Tag: nevin manimala

Obstet Med. 2024 Jul 25:1753495X241263135. doi: 10.1177/1753495X241263135. Online ahead of print.

ABSTRACT

BACKGROUND: Transthoracic echocardiography, a validated tool for risk assessment in non-pregnant population with sickle cell disease (SCD), uses tricuspid regurgitant velocity (TRV) over 2.5 m/s is an independent mortality risk factor. Its applicability in obstetrics lacks sufficient evidence.

METHODS: In this multicenter retrospective cohort study across five tertiary centers, we aimed to validate TRV as a determinant of increased maternal and fetal risk. Data was collected on 93 women and included 21 patients with TRV of at least 2.5 m/s. The maternal primary composite outcome included occurrence of vaso-occlusive crisis, acute chest syndrome, gestational hypertension, preeclampsia, and mortality. The fetal primary composite outcome comprised perinatal mortality, premature delivery, reduced birth weight, and fetal distress.

RESULTS: Adverse maternal and fetal events arose in both groups with no statistical difference.

CONCLUSION: This study cannot support TRV of 2.5 m/s or more as an independent predictor of adverse obstetric outcomes among women with SCD.

PMID:39553170 | PMC:PMC11563517 | DOI:10.1177/1753495X241263135

Cureus. 2024 Oct 16;16(10):e71587. doi: 10.7759/cureus.71587. eCollection 2024 Oct.

ABSTRACT

Background Currently, there is no known correlation between relevant parameters of respective non-adjacent spinal segments, which suggests the possibility of a third external factor. To our knowledge, no study has examined the humeral head position in consideration of spinal sagittal alignment.This study aims to establish new parameters related to the humeral head axis and evaluate the relationship between the axis of the humeral head and spinal sagittal alignment in asymptomatic volunteers. Methods Standing posteroanterior and lateral radiographs of the entire spine were obtained from 62 asymptomatic volunteers. We analyzed the relationship of the newly established parameters related to the humeral head axis We analyzed the relationship of the newly established parameters related to the humeral head axis and other established spinal parameters. The new parameters are: shoulder tilt (ST: the angle between a line drawn from the center of the humeral head to the center of the superior endplate of T1 and vertical line through the center of the humeral head), shoulder incidence (SI: the angle between a line perpendicular to the upper endplate of the T1 vertebra and a line joining the center of the upper endplate of the T1 vertebra and the axis of the humeral head), shoulder pelvic angle (SPA: the angle between a line joining the axis of the humeral head and the femoral head and a line joining the axis of the femoral heads and the center of the upper endplate of the S1 vertebra), C2 shoulder angle (C2SA: the angle between a line joining the C2 body center and the axis of the humeral head and a line joining the axis of the humeral head and the center of the upper endplate of the T1 vertebra). Statistical analysis was performed using Pearson’s correlation coefficient. Results Mean ST, SI, SPA, and C2SA were 20.0±20.6°, 43.7±21.6°, 7.7±6.6°, and 17.8±13.5° respectively. The SI was found to be correlated with pelvic tilt (r=0.373), lumbar lordosis (r=0.351), and thoracic kyphosis (r=0.469). Pelvic incidence was correlated with SPA (r=0.724), T1 pelvic angle (r=0.691), and C2 pelvic angle (r=0.667). Correlations were observed between SPA and T1PA (r=0.955) and C2PA (r=0.956), and between TIPA and C2PA (r=0.985). Conclusions This report introduced novel parameters related to humeral head position and confirmed their correlation with sagittal alignment from the cervical spine to the pelvis. Humeral head position may play a role in maintaining spinal sagittal balance.

PMID:39553153 | PMC:PMC11565215 | DOI:10.7759/cureus.71587

Cureus. 2024 Oct 18;16(10):e71756. doi: 10.7759/cureus.71756. eCollection 2024 Oct.

