Nevin Manimala

Glob Pediatr Health. 2021 Feb 10;8:2333794X21989538. doi: 10.1177/2333794X21989538. eCollection 2021.

ABSTRACT

Background. Under-five mortality has continued a key challenge to public health in Ethiopia, and other sub-Saharan Africa countries. The threat of under-five mortality is incessant and more studies are needed to generate new scientific evidence. This study aimed to model the number of under-five deaths a mother has experienced in her lifetime and factors associated with it in Ethiopia. Method. A retrospective cross-sectional study based on data obtained from the Ethiopian Demographic and Health Survey (DHS), 2016 was used. The response variable was the total number of under-five children died per mother in her lifetime. Variables such as maternal socioeconomic and demographic characteristics, health, and environmental factors were considered as risk factors of under-five mortality. Hurdle negative binomial (HNB) regression analysis was employed to determine the factors associated with under-five mortality. Results. The data showed that 27.2% (95%CI: 0263, 0.282) of women experienced under-five deaths. The study revealed the age of mother at first birth, the age of mother at the time of under-five mortality occurred, number of household members, household access to electricity, region, educational level of the mother, sex of household head, wealth index, mother residing with husband/partner at the time of under-five mortality occurred as factors associated with under-five mortality. Age of mother at first birth 18 to 24 (IRR = .663; 95%CI: 0.587, 0.749), 25 or higher years old (IRR = 0.424; 95%CI: 0.306, 0.588), access to electricity (IRR = 0.758; 95%CI: 0.588, 0.976), primary education level of the mother (IRR = 0.715; 95%CI: 0.584, 0.875) and the richer wealth index (IRR = 0.785; 95%CI: 0.624, 0.988) were associated with reduced incidence of under-five mortality controlling for other variables in the model. Whereas older age of mother 35 to 39 (IRR = 5.252; 95%CI: 2.992, 9.218), 40 to 44 (IRR = 7.429; 95%CI: 4.188, 13.177), 45 to 49 (IRR = 8.697; 95%CI: 4.853, 15.585), being a resident of the Benishangul-gumuz region (IRR = 1.781; 95%CI: 1.303, 2.434), female household head (IRR = 1.256; 95%CI: 1.034, 1.525) were associated with an increased incidence of under-five mortality. Conclusion. The findings suggested that early age of mothers’ at first birth and old ages of mothers’, female household head and being uneducated were found to increase the incidence of the under-five mortality, whereas access to electricity and living with husband was statistically associated with reduced incidence of under-five mortality. The implication of this study is that policymakers and stakeholders should provide health education for mothers not to give birth at an earlier age and improve living standards to achieve sustainable development goals.

PMID:33623812 | PMC:PMC7878955 | DOI:10.1177/2333794X21989538

Health Serv Res Manag Epidemiol. 2021 Feb 10;8:2333392820986639. doi: 10.1177/2333392820986639. eCollection 2021 Jan-Dec.

ABSTRACT

BACKGROUND: In the absence of an effective vaccine, the coronavirus disease (COVID-19) continues to cause more deaths. Evidence on the effectiveness of various COVID-19 management plans is inconclusive. This paper describes the characteristics of the first 102 severe COVID-19 in-patients treated with Convalescent Plasma (CP) therapy or Tocilizumab or both at Al-Nahdha hospital in Muscat, Oman. Additionally, differences in requiring critical care were explored across the treatment groups.

METHODS: Data of all the positive cases in Al-Nahdha hospital were retrieved from the electronic health information system retrospectively from April 1st to July 31st 2020. The required information was recorded in a bespoke sheet and exported to SPSS for further analysis. The primary outcome was defined as improved (discharged home) vs worsening (requiring critical care).

RESULTS: Out of the 102 severe cases of COVID-19 admissions, 20.6%, 59.8% and 20.6% received CP, Tocilizumab and both respectively. In average, CP was introduced at day 3.7(4.8) whereas Tocilizumab at day 7.8(5.1) from admission. The between-group differences in the proportion of patient who improved vs worsened were not significant (P = 0.7). However, the within-group difference in the proportion of patient who improved vs worsened was significant in the Tocilizumab treatment group (P = 0.03). All socio-demographics were not significantly different across the treatment groups. Most improvements in the studies parameters [CBC (total WBC, Lymph and neutrophil counts), oxygen and immune response “cytokine storm” parameters] post-treatment was attributed to the use of Tocilizumab. There was a statistically significant difference in the mean hospital stay between the improved and worsened cases across all treatment categories [at the population level: 8.2(5.0) improved vs 4.7(3.7) worsened-P < 0.001].

