Tag: nevin manimala

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7738-7748. doi: 10.26355/eurrev_202308_33428.

ABSTRACT

OBJECTIVE: The aim of this study was to develop an initial valid tool to measure attitudes toward cancer-related cognitive changes.

SUBJECTS AND METHODS: After revising the literature, three main dimensions were hypothesized. Eight judges were contacted to obtain content validity evidence. A robust Exploratory Factor Analysis (EFA) was performed via a parallel analysis with an Unweighted Least Squares (ULS) estimator and polychoric correlations. The results were crossed with sociodemographic variables to find possible statistical differences and estimate the size effect. Analysis was performed in the software Factor and the statistical package R.

RESULTS: A sample of 374 participants was obtained, involving oncology patients, their caregivers, and people from the general community. A statistical fit was found in two dimensions: Awareness and Judgments [root mean squared error of approximation (RMSEA) = 0.042, standardized root mean square residual (SRMR) = 0.02, comparative fit index (CFI) = 0.99, Tucker-Lewis index (TLI) = 0.98] with a moderate correlation between them (r = 0.612). Optimal reliability indices were obtained for the total scale and its dimensions. No real statistical difference was found between sociodemographic variables; the interpretation norms were established via the quartiles.

CONCLUSIONS: The first attempt to measure the construct of interest was developed with two primary validity evidence based on the content and its internal structure. This instrument could help strengthen the prevention of cancer-related cognitive changes. More research is needed to adhere more valid evidence to the scale.

PMID:37667952 | DOI:10.26355/eurrev_202308_33428

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7680-7687. doi: 10.26355/eurrev_202308_33421.

ABSTRACT

OBJECTIVE: The aim of our study is to determine the uropathogenic causing urinary tract infections (UTIs) and their incidences, assess their antibiotic resistance, and determine an appropriate empirical antibiotic treatment strategy.

PATIENTS AND METHODS: We retrospectively analyzed the culture and antibiogram results of urine cultures of 49,706 patients aged 1 day to 18 years who applied to Diyarbakır Children’s Hospital between March 2018 and October 2022.

RESULTS: A total of 4,064 cases meeting the study criteria were recorded. Girls comprised 76.7% of the study population. While reproduction in urine culture was more common in boys in the 0-1 age group, there was a decrease in the number of boys with increasing age, and the most common culture growth was seen in girls in the 5-10 age group (p<0.001). Escherichia coli (E. coli) infections were more common in girls, while non-E. coli infections were more common in boys (p<0.001). Gram-negative bacterial growth in urine cultures was the most common growth type. In descending order, E. coli was grown in 68.1% of all cultures, Klebsiella spp in 12.6%, and Proteus spp in 3.9%. Less commonly, Pseudomonas spp (2.8%), Enterobacter spp (1.5%), and fungi (1.1%) were grown. Antibiotic resistance/sensitivity tests revealed resistance patterns most commonly against ampicillin (73.2%), amoxicillin-clavulanate (57.9%), cefuroxime axetil (46.7%), cefixime (51%), and ceftriaxone (40.5%), and less commonly against meropenem (1.7%), amikacin (2.4%), and nitrofurantoin (9.8%). Escherichia coli showed resistance most commonly against ampicillin (69.8%), amoxicillin-clavulanate (59.7%), and cefixime (51.3%), while non-E.coli bacteria showed resistance most commonly against ampicillin (84.6%), amoxicillin (52.0%), and cefixime (50%). Resistance against nitrofurantoin was lower in E. coli infections than non-E. coli infections, although the difference did not reach statistical significance (3.7% and 27%, respectively; p=0.149). In contrast, resistance against trimethoprim-sulfamethoxazole was more common in E. coli infections than non-E. coli infections, although the difference was not statistically significant (42% and 29.7%, respectively; p=0.093).

CONCLUSIONS: Our study revealed that resistance has developed at very high rates against many oral and parenteral antibiotics that we use in the treatment of UTIs. If our rate of antibiotic use continues to increase this way, it is predicted that UTIs will, unfortunately, become untreatable with oral antibiotics. This upsetting point reached by our country, which is the state that uses antibiotics the most in Europe, exemplifies the importance of rational antibiotic use for the whole world.

PMID:37667945 | DOI:10.26355/eurrev_202308_33421

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7620-7628. doi: 10.26355/eurrev_202308_33414.

