Nevin Manimala

Otol Neurotol. 2022 Jan 1;43(1):e64-e71. doi: 10.1097/MAO.0000000000003407.

ABSTRACT

OBJECTIVES: Compare speech perception performance growth and benchmark score achievement among adult cochlear implant (CI) recipients with single-sided deafness (SSD) versus bilateral moderate to profound hearing loss.

STUDY DESIGN: Retrospective matched cohort analysis.

SETTING: Tertiary referral center.

PATIENTS: Adults with SSD or bilateral moderate to profound hearing sensorineural hearing loss who underwent cochlear implantation from 2014 to 2019.

INTERVENTIONS: Cochlear implantation.

MAIN OUTCOME MEASURES: Time-to-benchmark speech perception score (CNC, AzBio in quiet) and speech performance within first postoperative year.

RESULTS: Thirty-three SSD patients were matched to 66 bilateral hearing loss patients (referent cohort) for duration of deafness and preoperative ipsilateral CNC scores. Although SSD patients were more likely to achieve benchmark CNC scores more quickly compared with matched referents, this difference did not reach statistical significance (HR 1.72; 95% CI 0.78-3.82; p = 0.18). AzBio scores showed similar trends (HR 1.40; 95% CI 0.66-2.98; p = 0.38). At last follow-up, the SSD cohort had lower CNC (median 54% vs. 62%; p = 0.019) and AzBio scores (median 72% vs. 84%; p = 0.029) compared to the referent cohort.

CONCLUSIONS: No significant difference in speech perception performance growth (i.e., time-to-benchmark speech perception score) was identified between SSD and bilateral hearing loss CI recipients, although patients with bilateral hearing loss achieved higher scores in the implanted ear within the first year of follow-up.

PMID:34889843 | DOI:10.1097/MAO.0000000000003407

Niger J Clin Pract. 2021 Dec;24(12):1841-1845. doi: 10.4103/njcp.njcp_32_21.

ABSTRACT

AIMS: The aim of this study was to evaluate the pull-out bond strength of fiber post when cemented with a self-adhesive dual-cured resin luting cement and a conventional light-cured resin luting cement. In addition, the influence of a light-emitting diode (LED) and halogen (QTH) curing lights on the pull-out bond strength was assessed.

MATERIALS AND METHODS: A total of 40 extracted human teeth were selected. Post-space preparation of 10 mm was done and two types of resin cement i.e. RelyX Unicem (RXU) and variolink esthetic LC (VLE) were used for cementation of a translucent RelyX fiber post. Light activation for 60 s was done with LED and QTH curing units. The pull-out test was performed parallel to the long axis of the tooth and the post at a crosshead speed of 1 mm/min using a universal testing machine. The load required to dislodge each post was recorded in Newton (N). Statistical analysis was done and a value of P < 0.05 was considered statistically significant.

RESULTS: The RXU showed a mean (SD) pull-out bond strength of 203.5N (47.1) and 207.3N (31.3) when light activated with LED and QTH curing lights, respectively. For VLE, the mean pull-out bond strength was 78.9N (21.5) and 87.7N (30.7), when light activated with LED and QTH curing lights, respectively. Moreover, LED and QTH curing lights did not influence the pull-out bond strength for both the test materials.

CONCLUSION: It is concluded that a dual-cured resin luting cement should be used for the cementation of fiber post. Further research is required to understand the light transmission of translucent fiber posts.

PMID:34889794 | DOI:10.4103/njcp.njcp_32_21

Niger J Clin Pract. 2021 Dec;24(12):1835-1840. doi: 10.4103/njcp.njcp_469_20.

ABSTRACT

AIM: This study aims to comparatively evaluate the flexural strength, internal adaptation, elastic modulus, and maximum deflection of a newly introduced, strengthened injection-molded semi-flexed polyamide resin (Deflex) and a conventional heat-cured resin containing cross-linking polymethyl methacrylate denture base polymers (QC-20).

MATERIALS AND METHODS: A vinyl polysiloxane film replicating the gap between the denture base and the metallic master model of an edentulous maxilla was weighed using an analytical balance with an accuracy of 0.0001 g for the measurement of internal adaptation. The measurements were performed immediately after surface finishing. Seven rectangular test samples measuring 65 × 10 × 3.3 mm³ were set up for flexural strength test. Flexural strength test (three-point bending test) was performed using a universal machine under axial load at a crosshead speed of 5 mm/min. One-way ANOVA (α = 0.05) following by t tests was utilized in statistical analysis.

