Tag: nevin manimala

Acute Crit Care. 2023 May;38(2):209-216. doi: 10.4266/acc.2022.01550. Epub 2023 May 16.

ABSTRACT

BACKGROUND: Percent fluid overload greater than 5% is associated with increased mortality. The appropriate time for fluid deresuscitation depends on the patient’s radiological and clinical findings. This study aimed to assess the applicability of percent fluid overload calculations for evaluating the need for fluid deresuscitation in critically ill patients.

METHODS: This was a single-center, prospective, observational study of critically ill adult patients requiring intravenous fluid administration. The study’s primary outcome was median percent fluid accumulation on the day of fluid deresuscitation or intensive care unit (ICU) discharge, whichever came first.

RESULTS: A total of 388 patients was screened between August 1, 2021, and April 30, 2022. Of these, 100 with a mean age of 59.8±16.2 years were included for analysis. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 15.4±8.0. Sixty-one patients (61.0%) required fluid deresuscitation during their ICU stay, while 39 (39.0%) did not. Median percent fluid accumulation on the day of deresuscitation or ICU discharge was 4.5% (interquartile range [IQR], 1.7%-9.1%) and 5.2% (IQR, 2.9%-7.7%) in patients requiring deresuscitation and those who did not, respectively. Hospital mortality occurred in 25 (40.9%) of patients with deresuscitation and six (15.3%) patients who did not require it (P=0.007).

CONCLUSIONS: The percent fluid accumulation on the day of fluid deresuscitation or ICU discharge was not statistically different between patients who required fluid deresuscitation and those who did not. A larger sample size is needed to confirm these findings.

PMID:37313667 | DOI:10.4266/acc.2022.01550

J Cosmet Dermatol. 2023 Jun 14. doi: 10.1111/jocd.15834. Online ahead of print.

ABSTRACT

BACKGROUND: Melasma is a distressing disfiguring acquired pigmentary disorder especially affecting females and it is of high tendency of recurrence. Up till now, treatment of melasma is a challenging problem.

OBJECTIVES: We evaluated the effectiveness of microneedling with glutathione versus microneedling alone in treatment of melasma.

PATIENTS AND METHODS: In this study, 29 adult females with epidermal type of melasma (confirmed with Wood’s light examination) were enrolled. The affected area was subjected to microneedling using dermapen followed by application of glutathione solution on the right side only. This session was performed every 2 weeks for 3 months (six sessions for every patient). The response to therapy was measured using modified melasma area and severity index (m MASI) that were calculated on each side of the face (Hemi- m MASI) before treatment sessions.

RESULTS: There was statistically significant reduction in the mean of Hemi- m MASI score over the sessions on both sides of the face but the right side (microneedling with glutathione) showed more reduction and earlier response to therapy than the left side (microneedling alone). On the left side, mean of Hemi- m MASI score before and after sessions was (4.06 ± 1.91, 2.31 ± 1.450) and on the right side, it was (4.21 ± 2.08, 1.96 ± 1.30), respectively and this was statistically significant. Percentage of improvement on the left side was 46.92 ± 16.30 (%) while on the right side was 55.17 ± 15.50 (%) and this was statistically significant.

CONCLUSIONS: Microneedling is an effective promising tool in treatment of melasma and its combination with glutathione as a whitening agent, increases and accelerates its efficacy. So, combined therapy is more preferred than monotherapy in treatment of facial melasma.

PMID:37313658 | DOI:10.1111/jocd.15834

Sports Biomech. 2023 Jun 14:1-23. doi: 10.1080/14763141.2023.2223556. Online ahead of print.

ABSTRACT

Changes in surface hardness are likely to alter an athlete’s movement strategy. Anterior cruciate ligament (ACL) injury risk assessments that are performed on a different surface to that used for training and competition may, therefore, not represent an athlete’s on-field movement strategies. The aim of this study was to examine the influence of surface hardness on multidirectional field sport athletes’ movement strategies in movements that are commonly used in ACL injury risk assessments (bilateral and unilateral drop jumps, and a cutting manoeuvre). Ground reaction forcesand three-dimensional lower limb kinematics were recorded from 19 healthy, male, multidirectional field sport athletes performing bilateral and unilateral drop jumps, and a 90° cutting task on Mondo track (harder surface) and artificial turf (softer surface). Continuous (statistical parametric mapping) and discrete analyses revealed alterations in vertical and horizontal braking forces and knee and hip moments between surfaces of different hardness in all three movements (p ≤ 0.05, d > 0.5). Injury risk assessments performed on a harder surface (e.g. Mondo track) can misrepresent an athlete’s risk of ACL injury compared to the same movements performed on a softer more cushioned surface that is typically used for training and/or matches (e.g. artificial turf).

