Tag: nevin manimala

Nurs Open. 2022 Nov 30. doi: 10.1002/nop2.1511. Online ahead of print.

ABSTRACT

AIM: This study investigated healthcare professionals’ attitudes and perceptions towards the family’s participation in surgical cancer care.

DESIGN: A prospective mixed method study.

METHODS: The study was conducted at three hospitals in Sweden with registered nurses, assistant nurses and surgeons. Data included 43 completed Families Importance in Nursing Care (FINC-NA) questionnaires answered by registered nurses and qualitative data from 14 interviews with surgeons and assistant nurses. Data analysis was performed according to the Creswell convergent parallel mixed method.

RESULTS: Both quantitative and qualitative data demonstrated that the family was an important resource in nursing care, was highly valued as a conversational partner and had resources that should be considered. Each family should be supported in determining their role and as implements for maintaining a functioning family constellation and increasing their participation.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:36448419 | DOI:10.1002/nop2.1511

Clin Cardiol. 2022 Nov 30. doi: 10.1002/clc.23956. Online ahead of print.

ABSTRACT

Left atrial appendage occlusion is not inferior to oral anticoagulants in the prevention of stroke in several randomized controlled trials. However, the clinical efficacy and safety comparison of the Watchman and amplatzer cardiac plug (ACP)/Amulet devices for percutaneous left atrial appendage closure (LAAC) in patients with non-valvular atrial fibrillation was controversial. A database search was conducted using PubMed, EMBASE, Cochrane Library, and Clinicaltrials.gov for trials that compared Watchman device vs ACP/Amulet device. The effective outcomes were stroke and systemic embolism. Safety outcomes were all-cause death, cardiovascular death, and major bleeding. Device-related complications included device-related thrombus (DRT), peri-device leaks (PDL > 5 mm). A total of 19 articles involving 6224 patients were included in the present study. The Watchman and ACP/Amulet groups comprised 3267 and 2957 patients, respectively. No statistically significant differences were detected in the stroke (odd ratio [OR]:1.24, 95% confidence interval [CI]: 0.92-1.67, p = .17, I² = 0), systemic embolism (OR:1.10, 95% CI: 0.51-2.35, p = .81, I² = 0%), all-cause death (OR:0.97, 95% CI: 0.80-1.18, p = .77, I² = 1%), cardiogenic death (OR:0.99, 95% CI: 0.77-1.29, p = .96, I² = 0%), major bleeding (OR:1.18, 95% CI: 0.98-1.43, p = .08, I² = 25%). DRT (OR:1.48, 95% CI: 1.06-2.06, p = .02, I² = 0%) and PDL > 5 mm (OR:2.57, 95% CI: 1.63-4.04, p < .0001, I² = 0%) were significantly lower in ACP/Amulet group compared to Watchman group. The effective and safety outcomes were comparable between two groups. ACP/Amulet group had significantly lower rates of DRT and PDL > 5 mm than Watchman group.

PMID:36448417 | DOI:10.1002/clc.23956

Lupus. 2022 Nov 30:9612033221143286. doi: 10.1177/09612033221143286. Online ahead of print.

ABSTRACT

INTRODUCTION: The first biologic authorized for systemic lupus erythematosus (SLE) up to this date, belimumab, is currently not recommended for use during pregnancy due to lack of data. Provided that the health of the child begins with the health of the mother, pregnant patients face the dilemma of cessation or continuation of belimumab. If belimumab is stopped, there will be a risk of SLE flare and its consequences for the mother and the foetus. Continuation is also not optimal because of the lack of knowledge on safety for use during pregnancy.

AIM: To compare the reported foetal outcomes in SLE patients who stopped scheduled belimumab within the first trimester (group A) and those who continued scheduled belimumab during the first trimester or thereafter (group B).

MATERIAL AND METHOD: All belimumab-exposed pregnancy-related reports were extracted from the EudraVigilance (EV) database until March 11th, 2021. After case review, repeated cases, uninformative reports, non-medical elective abortions and foetal chromosomal abnormalities were excluded. Included pregnancies were divided into two groups (group A and B, as described above). Foetal outcomes were divided into live birth or foetal death (due to miscarriage or stillbirth) and were compared between both groups. Furthermore, neonatal outcomes, such as reporting rates of preterm birth, low birth weight and major congenital malformations were compared.

