Tag: nevin manimala

Andes Pediatr. 2022 Dec;93(6):807-814. doi: 10.32641/andespediatr.v93i6.3807.

ABSTRACT

Coronavirus 2 (SARS-CoV-2) infection has spread rapidly. In pediatrics, a condition similar to shock is described named multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). The mechanisms of cardiological involvement are not clear.

OBJECTIVE: To describe cardiological in volvement and inflammatory markers in hospitalized patients with MIS-C in a tertiary hospital.

PATIENTS AND METHOD: Observational, retrospective study in children under 15 years of age with MIS-C. Demographic, clinical, and laboratory variables were collected from an electronic plat form, including troponin, B-type natriuretic peptide (proBNP), ultrasound, and electrocardio gram. Patients with / without cardiological involvement (CCC / SCC) were compared. GraphPad QuickCalcs© 2018 Software was used for statistical analysis, considering p < 0.05.

RESULTS: Thir teen patients diagnosed with MIS-C, 9 males, median age 9.5 years. All presented with fever and abdominal pain, adding one or more of the following symptoms: vomiting, exanthema, diarrhea, altered mucous membranes and/or edema. Five patients had hemodynamic compromise, 9/13 were categorized as CCC. Troponins were elevated 4.1 times in CCC (p < 0.05), median ProBNP CCC 6940 pg/ml vs 921 pg/ml in SCC (p < 0.05), median Ferritin CCC 482 vs 154 ng/ml in SCC (p < 0.01), platelets CCC 106,000 vs SCC 207,000/mm3 (p < 0.05). Echocardiogram showed pe ricardial effusion (N = 6), mild systolic dysfunction (N = 4), moderate dysfunction (N = 1) and coronary alterations (N = 3). In the ECG, 3 patients presented transient repolarization disturbance and 1 first-degree atrioventricular block. None required support with extracorporeal membrane oxygenation, with no deaths.

CONCLUSION: cardiological involvement in hospitalized children with MIS-C is frequent. Our series showed nonspecific and transitory symptoms, and hemodynamic compromise which responded early to medical treatment, with a favorable evolution. The markers in CCC patients were troponin, ProBNP, ferritin, and thrombocytopenia. The most frequent ul trasound finding was pericardial effusion. The importance of both clinical and laboratory cardio logical evaluation in these patients is evident.

PMID:37906797 | DOI:10.32641/andespediatr.v93i6.3807

Rev Med Chil. 2023 Feb;151(1):32-41. doi: 10.4067/s0034-98872023000100032.

ABSTRACT

BACKGROUND: Long-term outcomes of Off-Pump Coronary Artery Bypass Grafting (OPCAB) as an alternative to the traditional Coronary Artery Bypass Grafting (CABG) technique with cardiopulmonary bypass (CPB) are not well defined.

AIM: To compare 10-year survival of isolated OPCAB versus CABG with CPB.

MATERIAL AND METHODS: Analysis of information obtained from databases, clinical records and surgical protocols of patients treated with isolated CABG between January 2006 and November 2008 at a Regional Hospital. Of 658 isolated CABG, 192 (29.2%) were OPCAB and 466 (79.9%) CPB. Propensity Score Matching (PSM) was performed to compare both groups. After PSM, two groups of 192 cases were obtained. Mortality data was obtained from the Chilean public identification service. Ten-year survival was calculated and compared with Kaplan-Meier and log-rank methods.

RESULTS: Follow-up data was obtained in all cases. No statistically significant differences were found when comparing 10-year survival between OPCAB versus CPB (78.6% and 80.2% respectively, p 0.720). There was also no statistical difference in cardiovascular death free survival (90.1% with CPB versus 89.1% OPCAB, p 0.737). Survival was comparable when analyzing subgroups with diabetes mellitus, left ventricular dysfunction or chronic kidney disease, among others.

CONCLUSIONS: In our series, OPBAB has a comparable 10-year survival with CABG with CPB.

PMID:37906744 | DOI:10.4067/s0034-98872023000100032

JCO Clin Cancer Inform. 2023 Sep;7:e2300132. doi: 10.1200/CCI.23.00132.

