Tag: nevin manimala

PLoS One. 2022 Mar 25;17(3):e0265337. doi: 10.1371/journal.pone.0265337. eCollection 2022.

ABSTRACT

BACKGROUND: Although antiretroviral therapy has significantly altered the natural history of human immunodeficiency virus infection and improved the quality of life of patients, there are conflicting reports regarding its impact on hematological outcomes. Thus, this study aimed at investigating the prevalence and predictors of anemia among adults on antiretroviral therapy in Northeast Ethiopia.

MATERIALS AND METHODS: A retrospective cohort study was carried out among adults who began antiretroviral treatment between September 2005 and January 2019 at two governmental hospitals in Dessie town. Data were collected from patients’ medical records using a pretested data extraction instrument. Anemia was the primary outcome variable of the study. It was defined based on WHO criteria after adjustment for altitude and smoking status of measured values. Data were entered and validated using EpiData Version 3.1 and then exported to SPSS Version 20.0 for analysis. Descriptive analysis was done for prevalence and binary logistic regression was carried out to assess whether covariates were associated with experiencing anemia. Statistical significance has been considered at p-value <0.05.

RESULTS: Medical records of 392 patients (mean age: 35.58 ± 9.46 years) were reviewed. Of the total 392 patients, 218 (55.6%) were females, 261 (66.6%) were categorized under WHO clinical stage III/IV and 134 (34.2%) had a baseline CD4 cell count of <100 cells/mm3. The mean baseline CD4 cell count was 179 cells/mm3 (range: 2 to 853 cells) and 230 (58.7%) of the participants were on zidovudine-based regimen. Anemia was diagnosed among 162 (41.3%) patients. After adjustment for other confounding factors, risk of anemia was significantly associated with low baseline CD4 cell count (AOR 1.80, 95% CI 1.05-3.06) and tenofovir based regimen (AOR 2.05, 95% CI 1.31-3.21). On the other hand, being educated was found to be protective (AOR 0.40, 95% CI 0.21-0.78).

CONCLUSION: In this research, the prevalence of anemia was relatively high. Low baseline CD4 cell count and tenofovir based regimen were independent predictors of anemia; while being educated was protective. Treatment programs should focus on early diagnosis and treatment of HIV as well as routine screening and proper treatment of anemia.

PMID:35333889 | DOI:10.1371/journal.pone.0265337

PLoS Negl Trop Dis. 2022 Mar 25;16(3):e0010233. doi: 10.1371/journal.pntd.0010233. Online ahead of print.

ABSTRACT

BACKGROUND: Rift Valley fever (RVF) is an emerging, neglected, mosquito-borne viral zoonosis associated with significant morbidity, mortality and expanding geographical scope. The clinical signs and symptoms in humans are non-specific and case definitions vary. We reviewed and analysed the clinical manifestations of RVF in humans.

METHODS: In this systematic review and meta-analysis we searched on different dates, the Embase (from 1947 to 13th October 2019), Medline (1946 to 14th October 2019), Global Health (1910 to 15th October 2019), and Web of Science (1970 to 15th October 2019) databases. Studies published in English, reporting frequency of symptoms in humans, and laboratory confirmed RVF were included. Animal studies, studies among asymptomatic volunteers, and single case reports for which a proportion could not be estimated, were excluded. Quality assessment was done using a modified Hoy and Brooks et al tool, data was extracted, and pooled frequency estimates calculated using random effects meta-analysis.

