Tag: nevin manimala

J Glob Health. 2022 Mar 26;12:04013. doi: 10.7189/jogh.12.04013. eCollection 2022.

ABSTRACT

BACKGROUND: Complications associated with preterm birth (PTB) are the largest contributor to under-five mortality globally. Success in reaching the Sustainable Development Goal target requires identifying potentially modifiable risk factors for PTB, estimating the relative importance of these risk factors, and identifying/implementing effective prevention strategies to address them.

METHODS: We conducted a literature review to define risk relationships and estimate prevalence for established risk factors for spontaneous PTB (sPTB). We then estimated population attributable fractions (PAF) for the sPTB risk factors identified in the review as statistically significant for the 81 low- and middle-income (LMIC) countries included in the Countdown 2030 initiative. We summed country-level findings to produce PAFs for each risk factor and regional estimates for sub-Saharan Africa and South Asia.

RESULTS: Forty-four potential sPTB risk factors were identified. and the final analysis included twenty-four risk factors with evidence of significant associations with sPTB. A second model with three additional risk factors with borderline insignificant associations was also run. Taken together, the twenty-four risk factors had a total PAF of 73% for all 81 countries and 77% and 72% of sPTB in sub-Saharan Africa and South Asia, respectively. For all countries, maternal undernutrition had the highest PAF (17.5%), followed by maternal infections (16.6%), environmental exposures (16%) and pregnancy history (8.7%).

CONCLUSIONS: While multiple risk factors contribute to sPTB, no single risk factor addresses a predominant fraction, and 27% of spontaneous preterm births are not associated with risk factors that we identified. Despite the significant role of preterm birth in child survival, there are major data gaps in LMIC settings. Furthermore, there is a paucity of evidence for effective interventions to prevent preterm birth. Preventing sPTB requires understanding underlying mechanisms leading to sPTB in different populations, and the identification/implementation of effective interventions.

PMID:35356651 | PMC:PMC8959104 | DOI:10.7189/jogh.12.04013

J Glob Health. 2022 Mar 19;12:11002. doi: 10.7189/jogh.12.11002. eCollection 2022.

ABSTRACT

BACKGROUND: Creating an enabling environment (EE) can help foster the development and health of children. The Chinese government implemented a new health care reform (NHR) in 2009 in a move to promote an EE for health. The purpose of this study was to evaluate the impact of the NHR on EE for children’s health.

METHODS: An interrupted time-series analysis was used to evaluate the changes in the EE before and after 2009 in China. This study analysed the EE through five quantitative indicators, including policy element coverage rate (PECR), service meeting with children’s needs rate (SMCNR), multisector participation rate (MPR), and accountability mechanism clarity rate (AMCR), based on the content analysis of available public policy documents (updated as of 2019) from 31 provinces in mainland China, and the number of health care personnel of maternity and child care centres per 10 000 population (HP per 10 000 population), based on the 2002-2019 China Health Statistical Yearbook and China Statistical Yearbook.

RESULTS: The average values of PECR, SMCNR, and MPR increased rapidly to 90.96%, 82.46%, and 81.31%, respectively, in 2019, representing a higher value compared to the AMCR (7.38%). The NHR promoted the EE, in which HP per 10 000 population showed the fastest increase (β₁ = 0.03, P < 0.01; β₃ = 0.10, P < 0.01), followed by SMCNR (β₁ = 0.94, P < 0.01; β₃ = 1.83, P < 0.01), AMCR (β₁ = 0.13, P < 0.01; β₃ = 0.24, P = 0.14), MPR (β₁ = 1.35, P < 0.01; β₃ = 2.47, P < 0.01) and PECR (β₁ = 1.43, P < 0.01; β₃ = 1.47, P < 0.01).

CONCLUSIONS: The NHR has a positive impact on the EE, especially on the human resources and service provision for children. Efforts should be intensified to improve the clarity of the accountability mechanism of the health-related sectors.

PMID:35356653 | PMC:PMC8932608 | DOI:10.7189/jogh.12.11002

China CDC Wkly. 2022 Mar 11;4(10):199-206. doi: 10.46234/ccdcw2022.048.

ABSTRACT

INTRODUCTION: With the large-scale roll-out of the coronavirus disease 2019 (COVID-19) booster vaccination effort (a vaccine dose given 6 months after completing primary vaccination) in China, we explore when and how China could lift non-pharmacological interventions (NPIs) against COVID-19 in 2022.

