Tag: nevin manimala

PLoS One. 2024 Aug 20;19(8):e0306240. doi: 10.1371/journal.pone.0306240. eCollection 2024.

ABSTRACT

This study aimed to quantitatively assess the statistical contributions between foreign and national players in men’s Euroleague Basketball. Data from 588 games in the 2021-2022 regular season and 612 games in the 2022-2023 regular season were analyzed through non-participant observation. Paired t-tests and Wilcoxon tests were employed to analyse variables with normal and non-normal distributions, respectively. The analysis indicated significant differences (p<0.05) between local and foreign players across several key variables, including Minutes, Points, Average Points, Usage Percentage, Individual Offensive Rating, Individual Defensive Rating, and True Shooting Percentage. These findings suggest pronounced distinctions between foreign players and national players concerning game volume indicators and game performance efficiency. Foreign players exhibited dominance in critical areas, such as playing time, total points scored, and average points per game, underscoring their substantial contributions to their respective teams. Consequently, these results offer practical implications for players, coaches, and fitness trainers, allowing for the design of more tailored training programs that account for distinct offensive and defensive needs, as well as the heightened physical demands experienced throughout the season.

PMID:39163411 | DOI:10.1371/journal.pone.0306240

PLoS One. 2024 Aug 20;19(8):e0304960. doi: 10.1371/journal.pone.0304960. eCollection 2024.

ABSTRACT

BACKGROUND: Our study aimed to describe the group of severe COVID-19 patients at an institutional level, and determine factors associated with different outcomes.

METHODS: A retrospective chart review of patients admitted with severe acute hypoxic respiratory failure due to COVID-19 infection. Based on outcomes, we categorized 3 groups of severe COVID-19: (1) Favorable outcome: progressive care unit admission and discharge (2) Intermediate outcome: ICU care (3) Poor outcome: in-hospital mortality.

RESULTS: Eighty-nine patients met our inclusion criteria; 42.7% were female. The average age was 59.7 (standard deviation (SD):13.7). Most of the population were Caucasian (95.5%) and non-Hispanic (91.0%). Age, sex, race, and ethnicity were similar between outcome groups. Medicare and Medicaid patients accounted for 62.9%. The average BMI was 33.5 (SD:8.2). Moderate comorbidity was observed, with an average Charlson Comorbidity index (CCI) of 3.8 (SD:2.6). There were no differences in the average CCI between groups(p = 0.291). Many patients (67.4%) had hypertension, diabetes (42.7%) and chronic lung disease (32.6%). A statistical difference was found when chronic lung disease was evaluated; p = 0.002. The prevalence of chronic lung disease was 19.6%, 27.8%, and 40% in the favorable, intermediate, and poor outcome groups, respectively. Smoking history was associated with poor outcomes (p = 0.04). Only 7.9% were fully vaccinated. Almost half (46.1%) were intubated and mechanically ventilated. Patients spent an average of 12.1 days ventilated (SD:8.5), with an average of 6.0 days from admission to ventilation (SD:5.1). The intermediate group had a shorter average interval from admission to ventilator (77.2 hours, SD:67.6), than the poor group (212.8 hours, SD:126.8); (p = 0.001). The presence of bacterial pneumonia was greatest in the intermediate group (72.2%), compared to the favorable group (17.4%), and the poor group (56%); this was significant (p<0.0001). In-hospital mortality was seen in 28.1%.

CONCLUSION: Most patients were male, obese, had moderate-level comorbidity, a history of tobacco abuse, and government-funded insurance. Nearly 50% required mechanical ventilation, and about 28% died during hospitalization. Bacterial pneumonia was most prevalent in intubated groups. Patients who were intubated with a good outcome were intubated earlier during their hospital course, with an average difference of 135.6 hours. A history of cigarette smoking and chronic lung disease were associated with poor outcomes.

PMID:39163410 | DOI:10.1371/journal.pone.0304960

PLoS One. 2024 Aug 20;19(8):e0293772. doi: 10.1371/journal.pone.0293772. eCollection 2024.

ABSTRACT

BACKGROUND: Haematological malignancies (blood cancers) often follow chronic trajectories that can span many months or years. Management of these diseases typically involves periods of ‘Watch & Wait’, whereby patients are monitored by the hospital and only treated at progression, if or when this occurs, which might be never or on multiple occasions. Such remitting-relapsing pathways are unpredictable and can cause anxiety and distress. This study aimed to generate evidence about information preferences, with a view to underpinning future patient-facing resources; potentially mitigating psycho-social difficulties and promoting effective shared decision-making.

METHODS: A qualitative study was conducted, set within a UK population-based cohort of patients with haematological malignancies. Sampling was purposive, based on age (initially around the median age of diagnosis) and disease subtype (chronic lymphocytic leukaemia, follicular lymphoma, marginal zone lymphoma and myeloma); and in-depth interviews took place with 35 patients (10 with relatives). Analysis drew on qualitative description and thematic content analysis and included critical reading and annotation of transcripts, identification of common and rare phenomena, generation of codes and coding of material, and theme development.

