Nevin Manimala

S Afr J Physiother. 2021 May 18;77(1):1524. doi: 10.4102/sajp.v77i1.1524. eCollection 2021.

ABSTRACT

BACKGROUND: A limited number of studies on the epidemiology of injuries and fitness profiles of netball players in South Africa have been conducted, but no research on the potential morphological and skill-related fitness predictors of injuries could be located.

OBJECTIVES: We investigated whether morphological or skill-related factors measured in the pre-season could predict injuries sustained in-season.

METHOD: In our cohort study, 77 under-18 (U18), U19, U21 and senior elite netball players underwent pre-season testing including anthropometry, balance, flexibility, explosive power, upper and lower body strength, core strength, speed and agility testing. A questionnaire was used to collect demographic data, elite-level experience and injury history. Injuries in pre-season, training and matches were recorded during the subsequent 2017-2018 season using an injury profile sheet.

RESULTS: Amongst the 77 players who underwent pre-season fitness tests, 33 players (42.9%) had at least one injury. Regarding player morphology, a significant association of body mass and body fat percentage with injury risk was found in a simple logistic regression. In a multiple logistic regression analysis, only fat percentage (p = 0.0508) remained a significant predictor of injury at the 10% significance level, with higher fat percentage being associated with lower injury risk.

CONCLUSION: Heavier players and players with a higher fat percentage had a decreased injury risk.

CLINICAL IMPLICATIONS: As a result of the apparent protective effect of heavier weight of players, referees should more strictly enforce the no-contact rule in netball. Further research on functional movement screening as a tool for potential prediction of injury in netball is recommended.

PMID:34192207 | PMC:PMC8182463 | DOI:10.4102/sajp.v77i1.1524

BMJ Paediatr Open. 2021 Feb 4;5(1):e000971. doi: 10.1136/bmjpo-2020-000971. eCollection 2021.

ABSTRACT

BACKGROUND: In Belgium, schools closed during the first lockdown in March 2020, with a partial reopening in May. They fully reopened in September. During the summer, infections started to increase in the general population, speeding up in September. Some measures were taken to limit social contacts but those were insufficient to mitigate the exponential rise of infections in October. Children were still receiving all lessons at school at that time and it was questioned whether this position was tenable. We systematically compared the benefits and harms of closing primary and secondary schools and developed a recommendation.

METHODS: A multidisciplinary panel, including school pupils and teachers, educational experts, clinicians and researchers, produced this recommendation in compliance with the standards for trustworthy rapid guidelines. The recommendation is based on data collected through national surveillance or studies from Belgium, and supported by a rapid literature review.

RESULTS: Closing schools during the first lockdown probably resulted in a large learning delay and possibly led to more cases of child abuse. We are uncertain about the effect on the infection rate, hospitalisations, transmission rates, mental health of children, teachers and parents. The panel concluded that the balance of benefits and harms of closing schools clearly shifts against closing schools. Detrimental effects are even worse for vulnerable children. This recommendation is affected by the local virus circulation.

CONCLUSION: The guideline panel issues a strong recommendation against closing schools when the virus circulation is low to moderate, and a weak recommendation against closing schools when the virus circulation is high. It does not apply when the school system cannot function due to lack of teachers, too many children who are at home or a shortage of support services. As the results of international studies are consistent with Belgian study results, this recommendation may also be relevant internationally.

PMID:34192193 | PMC:PMC7868123 | DOI:10.1136/bmjpo-2020-000971

BMJ Paediatr Open. 2021 Mar 15;5(1):e000967. doi: 10.1136/bmjpo-2020-000967. eCollection 2021.

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic and initial public health response led to significant changes in health service delivery, access and utilisation. However, SARS-CoV-2 illness burden in children and young people (CYP) is low. To inform effective child public health interventions, we aimed to compare patterns of paediatric emergency department presentation during the initial pandemic response with a previous non-pandemic period.

METHODS: Retrospective review of attendances (0-18 years) over the initial pandemic (2 March 2020-3 May 2020) compared with 2019. Outcome measures included number of attendances, referral source, presenting complaint, discharge diagnosis and disposal. Descriptive statistics with subgroup analysis by age/sex/ethnicity and pandemic time periods (pre-lockdown, lockdown weeks 1-3 and lockdown weeks 4-6) was performed.

RESULTS: 4417 attendances (57% illness and 43% injuries) occurred, compared with 8813 (57% illness and 43% injuries), a reduction of 50%, maximal in lockdown week 2 (-73%). Ranking of top three illness presentations changed across the pandemic weeks. Breathing difficulty dropped from first (300, 25%) to second (117, 21%) to third (59, 11%) (p<0.001). Abdominal pain rose from the third pre-lockdown (87, 7%) and lockdown weeks 1-3 (37, 7%) to second in weeks 4-6 (62, 12%; p=0.004). Fever ranked second (235, 19%) in pre-lockdown and first in weeks 1-3 (134, 24%) and weeks 4-6 (94, 18%; p=0.035).