ABSTRACT

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is known to be associated with endothelial dysfunction (ED). Reducing ED can attenuate the occurrence of cardiovascular diseases. One of the indicators of ED is decreased coronary blood flow (CBF). Sodium-glucose co-transporter 2 inhibitors (SGLT-2is) are known to directly improve ED in both euglycemic and hyperglycemic conditions and have been shown to decrease the incidence of major cardiovascular events. We aimed to investigate whether SGLT-2is improves CBF in patients with T2DM, who have angiographically normal or nearly normal coronary arteries.

PATIENTS AND METHODS: In this single-center retrospective study, all patients who underwent coronary angiography between January 2017 and September 2022 were screened. We designed the study by dividing the patients into two groups – those who used conventional antidiabetic medications (CAM) together with SGLT-2is (patients using an SGLT-2 inhibitor for at least 3 months) and those who used only conventional antidiabetic medications. Of the 18,205 patients who underwent coronary angiography, 5,040 patients had T2DM. After exclusion, 288 patients were divided into two groups – those who used CAM together with SGLT-2is and those who used only CAM. CBF was assessed by thrombolysis in myocardial infarction (TIMI) frame counting.

RESULTS: Two hundred eighty-eight patients who had T2DM and met the inclusion criteria were included in our study. The patients were divided into two groups – those who used CAM together with SGLT-2is (n = 75) and those who used only CAM (n = 213). The median age in the group that used CAM together with SGLT-2is was 55 (51-64), where 52 (69.3%) patients were female. The mean TIMI frame count (TFC) was 23.5 in the group using CAM + SGLT-2is and 27.5 in the group using only CAM. In the multivariable linear regression analysis, the mean TFC was significantly lower in the group using CAM together with SGLT-2is compared to the group using only CAM [β-coefficient = -12.766, 95% Cl: -5.304; -3.887, p < 0.001]. Moreover, there was a statistically significant correlation between an increase in BMI and hemoglobin with an increase in the mean TFC [β-coefficient = 3.018, 95% Cl 0.037-0.175, p = 0.003 and β-coefficient = 2.316, 95% Cl 0.033-0.405, p = 0.021, respectively].

CONCLUSIONS: We have demonstrated that the use of SGLT-2is improves coronary artery blood flow in patients with T2DM who have normal or nearly normal coronary angiography.

PMID:37667939 | DOI:10.26355/eurrev_202308_33414

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7582-7589. doi: 10.26355/eurrev_202308_33410.

ABSTRACT

OBJECTIVE: The aim of the study was to analyze the hospitalization costs of patients with intestinal polyps undergoing colonic polyp surgery and associated influencing factors and to explore the entry point of cost control and the way of fine management.

PATIENTS AND METHODS: One year before (2021) and one year after (2022) the implementation of the Diagnosis Related Grouping (DRG), the patients receiving APC, CSP and EMR in GK39 (colonoscopy operation) group were included in a second Affiliated Hospital in Nanjing according to the Nanjing grouping scheme. Descriptive analysis method and multiple linear regression method were used for analysis.

RESULTS: After the implementation of DRG in 2022, the average hospitalization cost of patients decreased by 19.46% compared with the same period last year. Before and after the implementation of DRG, medical technology costs accounted for the highest proportion of hospitalization costs. Age, hospitalization days, number of polyps, number of clamps and clinical pathway had statistically significant effects on hospitalization cost (p<0.05), among which hospitalization days, number of polyps, and number of clamps had the greatest impact on hospitalization cost, followed by age and clinical pathway.

CONCLUSIONS: The implementation of DRG has a positive effect on guiding hospitalization cost control. It is suggested to realize accurate cost control by analyzing the cost structure of the disease group. Clinical pathway completion rate has a direct impact on the implementation effect of DRG, including cost control. It is suggested to refine clinical pathway management and achieve scientific cost control through continuous optimization and improvement of clinical pathway management.

PMID:37667935 | DOI:10.26355/eurrev_202308_33410

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7492-7499. doi: 10.26355/eurrev_202308_33400.

ABSTRACT

OBJECTIVE: The aim of the study was to investigate the clinical effectiveness and safety of sclerotonyxis in acute angle-closure glaucoma (ACG) with persistent high intraocular pressure (IOP).

