Tag: nevin manimala

Vaccine. 2022 Jun 9:S0264-410X(22)00476-5. doi: 10.1016/j.vaccine.2022.04.048. Online ahead of print.

ABSTRACT

BACKGROUND: Influenza outbreaks in aged care facilities are a major public health concern. In response to the severe 2017 influenza season in Australia, enhanced influenza vaccines were introduced from 2018 onwards for those over 65 and more emphasis was placed on improving vaccination rates among aged care staff. During the COVID-19 pandemic, these efforts were then further escalated to reduce the additional burden that influenza could pose to facilities.

METHODS: An observational epidemiological study was conducted from 2018 to 2020 in nine Sydney (Australia) aged care facilities of the same provider. De-identified vaccination data and physical layout data were collected from participating facility managers from 2018 to 2020. Active surveillance of influenza-like illness was carried out from 2018 to 2020 influenza seasons. Correlation and Poisson regression analyses were carried out to explore the relationship between physical layout variables to occurrence of influenza cases.

RESULTS: Influenza cases were low in 2018 and 2019, and there were no confirmed influenza cases identified in 2020. Vaccination rates increased among staff by 50.5% and residents by 16.8% over the three-year period of surveillance from 2018 to 2020. For each unit increase in total number of beds, common areas, single rooms, all types of rooms (including double occupancy rooms), the influenza cases increased by 1.02 (95% confidence interval:1.018-1.025), 1.04 (95% confidence interval: 1.019-1.073), 1.03 (95% confidence interval: 1.016-1 0.038) and 1.02 (95% confidence interval:1.005-1.026) times which were found to be statistically significant. For each unit increase in the proportion of shared rooms, influenza cases increased by 1.004 (95% confidence interval:1.0001-1.207) which was found to be statistically significant.

CONCLUSIONS: There is a relationship between influenza case counts and aspects of the physical layout such as facility size, and this should be considered in assessing risk of outbreaks in aged care facilities. Increased vaccination rates in staff and COVID-19 prevention and control measures may have eliminated influenza in the studied facilities in 2020.

PMID:35691870 | DOI:10.1016/j.vaccine.2022.04.048

J Cardiothorac Vasc Anesth. 2022 May 13:S1053-0770(22)00337-8. doi: 10.1053/j.jvca.2022.05.012. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of anticoagulation targets and intensity on bleeding events, thrombotic events, and transfusion requirements in patients with acute respiratory distress syndrome (ARDS) receiving venovenous extracorporeal membrane oxygenation (ECMO) and continuous-infusion heparin.

DESIGN: A retrospective cohort study.

SETTING: At a single-center, large academic medical center.

PARTICIPANTS: One hundred thirty-six critically ill patients.

INTERVENTIONS: The following three therapeutic targets were implemented over time and evaluated: (1) no protocol (September 2013-August 2016): no standardized anticoagulation protocol or transfusion thresholds; (2) <50 seconds (September 2016-January 2018): standardized activated partial thromboplastin time (aPTT) goal of <50 seconds, maximum heparin infusion rate of 1,200 units/h, transfusion threshold of hemoglobin (Hgb) <8 g/dL; and (3) 40-to-50 seconds (February 2018-December 2019): aPTT goal of 40-to-50 sec, no maximum heparin infusion rate, transfusion threshold of Hgb <7 g/dL.

MEASUREMENTS AND MAIN RESULTS: Continuous variables were compared using the Kruskal-Wallis test, and categorical variables were compared using Fisher exact tests. The primary endpoint, an incidence of at least 1 bleeding event, was highest in the no-protocol group though not statistically different among groups (39.3% v 26.7% v 34%, p = 0.5). Thrombotic complications were similar. The median units of packed red blood cells transfused were highest in the no-protocol group (3 v 2 v 0.5, p < 0.001).

CONCLUSION: Anticoagulation protocols standardizing aPTT goals to <50 or 40-to-50 seconds may be a reasonable strategy for patients receiving venovenous ECMO for ARDS. More restrictive hemoglobin transfusion thresholds, in combination with lower aPTT targets, may be associated with a reduction in transfusion requirements.

PMID:35691853 | DOI:10.1053/j.jvca.2022.05.012

Can J Urol. 2022 Jun;29(3):11175-11181.

ABSTRACT

INTRODUCTION: Bladder spasm are common complications following cystoscopic urologic procedures. This study aims to determine the incidence and risk factors for bladder spasm after ambulatory cystoscopic urologic procedures.

