Nevin Manimala

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

N Z Med J. 2022 Jul 1;135(1557):38-48.

ABSTRACT

AIMS: The costs of being a medical student are large and increasing, and many students need to work part-time to meet financial pressures. This study explores the impact that part-time extracurricular paid work during the academic year has on medical student wellbeing, their interactions with the curriculum, and the effect of COVID-19 on work in 2020.

METHODS: An online survey in 2020 gathered demographic, quantitative and qualitative information from medical students and their work experiences. Descriptive statistics analysed quantitative data; qualitative data were analysed using qualitative content analysis.

RESULTS: Of the 36% (n=530) of students who responded, 255 (49%) reported undertaking paid part-time work, with 59 (24%) reporting they would not be able to remain studying if they did not work. When interacting with the medical programme, 43% of students reported their work conflicted with scheduled medical school commitments, and 70% reported conflicts between work and individual study. COVID-19 disrupted 57% of paid work during the year. Impacts on students’ wellbeing were both positive and negative. Positive aspects included developing new skills, self-confidence and resilience. Working also provided an escape from the study demands of the medical programme. Negative aspects were predominantly about the increased stress working had on students, specifically on the impact of paid work on their own health.

CONCLUSIONS: Almost half of medical students work part-time while studying. Understanding the perceived implications that part-time work has on student education and wellbeing could help medical schools provide appropriate advice and pastoral support for their students.

PMID:35772111

Asia Pac J Ophthalmol (Phila). 2022 May 1;11(3):279-286. doi: 10.1097/APO.0000000000000523.

ABSTRACT

PURPOSE: To investigate the longitudinal changes in the peripapillary retinal nerve fiber layer (pRNFL) thickness after epiretinal membrane (ERM) vitrectomy with internal limiting membrane (ILM) peeling, examine associations between pRNFL thickness and central retinal sensitivity, and identify predictors of postoperative pRNFL thickness.

DESIGN: Prospective, observational, cohort study.

METHODS: This study enrolled 82 eyes of 82 Japanese patients that underwent surgery for unilateral idiopathic ERM, with their fellow eyes as controls. pRNFL thickness was measured in 4 (superior, temporal, inferior, and nasal) quadrants preoperatively and at 1, 3, 6, and 12 months postoperatively. Microperimetry was performed at 12 months postoperatively to evaluate central retinal sensitivity. Regression tree analysis was performed to predict pRNFL thickness at 12 months postoperatively.

RESULTS: The temporal quadrant showed continuous pRNFL thinning after surgery, reaching statistical significance at 3, 6, and 12 months postoperatively (all P < 0.001). The pRNFL thicknesses in the fellow eyes significantly increased at all postoperative time points (all P < 0.001). At 12 months postoperatively, the average central retinal sensitivity was significantly correlated with the temporal pRNFL thickness in the eyes with ERM (r = 0.372, P < 0.001); no significant correlation was found in the fellow eyes. Regression tree analysis showed that the preoperative pRNFL thickness in the temporal quadrant and patient age were the main determinants of the temporal pRNFL thickness at 12 months postoperatively.

CONCLUSIONS: The risk of deterioration of central retinal sensitivity after ERM vitrectomy with internal limiting membrane peeling should be considered for patients with thin temporal pRNFLs and older adults.

PMID:35772086 | DOI:10.1097/APO.0000000000000523