Tag: nevin manimala

Orthod Craniofac Res. 2022 Jun 25. doi: 10.1111/ocr.12596. Online ahead of print.

ABSTRACT

OBJECTIVE: This randomized controlled trial (RCT) aims to investigate the short-term effects of chlorhexidine mouthwash (MW) on gingival health surrounding orthodontic miniscrew implants (OMIs) and their overall survivability.

MATERIALS AND METHODS: Thirty-two participants (mean age, 22.8 years) undergoing fixed orthodontic appliance treatment after maxillary premolar extraction were randomly allocated in a parallel fashion to either receive (1) MW with an active component of chlorhexidine, or (2) a placebo. Each participant received two maxillary buccal OMIs for anchorage reinforcement purposes. Participants were assessed for their gingival oral health status around all inserted OMIs and had their OMI survivability recorded at three time points; T1=1 month, T2=3 months, and T3=6 months after OMI placement. A Kaplan Meier plot was used to estimate the survival function of OMIs.

RESULTS: All randomized participants completed the follow-up period. In terms of gingival oral health, there were no statistically significant differences at any time point between the chlorhexidine MW group and the placebo-controlled group (P > 0.05). One OMI was lost in the chlorhexidine MW group and another two OMIs in the control group. There was no significant difference between both groups in terms of survivability (P = 0.585).

CONCLUSION: The use of chlorhexidine MW does not seem to have a significant clinical impact on the gingival health around OMIs or their survivability in this pilot study.

PMID:35751508 | DOI:10.1111/ocr.12596

Mol Ecol. 2022 Jun 25. doi: 10.1111/mec.16578. Online ahead of print.

ABSTRACT

Examining natural selection in wild populations is challenging, but crucial to understanding many ecological and evolutionary processes. Additionally, in hybridizing populations, natural selection may be an important determinant of the eventual outcome of hybridization. We characterized several components of relative fitness in hybridizing populations of Yellowstone cutthroat trout and rainbow trout in an effort to better understand the prolonged persistence of both parental species despite predictions of extirpation. Thousands of genomic loci enabled precise quantification of hybrid status in adult and subsequent juvenile generations; a subset of those data also identified parent-offspring relationships. We used linear models and simulations to assess the effects of ancestry on reproductive output and mate choice decisions. We found a relatively low number of late-stage (F3+) hybrids and an excess of F2 juveniles relative to the adult generation in one location, which suggests the presence of hybrid breakdown decreasing the fitness of F2+ hybrids later in life. Assessments of reproductive output showed that Yellowstone cutthroat trout are more likely to successfully reproduce and produce slightly more offspring than their rainbow trout and hybrid counterparts. Mate choice appeared to be largely random, though we did find statistical support for slight female preference for males of similar ancestry. Together, these results show that native Yellowstone cutthroat trout are able to outperform rainbow trout in terms of reproduction and suggests that management action to exclude rainbow trout from spawning locations may bolster the now-rare Yellowstone cutthroat trout.

PMID:35751487 | DOI:10.1111/mec.16578

Head Neck. 2022 Jun 25. doi: 10.1002/hed.27123. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with oral cancer are at higher risk of developing second primary esophageal cancer (SPEC) and the consensus for screening strategies remains unclear. This study aimed to examine comparative effectiveness and the stage-shift effect of endoscopic exam among patients with oral cancer.

METHOD: A population-based longitudinal retrospective observational matched case and control cohort study with at least 5 years follow-up was conducted. We identified 45 457 newly diagnosed patients with oral cancer, 2004-2013, and the eligible patient with oral cancer was 39 401. Propensity score matching was used to match comparable groups, and the two groups (screening vs. nonscreening) was 5941, individually. The study primary endpoints were to compare detection of incident SPEC and the stage-shift effect of endoscopic screening between screened and nonscreened incident oral cancer patients. Cox proportional hazard and competing risk models were analyzed. Statistical analyses were conducted in 2020-2021.

