Tag: nevin manimala

J Prosthodont Res. 2021 Dec 2. doi: 10.2186/jpr.JPR_D_21_00044. Online ahead of print.

ABSTRACT

PURPOSE: To compare the interfacial fracture toughness (IFT) of two MDP-based composite cements and a resin-modified glass-ionomer cement (RMGIC) with third-generation zirconia CAD-CAM restorations using two different airborne-particle abrasion (AB) pressures.

METHODS: Blocks were cut into prisms (n=60), split and sintered to the desired equilateral half prisms. Half-prisms were divided into two groups for AB at 0.5 or 2.5 bar with 50 µm Al₂O₃ particles. Each group was then further divided into 3 subgroups, and half-prisms were bonded to their counterparts with Panavia V5 (V5), Panavia Self Adhesive Cement Plus (SA), or RMGIC Fuji Plus (n=10/group). The IFT was determined using the Notchless Triangular Prism test in a water bath at 36°C after thermocycling (10,000 cycles). Surface roughness and SEM analyses were performed for representative zirconia samples after AB, and composite cements were tested for flexural strength and wettability.

RESULTS: SA (2.5 bar) showed a significantly higher IFT. The 3 other groups with SA and V5 showed no significant difference in their IFT values regardless of the AB pressure (1-way ANOVA). Weibull analysis of SA was higher than V5. All RMGIC samples debonded while thermocycling, and were, therefore, not included in the statistical analysis. Surface roughness increased with increasing AB pressure, and both cements showed similar flexural strength values and good wettability.

CONCLUSION: Contrary to RMGIC, composite cements show high performance with zirconia after AB. Increasing AB pressure enhances the micromechanical retention of composite cement. Future perspectives should include study of the effect of AB pressure on zirconia surface properties.

PMID:34853211 | DOI:10.2186/jpr.JPR_D_21_00044

Saudi Med J. 2021 Dec;42(12):1357-1361. doi: 10.15537/smj.2021.42.12.20210572.

ABSTRACT

OBJECTIVES: To determine the prognostic significance of nodal yield in patients with clinically node-negative (cN0) oral cavity squamous cell carcinoma (OCSCC).

METHODS: This retrospective observational study included 40 patients with cN0 OCSCC who underwent treatment with at least 6 months of follow-up data from November 2012 to April 2020. We recorded the variables, including patient demographics, cancer site, tumor-node-metastasis (TNM) staging, type of treatment, lymph node yield (LNY), histopathologic diagnosis, and recurrence. The recorded data were analyzed with descriptive and interferential statistics using specific tests.

RESULTS: Our study cohort comprised of 27 males and 13 females with a mean age of 60.08+13.153 years. Tongue (55%) was the commonly affected site. Seventeen (42.5%) patients belonged to TNM stage II. The mean LNY in our study was 38.65±25.41 (range 7-98). Following surgery, 19 (47.5%) patients further received adjuvant therapies. Recurrence was reported only in 4 (10%) patients. There was no significant difference between LNY and recurrence rate (p=0.892). Factors including, age (p=0.121), gender (p=0.209), site (p=0.519), size of tumor (p=0.416) did not influence the LNY.

CONCLUSION: There is no correlation between LNY and recurrence in cN0 OCSCC patients in our study. Meticulous neck dissection and thorough pathologic reporting prevents TNM under staging and improves the overall survival and prognosis.

PMID:34853142 | DOI:10.15537/smj.2021.42.12.20210572

Tob Control. 2021 Dec 1:tobaccocontrol-2021-056970. doi: 10.1136/tobaccocontrol-2021-056970. Online ahead of print.

ABSTRACT

OBJECTIVE: In light of the current U.S. Food and Drug Administration (FDA) proposal to ban menthol cigarettes, this study updates trends in menthol cigarette use among adolescents age 13-18 years up to the year 2020. The study considers a potential role for the ban to reduce black/non-black disparities in menthol cigarette use, as well as a counterargument that a ban is not necessary because menthol use is already diminishing.

METHODS: Data are from annual, cross-sectional, nationally representative Monitoring the Future (MTF) surveys of 85 547 8th, 10th and 12th grade students surveyed between 2012 and 2020. Analyses include trends in past 30-day menthol and non-menthol cigarette smoking among the total adolescent population, as well as stratified by race/ethnicity.