RESULTS: Of the 3765 articles retrieved, less than 1% (32 articles) were included in the systematic review and meta-analysis. Nine RVF clinical syndromes were reported including the general febrile, renal, gastrointestinal, hepatic, haemorrhagic, visual, neurological, cardio-pulmonary, and obstetric syndromes. The most common clinical manifestations included fever (81%; 95% Confidence Interval (CI) 69-91; [26 studies, 1286 patients]), renal failure (41%; 23-59; [4, 327]), nausea (38%; 12-67; [6, 325]), jaundice (26%; 16-36; [15, 393]), haemorrhagic disease (26%; 17-36; [16, 277]), partial blindness (24%; 7-45; [11, 225]), encephalitis (21%; 11-33; [4, 327]), cough (4%; 0-17; [4, 11]), and miscarriage (54%) respectively. Death occurred in 21% (95% CI 14-29; [16 studies, 328 patients]) of cases, most of whom were hospitalised.

DISCUSSION: This study delineates the complex symptomatology of human RVF disease into syndromes. This approach is likely to improve case definitions and detection rates, impact outbreak control, increase public awareness about RVF, and subsequently inform ‘one-health’ policies. This study provides a pooled estimate of the proportion of RVF clinical manifestations alongside a narrative description of clinical syndromes. However, most studies reviewed were case series with small sample sizes and enrolled mostly in-patients and out-patients, and captured symptoms either sparsely or using broad category terms.

PMID:35333856 | DOI:10.1371/journal.pntd.0010233

PLoS One. 2022 Mar 25;17(3):e0265495. doi: 10.1371/journal.pone.0265495. eCollection 2022.

ABSTRACT

INTRODUCTION: Recruitment is essential for the success of clinical trials. We are conducting a randomized clinical trial to test the effect of a Mediterranean dietary intervention with or without 1700 mg/day of metformin for the prevention of age-related chronic diseases, the MeMeMe trial (Trial registration number: EudraCT number: 2012-005427-32 ClinicalTrials.gov ID: NCT02960711). MeMeMe recruiting experience, highlighting strengths, limitations encountered and results is reported.

PATIENTS AND METHODS: Statistical analysis focused on the reasons for withdrawal according to the recruitment method (“active” versus “passive” criterion) and the time of withdrawal. Logistic regression models were used to explore the associations between the risk of withdrawal and sex, recruitment method, randomization arm, and with markers of compliance to the intervention, such as one-year change in body weight.

RESULTS: Out of 2035 volunteers, 660 (32.4%) were recruited “actively” and 1375 (67.6%) “passively”. Among people who dropped out of the trial after randomization, there were 19.5% for the “active” and 22.0% for the “passive” method (p = 0.28). The risk of withdrawal was significantly higher in women (OR:1.91; 95% CI:1.17-3.12; p = 0.01), in volunteers older at recruitment (OR:1.25; 95% CI:1.07-1.45; p = 0.004), and in those with a higher BMI at baseline (OR:1.23; 95% CI:1.07-1.43; p = 0.004). Volunteers who lost at least 2 kg (the median weight change) in the first year of intervention were significantly less (53%) likely to withdraw from the trial (OR:0.48; 95% CI:0.30-0.75; p = 0.001).

CONCLUSION: Our findings suggest that the “passive” recruitment method was more effective than the “active” one to advance recruitment. The benefits of “passive” recruitment hardly outweighed the drawbacks.

TRIAL REGISTRATION: Trial registration number: EudraCT number: 2012-005427-32. ClinicalTrials.gov ID: NCT02960711.

PMID:35333878 | DOI:10.1371/journal.pone.0265495

J Cataract Refract Surg. 2022 Mar 24. doi: 10.1097/j.jcrs.0000000000000946. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to assess the efficiency of an index derived from multiple logistic regression analysis (MLRA) to measure differences in corneal tomography findings between subclinical keratoconus (SKC) in one eye, corneal ectasia, and healthy corneas.

SETTING: Two private Brazilian ophthalmological centers.

DESIGN: Multicenter, case-control study.

METHODS: This study included 187 eyes with very asymmetric ectasia and normal corneal topography and tomography (VAE-NTT) in the VAE-NTT group (G), 2,296 eyes with healthy corneas in the control group (CG), and 410 eyes with ectasia in the ectasia group. An index, termed as Boosted Ectasia Susceptibility Tomography Index (BESTi), was derived using MLRA to identify a cutoff point to distinguish patients in the three groups. The groups were divided into two subgroups with equal number of patients: validation set and external validation (EV) set.

