Tag: nevin manimala

J Hand Surg Eur Vol. 2023 Sep 25:17531934231201955. doi: 10.1177/17531934231201955. Online ahead of print.

ABSTRACT

To compare the results of intraplexal repair and distal nerve transfer in babies with birth brachial plexus palsy (BBPP), children with Narakas group I obstetric palsy were assigned to two groups of 16 each. Children in group A were treated with classical intraplexal repair and those in group B were treated by distal nerve transfers. At 6 months, all the children in group B had achieved Modified Medical Research Council (MMRC) grade 3 elbow flexion along with 8 of the 16 children in group A, which was a statistically significant difference. At 6 months, all the children in group B achieved MMRC grade 3 or higher shoulder abduction and 8 of the 16 children in group A had done so, which was also statistically significant. At the final follow-up, the distal transfer surgical treatment group had a significantly higher Mallet score. Distal nerve transfers have a significant advantage in early recovery in elbow flexion and shoulder abduction, but the outcomes became similar after 9 months.Level of evidence: III.

PMID:37747709 | DOI:10.1177/17531934231201955

Cornea. 2023 Sep 22. doi: 10.1097/ICO.0000000000003385. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to examine endothelial cell loss (ECL) associated with preloaded Descemet stripping automated endothelial keratoplasty (DSAEK) grafts loaded into 3 carriers of different size and shape.

METHODS: Thirty-six donor corneas were prepared for DSAEK and loaded into an EndoGlide Ultrathin (control) (2.0 mm × 3.5 mm lumen, 4.5 mm/4.9 mm incision for scleral tunnel/clear corneal insertion), Descemet membrane endothelial keratoplasty EndoGlide (experimental) (1.1 mm × 1.7 mm lumen, 2.65 mm incision), or round glass Jones tube (experimental) (1.8 mm lumen, 3.0 mm incision). Control grafts were stored for 6 days in Optisol-GS and experimental grafts stored for 24 hours in Life4C before analysis using Calcein AM staining. Grafts were imaged and ECL was analyzed by FIJI segmentation. The statistical significance of ECL was determined using 1-way ANOVA and Tukey post hoc analysis.

RESULTS: There were no significant differences in donor characteristics for grafts in each cohort. ECL for grafts loaded into the EndoGlide Ultrathin was 10.3% ± 2.3% (graft thickness: 60-189 μm, n = 9). ECL for grafts loaded into the Descemet membrane endothelial keratoplasty EndoGlide was 22.2% ± 7.1% (graft thickness: 38-63 μm, n = 9). ECL for thin grafts (34-60 μm, n = 9) loaded into the Jones tube was 24.0% ± 5.0%. ECL for thick grafts (92-119 μm, n = 9) loaded into the Jones tube was 34.2% ± 6.1% ECL (P < 0.001). Combined regression analysis revealed that graft thickness is directly correlated to ECL (P < 0.01).

CONCLUSIONS: The size and shape of the carrier can influence the cell viability of preloaded DSAEK grafts. Compared with a larger carrier, smaller lumen carriers are associated with greater ECL. In smaller lumen carriers, ECL increases with increasing DSAEK graft thickness.

PMID:37747694 | DOI:10.1097/ICO.0000000000003385

J Hand Surg Eur Vol. 2023 Sep 25:17531934231200354. doi: 10.1177/17531934231200354. Online ahead of print.

ABSTRACT

In this second of a two-part article, we describe some of the common statistical pitfalls encountered in hand surgery research. These include dichotomania, the ‘Table 2 fallacy’, p-hacking, regression to the mean, overfitting and unaccounted data clustering. We explain the impact of these pitfalls on hand surgery research and describe techniques to avoid them. The aim of this two-part article was to provide a starting point for hand surgeons to refer to when conducting or analysing research and provide resources and references for interested readers to explore.