MATERIALS AND METHODS: Medical records of adult patients who underwent urologic procedures in our ambulatory center from May 1st, 2018 through December 30th, 2020, were reviewed. Bladder spasm was identified from the administration of antispasmodic therapy (e.g. oxybutynin) during anesthesia recovery. Multivariable analyses were performed to assess the association between bladder spasm and clinical factors.

RESULTS: Included were 2,671 patients, of which 917 (34.3%) developed postoperative bladder spasm, yielding an incidence of 343 (95%CI 325-361) per 1,000 procedures. Risk factors associated with bladder spasm were younger adult age (< 60 years), longer (> 45 minutes) and more complex procedures. Compared to cystoscopy the risk of spasm following transurethral resection of the bladder tumor was OR 4.35 (95%CI 3.22, 5.87) and for transurethral resection of the prostate OR 3.25 (95% CI 2.24, 4.71). Spasm prophylaxis with belladonna and opium suppositories (B&O) was used in 1,158 patients and 384 (33.2%) developed spasms. The use of B&O was not associated with reduction of bladder spasm, OR 0.91 (95%CI 0.75, 1.1, p = 0.318). Postoperative outcomes did not differ between patients who did or did not develop spasms.

CONCLUSION: Bladder spasms are common following ambulatory urologic procedures, more so with more extensive procedures. Prophylaxis with B&O was not significantly associated with a lower rate of bladder spasms.

PMID:35691040

Acta Biochim Pol. 2022 Jun 12. doi: 10.18388/abp.2020_5816. Online ahead of print.

ABSTRACT

BACKGROUND: Primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL) lacks specific clinical manifestations and its malignancy renders prognostication and choice of treatment strategy difficult. The aim of this study was to evaluate microRNA (miR)-21 as potential non-invasive biomarkers for prognosis in PGI-DLBCL patients.

METHODS: Serum miR-21 expression in de novo PGI-DLBCL patients, consecutively enrolled for this study, was detected by quantitative real-time polymerase chain reaction (qRT-PCR). Relative expression was calculated using the comparative Ct method. Statistical significance was determined using the Mann-Whitney rank sum and Fisher’s exact test. Survival analysis was conducted using the Kaplan-Meier method.

RESULTS: Compared with healthy controls, serum miR-21 levels were significantly elevated in the PGI-DLBCL patients (n=156). The high expression level of serum miR-21 at diagnosis was associated with worse progression-free survival (PFS) (30 (9-42) vs 42 (12-52) months in high and low miR-21 groups) and overall survival (OS) (35 (15-52) vs 48 (17-61) months in high and low miR-21 groups) and was an independent risk factor for PFS and OS (hazard ratios 4.345 and 3.311, respectively). Furthermore, Bcl-2, Bcl-6 and Ki-67 were independently and positively associated with miR-21 expression.

CONCLUSIONS: Our results suggest that miR-21 is a potential prognostic marker to predict clinical outcomes in PGI-DLBCL patients and a high miR-21 level is associated with poor outcomes.

PMID:35691029 | DOI:10.18388/abp.2020_5816

JNMA J Nepal Med Assoc. 2022 Jun 1;60(250):521-524. doi: 10.31729/jnma.7217.

ABSTRACT

INTRODUCTION: Neural adaptation to physical training allows a person to better coordinate the activation of all relevant muscles producing maximum force. Nerve conduction velocity measures the speed of impulse along the motor neuron and is strongly associated with muscle contraction time. This study aimed to find out the mean motor nerve conduction velocity of the right ulnar nerve among physically trained adult males in a tertiary care centre.

METHODS: This descriptive cross-sectional study was conducted in the Neurophysiology Laboratory of a tertiary care centre from 3rd November, 2019 to 2nd November, 2020. Thirty young adult males who were engaged in the physical training at a training centre for more than 3 months were studied after receiving ethical approval from the Institutional Review Committee (Reference number: 1578/019). Motor nerve conduction parameters of the right ulnar nerve were measured and data were entered in Microsoft Excel. Statistical analysis was done using the Statistical Packages for the Social Sciences version 25.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data, and mean and standard deviation for continuous data.

RESULTS: Among 30 males studied, the mean motor nerve conduction velocity of the ulnar nerve was found to be 61.02±5.86 m/sec (58.92-63.11 at 95% Confidence Interval). The mean distal latency and amplitude of the muscle action potential were 2.33±0.53 ms and 8.08±1.17 mv respectively.