CONCLUSIONS: Results from this study provided baseline information about the characteristics of confirmed COVID-19 cases in Al-Nahdha hospital who received CP, Tocilizumab or both. Results obtained seems to be promising in preventing critical care, especially for Tocilizumab. However, further randomized studies are needed.

PMID:33623809 | PMC:PMC7878948 | DOI:10.1177/2333392820986639

Orthop J Sports Med. 2021 Feb 9;9(2):2325967120979988. doi: 10.1177/2325967120979988. eCollection 2021 Feb.

ABSTRACT

BACKGROUND: Autologous chondrocyte implantation (ACI) is an increasingly popular technique for the treatment of articular cartilage defects. Because several companies have financial interests in ACI, it is important to consider possible conflicts of interest when evaluating studies reporting outcomes of ACI.

PURPOSE: To determine whether there is an association between authors’ financial conflicts of interest and the outcomes of ACI studies.

STUDY DESIGN: Cross-sectional study.

METHODS: A search of PubMed and MEDLINE databases for “autologous chondrocyte implantation” was performed. Clinical studies published after 2012 through May 15, 2019, and in English were included. Studies were determined to have financial conflicts of interest if any contributing author had relevant conflicts, either self-reported in the published study’s disclosures section or reported online in the American Academy of Orthopaedic Surgeons Disclosure database or the Centers for Medicare & Medicaid Services Open Payments database. The outcomes of each study were rated as favorable, equivocal, or unfavorable based on predefined criteria and then tested for association with conflicts of interest through use of the Fisher exact test.

RESULTS: A total of 79 studies met the inclusion criteria. Nearly all studies were of level 3 or 4 evidence. Conflicts of interest were established in 51.90% of studies (n = 41). Conflicts that were not self-reported by the authors were discovered in 18% of studies. The level of evidence was not associated with conflict of interest. No statistically significant difference was found in the rate of favorable outcomes between studies with conflicts (92.68%) and those with no conflicts (81.58%) (P = .126). Publications by US authors were more likely to have financial conflicts of interest (P = .003).

CONCLUSION: Favorable results were reported in a majority of studies involving ACI. No statistical association was found between the frequency of favorable outcomes and the presence of financial conflicts of interest, country of authorship, or level of evidence. There was a trend toward more favorable outcomes in studies with conflicts of interest. Additionally, nearly 20% of publications had possible conflicts found online that were not self-reported. It is critical for orthopaedic surgeons to judiciously evaluate published studies and consider financial conflicts of interest before performing ACI techniques on patients.

PMID:33623797 | PMC:PMC7876765 | DOI:10.1177/2325967120979988

J Public Health Res. 2021 Jan 29;10(1):1982. doi: 10.4081/jphr.2021.1982. eCollection 2021 Jan 14.

ABSTRACT

Background: School Nutritional Programmes (SNP) provide meals at school to reduce hunger, nutrient deficiencies and improve class alertness among children in poor communities. The purpose of the research was to determine the challenges encountered in implementing the SNP in KwaZulu-Natal Province, South Africa in 2017. Design and methods: A cross-sectional study underpinned by a concurrent triangulation research design where interviews were used to collect qualitative data from stakeholders, and a questionnaire collected quantitative data from students. The set of qualitative data was thematically analysed. Descriptive and inferential statistics were used to analyse the quantitative data. Analysis of variance (ANOVA) and Tukey HSD test were used to compare the mean scores for food quality on different days of the week. Results: Both the quality and quantity of food were affected by delays in payment of food suppliers, lack of training of stakeholders, and poor kitchen facilities. Health problems experienced by students after eating the food made them reluctant to consume meals on some days. The Tukey HSD test indicated that the mean score for the quality of food served on Wednesday (3.2 ± 1.3) was significantly higher than the mean score for the quality of the meal served on Friday (2.5 ± 1.3). Conclusions: Late payment of food-suppliers and inadequate training of food-handlers affected the quality and quantity of the meals. The researcher recommends that the programme administrators should improve the frequency of payment for food suppliers, training of food handlers, and find alternative meals for students who do not consume the regular meals due to various reasons.

