Tag: nevin manimala

Vet Res Commun. 2024 Nov 26;49(1):40. doi: 10.1007/s11259-024-10610-x.

ABSTRACT

The aim was to compare the outcomes acquired from the OSA-Vet^® device with conventional quantitative and qualitative tear tests and between groups within each test, in brachycephalic dogs both healthy and those diagnosed with keratoconjunctivitis sicca. The dogs were divided into four groups: healthy dogs (HD), with mild KCS (MIKCS); moderate KCS (MOKCS); severe KCS (SKCS). All patients underwent ocular surface diagnostic examination in the following order, with a 10-minute interval between tests: non-invasive tear film breakup time (TBUTNI – OSA-Vet^®), tear meniscus height (TMH-OSA-Vet^®), meniscometry (I-Tear^® test), Schirmer Tear Test-1 (STT-1), and tear film breakup time (TBUT). Kruskal-Wallis H tests were performed to establish the difference between the groups and Spearman´s correlation coefficient test to assess the correlation between tests. And an analysis of variance (ANOVA) followed by Tukey-Kramer post-hoc test was performed for TMH. Results with (p <.05) were considered statistically significant. The correlation of conventional tests in relation to those obtained by OSA-Vet^® proved to be low, except between TBUTNI (OSA-Vet^®) and TBUT in MOKCS, with a strong correlation (r =.925). In the comparison between TBUTNI (OSA-Vet^®) and TBUT in MIKCS the correlation was moderate (r =.547) as well as STT-1 and I-Tear^® test in MOKCS (r =.416). In the comparison between groups, the main result observed was a significant difference between all the KCS groups and HD, in the TBUT and TBUTNI (OSA-Vet^®) test. The OSA-Vet^® and conventional tests are useful for evaluating the ocular surface of brachycephalic dogs. However, the OSA-Vet^® does not correlate well with conventional standardized tests.

PMID:39589642 | DOI:10.1007/s11259-024-10610-x

Oral Radiol. 2024 Nov 26. doi: 10.1007/s11282-024-00789-9. Online ahead of print.

ABSTRACT

AIM: The present radiographic study was conducted to assess the subject and tooth prevalence of dilaceration in a cohort of Tamil population aided by morphometric analysis.

MATERIALS AND METHODS: After obtaining clearance from institutional human ethical clearance committee, 575 panoramic radiographs were retrieved. After exclusion of 233 radiographs based on the inclusion and exclusion criteria, a total of 342 panoramic radiographs were included. The angulation was estimated on Angle Meter software and categorized into three classes as mild, moderate and extreme. The data were recorded on Microsoft Excel spreadsheet 2021, and descriptively analyzed using IBM SPSS software.

RESULTS: Of the 342 subjects, there were 172 males and 170 females (1.012M:1F). Overall mean age was 33.75 ± 13.86 years. 100/342 subjects showed dilaceration in one or more teeth yielding a subject prevalence of 29.24%. There was no statistically significant difference in age and gender between the individuals who showed dilaceration and those without. The tooth prevalence was 1.49% (150/10089). The mandibular third molars were the most commonly affected teeth. Further, 97/150 teeth were mildly dilacerated (64.67%), 34/150 teeth showed moderate dilaceration (22.67%) and extreme dilaceration was noted in 19 teeth (12.66%).

CONCLUSION: Within the limits of the present study, we reported morphometric analysis of dilacerated teeth from South Indian population after examination of permanent 10,089 teeth from 342 panoramic radiographs. Mandibular third molars were the most commonly affected teeth, which led us to speculate that dilaceration is a true developmental anomaly, unrelated to trauma or other external stimuli.

PMID:39589640 | DOI:10.1007/s11282-024-00789-9

Updates Surg. 2024 Nov 26. doi: 10.1007/s13304-024-02039-3. Online ahead of print.