PMID:37747691 | DOI:10.1177/17531934231200354

Cornea. 2023 Sep 25. doi: 10.1097/ICO.0000000000003368. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to demonstrate the efficacy of cyclosporine A 0.1% cationic emulsion (CsA CE) eye drops 4 times a day in pediatric patients affected by a moderate form of vernal keratoconjunctivitis (VKC).

METHODS: This was a prospective study of pediatric patients, aged 5-16 years, with an active moderate form of VKC who were poor responders to topical antihistamines treatment and were treated 4 times a day with CsA CE. The clinical signs were graded for analysis as follows: hyperemia, tarsal papillae, and limbal papillae.

RESULTS: Twenty-eight patients (22 males and 6 females) with a minimum follow-up period of 3 months were included in the analysis. Statistical analysis excluded tarsal papillae because of the very low baseline value. The clinical score of hyperemia and limbal papillae improved from the first evaluation and was maintained over the follow-up. No side effects were noted.

CONCLUSION: CsA CE has been proposed as a treatment for severe forms of VKC. This study has shown that administration 4 times a day is also effective in the treatment of moderate forms of VKC in children.

PMID:37747690 | DOI:10.1097/ICO.0000000000003368

Eur Arch Paediatr Dent. 2023 Sep 25. doi: 10.1007/s40368-023-00842-x. Online ahead of print.

ABSTRACT

PURPOSE: Celiac Disease (CD) presents a wide variety of clinical signs and symptoms, including oral manifestations. This study pretended to characterize Oral Health-Related Quality of Life (OHRQoL) and reported oral manifestations in children with CD.

METHODS: Target-population were children with CD. An online questionnaire, applied to children’s parents, collected information about OHRQoL (using the Early Childhood Oral Health Impact Scale-ECOHIS), oral health behaviours, and history of oral manifestations. Data analysis included descriptive statistics, Mann-Whitney, Kruskall-Wallis, and Spearman correlation tests (α = 0.05).

RESULTS: The sample included 146 celiac patients, with a mean age of 10.5 years (sd = 4.1). Mean ECOHIS score was 5.2 (sd = 6.8). The most frequently reported oral manifestations were recurrent aphthous stomatitis (46.6%), dental caries (45.2%) and dental opacity (39%). About one third of the participants mentioned improvements in oral health when a gluten-free diet was introduced. Most of the reported oral manifestations had a significant association with the ECOHIS score (p < 0.05).

CONCLUSIONS: The OHRQoL of children was good, however oral manifestations had a negative impact on OHRQoL. The most reported oral manifestations were recurrent aphthous stomatitis, dental caries, and dental opacities. Oral health professionals must be aware about the heterogeneity of the disease, to recognize oral manifestations associated and their importance in the early diagnosis to reduce complications and to an improvement in the OHRQoL of these patients.

PMID:37747657 | DOI:10.1007/s40368-023-00842-x

Phys Eng Sci Med. 2023 Sep 25. doi: 10.1007/s13246-023-01340-6. Online ahead of print.

ABSTRACT

Although it is clinically important, a reliable and economical solution to automatic seizure detection for patients at home is yet to be developed. Traditional algorithms rely on multi-channel EEG signals and features of canonical EEG power description. This study is aimed to propose an effective single-channel EEG seizure detection method centered on novel EEG power parameterization and channel selection algorithms. We employed the publicly available multi-channel CHB-MIT Scalp EEG database to gauge the effectiveness of our approach. We first adapted a power spectra parameterization algorithm to characterize the aperiodic and periodic components of the ictal and inter-ictal EEGs. We selected four features based on their statistical significance and interpretability, and developed a ranking approach to channel selection for each patient. We then tested the effectiveness of our approaches to channel and feature selection for automatic seizure detection using support vector machine (SVM) as the classifier. The performance of our algorithm was evaluated using five-fold cross-validation and compared to those methods of comparable complexity (using one or two channels of EEG), in terms of accuracy, specificity, sensitivity, precision and F1 score. Some channels of EEG signals show strikingly different distributions of PSD features between the ictal and inter-ictal states. Four features including the offset and exponent parameters for the aperiodic component and the first and second highest total power (TPW1 and TPW2) form the basis of channel selection and the input of SVM classifier. The selected channel is found to be patient-specific. Our approach has achieved a mean sensitivity of 95.6%, specificity of 99.2%, accuracy of 98.6%, precision of 95.5%, and F1 score of 95.5%. Compared with algorithms in previous studies that used one or two channels of EEG signals, ours outperforms in specificity and accuracy with comparable sensitivity. EEG power spectra parameterization to feature extraction and feature ranking-based channel selection are found to enable efficient and effective automatic seizure detection based on single-channel EEG signal.