ABSTRACT

Waterfall plots have gained popularity as a visualization tool to present antitumor activity of treatments in oncology, especially for phase I and II trials. The typical waterfall plot in oncology is a bar plot with each bar representing the best percent tumor size reduction from baseline for a patient sorted in descending order along the x-axis. As new therapies are routinely developed in combination with standard of care or other investigational treatments, waterfall plot comparison between combination therapy and monotherapy may facilitate development decisions in addition to overall response rate or duration of response. However, waterfall plots are often assessed heuristically in practice with lack of statistical rigor. In this work, we examine the correspondence between the waterfall plot and the empirical cumulative distribution function. We demonstrate how to derive key summary statistics directly from the waterfall plot. Using real examples from published waterfall plots, we show how comparisons of waterfall plots can elucidate clinically meaningful information, such as treatment effect patterns in progression-free survival and overall survival.

PMID:37906725 | DOI:10.1200/CCI.23.00132

West Afr J Med. 2023 Oct 31;40(10):1086-1095.

ABSTRACT

INTRODUCTION: Various factors influence the expression of dental anxiety (DA) among patients. Knowledge of these factors may aid the management of mandibular third molar (M3) dis-impaction patients.

AIM: The study aimed to determine the predictive and relative factors of DA among Mandibular third molar (M3) dis-impaction patients at the Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria.

METHODOLOGY: The study was a cross-sectional type conducted at the Oral Surgery clinic of AKTH, Kano among M3 dis-impaction patients between September 2016 and August 2017. Biodata and information on the past dental history of the participants were collected and recorded. The level of anxiety of participants was assessed with the Modified Dental Anxiety Scale (MDAS). Data were analyzed using Statistical Package for Social Sciences (SPSS) for windows (IBM SPSS statistic version 23). The significance level in the study was set at p ≤ 0.05.

RESULTS: One hundred and sixteen patients comprising 62(55.2%) males and 54(44.8%) females were recruited. The sample’s median age was 27 years and the majority of the participants were students (n=49,42.2%). The participants’ MDAS scores ranged from 5 to 22 with a median score of 11. Females (median MDAS score of 12.50) were significantly (p<0.0001) more anxious than males (median MDAS score of 9.00). Bivariate analysis showed statistically significant differences in DA of the categories of the following independent variables – gender (p<0.0001), ethnicity (p=0.041), occupational status (p=0.044), previous surgical extraction experience (p=0.006), previous bad dental treatment experience (p<0.0001) and history of postponement of dental treatment due to anxiety(p<0.0001). Binary logistic regression analysis with these variables as independent predictors of DA showed that only gender (p=0.013) and previous surgical extraction experience (p=0.042) had statistically significant odds of predicting dental anxiety among the patients. Females had significantly higher odds of being anxious than males [adjusted odds ratio (OR) = 4.180, 95% Confidence Interval (CI)=1.359 to 12.852] and patients with previous surgical extraction experience had higher odds of being anxious than those without surgical extraction experience [adjusted OR=3.65, 95% CI=1.02 to 13.03].

CONCLUSION: The predictors of DA in the study are female gender and previous surgical extraction experience. These and other DA-related factors such as patients’ occupation and previous bad dental treatment experiences should be considered preoperatively to identify and manage anxious M3 dis-impaction patients.

PMID:37906714

J Phys Chem A. 2023 Oct 31. doi: 10.1021/acs.jpca.3c05078. Online ahead of print.

ABSTRACT

In this study, mixed carbonyl and nitrous oxide complexes with Rh⁺ were studied by mass-selective infrared photodissociation spectroscopy in a molecular beam. The infrared spectra, recorded in the region of the CO and N₂O N═N stretches, were assigned and interpreted with the aid of simulated spectra of low-energy structural isomers. Clear evidence of an inner coordination shell of four ligands is observed. The observed vibrational structure can be understood on the basis of local mode vibrations in the two ligands. However, there is also evidence of multiple low-lying isomers and cooperative binding effects between the two ligands. In particular, σ donation from directly coordinated nitrous oxide ligands drives more classical carbonyl bonding than has been observed in pure carbonyl complexes. The observed fragmentation branching ratios following resonant infrared absorption are explained by simple statistical and energetic arguments, providing a contrast with those of equivalent Au⁺ complexes.