ABSTRACT

Background There is not much data regarding the effect of plasma glucose on thyroid hormones. Currently, there is no consensus regarding the timing of blood sample collection for thyroid hormones. Evaluation of the correlation between plasma glucose and thyroid hormones may enhance pathophysiological understanding of postprandial thyroid stimulating hormone (TSH) decline. Objectives To study the effect of pre-and postprandial plasma glucose levels on thyroid hormones. Methodology A cross-sectional study was done among participants aged 18 years and above after obtaining informed consent. Venous blood samples for fasting and postprandial plasma glucose, fasting, and postprandial thyroid profile ((FT3), (FT4), and TSH) were collected. The association was studied using the t-test and chi-square test between groups, while correlation using Pearson’s correlation coefficient. A p-value of <0.05 was considered statistically significant. Results Among the 197 participants, 126 (64%) were female and 71 (36%) were male. The mean (± S.D.) of age was 43.74 (± 12.62) years. Mean (± S.D.) postprandial TSH (4.31 μU/ml (± 7.79)) and free T3 (285.52 pg/dl (± 32.46)) were less than the fasting values (4.99 μU/ml (± 7.78)) and (295.84 pg/dl (± 32.56)). The mean (± S.D.) of both fasting and postprandial TSH and free T4 were less in the high plasma glucose group compared to the normal plasma glucose group (fasting state p-values 0.005, <0.0001 & postprandial state p-values 0.016, <0.0001). The correlation between fasting plasma glucose and fasting TSH values (Pearson correlation; r=-0.18; p-value 0.232) was observed across all the plasma glucose ranges. Conclusion There is a significant postprandial decline in TSH levels than the fasting TSH, indicating that there is a plasma glucose-mediated reduction in TSH values.

PMID:39553151 | PMC:PMC11569395 | DOI:10.7759/cureus.71756

Cureus. 2024 Oct 16;16(10):e71588. doi: 10.7759/cureus.71588. eCollection 2024 Oct.

ABSTRACT

Amphotericin B deoxycholate (AMPH-B) is a polyene macrolide with antifungal activity. Liposomal AMPH-B (L-AMB) was developed to reduce side effects while maintaining antifungal activity. This study was aimed at evaluating and comparing the adverse event profiles of AMPH-B and L-AMB using a spontaneous reporting system. We analyzed the adverse event reports of AMPH-B and L-AMB from the United States Food and Drug Administration Adverse Event Reporting System (FAERS). Case report counts of adverse events were generated according to the preferred terms of the Medical Dictionary for Regulatory Activities (MedDRA). Standardized MedDRA queries (SMQs) and system organ classes (SOCs) were used to compare the organ-specific adverse event profiles of AMPH-B and L-AMB. The reporting odds ratio and proportional reporting rate were used to detect pharmacovigilance signals. The FAERS database contains 21,173,818 cases from January 2004 to March 2024. Adverse events were reported in 2438 cases receiving AMPH-B treatment and 3344 cases receiving L-AMB treatment, including 848 and 1591 cases receiving intravenous AMPH-B and L-AMB injections, respectively. The most frequently reported drug-related adverse event in the AMPH-B and L-AMB groups was hypokalemia. SOCs with statistically significant differences were “Inv” (laboratory tests), “Resp” (respiratory, thoracic, and mediastinal disorders), “Genrl” (general and systemic disorders and conditions at the site of administration), “Card” (cardiac disorders), and “Blood” (blood and lymphatic system disorders). No statistically significant difference was observed in the SMQ profile of adverse events in “Renal” (renal and urinary disorders) and “Hepat” (hepatobiliary disorders) between the L-AMB and AMPH-B formulations in this study. Based on real-world data from FAERS, adverse event profiles of AMPH-B and L-AMB were compared. No statistically significant difference was observed in the SMQ profile of adverse events in the renal and hepatic SOCs between the L-AMB and AMPH-B formulations. Our results suggest that L-AMB is more tolerated by the kidneys than AMPH-B.

PMID:39553150 | PMC:PMC11565214 | DOI:10.7759/cureus.71588

Cureus. 2024 Oct 16;16(10):e71639. doi: 10.7759/cureus.71639. eCollection 2024 Oct.