PMID:37747646 | DOI:10.1007/s13246-023-01340-6

Ophthalmol Ther. 2023 Sep 25. doi: 10.1007/s40123-023-00813-x. Online ahead of print.

ABSTRACT

INTRODUCTION: This study evaluated the differences and agreement between a new Scheimpflug camera (Scansys) and a swept-source anterior segment optical coherence tomographer (CASIA 2) for measurements of the anterior segment of the eye in normal subjects.

METHODS: This prospective study included 84 eyes from 84 normal adult subjects who underwent three consecutive measurements with the Scansys and the CASIA 2 in random order. The mean keratometry (Km), astigmatism magnitude (AST), J₀, and J₄₅ vectors for both anterior and posterior corneal surfaces, central corneal thickness (CCT), thinnest corneal thickness (TCT), and anterior chamber depth (ACD) were obtained by both devices. The difference between these two devices was assessed using paired t test and violin plots. Bland-Altman plots and 95% limits of agreement (LoAs) were used to evaluate agreement.

RESULTS: No statistically significant differences between the two devices were found for the anterior AST, anterior J₄₅, and posterior J₄₅ (P > 0.05). The remaining parameters were statistically significant (P ≤ 0.05), but the differences not clinically significant. The violin plots showed that the distribution and probability density of the measured parameters were similar for both devices. Bland-Altman plots revealed high agreement for the measured parameters between the Scansys and CASIA 2, with narrow 95% LoAs.

CONCLUSIONS: In terms of assessing parameters for the anterior segment, our study indicated that Scansys and CASIA 2 generally showed significant agreement. The two devices used in this study’s assessment of all the parameters can be used interchangeably in refractive analysis.

PMID:37747639 | DOI:10.1007/s40123-023-00813-x

Ophthalmol Ther. 2023 Sep 25. doi: 10.1007/s40123-023-00816-8. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this work is to utilize swept-source optical coherence tomography angiography (SS-OCTA) to assess the long-term changes in the choroidal and choriocapillaris (CC) layers of the fellow unaffected eye of patients with unilateral resolved chronic central serous chorioretinopathy (cCSC) following treatment with continuous oral eplerenone (EPL).

METHODS: The study included 35 patients with cCSC and subretinal fluid (SRF) in one eye. SS-OCTA imaging was performed on the fellow cCSC eyes at baseline, 6 months, and 12 months during eplerenone therapy. CC OCT angiography was analyzed to determine the percentage of choriocapillaris flow deficits (FD%), the number of flow deficits (FDn), and the average area of flow deficits (FDa).

RESULTS: The results demonstrated significant changes in CC flow deficits from baseline to follow-up visits. Specifically, there was a significant decrease in FD% from 28.9 ± 2.2% at baseline to 26.4 ± 1.9% at 6 months (p = 0.023), and further to 24.9 ± 1.7% at 12 months (p = 0.001). Additionally, the FD area gradually contracted over the follow-up period (p < 0.05). Conversely, there was a significant increase in the number of flow deficits compared to baseline (p < 0.05). No statistically significant changes were observed in best-corrected visual acuity (BCVA) at the follow-up visits (p > 0.05).