PMID:37906705 | DOI:10.1021/acs.jpca.3c05078

Epidemiol Health. 2023 Oct 24:e2023095. doi: 10.4178/epih.e2023095. Online ahead of print.

ABSTRACT

OBJECTIVES: Inhalation exposure to humidifier disinfectants has resulted to various types of health damages in Korea. To determine the epidemiological correlation necessary for presuming the legal causation, we aimed to develop a method to synthesize the entire evidence.

METHODS: Epidemiological and toxicological studies are systematically reviewed. Target health problems are selected by criteria such as frequent complaints of claimants. Relevant epidemiologic studies are reviewed and the risk of bias and confidence level of the total evidence are evaluated. Toxicological literature reviews are conducted on a line of evidence comprising hazard information, animal studies, and mechanistic studies. The confidence levels for evidence-based toxicological effects and source-to-outcome pathways are synthesized to classify the toxicological evidence levels for the causality between humidifier disinfectant exposure and health effects. Finally, the levels of epidemiological and toxicological evidence are synthesized.

RESULTS: Under the Special Act revised in 2020, if the history of exposure and the disease occurred/worsened after exposure were approved, and the epidemiological correlation between the exposure and disease was verified, the legal causation is presumed unless the company proves the evidence against it. The epidemiological correlation can be verified through epidemiological investigations, health monitoring, cohort investigations and toxicological studies. It is not simply as statistical correlation as understood in judicial precedents, but a general causation established by the evidence as a whole, i.e., through weight-of-the-evidence approach.

CONCLUSION: The weight-of-the-evidence approach differs from the conclusive single study approach and this systematic evidence integration can be used in presumption of causation.

PMID:37905312 | DOI:10.4178/epih.e2023095

Cureus. 2023 Sep 29;15(9):e46178. doi: 10.7759/cureus.46178. eCollection 2023 Sep.

ABSTRACT

Introduction It has been discovered that low levels of thiamine reserves in the body are related to diabetes mellitus (DM) because thiamine directly influences carbohydrate metabolism. Therefore, the purpose of this study was to assess several metabolic variables and blood thiamine levels in patients with type 1 and type 2 DM and compare them with those in a control group of healthy individuals. Methods This case-control study was conducted at multiple diabetic outpatient centers in Karachi. A total of 90 participants, who were divided into three groups, each containing 30 individuals, were chosen using a convenient non-probability sampling technique. Group A served as the control group and consisted of healthy, non-diabetic individuals. Groups B and C contained subjects with type 1 and type 2 DM, respectively. Descriptive analysis was reported as mean standard deviation, whereas gender and comorbidities were expressed as frequencies and percentages. The chi-square test and Pearson’s correlation coefficient were used to determine the associations of the variables with type 1 DM, type 2 DM, and controls. Results The study results revealed statistically significant differences between controls, type 1 and type 2 DM, in the means of blood glucose levels and all lipid profiles, such as glycated hemoglobin (HbA1c), fasting blood sugar (FBS), random blood sugar (RBS), serum thiamine, triglycerides (p < 0.001), high-density lipoprotein (HDL) (p = 0.014), and total cholesterol (p = 0.013). Furthermore, it was shown that among the control group, type 1 and type 2 DM, HbA1c, and FBS were insignificantly correlated with thiamine levels, whereas the HbA1c and FBS of the combined diabetic groups were significantly correlated with the thiamine level (r = 0.465, p < 0.001) and (r = 0.360, p = 0.005), respectively, where ‘r’ is the Pearson correlation coefficient. Additionally, HbA1c and FBS in the combined three groups were significantly correlated with the thiamine level (r = -0.626, p < 0.001) and (r = -0.561, p < 0.001), respectively. Conclusion This study concluded that patients with type 1 and type 2 DM had significantly higher levels of FBS, RBS, HbA1c, triglycerides, and total cholesterol than controls. Furthermore, both type 1 and type 2 DM patients’ serum thiamine and HDL levels were observed to be considerably lower than those of controls. Additionally, among both types of DM and controls, there was a strong correlation between FBS and HbA1c. Therefore, we recommend that serum thiamine levels be routinely monitored in diabetic patients, and thiamine supplementation should be considered to avoid complications, especially vascular complications of DM.