METHODS: Using a modified susceptible-infectious-recovered (SIR) mathematical model, we projected the COVID-19 epidemic situation and required medical resources in Guangdong Province, China.

RESULTS: If the number of people entering from overseas recovers to 20% of the number in 2019, the epidemic in 2022 could be controlled at a low level by a containment (215 local cases) or suppression strategy (1,397 local cases). A mitigation strategy would lead to 21,722 local cases. A coexistence strategy would lead to a large epidemic with 6,850,083 local cases that would overwhelm Guangdong’s medical system. With 50% or 100% recovery of the 2019 level of travelers from overseas, the epidemic could also be controlled with containment or suppression, but enormous resources, including more hotel rooms for border quarantine, will be required. However, coexistence would lead to an uncontrollable epidemic with 12,922,032 local cases.

DISCUSSION: With booster vaccinations, the number of travelers from overseas could increase slightly in 2022, but a suppression strategy would need to be maintained to ensure a controllable epidemic.

PMID:35356641 | PMC:PMC8930405 | DOI:10.46234/ccdcw2022.048

J Healthc Eng. 2022 Mar 21;2022:8223336. doi: 10.1155/2022/8223336. eCollection 2022.

ABSTRACT

The efficacy and safety of transcatheter arterial chemoembolization (TACE) are systematically evaluated in the treatment of primary liver cancer, which provides a reference for clinical practice and more in-depth research. Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP, and WanFang Data, supplemented by other searches, collected all randomized controlled trials (RCT) comparing TACE combined with TACE alone for HCC. The meta-analysis, after selecting the literature, extracting data, and evaluating the methodological quality of the included studies following the inclusion criteria, was performed using RevMan 5.1 software. There was statistical difference in 3-year survival rate of TACE combined with heat treatment for advanced hepatocellular carcinoma (OR = 1.72,95%CI (1.22,2.41), P=0.002, I² = 0%, and Z = 3.12), total effective rate (OR = 1.91,95%CI (1.31,2.78), P=0.0008, I² = 0%, and Z = 3.37), quality-of-life improvement rate (OR = 2.29,95%CI (1.62,3.23), P < 0.00001, I² = 83%, and Z = 3.37), and complication rate (OR = 2.29,95%CI (1.62,3.23), P < 0.00001, I² = 83%, and Z = 3.37). Compared with TACE alone, TACE combined with hyperthermia can significantly improve the survival rate and recent efficacy of patients, improve the quality of life, and have a trend to reduce the incidence of toxicity. However, its long-term efficacy and more comprehensive safety need to be verified by more sample and high-quality RCT.

PMID:35356619 | PMC:PMC8959991 | DOI:10.1155/2022/8223336

J Healthc Eng. 2022 Mar 21;2022:8432360. doi: 10.1155/2022/8432360. eCollection 2022.

ABSTRACT

Osteoporotic vertebral compression fractures are on the rise in modern society due to the aging population, and this often results in painful symptoms and kyphotic abnormalities in patients. Bone cement was injected into the vertebral body to reinforce the vertebral body and restore most of the damaged vertebrae’s natural height. Percutaneous kyphoplasty is the name given to this type of procedure (PKP). Bone cement leakage has been linked to several problems, according to the research. Neurological problems might arise if bone cement leaks into the spinal canal or the nerve root canal during surgery. As a result, PKP surgeons must now deal with the issue of reducing bone cement leakage. Using smart medical big data, this paper examines a sample of PKP operations and then examines different associated aspects that influence complication rates in order to better advice clinical PKP surgery use. There were 172 vertebral bodies in total in 72 patients receiving PKP surgery at a Chinese hospital that were examined by smart medical big data for vertebral degeneration and fusion. Bone cement leakage and variations in preoperative average anterior vertebral column height, preoperative Cobb angle, and the volume of injected bone cement were considered when dividing the patients into leakage and nonleakage groups; then, we figure out what is causing the bone cement to leak. Five patients experienced lung-related problems out of the 18 vertebral bodies with bone cement leaking that were selected for study. That leakage rate was 10.5%. The differences between the two groups in terms of vertebral compression and bone cement injection were statistically significant based on a single-factor analysis. Bone cement leakage in PKP surgery has been linked to the amount of bone cement injected and whether the vertebral body’s peripheral wall was injured, according to multivariate analysis. Lung-related problems are more common in patients with a prior history of illness. Osteoporotic vertebral compression fractures can be successfully treated with percutaneous kyphoplasty. An important risk factor for bone cement extravasation in PKP surgery is the amount of bone cement injected, as well as its viscosity and whether damage to the vertebral body’s peripheral wall has occurred.