PMID:33623777 | PMC:PMC7883013 | DOI:10.4081/jphr.2021.1982

J Microsc Ultrastruct. 2020 Dec 10;8(4):198-204. doi: 10.4103/JMAU.JMAU_77_20. eCollection 2020 Oct-Dec.

ABSTRACT

INTRODUCTION: As soon as the WHO declared COVID-19 a pandemic, many higher education facilities had to change their educational and teaching strategies to cope with the lockdown. Some medical schools decided to rely on online teaching while others depended on students’ self-learning abilities. Methods of assessment also changed as some medical schools implemented pass/fail exams, online examinations, and research projects while others postponed their final exams. In Egypt, medical schools started delivering their lectures online and changed the assessment criteria of the preclinical academic years to depend mainly on research and online exams while postponed the clinical rotations and final exams of the clinical years.

AIM: This study assesses medical students’ awareness of the current situation regarding the safety guidelines and their satisfaction with the solutions provided by their schools for the plans to continue their learning and the new assessment methods and criteria.

METHODOLOGY: The method used for data collection is an online survey filled by medical students from around Egypt. Moreover, data were statistically analyzed using IBM statistical package SPSS for doing a Chi-squared test on two variables.

RESULTS: After collecting the data and analyzing responses, we found that 66.2% of students who answered the survey do not think that the safety measures taken by their universities after the return back will be enough.

CONCLUSION: This shows that the basic knowledge of COVID-19 among medical students is average and there is a need to start programs for infection control practices against COVID-19 for all medical students and professionals.

PMID:33623747 | PMC:PMC7883500 | DOI:10.4103/JMAU.JMAU_77_20

J Microsc Ultrastruct. 2020 Nov 9;8(4):168-174. doi: 10.4103/JMAU.JMAU_40_20. eCollection 2020 Oct-Dec.

ABSTRACT

PURPOSE: The purpose was to assess students’ and faculty readiness toward online dental education in Saudi Arabia.

MATERIALS AND METHODS: This is a cross-sectional study using a 5-point Likert scale questionnaire distributed to students (undergraduates and postgraduates) and faculty at King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia, in 2018. It assessed individual characteristics, system competency needs, social influence, institutional support, overall readiness, and the needed technical support in using e-learning for personal as well as teaching and learning (T&L) purposes. The readiness response scale for each domain was categorized as follows: low (mean value = 1-<3), acceptable/moderate (mean value = 3-<4), and high readiness level (mean value = 4-5). Descriptive and group comparisons were conducted using Pearson’s Chi-square test, paired sample t-test, independent sample t-test, one-way ANOVA, and Tukey’s post hoc test. The statistical significance level was set at P < 0.05.

RESULTS: the total completed response rate was 400/550 (72.7%) comprising undergraduates (n = 312), postgraduates (n = 38), and faculty (n = 50). The results showed an acceptable level of online skills with no statistically significant difference between the groups (P > 0.05). A statistically significant difference between the two categories of uses, personal and T&L, was found (P < 0.05). The undergraduate students reported statistically significantly lower readiness level in online English literacy, perceived impact of online technology on education, technology accessibility, importance of institutional support, overall readiness, and the need for technical support (P < 0.05).

CONCLUSION: Significant differences between students’ and faculty readiness for e-learning adoption in dental education were reported. The current study captured the prepandemic e-readiness of students and faculty as a baseline for future assessment of pandemic effect on education.

PMID:33623743 | PMC:PMC7883505 | DOI:10.4103/JMAU.JMAU_40_20

Results Phys. 2021 Mar;22:103956. doi: 10.1016/j.rinp.2021.103956. Epub 2021 Feb 18.

ABSTRACT

It is of great curiosity to observe the effects of prevention methods and the magnitudes of the outbreak including epidemic prediction, at the onset of an epidemic. To deal with COVID-19 Pandemic, an SEIQR model has been designed. Analytical study of the model consists of the calculation of the basic reproduction number and the constant level of disease absent and disease present equilibrium. The model also explores number of cases and the predicted outcomes are in line with the cases registered. By parameters calibration, new cases in Pakistan are also predicted. The number of patients at the current level and the permanent level of COVID-19 cases are also calculated analytically and through simulations. The future situation has also been discussed, which could happen if precautionary restrictions are adopted.