ABSTRACT

Long-term survivors after pancreatic resection for PDAC are rare, constituting a specific subset of patients that remains poorly understood. The aim of this survey is to describe the current landscape related to survival in the Italian context and identify factors associated with long-term survival. An online survey, conducted by the Italian Society of Oncological Surgery (SICO) and endorsed by Italian Association of the Study of the Pancreas (AISP) and Italian Association of Hepatobiliary Pancreatic Surgery (AICEP), was distributed to surgeons in July 2023. The survey included 27 multiple-choice questions covering demographics, professional details, clinical practices, and long-term survival data. Responses were analyzed using descriptive statistics and multinomial logistic regression to identify factors related to long-term survival. The majority of surgeons (46.9%) considered LTS as “alive at 5 years, regardless of disease-free status”. The percentage of patients alive at 5 years post-2013 was higher compared to pre-2013. Almost all centers (93.2%) held multidisciplinary discussions. Very high-volume centers (> 100 resections/year) in comparison to very low-volume (< 10 resections/year) showed better long-term survival rates. No difference in survival were observed between centers with low, medium, high, and very high volumes. In addition, centers with multidisciplinary approach showed better survival rates. Centers with more neoadjuvant chemotherapy rates, low-grade and low-stage tumors were also associated with improved survival outcomes. This survey has allowed to understand the Italian scenario regarding survival in patients undergoing surgery for PDAC.

PMID:39589628 | DOI:10.1007/s13304-024-02039-3

Health Econ Rev. 2024 Nov 26;14(1):98. doi: 10.1186/s13561-024-00566-8.

ABSTRACT

BACKGROUND: The incomplete immunization has potentially exposed vulnerable children, especially from the socioeconomically disadvantage group, to vaccine preventable diseases. The schemes would maximize social benefit only when the immunization is effectively distributed on an equitable principle.

METHOD: The empirical study is based on unit level data from India’s National Sample Survey: “Social Consumption: Health Survey- NSS 75th Round (2017-18) database. The nationwide survey is designed on the stratified multi-stage sampling method with an objective to make the sample representative. The egalitarian equity principle requires that distribution of vaccine should be based on health needs of children, irrespective of their socioeconomic and regional factors and the principle is broadly based on two aspects – horizontal and vertical equity. The horizontal inequity (HI) is a direct form of injustice, when children with equal needs of routine immunisation are treated differentially due to their socioeconomic status, while vertical inequity (VI) is indirect form of injustice when children with differential health needs and risks exposure do not receive appropriately unequal but equitable immunisation. Using Indirect Standardisation Method and Erreygers’ Corrected Concentration Index, we measure the degree of horizontal and vertical inequities, and then linearly decompose them to identify the major factors contributing towards the respective indices.

CONCLUSION: Our findings show that incomplete immunization is significantly concentrated among children belonging to poorer households. After controlling for the confounding effects of need factors, the inequity is still significantly pro-poor (i.e., horizontal inequity). The decomposition reveals that lower education, lower consumption and rural habitation are the major factors driving the corresponding inequity. Further, the differential effect of the needs between all and the target groups (at least based on education), is observed, however, is not statistically significant enough to realize inequity (i.e., no vertical inequity). Overall, the inequity is being induced via non-need factors. We further find that community health services (like anganwadi) have contributed towards reducing the inequity in child immunization significantly. The paper highlights the policy recommendation that the child immunisation program should target factors driving HI and need to align their distribution in terms of risks exposures.

PMID:39589599 | DOI:10.1186/s13561-024-00566-8

World J Urol. 2024 Nov 26;42(1):646. doi: 10.1007/s00345-024-05373-8.

ABSTRACT

PURPOSE: To assess active surveillance (AS) adherence for prostate cancer (PCa) in a “real-world” clinical practice.

MATERIALS AND METHODS: We utilized our institutional database which was built by interrogating electronic medical records for all men who got diagnosed with PCa from 1995 to 2022. Our cohort included all patients aged < 76 years, with PCa Gleason Grade (GG) 1 or 2, ≤ cT2c, PSA ≤ 20 ng/ml at diagnosis, enrolled on AS, and with at least one biopsy after diagnosis. Patients were separated into two groups based on the monitoring intensity. Patients with at least 1 PSA/year and at least 1 biopsy every 4 years were categorized as adherent to guidelines. Univariable and Multivariable logistic regression analyses were used to examine the impact of covariates on non-adherence to guidelines. Competing risks cumulative incidence was used to depict prostate cancer-specific mortality (PCSM).