CONCLUSIONS: Despite a 50% reduction, there was no significant change in acuity of illness. Rank of illness presentations changed, with abdominal pain ranking second and fever first, an important change from previous, which should prompt further research into causes. CYP-specific public health messaging and guidance for primary care are required in this second wave to ensure access to appropriate emergency services.

PMID:34192192 | PMC:PMC7969761 | DOI:10.1136/bmjpo-2020-000967

BMJ Paediatr Open. 2021 Feb 2;5(1):e000942. doi: 10.1136/bmjpo-2020-000942. eCollection 2021.

ABSTRACT

COVID-19 has significantly impacted young people’s lives yet little is known about the COVID-19 related sources of information they access. We performed a cross-sectional survey of pupils (11-16 years) in North Staffordshire, UK. 408 (23%) pupils responded to an online survey emailed to them by their school. Descriptive statistics were used to summarise the data. Social media, accessed by 68%, played a significant role in the provision of information, despite it not being considered trustworthy. 89% felt that COVID-19 had negatively affected their education. Gaps in the provision of information on COVID-19 have been identified.

PMID:34192190 | PMC:PMC7868121 | DOI:10.1136/bmjpo-2020-000942

BMJ Paediatr Open. 2020 Sep 22;4(1):e000801. doi: 10.1136/bmjpo-2020-000801. eCollection 2020.

ABSTRACT

OBJECTIVE: To describe and compare the effect of level 5 lockdown measures on the workload and case mix of paediatric patients presenting to a district-level emergency centre in Cape Town, South Africa.

METHODS: Paediatric patients (<13 years) presenting to Mitchells Plain Hospital were included. The level 5 lockdown period (27 March 2020-30 April 2020) was compared with similar 5-week periods immediately before (21 February 2020-26 March 2020) and after the lockdown (1 May 2020-4 June 2020), and to similar time periods during 2018 and 2019. Patient demographics, characteristics, International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) diagnosis, disposition and process times were collected from an electronic patient tracking and registration database. The χ² test and the independent samples median test were used for comparisons.

RESULTS: Emergency centre visits during the lockdown period (n=592) decreased by 58% compared with 2019 (n=1413) and by 56% compared with the 2020 prelockdown period (n=1342). The proportion of under 1 year olds increased by 10.4% (p<0.001), with a 7.4% increase in self-referrals (p<0.001) and a 6.9% reduction in referrals from clinics (p<0.001). Proportionally more children were referred to inpatient disciplines (5.6%, p=0.001) and to a higher level of care (3.9%, p=0.004). Significant reductions occurred in respiratory diseases (66.9%, p<0.001), injuries (36.1%, p<0.001) and infectious diseases (34.1%, p<0.001). All process times were significantly different between the various study periods.

CONCLUSION: Significantly less children presented to the emergency centre since the implementation of the COVID-19 lockdown, with marked reductions in respiratory and infectious-related diseases and in injuries.

PMID:34192174 | PMC:PMC7509946 | DOI:10.1136/bmjpo-2020-000801

Exp Oncol. 2021 Jun;43(2):159-167.

ABSTRACT

BACKGROUND: To date, BRAF mutations in brain tumor patients have not been characterized in the Malaysian population. Based on the numerous reported studies, there are main mutations that exist in BRAF gene in various types of cancers. A missense mutation in codon 600 of the BRAF nuclear oncogene (BRAF^V600E) is the most prevalent hotspot point mutation that has been identified in multiple human malignancies.

AIM: We here aimed to find out the frequency of BRAF^V600E mutation in a series of Malaysian patients with brain tumors and if any association exists between BRAF^V600E mutation and clinicopathological features of patients.

MATERIAL AND METHODS: Fresh frozen tumor tissue samples from 50 Malaysian brain tumor patients were analyzed for BRAF^V600E mutational status, and its correlation with clinicopathological features (including age, gender, and tumor localization such as intra-axial: within the brain substance or extra-axial: outside the brain substance) was examined.

RESULTS: The overall BRAF^V600E mutation frequency was determined to be 22% (in 11 of 50 patients). BRAF^V600E was significantly correlated with the tumor location group, which shows BRAF^V600E was more frequent in the intra-axial tumor than the extra-axial tumor group. In this study, we also observed that male patients were slightly more susceptible to BRAF^V600E mutation, and this mutation was predominant in patients of the age group < 40 years. However, these parameters did not translate to statistical significance.

CONCLUSION: The data demonstrate that BRAF^V600E mutation is observed significantly more often in intra-axial brain tumor patients, which can serve as baseline information for further research on genetic alteration that occurs during brain tumor progression in the Malaysian population.

PMID:34190524

Exp Oncol. 2021 Jun;43(2):149-154.

ABSTRACT

BACKGROUND: Genetic predisposition to breast cancer (BC) has been extensively explored to achieve an enhanced understanding of the biology of BC. Targeting candidate genes to screen different genetic variants such as RAD51 gene that plays a critical role in DNA repair pathways including the double-strand break repair system is an important task.