RESULTS: No statistical difference in foetal death was observed between group A and B (reported numbers (%) = 32 (46.4) and 11 (52.4), respectively). Odds ratio (OR, [95% Confidence Intervals (CIs)]) of foetal death in group B compared to group A was 1.27 [0.48, 3.32]. Reporting rates of preterm birth and low birth weight were higher – though not statistically different – in group A.

CONCLUSION: The positive results of our study are supportive for the continuation of belimumab during pregnancy. Since the analysis is based on spontaneous reports/retrospective data, additional studies are needed to confirm the results.

PMID:36448410 | DOI:10.1177/09612033221143286

Med J Malaysia. 2022 Nov;77(6):730-735.

ABSTRACT

INTRODUCTION: Dizziness is a common complaint by patients, yet it always presents as a diagnostic challenge to the attending clinician. An accurate diagnosis is essential to correctly administer the precise treatment regime, alleviate the symptoms, and improve the quality-of-life of patients who present with dizziness. A specialised vestibular clinic with a holistic approach of meticulous history-taking, complete physical examination, a collection of audiovestibular test battery, and facilities for vestibular rehabilitation was set up to assist in the management of these patients. This study aims to investigate the effect of vestibular clinic intervention on the symptoms and qualityof- life of patients who were managed in the vestibular clinic.

MATERIALS AND METHODS: A total of 64 new patients who were managed in the vestibular clinic were selected and the validated Malay – Vestibular Rehabilitation Benefit Questionnaire (My-VRBQ) was completed during the first and follow-up visits to measure the changes in symptoms and quality-of-life before and after receiving care at the vestibular clinic.

RESULTS: Our study showed that there was a positive effect of vestibular clinic intervention on the symptoms and quality-of-life of patients who were managed by the vestibular clinic. Statistically significant improvements were seen in the total My-VRBQ scores, symptoms scores, and quality-of-life scores. The subscale scores of dizziness, anxiety, and motion-provoked dizziness also showed statistically significant improvement among the patients who received care at the vestibular clinic.

CONCLUSION: This indicates that the vestibular clinic was an essential part of the work-up, diagnosis, and treatment of patients with dizziness; and a specialised vestibular clinic was able to bring about positive outcomes in the symptoms and quality-of-life of patients with balance disorders.

PMID:36448392

Med J Malaysia. 2022 Nov;77(6):643-649.

ABSTRACT

INTRODUCTION: Psychological distress had been documented since the beginning of the COVID-19 outbreak in 2019. The aim of the study is to describe the psychological impact among those who were hospitalized for COVID-19 infection within 6 months after being discharged from the hospital. The psychological impact in this study is defined as depression, anxiety, and stress.

MATERIALS AND METHODS: This was a cross-sectional study conducted from July 2020 till August 2021 in a regional state hospital, north of Malaysia. All patients requiring hospitalization for COVID-19 were approached within the first 2 weeks after admission to administer the Depression, Anxiety and Stress Scale – 21 Items (DASS-21) scale. Follow-up phone calls were made within 3 months of discharged to enquire about the DASS-21 items as well as the Impact of Event Scale-Revised (IES-R) scale items. Participants above the age of 18 and technology savvy to answer an online questionnaire were recruited for the study. We excluded participants with a known history of psychotic disorder from the study. We utilised the DASS-21 to screen for depression, anxiety, and stress, as well as the IES-R to identify symptoms of post-traumatic stress disorder. Participants could answer the questionnaires in either English or Bahasa Malaysia. For comparison of two categorical data, a chi-square was applied. A univariate analysis was first conducted and all variables with a p ≤0.3 was then entered into the multivariate analysis for the final output. Other than the univariate analysis, all other p values <0.05 were considered to be statistically significant. All data collected were tabulated and analysed in the SPSS v21.0 system.

