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Nevin Manimala Statistics

Assessment of mandibular bony healing, mandibular condyle and angulus after orthognathic surgery using fractal dimension method

Med Oral Patol Oral Cir Bucal. 2024 Apr 14:26587. doi: 10.4317/medoral.26587. Online ahead of print.

ABSTRACT

BACKGROUND: This study aims to compare the trabeculation changes in the bone structure observed at the mandibular osteotomy line and the mandibular condyle in patients after single and double-jaw orthognathic surgery.

MATERIAL AND METHODS: The study included 38 patients (23 female, 15 male) who underwent mandibular surgery with bilateral sagittal split ramus osteotomy technique. The patients were divided into two groups according to their surgical operation: single-jaw (bilateral sagittal split ramus osteotomy) or double-jaw (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) surgery. Trabecular changes seen in mandibular osteotomy lines, mandibular condyle and mandibular angulus were evaluated on panoramic radiographs of patients (preoperative, postoperative 2nd day, postoperative 3rd month and 12th month) using fractal analysis method. Fractal dimension analysis was calculated by box counting method.

RESULTS: No statistically significant difference was found between the fractal analysis values in the mandibular condyle and angulus region preoperatively, postoperative 2nd day, postoperative 3rd month and postoperative 12th month in the single jaw group. There was no statistically significant difference between the fractal analysis values in the mandibular condyle and angulus region preoperatively, postoperative 2nd day, postoperative 3rd month and postoperative 12th month in the double jaw group. A significant difference was found in fractal analysis values in osteotomy lines in both groups. The lowest value was found on the 2nd postoperative day and reached the preoperative values in the 3rd and 12th months postoperatively. Fractal analysis values didn’t show significant difference between the single, double-jaw groups in all periods.

CONCLUSIONS: This result suggests that the fractal analysis method can be used to evaluate trabeculation in the bone healing process of the osteotomy lines and indirectly affected areas in the postoperative period after orthognathic surgery.

PMID:38615248 | DOI:10.4317/medoral.26587

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Association of serum IL-30 and soluble GP130 with the risk of psoriasis vulgaris

Egypt J Immunol. 2024 Apr;31(2):61-70.

ABSTRACT

Cytokines play a major role in the pathogenesis and progression of psoriasis. Interleukin (IL)-30 is a multifunctional cytokine. It binds to glycoprotein 130 (GP130) and inhibits the GP130 signaling pathways of psoriasis associated cytokines such as IL-6, IL-11, and IL-27. The study intended to assess associations of IL-30 and GP130 with the risk of psoriasis and Psoriasis Area Severity Index (PASI) score. Therefore, we measured the serum levels of IL-30 and GP130 in psoriasis patients and in a control group. An enzyme linked immunosorbent assay (ELISA) technique was used to measure IL-30 and GP130 levels in the serum of 43 patients and 43 normal controls. Statistical analysis of IL-30 and GP130 serum levels among patients and control groups and their correlation with PASI scores were performed. IL-30 serum levels showed a significant increase in patients with psoriasis compared with controls (p < 0.001) and a positive correlation with PASI scores. While serum levels of GP130 were not different in psoriatic patients and in the control group. Furthermore, the receiver operating characteristic (ROC) curve showed that IL-30 had diagnostic ability for prediction of psoriasis in comparison to controls, at cut of point of >14.34 showed a sensitivity of 97.7%, 100% specificity. In conclusion, IL-30 was elevated in psoriasis patients than controls, therefore, it can be considered a sensitive biomarker for diagnosis of psoriasis.

PMID:38615236

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Nevin Manimala Statistics

Sexual Dysfunctions among Diabetic and Non-diabetic People Attending in Tribhuvan University Teaching Hospital, Kathmandu Nepal

J Nepal Health Res Counc. 2024 Mar 22;21(3):514-522. doi: 10.33314/jnhrc.v21i3.4991.

ABSTRACT

BACKGROUND: Sexual dysfunctions including erectile dysfunction among men, a widespread sexual health issue, pose challenges to sexual satisfaction. This cross-sectional study aimed to assess the prevalence and determinants of sexual dysfunctions in both diabetic and non-diabetic individuals aged 30-70.

METHODS: A study at Tribhuvan University Teaching Hospital in Kathmandu, Nepal, surveyed 350 participants (176 men, 174 women), aged 30-70, with 52.6% having diabetes. The structured interviews and validated questionnaires like IIEF-5 for men and FSFI-6 for women to assess the prevalence and factors associated with erectile dysfunction were used. Statistical tools were employed to measure the associations of different variables with Sexual dysfunctions.