RESULTS: The difference between the flexural strength of the denture base resins of Deflex and QC-20 was found to be statistically significant. The injection-molded resin demonstrated better internal adaptation compared to the conventional heat-polymerized resin. Evaluation of the physical test results revealed that the polyamide samples were more flexible than polymethyl methacrylate and did not break during flexural strength tests.

CONCLUSION: Some properties of denture base resins, such as resin types, internal adaptation, and mechanical strength, may play a significant role in clinical performance of complete dentures and removable partial prostheses. Because of the superior flexural strength properties and internal adaptation characteristics, Deflex may prove to be a useful alternative to conventional denture base resin.

PMID:34889793 | DOI:10.4103/njcp.njcp_469_20

Niger J Clin Pract. 2021 Dec;24(12):1814-1823. doi: 10.4103/njcp.njcp_371_20.

ABSTRACT

BACKGROUND: Recent reports have shown that left-and right-sided colon cancers display different clinical and biological features. Chromosomal instability, epigenetic alterations, and defects in the deoxyribonucleic acid (DNA) mismatch repair (MMR) system may lead to the development of colorectal cancer (CRC). Besides microsatellite instability (MSI) caused by DNA MMR activity degradation increases the risk for CRC.

AIM: We aimed to show the differences between CRCs in different locations, to research the cause of these differences, to present whether there is a relation between MMR and MSI, and to evaluate their effects on prognosis.

PATIENTS AND METHODS: 641 CRC cases were divided into three groups: Group 1 (right-sided), Group 2 (left-sided), and Group 3 (rectum). Demographics, cancer stages, location of the tumors, number of the lymph nodes removed, MMR deficiency or proficiency, MSI status, and survival were assessed by retrospective review of the patients.

RESULTS: Among 641 patients, 64.9% were males. Group 1, 2, and 3 comprised 31.2%, 45.7%, and 23.1% of all the cases, respectively. There was a significant difference in terms of survival and location only in stage II tumors. Stage II left colon cancer (LCCs) had a statistically significant lower survival rate. There was no significant difference in survival between both MSI and MMR statuses. In addition, cases were also stratified by stages. According to this data, 10.1, 45.7, and 44.2% of the patients had stages I, II, and III disease, respectively.

CONCLUSIONS: Although it was not statistically significant, tumors with MMR deficiency (dMMR) and high microsatellite instability (MSI-H) are more common in right-sided colon tumors.

PMID:34889790 | DOI:10.4103/njcp.njcp_371_20

Niger J Clin Pract. 2021 Dec;24(12):1800-1807. doi: 10.4103/njcp.njcp_78_21.

ABSTRACT

AIMS: This study aims to investigate the potential application of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict concurrent chemoradiation (CRT) in locally advanced esophageal carcinoma.

PATIENTS AND METHODS: This study involved 33 patients with locally advanced esophageal cancer and treated with CRT. The patients underwent DCE-MRI before CRT (pre) and 3 weeks after starting CRT (mid). The patients were categorized into two groups: complete response (CR) and non-complete response (non-CR) after 3 months of treatment. The quantitative parameters of DCE-MRI (K^trans, Kep, and Ve), the changes and ratios of parameters (ΔK^trans, ΔKep, ΔVe, rΔK^trans, rΔKep, and rΔVe), and the relative ratio in the tumor area and a normal tube wall (rK^trans, rKep, and rVe) were calculated and compared between two timeframes in two groups, respectively. Moreover, the receiver operating characteristics (ROC) statistical analysis was used to assess the above parameters.

RESULTS: We divided 33 patients into two groups: 22 in the CR group and 11 in the non-CR group. During the mid-CRT phase in the CR group, both K^trans and Kep rapidly decreased, while only Kep decreased in the non-CR group. The pre-K^trans and pre-Kep in the CR group were substantially higher compared to the non-CR group. Moreover, the rK^trans was also apparently observed as higher at pre-CRT in the CR group compared to the non-CR group. The ROC analysis demonstrated that the pre-K^trans could be the best parameter to evaluate the treatment performance (AUC = 0.74).

CONCLUSION: Pre-K^trans could be a promising parameter to forecast how patients with locally advanced esophageal cancer will respond to CRT.

PMID:34889788 | DOI:10.4103/njcp.njcp_78_21

Niger J Clin Pract. 2021 Dec;24(12):1793-1799. doi: 10.4103/njcp.njcp_46_18.

ABSTRACT

BACKGROUND: Intrauterine growth restriction (IUGR) is an important cause of perinatal morbidity and mortality, the prevalence of which is six times higher in developing countries. The sequelae of IUGR extend into adulthood with higher risk of neurodegenerative diseases for the patients. Umbilical artery (UA) Doppler is an affordable and noninvasive tool for predicting perinatal outcome in IUGR pregnancies.

AIMS: The objective of this study is to compare the predictive ability of UA Doppler ultrasonography in discriminating normal from growth-restricted pregnancies and to find out if there is any relationship between antenatal Doppler indices and perinatal outcomes.

PATIENTS AND METHODS: This is a cross-sectional study including 100 normal and 100 IUGR-suspected pregnancies, respectively. Each participant had a third trimester UA Doppler scan. Data were analyzed using SPSS version 18.0 (PASW Statistics for Windows, Version 18.0, Chicago: SPSS Inc.). Means were compared using Student’s t-test and ANOVA. Tests of relationship and prediction were done using linear regression analysis and receiver operating characteristics. P ≤ 0.05 was considered statistically significant.

RESULTS: As pregnancy advanced, the mean values of UA Doppler indices decreased in normal and IUGR fetuses; however, they were significantly higher in the latter. UA systolic/diastolic (S/D) ratio showed the highest sensitivity (0.80) and specificity (0.91) for predicting IUGR compared to PI and RI. Cutoff values for PI, RI, and S/D ratio were 0.93, 0.67, and 2.93, respectively.

CONCLUSION: IUGR fetuses had higher UA flow velocimetric indices compared with normal fetuses. UA Doppler study is highly sensitive in the prediction of IUGR.

PMID:34889787 | DOI:10.4103/njcp.njcp_46_18

Niger J Clin Pract. 2021 Dec;24(12):1773-1778. doi: 10.4103/njcp.njcp_682_19.

ABSTRACT

BACKGROUND: Although the intensive care unit (ICU) admission criteria are specified clearly, it is difficult to make the decision of discharge from ICU.

AIMS: The purpose of this study is to test whether or not early warning scores will allow us to estimate early clinical deterioration within 24 hours and predict readmission to intensive care. A total of 1330 patients were included in the retrospective study.

PATIENTS AND METHODS: All the patients’ age, gender, ICU hospitalization reasons and Acute Physiological and Chronic Health Evaluation (APACHE II) scores were recorded. National Early Warning Score (NEWS) and VitalpacTM early warning score (VIEWS) scores were calculated using the physiological and neurological examination records. Discharge NEWS and VIEWS values of the patients who were readmitted to intensive care 24 hours after discharge were compared with the patients who were not readmitted to intensive care. The statistical analysis was performed using the IBM SPSS version 21 package software.

RESULTS: Age average of all the patients was 64.3 ± 20.8 years. The number of the patients who were readmitted to intensive care was 118 (8.87%). When examining the factors that affect early clinical deterioration, it was found that advanced age, high APACHE II scores, higher NEWS and VIEWS scores, lower DAP values and the patient’s transfer from the ward were significantly predictive (P < 0.05).

CONCLUSIONS: In this study, high NEWS and VIEWS are strong scoring systems that can be used in estimating early clinical deterioration risk and are easy-to-use and less time consuming.

PMID:34889784 | DOI:10.4103/njcp.njcp_682_19

Niger J Clin Pract. 2021 Dec;24(12):1759-1765. doi: 10.4103/njcp.njcp_431_20.

ABSTRACT

BACKGROUND: Although combined oral contraceptive (COC) is commonly used in sub-Saharan Africa, data on its cardiovascular disease risk remains scanty. The study aimed to determine serial serum lipid profiles and cardiovascular disease risks among COC-users.

METHODS: This is a prospective, comparative multicentered study conducted at four health facilities in Nigeria. Participants were new users of contraceptives; 120 each of women initiating COCs (group I) and those initiating other forms of nonhormonal contraceptives (group II) were recruited and monitored over a 6-month period. Serial lipid profile, blood pressure, and atherogenic risk for cardiovascular diseases were measured at recruitment (start) and scheduled follow-up clinic visits at 3 months and 6 months for all participants. Statistical analysis was performed with SPSS (version 21.0) and P value < 0.05 was considered significant.

RESULTS: In all, 225 participants (111 COC-users, 114 nonCOC-users) that completed the study were aged 18 to 49 years. There was a statistically significant increase in the diastolic blood pressure (P = 0.001), Low Density Lipoprotein- Cholesterol (P = 0.038) and higher atherogenic risk (P = 0.001) among COC-users compared to nonCOC-users. The serial total serum cholesterol, triglyceride, High Density Lipoprotein, systolic blood pressure, and body mass index were higher among COC-users but were not statistically significant compared to nonCOC-users.