AIM: To study several single nucleotide polymorphisms (SNPs) within RAD51-UTR gene and to find their relationship with BC risk and prognosis among Jordanian females.

MATERIALS AND METHODS: In this case-control study, DNA sequencing technique was used to screen SNPs within the untranslated region (UTR) of RAD51 in 206 cases and 185 controls and the resulting data were statistically analyzed using different types of genetic analyses. Patients’ clinical and pathological features were obtained from their medical records to perform genotype-phenotype association analysis.

RESULTS: Our findings show a significant association between both SNPs rs528590644, rs1801320 and BC risk (p = 0.016). We estimated the correlation between many of BC prognostic factors and BC risk, and we found an association between rs1801321 and age at first menstruation (p = 0.032) in addition to a strong correlation between age at BC diagnosis and rs1801320 (p = 0.008).

CONCLUSION: RAD51-UTR polymorphisms may be involved in BC development and progression.

PMID:34190511

Med Glas (Zenica). 2021 Aug 1;18(2). doi: 10.17392/1353-21. Online ahead of print.

ABSTRACT

Aim To investigate the relationship between preoperative level of serum albumin in patients with colorectal cancer (CRC), stage of CRC and postoperative complications. Methods This cross-sectional retrospective study was conducted at the Clinic for General and Abdominal Surgery of the University Clinical Centre Sarajevo (UCCS). A total of 107 patients surgically treated for CRC in the period between 2013 and 2018 were enrolled in this study and divided into two groups: with hypoalbuminemia (group A) and without hypoalbuminemia (group B). Results The average level of albumin in group A was 29 (25-32) g/L versus 39 (37-41) g/L in group B (p<0.05). The average length of hospital stay in group A was 18 (13-25) days, and in group B 14.5 (12-21) days. Patients with hypoalbuminemia (group A) had wound dehiscence more often and more re-interventions compared to group B (p<0.05). Binary logistic regression found that serum protein, albumin and globulin levels were not statistically significant in the prediction of CRC stadium or postoperative complications (p>0.05). Conclusion Study results show that preoperatively measured levels of serum albumin are not associated with the stage of colorectal cancer and cannot serve as predictors for postoperative complications.

PMID:34190507 | DOI:10.17392/1353-21

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 May;29(3):560-566. doi: 10.32687/0869-866X-2021-29-3-560-566.

ABSTRACT

The article is devoted to the history of the emergence and functioning of departmental medical statistics in the German states in 1800-1871. The authors, on the basis of the analysis of German historiography, identify main actors, goals, methods of administration and representation of health statistics. Starting from the specifics of German terminology concerning the umbrella term “medical statistics” (“medizinische Statistik”, “Medizinalstatistik”, “sanitäre Statistik”, “Gesundheitsstatistik”), the authors elaborate in detail on the cases of the Bavarian and Prussian kingdoms. By the beginning of the XIX century, the mechanisms of building modern state were started up in these countries. In its functioning, it was primarily based on statistical surveys of people and territories. The gradual institutionalization of medical statistics, its complexification and enhancement are considered in the context of state bureaucratic system reforming. The analysis of historical research results permitted to generate cumulative picture of becoming and development of medical statistics in Bavaria and Prussia. The study of transformation of reporting forms allowed to see how the bureaucratic institutions, by means of statistical methods, sought to rate the “death” and “health” of population.

PMID:34190494 | DOI:10.32687/0869-866X-2021-29-3-560-566

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2021 May;29(3):481-485. doi: 10.32687/0869-866X-2021-29-3-481-485.

ABSTRACT

The issues of protecting the health of the children and adolescent population of Russia require detailed study of the regional characteristics of the indices of physical development, determined by anthropometric growth and weight criteria. The purpose of the study is to analyze the regional characteristics of average height and weight anthropometric indices of children of school age (7-17 years) living in various regions of the Russian Federation. The assessment of statistically significant differences in average height and weight anthropometric indices children of school age was carried out to establish the basis of developing normative indices of 10 regional “Standards of physical development of children of school age (7-17 years old)” covering such Federal Okrugs as the Central (Kostroma), North-West (St. Petersburg), North Caucasian (Makhachkala, Grozny, Vladikavkaz), Privolzhsky (Kazan, rural areas of the Republic of Tatarstan, Cheboksary ) and Far East (Yakutsk, Yuzhno-Sakhalinsk). For the first time the statistical analysis considered simultaneously the anthropometric data of the population sample of the examined children of health groups I and II (healthy and practically healthy). Namely, 41030 persons were allocated to conditional age groups: junior (7-9 years), middle (10-14 years) and senior (15-17 years old) school age. The differences in regional height and weight indices of physical development of children were statistically significant only in groups of comparison of indices of height and body weight of schoolchildren in the older age group.

PMID:34190480 | DOI:10.32687/0869-866X-2021-29-3-481-485