RESULTS: Overall, the prevalence of sexual dysfunction was 73.7% (95% CI: 72.4- 73.7) with higher rates in men 83.9% (95% CI: 83.1- 84.7) than women 63.6% (95% CI: 62.0 – 65.2). Individuals with diabetes experienced an 81.5% prevalence of sexual dysfunction (95% CI: 80.6-82.4), whereas non-diabetic individuals exhibited a 65.1% prevalence (95% CI: 63.5-66.7). In the diabetic male population, the prevalence of sexual dysfunction was 97.5% (95% CI: 97.4-97.6), while diabetic females had a prevalence of 68.9% (95% CI: 67.5-70.3). Among non-diabetic men, the percentage of erectile dysfunction was 72% (95% CI: 70.7-73.3), and among non-diabetic women, sexual dysfunction remained 56.2% (95% CI: 54.4-58.0). Among individuals with diabetes, those who used tobacco exhibited a sexual dysfunction prevalence of 93.8% (95% CI: 93.5-94.1), while non-tobacco users had a prevalence of 74.8% (95% CI: 73.6-76.0). In non-diabetic individuals, obesity was associated with a higher prevalence of sexual dysfunctions, reaching 84.6% (95% CI: 83.8-84.6). High blood pressure showed a strong association with sexual dysfunctions in both diabetic (83% with 95% CI: 81.9-83.4) and non-diabetic (70% with 95% CI: 67.7-70.1) groups. Individuals with diabetes for more than five years had a higher rate of sexual dysfunction as 87.8% (95% CI: 86.6-89.0) with 100% in men and 79% in women. However, there was no significant difference in the prevalence of sexual dysfunctions related to obesity and alcohol consumption between diabetics and non-diabetics.

CONCLUSIONS: The research highlights a noteworthy association of sexual dysfunctions with individuals with diabetes, male sex, tobacco use, and hypertension. The observed high prevalence of sexual dysfunctions in both diabetic and non diabetic people is a public health concern, emphasizing the need for culturally tailored approaches to address the sexual health of the affected individuals.

PMID:38615226 | DOI:10.33314/jnhrc.v21i3.4991

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Health Promoting Behaviors among Adolescents at Selected Schools of Chitwan

J Nepal Health Res Counc. 2024 Mar 22;21(3):498-504. doi: 10.33314/jnhrc.v21i3.4797.

ABSTRACT

BACKGROUND: Health Promotion and maintenance are fundamental prerequisites to achieve optimum health in an individual and limit the illness. The objective of the study was to assess the health promoting behaviors among adolescents at selected schools.

METHODS: A descriptive cross-sectional study was conducted among 238 adolescents age 14-18 years of age studying in three different government schools of Bharatpur-10 Chitwan. Probability simple random method was used for selecting the required respondent. Data were collected using Adolescents Health Promoting Scale questionnaire through self-administered technique. Obtained data were analyzed using descriptive and inferential statistics.

RESULTS: The study revealed that 47.5% had high level of health promoting behaviors whereas 52.5% had low level of health promoting behavior. Regarding, the subscale, the highest score was obtained in the area of exercise (median percentage=72.5%) and lowest score was obtained in the area of stress management (median percentage=48%). Moreover, statistically significant variables for health promoting behavior were respondents age, availability of school health nurse, educational status of both the parents and and occupation of father (p<0.05).

CONCLUSIONS: More than half of the adolescents in schools have low health promoting behavior, particularly in the area of stress management and nutrition. Adolescence is the period when most of the healthy and unhealthy habits are developed. Hence, it is necessary to focus on developing efficient health promotion and disease prevention strategies in collaboration with school teachers and school health nurse.

PMID:38615224 | DOI:10.33314/jnhrc.v21i3.4797

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Cranial Base Measurements in Skeletal Malocclusion among Orthodontic Patients

J Nepal Health Res Counc. 2024 Mar 22;21(3):486-490. doi: 10.33314/jnhrc.v21i3.4752.

ABSTRACT

BACKGROUND: Facial growth and development is necessary for proper orthodontic diagnosis and treatment planning. Growth of cranial base is linked to the overall growth of facial bones, especially the maxilla and mandible. Any change in the amount and direction of growth of the cranial base can have direct or indirect effects on the developing maxilla and mandible. Thus the aim of this study was to determine the linear and angular cranial base measurements in different skeletal malocclusion in Nepalese population.

METHODS: Pretreatment lateral cephalograms of 225 patients aged between 17-30 years were collected. Linear measurements Sella-Nasion (S-N), Sella-Articulare (S-Ar), Articulare-Gonion (Ar-Go), Gonion-Gnathion (Go-Gn) and angular measurements Saddle angle (N-S-Ar), Articular angle (S-Ar-Go) and Gonial angle (Ar-Go-Gn) were measured.

RESULTS: In angular measurements statistically significant differences were found in the saddle and gonial angles between class I, II, and III skeletal pattern. In linear measurements, anterior and posterior cranial base lengths were not significantly different among groups however, ramal height and mandibular body length were significantly different among groups with a P value < 0.05.

CONCLUSIONS: Skeletal class III has a larger gonial angle, ramal height and mandibular length. Males have larger linear measurements and females have larger angular measurements.

PMID:38615222 | DOI:10.33314/jnhrc.v21i3.4752

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Variations in the Root Form and Root Canal Morphology of Permanent Mandibular canine

J Nepal Health Res Counc. 2024 Mar 22;21(3):463-466. doi: 10.33314/jnhrc.v21i3.4707.

ABSTRACT

BACKGROUND: Mandibular canines are recognized as usually having one root and one root canal in most cases. However, many investigators have reported the anatomical variations associated with mandibular canines. Thus; the objective of this study is to determine the number of roots and morphology of the root canal system of permanent mandibular canine in a Nepalese population.

METHODS: Cone Beam Computerized Tomography images of 390 patients in a Nepalese population were selected, and a total of 780 mandibular canines were analyzed. The number of root and the canal configurations were investigated. Data were analyzed with descriptive analysis and Chi-square tests using the Statistical Package for the Social Sciences (SPSS) software version 20 (SPSS Inc, Chicago, IL, USA).

RESULTS: Out of the 780 mandibular canines, 741(95%) were single-rooted canines while only 39 (5%) were double-rooted canines. The most common type of Vertucci in single-rooted canines was Type I (1-1) in the percentage of 85.6% and the least type was Type IV (1-2) in the percentage of (2.5%). The Chi-square tests showed no significant association between gender and number of roots (P = 0.87) and gender and root canal configuration in single-rooted canine (P = 0.52).

CONCLUSIONS: All mandibular permanent canines were single rooted but 5.2% of the permanent mandibular canines had two roots.

PMID:38615218 | DOI:10.33314/jnhrc.v21i3.4707

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Surgeon Experience as Predictors of Outcome of Dacryocystorhinostomy Surgery

J Nepal Health Res Counc. 2024 Mar 22;21(3):458-462.

ABSTRACT

BACKGROUND: Dacryocystorhinostomy surgery aims to treat nasolacrimal duct obstruction and are often performed by general ophthalmologists in developing countries. The aim of this study is to estimate the clinical burden, surgeon’s experience, and outcome of dacryocystorhinostomy surgery.

METHODS: A cross-sectional survey of Nepalese Ophthalmologists registered with the Nepal Ophthalmic Society was conducted after ethical clearance from Nepal Health Research Council. The survey form consisted of a single mail-shot questionnaire information including the age and experience, average case per month, and participant-reported post-operative complications and failures. Data were entered onto Microsoft excel (Microsoft Corp) and analyzed using SPSS 22.0. The data were presented in graphical and tabular format and appropriate statistical tools were employed for the analysis.

RESULTS: Out of 300 practicing ophthalmologist, 135 (45%) comprising male 60 (44.4%) and female 75(55.6%) responded to the survey. Majority of respondents were general ophthalmologists (37 ,41.6%) followed by oculoplastic surgeons (27,30.3%) and other subspecialties (25,28.1%). More than 70% respondents perform 1-10 surgeries /month and only 3% perform >50 surgeries /month. The success rate of 75-90% was reported by 45(50%) respondents whereas > 90% success rate by 41 (46.1%). More than 80% surgeons experienced an infection rate of <1% regardless of the intubation status.

CONCLUSIONS: This survey revealed huge differences in surgery practice patterns among ophthalmologists in Nepal. The surgical success rate and post-operative infection rate depends upon surgeon experience. Moreover, uniform surgery protocols and training budding ophthalmologists/ young Oculoplastic surgeons in the best modern dacryocystorhinostomy surgery are required.

PMID:38615217

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Belief and Risk Factors Associated with Suicidal and Self-harm Behaviour among Young Adults of Kathmandu District

J Nepal Health Res Counc. 2024 Mar 22;21(3):445-449.

ABSTRACT

BACKGROUND: Suicide is an emerging public health problem accounting for over 700,000 annual deaths globally. It is also the fourth leading cause of death among the age group 15-29 years in the world. In Nepal, on average 14 people commit suicide every day. Our study explores the factors associated with suicidal and self-harm behaviours among young adults in the Kathmandu district, Nepal.