PATIENTS AND METHODS: The clinical data of 50 eyes from 50 patients (mean age: 68.9±7.19 years) with acute ACG and persistently high IOP who were admitted to our department between January 2012 and January 2022 were retrospectively analyzed. Patients who were administered the maximum dose of systemic and topical anti-glaucoma drugs and still had an IOP of >40 mmHg 24 hours after admission underwent sclerotonyxis. After the IOP control, an individualized phase II treatment plan was designed according to the patient’s ocular condition.

RESULTS: Forty-eight patients showed improvement in their visual acuity 6 months postoperatively compared to their preoperative values. The mean IOPs were 54.84±7.82 mmHg and 21.34±7.81 mmHg 24 hours pre and postoperatively, respectively. The mean anterior chamber depth showed statistically significant differences pre and postoperatively (1.75±0.16 mm and 1.84±0.17 mm, respectively) (p<0.05). After IOP stabilized, four patients underwent YAG laser peripheral iridectomy, 18 underwent simple cataract phacoemulsification combined with intraocular lens (IOL) implantation, 21 underwent cataract phacoemulsification combined with IOL implantation and goniosynechialysis under a gonioscope, and 7 patients underwent combined surgery of glaucoma and cataract. The mean IOPs were 15.94±3.3 mmHg and 15.64±2.99 mmHg 1 week and 6 months after stage II surgery, respectively. Moreover, 42 eyes (84%) attained complete success and 8 eyes (16%) attained conditional success 6 months postoperatively. No serious complications, such as corneal endothelial decompensation, malignant glaucoma, vitreous or eruptive choroidal hemorrhage, and retinal detachment, were observed intraoperatively or postoperatively in both procedures.

CONCLUSIONS: Sclerotonyxis can rapidly lower IOP, release the pupillary blockage, reconstruct the anterior chamber, and reduce systemic complications caused by long-term high-dose antiglaucoma drugs. Thus, it normalizes the IOP and provides a safe operating space for stage II surgery, effectively reducing complications in patients in a persistent high IOP state.

PMID:37667925 | DOI:10.26355/eurrev_202308_33400

Eur Rev Med Pharmacol Sci. 2023 Aug;27(16):7401-7408. doi: 10.26355/eurrev_202308_33391.

ABSTRACT

OBJECTIVE: The aim of this study was to compare the body fat content, vitamin D, serum lipid levels, and obesity values of individuals doing sports indoors and outdoors and sedentary individuals.

PATIENTS AND METHODS: The research was conducted as a case-control study. The case group consisted of 30 participants between the ages of 18-30 who did outdoor sports, the first control group consisted of 30 participants doing sports indoors, and the second control group consisted of 30 sedentary participants. Voluntary consent was obtained from the research group, which consisted of 90 participants in total. As inclusion criteria for the study, they were asked to be healthy, not have chronic diseases, to be doing sports outdoors or indoors, and as the control group, individuals who did not do sports. Participants were asked to complete a questionnaire about their socio-demographic characteristics, vitamin D level, and factors affecting body fat ratio.

RESULTS: 57.8% of the participants (52 participants) were male, and 42.2% (38 female) were female. The mean age of the study group was 22.26 ± 3.86. The body mass index (BMI) was 22.91 ± 4.06. Waist/hip ratio 0.76 ± 0.06. Serum values averages were as follows: calcium 11.74 ± 0.06, cholesterol 156.23 ± 32.34, high-density lipoprotein (HDL) 48.68 ± 12.45, magnesium 1.83 ± 0.14, phosphorus 3.52 ± 0.78, triglyceride (TGL) 120.76 ± 56.25, vit 25-OH 24.71 ± 1.35, parathormone (PTH) 48.24 ± 2.95. BMI was 21.03 ± 2.94 for those doing outdoor sports, 23.51 ± 3.31 for those who play sports in the indoor area, and 24.06 ± 5.22 for those who cannot do any sport, the difference was statistically significant (p = 0.001). Vitamin 25-OH was found to be 30.75 ± 11.54 in the outdoor sports, 21.59 ± 7.04 in the indoor sports 22.77 ± 3.16 in the non-sports groups and the difference was statistically significant (p < 0.004). Total cholesterol levels were 150.63 ± 6.09 for those doing outdoor sports, 150.92 ± 4.56 for those doing indoor sports, and 169.61 ± 6.57 for non-athletes. Total cholesterol was significantly lower in those who do sports indoors and outdoors compared to those who do not (p < 0.02 and p < 0.03, respectively).

