Tag: nevin manimala

Chron Respir Dis. 2023 Jan-Dec;20:14799731231211845. doi: 10.1177/14799731231211845.

ABSTRACT

BACKGROUND: Early commencement of rehabilitation might counteract the loss of muscle strength due to a chronic obstructive pulmonary disease acute exacerbation (COPDAE). Blood flow restriction resistance exercise (BFR-RE) using a low intensity of training load has demonstrated muscle strength gain in varieties of clinical populations. This trial aimed at studying the efficacy and acceptability of BFR-RE in patients with post-COPDAE which was not reported before.

METHOD: A prospective, assessor blinded, randomized controlled study with 2-week in-patient rehabilitation program with BFR-RE was compared to a matched program with resistance exercise without BFR in patients with post-COPDAE. The primary outcome was the change of muscle strength of knee extensor of dominant leg. The secondary outcomes included changes of hand grip strength (HGS), 6-minute walk test (6MWT) distance, short physical performance battery (SPPB) scores, COPD assessment test (CAT) scores; acceptability and feasibility of BFR-RE; and 1-month unplanned re-admission rate.

RESULTS: Forty-Five post-COPDAE patients (mean age = 76 ± 10, mean FEV1%=49% ± 24%) were analyzed. After training, BFR-RE group and control group demonstrated a statistically significant median muscle strength gain of 20 (Interquartile range (IQR) 3 to 38) Newton(N) and 12 (IQR -9 to 30) N respectively. BFR-RE group showed a significant change in SPPB scores, but not in 6MWT distance and HGS after training. Between groups did not have statistically significant different in all primary and secondary outcomes, though with similar acceptability. Drop-out rate due to training-related discomfort in BFR-RE group was 3.7%.

CONCLUSION: BFR-RE is feasible and acceptable in patients with post-COPDAE. A 2-week inpatient pulmonary rehabilitation with BFR-RE improved muscle strength of knee extensors, but not a greater extent than the same rehabilitation program with resistance exercise without BFR. Further studies could be considered with a longer training duration and progression of resistance load. [ClinicalTrials.gov Identifier: NCT04448236].

PMID:37976375 | DOI:10.1177/14799731231211845

West Afr J Med. 2023 Nov 10;40(11 Suppl 1):S24-S25.

ABSTRACT

INTRODUCTION: Though some studies showed biochemical and haematologic derangements in patients with pulmonary tuberculosis (PTB), but information with regards to the correlation between serum albumin and packed cell volume (PCV) is scarce. The aim of this study was to determine the correlation between serum albumin level and PCV in newly diagnosed patients with PTB at Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi, Northeastern Nigeria.

METHODOLOGY: This was a cross-sectional study of consecutive newly diagnosed patients with PTB who were Sputum smear-positive as determined by Gene Expert/Rif MTB machine and HIV-negative by ‘Determine’ test, that were recruited from the medical outpatient department (MOPD) and directly observed treatment short course (DOTS) clinic of ATBUTH, Bauchi. The study was conducted between 2019-2022. Three milliliters of blood sample was analyzed at ATBUTH laboratory for serum albumin and PCV. Extracted data was analyzed using IBM SPSS version 23.0 software.

RESULT: There were 61 patients studied comprising 46 (75.4%) males and 15 (24.6%) females with male to female ratio of 3:1. Their ages range from 14-64 years old. The mean age ± standard deviation (SD) of the patients was 32.21 ± 13.67 years. The mean ± SD of serum albumin and PCV were 2.99 ± 0.55 g/dl, 33.42 ± 5.66 % respectively. Pearson’s product-moment correlation coefficient (r) was +0.475, p = 0.000 which was statistically significant at the 0.01 level suggesting a positive correlation between serum albumin and PCV.

CONCLUSION: There was a significant correlation between serum albumin level and PCV in the patients studied.

PMID:37976370

Sci Adv. 2023 Nov 15;9(46):eade7130. doi: 10.1126/sciadv.ade7130. Epub 2023 Nov 17.

ABSTRACT

Toward the poles, life on land is increasingly dominated by microorganisms, yet the evolutionary origin of polar microbiomes remains poorly understood. Here, we use metabarcoding of Arctic, sub-Antarctic, and Antarctic lacustrine benthic microbial communities to test the hypothesis that high-latitude microbiomes are recruited from a globally dispersing species pool through environmental selection. We demonstrate that taxonomic overlap between the regions is limited within most phyla, even at higher-order taxonomic levels, with unique deep-branching phylogenetic clades being present in each region. We show that local and regional taxon richness and net diversification rate of regionally restricted taxa differ substantially between polar regions in both microeukaryotic and bacterial biota. This suggests that long-term evolutionary divergence resulting from low interhemispheric dispersal and diversification in isolation has been a prominent process shaping present-day polar lake microbiomes. Our findings illuminate the distinctive biogeography of polar lake ecosystems and underscore that conservation efforts should include their unique microbiota.

PMID:37976353 | DOI:10.1126/sciadv.ade7130

Biomol Biomed. 2023 Nov 16. doi: 10.17305/bb.2023.9829. Online ahead of print.

ABSTRACT

This study undertakes a comprehensive comparison of five different interventions for the treatment of type-1 retinopathy of prematurity (ROP) and aggressive posterior retinopathy of prematurity (APROP), offering insights into their relative efficacies and contributing to better clinical decision-making. The aim of this study was to compare the efficacy of intravitreal aflibercept (IVA), intravitreal bevacizumab (IVB), intravitreal conbercept (IVC), intravitreal ranibizumab (IVR), and laser therapy in treating these conditions. We conducted a search for relevant randomized controlled trials (RCTs) in databases, namely PubMed, Embase, Cochrane Library, Web of Science, and Ovid, focusing on these five treatment modalities for ROP. The quality of included studies was evaluated using the Cochrane Risk of Bias Assessment Tool, and data analysis was performed using STATA software. The results from our network meta-analysis (NMA) indicated that IVA significantly prolonged the interval between initial treatment and relapse in patients, with a surface under the cumulative ranking cruve (SUCRA) value of 99.1%. Additionally, patients in the IVB group had a significantly higher spherical equivalent refraction (SER) after surgery, with a SUCRA value of 84.4%. Furthermore, IVR was the most effective in reducing the duration of peripheral retinal vascularization, with a SUCRA value of 95.6%. However, no statistically significant differences were found in relapse rates among the five treatment options. Our analysis concludes that intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) drug monotherapy generally offer better outcomes than laser treatment for ROP. Nonetheless, additional RCTs are necessary to further evaluate the safety of anti-VEGF agents.

PMID:37976345 | DOI:10.17305/bb.2023.9829

Vestn Otorinolaringol. 2023;88(5):63-68. doi: 10.17116/otorino20238805163.

ABSTRACT

Data on the detection incidence of nosebleeds (NBs) of non-traumatic origin in the population show considerable variability in statistical indicators, and NBs treatment and consequences depend on the localization of hemorrhage source, the volume of blood loss, patient’s general condition, the presence and nature of comorbid pathology and a number of other factors. There are some differences in the choice of NBs treatment options, evaluation of their clinical and economic efficiency, which indicates the need to analyze and systematize the results of such studies.

OBJECTIVE: To analyze data on prevalence and current treatment approaches of non-traumatic nosebleeds.

MATERIAL AND METHODS: The search for publications (articles and related abstracts) on the subject of the study, presented in the PubMed database, has been conducted. The choice of material was made according to the following key words: non-traumatic nosebleeds, causes, incidence, methods of stopping nosebleeds.

RESULTS: The literature data show a significant prevalence of NBs in the population, their potential hazard to the life of patient and the importance of clinical and demographic characteristics of persons for determining treatment tactics in each case. In practical terms, primary and secondary NBs should be distinguished. In case of primary NB, the use of coagulation and nasal packing is recommended after determining the place of bleeding. In secondary NB it is necessary to establish its cause in order to assess risk factors and apply appropriate topical or systemic drug therapy. The so-called difficult (difficult-to-treat) NBs deserve special attention. As a rule, these cases involve bleeding from the posterior parts of nose. The analysis of publications shows a high (90%) efficacy of surgical interventions, used as first-line treatment. Effectiveness of embolization in such cases was 75% and of anterior/posterior nasal packing was 62%.

CONCLUSION: The literature data show a significant prevalence of nosebleeds in the population and their potential hazard to the life of patient. The existing differences in the assessments of treatment options for this pathology, their clinical and economic efficiency are the basis for further research, in particular, to clarify the causes of nosebleeds’ occurrence and recurrence, the impact of treatment methods on quality of patients’ life.

PMID:37970772 | DOI:10.17116/otorino20238805163

Vestn Otorinolaringol. 2023;88(5):58-62. doi: 10.17116/otorino20238805158.

ABSTRACT

Data on the features of the anatomical structure of the hard palate are little described in the scientific literature, and therefore are not taken into account when planning surgical treatment. One of the intraoperative complications during intervention on the lower part of the nasal septum is perforation of the bottom of the nasal cavity, which can develop during a christotomy. This complication mainly depends on the features of the anatomical structure of the hard palate.

OBJECTIVE: To study the anatomical structure of the hard palate from the point of view of rhinosurgery, using vector analysis of multispiral computed tomography (MSCT), and to establish anatomical features that should be taken into account when performing surgical interventions on the nasal septum.

MATERIAL AND METHODS: 107 patients (30 men, 77 women) were examined without congenital cleft palate and surgical interventions on the structures of the nasal cavity and hard palate. All patients underwent MSCT of the nose and paranasal sinuses (PNS) followed by multiplanar image reconstruction. The key point relative to which the measurements were carried out was the posterior wall of the incisor canal from the side of the nasal cavity. The line corresponding to the bottom of the nasal cavity was chosen as the main vector. In the work, measurements of the thickness of the hard palate (THP) at the level of the palatal suture and the width of the palatal suture (WPS) were carried out.

RESULTS: Statistical analysis of the obtained results showed that the THP is 1.74 mm [min 0.28; max 6.46], the WPS is 0.9 mm [min 0.2; max 2.51] (conditional norm). In 19 patients (17.8%), the THP was 0.82 mm, in 2 patients (1.9%) – 0.2 mm. In 3 patients (2.8%), the WPS was equal to 2.5 mm.

CONCLUSION: Thus, the data obtained by us indicate that the surgical anatomy of the hard palate is characterized by significant variability, while in some patients the THP can be reduced by 8.8 times, and the WPS increased by 2.7 times compared to normal values. Such anatomical features of the structure of the hard palate should be taken into account when planning septoplasty, since this contingent of patients has an increased risk of developing iatrogenic perforation of the nasal floor during surgical intervention on the lower floor of the nasal septum.

PMID:37970771 | DOI:10.17116/otorino20238805158

Vestn Otorinolaringol. 2023;88(5):49-57. doi: 10.17116/otorino20238805149.

ABSTRACT

INTRODUCTION: The issues of epidemiology, etiopathogenesis, diagnostics and clinic of acute catarrhal rhinosinusitis are considered, the possibility of using the herbal medicinal product Sinupret extract in the treatment of patients with acute viral rhinosinusitis is substantiated.

OBJECTIVE: To evaluate the efficacy and safety of using the drug Sinupret extract in patients with acute viral rhinosinusitis.

MATERIAL AND METHODS: A comparative study of the efficacy and safety of clinical use in patients of the drug Sinupret extract in patients with acute viral rhinosinusitis was carried out in comparison with symptomatic treatment.

RESULTS AND DISCUSSION: After analyzing and processing the results obtained using statistical methods for the main group, a faster rate of decrease in the severity of complaints (data with the use of the MSS visual analogue scale), the severity of inflammation in the nasal cavity and nasopharynx, the amount of discharge from the nose and its viscosity were confirmed. Restoration of respiratory function according to rhinomanometry and mucociliary transport according to the results of the saccharin test also occurred more quickly in patients of the main group compared to the control group. The effectiveness of using Sinupret extract is also confirmed by the results of photoplethysmography.

CONCLUSIONS: The use of the drug Sinupret extract not only contributes to a more rapid improvement in the general well-being of patients and a decrease in the severity of complaints, but also leads to an improvement in the objective picture of the disease (rhinoscopy, the results of anterior active rhinomanometry, saccharin test) compared with the control group, favorably affects the quality life of patients, causes a decrease in economic and social costs against the background of the development of acute viral rhinosinusitis.

PMID:37970770 | DOI:10.17116/otorino20238805149

Vestn Otorinolaringol. 2023;88(5):41-48. doi: 10.17116/otorino20238805141.

ABSTRACT

According to the statistical forms medical and preventive treatment centres (MPTC), the analysis of dynamic indicators of the treatment of patients with acute sinusitis (AS) in outpatient polyclinic centers (OPC) and ENT hospitals in Moscow for the period from 2017 to 2021 was carried out. The total number of visits to an otorhinolaryngologist in the OPC in Moscow for 2017-2021 amounted to 6 834 952 patients, including 245 172 patients with AS (3.6%).The total number of hospitalizations in the departments of otorhinolaryngology for the same period amounted to 184 735 patients, including 12 906 patients with AS (7%).The number of patients with AS who was consulted by an otorhinolaryngologist from 2017 to 2021 decreased by 18.2%, which can be explained by a change in the routing of patients with mild form of AS to general practitioners. An analysis of the dynamic indicators of maxillary sinus punctures carried out in the medical and preventive treatment centres (MPTC) in Moscow during the period from 2017 to 2021 showed that there was a redistribution of this manipulation from ENT hospitals to the OPC. At the same time, the proportion of patients requiring puncture treatment in the OPC for 2017-2019 was stable and amounted to 9.3%. However, since 2020, there has been an increase in this indicator by more than 2 times (21.7%), which probably indicates an increase in the treatment of patients with moderate forms of AS in the OPC. The frequency of maxillary sinus punctures that were performed in ENT hospitals in 2017-2019 amounted to 83.5%, in 2020-2021 decreased to 63.4%. The average number of maxillary sinus punctures per patient in ENT hospitals from 2017 to 2019 was 13.3. Since 2020, this value has decreased by about 2 times and has become equal to 8.5. The decrease in the number of maxillary sinus punctures that were performed in ENT hospitals is probably due to the fact that patients with severe and complicated forms of acute sinusitis hospitalized from 2020 to 2021 required more radical surgical treatment.