RESULT: Detection of incident SPEC in the screened group was significantly higher than in the nonscreened group (hazard ratio: 2.92, 95% confidence interval [CI]: 2.29-3.72). The stage-shift effect from endoscopic screening was found overall in patients with oral cancer (odds ratio [OR]: 0.39, 95%CI: 0.21-0.70), in particular in advanced-stage patients (OR: 0.25, 95%CI: 0.11-0.61), but not in early-stage patients (OR: 0.60, 95%CI: 0.26-1.40).

CONCLUSION: This study confirmed that endoscopic screening achieved early detection of SPEC among patients with oral cancer. To improve the screening stage-shift effect, patients with oral cancer are encouraged to undergo routine endoscopic screening.

PMID:35751477 | DOI:10.1002/hed.27123

J Obstet Gynaecol Res. 2022 Jun 24. doi: 10.1111/jog.15343. Online ahead of print.

ABSTRACT

AIM: To evaluate the effectiveness of a preeclampsia (PE) screening program using the National Institute for Health and Care Excellence (NICE) guideline in pregnant Thai women.

METHODS: A total of 2552 pregnancies received antenatal care and were delivered at Songklanagarind Hospital between November 2016 and April 2020. PE screening with the NICE guideline was used to identify mothers at risk. In cases of positive screening results, a daily dose of 81 mg aspirin was prescribed. Pregnancy outcomes were compared with 2783 participants who had maternity care before the implementation of the screening program. The effectiveness of aspirin prophylaxis following the NICE guideline was assessed by a logistic regression model to compare the risk of PE development between before and after guidance.

RESULTS: The screening positive rate by NICE was 8.3%. Of these, 77.36% of the participants received aspirin prophylaxis according to the NICE recommendation. After the implementation of the PE screening program, the incidence of PE slightly decreased (from 4.31% to 3.72%, p = 0.274). The chance of PE in pregnancies who had high-risk factors was reduced after using low-dose aspirin prophylaxis, even though the difference was not statistically significant.

CONCLUSIONS: Screening with the NICE guidelines followed by prescription of low-dose aspirin (81 mg/day) was probably not an effective strategy for the prevention of PE in our population. Combining biophysical and biochemical markers to identify pregnant women who subsequently develop PE, concurrently with an increased dose of aspirin prophylaxis, may provide a better outcome in clinical practice.

PMID:35751401 | DOI:10.1111/jog.15343

ESC Heart Fail. 2022 Jun 24. doi: 10.1002/ehf2.14035. Online ahead of print.

ABSTRACT

AIMS: The analysis of heart rate (HR) changes, such as the HR variability or HR turbulence, has been reported as a marker of cardiovascular events during sinus rhythm; however, those relationships during atrial fibrillation (AF) remain controversial, and those parameters are not commonly used in AF patients. We sought to investigate the relationship between a simple index focused on the HR and heart failure (HF) events in patients with permanent AF.

METHODS AND RESULTS: We enrolled 198 patients with permanent AF and evaluated the HR range, defined as the maximum HR minus the minimum HR on 24-h Holter electrocardiogram recordings. The patients were divided into two groups, i.e., the larger (n = 101) and smaller (n = 97) HR range (HRR) groups, determined by the median value. The HF events were defined as hospitalizations for HF or urgent hospital visits due to exacerbations of one’s HF status. The observation period of this study was set at 5 years from registration. The median age was 73 (68-77) years, and 29% were female. The median HRR was 84 (63-118) beats per minutes (bpm). During the observational period of 1825 days (median), HF events occurred in 37 (0.047 per patient-year) patients. In a log-rank test, the larger HRR group had more frequent HF events than the smaller HRR group (P = 0.0078). In the adjusted Cox proportional hazards model using the significantly different factors from the univariate analysis (Model 1) and factors and medications associated with HF (Model 2), the larger HRR group had a higher prevalence of HF events than the smaller HRR group for both models [Model 1, adjusted hazard ratio = 3.21, 95% confidence interval (CI) 1.593-6.708, P = 0.0009; Model 2, adjusted hazard ratio = 3.12, 95% CI 1.522-6.685, P = 0.002]. When analysed using the time-dependent Cox proportional hazards model, the HRR was associated with HF with a statistically significant difference in both the univariate and multivariate analyses [hazard ratio = 1.01, 95% CI 1.006-1.020, P = 0.0002; Model 1, adjusted hazard ratio = 1.02, 95% CI 1.011-1.027, P < 0.0001; Model 2, adjusted hazard ratio = 1.01, 95% CI 1.008-1.021, P = 0.0003). There was no significant difference in the chronotropic medications between the two groups.