CONCLUSIONS: Our study found that the mean nerve conduction velocity of the ulnar nerve was similar when compared to studies conducted in similar settings.

KEYWORDS: Nepal; nerve conduction; ulnar nerve.

PMID:35690989 | DOI:10.31729/jnma.7217

J Periodontol. 2022 Jun 12. doi: 10.1002/JPER.21-0555. Online ahead of print.

ABSTRACT

BACKGROUND: This study evaluated the effects of systemic administration of Bifidobacterium animalis subsp. lactis HN019 (B. lactis HN019) on experimental periodontitis (EP) in rats.

METHODS: Thirty-two rats were allocated to groups C (control), C-HN019 (probiotic), EP (EP only) and EP-HN019 (EP+probiotic). From day 0, the animals of C-HN019 and EP-HN019 groups received B. lactis HN019 (1×10⁹ CFU/mL) daily. On the 14th day, the animals of EP and EP-HN019 groups received silk ligature around mandibular molars. Animals were euthanized on the 28th day. Samples of oral biofilm, gingival tissues, blood serum and mandible were obtained for microtomographic, histomorphometric, microbiological and immunological analyses. Data were statistically analyzed (p<0.05).

RESULTS: Group EP-HN019 presented significantly less alveolar bone loss when compared with Group EP in histomorphometric and microtomographic analyses. In gingival tissue and serum, Group EP-HN019 presented lower pro-inflammatory/anti-inflammatory cytokines ratios than Group EP. Group EP-HN019 showed higher expression of beta-defensins and less TRAP-positive cells than Group EP. Group EP presented higher gene expression of Ifng and lower gene expression of Foxp3 when compared with Group EP-HN019 in gingival tissue. In oral biofilm, EP-HN019 group presented a lower percentage of species similar to Fusobacterium periodonticum and a higher percentage of species similar to Actinomyces gereneseriae, A. israelli and Streptococcus gordonii when compared with Group EP. There was a significant increase of B. lactis HN019 after administration of probiotic therapy in oral biofilm of Group EP-HN019.

CONCLUSION: The consumption of B. lactis HN019 promotes a protective effect against alveolar bone loss by modifying local and systemic microbiological and immunoinflammatory parameters. This article is protected by copyright. All rights reserved.

PMID:35690993 | DOI:10.1002/JPER.21-0555

JNMA J Nepal Med Assoc. 2022 Jun 1;60(250):537-540. doi: 10.31729/jnma.7257.

ABSTRACT

INTRODUCTION: Middle ear barotrauma is a tissue injury to the ear secondary to inadequate pressure equalisation between the middle ear and the external environment. Paragliding, though an exciting sport, has its own risks and hazards. Para-pilots experience a variety of ear-related symptoms due to pressure discrepancies between the middle ear and ambient air. Middle ear barotrauma amongst para-pilots is a common yet neglected problem. The aim of this study was to find the prevalence of middle ear barotrauma among licensed para-pilots of a metropolitan city.

METHODS: A descriptive cross-sectional study was conducted amongst para-pilots practising in different paragliding companies in a metropolitan city. The study was conducted from 10th October, 2021 to 22nd October, 2021 after getting ethical approval from the Institutional Review Committee (Reference number: 0410202109/2021). A sample size of 76 participants was taken using convenience sampling technique. Data was collected from participants after performing an otoscope examination. The data were entered into Microsoft Excel version 2016 and analysed using the Statistical Package for the Social Science Version 22.0. Point estimate at a 95% Confidence Interval was calculated along with frequency and proportion for binary data and mean and standard deviation for continuous data.

RESULTS: Out of 76 participants, the prevalence of middle ear barotrauma was 10 (13.2%) (5.58-20.81 at 95% Confidence Interval).

CONCLUSIONS: The prevalence of middle ear barotrauma was similar to other studies done in similar settings.

KEYWORDS: barotrauma; eustachian tube; Nepal; pilots.

PMID:35690988 | DOI:10.31729/jnma.7257

JNMA J Nepal Med Assoc. 2022 Jun 1;60(250):525-528. doi: 10.31729/jnma.7416.

ABSTRACT

INTRODUCTION: Mandibular condyle is a prominent structure in the mandible, which forms the temporomandibular joint. An oval-shaped condyle is considered to be present with a normal temporomandibular joint and any morphological variation of the condyle is assumed to be pathologic in temporomandibular disorders. The aim of the study was to find out the prevalence of oval shaped mandibular condyle among orthopantomogram radiographs of patients visiting the tertiary care centre.