PMID:37970769 | DOI:10.17116/otorino20238805141

Vestn Otorinolaringol. 2023;88(5):19-22. doi: 10.17116/otorino20238805119.

ABSTRACT

The article is devoted to the problems of binaural cochlear implantation, especially in patients with a long time interval between surgeries. The purpose of the study was to evaluate the effect of the time range between successive interventions in patients with binaural prosthetics using the CI system.

MATERIALS AND METHODS: the study included 50 patients aged 10 to 14 years, divided into 3 study groups: patients with unilateral cochlear implantation (group I), patients with bilateral implantation with a less than 1 year range between operations (group II) and patients with bilateral implantation with a more than 5 year range between interventions (group III). Comparative analysis was carried out using speech audiometry in silence and noise, assessment of sound localization and questionnaires to assess the auditory dynamics and speech development.

RESULTS: Patients in groups II and III showed comparable results in speech intelligibility in noise and sound localization. At the same time, these indicators turned out to be higher than in patients of group I. Patients from all three groups did not show statistically significant differences in speech intelligibility in silence and in the level of speech development.

CONCLUSION: a long interval (more than 5 years) after the first implantation should not be considered as a contraindication to binaural implantation.

PMID:37970765 | DOI:10.17116/otorino20238805119

Ultrasound Obstet Gynecol. 2023 Nov 16. doi: 10.1002/uog.27535. Online ahead of print.

ABSTRACT

OBJECTIVE: A timely and correct preoperative diagnosis of a uterine sarcoma will increase patients’ survival. The primary aim of our study was to describe the ultrasound features in uterine sarcomas compared to uterine leiomyomas based on MUSA (Morphological Uterus Sonographic Assessment) terms and definitions. The secondary aim was to assess the interobserver agreement of the MUSA ultrasound features.

METHODS: This retrospective cohort study assessed uterine sarcomas from 1997 until 2019 and uterine leiomyomas from 2016 until 2019 treated in a single tertiary center. Patients’ demographics, presenting symptoms and outcome were extracted from the patients’ files. The ultrasound images were re-evaluated independently by two sonologists using the MUSA terms and definitions. Descriptive statistics were calculated and interobserver agreement was assessed with Cohen’s Kappa (with squared weights) or intraclass correlation coefficient depending on the type of variable.

RESULTS: Hundred and seven patients were included, of whom 16 had a uterine sarcoma and 91 a uterine leiomyoma. Abnormal uterine bleeding was the most frequent presenting symptom (69/107, 65%). Compared to leiomyoma cases, uterine sarcoma patients were older (mean age of 65 years (IQR 60-70 years) versus (vs.) 48 years (IQR 43-52 years)) and mostly postmenopausal (13/16 (81%) vs. 15/91 (16%)). In the uterine sarcoma cohort, leiomyosarcoma was the most frequent histological type (6/16 (38%) followed by adenosarcoma (4/16 (25%). On ultrasound evaluation, according to observer 1 and 2, the tumor border was irregular in most sarcomas (in 11/16 (69%) and 13/16 (81%), respectively), whereas leiomyomas were most frequently regular (in 65/91 (71%) and 82/91 (90%), respectively). The observers classified the lesion echogenicity as non-uniform, in 68/91 (75%) and 51/91 (56%) of leiomyomas and 15/16 (94%) of uterine sarcoma. More than 60% of the uterine sarcomas showed acoustic shadows (in 11/16 (69%) and 10/16 (62%) respectively) whereas calcifications were reported in a small minority of them (in 0/16 (0%) and 2/16 (13%) respectively). In uterine sarcomas, the intralesional vascularity was reported as moderate to abundant in 13/16 (81%) and 15/16 (94%) respectively while circumferential vascularity was scored as high in 6/16 (38%) by both observers. The interobserver agreement for presence of cystic areas, calcifications, acoustic shadow and central necrosis, color score (overall, intralesional and circumferential), and maximal diameter of the lesion, was moderate. The agreement for lesion tumor border and echogenicity was fair.

CONCLUSIONS: A postmenopausal patient, presenting with abnormal uterine bleeding and a new or growing mesenchymal mass with irregular tumor borders at ultrasonography, moderate to abundant intralesional vascularity, presence of cystic areas and absence of calcifications, carries a higher risk of having a uterine sarcoma. The interobserver agreement for most MUSA terms and definitions is moderate. Future studies should validate the above clinical and ultrasound findings in a prospective multicenter collection of uterine mesenchymal tumors. This article is protected by copyright. All rights reserved.

PMID:37970762 | DOI:10.1002/uog.27535