CONCLUSIONS: In patients with permanent AF, a larger HRR was associated with HF events.

PMID:35751389 | DOI:10.1002/ehf2.14035

J Pak Med Assoc. 2022 Jun;72(6):1250-1254. doi: 10.47391/JPMA.1782.

ABSTRACT

OBJECTIVES: To evaluate YAG capsulotomy rates following implantation of two types of trifocal intraocular lenses (IOLs).

METHODS: In this retrospective cohort study consecutive patients who underwent cataract surgery with a trifocal IOL from 1st May 2017 to 30th October 2019 at Aga Khan University Hospital, Karachi were included. Eyes which either had an AT Lisa Tri or Alcon PanOptix IOL implant were included. The primary outcome measure was Nd: YAG laser. Univariate analysis of all predictor variables was performed followed by a multivariate regression analysis of those which were significant. A p-value of < 0.05 was taken as significant.

RESULTS: A total of 328 eligible eyes were identified. Nine eyes were excluded. Out of the 319 eyes of 177 patients included in this study, 180 received AT Lisa Tri while 139 of them received Alcon PanOptix Trifocal IOLs. The mean (SD) age of the patients was 52.29 years (±11.04). Gender was equally distributed with 91(51.4%). male patients. Median (IQR) time to laser capsulotomy was 8 months (3-16). Clinically posterior capsular opacification (PCO) was present in 75(23.5%) eyes. A total of 39(12.2%) eyes underwent Nd: YAG laser capsulotomy. Among the AT Lisa Tri group 29 (16.1%) eyes underwent laser capsulotomy compared to 10 (7.2%) (n=10) in Alcon PanOptix group (p=0.016). In both univariate and multivariate analyses, gender and IOL type were statistically significant.

CONCLUSIONS: Eyes implanted with AT Lisa Tri showed a significantly increased rate of YAG capsulotomy. A prospective randomized control trial is recommended to confirm these findings.

PMID:35751355 | DOI:10.47391/JPMA.1782

Indian Pediatr. 2022 Jun 11:S097475591600436. Online ahead of print.

ABSTRACT

OBJECTIVE: To study the association between serum magnesium level and migraine in children.

METHODS: This cross-sectional study enrolled children aged 5-18 years diagnosed with migraine, and age-and sex-matched controls without a headache disorder. International Classification of Headache Disorders 3 (ICHD-3) was used for the diagnosis of migraine. The association between serum magnesium level and migraine headache was analyzed.

RESULTS: A total of 35 children with migraine were enrolled with 35 control subjects. The median (IQR) serum magnesium levels were comparable among children with migraine and controls [2.0 (2.0,2.1) vs. 2.2 (1.9, 2.2) mg/dL; P=0.23], respectively. In adolescent sub-group, median (IQR) serum magnesium levels were significantly low among the children with migraine [2.0 (1.9, 2.1) vs. 2.2 (2.0, 2.2 mg/dL); P<0.045].

CONCLUSION: We found a statistically significant association between low serum magnesium levels and the occurrence of migraine in adolescents which needs further exploration as it may have treatment implications.

