Nevin Manimala

Fundam Clin Pharmacol. 2022 Feb 2. doi: 10.1111/fcp.12765. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetic dyslipidemia is a significant contributor in the pathogenesis of type 2 diabetes (T2D).

OBJECTIVES: The study aimed at comparing effect of dapagliflozin, liraglutide and atorvastatin alone or their combinations on lipids and inflammatory markers and their vascular impact in T2D rats.

METHODS: 56 male albino rats were included in the study and divided into 2 main groups. Group A (8 rats) served as normal control. Group B (48 rats) were streptozotocin – nicotinamide – induced diabetic rats. Subgroups (B-1, B-2, B-3, B-4, B-5 and B-6) received (no medications, dapagliflozin, liraglutide, atorvastatin, dapagliflozin + atorvastatin and liraglutide + atorvastatin) respectively. Urine albumin/creatinine ratio (UACR), glycosylated hemoglobin (HBA1c), fasting serum glucose (FSG), serum LDL-C, HDL-C, TGs, lipoprotein(a) Lp (a), serum thyrotropin (TSH), highly sensitive C-reactive protein (hs-CRP) and advanced glycation end products (AGEs), were assessed. Qualitative and quantitative histological examination of kidneys focused on renal corpuscles.

RESULTS: Dapagliflozin improved the studied parameters but with statistically insignificant increase in LDL-C, Lp (a) and significant increase in UACR. Atorvastatin improved the studied parameters but with statistically insignificant increase in FSG and HbA1C. Liraglutide and the combination groups significantly improved all studied parameters. Histologically; liraglutide, atorvastatin produced therapeutic effect, while dapagliflozin depicted nephrotoxic effect. Combination groups resulted in better effects with normalization of most of renal corpuscles. There were positive correlations between LDL-C & hs-CRP, AGEs, TSH and mesangial expansion.

CONCLUSION: Combination of atorvastatin with liraglutide can improve its vasculoprotective effect. Moreover, combination of atorvastatin with dapagliflozin can ameliorate its possible nephrotoxic effect.

PMID:35106814 | DOI:10.1111/fcp.12765

Br J Clin Pharmacol. 2022 Feb 1. doi: 10.1111/bcp.15253. Online ahead of print.

ABSTRACT

There is significant interest in the potential for nebulised unfractionated heparin (UFH) as a novel therapy for patients with COVID-19 induced acute hypoxaemic respiratory failure requiring invasive ventilation. The scientific and biological rationale for nebulised heparin stems from the evidence for extensive activation of coagulation resulting in pulmonary microvascular thrombosis in COVID-19 pneumonia. Nebulised delivery of heparin to the lung may limit alveolar fibrin deposition and thereby limit progression of lung injury. Importantly, laboratory studies show that heparin can directly inactivate the SARS-CoV-2 virus, thereby prevent its entry into and infection of mammalian cells. UFH has additional anti-inflammatory and mucolytic properties that may be useful in this context. METHODS AND INTERVENTION: The Can nebulised HepArin Reduce morTality and time to Extubation in Patients with COVID-19 Requiring invasive ventilation Meta-Trial (CHARTER-MT) is a collaborative prospective individual patient data analysis of on-going randomised controlled clinical trials across several countries in 5 continents, examining the effects of inhaled heparin in patients with COVID-19 requiring invasive ventilation on various endpoints. Each constituent study will randomise patients with COVID-19 induced respiratory failure requiring invasive ventilation. Patients are randomised to receive nebulised heparin or standard care (open label studies) or placebo (blinded placebo-controlled studies) while under invasive ventilation. Each participating study collect a pre-defined minimum dataset. The primary outcome for the meta-trial is the number of ventilator-free days up to day 28 day, defined as days alive and free from invasive ventilation. ETHICS AND DISSEMINATION: The meta-trial is registered at ClinicalTrials.gov ID NCT04545541. Each contributing study is individually registered and has received approval of the relevant ethics committee or institutional review board. Results of this study will be shared with the WHO, published in scientific journals, and presented at scientific meetings.

PMID:35106809 | DOI:10.1111/bcp.15253

J Ultrasound Med. 2022 Feb 2. doi: 10.1002/jum.15952. Online ahead of print.

ABSTRACT

OBJECTIVE: We aims to determine the relationship of amniotic fluid sludge (AFS) and/or short cervical length (CL, ≤25 mm) with a high rate of preterm birth in women after cervical cerclage.