PMID:37905298 | PMC:PMC10613325 | DOI:10.7759/cureus.46178

Cureus. 2023 Sep 29;15(9):e46189. doi: 10.7759/cureus.46189. eCollection 2023 Sep.

ABSTRACT

BACKGROUND: Craniotomy is associated with significant postoperative discomfort. Standardized pain management and enhanced recovery after surgery (ERAS) protocol could improve patient-reported outcomes and lower medical expenses.

AIM: The aim of this study is to prospectively assess the effectiveness of an ERAS protocol for neurosurgery in the treatment of postoperative pain following elective craniotomies.

METHODS AND MATERIALS: A total of 128 patients were assigned to the ERAS group and received care in accordance with the neurosurgical ERAS regulations, while 130 other participants were assigned to the control group and received traditional postoperative assistance. The participants’ postoperative pain ratings using the numerical rating scale (NRS) were this study’s main outcome of interest. The verbal NRS uses the numbers 0 to 10, with 0 indicating no sensation of pain and 10 indicating the most severe pain. On postoperative day (POD) 1, the patients’ postoperative pain level at the surgical site was evaluated using the NRS. This was repeated every day until the patient either reported feeling no sensation of pain or was discharged home.

RESULTS: The mean value of pain on the day of surgery was 4.43 ± 0.43 and 4.72 ± 0.68 for patients in the ERAS and control groups, respectively. The pain values were higher in the control group compared to the ERAS group. However, the difference was not statistically significant (p = 0.478). The mean value of pain on POD1 was 3.13 ± 0.21 and 4.45 ± 0.95 for patients in the ERAS and control groups, respectively. These pain values were higher in the control group compared to the ERAS group, and the difference was statistically significant (p = 0.011). The mean value of pain on POD2 was 2.86 ± 0.3 and 4.33 ± 0.37 for patients in the ERAS and control groups, respectively. The values of pain were higher in the control group compared to the ERAS group, and the difference was statistically significant (p = 0.003). The mean value of pain on POD3 was 2.33 ± 0.52 and 4.04 ± 0.15 for patients in the ERAS and control groups, respectively. The pain values were higher in the control group compared to the ERAS group. The difference was meaningful statistically (p < 0.001). The mean value of pain on POD4 was 2.26 ± 0.9 and 2.84 ± 0.13 for the ERAS and control groups, respectively. However, the difference was not statistically significant (p = 0.274). The ERAS group had a significantly higher proportion of participants rating their pain between 1 and 3 (68.9%) and a lower proportion rating their pain between 4 and 7 (28.2%), compared to the control group (p < 0.001). Differences in the highest pain ratings (8-10) between the groups were not statistically significant. The duration of hospital stay, beginning from surgery to discharge, was lesser among study participants in the ERAS group, and this finding was statistically significant (p < 0.001).

CONCLUSION: The findings of this study imply that the ERAS protocol may aid pain management following elective craniotomies. Additionally, the ERAS protocol decreased the overall expense of medical care and the cumulative/postoperative length of hospital stay.

PMID:37905293 | PMC:PMC10613341 | DOI:10.7759/cureus.46189

Cureus. 2023 Sep 29;15(9):e46196. doi: 10.7759/cureus.46196. eCollection 2023 Sep.