RESULTS: BESTi had an area under the curve (AUC) of 0.91 with 86.02% sensitivity (Se) and 83.97% specificity (Sp) between CG and VAE-NTT G in the EV set, which were significantly greater than those of the Belin-Ambrósio Deviation Index (BAD-D; AUC: 0.81; Se: 66.67%; Sp: 82.67%; P < .0001) and Pentacam Random Forest Index (PRFI; AUC: 0.87; Se: 78.49%; Sp: 79.88%; P = .021).

CONCLUSIONS: BESTi facilitated early detection of ectasia in SKC. BESTi demonstrated higher Se and Sp than PRFI and BAD-D for detecting SKC.

PMID:35333829 | DOI:10.1097/j.jcrs.0000000000000946

J Sports Med Phys Fitness. 2022 Mar 25. doi: 10.23736/S0022-4707.22.13566-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Chronic ankle instability (CAI), which is characterized by deficient postural control, is associated with functional limitations and diminished self-reported quality of life. Recent studies have suggested that balance training can improve postural control, but high-quality evidence-based research to confirm the effect of balance training on dynamic postural stability in CAI patients is lacking.The purpose of this study was to synthesize current evidence regarding the effect of balance training on dynamic postural stability in Chronic ankle instability (CAI) patients.

EVIDENCE ACQUISITION: PubMed, Embase, Web of Science and Cochrane Library databases were searched for clinical trials that evaluated the effect of balance training on posture and balance in CAI patients from their inception to 15 July 2021. All statistical analyses were performed in RevMan 5.4. The risk of bias was assessed by the Cochrane Collaboration’s risk of bias tool, and studies that reported statistically comparable outcomes were analysed in meta-analyses using random effects models. Heterogeneity was assessed using the I2 statistic index.

EVIDENCE SYNTHESIS: A total of 12 RCTs included in this meta-analysis and revealed that balance training was effective for improving the dynamic posture stability of CAI patients (SMD=0:90; 95%CI: 0.54 to 1.26; P<0:00001, I2 = 71%; Star Excursion Balance Test). Subgroup analysis (balance training vs. other training) revealed a small negative effect size, but this was not statistically significant (SMD=-0.12, 95% CI=-0.53 to 0.29, P=0.56, I² = 9%). Another subgroup analysis (balance training vs. no training) revealed that balance training was more likely to have greater improvement on the dynamic posture stability of CAI patients (SMD=0.94, 95% CI: 0.71 to 1.17; P<0.00001, I² = 0%).

CONCLUSIONS: Balance training yielded a statistically significant and clinically meaningful improvement in dynamic postural stability in CAI patients. Limited evidence indicates that balance training was more effective than other training methods.

PMID:35333029 | DOI:10.23736/S0022-4707.22.13566-8

J Sports Med Phys Fitness. 2022 Mar 25. doi: 10.23736/S0022-4707.22.13655-8. Online ahead of print.

ABSTRACT

BACKGROUND: female soccer players are often diagnosed with medial shin pain, which includes tibial stress fracture, medial tibial stress syndrome, and chronic exertional compartment syndrome. As the possibility of varied sites of pain affecting sports activities has not been fully researched, an urgent discussion and evidence is required. This study investigates the prevalence and effect of sites of pain on the sports activities of female soccer players with medial shin pain.

METHODS: a questionnaire survey was conducted for 196 female soccer players with medial shin pain to assess symptom duration, the effect of practice and performance, and sites of pain. The players were classified into three conditions (tibial stress fracture, medial tibial stress syndrome, or medial shin pain with neurological symptoms) and compared based on sites of pain.