RESULTS: A total of 546 men met the inclusion criteria. Overall, 63 (11%) patients were adherent to guidelines (Group 1), while 483 (89%) were not (Group 2). Median PSAs/year and median biopsies/year were 2.3 (2.0-2.7) and 0.4 (0.3-0.6) for Group 1, and 1.2 (0.7-1.8) and 0.2 (0.1-0.2) for Group 2, respectively (both p < 0.0001). At multivariable analysis, Black men had a 2.20-fold higher risk of being in Group 2 than White men (p < 0.05). Patients with cT2 (OR:0.24, CI:0.11-0.52) and those with CCI ≥2 (OR:0.40, CCI:0.19-0.82) were less likely to be in Group 2, when compared to cT1 stage and CCI = 0, respectively (both p < 0.05). At 10 years, the cumulative incidence estimate of PCSM for the entire cohort was 2.1%.

CONCLUSION: We found substantial deviations from AS monitoring guidelines, particularly in biopsy frequency, which did not seem to compromise PCSM in patients with stable PSA. Notably, our findings suggest that strict adherence to guidelines, especially in patients with cT2 at diagnosis, remains crucial.

PMID:39589591 | DOI:10.1007/s00345-024-05373-8

Aging Clin Exp Res. 2024 Nov 26;36(1):226. doi: 10.1007/s40520-024-02879-4.

ABSTRACT

BACKGROUND: Elevated blood pressure is a major risk factor for severe medical conditions. Adherence to antihypertensive medication, especially in free-dose combinations, poses a significant challenge. This study aims to develop a novel method for assessing co-exposure to free-dose antihypertensive medications using secondary data sources.

METHODS: A register-based cohort study was conducted on individuals aged 65 years or older in Denmark who initiated antihypertensive therapy from 1996 to 2016 and followed for 730 days from the index date. A new method was developed to assess co-exposure to antihypertensive medications through redeemed prescriptions, treatment episodes, and overlapping medication events. The method’s accuracy was evaluated using a random sample of 400 individuals.

RESULTS: A total of 1,021,819 individuals were included in the study, with a mean age of 68.8 years, and 53.7% were women. The method achieved 100% accuracy in identifying co-exposure periods. During the early stage of the follow-up (0-180 days), 54.1% of individuals were co-exposed to at least two antihypertensive medications, while 37.5% were co-exposed during the late stage of the follow-up period (181-730 days). The most frequent antihypertensive combinations included bendroflumethiazide and potassium with either amlodipine or enalapril in the early (13.2% and 12.5% of patients, respectively) and late stages (16.9% and 15.0% of patients, respectively).

CONCLUSIONS: The newly developed method effectively assesses co-exposure to antihypertensive medications, overcoming previous limitations. The findings reveal common co-exposure combinations and evolving trends in antihypertensive medication use among older individuals, reflecting changes in clinical practice and guidelines over two decades.

PMID:39589584 | DOI:10.1007/s40520-024-02879-4

Langenbecks Arch Surg. 2024 Nov 26;409(1):359. doi: 10.1007/s00423-024-03547-x.

ABSTRACT

INTRODUCTION: Resection margin status is the important prognostic factor in resected perihilar cholangiocarcinoma (pCCA). Although the impact of ductal margin (DM) was reported in many studies, the influence of radial margin (RM) is unclear. This study aims to investigate the effect of positive RM on survival.

METHODS: Patients with pCCA underwent curative resection between 2013 and 2018 were retrospectively reviewed. Resection margin status was divided into negative resection margin (R0) and positive resection margin (R1); positive RM alone (RM+) and positive DM with or without positive RM (DM+).

RESULTS: Of the 167 pCCA patients, 62 (37.1%) had R1 margin. Among 62 R1 patients; 17 (27.4%) had positive DM alone, 20 (32.3%) had positive RM alone and 25 (40.3%) had both positive DM and RM. The R1 patients had a significantly greater number of lymph node metastasis (LNM) and advanced tumor staging than R0 patients, however there was no difference between the RM + and DM + patients. The median survival time of patients with RM + was significantly poorer than R0 patients (13.8 vs. 24.5 months; p < 0.001, respectively) and similar to the DM + patients (9.1 months, p = 0.556). However, in patients with LNM, those who underwent R0 resection had no statistically significant difference in survival outcomes compared to those with R1 resection.