ABSTRACT

Aim Injectable platelet-rich fibrin (i-PRF) and leukocyte and platelet-rich fibrin (l-PRF) are both blood-derived products used in regenerative medicine and dentistry. They contain platelets, growth factors, and leukocytes, which can have antimicrobial properties to some extent, but their primary purpose is tissue regeneration and wound healing. i-PRF and l-PRF may have some indirect antimicrobial properties due to their composition and ability to enhance tissue healing and immune responses, and they are primarily used in dentistry for their regenerative and wound healing capabilities rather than as standalone antimicrobial agents. This study aims to compare the anti-microbial activity of i-PRF and l-PRF against oral microbes. Methodology This study included 30 patients who were selected using G*Power software version 3.1 (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) calculation with the population size. The plaque samples were collected from the subjects using area-specific Gracey curettes used for scaling and root planing to remove plaque and calculus from the teeth and root surfaces. The collected plaque samples were transferred to a tube containing 5 ml of saline (sterile saltwater). The purpose of using saline is to preserve the microbial content of the plaque sample without altering the microbial composition. To obtain a uniform solution, the samples in the saline-containing tube were vortexed for 5 minutes. After vertexing, a small amount of the suspension (0.1 ml) was taken for further analysis. The 0.1 ml suspension was used to plate blood agar using the streak method. A loop or needle is used to streak the sample back and forth across the surface of the agar, leading to the dilution and separation of the bacteria. Results Results state that i-PRF has a maximum zone of inhibition (2.19±0.47 mm) when compared with metronidazole (0.14±0.09 mm). It can be stated that platelet concentrates demonstrate better antimicrobial activity due to their higher oxygen metabolites which help in the aggregation and internalization of microorganisms, which enhances the clearance of pathogens from the bloodstream. Paired t-test has been used for the comparison between the two groups, and the p-value is >0.05 stating that the difference is statistically significant. Conclusion The present study states that i-PRF demonstrated better antimicrobial efficacy as compared to l-PRF. Hence, i-PRF helps in reducing microbial load at the periodontally infected sites when compared with l-PRF.

PMID:37905284 | PMC:PMC10613344 | DOI:10.7759/cureus.46196

Cureus. 2023 Sep 29;15(9):e46191. doi: 10.7759/cureus.46191. eCollection 2023 Sep.

ABSTRACT

Background Plaque and dental caries are the primary agents causing gingival and periodontal diseases, eventually progressing into tooth loss. If oral hygiene practice is poor, plaque easily accumulates on the tooth surface, especially in interproximal areas. To maintain a good oral environment, it is mandatory to remove or at least reduce the percentage of plaque formation from the oral cavity. To achieve this, interdental aids should be used along with toothbrushes, as cleansing the teeth only with a toothbrush is not effective. Various interdental aids, like interdental brushes, floss, toothpicks, etc., are now available on the market. The objective of the current survey was to rate knowledge as well as make a comparison between the cleaning effectiveness of interdental brushes and interdental floss to determine which was better at reducing plaque accumulation and, subsequently, dental caries. The survey was accessed by measuring individual plaque and gingival index before and after using interdental cleaning aids. Methodology The objective of the survey was to evaluate and analyze the efficiency of interdental brushes and interdental floss in maintaining oral hygiene among orthodontic patients residing in the Vidarbha region. After receiving approval from the Ethical Committee DMIHER(DU)/IEC/2023/721, a study was conducted over a 30-day period, focusing on a group of 100 individuals aged between 15 and 30 years, and their assessments were analyzed. The patient was briefed about the study and asked to make use of an interdental brush and interdental floss. The gingival index and plaque index were calculated on the same patients before and after the use of the interdental brush and interdental floss to determine which was better at reducing plaque accumulation on the surface of teeth. Descriptive analysis, unpaired for intergroup comparison, and paired T-tests for intragroup comparison were used. The software used was SPSS 24.0 (IBM Corp., Armonk, NY) and GraphPad Prism 7.0 (GraphPad Software, Inc., La Jolla, CA). Result Everyone’s tooth surfaces naturally develop a thin layer of plaque biofilm, but the presence of heavy plaque deposits on teeth indicates poor dental hygiene, which can lead to various oral health issues. Failure to improve dental hygiene status can result in problems such as halitosis, gingival issues, periodontal disease, and eventually tooth loss. Dentists play a crucial role in raising awareness about these concerns among their patients and providing education on effective oral care practices, including the use of interdental aids in conjunction with toothbrushes. When comparing the effectiveness of interdental brushes and dental floss in removing plaque, interdental brushes have been found to be more efficient. They not only excel in plaque removal but also contribute to a reduction in gingival problems. The statistical analysis supports this, with a significant p-value of less than 0.01 for both the plaque index and gingival index when using interdental brushes, indicating their superior performance in maintaining oral health. Conclusion The study will help every individual improve their oral hygiene status with the help of an interdental aid and a toothbrush. This will reduce the chances of having gingival and periodontal diseases and eventually reduce the risk of tooth loss.

PMID:37905279 | PMC:PMC10613348 | DOI:10.7759/cureus.46191