RESULTS: we observed that medial tibial stress syndrome had a lower impact on performance compared to that of tibial stress fracture and medial shin pain with neurological symptoms. While participants with tibial stress fracture had to suspend practice sessions more frequently, the difference in symptom duration between the classified groups was not statistically significant. The effect of sites of pain on sports activities was not significantly different in participants with medial tibial stress syndrome.

CONCLUSIONS: medial shin pain should be evaluated carefully to differentiate between medial tibial stress syndrome and medial shin pain with neurological symptoms. Restriction of sports activities may help improve the patient’s condition early, regardless of the presentation.

PMID:35333031 | DOI:10.23736/S0022-4707.22.13655-8

J Sports Med Phys Fitness. 2022 Mar 25. doi: 10.23736/S0022-4707.22.13498-5. Online ahead of print.

ABSTRACT

BACKGROUND: Our previous study has developed FIVE, futsal neuromuscular warm-up program to improve physical performance components and prevent the incidence of futsal injury. Experimental research was needed to verify the effect of FIVE program on physical performance components affecting injury, such as lower limb muscle strength. This study aimed to investigate the effect of FIVE program on the lower limb muscle strength among young futsal players.

METHODS: Ninety-five young male futsal players were recruited using purposive random sampling from futsal clubs in Indonesia. The players were randomized into 2 groups; 42 players were in the experimental (EXP) group, and 53 players were in the control (CON) group. The EXP group performed FIVE exercises in addition to their regular futsal training, and the CON group performed their regular futsal training only. Both groups performed the intervention 3 times per week within 6 weeks. All players completed pre-and post-intervention lower limb muscle strength tests comprising the isometric leg strength, isometric hip abduction strength, and isometric hip adduction. The strength test was conducted using dynamometer. Changes in performance (pre- vs. post-intervention) of each group were analyzed using paired T-test and Wilcoxon test. The pre- and post-strength test changes (Δ post-pre) between EXP and CON group was compared using independent T-test and Mann Whitney test. Statistical significance was set to p < 0.05. Thirty-one players dropped out in this study.

RESULTS: This study showed all measurements on lower limb muscle strength improved significantly in the EXP group (p < 0.05) while hip abduction and hip adduction strength were significantly decreased in the CON group. Improvement of isometric hip abduction and adduction strength in the EXP group was significantly different from the CON group (p = 0.00 and p = 0.00, respectively).

CONCLUSIONS: Results suggest that FIVE could be an alternative warm-up program to improve lower limb muscle strength among young futsal players.

PMID:35333027 | DOI:10.23736/S0022-4707.22.13498-5

Musculoskeletal Care. 2022 Mar 25. doi: 10.1002/msc.1635. Online ahead of print.

ABSTRACT

BACKGROUND: Pain, as a psychological experience, is caused by complex interactions among sensory-discriminative, motivational-affective, and cognitive-evaluative dimensions. The psychosocial approach is one of the important approaches in managing musculoskeletal pain in patients. Therefore, this study aimed to determine and compare the effects of psychosocial skills training on pain intensity in patients with acute and chronic musculoskeletal pain.

METHODS: In this quasi-experimental study, 64 patients with acute and chronic musculoskeletal pain were selected using convenience sampling and were divided into a control and an intervention group. Both groups received psychosocial training in pain management in groups of 8-10 people over six 1-h sessions. The data were collected at baseline, after the intervention, and 3 months later using a numerical rating scale (NRS). Then, the data were entered into the SPSS 22 software and were analysed using descriptive and inferential statistics.

RESULTS: In this study, the mean age of the participants was 50.10 ± 10.63 years and 60.9% of them were female. Based on the results, time had a significant effect on pain intensity (p < 0.001), but the effect of group on pain intensity was not statistically significant (p = 0.07). The group × time effect on pain intensity was also statistically significant (p < 0.001).

CONCLUSION: Psychosocial training had a positive impact on the reduction of pain among the patients with acute and chronic musculoskeletal pain. Additionally, the training was more effective in patients with acute pain due to early training. These findings can help healthcare providers in the field of musculoskeletal pain management, especially in patients with acute pain.