ABSTRACT

Non-alcoholic fatty liver disease (NAFLD) has emerged as a major global health concern due to its association with increased mortality. While previous studies have indicated a link between NAFLD and mortality, variations in risk factors such as age, sex, and disease severity warrant a comprehensive meta-analysis to clarify these associations. This meta-analysis aimed to evaluate the overall cardiovascular disease (CVD) mortality risk associated with NAFLD, considering various subgroups defined by age, sex, disease severity, presence of cirrhosis or fibrosis, study quality, and follow-up duration. A systematic search of eight studies was conducted to assess the hazard ratios (HRs) for all-cause and CVD mortality associated with NAFLD. Heterogeneity among studies was evaluated using the I² statistic, and subgroup analyses were performed based on participant age, sex, disease severity, presence of cirrhosis or fibrosis, study quality, and follow-up duration. NAFLD was significantly associated with an increased risk of all-cause mortality (HR = 1.34, 95% CI: 1.17-1.54, I² = 80.0%). Subgroup analyses revealed that individuals aged ≥50 years (HR = 1.50, 95% CI: 1.31-1.73) and males (HR = 1.43, 95% CI: 1.29-1.59) had a higher mortality risk. Patients with nonalcoholic steatohepatitis (NASH) showed a significant association with both overall (HR = 1.37, 95% CI: 1.14-1.65) and CVD mortality (HR = 1.56, 95% CI: 1.25-1.97). The presence of cirrhosis or fibrosis further elevated the risk of mortality (HR = 3.22, 95% CI: 2.40-4.33). However, NAFLD was not significantly associated with CVD mortality in the overall analysis (HR = 1.13, 95% CI: 0.92-1.38). Heterogeneity was high across most subgroups, indicating varying effects based on study characteristics. NAFLD is significantly associated with increased all-cause mortality, particularly in older individuals, males, and those with NASH or cirrhosis/fibrosis. The association with CVD mortality was not significant in the overall analysis but was evident in specific subgroups. These findings underscore the importance of early detection and tailored management of NAFLD to mitigate its impact on mortality. Further research is needed to elucidate the mechanisms linking NAFLD with adverse health outcomes and to develop effective interventions.

PMID:39553144 | PMC:PMC11567170 | DOI:10.7759/cureus.71639

Cureus. 2024 Oct 16;16(10):e71611. doi: 10.7759/cureus.71611. eCollection 2024 Oct.

ABSTRACT

INTRODUCTION: The modified OXIS (O – open contact, X – point contact, I – straight contact, S – curved contact) classification provides a useful framework for assessing interproximal contacts in primary canines and predicting caries risk. The study aimed to assess the incidence of modified OXIS classification of canine interproximal contacts in six-to-nine-year-old children from the Delhi National Capital Region (NCR) population.

METHODS: A cross-sectional study was conducted to assess the interproximal contact areas between primary canine and first molar among six-to-nine-year-old children (n=400) according to the modified OXIS classification using the die stone study model. A single calibrated examiner performed a type III examination to assess a total of 1,536 contact areas from the occlusal aspect. The prevalence of each type was reported in terms of both numbers and percentages using the Chi-square test to find the prevalence, Fisher’s exact test to compare the inter- and intra-arch occurrence of the different contact types, and Kruskal-Wallis test to find its correlation with age.

RESULTS: The Chi-square test showed that the most common contact type was I at 46.55% (715), followed by S1 at 28.06% (431), X at 18.56% (285), O at 6.19% (95), and S2 at 0.65% (10). The p-value of 0.000 indicated a statistically significant difference among the groups. The Kruskal-Wallis test found no statistically significant differences in patient ages. Additionally, Fisher’s exact test demonstrated a statistically significant prevalence of types O, I, and S1 when comparing them across arches.

CONCLUSION: Based on the current study, the most common contact type observed was type I, followed by type S1, according to the modified OXIS criteria. The findings indicate a higher prevalence of closed-type contacts in this population, suggesting that the occurrence of such contacts increases as permanent teeth erupt. This tool may be useful for assessing caries risk in this age group.

PMID:39553136 | PMC:PMC11566099 | DOI:10.7759/cureus.71611

Cureus. 2024 Oct 17;16(10):e71682. doi: 10.7759/cureus.71682. eCollection 2024 Oct.

