Tag: nevin manimala

J Invest Surg. 2022 Sep 4:1-7. doi: 10.1080/08941939.2022.2116134. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the safety and efficiency of hysteroscopic laser vaporesection and hysteroscopic resection in the treatment of endometrial polyps.Methods: The literatures in databases were searched comprehensively, the literatures that met the inclusion criteria were screened out and the data were extracted. The data were combined with Stata12.0 statistical software.

RESULTS: 4 literatures were included with a total sample size of 334. Meta-analysis showed that intraoperative blood loss in laser group was less than that in electrosurgical group [-3.043, 95% CI (-4.09, -2.00), P < 0.001]. Length of stay in the laser group was shorter than that in the electrotomy group [-1.013, 95% CI (-1.37, -0.65), P < 0.001]. The recurrence rate [0.275, 95%CI (0.135,0.563), P < 0.001] and complication rate [0.148, 95%CI (0.07,0.32), P < 0.001] in the laser group were lower than those in the electrotomy group. There was no significant difference in operative time between hysteroscopy combined with 2 μm laser and hysteroscopic electrotomy for endometrial polyps [-0.38, 95% CI (-1.34, 0.58), P = 0.441 > 0.05].

CONCLUSION: Hysteroscopic 2 μm laser vaporesection for the treatment of endometrial polyps has better safety and clinical efficacy. Compared with hysteroscopic electroresection, hysteroscopic laser vaporesection in the treatment of endometrial polyps may be safer and more effective. Given the potential limitations, we need larger, well-designed randomized controlled trials to verify our findings.

PMID:36062372 | DOI:10.1080/08941939.2022.2116134

Vet Surg. 2022 Sep 5. doi: 10.1111/vsu.13875. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the ability of a cell salvage device to recover canine erythrocytes by direct aspiration of diluted packed red blood cells (pRBC) and saline rinse from blood-soaked surgical swabs.

STUDY DESIGN: Experimental study.

SAMPLE POPULATION: Twelve recently expired units of canine pRBC.

METHODS: pRBC units donated from a pet blood bank (after quality analysis) were diluted with anticoagulant, divided into two equal aliquots, and subsequently harvested by direct suction (Su), or soaked into swabs, saline-rinsed and suctioned (Sw). The volume of product, manual packed cell volume (PCV), and red blood cell mass (rbcM) were measured and compared before and after salvaging. The rbcM recovery was recorded as percentage ([rbcM post salvage]/[rbcM presalvage]x100). Statistical analysis of all measured values was performed (significance p < .05).

RESULTS: No difference was detected between pre- and post-salvage PCV or mean rise of PCV for either group. The volume of salvaged blood was 143 ml (SD ± 2.89 ml; Su) and 139.83 ml (SD ± 3.30 ml; Sw), p < .001. The average rbcM recovered was 88.43% (Su) and 84.74%. (Sw) averaged 84.74% (p = .015). Blood type and order of processing did not influence recovery.

CONCLUSION: The tested cell saver device reliably salvages canine blood in this ex vivo setting. Cell salvage via direct suction produces higher volumes of salvaged blood than rinsing blood-soaked swabs and salvaging the flush.

CLINICAL SIGNIFICANCE: Washing blood-saturated surgical swabs results in a high harvest of red blood cells. The authors recommend it as an adjunct to direct suction to maximize erythrocyte recovery.

PMID:36062370 | DOI:10.1111/vsu.13875

Microsc Microanal. 2022 Sep 5:1-15. doi: 10.1017/S1431927622012314. Online ahead of print.

ABSTRACT

Toll-like receptor (TLR)-mediated inflammatory processes play a critical role in the innate immune response during the initial interaction between the infecting microorganism and immune cells. This study aimed to investigate the possible microanatomical and histological differences in mandibular and bronchial lymph nodes in Akkaraman and Romanov lambs induced by lipopolysaccharide (LPS) and lipoteichoic acid (LTA) and study the gene, protein, and immunoexpression levels of TLR4, myeloid differentiation factor 88 (MyD88), and tumor necrosis factor-α (TNF-α) that are involved in the immune system. Microanatomical examinations demonstrated more intense lymphocyte infiltration in the bronchial lymph nodes of Akkaraman lambs in the LPS and LTA groups compared to Romanov lambs. TLR4, MyD88, and TNF-α immunoreactivities were more intense in the experimental groups of both breeds. Expression levels of MyD88 and TNF-α genes in the bronchial lymph node of Akkaraman lambs were found to increase statistically significantly in the LTA group. TLR4 gene expression level in the mandibular lymph node was found to be statistically significantly higher in the LTA + LPS group. In conclusion, dynamic changes in the immune cell populations involved in response to antigens such as LTA and LPS in the lymph nodes of both breeds can be associated with the difference in the expression level of the TLR4/MyD88/TNF-α genes.

