Tag: nevin manimala

Wilderness Environ Med. 2022 Apr 28:S1080-6032(22)00052-7. doi: 10.1016/j.wem.2022.03.006. Online ahead of print.

ABSTRACT

INTRODUCTION: While avalanche fatalities have remained relatively steady per year, data suggest a possible increase in sidecountry use and snowmobile fatalities. Limited information is known regarding the accident details and preparedness among different groups of backcountry users including snowmobiles, sidecountry, and backcountry skiers, and what specific factors could contribute to their fatalities.

METHODS: Avalanche fatality reports covering all US states posted by the Colorado Avalanche Information Center available online for 10 seasons (2009-2010 through 2018-2019 seasons) were analyzed for group size, specific equipment carried, burial depth, burial time, and other details. Only reports in the 3 following categories were included in the analysis: backcountry ski/snowboard, sidecountry ski/snowboard, and snowmobile/snowbike. These aspects were compared among the 3 tourer types using statistical analyses (ANOVA).

RESULTS: Two hundred and five fatalities were analyzed (n=32 sidecountry, n=91 skier/snowboard, n=82 snowmobile/snowbike). Using 2 preparedness scores, the ski/snowboard group had the greatest distribution of high scores when evaluated by equipment carried and group size, with significant differences per group (P<0.01). Of the fatalities that were buried, burial time was related to the tourer group (P=0.04), with the ski/snowboard group having the highest proportion of burials <15 min. Burial depth was significantly different among the 3 tourer groups, with snowmobiles buried the deepest on average (P<0.01).

CONCLUSIONS: Despite limited data available on fatalities, an analysis of preparedness suggests that backcountry skiers and snowboarders are more prepared for avalanche accidents compared to snowmobiles and sidecountry users when evaluated by equipment carried and group size.

PMID:35491311 | DOI:10.1016/j.wem.2022.03.006

Prim Care Diabetes. 2022 Apr 1:S1751-9918(22)00074-2. doi: 10.1016/j.pcd.2022.03.014. Online ahead of print.

ABSTRACT

BACKGROUND: Elderly patients have higher risks for complications during Ramadan fasting. Educating patients is essential for fasting safely.

AIM: To evaluate the impact of pre-Ramadan education in reducing risk of hypoglycemia and achieving glycemic control in elderly.

METHODS: A prospective study carried out in outpatients clinics of Internal Medicine department in Assiut university hospital. It included 316 type 2 diabetic patients who intended to fast. They were grouped into 2 groups; < 65 years and ≥ 65 years patients. The patients received pre-Ramadan individual education sessions. A semi-structured questionnaire was used to collect the data to stratify the risk of fasting. The study was carried out in 3 phases. Assessment of hypoglycemia and biochemical parameters after the education was the primary outcome.

RESULTS: Fasting blood glucose decreased during and after Ramadan in elderly significantly (p = 0.0001). The patients who achieved fasting blood glucose less than 8 mmol/L increased from 29.3% to 46.6% after Ramadan in elderly patients. HbA1c decreased significantly after Ramadan (p = 0.001). The main cause of breaking fast was hypoglycemia in both groups; 9% vs.7.7% in patients < 65 and ≥ 65 years respectively. The waist circumference showed significant decrease in patient with 65 years old or more (p = 0.05). Total cholesterol and LDL increased with no statistical significance in patients ≥ 65 years (p = 0.512, 0.470). Both groups showed improvement of HDL cholesterol during and after Ramadan (P = 0.0001).

CONCLUSION: Pre-fasting education had positive impact on decreasing the risk of symptomatic hypoglycemia in elderly diabetic patients.

PMID:35491316 | DOI:10.1016/j.pcd.2022.03.014

J Diabetes Complications. 2022 Apr 21:108202. doi: 10.1016/j.jdiacomp.2022.108202. Online ahead of print.

ABSTRACT

AIMS: To quantify metabolic impairment via a one-factor approach with confirmatory factor analysis (CFA) including MRI-derived visceral and subcutaneous adipose tissues and to associate it with diastolic dysfunction.

METHODS: In this cross-sectional analysis, 916 participants (53% female, mean age (SD): 56 (6)) underwent abdominal and cardiovascular MRI. With CFA a metabolic-load factor of metabolic-syndrome variables and visceral and subcutaneous adipose tissues was constructed. A piecewise structural equation model approach with adjustment for confounding factors was used to determine associations with left-ventricular diastolic function, cardiac morphology and hemodynamics.

