in O3AEE-treated patients (N = 6,580) and 2.7% (2.4%-3.1%) in non-O3AEE-treated patients (N = 7,784; hazard ratio, 0.99; 95% confidence interval, 0.79-1.23). Incidence of heart failure requiring hospitalization was 0.4% with O3AEE versus 0.8% in non-O3AEE-treated patients (hazard ratio, 0.47; 95% confidence interval, 0.28-0.78; P<0.05).

CONCLUSIONS: Among patients receiving statins, cardiovascular event incidence did not differ significantly between O3AEE-treated patients and non-O3AEE-treated patients. Further studies are required before definitive conclusions can be drawn on the effect of O3AEE on cardiovascular event incidence in high-risk patients with hypertriglyceridemia.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT02285166.

PMID:35772177 | DOI:10.1080/14740338.2022.2094914

Psychiatr Danub. 2022 Summer;34(2):348-355. doi: 10.24869/psyd.2022.348.

ABSTRACT

BACKGROUND: The COVID-19 epidemic and earthquakes in Croatia during 2020 suddenly disrupted everyday life and caused psychological disturbances in population. The purpose of the present study was to assess the prevalence of anxiety symptoms and the level of treatment adherence in glaucoma patients during the pandemic. The paper also aimed to evaluate the correlation between anxiety symptoms, treatment adherence and treatment outcomes in the studied cohort.

SUBJECTS AND METHODS: This cross-sectional study was conducted among primary open-angle glaucoma (POAG) patients at the Department of Ophthalmology, Zagreb University Hospital Center, during one year. The Beck Anxiety Inventory (BAI) was used to measure the level of anxiety symptoms. Treatment adherence was estimated by the Culig adherence scale (CAS). Glaucoma damage was determined for each patient from the level of structural and functional impairment of the worse eye, by retinal nerve fiber layer (RNFL) thickness and mean defect (MD), respectively. Statistical analyses were performed, with a P value of less than 0.05 considered being statistically significant.

RESULTS: This study included 113 POAG patients, with a mean age of 65.89 years. The median of the BAI total score in all patients was 10. According to the CAS, 60.2% of patients were non-adherent to glaucoma treatment during the COVID-19 outbreak. The BAI total score was significantly negatively related to adherence to local glaucoma treatment (p<0.001). A significant negative association was also observed between adherence and MD (p=0.017), while no correlation was found between adherence and RNFL thickness (p=0.228).

CONCLUSION: Considerable proportion of patients with glaucoma have shown non-adherence to treatment during the COVID-19 pandemic. Anxiety severity was associated with lower adherence, thus indirectly influencing therapeutics outcomes. Special consideration should be given to the strategies promoting mental health and interventions focusing on treatment adherence in glaucoma patients in a time of emergencies.

PMID:35772157 | DOI:10.24869/psyd.2022.348

Psychiatr Danub. 2022 Summer;34(2):342-347. doi: 10.24869/psyd.2022.342.

ABSTRACT

BACKGROUND: Several cases of psychosis caused directly or indirectly by the COVID-19 pandemic have been identified. Especially psychosocial stress factors are thought to trigger first-episode psychosis. The aim of this study was to compare the sociodemographic and clinical features of the cases diagnosed with psychotic disorder for the first time in the two periods 1 year before and 1 year after the date of 11.03.2020, when COVID-19 was first detected in Turkey and COVID-19 was declared as a pandemic by World Health Organization (WHO).

SUBJECTS AND METHODS: In this retrospective cohort study, we compared age, gender, marital status, and clinical characteristics of 27 pre-pandemic (PR) and 32 post-pandemic (PS) patients during their first psychotic episode.

RESULTS: We compared age, gender and clinical features of PR and PS cases and no statistically significant difference was found (age p=0.836, gender p=0.091, clinical features p=0.579).

CONCLUSIONS: There are a limited number of studies comparing first-episode psychosis (FEP) patients in the PR and PS periods. This is the first study conducted in Turkey on this subject. The present study may contribute to the literature by examining the impact of the pandemic process on the epidemiology of psychiatric diseases.

PMID:35772156 | DOI:10.24869/psyd.2022.342

Psychiatr Danub. 2022 Summer;34(2):334-341. doi: 10.24869/psyd.2022.334.

ABSTRACT

BACKGROUND: Suicides are among the leading causes of death in the world and pose a major public health problem. It is not yet entirely clear to what extent the 2019 coronavirus pandemic (COVID-19) affects suicide rates, but is likely to result in an increase in risk factors for suicidal behaviors. The research objective was to compare the suicide rate in 2019 with the suicide rate in 2020 in the Republic of Croatia.

SUBJECTS AND METHODS: A cross-sectional study was conducted for the period from January 2019 to December 2020. The necessary data on persons who committed suicide in the Republic of Croatia in that period were collected in cooperation with the Osijek-Baranja County Police Department. The number of suicides in that period was statistically processed according to demographic characteristics, suicide motives, days of the week and months by years.

RESULTS: There was no significant difference in the total number of suicides comparing 2019 and 2020. Observed by months, significantly more suicides were committed during February 2020 compared to February 2019 (χ²-test, p=0.04). According to marital status, in 2019 compared to 2020, significantly more suicides were recorded among married persons (χ²-test, p<0.001) and among those who were unemployed (χ²-test, p<0.001). Persons with the status of veterans committed suicide significantly more often in 2019, compared to 2020 (χ²-test, p<0.001) During 2019, compared to 2020, significantly more suicides were committed by persons working in service and trade occupations (χ²-test, p=0.001).

CONCLUSION: At the beginning of the pandemic in Croatia, in February 2020, there was a significant increase in suicides compared to 2019, which may indicate that the spread of the pandemic since the end of 2019, with uncertainty and cataclysmic atmosphere, had a negative effect on mental health.

PMID:35772155 | DOI:10.24869/psyd.2022.334

Psychiatr Danub. 2022 Summer;34(2):195-204. doi: 10.24869/psyd.2022.195.

ABSTRACT

INTRODUCTION: In recent years, the incidence of perinatal depression in female population is very high. Perinatal depression has adverse effects on the physical and mental health of mothers and children. However, according to current researches, Yoga has been considered as an effective exercise that can help pregnant women to regulate their emotions. Thus, this review reports the effectiveness of yoga on perinatal depression.

METHODS: We reviewed all of the relevant RCT (Randomized Control Trial, RCT) studies published until June 2021 from the major open-access databases.

RESULTS: 12 RCTs were selected and included in this study, and the total number of people included in the analysis in the combined study was 594. The level of depression and anxiety of participants was evaluated using detailed and recognized scale. Compared with the control group, the yoga intervention group indicates a statistically significant decrease in depression levels (SMD (Standardised Mean Difference, SMD), -2.31; 95% CI, -3.67 to -0.96; P=0.139) and anxiety (SMD, -4.75; 95% CI, -8.3 to -1.19; P=0.002). In addition, we also conducted a subgroup analysis according to the type of population. The subgroup analysis successfully reduced the level of heterogeneity and the results indicated that the difference in population types in the combined analysis leads to the higher heterogeneity. The SMD value for healthy women is -2.3 (95% CI, -4.83 to 0.23) and for depressed women is -9.02 (95% CI, -11.42 to -6.62). Finally, the meta-analysis results of the self-control group prove that yoga can reduce the depression scores (SMD, 5.23; 95% CI, 1.90 to 8.56; P=0.049) compared with baseline.

CONCLUSIONS: Yoga can effectively relieve symptoms of depression and anxiety in the perinatal period, which can be used as an auxiliary treatment option clinically.

PMID:35772128 | DOI:10.24869/psyd.2022.195