PMID:36062368 | DOI:10.1017/S1431927622012314

Int J Med Educ. 2022 Sep 2;13:249-255. doi: 10.5116/ijme.62f6.10b6.

ABSTRACT

OBJECTIVES: To evaluate the association between the achievements of medical students and whether they were admitted via the pre-medical track or the regular direct track.

METHODS: We performed a comparative retrospective data study using data from a three-year experimental cohort in a six-year medical school. We analyzed the academic achievements of all students admitted at one Israeli medical school between 2013-2015, either directly to the six-year program or via a pre-medical track. We compared averages of both yearly final grades and final medical examinations grades between the two groups. Descriptive statistics were calculated and differences between groups were evaluated using multivariate analysis.

RESULTS: Of the 324 students included in the study, 65 (20.1%) were enrolled in all three cohorts of the pre-medical track. Age and Gender distribution were nearly similar for both tracks. For the first two cohorts, the average final grades of year one of pre-medical students were significantly higher than those of regular direct track (F=_(3,167) 6.10, p=0.001), but the opposite was true for the third cohort (F=_(3,110)2.38, p=0.073). No further statistically significant differences were found neither between the groups in their final exams grades nor between choosing a MD/PhD optional track and admission pathway.

CONCLUSIONS: Our results suggest promising achievements with the pre-medical admission pathway. This should encourage further discussion about the significant potential human resources lost by current admission processes and may question the effectiveness of six-year programs in medical schools.

PMID:36062311 | DOI:10.5116/ijme.62f6.10b6

J Clin Transl Hepatol. 2022 Aug 28;10(4):770-777. doi: 10.14218/JCTH.2021.00303. Epub 2021 Oct 12.

ABSTRACT

BACKGROUND AND AIMS: The anticipated fear of serious outcomes in coronavirus infected liver transplant recipients led to disruption of transplant services globally. The aim of our study was to analyze COVID-19 severity in transplant recipients and to compare the difference of COVID-19 clinical outcomes in early (<1 year) vs. late (>1 year) post-transplant period.

METHODS: 41 post-living donor liver transplant recipients with COVID-19 infection were studied retrospectively from 1st April 2020 to 28th February 2021.

RESULTS: The median age was 49.00 years with a male preponderance (80.49%). Fifteen patients had infection within 1 year of transplant and 26 were infected after 1 year of transplant. The overall median interval between transplantation and COVID-19 diagnosis was 816.00 days. Fever and malaise were the common presenting symptoms. The most common associated comorbidities were diabetes mellitus (65.85%) and hypertension (46.34%). The severity of illness was mild in 28 (68.29%), moderate in 4 (9.76%), severe in 6 (14.63%) and critical in 3 (7.32%). To identify associated risk factors, we divided our patients into less severe and more severe groups. Except for lymphopenia, there was no worsening of total bilirubin, transaminases, alkaline phosphatase, and gamma-glutamyl transferase in the more severe group. Eight (19.51%) patients required intensive care unit admission and three (7.32%) died, while none suffered graft rejection. In recipients with early vs. late post-transplant COVID-19 infection, there were similar outcomes in terms of severity of COVID-19 illness, intensive care unit care need, requirement of respiratory support, and death.

CONCLUSION: Living donor liver transplantation can be performed during the COVID-19 pandemic without the fear of poor recipient outcome in cases of unfortunate contraction of severe acute respiratory syndrome coronavirus-2.

PMID:36062268 | PMC:PMC9396325 | DOI:10.14218/JCTH.2021.00303

Surg J (N Y). 2022 Sep 2;8(3):e232-e238. doi: 10.1055/s-0042-1755623. eCollection 2022 Jul.