METHODS: A retrospective cohort study was conducted among singleton pregnancies after cervical cerclage between January 2018 and December 2021. A total of 296 patients who underwent transvaginal ultrasound to evaluate CL and the presence of AFS within 2 weeks after cerclage were included. Pregnancy outcome after cerclage was analyzed in accordance with the presence of AFS and CL ≤25 mm.

RESULTS: In patients with cerclage, AFS was an independent risk factor for preterm birth at <28 and <36 weeks but not for preterm birth at <32 weeks, and CL ≤25 mm was an independent risk factor for preterm birth at <28, <32, and <36 weeks. The Kaplan-Meier analysis showed that the association between the presence of AFS and short gestational age at delivery was statistically significant in women with CL ≤25 mm (log rank test, P = .000). The Cox regression analysis showed that these results remained significant after adjusting for confounding factors (P = .000). The negative linear relationships between AFS and CL (R = -0.454, P < .001) also explained the outcome.

CONCLUSIONS: AFS and short cervix have a direct effect on pregnancies after cerclage. Mid-trimester AFS can become a supplementary ultrasound index for detecting preterm birth after cerclage in pregnant women with a short cervix.

PMID:35106799 | DOI:10.1002/jum.15952

J Dent Educ. 2022 Feb 1. doi: 10.1002/jdd.12897. Online ahead of print.

ABSTRACT

OBJECTIVES: Previous studies only focused on attitudes and behaviors of US dental students without examining direct effects of the COVID-19 pandemic on academic performance. This study examined effects of COVID-19 pandemic on dental students’ academic performance, self-reported attitudes, behavior, and service utilization. We hypothesized that the pandemic provided more beneficial learning environments.

METHODS: This mixed study design implemented a cross sectional survey with retrospective extraction of students’ academic grades. A survey of 274 predoctoral students assessed self-reported attitudes/behaviors and service utilization. First year Doctor of Dental Medicine (DMD1) 2021-2024 students’ academic performance data were extracted. Independent t-test and chi-square crosstab analyses were conducted assessing differences between pre-COVID and post-COVID cohorts.

RESULTS: Participants’ academic grades identified statistically significant associations between pre-/post-COVID grades in five of 12 DMD1 courses. Grade percentages identified increased average grades in four of 12 DMD1 courses, with one of 12 courses demonstrating decreased grade percentage. Half of survey participants were female (n = 37/72, 51.4%), 79.2% were 25-34 years old, and 44.4% (n = 32) were DMD 2024. About 1/5 (20.8%, n = 15) sought counseling/therapy. Students agreed staying home allowed more time to study (66.7%, n = 48), while 59.2% (n = 42) reported increased financial concerns. A majority reported lacking in-person group studying decreased performance, and 55.6% (n = 40) reported feeling depressed.

CONCLUSION: Students performed better overall in courses delivered remotely with clinical application and team-based engagement. Students performed equally overall; however, the majority had concerns regarding finances, group studying, and mental health challenges. This highlights the need for more readily available resources at institutions.

PMID:35106782 | DOI:10.1002/jdd.12897

J Dent Educ. 2022 Feb 1. doi: 10.1002/jdd.12890. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate attitudes and satisfaction of faculty members about calibration efforts in the undergraduate dental program at Imam Abdulrahman Bin Faisal University, Saudi Arabia.

METHODS: The cross-sectional study included faculty members (n = 75) who participated in calibration exercises for effective assessments in preclinical and clinical courses. The previously validated questionnaire was utilized. The questionnaire was composed of four sections: demographics, faculty members’ attitude, quality of calibration efforts, and faculty satisfaction. The satisfaction score of faculty members was calculated and compared with their demographic data. Descriptive statistics included means, standard deviations, frequencies, and proportions. The data were analyzed using an independent sample t-test and one-way analysis of variance.

RESULTS: The response rate was 92% (n = 69). Note that 97% participants agreed that faculty calibration was an important aspect of dental education and 88.10% were willing to attend calibration exercises even if not required by their institution. Most participants (82.1%) agreed students were more satisfied with their clinical education when faculty members were calibrated. In this study, the perception of 85.1% of the participants was that calibration efforts reduced faculty variations. Most participants (73.10%) were satisfied with the quality of faculty calibration exercises in the college. The mean satisfaction score of the sample was 13.21 ± 3.65, which was significantly higher among faculty members with a doctoral degree (13.88 ± 3.64) than those with a master’s degree (12.08 ± 3.46) (p = 0.048). The study showed no significant relationship of gender, age, status, and year of experience with faculty’s satisfaction with calibration efforts.