PMID:35332994 | DOI:10.1002/msc.1635

Health Info Libr J. 2022 Mar 25. doi: 10.1111/hir.12427. Online ahead of print.

ABSTRACT

BACKGROUND: A validated generic impact questionnaire can demonstrate how individual and groups of health libraries contribute to continuing education and patient care outcomes.

OBJECTIVES: To validate an existing generic questionnaire for Knowledge for Healthcare, England by examining: (1) internal reliability; (2) content validity; and (3) suggest revisions.

METHODS: Methods used included Cronbach’s alpha test, simple data mining of patterns among a data set of 187 questionnaire responses and checking respondents’ interpretation of questions.

RESULTS: Cronbach’s alpha was 0.776 (acceptable internal reliability). The patterns of responses indicated that respondents’ interpretations of the questions were highly plausible, and consistent. The meaning of ‘research’ varied among different occupational groups, but overall, respondents could identify relevant personal and service impacts. However, users were confused about the terms that libraries use to describe some services.

DISCUSSION: The analysis indicated that the questionnaire worked well for the two types of personal services (literature/evidence searches and training/e-learning) frequently cited on the responses. Further research may be required for library assessment of the impact of other services such as digital resource services.

CONCLUSIONS: The generic questionnaire is a reliable way of assessing the impact of health library and knowledge services, both individually and collectively.

PMID:35332978 | DOI:10.1111/hir.12427

J Esthet Restor Dent. 2022 Mar 25. doi: 10.1111/jerd.12908. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate, in vitro, the influence of at-home bleaching with 16% carbamide peroxide (CP) gels containing different thickeners on the color, gloss, roughness, and microhardness of a composite resin with bisphenol A (BPA) and without bisphenol A (BPA-free).

MATERIAL AND METHODS: Cylindrical samples (7 × 2 mm) of a composite resin with BPA (Filtek Z350 XT®; 3M/ESPE) and composite resin BPA-free (Vittra APS®; FGM) were subdivided into six subgroups (n = 12), according to the bleaching gel used: no bleaching (control), commercial gel with 16% CP and carbopol, experimental gel with 16% CP and carbopol, experimental gel with 16% CP and natrosol, experimental gel with carbopol and experimental gel with natrosol. At the end of the experimental phase, the specimens were analyzed for color (ΔE*_ab and ΔE₀₀ ), surface roughness (Ra), gloss (GU), and surface microhardness (SMH). The data for all analyzes were submitted to Levene’s test, Shapiro-Wilk’s test and ANOVA.

RESULTS: For ΔE*_ab and ΔE₀₀ no statistically significant differences were found between all groups evaluated. Bleaching with experimental 16% CP gel with carbopol resulted in the lowest GU values for both composite resins evaluated. 16% CP experimental gel with natrosol resulted in higher Ra for the BPA composite resin and the bleaching with natrosol resulted in higher Ra for BPA-free. About 16% CP experimental gel with carbopol and 16% CP experimental gel with natrosol resulted in the lowest final SMH for composite resin with BPA. For the BPA-free composite resin, no differences were found between the groups in SMH for the same resin, however they presented the lowest values compared with all others groups.

CONCLUSION: The effects on physical properties are dependent on the composition of the composite resin and the thickener/bleaching gel used. The BPA-free composite resin showed less changes after exposure to bleaching agent, although its initial physical properties were worse compared to a bleached BPA.

CLINICAL RELEVANCE: The hydrogen peroxide and thickener of the at-home bleaching gel does impact the properties of composites with BPA or BPA-free such as gloss, roughness and surface microhardness, extremely important factors for maintaining an aesthetically and physically satisfactory restoration. BPA-free composite resins have inferior properties after at-home bleaching with different thickeners.

PMID:35332985 | DOI:10.1111/jerd.12908