RESULTS: Model fitting excluding blood pressure and waist circumference but including visceral and subcutaneous adipose tissues, fasting glucose, HDL-c and triglycerides was used to construct the metabolic-load factor. Evaluating measurement invariance demonstrated sex-specificity. Change in mitral early/late peak filling rate ratio was -0.12 for both males [-0.20; -0.05, p > 0.05] and females [-0.17; -0.07, p > 0.001] per SD of metabolic-load factor. Change in deceleration time of mitral early filling was -11.83 ms in females [-17.38; -6.27] per SD of metabolic-load factor.

CONCLUSION: A single latent metabolic-load factor via CFA including MRI-derived adipose tissues increased sensitivity for metabolic impairment obsoleting waist circumference and is associated with a decreased left-ventricular diastolic function, more apparent in females than in males.

PMID:35491309 | DOI:10.1016/j.jdiacomp.2022.108202

J Pediatr Urol. 2022 Apr 1:S1477-5131(22)00118-8. doi: 10.1016/j.jpurol.2022.03.021. Online ahead of print.

ABSTRACT

INTRODUCTION: We have recently validated a meatal Stenosis (MS) severity grading system that is based on physical examination.

OBJECTIVES: The study objective was to examine the correlation between this grading system, patients’ urinary symptoms, uroflowmetry and postvoid residual parameters.

STUDY DESIGN: Patients referred for our clinic for urinary and non-urinary complaints, were prospectively enrolled. Urinary symptoms questionnaire, uroflowmetry parameters and post-voiding residuals (PVR) were assessed, and photographs of the urethral meatus were taken for each patient. The photographs were graded blindly according to the previously validated grading system and correlated with urinary symptoms, uroflowmetry parameters and PVR.

RESULTS: Overall, 75 patients were assessed (20 grade 0, 23 grade 1 and 32 grade 2). When using grade 0 as a reference, the odds ratio (OR) for reporting narrow stream was 6.4 (95%CI 1.65-24.77) and 4 (95%CI 1.18-14.16) for grade 1 and 2 respectively. OR for prolonged urination was 6 (95% CI 1.47-24.89) for Grade 1 and 2; OR for upward stream deviation was10.08 (95%CI -2.43-41.82) for grade 1 and 15.12 (95%CI – 3.74-61.17) for grade 2. Uroflowmetry results showed lower Qmax from 16.8(SD ± 8.0) ml/sec in grade 0-9.6 ml/s on grade 1 and 2 (p < 0.001) (Figure 1). PVR was not statistically different in the three groups.

DISCUSSION: Our main findings were that meatal stenosis severity grade is associated with narrow stream as reported by parent, prolonged urination, and upward deviation of urinary stream, with increasing severity with worsening stenosis. MS grade was also associated with significant worsening of uroflow measures: a lower Qmax, Qmean and a longer time-to-Qmax. Post-void residual volume was not significantly different between the different severity grades. This study showed the clinical significance of the grading system. With subjective and objective measures. The implementation of this grading system in clinics, may aid in decision making regarding surgical intervention in the appropriate patients, and avoid unnecessary procedures.

CONCLUSION: The Severity of MS seen on physical examination correlates well with obstructive symptoms and decrease of urine stream seen on uroflowmetry. These findings confirm the importance of the grading system in the evaluation of patients with MS and may be additional measure that assist in consulting parents on the indications to meatotomy.

PMID:35491305 | DOI:10.1016/j.jpurol.2022.03.021

J Orthop Sci. 2022 Apr 28:S0949-2658(22)00087-2. doi: 10.1016/j.jos.2022.04.007. Online ahead of print.

ABSTRACT

BACKGROUND: In soft tissue sarcomas, the oncological and functional outcomes between planned excision and unplanned excision with additional wide resection remains controversial. The purpose of this study is to determine the impact of unplanned excision on oncological and functional outcomes.

METHODS: A retrospective single-center study was performed. Patients with soft tissue sarcoma surgically treated in 2005-2019 were included in this study. A total of 120 patients consisting of planned excision (PE) group (n = 88), and unplanned excision (UE) group (n = 32) were included. Overall-survival (OS), local recurrence-free survival (LRFS), metastasis-free survival (MFS), disease-free survival (DFS), incidence rate of reconstructive surgery and musculoskeletal tumor society (MSTS) score were assessed. Propensity score matching method was used in statistical analysis.

RESULTS: The 5-year survival rate of OS, LRFS, MFS, and DFS did not differ between the PE and UE groups, however, rates of reconstructive surgery were higher in the UE group (PE: 48% vs. UE: 84%, p < 0.001). These results did not differ (PE: 41% vs. UE: 82%, p = 0.012) after propensity score matching was performed to align the backgrounds with difference in tumor size and depth. For MSTS score, the total score and “pain” and “emotional acceptance” scores were higher in the PE group before propensity score matching. The “pain” and “emotional acceptance” scores were higher in the PE group after propensity score matching also.

CONCLUSIONS: Unplanned excision did not deteriorate oncological outcomes, however unplanned excision lead to unnecessary reconstructive surgery. Unplanned excision adversely affected patient-reported outcomes without worsening pure functional outcomes.

PMID:35491297 | DOI:10.1016/j.jos.2022.04.007

J Prosthet Dent. 2022 Apr 28:S0022-3913(22)00150-0. doi: 10.1016/j.prosdent.2022.03.005. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Loss of retention is a clinical complication for fixed partial dentures (FPDs). However, a method sensitive enough to measure the early retention loss of FPDs is lacking.

PURPOSE: The purpose of this in vitro and finite element analysis (FEA) study was to determine whether resonance frequency analysis (RFA) with a newly developed system can detect lack of FPD retention caused by cement loss.

MATERIALS AND METHODS: Two evaluation methods were used: RFA of an in vitro model of a 3-unit FPD from the second premolar to the second molar and FEA by using a simplified model. The in vitro model was used to evaluate 4 connecting conditions: both crowns cemented, only the premolar crown cemented, only the molar crown cemented, and both crowns uncemented. Tapping stimulation (16 impulsive forces, 4 Hz) was directly applied to the buccal side of the second molar or the second premolar, and an attached 3D accelerometer sensor was used to record the resonance frequency (RF) of the tapped tooth. The amplitude, frequency, Q-value, and total area under the curve (AUC) of the RF values in the buccolingual direction were compared between connecting conditions. The FEA was done by using a simplified model of a 3-unit FPD with similar connecting conditions as the in vitro model study, and the RF amplitude and frequency of each tooth were calculated. Statistical evaluation included 1-way analysis of variance and the Tukey HSD test to compare the differences among each connecting condition under each parameter for measurement sites on the molar and the premolar, respectively (α=.05).

RESULTS: For both the molar and premolar measurements in both the in vitro and FEA models, when the measurement site was on the uncemented tooth, the amplitude of RF-1 increased, the Q-value of RF-2 decreased, and the area under the curve increased (P<.05).

CONCLUSIONS: The same 3 trends found between the measurement sites of the in vitro study and FEA indicated that RFA may be useful for detecting an FPD with loosening caused by cement loss, even partial cement loss.

PMID:35491260 | DOI:10.1016/j.prosdent.2022.03.005

Transplant Proc. 2022 Apr 28:S0041-1345(22)00197-X. doi: 10.1016/j.transproceed.2022.02.047. Online ahead of print.

ABSTRACT

BACKGROUND: For a number of years, the system of procured livers for transplantation by transplant centers in a fixed order, regardless of the location of the procurement site, was in force in Poland. In mid-2018, priority was introduced in the collection of livers by a team from a given province. The aim of the study was to evaluate the impact of changing the liver transplantation allocation system at the Katowice Transplant Center (KTW) on the number of transplanted livers and on the selected parameters of donors from which the liver was procured.

METHODS: The rates and cold ischemia time (CIT) of procured livers were analyzed.

RESULTS: The rate of livers procured by the KTW transplant team increased from 36.6% to 53.3%, and at the same time the rate of livers procured by this team and sent for transplantation in other transplant centers increased. The rate of livers transplanted in the KTW, which were procured in the Silesian Voivodeship, increased from 37.4% to 61.0%, and the rate of livers procured outside the Silesian Voivodeship decreased from 54.8% to 36.4%. The CIT of livers transplanted in the KTW was reduced from 407.5 to 360.0 minutes. The comparative analysis of donor parameters of livers procured by the KTW transplant team and transplanted in Katowice revealed no differences regarding analyzed clinical and biochemical parameters.

CONCLUSION: The change in the allocation system increased the number of livers procured by the local team and shortened CIT of livers transplanted at the KTW.

PMID:35491283 | DOI:10.1016/j.transproceed.2022.02.047

J Prosthet Dent. 2022 Apr 28:S0022-3913(22)00174-3. doi: 10.1016/j.prosdent.2022.03.006. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Visual color determination in clinics or dental offices should take place under reproducible environmental conditions. To reduce false tooth color measurements, daylight and illumination lamps (5000-7500 K) have been recommended. Those can be used either as stationary or mobile handheld illumination units. However, depending on the manufacturer, the handheld lights use different illuminance brightness, and whether the choice of unit affects shade selection is unclear.

PURPOSE: The purpose of this in vitro study was to determine whether the mobile handheld light-emitting diode (LED) lighting unit shows a significantly better result in visual color determination than the conventional reference lighting unit.

MATERIAL AND METHODS: Trained preclinical dental students (N=23) with a mean ±standard deviation age of 24 ±5 years participated in the study. Two color differentiation lamps (Smile lite 1620lx and Dialite Color 4450lx) (SL and DC) were each placed at a 15-cm distance to determine the color of the shade tabs (templates, N=10) with the VITA Linear Guide 3D Master in a double-blinded study. According to the manufacturer’s recommendation, polarization filters were used with the Smile lite lamp.

RESULTS: Of N=220 shade determinations each, 31.8% (SL) and 33.2% (DC) were correct; the median (ΔE₀₀) and interquartile range were 0.96 (±3.32) for SL and 1.35 (±3.28) for DC. The differences between the groups were not statistically significant (P=.67).

CONCLUSIONS: The results show that the use of the mobile LED illumination unit did not improve color determination compared with the reference illumination. The different illumination intensities of 980 lux (SL) with a polarizing filter or 1500 lux (DC) did not have a positive effect.

PMID:35491259 | DOI:10.1016/j.prosdent.2022.03.006

Drug Discov Ther. 2022 Apr 29. doi: 10.5582/ddt.2022.01030. Online ahead of print.

ABSTRACT

Hepatitis B virus genotype C (HBV/C) is one of the most prevalent HBV strains worldwide, especially in the Western Pacific and the South-East Asia. However, the origin and evolutionary timescale of HBV/C remains largely unresolved. We analyzed the evolutionary rate and molecular clock phylogeny of 101 full-genome HBV/C sequences sampled globally using a Bayesian Markov Chain Monte Carlo (MCMC) approach. We inferred the spatiotemporal dynamics of the HBV/C worldwide by the Bayesian Stochastic Search Variable Selection (BSSVS). We found that the estimated mean evolution rate of the HBV/C genotype full-genome was 4.32 × 10^-5 subs/site/year (95% highest posterior density 3.02 × 10^-6 – 8.97 × 10^-5). Phylogeographic reconstruction was able to identify a single location for the origin of the global HBV/C in Australia around A.D. 715. The subgenotype C4 diverged earliest and mainly circulated in Australia, C1 mainly in Southeast Asia, C2 mainly in East Asia and C3 in Remote Oceania. The effective number of HBV infection presented a rapid exponential increase between the 1760s and 1860s followed by a maintained high level until now. Our study, for the first time, provides an estimated timescale for the HBV/C epidemic, and brings new insight to the dispersal of HBV/C in humans globally. Based on the continuous presence of a highly effective viral population, this study provides further evidence of the challenge from a population-based molecular level to eliminate HBV by 2030, and calls for a concerted effort from policy makers, health providers, and society in the globalized world.

PMID:35491234 | DOI:10.5582/ddt.2022.01030

West Afr J Med. 2022 Apr 29;39(4):415-424.

ABSTRACT

INTRODUCTION: The burden of HIV infection in households of people living with HIV (PLHIV) is usually high. The existence of HIV discordance and reasons for that is largely unknown. Moreover, how people in a discordant relationship can live happily together with negative partner not getting infected and/or safely have children are not well understood. This study is to determine the prevalence and factors associated with HIV sero-discordance among in-union HIV patients receiving care in a private health facility in Jos, north central Nigeria.

METHODS: A descriptive cross sectional design was used for the study involving HIV clients. Their records were reviewed and a proforma used to extract needed information. Questionnaire was equally used. A total of 1505 patients were studied out of which 75 were sero-discordant. They were recruited consecutively. Data was analyzed using SPSS version 20 and presented using frequencies, percentages, and tables.

RESULTS: Findings revealed that 75 (5.0%) were discordant giving a prevalence of 5%. Majority of the clients were females: [non-discordant 805(56.3%), discordant 45(60.0%)], attained secondary education [non-discordant 590(41.3%), discordant 60(80.0%)], have been in partnership for 1-10 years [non-discordant 525(36.7%). discordant 45(60.0%)], have sex with partner weekly [non-discordant 1385(96.9%), discordant 60(80.0%)], have no other sexual partner [non-discordant 1070(74.8%), discordant 75(100.0%)]. have viral load of <100 [non-discordant 1315(92.0%), discordant 75(100.0%)], have CD4 count of 200-499 [non-discordant 585(40.9%), discordant 30(40.0%)]. Most of participants knew that ART, consistent use of condom, abstinence and post exposure prophylaxis prevent HIV. There were statistical significant associations of characteristics of clients and their knowledge on HIV prevention with HIV status of partner.

CONCLUSION: Prevalence of discordance is high. There was no identified predictor of HIV status of partner. For HIV prevalence and sero-discordant status to reduce, women should have a say or be at an equal platform as men in terms of control over their sexuality.

PMID:35490416