PMID:35356609 | PMC:PMC8959986 | DOI:10.1155/2022/8432360

Psychiatr Danub. 2021 Spring-Summer;33(Suppl 4):1118-1129.

ABSTRACT

Addiction does not mean “addiction to substances” only. At the core of the definition of substance dependence is the loss of control. Gambling addiction belongs to non-substance / non-chemical addictions or behavioral/behavioral addictions. The concept of behavioral addictions is new and revolutionary in psychiatry. Gambling addiction, formerly pathological or problematic gambling occurs due to loss of control over gambling. There is growing evidence to suggest that behavioral addictions resemble substance addictions in many domains, including phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment. Behavioral addiction has been proposed as a new class in the Diagnostic Statistical Manual Fifth Revision (DSM-5), but the only category included is gambling addiction. The prevalence of gambling disorders in adolescence is very high and for certain disorders (especially related to the use of the Internet) it becomes more pronounced over time. In this paper, we presented a comprehensive overview of gambling disorders from definition, epidemiology, manifestations, comorbidities, assessment, treatment options, and existing forms of treatment. Given the complexity of the approach to the treatment of gamblers, a creative individualized integrative approach is necessary, which is the basis of creative psychopharmacotherapy. Due to the possibility of the emergence of problem gambling and other impulse-control deficits we need to be very careful when commencing a patient on dopamine replacement therapy or therapy with aripiprazole.

PMID:35354178

Psychiatr Danub. 2021 Spring-Summer;33(Suppl 4):1106-1112.

ABSTRACT

INTRODUCTION: Hyperprolactinemia (HPRL) is known as a side effect of some antidepressants and antipsychotics. These medicines are common in treatment of schizophrenia. Thus, HPRL is often observed in schizophrenic patients. It is also known that HPRL can occur in Hashimoto’s thyroiditis due to prolactoliberin effect of thyroliberin. The clinical pathophysiology of the patients with the comorbidity of schizophrenia and Hashimoto’s thyroiditis, receiving antipsychotics, is of special interest. It’s fair to assume that these patients have higher risks of HPRL. To analyze risks of HPRL with antipsychotic treatment, to identify an association between the antipsychotic therapy (AT) and HPRL in Hashimoto’s patients receiving AT, to explore the association of HPRL and other laboratory parameters in patients with Hashimoto’s thyroiditis and schizophrenia during AT.

SUBJECTS AND METHODS: We studied 17 patients with HT in comorbidity with schizophrenia receiving AT (mean age 46.5±12.8 years), all euthyroid or with light hypothyroidism. Different laboratory parameters such as anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies, blood levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and prolactin (PRL) were analysed.

RESULTS: The study revealed the high levels of PRL, anti-TPO and anti-TG autoantibodies. Thus, patients were classified into 3 groups by the degree of expected HPRL risk from the antipsychotics used: without expected risk, with low and high expected risks. The correlation analysis detected an inverse significant correlation (R=-0.51; p=0.037) between expected level of drug-associated HPRL risk and actual PRL levels in studied group. At the same time, we detected a positive significant correlation between the levels of PRL and FT4 in the groups (R=0.53; p=0.03). The correlations between the levels of PRL and other parameters such as TSH, FT3, anti-TPO, anti-TG, anti-TSH receptor antibodies were not statistically significant.

CONCLUSIONS: HPRL in the group was not associated with taking of antipsychotic drugs with high expected HPRL risk. Yet, a significant positive correlation existed between the levels of PRL and FT4. Hence, in Hashimoto’s thyroiditis accompanied with treated mental illness there are some non-iatrogenic stimulants of prolactogenesis. It cannot be ruled out that antipsychotics may interfere with prolactin metabolism, which creates a false effect of a positive correlation between prolactin and free thyroxine levels, in contrast to common HPRL of hypothyroidism.

PMID:35354176

Pharmacology. 2022 Mar 30:1-9. doi: 10.1159/000522396. Online ahead of print.