METHODS: A descriptive cross-sectional study was performed among 752 condyles visiting a tertiary care center from November 29, 2021 to April 1, 2022. The ethical approval was taken from the Institutional Review Committee (Reference number: 184 (6-11) 078/079) before conducting the study. Convenience sampling was done. The radiographs were first examined and the observed morphological type of mandibular condyle was noted. Data analysis was done using Statistical Package for the Social Sciences version 22.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.

RESULTS: The prevalence of oval shaped mandibular condyles out of 752 condyles was 416 (55.32%) (51.77-58.87 at 95% Confidence Interval). The oval-shaped condyle on the right side was 205 (54.52%) and on the left side was 211 (56.12%).

CONCLUSIONS: The prevalence of oval shaped condyles among patients in this study was similar to the studies done in similar settings.

KEYWORDS: condyle; mandible; Nepal; X-ray.

PMID:35690981 | DOI:10.31729/jnma.7416

JNMA J Nepal Med Assoc. 2022 Jun 1;60(250):529-532. doi: 10.31729/jnma.7485.

ABSTRACT

INTRODUCTION: Xanthelasma palpebrarum refers to lipid deposition that occurs on eyelids and inner canthi. It is an important cutaneous manifestation of hyperlipidemia, atherosclerosis and coronary artery disease. Few studies have been done in Nepal regarding lipid abnormality in xanthelasma patients. The aim of this study was to find out the prevalence of dyslipidemia among patients with xanthelasma palpebrarum visiting the Department of Dermatology of a tertiary care centre.

METHODS: This is a descriptive cross-sectional study conducted among 80 patients from January, 2021 to February, 2022 in the Department of Dermatology of a tertiary care centre. Ethical approval was taken from the Institutional Review Committee (Reference number: 60512021). Convenience sampling was used. Lipid profile analysis was done among patients with clinical diagnosis of xanthelasma palpabrarum. Data was collected using Microsoft Excel for Mac version 16.16.27 and analyzed using the Statistical Package for the Social Sciences version 22.0. Point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data.

RESULTS: Out of 80 patients with xanthelasma palpebrarum, the prevalence of dyslipidemia was 64 (80.00%) (74-86 at 90% Confidence Interval). Among them, 29 (45.31%) were males and 35 (54.69%) were females.

CONCLUSIONS: In our study, the prevalence of dyslipidemia among patients with xanthelasma palpebrarum was found to be higher than in similar studies conducted in similar settings.

KEYWORDS: dyslipidemia; gender; lipid.

PMID:35690977 | DOI:10.31729/jnma.7485

JNMA J Nepal Med Assoc. 2022 Jun 1;60(250):511-516. doi: 10.31729/jnma.7491.

ABSTRACT

INTRODUCTION: Stroke is a leading cause of morbidity and disability in Asian population. Dyslipidemia is considered a major risk factor for various cardiovascular diseases. The study aimed to find the prevalence of dyslipidemia among patients with ischemic stroke in the Department of Medicine of a tertiary care centre.

METHODS: This is a descriptive cross-sectional study conducted among 150 diagnosed cases of ischemic stroke admitted in the Department of Medicine from 1st October, 2020 to 1st October, 2021. The ethical clearance was taken from the Institutional Review Committee (Reference number: 358/2077/78). Fasting blood samples were collected from the patients, serum lipids were measured and atherogenic indices of plasma were calculated. Demographic, anthropometric and cardiovascular risk factors related data were collected. Data were entered in Microsoft Excel 2010 and analysis was using the Statistical Package for the Social Sciences version 22.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data, and mean and standard deviation for continuous data.

RESULTS: The prevalence of dyslipidemia among the ischemic stroke patients was 120 (80.00%) (73.60-86.40 at 95% Confidence Interval). High total cholesterol was found in 64 (53.33%) patients, high triglycerides in 70 (58.33%), high low-density lipoprotein cholesterol in 54 (45.00%) and low high-density lipoprotein cholesterol in 51 (42.50%) patients.

CONCLUSIONS: The prevalence of dyslipidemia among ischemic stroke patients was higher than the studies done in similar settings.

KEYWORDS: dyslipidemia; ischemic stroke; lipid; prevalence.

PMID:35690976 | DOI:10.31729/jnma.7491