CONCLUSION: Most faculty members recognized the importance of faculty calibration in dental education and were satisfied with the quality of calibration efforts. Satisfaction with calibration efforts was significantly related to the high education of faculty members.

PMID:35106776 | DOI:10.1002/jdd.12890

Nurs Forum. 2022 Feb 1. doi: 10.1111/nuf.12700. Online ahead of print.

ABSTRACT

BACKGROUND: Intimate partner violence (IPV) is the most common form of abuse against women. It comes in the form of physical, sexual, emotional, and controlling behaviors abuse, and affects women’s physical and psychological well-being. Perceived social support decreases IPV risk.

PURPOSE: This study explores the determinants of IPV in J society.

METHOD: One hundred and eighty-seven women exposed to IPV were recruited from J Women Unions to take part in this cross-sectional prospective quantitative design, administering the Arabic version of the Multidimensional Scale of Perceived Social Support (AVMSPSS) to 187, who also answered the demographic characteristics data sheet.

RESULTS: Almost 83% of participants perceived that they received lower to moderate PSS. Based on multiple regression, determinants of IPV were PSS, followed by participant education, husband education, participant age, and financial income (p < .001). The number of children and parental level of education showed no statistical significance.

CONCLUSION: The findings highlight the importance of social support systems among IPV women. Alongside socioeconomic development continuing to increase education among both men and women, there is a need to increase societal awareness and foster social support systems to prevent violence against women and offer resources to affected women, targeted at the most at-risk age groups.

PMID:35106765 | DOI:10.1111/nuf.12700

Ginekol Pol. 2022 Feb 2. doi: 10.5603/GP.a2021.0211. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to examine whether expectant management in twin pregnancies with preterm premature rupture of membranes (pPROM) is as safe as in singleton pregnancies.

MATERIAL AND METHODS: It was a retrospective cohort study comparing pregnancy course and outcome in singleton (n = 299) and twin pregnancies (n = 49) complicated by preterm premature rupture of membranes. Analysed factors included maternal diseases, gestational age at (premature rupture of membranes) PROM, management during hospitalization, latency periods between PROM and delivery, gestational age at delivery, neonatal management and outcome.

RESULTS: The difference in the proportion of patients with latency up to 72 hours, latency between 72 hours and seven days, and latency exceeding seven days were insignificant. The percentage of patients who received intravenous tocolysis and antenatal corticosteroids were similar; however, patients in twin pregnancies more often received incomplete steroids dose (p = 0.01). The occurrence of the positive non-stress test result and signs of intrauterine infection were similar between the groups. No statistically significant differences in the prevalence of neonatal complications except transient tachypnoea of the newborn were identified (24% in the singleton vs 13% in the twin group, p = 0.03).

CONCLUSIONS: Expectant management of pPROM in singleton and twin pregnancies results in similar perinatal and neonatal outcome. Consequently, in case of no evident contraindications, expectant management of twin pregnancies seems to be equally as safe as in singleton pregnancies. Patients in twin pregnancies may be at higher risk of delivery before administration of full antenatal corticosteroids dose, therefore require immediate management initiation and transfer to a tertiary referral centre.

PMID:35106749 | DOI:10.5603/GP.a2021.0211

Transl Stroke Res. 2022 Feb 1. doi: 10.1007/s12975-022-00988-8. Online ahead of print.

ABSTRACT

Normal-appearing white matter (NAWM) is a hub of plasticity, but data relating to its influence on post-ischemic stroke (IS) outcome remain scarce. The aim of this study was to evaluate the relationship between NAWM integrity and cognitive outcome after an IS. A longitudinal study was conducted including supra-tentorial IS patients. A 3-Tesla brain MRI was performed at baseline and 1 year, allowing the analyses of mean fractional anisotropy (FA) and mean diffusivity (MD) in NAWM masks, along with the volume of white matter hyperintensities (WMH) and IS. A Montreal Cognitive Assessment (MoCA), an Isaacs set test, and a Zazzo’s cancellation task were performed at baseline, 3 months and 1 year. Mixed models were built, followed by Tract-based Spatial Statistics (TBSS) analyses. Ninety-five patients were included in the analyses (38% women, median age 69 ± 20). FA significantly decreased, and MD significantly increased between baseline and 1 year, while cognitive scores improved. Patients who decreased their NAWM FA more over the year had a slower cognitive improvement on MoCA (β = – 0.11, p = 0.05). The TBSS analyses showed that patients who presented the highest decrease of FA in various tracts of white matter less improved their MoCA performances, regardless of WMH and IS volumes, demographic confounders, and clinical severity. NAWM integrity deteriorates over the year after an IS, and is associated with a cognitive recovery slowdown. The diffusion changes recorded here in patients starting with an early preserved white matter structure could have long term impact on cognition.