METHODS: A descriptive cross-sectional study was conducted among a total of 242 young adults of the Kathmandu district. Data were collected through interview using a developed semi-structured questionnaire. Descriptive statistics and odds ratios were used for data analysis.

RESULTS: The mean age for initial suicidal and self-harm behaviour was found to be 14 and 15 years respectively, with 28.51% reporting suicidal behaviours including making a plan or suicidal ideation or attempts, and 18.5% with self-harm behaviours. Avoidance and emotional discharge were found as common coping strategies adopted by participants. Belief, family functioning, depression status and self-harm behaviour were found statistically associated with suicidal behaviour.

CONCLUSIONS: Various factors including belief, family functioning, and depression were found to influence individual suicidal behaviour. Hence, an integrated approach addressing these factors is crucial for the prevention and control of suicide among young adults at risk.

PMID:38615215

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Clinicopathological Significance of Tumor Budding in Breast Carcinoma

J Nepal Health Res Counc. 2024 Mar 22;21(3):417-427. doi: 10.33314/jnhrc.v21i3.4538.

ABSTRACT

BACKGROUND: Tumour budding Tuberculosis is a new prognostic marker whose role in breast cancer is still under evaluation. Our aim was to study Tuberculosis in breast carcinoma and correlate it with other prognostic markers.

METHODS: A descriptive cross-sectional study was conducted over 2 years on 75 invasive breast carcinoma specimens and biopsies. Hematoxylin and Eosin sections were examined for tumour grade, stage, molecular subtype, necrosis, lymphovascular invasion inflammation and counting of Tuberculosis. Lymph node metastasis was studied only in mastectomies. TB was defined as a cluster of 1-5 tumour cells and counted in 10 consecutive 400X fields. The cut-off for high grade TB was taken as ?10 per 10 HPFs. Immunohistochemical staining was done for molecular subtyping and differentiating Tuberculosis from mimickers. Statistical analysis was done using chi square test and Fischer’s exact test.

RESULTS: Tuberculosis was present in 66/75 cases; 53% (n=35) were high grade. Among these, majority were of T2 (74%, n= 26), grade 2 (52%, n= 18), luminal A (34%, n= 12), had 3+ inflammation (46%, n= 16) and peripheral tumour buds (54%). Necrosis and lymphovascular invasion were absent in 77% and 71%, respectively. Lymph node metastasis was seen in 63% (n= 25/28) cases. Statistically significant association (p= 0.016) was observed between degree of inflammation and Tuberculosis grade. However, no significant association was observed between TB and other prognostic markers of breast carcinoma.

CONCLUSIONS: In our study, association of Tuberculosis with different prognostic markers was appreciated but was not statistically significant. However, it highlights need for standardization of Tuberculosis reporting.

PMID:38615212 | DOI:10.33314/jnhrc.v21i3.4538

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Immediate Effect of Physiotherapist-demonstrated Action Observation with Execution for Improving Upper Extremity Motor Function in Stroke: a Pre-post Pilot Study

J Nepal Health Res Counc. 2024 Mar 22;21(3):400-409. doi: 10.33314/jnhrc.v21i3.4471.

ABSTRACT

BACKGROUND: Video-demonstrated action-observation-execution is an effective intervention for motor re-learning in stroke rehabilitation. But customization of video for each task repeatedly questions its feasibility within limited resources, particularly for daily routine practice and in community settings. Physiotherapist-demonstrated action-observation-execution is a practical intervention based on the principle of observation and consecutive repetitions of observed real, live movements. The main objective of this study was to investigate the immediate effect of Physiotherapist-demonstrated action-observation-execution in upper extremity motor training in stroke.

METHODS: Individuals with stroke were screened and 5 eligible participants were recruited. The research was a pre-post. A single session of Physiotherapist-demonstrated action-observation-execution was administered. A functional “Drinking” task was subdivided into simpler acts and trained. Pre and post intervention assessment of movement time using five hand-and-arm items of Nepali Wolf Motor Function Test were carried out. Global recovery was assessed in the form of Visual Analogue Scale.

RESULTS: Paired t-test provided statistically significant difference in total movement time (mean difference=5.04 seconds, standard deviation=1.92, p=0.004) with larger effect size (0.95) indicating impressive improvement in movement time with the training. Substantial difference in global recovery score was noted (mean difference=17.40, standard deviation=3.65, p<0.0001, effect size=1.00) signifying the increased confidence and improved performance of upper extremity post treatment.

CONCLUSIONS: The findings indicated that Physiotherapist-demonstrated action-observation-execution could be a feasible intervention to train motor functions in participants with stroke. Large-scale studies are recommended to establish the effectiveness of the intervention.

PMID:38615210 | DOI:10.33314/jnhrc.v21i3.4471