RESULTS: Patients discussed their preferences and experiences at length and rich data were generated from diagnosis onwards, across diagnostic subtypes. The overarching theme identified was ‘Variations in preferences’ with needs seen to differ from person to person; as well as changing over time for individuals. Five sub-themes were identified: 1) To know or not to know? 2) Needs are dynamic; 3) The polarising issue of prognosis; 4) Preferred sources; and 5) Differences in content, depth and presentation.

CONCLUSIONS: Varied, dynamic information preferences indicate that resources should be developed in a way that provides maximum choice, enabling patients to select relevant material at different time-points on their trajectory. The development of blood cancer subtype-specific “real-world clinical scenarios” could improve patient experiences and inform shared decision-making.

PMID:39163402 | DOI:10.1371/journal.pone.0293772

PLoS One. 2024 Aug 20;19(8):e0307265. doi: 10.1371/journal.pone.0307265. eCollection 2024.

ABSTRACT

BACKGROUND: Among therapeutic options for severe and critical COVID- 19 infection, dexamethasone six milligrams once daily for ten days has demonstrated mortality benefit and is guideline recommended at this dose. In practice, variable doses of steroids have been used, especially in critical care settings. Our study aimed to determine the pattern of steroid dosing and outcomes in terms of critical care mortality, occurrence of dysglycaemias, and occurrence of superadded infections in patients with critical COVID-19.

METHODS: A retrospective cohort study was carried out on all eligible patients admitted to the Aga Khan University Hospital, Nairobi, with critical COVID-19 between 1st March 2020 and 31st December 2021. The intervention of interest was corticosteroids quantified as the average daily dose in milligrams of dexamethasone. A steroid dose of six milligrams once a day was compared to high dose steroid dosing, which was defined as any dose greater than this. The primary outcome measure was ICU mortality and secondary outcomes included occurrence of dysglycaemias, superadded infections and duration of critical care admission.

RESULTS: The study included 288 patients. The median age was 61.2 years (IQR: 49.7, 72.5), with 71.2% of patients being male. The most common comorbidities were diabetes mellitus (60.7%), hypertension (58%), and heart disease (12.2%). The average oxygen saturation and C-reactive protein at admission were 82% [IQR: 70.0-89.0]and 113.0 [IQR: 54.0-186.0], respectively. Fifty-eight percent of patients received a standard dose (6mg) of steroids. The mortality rate was higher in the high-dose group compared to the standard-dose group; however, the difference was not statistically significant (47.9% vs 43.7% p = 0.549). The two most common steroid associated adverse effects were uncomplicated hyperglycemia (62.2%) and superimposed bacterial pneumonia (20.1%). The high-dose group had a higher incidence of uncomplicated hyperglycemia compared to the standard-dose group (63.6% vs 61.1%). However, the incidence of diabetic ketoacidosis was lower in the high dose group (0.6% vs 6.6%). Oxygen saturation at admission was associated with survival where it was lower among non-survivor patients with critical COVID-19.

CONCLUSION: The study found that high-dose steroids in the treatment of critically ill patients with COVID-19 pneumonia did not confer any mortality benefit and were associated with an increased risk of dysglycemia and superimposed infections.

PMID:39163391 | DOI:10.1371/journal.pone.0307265

J Med Internet Res. 2024 Aug 20;26:e55403. doi: 10.2196/55403.

ABSTRACT

BACKGROUND: In China, mitral valve regurgitation (MR) is the most common cardiovascular valve disease. However, patients in China typically experience a high incidence of this condition, coupled with a low level of health knowledge and a relatively low rate of surgical treatment. TikTok hosts a vast amount of content related to diseases and health knowledge, providing viewers with access to relevant information. However, there has been no investigation or evaluation of the quality of videos specifically addressing MR.

OBJECTIVE: This study aims to assess the quality of videos about MR on TikTok in China.

METHODS: A cross-sectional study was conducted on the Chinese version of TikTok on September 9, 2023. The top 100 videos on MR were included and evaluated using quantitative scoring tools such as the modified DISCERN (mDISCERN), the Journal of the American Medical Association (JAMA) benchmark criteria, the Global Quality Score (GQS), and the Patient Education Materials Assessment Tool for Audio-Visual Content (PEMAT-A/V). Correlation and stepwise regression analyses were performed to examine the relationships between video quality and various characteristics.

RESULTS: We obtained 88 valid video files, of which most (n=81, 92%) were uploaded by certified physicians, primarily cardiac surgeons, and cardiologists. News agencies/organizations and physicians had higher GQS scores compared with individuals (news agencies/organizations vs individuals, P=.001; physicians vs individuals, P=.03). