Nevin Manimala

J Gerontol A Biol Sci Med Sci. 2021 Oct 4:glab281. doi: 10.1093/gerona/glab281. Online ahead of print.

ABSTRACT

BACKGROUND: The present study assessed whether reporting multiple reasons for perceived everyday discrimination was associated with an increased risk for all-cause mortality risk among older Black adults.

METHODS: This study utilized data from a subsample of older Black adults from the Health and Retirement Study (HRS), a nationally representative panel study of older adults in the United States. Our measure of multiple reasons for perceived everyday discrimination was based on self-reports from the 2006/2008 HRS waves. Respondents’ vital status was obtained from the National Death Index and reports from key household informants (spanning 2006-2019). Cox proportional hazard models, which accounted for covariates linked to mortality, were used to estimate the risk of all-cause mortality.

RESULTS: During the observation period, 563 deaths occurred. Twenty percent of Black adults attributed perceived everyday discrimination to three or more sources. In demographic adjusted models, attributing perceived everyday discrimination to three or more sources was a statistically significant predictor of all-cause mortality risk (hazard ratio= 1.45; 95%, confidence interval=1.12 – 1.87). The association remained significant (hazard ratio=1.49, 95%, confidence interval=1.15 – 1.93) after further adjustments for health, behavioral, and economic characteristics.

CONCLUSION: Examining how multiple reasons for perceived everyday discrimination relate to all-cause mortality risk has considerable utility in clarifying the unique contributions of perceived discrimination to mortality risk among older Black adults. Our findings suggest that multiple reasons for perceived everyday discrimination are a particularly salient risk factor for mortality among older Black adults.

PMID:34605539 | DOI:10.1093/gerona/glab281

Am J Hypertens. 2021 Oct 4:hpab155. doi: 10.1093/ajh/hpab155. Online ahead of print.

ABSTRACT

BACKGROUND: The Spontaneously Hypertensive Rat (SHR) Colony was established in 1963 and is the most commonly used rodent model for studying heart failure. Ideally, animal models should recapitulate the clinical disease as closely as possible. Any drift in a genetic model may create a new model that no longer adequately represents the human pathology. Further, instability overtime may lead to conflicting data between laboratories and/or irreproducible results. While systolic blood pressure is closely monitored during inbreeding, the sequelae of heart failure (e.g., cardiac hypertrophy) are not. Thus, the object of this review was to investigate whether the hypertension-induced sequelae of heart failure in the SHR have remained stable after decades of inbreeding.

METHODS: A systematic review was performed to evaluate indices of cardiovascular health in the SHR over the past 60 years. For post hoc statistical analyses, studies were separated into 2 cohorts: Initial (mid – late 1900’s) and Current (early 2000’s – present) Colony SHRs. Wistar-Kyoto rats (WKY) were used as controls.

RESULTS: Systolic blood pressure was consistent between Initial and Current Colony SHRs. However, Current Colony SHRs presented with increased concentric hypertrophy (i.e., elevated heart weight and posterior wall thickness) while cardiac output remained consistent. Since these changes were not observed in the WKY controls, cardiac-derived changes in Current Colony SHRs were unlikely due to differences in environmental conditions.

CONCLUSIONS: Together, these data firmly establish a cardiac-based phenotypic shift in the SHR model and provide important insights into the beneficial function of concentric hypertrophy in hypertension-induced heart failure.

PMID:34605538 | DOI:10.1093/ajh/hpab155

Rev Esc Enferm USP. 2021 Oct 1;55:e20210209. doi: 10.1590/1980-220X-REEUSP-2021-0209. eCollection 2021.

ABSTRACT

OBJECTIVE: To analyze the role of sociodemographic factors and self-efficacy in the perception of social support by nursing students of the first years of nursing school.

METHOD: This is a quantitative cross-sectional research, developed with 121 undergraduate students from the early years of the course. A sociodemographic questionnaire, the Higher Education Self-Efficacy Scale and the abbreviated version of the Social Support Questionnaire were used. Spearman and Mann-Whitney correlation tests were performed using software for statistical analysis.

RESULTS: It was identified that students with better self-efficacy and who are self-declared black or brown reported, respectively, greater satisfaction with the support and a smaller number of supporters.

CONCLUSION: Considering that the race/color factor had a negative influence and self-efficacy a positive influence in the perception of social support, it is recommended that mental health promotion strategies be conducted that permeate both affirmative action policies and improvements in the teaching-learning process, especially in the first years of the nursing course.

PMID:34605537 | DOI:10.1590/1980-220X-REEUSP-2021-0209

Mymensingh Med J. 2021 Oct;30(4):1163-1167.

ABSTRACT

Various yogic practices focus on breathing. Breathing may affect brain waves. This cross-sectional study was conducted to see the effect slow and deep respiration on EEG activity in experienced Yoga practitioners at the Department of Physiology at AIIMS, Bhopal, India. The duration of the study was about one year. EEG was taken and was analyzed by Dinamika – Advanced Test System, Moscow, Russia. Paired t-test using graph pad software was used for statistical analysis. The Delta percentage decreased and the other wave’s percentages theta, alpha, and beta increased significantly. The person becomes deeply relaxed and more focussed on slow and deep breathing.

PMID:34605491

Mymensingh Med J. 2021 Oct;30(4):1131-1138.

ABSTRACT

The objective of this study was to determine whether Magnetic Resonance Imaging is a sensitive and specific alternative method to clinical FIGO criteria in the staging of cervical carcinoma. This prospective cross-sectional study was conducted in the Department of Radiology and Imaging, BSMMU, Dhaka during the period of September 2018 to August 2020. A total of 60 patients were selected purposively and all are staged clinically by EUA. Then all samples underwent MRI in Department of Radiology and Imaging, BSMMU. Images of uterine cervix, corpus, vagina and parametrium were taken with a prefixed standard protocol (TIWI axial, T2WI axial and sagittal, DWI axial & DCE) and reporting was done by Radiologist. Comparison was done between the MRI and clinical FIGO criteria of staging of cervical carcinoma. P value <0.05 was considered as significant. Sensitivity & specificity of the MRI was measured. Data were analyzed by using Statistical Package for Social Sciences (SPSS) software version 23.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Out of 60 patients in this study the mean age was found 47.5±10.1 years with range from 22 to 60 years. Positive correlation (r=0.993; p=0.001) between histopathological size and MRI size of tumour. Positive correlation (r=0.950; p=0.001) between histopathological size and FIGO size of tumour. MRI findings more correlates with histopathology than clinically detected tumor size. The sensitivity, specificity, accuracy, positive and negative predictive values of MRI diagnosis evaluation for vaginal extension was 100.00%, 95.20%, 100.00%, 98.30% and 97.50% respectively. Sensitivity, specificity, accuracy, positive and negative predictive values of MRI diagnosis evaluation for parametrial invasion was 100.00%, all. In this study we observed that MRI staging was more likely to be concordant with pathological stage in comparison to the clinical stage. There was a concordance rate of 95.00% in MRI and 65.00% in clinical staging respectively. Out of 3 non-concordant cases in MRI, 2 were upstaged and 1 case was down staged in histopathology. FIGO staging concurred with histopathology in 39(65.00%) cases and differed in 21(35.00%) cases. Magnetic resonance imaging (MRI) is a sensitive and specific modality for accurate staging of cervical carcinoma in comparison with clinical FIGO criteria considering histopathology as gold standard.

PMID:34605487

Mymensingh Med J. 2021 Oct;30(4):1079-1085.