RESULTS: Declines in adolescent menthol and non-menthol cigarette smoking continued through 2020 so that in 2018-2020 past 30-day prevalence for each was less than 1% for non-Hispanic black adolescents and less than 2.2% for non-black adolescents. For non-Hispanic black adolescents no smoking declines in mentholated or non-mentholated cigarette use from 2015-2017 to 2018-2020 were statistically significant, in part because prevalence levels approached a floor effect and had little room to fall further. Menthol levels were lower for non-Hispanic black versus all other adolescents in all study years.

CONCLUSIONS: Continuing declines in adolescent menthol prevalence indicate that both menthol prevalence and also black/non-black disparities in its use are steadily decreasing. However, these decreases in adolescence will take decades to reach later ages through generational replacement. Efforts to accelerate menthol decreases will require new initiatives to increase cessation among adult menthol users.

PMID:34853161 | DOI:10.1136/tobaccocontrol-2021-056970

Saudi Med J. 2021 Dec;42(12):1341-1352. doi: 10.15537/smj.2021.42.12.20210576.

ABSTRACT

OBJECTIVES: To identify the self-reported vaccine-related side effects among healthcare professionals (HCPs) in the Jazan province, Saudi Arabia, and determine the associated socio-demographic factors. With the recent second and third waves of coronavirus disease -19 (COVID-19) infections worldwide, the race is not only to encourage but also to achieve mass vaccination.

METHODS: A total of 397 HCPs from across Jazan province participated in an anonymous online cross-sectional survey conducted for a period of 45 days (March 30, 2021 to May 13, 2021) in Jazan province, Saudi Arabia. Data was collected using a validated 22-items self-report survey.

RESULTS: For both COVID-19 vaccines, majority of reports were related to flu-like symptoms including fever, chills, headache, fatigue, tiredness, and myalgia. Statistically significant associations were observed between the severity of side effects and gender (χ²=73.32; p<0.001), type of vaccine (χ²=112.08; p<0.001), and presence of known allergies (χ²=99.69; p<0.001). Female HCPs were more likely to report any side effects compared with male HCPs (adjusted odds ratio [AOR]: 3.72; p<0.001). Furthermore, HCPs with known allergies were more likely to report any side effects than their counterparts with unknown allergies (AOR: 16.29; p<0.001).

CONCLUSION: The findings of the present study would help in designing educational programs aimed at combating the misconstrued fear of vaccination and highlighting the urgent need of getting vaccinated. This study also helps in the identification of factors affecting the presence and severity of side effects.

PMID:34853140 | DOI:10.15537/smj.2021.42.12.20210576

Saudi Med J. 2021 Dec;42(12):1325-1332. doi: 10.15537/smj.2021.42.12.20200724.

ABSTRACT

OBJECTIVES: To explore the benefits of invoking unconscious sentiment to improve the treatment of stuttering and misarticulation.

METHODS: This cross-sectional study of 80 participants with speech issues (44 patients with misarticulation and 36 with stuttering) who underwent comprehensive speech and hearing evaluations to confirm and diagnose speech difficulties. Speech and language pathologists then calculated either the percentage of correctly pronounce sounds in misarticulation cases or stuttering severity index-4 scores in cases of stuttering following the use of therapeutic stimuli recorded with familiar and non-familiar voices of similar linguistic and phonetic complexity. Descriptive and inferential statistics were used to compare the data collected following the use of familiar and unfamiliar stimuli.

RESULTS: The analysis showed that the number of dysfluencies in cases of stuttering were significantly fewer when employing familiar voices than unfamiliar voices (3% errors vs 12% errors; Z= -5.16 p<0.001). Additionally, the percentages of correct pronouncing of target sounds in cases of articulation disorders were prominently higher when using familiar voices compared with unfamiliar voices (88% PCC vs 66% PCC; Z= -5.65, p<0.001) CONCLUSION: This study confirms the utility of invoking emotion in improving speech therapy and maximizing therapeutic outcomes. This study also recommends engaging families and friends in providing speech services to the speech-impaired population to improve patient progress.

PMID:34853138 | DOI:10.15537/smj.2021.42.12.20200724

Saudi Med J. 2021 Dec;42(12):1272-1280. doi: 10.15537/smj.2021.42.12.20210483.

ABSTRACT

OBJECTIVES: To evaluate the impact of COVID-19 on cancer management in Saudi Arabia’s military hospitals.

METHODS: This multi-centric, retrospective study compared cancer patients diagnosed from February-July 2019 and 2020, focusing on the time duration for acceptance and time for oncologic treatment initiation. Eligibility and referral status were recorded. Clinical data of COVID-19-positive cancer patients were collected and evaluated their outcomes and survival.

RESULTS: Data of 1574 cancer patients (mean age, 57.1 years) were collected. Mean time for acceptance was 7.3 days in 2019 and 8 days in 2020, with no statistically significant difference. Mean time for oncology treatment initiation was 38.4 days in 2019 and 44.3 days in 2020, with no statistically significant difference. The number of new cancer patients decreased in 2020 but increased in peripheral hospitals. It decreased in Riyadh and Jeddah hospitals. Concerning referral status, a statistically significant modification was recorded only in Riyadh and Tabuk hospitals. No significant changes observed in time duration for acceptance of new patients and oncology treatment initiation from 2019-2020. A total of 76 COVID-19-positive cancer patients recorded; 72% were symptomatic, 73.6% recovered, 22.3% died due to COVID-19 complications, and 8% died due to cancer; cancer progressed in 7 patients.

CONCLUSION: COVID-19 did not affect oncology service in Saudi Arabia’s military hospitals. New cancer cases reduced during the pandemic. Cancer patients are at increased risk for COVID-19 complications, including death.

PMID:34853131 | DOI:10.15537/smj.2021.42.12.20210483

BMJ Open. 2021 Dec 1;11(12):e053481. doi: 10.1136/bmjopen-2021-053481.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has exacerbated health inequalities across the globe, disproportionately affecting those with poor social determinants of health (SDOHs). It is imperative to understand how SDOH influences the transmission and outcomes (positive case, hospitalisation and mortality) of COVID-19. This systematic review will investigate the impact of a wide range of SDOHs across the globe on the transmission and outcomes of COVID-19.

METHODS AND ANALYSIS: This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. We will search three electronic bibliographical databases (MEDLINE via PubMed, Embase and Scopus), as well as the WHO COVID-19 Global Research on Coronavirus Disease database. We will consider observational studies that report statistical relationships between the SDOHs (as listed in PROGRESS-Plus and Healthy People 2020) and COVID-19 transmission and outcomes. There will be no limitation on the geographical location of publications. The quality of included observational studies will be assessed using a modified version of the Newcastle-Ottawa Scale. A narrative synthesis without meta-analysis reporting standards will be used to report the review findings.

ETHICS AND DISSEMINATION: This review will be based on published studies obtained from publicly available sources, and therefore, ethical approval is not required. We will publish the results of this review in a peer-reviewed journal, as well as present the study findings at a national conference.

PROSPERO REGISTRATION NUMBER: CRD42021228818.

PMID:34853106 | DOI:10.1136/bmjopen-2021-053481

BMJ Open. 2021 Dec 1;11(12):e055916. doi: 10.1136/bmjopen-2021-055916.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic is spreading globally with a high risk of mortality. It is also significantly affecting mental health. For nursing students, the impact of COVID-19 on mental health is predicted to be significant; however, sufficient data have not been obtained. Therefore, this study will aim to assess the mental health of nursing students and evaluate the related factors.

METHODS AND ANALYSIS: This proposed study is a cross-sectional survey using a self-report questionnaire. An online questionnaire will be distributed among all nursing students of eight universities in Japan. The survey questionnaire will consist of questions related to demography, life satisfaction, fear of COVID-19, mental health and physical activities. The target sample size is 1300 nursing students. We will calculate descriptive statistics for each measurement item and perform univariate and logistic regression analyses to evaluate the potential risk factors for anxiety, depression and insomnia symptoms in nursing students. The strength of association will be assessed using the OR and its 95% CIs. Statistical significance will be set at a p<0.05.

ETHICS AND DISSEMINATION: The protocol was approved by the Institutional Review Board (IRB) of the University of Hyogo on 22 March 2021 (ID: 2020F29). In addition, all of the participating facilities required ethical approval from their local IRBs. The findings will be disseminated through peer-reviewed publications and conference presentations. We believe that the proposed large-scale investigation of the mental health of nursing students during the COVID-19 pandemic and the relationship between mental health and fear of COVID-19 are novel and will be a strength of this study.

PMID:34853113 | DOI:10.1136/bmjopen-2021-055916

BMJ Open. 2021 Dec 1;11(12):e050236. doi: 10.1136/bmjopen-2021-050236.