PMID:37313654 | DOI:10.1080/14763141.2023.2223556

J Cosmet Dermatol. 2023 Jun 14. doi: 10.1111/jocd.15805. Online ahead of print.

ABSTRACT

BACKGROUND: Alopecia areata (AA) is a common disease characterized by hair loss with an autoimmune background. There are many lines of therapy, but no standard line for all cases. Consequently, treating severe forms of AA is challenging.

OBJECTIVE: This study aimed to compare the efficacy and safety of the combination of diphenylcyclopropenone (DPCP) and platelet-rich plasma (PRP) with DPCP alone in treating patients with severe or refractory AA.

PATIENTS AND METHODS: Our randomized clinical trial was conducted on patients with severe and recalcitrant AA. Group A included 13 patients who received only DPCP, while Group B included 11 patients who received both DPCP and PRP. After sensitization in both groups of patients, DPCP was applied to half the scalp weekly. In addition, PRP injection in all scalp was performed once a month in group B. The patients in both groups completed the study for six months.

RESULTS: The regrowth scale results were 53.85% and 54.5% for groups A and B, respectively. Although the response rate of group B was higher than that of group A, there is no statistically significant difference between the two groups.

CONCLUSION: From our clinical trial, it can be concluded that DPCP alone or combined with PRP is an effective and safe method for treating severe or recalcitrant AA.

PMID:37313640 | DOI:10.1111/jocd.15805

Protein Sci. 2023 Jun 14:e4700. doi: 10.1002/pro.4700. Online ahead of print.

ABSTRACT

We investigated the relationship between mutations and dynamics in Escherichia coli dihydrofolate reductase (DHFR) using computational methods. Our study focused on the M20 and FG loops, which are known to be functionally important and affected by mutations distal to the loops. We used Molecular Dynamics simulations and developed position-specific metrics, including the Dynamic Flexibility Index (DFI) and Dynamic Coupling Index (DCI), to analyze the dynamics of wild-type DHFR and compared our results with existing deep mutational scanning data. Our analysis showed a statistically significant association between DFI and mutational tolerance of the DHFR positions, indicating that DFI can predict functionally beneficial or detrimental substitutions. We also applied an asymmetric version of our DCI metric (DCI_asym ) to DHFR and found that certain distal residues control the dynamics of the M20 and FG loops, whereas others are controlled by them. Residues that are suggested to control the M20 and FG loops by our DCI_asym metric are evolutionarily non-conserved; mutations at these sites can enhance enzyme activity. On the other hand, residues controlled by the loops are mostly deleterious to function when mutated and are also evolutionary conserved. Our results suggest that dynamics-based metrics can identify residues that explain the relationship between mutation and protein function or can be targeted to rationally engineer enzymes with enhanced activity. This article is protected by copyright. All rights reserved.

PMID:37313628 | DOI:10.1002/pro.4700

Expert Rev Anticancer Ther. 2023 Jun 14. doi: 10.1080/14737140.2023.2219899. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common clinical malignant tumors, and patients undergoing interventional treatment often experience emotional and physical distress in the postoperative period. This meta-analysis aimed to evaluate the effects of quality control circle (QCC) intervention on patient awareness of health education and postoperative complications following hepatocellular carcinoma (HCC) intervention.

METHODS: A systematic search was conducted to identify relevant controlled trials on the impact of QCC on patients’ knowledge of health education and complications after HCC intervention. The search was conducted using various online databases from the earliest available date to July 2022. Following inclusion and exclusion criteria, data were analyzed using RevMan 5.3 software, and the heterogeneity of the studies was explored.