RESULTS: A total of 306 out of 696 COVID-19 patients responded. The mean age for the participants was 31.69 (SD:11.19) years old. From the total, 54.2% were ladies, 78.8% were Malay, 50.7% were unmarried, 55.2% had higher education, and 67.6% were employed at the time of the survey. We found 20.5% of the participants were depressed, 38.9% had moderate anxiety, and 17.3% were stressed. From the total, 31.7% of the participants were deemed to have had some symptoms of post-traumatic stress disorder (PTSD) ranging from mild to severe. From the final multivariate analysis, it was found that depression (p=0.02) had a 2.78 times likeliness of having PTSD, anxiety (p<0.001) had a 3.35 times likeliness of having PTSD and stressed patients (p=0.02) 2.86 times likeliness of having PTSD when compared to those without PTSD.

CONCLUSION: Patients reported to suffer from symptoms of PTSD and might benefit from psychological interventions to mitigate the impact in the long run.

PMID:36448379

Ginekol Pol. 2022 Nov 30. doi: 10.5603/GP.a2022.0096. Online ahead of print.

ABSTRACT

OBJECTIVES: Angiogenesis is engaged in endometriosis. It is regulated by regulatory factors and cytokines, transported in microvesicles. The purpose was to investigate the presence of MVs with vascular endothelial growth factor (VEGF) and metalloproteinase-9 (MMP-9) in peripheral blood and peritoneal fluid of women operated on for endometrioma or teratoma Material and methods:Microvesicles (MVs) were determined in blood samples and peritoneal fluid samples collected from women aged 20-60 years operated on for endometriosis (test group) and teratoma (control group). The final investigations were performed on 47 patients, who qualified for the study based on the meticulous inclusion criteria. MVs were analyzed by flow cytometry (FACS) using annexin V, antibodies for molecules characteristic of cells from endometriosis foci (keratin 18 (K18), CD105, CD146), and antibodies for intraepithelial vascular growth factor VEGF and metalloproteinase-9 (MMP-9). The sample was double “reading” using flow cytometry (FACSCantoII).

RESULTS: Cytometry analysis confirmed MVs’ presence in plasma and peritoneal fluid collected from patients with both endometriosis and teratomas. A statistically significant higher level of AnnexinV (+) MVs were observed in plasma samples of endometriosis patients. In the control group, there was a higher percentage of double-positive VEGF (+)/MMP-9 (+) and single MMP-9 (+) positive MVs in the serum. In the peritoneal fluid higher frequency of double-positive VEGF (+)/MMP-9 (+) MVs were found in the control group. However, the amount of VEGF (+) / MMP-9 (+) MVs object did not enable to differentiate between the test and control groups. The study was the first, in which MVs were confirmed in plasma and peritoneal fluid in benign adnexa tumors.

CONCLUSIONS: Microvesicles are present in peripheral blood and peritoneal fluid samples collected from patients with endometriosis and teratomas. Microvesicles with proangiogenic factors (VEGF and MMP-9) are more abundant in blood and peritoneal fluid samples from patients with teratomas.

PMID:36448351 | DOI:10.5603/GP.a2022.0096

Ginekol Pol. 2022 Nov 30. doi: 10.5603/GP.a2022.0134. Online ahead of print.

ABSTRACT

OBJECTIVES: To explore the application effect of virtual reality (VR) combined with moderate perineal protection on singleton primipara delivery.

MATERIAL AND METHODS: The study utilised a two-group design intervention and a randomised clinical trial. A total of 200 singleton primiparas who had a regular prenatal examination in a third-class hospital (between 1 September 2018 and 30 December 2018) and were willing to give birth naturally were randomly divided into treatment (traditional prenatal health mission combined with desktop VR health education system mode) and control (traditional health education mode) groups. The delivery conditions of the two groups were surveyed, recorded, analysed and compared.

RESULTS: There was no significant difference in the time of the second stage of labour between the treatment and control groups, and the comparison of neonatal Apgar scores and neonatal weight between the two groups showed that the different modes of prenatal education had no effect on newborns (p > 0.05). The amount of postpartum haemorrhage in 2 h and the pain score in the treatment group were significantly lower than in the control group, and the degree of perineal injury in the treatment group was not as serious as that in the control group. Meanwhile, there was a statistically significant difference in the anxiety score, self-efficacy score and quality of life satisfaction between the treatment and control groups (p < 0.05).

CONCLUSIONS: VR technology combined with moderate perineal protection could improve the delivery outcome of a primipara, maternal self-confidence of delivery and the quality of vaginal delivery; effectively alleviate the anxiety of a primipara; have no adverse effects on both mothers and newborns; and be widely used in clinical settings.