ABSTRACT

BACKGROUND: Botulinum toxin type A (BTA) has a wide range of clinical applications, and its use in improving aesthetics is one of them. The aim of this study was to better assess the efficacy and safety of BTA in patients with facial scars.

SUMMARY: We extracted the data of the visual analog scale (VAS) score, Vancouver scar scale (VSS) score, scar width, observer scar assessment scale (OSAS), patient scar assessment scale (PSAS), and/or drug-related adverse events. Five studies provided the data of VAS score, and the results showed that the VAS score in the BTA group was significantly higher than that in the control group. Three randomized controlled trials (RCTs) reported the VSS score. A statistically significant difference exists between the BTA group and the control group. Three RCTs reported the scar width after BTA treatment. A more favorable change was found in the BTA group with scar width even without statistical significance. Data about the OSAS and PSAS scores were available in two trials. There was no significant difference in OSAS and PSAS scores between the BTA group and the control group. Only three studies recorded three slight adverse events. There were no reports of severe complications. In conclusions, this study demonstrated that BTA has the potential to improve facial scars with an acceptable safety profile.

PMID:35354154 | DOI:10.1159/000522396

Biomed Phys Eng Express. 2022 Mar 30. doi: 10.1088/2057-1976/ac6292. Online ahead of print.

ABSTRACT

MOSFET dosimeters have widely been used to measure radiation doses caused by x-rays. When using the MOSFET dosimeters, calibration factors (CFs) have a direct effect on reliability of dose measurements. The aim of this paper was to study the effect of various calibration methods on the CFs of the MOSFET dosimeters. The CFs were measured on clinical digital x-ray angiography (XA) and computed tomography (CT) devices using a calibrated CT ionization chamber and a standard polymethyl methacrylate (PMMA) phantom. The measurements were conducted by having the dosimeters 1) in air, 2) on the surface of the PMMA phantom and 3) inside the phantom. A statistically significant difference was seen between the CFs measured on the XA and CT devices. The CFs measured on the CT device were 20-165% higher than those measured with the XA device (p < 0.001) in every calibration geometry. Furthermore, the calibration geometry had a notable effect on the CFs on CT. The CFs on the surface of the phantom were 18-25% higher than in air (p < 0.05), and the CFs inside the phantom were 32-39% smaller than in air (p < 0.05). These results suggest that the calibration of the MOSFET dosimeters should be conducted with the same device that is used in actual dose measurements. Also, the scattering conditions and the calibration geometry should be similar in the calibration and subsequent dose measurements.

PMID:35354122 | DOI:10.1088/2057-1976/ac6292

Eur Addict Res. 2022 Mar 30:1-12. doi: 10.1159/000522618. Online ahead of print.

ABSTRACT

AIM: The study aimed to evaluate the psychometric properties of the Problematic Khat Use Screening Test (PKUST-17) in Ethiopia.

METHODS: A validation study of PKUST-17 was carried out among 510 khat users, using a house-to-house survey. Confirmatory factor analysis and 2-parametric item response theory (IRT) were used to evaluate the construct validity of PKUST-17. We also used Spearman’s rank-order correlation coefficient and other test statistics to assess the convergent validity of PKUST-17 with depression symptoms, functional impairment, and other characteristics of participants. We generated latent classes of problematic khat use using latent profile analysis (LPA) and validated the classes using multinomial logistic regression.

RESULTS: The data confirm the unidimensional model of the PKUST-17. The internal consistency of PKUST-17 was excellent (Cronbach’s alpha = 0.93). IRT discrimination parameters indicated that each item had a strong ability to distinguish participants across the spectrum of problematic khat use (α thresholds range from 1.02 to 2.9). The items were fairly or moderately severe to be endorsed by participants (β thresholds vary from 1.43 to 5.57). The LPA identified three latent classes which have severity differences: mild (34%), moderate (34%), and severe (32%) problematic khat use. Depression symptoms, functional impairment, and other khat use patterns were also associated with moderate and severe problematic khat use class membership compared to mild problematic khat use class.

CONCLUSION: We found that the PKUST-17 is a culturally appropriate, brief, easy to use, and psychometrically sound screening test. PKUST-17 can be used to screen khat users with different levels of risk for providing stepped care at different healthcare levels, including integration of services in primary care. Future studies need to test the predictive capacity of the PKUST-17 for khat-related harms.

PMID:35354141 | DOI:10.1159/000522618