CONCLUSIONS: The findings of this study demonstrated long-term reperfusion of the choriocapillaris in unaffected fellow cCSC eyes during continuous oral eplerenone therapy. The beneficial effects of eplerenone therapy were observed after 6 months and maintained at 1 year. These results suggest that specific mineralocorticoid receptor (MR) antagonists may be effective in promoting choriocapillaris recovery in the unaffected eyes of patients with cCSC.

PMID:37747638 | DOI:10.1007/s40123-023-00816-8

Indian J Pediatr. 2023 Sep 25. doi: 10.1007/s12098-023-04849-6. Online ahead of print.

ABSTRACT

OBJECTIVES: To find out the diagnostic accuracy of stool Cartridge-based nucleic acid amplification test (CBNAAT) as an alternate method as compared to CBNAAT in gastric aspirate (GA) samples in pediatric tuberculosis (TB).

METHODS: This cross-sectional study was performed at Department of Pediatrics of a tertiary care hospital. Children aged 0-18 y diagnosed as presumptive tuberculosis were consecutively enrolled. Gastric aspirate and corresponding stool sample was subjected to CBNAAT and its performance was compared in both samples using appropriate statistical tests.

RESULTS: Total 100 patients were enrolled in the study. Diagnostic accuracy of CBNAAT was 81% and 80% in gastric aspirate and stool sample respectively. On comparing gastric aspirate with corresponding stool sample there was 97% agreement, with Cohen’s kappa value of 0.94. There was a statistically significant association observed between gastric aspirate CBNAAT and stool CBNAAT p <0.001 using chi square test. Sensitivity of gastric aspirate CBNAAT and stool CBNAAT was 75% and 73% respectively and specificity was 100% for both the samples compared against Composite Reference Standard (CRS).

CONCLUSIONS: The diagnostic accuracy of stool CBNAAT is comparable to GA CBNAAT in children and can be used as a good alternative to gastric aspirate for diagnosis of pulmonary and disseminated tuberculosis in children.

PMID:37747634 | DOI:10.1007/s12098-023-04849-6

Indian J Pediatr. 2023 Sep 25. doi: 10.1007/s12098-023-04848-7. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare the growth of preterm neonates with fetal growth restriction (FGR) and preterm neonates born appropriate-for-gestational-age (AGA) from birth to 12-18 mo of corrected age (CA).

METHODS: In this prospective cohort study, 85 preterm neonates with FGR and 85 gestation- and gender-matched AGA neonates were followed up from birth till 12-18 mo corrected age. Anthropometric indices were compared at specific time points and the risk factors for underweight status were analyzed.

RESULTS: Mean gestational age of the cohort was 32.8 ± 2.1 wk. Mean birth weight was 1414 ± 248 g in the FGR and 1806 ± 416 g in AGA neonates. At 12-18 mo of corrected age, a significantly greater proportion of FGR infants were wasted (24.3% vs. 7.2%, P = 0.005). A greater proportion of FGR infants were underweight (27% vs. 17.4%, P = 0.11), stunted (41.9% vs. 36.2%, P = 0.30), and microcephalic (27% vs. 23.1%, P = 0.36), although the differences were not statistically significant. Significant catch-up growth from 40 wk postmenstrual age (PMA) to 12-18 mo corrected age in weight (52.8% vs. 13.1%, P <0.001) and length (37.9% vs. 8.7%, P <0.001) was observed in the FGR neonates. The z-score of weight for age at 3 mo (adjusted OR 0.65, 95% CI: 0.52-0.8; P <0.001), the median time to full feeds (aOR: 1.10, 95% CI: 1.04-1.15; P = 0.001), and hypothyroidism (aOR 2.44, 95% CI: 1.46-4.08; P = 0.001), were independent predictors of underweight status at 12-18 mo.

CONCLUSIONS: At 12-18 mo of corrected age, a significantly greater proportion of preterm FGR neonates were wasted compared to AGA ones. The former also exhibited significantly greater catch-up growth than the latter.

PMID:37747632 | DOI:10.1007/s12098-023-04848-7