ABSTRACT

OBJECTIVES: To determine if comparable older women and men received different durations of P2Y₁₂ inhibitor therapy following acute myocardial infarction (AMI) and if therapy duration differences were justified by differences in ischaemic benefits and/or bleeding risks.

DESIGN: Retrospective cohort.

SETTING: 20% sample of 2007-2015 US Medicare fee-for-service administrative claims data.

PARTICIPANTS: ≥66-year-old P2Y₁₂ inhibitor new users following 2008-2013 AMI hospitalisation (N=30 613). Older women compared to older men with similar predicted risks of study outcomes.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome: P2Y₁₂ inhibitor duration (modelled as risk of therapy discontinuation).

SECONDARY OUTCOMES: clinical events while on P2Y₁₂ inhibitor therapy, including (1) death/hospice admission, (2) composite of ischaemic events (AMI/stroke/revascularisation) and (3) hospitalised bleeds. Cause-specific risks and relative risks (RRs) estimated using Aalen-Johansen cumulative incidence curves and bootstrapped 95% CIs.

RESULTS: 10 486 women matched to 10 486 men with comparable predicted risks of all 4 study outcomes. No difference in treatment discontinuation was observed at 12 months (women 31.2% risk; men 30.9% risk; RR 1.01; 95% CI 0.97 to 1.05), but women were more likely than men to discontinue therapy at 24 months (54.4% and 52.9% risk, respectively; RR 1.03; 95% CI 1.00 to 1.05). Among patients who did not discontinue P2Y₁₂ inhibitor therapy, women had lower 24-month risks of ischaemic outcomes than men (13.1% and 14.7%, respectively; RR 0.90; 95% CI 0.84 to 0.96), potentially lower 24-month risks of death/hospice admission (5.0% and 5.5%, respectively; RR 0.91; 95% CI 0.82 to 1.02), but women and men both had 2.5% 24-month bleeding risks (RR 0.98; 95% CI 0.82 to 1.14).

CONCLUSIONS: Risks for death/hospice and ischaemic events were lower among women still taking a P2Y₁₂ inhibitor than comparable men, with no difference in bleeding risks. Shorter P2Y₁₂ inhibitor durations in older women than comparable men observed between 12 and 24 months post-AMI may reflect a disparity that is not justified by differences in clinical need.

PMID:34853104 | DOI:10.1136/bmjopen-2021-050236

BMJ Open. 2021 Dec 1;11(12):e049533. doi: 10.1136/bmjopen-2021-049533.

ABSTRACT

OBJECTIVES: Limb amputation incidence is particularly high in fragile contexts due to conflict, accidents and poorly managed diabetes. The study aim was to analyse (1) demographic and amputation characteristics of persons with any type of acquired amputation (PwA) and (2) time between amputation and first access to rehabilitation in five conflict and postconflict countries.

DESIGN: A retrospective, observational study analysing differences in demographic and clinical factors and time to access rehabilitation between users with traumatic and non-traumatic amputations.

SETTING: Five countries with the highest numbers of PwA in the global International Committee of the Red Cross database (Afghanistan, Cambodia, Iraq, Myanmar, Sudan). Cleaned and merged data from 2009 to 2018 were aggregated by sex; age at amputation and registration; cause, combination and anatomical level of amputation(s); living environment.

PARTICIPANTS: All PwA newly attending rehabilitation.

RESULTS: Data for 28 446 individuals were included (4329 (15.2%) female). Most were traumatic amputations (73.4%, 208 90); of these, 48.6% (138 01) were conflict related. Average age at traumatic amputation for men and women was 26.9 and 24.1 years, respectively; for non-traumatic amputation it was 49.1 years and 45.9 years, respectively. Sex differences in age were statistically significant for traumatic and non-traumatic causes (p<0.001, p=0.003). Delay between amputation and rehabilitation was on average 8.2 years for those with traumatic amputation, significantly higher than an average 3 years for those with non-traumatic amputation (p<0.001).

CONCLUSIONS: Young age for traumatic and non-traumatic amputations indicates the devastating impact of war and fragile health systems on a society. Long delays between amputation and rehabilitation reveal the mismatch of needs and resources. For rehabilitation service providers in fragile settings, it is an enormous task to manage the diversity of PwA of various causes, age, sex and additional conditions. Improved collaboration between primary healthcare, surgical and rehabilitation services, a prioritisation of rehabilitation and increased resource provision are recommended to ensure adequate access to comprehensive rehabilitation care for PwA.

PMID:34853101 | DOI:10.1136/bmjopen-2021-049533