CONCLUSIONS: Sport has a positive effect on body mass index and serum cholesterol levels. Outdoor sports have a more positive effect on the vit 25-OH levels and serum lipid profile than indoor sports.

PMID:37667916 | DOI:10.26355/eurrev_202308_33391

Geospat Health. 2023 Aug 31;18(2). doi: 10.4081/gh.2023.1220.

ABSTRACT

Under-5 mortality rate (U5MR) is a key indicator of child health and overall development. In Thailand, despite significant steps made in child health, disparities in U5MR persist across different provinces. We examined various socio-economic variables, health service availability and environmental factors impacting U5MR in Thailand to model their influences through spatial analysis. Global and Local Moran’s I statistics for spatial autocorrelation of U5MR and its related factors were used on secondary data from the Ministry of Public Health, National Centers for Environmental Information, National Statistical Office, and the Office of the National Economic and Social Development Council in Thailand. The relationships between U5MR and these factors were modelled using ordinary least squares (OLS) estimation, spatial lag model (SLM) and spatial error model (SEM). There were significant spatial disparities in U5MR across Thailand. Factors such as low birth weight, unemployment rate, and proportion of land use for agricultural purposes exhibited significant positive spatial autocorrelation, directly influencing U5MR, while average years of education, community organizations, number of beds for inpatients per 1,000 population, and exclusive breastfeeding practices acted as protective factors against U5MR (R2 of SEM = 0.588).The findings underscore the need for comprehensive, multi-sectoral strategies to address the U5MR disparities in Thailand. Policy interventions should consider improving socioeconomic conditions, healthcare quality, health accessibility, and environmental health in high U5M areas. Overall, this study provides valuable insights into the spatial distribution of U5MR and its associated factors, which highlights the need for tailored and localized health policies and interventions.

PMID:37667901 | DOI:10.4081/gh.2023.1220

Heart. 2023 Sep 4:heartjnl-2023-322980. doi: 10.1136/heartjnl-2023-322980. Online ahead of print.

ABSTRACT

INTRODUCTION: Takotsubo syndrome (TTS) is an acute heart failure syndrome, featured by transient left ventricular systolic dysfunction. Recurrences of TTS are not infrequent and there is no standard preventive therapy. The aim of this study was to evaluate in a network meta-analysis if beta-blockers (BB) and ACE inhibitors/angiotensin receptor blockers (ACEi/ARBs), in combination or not, can effectively prevent TTS recurrences.

METHODS: We performed a systematic network meta-analysis, using MEDLINE/EMBASE and the Cochrane Central Register of Controlled Trials for clinical studies published between January 2010 and September 2022. We considered all those studies including patients receiving medical therapy with BB, ACEi/ARBs. The primary outcome was TTS recurrence.

RESULTS: We identified 6 clinical studies encompassing a total of 3407 patients with TTS. At 40±10 months follow-up, TTS recurrence was reported in 160 (4.7%) out of 3407 patients. Mean age was 69.8±2 years and 394 patients (11.5%) out of 3407 were male. There were no differences in terms of TTS recurrence when comparing ACEi/ARBs versus control (OR 0.83; 95% CI 0.47 to 1.47, p=0.52); BB versus control (OR 1.01; 95% CI 0.63 to 1.61, p=0.96) and ACEi/ARBs versus BB (OR 0.88; 95% CI 0.51 to 1.53, p=0.65).Combination of BB and ACEi/ARBs was also not effective in reducing the risk of recurrence versus control (OR 0.91; 95% CI 0.58 to 1.43, p=0.68) vs ACEi/ARBs (OR 0.79; 95% CI 0.46 to 1.34, p=0.38)) and vs BB (OR 0.77; 95% CI 0.49 to 1.21, p=0.26).

CONCLUSIONS: Our study did not find sufficient statistical evidence regarding combination therapy with BB and ACEi/ARBs in reduction of TTS recurrence.

PMID:37666647 | DOI:10.1136/heartjnl-2023-322980

BMJ Glob Health. 2023 Sep;8(9):e012529. doi: 10.1136/bmjgh-2023-012529.