ABSTRACT

Background Pain relief can be achieved by diversity of methods with analgesics being the basic form of treatment. Analgesic safety and clinical effectiveness are the core factors in determining the analgesic of choice. One adverse effect of concern with opioids is the postoperative ileus (POI). Objective In this study, we looked at the severity of postoperative pain, the type of analgesics used to control the pain, and the incidence of POI at Baghdad Teaching Hospital. We hypothesized that we would find an association between the type of analgesia used and POI. Methods This observational study was conducted among 100 patients who were residents at the general surgery wards of Baghdad Teaching Hospital. A structured questionnaire was employed focusing on types of analgesics, degree of pain control, and the presence of ileus. Results Sixty-nine percent of patients received a combination of opioids and nonopioids. Moderate-to-severe pain was the most commonly reported category on pain scales. More than half of the patients (57%) were found to have POI during their hospital stay and there was a statistically significant association between the type of analgesia and POI development ( p =0.001). Conclusions A mix of analgesics (opioids and nonopioids) was the most common regimen at our center. The majority of the surgical inpatients reported having moderate-to-severe pain on both pain scales used in this study. Ileus incidence following abdominal surgeries (61%) was significantly higher than the reported incidence worldwide (10-30%). Postoperative ileus has multifactorial causes, one of which is the use of opioids for pain control. Considering the high incidence of ileus in our center and the association we found between the use of opioids and ileus, further studies should look at the doses of opioids used and whether alternative analgesic methods might result in less ileus.

PMID:36062183 | PMC:PMC9439878 | DOI:10.1055/s-0042-1755623

Evid Based Complement Alternat Med. 2022 Aug 25;2022:1605359. doi: 10.1155/2022/1605359. eCollection 2022.

ABSTRACT

OBJECTIVE: Aplastic anemia (AA) is an uncommon disease, characterized by pancytopenia and hypocellular bone marrow, but it is common in the blood system. The medication rules of traditional Chinese medicine (TCM) in the treatment of AA are not clear, for which it is worth exploring the medication rules by data mining methods.

METHODS: This study used SPSS Modeler 18.0 and SPSS statistics to analyze the cases of AA from Zhejiang Provincial Hospital of Chinese Medicine (ZJHCM) from March 1, 2019, to March 1, 2022. Data mining methods, including frequency analysis, cluster analysis, and association rule learning, were performed in order to explore the medication rules for AA.

RESULTS: (1) A total of 859 prescriptions, which met the inclusion criteria, consisted of 255 herbs. In descending order of the frequency of herbal medicine, we have Danggui, Huangqi, Shudihuang, Fuling, Gancao, Shanyao, Shanzhuyu, Baizhu, Dangshen, and Xianhecao. (2) Frequency analysis of herb properties: the Four Qi of 255 kinds of TCMs are mainly warm and neutral medicines. The Five Flavors are mainly sweet medicines, followed by bitter medicines. The main meridians are the liver, spleen, and kidney. (3) Clustering of medications: TCMs with the top 20 frequencies are classified into 9 groups by cluster analysis. (4) Association rule analysis of high-frequency herbs: using the Apriori algorithm, the results showed that there were 3 herb pairs with support of over 0.3 and 12 herb pairs with confidence above 0.85.

CONCLUSION: The basic pathogenesis of AA (Sui Lao) is spleen and kidney essence deficiency, Qi deficiency, and blood stasis. The main herbs have warm and neutral properties, sweet tastes, and liver, spleen, and kidney meridian tropisms, whose purpose is to tonify the kidney and invigorate the spleen, tonify Qi, and promote blood circulation.

PMID:36062179 | PMC:PMC9436587 | DOI:10.1155/2022/1605359

Psychiatry Investig. 2022 Aug;19(8):661-667. doi: 10.30773/pi.2022.0092. Epub 2022 Aug 24.

ABSTRACT

OBJECTIVE: This study presents the reliability and validity of the Korean version of the post-traumatic stress disorder (PTSD) checklist for the Diagnostic and Statistical Manual for Mental Disorders-fifth edition (DSM-5) (K-PCL-5) and the short form (K-PCL-5-S).