CONCLUSION: Alterations in lipid profile and increased short-term atherogenic risk for cardiovascular disease were reported among the COC-users in this study. Serial lipid profile and atherogenic risk assessment for cardiovascular diseases are recommended for monitoring of COC-users.

PMID:34889782 | DOI:10.4103/njcp.njcp_431_20

Folia Parasitol (Praha). 2021 Nov 23;68:2021.026. doi: 10.14411/fp.2021.026.

ABSTRACT

Apoptosis plays crucial role in the pathogenesis of toxoplasmosis, as it limits further development of the disease. The current study aimed to investigate the effects of different concentrations of soluble total antigen (STAg) of Toxoplasma gondii (Nicolle et Manceaux, 1908) on the apoptotic and anti-apoptotic pathways. PMA-activated THP-1 cell line was sensed by T. gondii STAg and the expression patterns of caspase-3, -7, -8, -9, Bax, Bcl-2, and Mcl-1 genes were evaluated. The results showed statistically significant concentration-dependent overexpression of both Bcl-2 (P-value < 0.0001) and Mcl-1 (P-value = 0.0147). The cas-7 showed overexpression in all concentrations (P-value < 0.0001). The cas-3 was suppressed in concentrations 100, 80, and 40 µg, but statistically significant downregulated in concentrations 10 and 20 µg. The Bax was suppressed in concentrations 100 to 20 µg, while it slightly downregulated 1.42 fold (P-value = 0.0029) in concentration 10 µg. The expression of cas-8 and -9 was suppressed in all concentrations. Our results indicated that T. gondii STAg downregulated and suppressed apoptotic and upregulated anti-apoptotic pathways. The upregulation of cas-7 in this study may indicate the role of T. gondii STAg in activation of inflammatory responses.

PMID:34889779 | DOI:10.14411/fp.2021.026

JMIR Res Protoc. 2021 Dec 9;10(12):e31995. doi: 10.2196/31995.

ABSTRACT

BACKGROUND: Acquired brain injuries (ABIs) commonly cause cognitive-communication disorders, which can have a pervasive psychosocial impact on a person’s life. More than 135 million people worldwide currently live with ABI, and this large and growing burden is increasingly surpassing global rehabilitation service capacity. A web-based service delivery model may offer a scalable solution. The Social Brain Toolkit is an evidence-based suite of 3 web-based communication training interventions for people with ABI and their communication partners. Successful real-world delivery of web-based interventions such as the Social Brain Toolkit requires investigation of intervention implementation in addition to efficacy and effectiveness.

OBJECTIVE: The aim of this study is to investigate the implementation and effectiveness of the Social Brain Toolkit as a web-based service delivery model.

METHODS: This is a mixed methods, prospective, hybrid type 2 implementation-effectiveness study, theoretically underpinned by the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework of digital health implementation. We will document implementation strategies preemptively deployed to support the launch of the Social Brain Toolkit interventions, as well as implementation strategies identified by end users through formative evaluation of the Social Brain Toolkit. We will prospectively observe implementation outcomes, selected on the basis of the NASSS framework, through quantitative web analytics of intervention use, qualitative and quantitative pre- and postintervention survey data from all users within a specified sample frame, and qualitative interviews with a subset of users of each intervention. Qualitative implementation data will be deductively analyzed against the NASSS framework. Quantitative implementation data will be analyzed descriptively. We will obtain effectiveness outcomes through web-based knowledge tests, custom user questionnaires, and formal clinical tools. Quantitative effectiveness outcomes will be analyzed through descriptive statistics and the Reliable Change Index, with repeated analysis of variance (pretraining, posttraining, and follow-up), to determine whether there is any significant improvement within this participant sample.

RESULTS: Data collection commenced on July 2, 2021, and is expected to conclude on June 1, 2022, after a 6-month sample frame of analytics for each Social Brain Toolkit intervention. Data analysis will occur concurrently with data collection until mid-2022, with results expected for publication late 2022 and early 2023.

CONCLUSIONS: End-user evaluation of the Social Brain Toolkit’s implementation can guide intervention development and implementation to reach and meet community needs in a feasible, scalable, sustainable, and acceptable manner. End user feedback will be directly incorporated and addressed wherever possible in the next version of the Social Brain Toolkit. Learnings from these findings will benefit the implementation of this and future web-based psychosocial interventions for people with ABI and other populations.

TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Registry ACTRN12621001170819; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001170819, Australia and New Zealand Clinical Trials Registry ACTRN12621001177842; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001177842, Australia and New Zealand Clinical Trials Registry ACTRN12621001180808; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001180808.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31995.

PMID:34889770 | DOI:10.2196/31995