RESULTS: A total of 120 articles were retrieved, and 11 controlled trials were included according to the inclusion and exclusion criteria. Meta-analysis showed that QCC reduced postinterventional fever (OR: 0.41, 95% CI: 0.26, 0.65, P=0.0002), nausea and vomiting (OR: 0.36, 95% CI: 0.22, 0.58, P<0.0001), abdominal pain (OR: 0.34, 95% CI: 0.20, 0.56, P<0.0001), loss of appetite (OR: 0.37, 95% CI: 0.21, 0.68, P=0.001), improved patient knowledge of health education (OR: 4.84, 95% CI: 3.03, 7.74, P<0.0001), and increased patient satisfaction with nursing care (OR: 6.63, 95% CI: 4.21, 10.45, P<0.00001). All differences were statistically significant.

CONCLUSIONS: QCC after HCC intervention can reduce postoperative fever, nausea and vomiting, abdominal pain, and loss of appetite. It also improves patient knowledge of health education and satisfaction with care.

PMID:37313599 | DOI:10.1080/14737140.2023.2219899

Quintessence Int. 2023 Jun 14;0(0):0. doi: 10.3290/j.qi.b4157323. Online ahead of print.

ABSTRACT

OBJECTIVES: Although minimally- and non-invasive caries management are advocated in pediatric dentistry, extensive caries progression often requires endodontic treatment followed by crowning of the tooth. Thus, the aim of this study was to evaluate the success of aesthetic preformed zirconia crowns (PZC) compared to the standard preformed metal crowns (PMC) after pulpotomy in primary molars retrospectively.

METHODS AND MATERIALS: Patient’s digital records in a specialized pediatric clinic in Germany were analyzed to include 2-9-year-olds, who had received one or more PMC or PZC after a pulpotomy between 2016 and 2020. Main outcomes were success, minor failure (restoration loss, wear or fracture), or major failure (need for extraction or pulpectomy).

RESULTS: 151 patients with 249 teeth (PMC: n=149; PZC: n=100) were included. Mean followup time was (19.9 months), with 90.4% of the crowns followed for at least 18 months. The majority of crowns were considered successful (94.4%). The differences in the success rates between PMC (96%) or PZC (92%) did not reach the level of statistical significance (p=0.182). All minor failures (1.6%) were in the PZC group. Especially crowns in first primary molars and the maxilla were prone to failure.

CONCLUSION: PMCs and PZCs both show high clinical success rates as restorations of primary teeth after a pulpotomy. However, there was a tendency of higher minor or major failure in the PZC group.

PMID:37313578 | DOI:10.3290/j.qi.b4157323

Quintessence Int. 2023 Jun 14;0(0):0. doi: 10.3290/j.qi.b4157183. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to develop an artificial intelligence (AI) model that can able automatic tooth numbering, frenulum attachments, gingival overgrowth areas, and gingival inflammation signs on intraoral photographs and to evaluate the performance of this model.

METHOD AND MATERIALS: A total of 654 intraoral photographs were used in the study (n=654). All photographs were reviewed by 3 periodontists, and all teeth, frenulum attachment, gingival overgrowth areas, and gingival inflammation signs on photographs were labeled using the segmentation method in a web-based labeling software. In addition, tooth numbering was carried out according to the FDI system. An AI model was developed with the help of YOLOv5x architecture with labels of 16795 teeth, 2493 frenulum attachments, 1211 gingival overgrowth areas, and 2956 gingival inflammation signs. The confusion matrix system and ROC analysis were used to statistically evaluate the success of the developed model.

RESULTS: The sensitivity, precision, F1 score, and AUC for tooth numbering were found as 0.990, 0.784, 0.875, and 0.989; were found as 0.894, 0.775, 0.830, and 0.827 for frenulum attachment; were found as 0.757, 0.675, 0.714, and 0.774 for gingival overgrowth area, and were found as 0.737, 0.823, 0.777, and 0.802 for gingival inflammation sign, respectively.

CONCLUSION: The results of the present study have shown that AI systems can be successfully used to interpret intraoral photographs. These systems have the potential to accelerate the digital transformation in the clinical and academic functioning of dentistry with the automatic determination of anatomical structures and dental conditions from intraoral photographs.

PMID:37313576 | DOI:10.3290/j.qi.b4157183

Zhongguo Zhen Jiu. 2023 Jun 12;43(6):715-20. doi: 10.13703/j.0255-2930.20220911-k0004.