ABSTRACT

BACKGROUND: The comprehension of breastfeeding patterns and trends through comparable indicators is essential to plan and implement public health policies.

OBJECTIVE: To evaluate the trends of breastfeeding indicators in Brazil from 1996 to 2019 and estimate the gap to achieve the WHO/UNICEF 2030 targets in children under 5 years.

METHODS: Microdata from two National Surveys on Demography and Health of Women and Children (PNDS-1996 and PNDS-2006) and the Brazilian National Survey on Child Nutrition-2019 were used. The indicators of early initiation of breastfeeding (EIBF), exclusive breastfeeding of infants 0-5 months of age (EBF<6 mo), continued breastfeeding at 1 year of age (CBF1yr) and CBF at 2 years of age (CBF2yr) were analysed using prevalence and 95% CI. The average annual variation and years to achieve the WHO/UNICEF 2030 targets were calculated for Brazil and the macroregions. Statistical analyses considered the survey’s complex sample design for each database.

RESULTS: EIBF increased from 36.3% (95% CI 33.6% to 39.0%) in 1996 to 60.9% (95% CI 56.5% to 65.3%) in 2006 (statistically significant) and 62.5% (95% CI 58.3% to 66.6%) in 2019. EBF<6 mo increased from 26.9% (95% CI 21.3% to 31.9%) in 1996 to 39.0% (95% CI 31.0% to 47.1%) in 2006 and 45.8% (95% CI 40.9% to 50.7%) in 2019 (significant increases for 1996-2019 for Brazil, Northeast and Midwest regions). CBF1yr rose from 36.6% (95% CI 30.8% to 42.4%) in 1996 to 48.7% (95% CI 38.3% to 59.0%) in 2006, and 52.1% (95% CI 45.4% to 58.9%) in 2019. CBF2yr increased from 24.7% (95% CI 19.5% to 29.9%) in 1996 to 24.6% (95% CI 15.7% to 33.5%) in 2006 and 35.5% (95% CI 30.4% to 40.6%) in 2019 (significant increase for 1996-2019). The South and Southeast regions need to double the 2019 prevalence to reach the target for the CBF1yr and CBF2yr; the Northeast and North need to increase 60% the current prevalence for the indicator of EBF<6 mo.

CONCLUSION: A substantial improvement in breastfeeding indicators occurred in Brazil from 1996 to 2019, although at an insufficient rate to achieve the WHO/UNICEF 2030 targets.

PMID:37666574 | DOI:10.1136/bmjgh-2023-012529

BMJ Open. 2023 Sep 4;13(9):e067959. doi: 10.1136/bmjopen-2022-067959.

ABSTRACT

OBJECTIVE: This paper analyses the optimal utilization of maternal health services in Indonesia from 2015 to 2018.

DESIGN: National cross-sectional study.

SETTING: This study takes place in 34 provinces in Indonesia.

PARTICIPANTS: The population in this study were mothers in all household members in Basic Health Research of Riskesdas 2018. The sample was all mothers who had a live birth within 5 years before data collection (1 January 2013 to July 2018) and had complete data. The number of samples analysed was 70 878.

PRIMARY OUTCOME: We developed a scoring for the optimal utilization of maternal health services as the outcome variable.

RESULTS: This analysis involved 70 787 mothers. The utilization of maternal care was not optimal. Mothers who delivered in health facilities achieved 83.3% of services. Better care is experienced more by mothers who live in urban areas. Mothers who delivered at health facilities significantly used threefold optimal care (ORa=3.15; 95% CI 3.00 to 3.30; p<0001). A statistically significant difference of optimal maternal care was found in mothers with better education (ORa=1.22; 95% CI 1.18 to 1.27; p=0.001); holding health insurance (ORa=1.25; 95% CI 1.21 to 1.30; p<0001), having more access to health facilities (ORa=1.13; 95% CI 1.09 to 1.17); p<0.001), less parity (ORa=1.16; 95% CI 1.11 to 1.20; p<0.001).

CONCLUSION: The optimal utilization of MHS is independent of the free services delivery, but having health insurance and less parity brought about a better optimal score for MHS. Mothers in rural areas were more protective of optimal utilization. Finally, the eastern region used more optimal health services.

PMID:37666563 | DOI:10.1136/bmjopen-2022-067959