ABSTRACT

Background Rock climbing is becoming increasingly popular in Singapore resulting in an increasing number of rock-climbing-associated injuries requiring surgery. The main objective of this study is to evaluate the demographics, mechanism, and extent of injuries in patients admitted following rock-climbing-related injuries over a seven-year period. Method All patients admitted to the Department of Orthopedic Surgery between January 2017 and December 2023 with injuries related to rock-climbing accidents were recruited. Data collection was performed retrospectively on the patient profile, day and time of injury, type of rock climbing, mechanism, pattern, and the extent of injury. Results Across 22 patients, 68.4% of injuries occurred in the afternoon, distributed equally across the week. Demographically, majority were young adults (27.3 + 7.8 years), female (77.3%) with a mean BMI of 23.67 + 3.27 kg/m². A total of 90.9% of them fell from height commonly resulting in fractures (95.5%), of which 54.5% sustained two or more fractures and 9.5% sustained open fractures. Comparatively, falling from a higher height resulted in multiple injuries, though not statistically significant. The two patients who sustained open fractures fell from a height of 2 m and 10 m. Lower limb injuries (72.7%) were more common than upper limb (18.2%) and spine (22.7%) injuries. A total of 90.9% of them required surgery, of which 36.8% required a second surgery. A relatively equal number of injuries were sustained from bouldering (45.5%) and sport climbing (54.5%). Females were shown to be more likely injured from bouldering than sport climbing (p = 0.040). A total of 100% of bouldering injuries occurred due to falls from height, while 16.7% of injuries during sport climbing were due to laceration or hand-hold injury. Patients who fell from sport climbing fell from a higher height of 3.35 + 2.6 m compared to bouldering at 2.5 + 0.9 m. Moreover, 33.3% of patients injured from sport climbing sustained multiple regions of injuries, two of which were open fractures, while all injured from bouldering only sustained injuries in a single region, only sustained closed fractures, and none affected the upper extremity. A total of 100% of bouldering injures and 80% of sport-climbing injuries required surgery where around 37% of patients in both groups required repeat surgery. Patients with sport-climbing injuries had a longer length of hospital stay (13.8 + 18.3 days) and duration of hospitalization leave (dHL) (81.3 + 45.5 days) compared to bouldering injuries. Conclusion Rock-climbing-associated injuries are predominantly caused by falls, commonly resulting in fractures requiring admission and surgical intervention, especially in the lower extremities. With increasing popularity and accessibility of the sport in Singapore, there is an expected increase in the number of orthopedic injuries. Injuries vary widely from lacerations to fractures of the extremities and spine to open fractures requiring emergency surgery. Proper safety precautions, equipment, training, and strict regulations for belay certification should be put in place to mitigate the risk of such injuries.

PMID:39553129 | PMC:PMC11568870 | DOI:10.7759/cureus.71682

Cureus. 2024 Oct 17;16(10):e71714. doi: 10.7759/cureus.71714. eCollection 2024 Oct.

ABSTRACT

Introduction Oral lichen planus (OLP) comprises a chronic inflammatory autoimmune disease observed in the oral cavity. It most commonly manifests as white papules arranged confluently, drawing a picture of white lines in the form of a network (reticular form). It may emerge in other forms as well. In our study, the erosive form presents the most clinical interest. Among the biomarkers that participate in the tumorigenesis process, DAPK-1 seems promising, rendering its study necessary. This study focuses on the investigation of the presence of the DAPK-1 using immunohistochemistry in OLP compared to oral squamous cell carcinoma (OSCC), oral leukoplakia (OL), a well-established oral potentially malignant disorder, and normal oral epithelium to evaluate its possible role as an early predictor of the possibility of malignant transformation risk of OLP lesions. Methods To monitor the expression profile of the tumor suppressor protein DAPK-1, an immunohistochemical detection took place in 18 samples of OLP (reticular and erosive type), in 22 OSCC samples of all degrees of differentiation, in 30 OL samples of all degrees of dysplasia, and five normal tissue samples used as the control group. To complete the above procedure, immunohistochemistry was used in a semiquantative manner. The paraffin-embedded tissue samples were selected from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, from biopsies performed in this department as well as from St. Lukas Hospital of Thessaloniki, Greece, between 2014 and 2019. The study was conducted per the Research and Ethics Committee guidelines of Aristotle University, School of Dentistry, and the Helsinki II declaration (protocol number 29/21.11.2018). Results The statistical analysis showed that there was no statistically significant difference in DAPK-1 staining between normal tissues and OLP (p=0.588, independent-samples Kruskal-Wallis test). On the other hand, there was a statistically significant difference between OSCCs and OLPs (p<0,001, independent-samples Kruskal-Wallis test), with the extent of expression of DAPK-1 being greater in OLP than in OSCC. In addition, there was a statistical difference in DAPK-1 expression between OLPs and OLs (p=0,001, independent-samples Kruskal-Wallis test), with DAPK-1 being expressed more in OLP than in OL. Conclusion The DAPK-1, as a pro-inflammatory with its role as a tumor suppressor factor, was highly expressed in OLP, both reticular and erosive. The relatively milder expression of DAPK-1 in OL means that, between the two disorders, OLP is less likely to progress to oral cancer. On the other hand, OLP could also offer the background for further investigation of a possible correlation between methylation (immunohistochemical expression of proteins, deriving from potentially DNA-methylated genes) and the development of inflammation. It appears that DNA methylation is important in the regulation of inflammatory genes. Conversely, inflammation may regulate the DNA methylation of many genes involved in carcinogenesis and thus should be taken into account when studying the methylation behavior of genes such as DAPK-1 in pathologies characterized by a sparse inflammatory infiltrate.