ABSTRACT

Complete assessment of obstructive jaundice requires the use of various imaging modalities that are required to detect the cause and level of obstruction thus helping in treatment planning. Magnetic Resonance Cholangio Pancreatography (MRCP) is a current available technology which is a non-invasive technique that visualizes the gallbladder, biliary tree and pancreatic duct and also provides information about surrounding structures. This study was done to correlate the MRCP findings with post-operative result and thereby demonstrate the specificity, sensitivity and efficacy of MRCP as an accurate investigatory tool for biliary obstruction. Total of fifty (50) patients of clinically diagnosed obstructive jaundice were studied from March 2017 to August 2017 in the Department of Radiology and Imaging, Combined Military Hospital, Dhaka, Bangladesh. In all these cases, USG was the initial screening investigation followed by MRCP. Cause and level of obstruction were evaluated using MRCP findings. MRCP results were correlated with surgical findings and few cases also with direct ERCP findings. Statistical analysis was done to see the sensitivity, specificity, accuracy, positive and negative predictive values of MRCP in diagnosis of biliary obstruction. In this study, USG detected level of obstruction in 56% (28 out of 50) cases. USG could detect causes of obstruction in 100% (02 out of 02) cases of choledocal cyst and 66.67% (02 out of 03) benign stricture, 60% (03 out of 05) cases of periampullary carcinoma, 57.70% (06 out of 14) cases of choledocholithiasis, and 42.86% (15 out of 26) cases of cholangiocarcinoma. On the other hand, MRCP detected level of obstruction in 98% (49 out of 50) cases. MRCP could detect causes of obstruction in 100% cases of cholangiocarcinoma, choledocholithiasis, benign stricture and choledocal cyst and 80% (04 out of 05) cases of periampullary carcinoma. In this study, ERCP could detect causes of obstruction in 32 cases of choledocholithiasis and benign stricture, but in case of cholangiocarcinoma ERCP was failed in 3 cases. In this study, for detection of cause of obstruction, ERCP had the highest sensitivity (97.79%); followed by MRCP (96.65%) and USG (60.25%). The overall diagnostic accuracy for detection of cause of obstruction was the highest for ERCP (95.50%); followed by MRCP (94.50%) and USG (64.50%). MRCP can be done in a short duration and is a noninvasive diagnostic modality compared to ERCP. MRCP needs to be advocated as a viable and non-invasive alternative with compararable sensitivity and specificity to ERCP.

PMID:34605480

Mymensingh Med J. 2021 Oct;30(4):1009-1015.

ABSTRACT

This prospective study was conducted to find the rate of deep and risk factors associated with vein thrombosis following major abdominal surgery in Sylhet MAG Osmani Medical College Hospital from 1st November 2017 to 30th April 2018. Total 103 patients aged above 20 years both male and female who got admitted in Department of Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet for their disease requiring routine and emergency major abdominal operation during the study period and fulfilling the inclusion and exclusion criteria were selected in this study. Informed written consent was obtained from the patients after full explanation of the purpose of the study. After full investigations and proper preparation of each patient for operative procedure major abdominal surgery were done. Peroperative findings were noted and post-operative period were followed up routinely. Duplex scanning was done on 3rd POD in all cases. The age of the patients ranged from 25 to 74 years with the mean age of 49.5±13.8 years. There were 60(58.3%) male and 43(41.7%) female. Deep vein thrombosis (DVT) developed in 5(4.9%) of cases and not developed in 98(95.1%) cases. All the five cases were confirmed by color duplex scan. DVT was detected in 2(3.3%) of the 60 males and 3(7.0%) of the 43 females undergoing major general surgical procedures. Among 63 patients in whom the duration of surgery was up to 2 hours, none developed DVT, while among the 40 patients in whom the duration of surgery lasted more than 2 hours, 5(12.5%) developed DVT. Among 23 patients in whom the surgery for malignancy was done, 4(17.4%) developed DVT, while among the 80 patients in whom surgery for non-malignancy, 1(1.2%) developed DVT. The Incidence of DVT in patients undergoing major abdominal surgery is 4.9%. Patients undergoing major abdominal surgery for malignancy and duration of operation greater than 2 hours have higher risk of developing DVT. But there is no significant increase in risk of development of DVT relation to age and sex; and also in patients on oral contraceptives, diabetes mellitus, obesity and smoking. Clinical findings alone cannot be relied upon for the diagnosis of DVT. The study has to be continued with larger sample size to get statistically significant results.

PMID:34605471

Mymensingh Med J. 2021 Oct;30(4):913-920.