CONCLUSION: Positive resection margin remains the important prognostic factor, and positive RM is common in these patients. Positive RM also had a comparable effect on survival as positive DM. As a result, in pCCA, surgical resection should target both RM and DM.

PMID:39589565 | DOI:10.1007/s00423-024-03547-x

Cranio. 2024 Nov 26:1-12. doi: 10.1080/08869634.2024.2431347. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the prevalence of serum vitamin D and B12, calcium, phosphorus, magnesium levels, and rheumatoid factor (RF) status in patients with bilateral temporomandibular joint osteoarthritis (TMJ-OA) and their correlations with clinical and radiological findings.

METHODS: The clinical and radiologic findings and serum vitamin and mineral levels of 90 patients diagnosed with bilateral TMJ-OA were recorded. Descriptive statistics and the Spearman’s Rho correlation test were performed.

RESULTS: Low serum vitamin D and B12 levels were detected in 82 (91.1%) and 74 (82.2%) patients. Calcium and phosphorus levels were seen at low rates. RF status was recorded as unfavorable in all patients. Correlations were found between age and the serum vitamin and mineral levels, except phosphorus. Low serum vitamin D levels correlated with pain complaints at rest and painless MIO. Serum B12 levels correlated with condylar erosion. Serum magnesium levels correlated with painful MIO and condylar osteophyte.

CONCLUSION: Patients with bilateral TMJ-OA showed a high prevalence of low serum vitamin D and B12 levels.

PMID:39588727 | DOI:10.1080/08869634.2024.2431347

Sci Diabetes Self Manag Care. 2024 Nov 26:26350106241293113. doi: 10.1177/26350106241293113. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study was to test the effectiveness of a nurse-led mobile phone intervention (NMPI) on glycemic variability and self-management among people living with type 2 diabetes (T2DM) in Ghana.

METHODS: In this randomized controlled trial, the intervention group received a 3-month NMPI program plus standard care, and the control group received standard care alone in a tertiary health care setting. Ninety-eight participants (baseline A1C > 7%) were randomized 1:1 to either NMPI or standard care group. The primary study outcomes were changes in A1C testing and self-management assessed using the Summary of Diabetes Self-Care Activities tool at baseline and end of the study.

RESULTS: The intervention group had statistically significant improvement in their mean A1C level from baseline to the end of the study. In comparison, the control group also had improvement in their mean A1C level but was not statistically significant. Consistently, the intervention participants had better statistically significant improvements in self-management behaviors than the control group. There was a medium, negative correlation between A1C changes and overall self-care changes for the intervention group, whereas that of the control group was smaller.

CONCLUSIONS: Study findings have shown that a tailored NMPI program in addition to standard care could improve glycemic variability and self-management among people living with poorly managed T2DM in Ghana better than standard care alone.

PMID:39588726 | DOI:10.1177/26350106241293113

Surg Laparosc Endosc Percutan Tech. 2024 Nov 25. doi: 10.1097/SLE.0000000000001343. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic cholecystectomy (LC) is widely performed with generally favorable outcomes, but postoperative pain remains a significant issue, influenced by various factors including the specimen extraction site and gallstone size.

METHODS: A prospective randomized controlled study was conducted on 100 patients undergoing LC. Participants were randomized to have the specimen removed through either the epigastric or umbilical trocar. Postoperative pain was assessed using the visual analog scale (VAS) on postoperative days 1, 3, and 7. Statistical analyses were performed to evaluate the impact of trocar site and gallstone size on pain levels.

RESULTS: Patients whose specimens were extracted through the umbilical trocar experienced significantly less pain on postoperative days 1 and 3 (P=0.006 and 0.014, respectively) than those with epigastric trocar extraction. In addition, patients with gallstones larger than 10 mm reported higher pain levels on day 3 (P=0.001) irrespective of the extraction site.

CONCLUSIONS: The umbilical trocar site for specimen extraction and smaller gallstone size is associated with reduced early postoperative pain following LC. These findings suggest the importance of considering extraction site and gallstone size in managing postoperative pain in LC patients.

PMID:39588713 | DOI:10.1097/SLE.0000000000001343