PMID:33623733 | PMC:PMC7889458 | DOI:10.1016/j.rinp.2021.103956

Results Phys. 2021 Feb 19:103976. doi: 10.1016/j.rinp.2021.103976. Online ahead of print.

ABSTRACT

One of the greatest challenges facing the humankind nowadays is to confront that emerging virus, which is the Coronavirus (COVID-19), and therefore all organizations have to unite in order to tackle that the transmission risk of this virus. From this standpoint, the scientific researchers have to find good mathematical models that do describe the transmission of such virus and contribute to reducing it in one way or another, where the study of COVID-19 transmission dynamics by mathematical models is very important for analyzing and controlling this disease propagation. Thus, in the current work, we present a new fractional-order mathematical model that describes the dynamics of COVID-19. In the proposed model, the total population is divided into eight classes, in addition to three compartments used to estimate the parameters and initial values. The effective reproduction number ( R0 ) is derived by next generation matrix (NGM) method and all possible equilibrium points and their stability are investigated in details. We used the reported data (from January 23, 2020, to November 21, 2020) from the National Health Commission (NHC) of China to estimate the parameters and initial conditions (ICs) which suggested for our model. Simulation outcomes demonstrate that the fractional order model (FOM) represents behaviors that follow the real data more accurately than the integer-order model. The current work enhances the recent reported results of Zu et al. published in THE LANCET (doi:10.2139/ssrn.3539669).

PMID:33623732 | PMC:PMC7892305 | DOI:10.1016/j.rinp.2021.103976

Results Phys. 2021 Feb 19:103913. doi: 10.1016/j.rinp.2021.103913. Online ahead of print.

ABSTRACT

In this paper we consider ant-eating pangolin as a possible source of the novel corona virus (COVID-19) and propose a new mathematical model describing the dynamics of COVID-19 pandemic. Our new model is based on the hypotheses that the pangolin and human populations are divided into measurable partitions and also incorporates pangolin bootleg market or reservoir. First we study the important mathematical properties like existence, boundedness and positivity of solution of the proposed model. After finding the threshold quantity for the underlying model, the possible stationary states are explored. We exploit linearization as well as Lyapanuv function theory to exhibit local stability analysis of the model in terms of the threshold quantity. We then discuss the global stability analyses of the newly introduced model and found conditions for its stability in terms of the basic reproduction number. It is also shown that for certain values of R0 , our model exhibits a backward bifurcation. Numerical simulations are performed to verify and support our analytical findings.

PMID:33623730 | PMC:PMC7892304 | DOI:10.1016/j.rinp.2021.103913

Geriatr Orthop Surg Rehabil. 2021 Feb 9;12:2151459321991503. doi: 10.1177/2151459321991503. eCollection 2021.

ABSTRACT

In patients over 65y.o. who were surgically treated for a hip fracture, electrolytes have not been specifically studied as predictors of mortality. The main purpose of this study was to assess whether electrolytes and chronic kidney disease (CKD) stages, evaluated at admission, could represent a pre-operative prognostic factor in this population. Moreover, the role of epidemiological and clinical parameters was analyzed with and without a surgical timing stratification. This retrospective study included 746 patients. For each patient, their age, gender, fracture classification, Hb value, comorbidities, ASA class, chronic kidney disease, creatinine levels, electrolytes and surgical timing were collected. CKD-epi, MDRD, modified MDRD and BIS1 were used to obtain eGFR and CKD stages. All parameters were analyzed individually and in relation to the different surgical timing. Descriptive statistics, Chi-square test and survivability analysis with Kaplan Meier curve were used. In patients with a hip fracture non-significant association with increased mortality was shown for the following variables: Hb value, sodium values, calcium values, CKD stages and creatinine values. Otherwise altered kalemia was associated with a statistically significant increase in mortality as well as male gender, two or more comorbid medical conditions, advanced age (>75 years), higher ASA class. Surgery performed within 72h resulted in a statistically significant reduction in mortality at 6 months and, when performed in 24h-48h, a further reduction at 4 years. Age and ASA class statistically significant increased mortality regardless the surgical timing. Male patients operated after 48h from hospitalization were associated with a statistically significant increase in mortality rate. Two or more comorbidities were related to a statistically significant increased number of deaths when patients were treated after 96h. Altered kalemia values at hospitalization are associated with a statistically significant increase in mortality in patients operated after 72h from admission.

PMID:33623723 | PMC:PMC7876745 | DOI:10.1177/2151459321991503