PMID:39553125 | PMC:PMC11568832 | DOI:10.7759/cureus.71714

Cureus. 2024 Oct 29;16(10):e72667. doi: 10.7759/cureus.72667. eCollection 2024 Oct.

ABSTRACT

BACKGROUND: Understanding the attributes of vertical patterns is essential for delivering optimal orthodontic care. Cone-beam computed tomography (CBCT) represents a valuable resource for assessing the buccolingual inclination of the teeth. The present research delves into examining the buccolingual inclination of premolars in nongrowing individuals exhibiting diverse vertical facial patterns.

METHODS: CBCT scans of 66 adult patients (31 males and 35 females), mean age 31.6 years (SD = 6.4 years), exhibiting class II division I maxillomandibular relationships, were employed. Participants were categorized into three groups based on linear and angular measurements: normodivergent group (n = 22), hypodivergent group (n = 22), and hyperdivergent group (n = 22). The independent samples t-test and Mann-Whitney U test were conducted to investigate statistical differences in the buccolingual inclination of the premolars among the three vertical patterns.

RESULTS: Statistically significant differences between the three groups were observed in the buccolingual inclinations of both maxillary and mandibular first and second premolars (p < 0.05). The upper right first premolars exhibited a significantly increased buccal inclination in the normodivergent group compared to the hypodivergent group (p < 0.05). In contrast, the two groups had no notable differences in the inclination of the remaining premolars. The upper right and left first premolars exhibited a significantly increased buccal inclination in the hyperdivergent group compared to the hypodivergent group (p < 0.05). In contrast, there were no notable differences in the inclination of the remaining premolars between the two groups. The lower left first premolars exhibited a significantly increased lingual inclination in the hyperdivergent group compared to the normodivergent group (p < 0.05). In contrast, the two groups had no notable differences in the inclination of the remaining premolars. The upper right second premolars exhibited a significantly increased buccal inclination, and the lower left second premolars exhibited greater lingual inclination in the normodivergent group than in the hypodivergent group (p < 0.05). In contrast, there were no notable differences in the inclination of the remaining premolars between the two groups. The upper right and left second premolars exhibited a significantly increased buccal inclination, and the lower left second premolars exhibited greater lingual inclination in the hyperdivergent group than in the hypodivergent group (p < 0.05). In contrast, there were no notable differences in the inclination of the lower right second premolars between the two groups. There were no notable differences in the inclination of the second premolars between the hyperdivergent and normodivergent groups.

CONCLUSIONS: In individuals presenting with class II relationships, the buccolingual inclinations of the first and second premolars exhibit similarities and variations across distinct facial patterns. As such, it is imperative for orthodontic practitioners to exercise meticulous consideration of these nuances throughout treatment.

PMID:39553121 | PMC:PMC11568827 | DOI:10.7759/cureus.72667

Cureus. 2024 Oct 17;16(10):e71724. doi: 10.7759/cureus.71724. eCollection 2024 Oct.

ABSTRACT

Background As populations age, musculoskeletal disorders significantly affect the quality of life (QOL) and functional independence of elderly individuals. While BMI is commonly used to assess nutritional status and is linked to physical function, the relationship between BMI reduction and improvements in activities of daily living (ADL) remains unclear in elderly patients with musculoskeletal disorders. This study aimed to explore this relationship in a rehabilitation setting. Methods This retrospective cohort study included 75 elderly patients (65 years and older) with musculoskeletal disorders admitted to a convalescent rehabilitation ward. Patients were categorized into two groups based on BMI reduction: those with a decrease of ≥0.7 kg/m² and those with <0.7 kg/m². Functional Independence Measure (FIM) scores were recorded at admission and discharge. Statistical analyses, including logistic regression, were conducted to examine the relationship between BMI reduction and FIM improvement. Results There was no significant difference in FIM gain between the BMI-reduced and non-BMI-reduced groups. Logistic regression analysis also found no significant association between BMI reduction and FIM improvement, even after adjusting for age, gender, length of stay, and initial FIM scores. Discussion The absence of a significant association may be due to factors such as postoperative swelling, comorbidities, and the predominance of female participants, who may experience less muscle mass loss. Study limitations include the lack of data on dietary intake and body composition. Future research should include broader assessments, such as muscle mass and swelling, to better evaluate rehabilitation outcomes in elderly patients with musculoskeletal disorders.

PMID:39553114 | PMC:PMC11568862 | DOI:10.7759/cureus.71724