PMID:35106712 | DOI:10.1007/s12975-022-00988-8

J Assist Reprod Genet. 2022 Feb 1. doi: 10.1007/s10815-022-02402-6. Online ahead of print.

ABSTRACT

PURPOSE: Assisted reproductive technology (ART) treatments with donor sperm have been allowed for women in lesbian relationships (WLR) since 2005 in Sweden, but for single women (SW), these became approved only recently in 2016. This study was conducted to compare the outcomes of ART treatments in SW vs. WLR.

METHODS: This is a prospective controlled cohort study of 251 women undergoing intrauterine insemination (D-IUI) or in vitro fertilization (D-IVF) using donor sperm between 2017 and 2019 at the department of Reproductive Medicine, Karolinska University Hospital. The cohort comprised 139 SW and 112 WLR. The main outcomes included differences in live birth rate (LBR) and cumulative live birth rate (cLBR) between the groups. The SW underwent 66 D-IUI and 193 D-IVF treatments and WLR underwent 255 D-IUI and 69 D-IVF treatments. Data on clinical characteristics, treatment protocols and clinical outcomes were extracted from the clinic’s electronic database. The outcomes of D-IUI and D-IVF were separately assessed.

RESULTS: The cohort of SW was significantly older than WLR (37.6 vs. 32.4 years, P < 0.001), and more commonly underwent IVF at first treatment (83% vs. 29%, P < 0.000). Conversely, WLR underwent more frequently D-IUI as a first treatment (71% vs. 17% of SW, P < 0.001) and more often in the natural cycle (89.9% vs. 70.8%, P = 0.019), respectively. There was no statistically significant difference in the main outcome LBR between the two groups, or between the two different types of treatment, when adjusted for age. Perinatal outcomes and cLBR were also similar among the groups.

CONCLUSIONS: SW were, on average, older than WLR undergoing treatment with donor sperm. No significant differences were seen in the LBR and cLBR when adjusted for age between the two groups and between the two types of treatment (D-IVF vs. D-IUI).

TRIAL REGISTRATION: ClinicalTrials.gov NTC04602962.

PMID:35106694 | DOI:10.1007/s10815-022-02402-6

Metab Brain Dis. 2022 Feb 2. doi: 10.1007/s11011-022-00922-9. Online ahead of print.

ABSTRACT

Multiple sclerosis (MS) is a chronic inflammatory and autoimmune disease characterized by demyelination of the central nervous system (CNS). Neuregulin 1 (NRG1) is a signaling protein that plays an important role in a variety of biological processes, including potentiate oligodendrocyte differentiation and myelination in the CNS, immune response regulation, and inflammation. Single nucleotide polymorphism (SNP) rs77493513 is located in the untranslated region of the 3′ mRNA (3′-UTR) of the NRG1 gene, which is predicted to be the binding site of several microRNAs and may play an important role in post-transcriptional regulation. Study aimed to investigate the association of SNP rs77493513 in the NRG1 gene with the risk of MS disease. In this study, genomic DNA was extracted from whole blood samples of 182 patients with relapsing-remitting multiple sclerosis (RRMS) and 198 controls. Different genotypes of rs77493513 polymorphism were determined using RFLP-PCR technique. Statistical analysis was performed using SPSS 21.0 software and by t, χ2 and logistic regression tests. Our data showed that genotypes AC (OR=3.63, CI= 1.93-6.81, p<0.001) and CC (OR=7.90, CI= 4.13-15.11, p<0.001) significantly increased the risk of MS disease and C allele is risk allele. Also, AC (OR=0.16, CI= 0.04-0.63, p= 0.009) and CC (OR=0.14, CI= 0.03-0.53, p=0.04) genotypes significantly decrease the age of onset of the disease. The results show that allele C of rs77493513 polymorphism in the NRG1 gene can be a risk factor for MS.

PMID:35106689 | DOI:10.1007/s11011-022-00922-9