ABSTRACT

OBJECTIVE: To analyze the acupoint selection rules of acupuncture and moxibustion for post-stroke epilepsy by data mining technology.

METHODS: The literature regarding acupuncture and moxibustion for post-stroke epilepsy included in CNKI, VIP, Wanfang, SinoMed and PubMed databases from the establishment of the database to August 1st 2022 was retrieved. Microsoft Excel 2019 software was used to establish a database to conduct the descriptive analysis of acupoints; SPSS Modeler 18.0 Apriori algorithm was used to conduct association rule analysis; high-frequency acupoint co-occurrence network diagrams were drawn by Cytoscape3.9.0 software; SPSS Statistics 25.0 software was used to perform hierarchical cluster analysis on high-frequency acupoints and a tree diagram was drawn.

RESULTS: Totally 39 articles were included, and 63 prescriptions of acupuncture and moxibustion were extracted, involving 56 acupoints, with a total frequency of 516 times; the top three acupoints with the highest frequency of use were Baihui (GV 20), Fenglong (ST 40) and Neiguan (PC 6); the selected meridians were mainly the governor vessel, the hand and foot yangming meridians; the selection of acupoints were mostly in the head, neck and lower limbs; in terms of acupoint compatibility, Hegu (LI 4)-Shuigou (GV 26) and Neiguan (PC 6) had the highest confidence degree; The top 20 high-frequency acupoints could be divided into 4 effective clusters.

CONCLUSION: Modern acupuncture and moxibustion treatment for post-stroke epilepsy attaches great importance to the use of yang meridians and meridians with enrich qi and blood; the core prescription is Shuigou (GV 26)-Neiguan (PC 6)-Hegu (LI 4)-Baihui (GV 20). In addition, the combination of distant and near acupoints is highly valued to improve clinical efficacy.

PMID:37313568 | DOI:10.13703/j.0255-2930.20220911-k0004

Zhongguo Zhen Jiu. 2023 Jun 12;43(6):639-44. doi: 10.13703/j.0255-2930.20220719-k0003.

ABSTRACT

OBJECTIVE: To compare the clinical efficacy on lumbar muscle strain with cold and dampness between the different operation sequences of acupuncture and cupping therapy.

METHODS: Seventy-six patients with lumbar muscle strain with cold and dampness were randomly divided into an acupuncture + cupping group (A + C group, 38 cases) and a cupping + acupuncture group (C + A group, 38 cases, 1 case dropped off). In the A + C group, cupping therapy was delivered 10 min after the end of treatment with acupuncture, while in the C + A group, acupuncture therapy was exerted 10 min after the end of treatment with cupping. Acupuncture was applied to Mingmen (GV 4), Yaoyangguan (GV 3), ashi point and bilateral Shenshu (BL 23), Dachangshu (BL 25), Weizhong (BL 40) and Yanglingquan (GB 34), and the needles were retained for 30 min in each intervention. Flash cupping was operated along the bilateral sides of the lumbar spine for 3 min, and the cups were retained for 10 min at bilateral Shenshu (BL 23), Dachangshu (BL 25) and ashi points. The intervention was delivered once every two days, 3 times weekly, for 3 weeks totally in each group. The scores of visual analogue scale (VAS) and Oswestry disability index (ODI), TCM syndrome score and the mean temperature of the lumbar region before and after treatment were compared between the two groups. The safety and the clinical efficacy were assessed for the interventions of the two groups.

RESULTS: Compared with the values before treatment, except for the sleep score of ODI, the VAS scores, ODI scores and TCM syndrome scores were decreased after treatment (P<0.01, P<0.05); while the mean temperature of the lumbar region was increased (P<0.01) in both groups. After treatment, the VAS score and the pain score of ODI in the C + A group were lower than those in the A + C group (P<0.05). The incidence rate of adverse reactions of the C + A group was lower than that of the A + C group (P<0.01). The effective rate in the A+C group was 92.1% (35/38), that in the C+A group was 94.6%(35/37), there was no statistical difference between the two groups (P>0.05).

CONCLUSION: Different operation sequences between acupuncture and cupping therapy obtain the similar efficacy on lumbar muscle strain with cold and dampness, but cupping therapy delivered prior to acupuncture has certain advantages in relieving pain and improving safety.

PMID:37313557 | DOI:10.13703/j.0255-2930.20220719-k0003