PMID:36448347 | DOI:10.5603/GP.a2022.0134

J Dev Orig Health Dis. 2022 Nov 30:1-8. doi: 10.1017/S2040174422000617. Online ahead of print.

ABSTRACT

Characterizing and quantifying the trajectories of variables of interest through time in their field of study is of interest to a range of disciplines. The aim of this study was to investigate the growth speed in height of children and its determinants. A total of 3401 males and 3200 females from four low- and middle-income countries with measured height on five occasions from 2002 to 2016 were included in the study. Data were analyzed using a latent growth model. The results of the study reported that children in four low- and middle-income countries exhibited substantial growth inequalities. There was a significant gender difference in change of growth with males had a higher baseline, rate of change, and acceleration in height growth than females. Comparing the component of slopes across countries, the growth change inequalities were observed among children. These inequalities were statistically significant, with the highest rate of change observed in Peru and Vietnam.

PMID:36448333 | DOI:10.1017/S2040174422000617

Disabil Rehabil. 2022 Nov 30:1-6. doi: 10.1080/09638288.2022.2151652. Online ahead of print.

ABSTRACT

PURPOSE: To examine the effect of early mobility (EM) on functional recovery after hip fracture surgery, and to investigate the potential factors that delay mobility.

METHODS: In this retrospective observational study, 110 hip fracture patients were divided into two groups according to the days between surgery and mobility referred to as the EM and the delayed mobility groups. Demographic data, perioperative data, functional outcomes, and discharge destination were compared statistically between the groups using univariate analysis and logistic regression analysis. As a sensitivity analysis, the factors associated with the timing of physiotherapy were also assessed.

RESULTS: The EM group had significantly better walking ability and Barthel index (p < 0.05), and home discharge rate (p = 0.004). The factors associated with delayed mobility (odds ratio; 95% confidence interval) were delayed postoperative physiotherapy initiation (3.59; 1.76-7.33), days from admission to surgery (1.23; 1.04-1.46), and postoperative CRP (1.14; 1.01-1.29) and hemoglobin level (0.72; 0.54-0.96). Furthermore, patients who received surgery on the day before any holiday were significantly delayed in physiotherapy intervention (p = 0.006).

CONCLUSIONS: This study demonstrated that EM after hip fracture surgery was associated with improving functional recovery and home discharge rate, and early physiotherapy intervention was associated with EM.

PMID:36448297 | DOI:10.1080/09638288.2022.2151652

Oral Health Prev Dent. 2022 Nov 30;20(1):501-508. doi: 10.3290/j.ohpd.b3630331.

ABSTRACT

PURPOSE: To compare the effectiveness of two varieties of special needs toothbrushes in terms of dental plaque removal and bacterial contamination vs a conventional toothbrush in patients with Down syndrome.

MATERIALS AND METHODS: This single-blinded, two-group, randomised clinical trial included 16 patients diagnosed with Down syndrome (age 6-15 years) from various special needs centers located in the Jazan Province of Saudi Arabia. The patients were randomly allocated to two groups based on the type of special needs toothbrush provided (Collis Curve or superfine nano). The plaque and bleeding indices of the patients in both groups were measured at baseline (T0) and both groups were initially given a conventional toothbrush to use for four weeks. After this period, the plaque and bleeding indices were re-evaluated (T1). The patients were instructed to use the special needs toothbrush for 4 weeks, after which the periodontal indices were re-evaluated (T2). Microbial contamination on the bristles of the special needs brushes was evaluated at T2.

RESULTS: No notable changes in the mean plaque and bleeding indices were observed between the two groups at each visit; however, statistically significant reductions were noted between visits in both groups (p < 0.05). The CFU scores in cultures from the Collis Curve toothbrush bristles (1411.5 ± 541.1) were higher than those obtained from the superfine nano-toothbrush bristles (1118.3 ± 423.9), but without statistically significant differences.

CONCLUSION: The findings indicate that the use of special needs toothbrushes can statistically significantly improve the gingival health status in individuals with Down syndrome in terms of both resolution of periodontal inflammation and reduction of plaque accumulation.

PMID:36448278 | DOI:10.3290/j.ohpd.b3630331