METHODS: Seventy-one subjects with PTSD, 74 subjects with mood or anxiety disorders, and 99 healthy controls were enrolled. The Korean version of the Structured Clinical Interview for DSM-5-research version was used to confirm the presence of PTSD. The Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Impact of Event Scale-Revised (IES-R), and Spielberger State Trait Anxiety Inventory (STAI) were used to evaluate the concurrent validity of the K-PCL-5 and K-PCL-5-S.

RESULTS: It presented good internal consistency (Cronbach’s α=0.93) and test-retest reliability (r=0.90). The K-PCL-5 and K-PCL-5-S were highly correlated with the BDI-II, BAI, IES-R, STAI-S, and STAI-T. The suggested cutoff score for PTSD was 33 for the K-PCL-5 with a sensitivity of 88.51 and specificity of 89.09, and 6 for the K-PCL-5-S with a sensitivity of 91.95 and specificity of 89.09. The data were best explained with a one-factor model.

CONCLUSION: These results demonstrated the good reliability and validity of the K-PCL-5 and K-PCL-5-S, and their suitability as simple tools for PTSD assessment.

PMID:36059055 | DOI:10.30773/pi.2022.0092

Psychiatry Investig. 2022 Aug;19(8):637-645. doi: 10.30773/pi.2021.0342. Epub 2022 Aug 24.

ABSTRACT

OBJECTIVE: This study aimed to investigate the association of sleep with mental health among Korean adolescents during the coronavirus disease (COVID-19) pandemic.

METHODS: Using data from the 16th Korea Youth Risk Behavior Web-Based Survey (2020) of 46,475 adolescents, we examined sleep duration and satisfaction and examined mental health for depressive symptoms, anxiety, and suicidal ideation. The data were analyzed using complex sample descriptive statistics and a multiple logistic regression model.

RESULTS: In 2020, the average sleep duration was 6.3 hours, and the sleep satisfaction rate was 30.8%. Depressive symptom and suicidal ideation rates were 24.2 and 10.3, respectively. These values are slightly better than those previously reported, before COVID-19. However, poor sleep was still associated with mental health. The likelihood of mental health problems was higher among those who slept for six hours or less than for those who slept for eight hours or more (p<0.05). Additionally, the results showed that the lower the sleep satisfaction, the higher the likelihood of mental health problems (p<0.05).

CONCLUSION: Even after the COVID-19 outbreak, poor sleep associated with mental health problems remained as high as before the outbreak of COVID-19.

PMID:36059052 | DOI:10.30773/pi.2021.0342

World J Surg. 2022 Sep 4. doi: 10.1007/s00268-022-06719-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Surgical exploration is still considered mandatory in the setting of small bowel obstruction (SBO) in patients without prior intra-abdominal surgery. However, recent studies have challenged this ‘classic’ approach describing success with conservative non-surgical treatment. The aim of this study is to identify clinical, radiological and biochemical variables that may be associated with the absence of intra-abdominal pathology in patients with SBO who have not undergone previous surgery.

METHODS: This is a retrospective cohort study of prospectively recorded data. Patients with SBO without prior abdominal surgery who presented to a single tertiary referral medical center between 2009 and 2019 were included.

RESULTS: Eighty-seven patients were included of whom 61(70.0%) were allocated to the ‘therapeutic exploration’ group and 26 (30.0%) to the ‘non-therapeutic exploration’ group. Forty-eight patients (55.0%) had adhesions, 17.2% had closed-loop obstruction, 10.0% had an internal hernia, 27.6% had bowel ischemia and 5.7% had bowel necrosis. Although multiple clinical, laboratory, radiological and preoperative factors were examined, none were significantly associated with pathological findings during surgical exploration. There was no statistically significant difference in the incidence of complications when comparing between those groups.

CONCLUSIONS: In this series, no variables were associated with intra-abdominal pathology in patients who underwent surgery for SBO with no history of prior abdominal surgery. However, the fact that 27.0% had ischemic bowel upon surgical exploration suggests that this approach is still mandatory for this specific group of patients. Furthermore, clinicians and patients should be aware that negative exploration may be expected in up to 30.0%.

PMID:36059038 | DOI:10.1007/s00268-022-06719-2