PMID:35751375

J Pak Med Assoc. 2022 Jun;72(6):1158-1165. doi: 10.47391/JPMA.3885.

ABSTRACT

OBJECTIVE: To determine the effectiveness of digital health technologies in the management of chronic pain.

METHODS: The systematic review comprised search for randomised controlled trials and controlled clinical trials involving patients with chronic pain published between 2010 and 2020. The search was conducted on PubMed, Google Scholar, MEDLINE, National Centre for Biotechnology Information, and National Library of Medicine databases. Risk bias tool was used to evaluate the biasness in the studies and Pedro scale was used to assess the quality of the included articles.

RESULTS: Of the 33 articles fully assessed, 14(42.42%) were analysed. All the studies analysed were randomised controlled trials and scored 6-10 on the Pedro scale which showed high quality of methodology. The studies typically reported statistically significant benefits of digital health technologies in the management of chronic pain. One of the main benefits was enhanced pain coping skills of the patients. Additionally, majority of the studies included increased adherence to exercise as an essential advantage.

CONCLUSIONS: All the studies analysed reported favourable conclusions regarding the use of digital intervention for chronic pain management.

PMID:35751328 | DOI:10.47391/JPMA.3885

J Pak Med Assoc. 2022 Jun;72(6):1123-1127. doi: 10.47391/JPMA.3368.

ABSTRACT

OBJECTIVE: To assess the diagnostic accuracy of haematoxylin-eosin staining in clinically suspected Hirschsprung disease, and to compare the findings with calretinin and S100 immunohistochemistry.

METHODS: The retrospective study was conducted at the AL-Khansaa Teaching Hospital, Nineveh, Iraq, and comprised data from January 2017 to October 2020 of rectal suction biopsies of patients with clinically and radiologically suspected Hirschsprung disease. Histopathology and immunohistochemistry were performed. Data was analysed using SPSS 16.

RESULTS: Of the 114 patients, 74(64.9%) were males and 40(35.1%) were females. Based on histology, 28(24.6%) cases were negative for ganglion cells, and, of them 25(89.2%) revealed nerve bundle hypertrophy. The diagnostic accuracy for the detection of ganglion cell and nerve hypertrophy using haematoxylin-eosin stain was 99.1% and 94.4%, respectively. Correlation of haematoxylin-eosin staining with calretinin and S100 was statistically near perfection (κ= 0.976 and κ = 0.923), respectively.

CONCLUSIONS: The mainstay to confirm or exclude Hirschsprung disease remains an accurate histopathological evaluation of the haematoxylin-eosin-stained sections of an adequate colorectal biopsy.

PMID:35751321 | DOI:10.47391/JPMA.3368

J Pak Med Assoc. 2022 Jun;72(6):1044-1047. doi: 10.47391/JPMA.800.

ABSTRACT

OBJECTIVE: To compare incubator and thermal blanket for thermoregulation in preterm and low birth weight neonates.

METHODS: The pilot study was conducted from January to March 2018 at the emergency department of the National Institute of Child Health, Karachi, and comprised preterm and low birth weight neonates without any co-morbidity who were randomised to control and interventional groups. Data was collected using a proforma about demographics, weight, gestational age and brief clinical history. Temperature, blood pressure and pulse were monitored along with other routine care after every 15 minutes in the incubator, and the same procedure was adopted for thermal blankets. Data was analysed using Statistical Package for Social Sciences (SPSS) Version 23.

RESULTS: Of the 38 subjects, 19(50%) each were cases and controls. The mean gestational age between the groups was not significantly different (p>0.05). Temperature for the first 60 minutes remained similar in the two groups, but at 75 minutes and onwards, the incubator showed a significantly better results (p<0.05).

CONCLUSION: Thermal blankets can sufficiently provide a hyperthermic environment to the neonates, but an incubator is a more reliable option to provide sustained temperature.

PMID:35751306 | DOI:10.47391/JPMA.800