ABSTRACT

Peripheral neuropathy caused by diabetes mellitus (DM) and vitamin B12 deficiency may produce overlapping clinical pictures. Metformin use is a known cause of B12 deficiency in patients with type 2 DM (T2DM). This cross-sectional comparative study was conducted at two specialized endocrine outpatient clinics in Mymensingh and Cumilla cities of Bangladesh over one year from July 2019 to June 2020. Non-pregnant adults (≥18 years of age) receiving drug treatment for T2DM for at least six months were included in this study. The study subjects were divided into two groups: those with ongoing treatment with metformin and those who never received metformin in their lifetime. Out of 99 subjects evaluated, 66 (66.7%) were in the metformin group, and 33 (33.3%) were in the non-metformin group. Subjects in the metformin group had significantly lower B12 levels compared to the non-metformin group [448.5 (343.0-570.9) vs. 549.0 (487.5-847.0) pg/mL, median (IQR), p<0.001]. None of the study subjects in the non-metformin group were either borderline deficient or deficient of B12 compared to five borderline deficient and three deficient subjects in the metformin group. Among the study subjects, 88.9% had peripheral neuropathy (PN) (43.4% mild, 21.2% moderate and 24.2% severe PN); the two groups had similar frequencies of PN. Though median serum B12 levels were lower in mild [483.0 (411.2-620.0) pg/mL], moderate [492.0 (366.5-680.0) pg/mL] and severe PN [524.5 (363.5-654.2) pg/mL] groups compared to absent PN group [540.0 (340.0-685.0) pg/mL]; the difference in B12 levels across the four groups was not statistically significant. B12 levels had weak negative correlation (r = -0.061, p = 0.624) with gram-years of metformin use. Periodic screening for serum vitamin B12 levels should be done to identify metformin-induced B12 deficiency in T2DM, especially those with PN.

PMID:34605456

Acta Crystallogr D Struct Biol. 2021 Oct 1;77(Pt 10):1282-1291. doi: 10.1107/S2059798321009475. Epub 2021 Sep 29.

ABSTRACT

In 2020, cryo-EM single-particle analysis achieved true atomic resolution thanks to technological developments in hardware and software. The number of high-resolution reconstructions continues to grow, increasing the importance of the accurate determination of atomic coordinates. Here, a new Python package and program called Servalcat is presented that is designed to facilitate atomic model refinement. Servalcat implements a refinement pipeline using the program REFMAC5 from the CCP4 package. After the refinement, Servalcat calculates a weighted F_o – F_c difference map, which is derived from Bayesian statistics. This map helps manual and automatic model building in real space, as is common practice in crystallography. The F_o – F_c map helps in the visualization of weak features including hydrogen densities. Although hydrogen densities are weak, they are stronger than in the electron-density maps produced by X-ray crystallography, and some H atoms are even visible at ∼1.8 Å resolution. Servalcat also facilitates atomic model refinement under symmetry constraints. If point-group symmetry has been applied to the map during reconstruction, the asymmetric unit model is refined with the appropriate symmetry constraints.

PMID:34605431 | DOI:10.1107/S2059798321009475

Arch Esp Urol. 2021 Oct;74(8):762-767.

ABSTRACT

INTRODUCTION: Prostate cancer is thesecond most common neoplasm in men. The prostate biopsy is the fundamental support for the therapeutic decision, the histopathological results of the surgical piece differ from those obtained in the diagnostic prostate biopsy generating under-staging or over-staging inpatients.

MATERIALS AND METHODS: This study collects data from a total of 147 patients who under went radicalrobot-assisted prostatectomy at the Carlos Andrade Marín Hospital in the period January 2016 to December 2018, a statistical analysis is performed by the Chisquared test with a significance level of 5%.

RESULTS: The percentage agreement of prostate biopsy with the histopathological result of the surgical piece was 49%, over-staging was 14% and under-staging was 35%. The Gleason score most commonly found in this study was 6 (3 + 3) both in prostate biopsy and in the radical prostatectomy surgical piece. There were 3 patients with vanishing prostate cancer in this study group.

CONCLUSIONS: The agreement of the prostate biopsy in relation to the surgical piece of radical prostatectomy is in the context of that reported in international studies, over staging does not represent a major health problem since patients could benefit from the radical prostatectomy but under-Staging could lead to the decision not to provide the patient a curative treatment of his disease tobe referred to an active surveillance protocol. Vanishing prostate cancer in this study group is explained by the use of hormonal blockade with leuprolideacetate prior to surgical treatment in two patients and a low tumor invasion in the histopathology sample of the third patient.

PMID:34605416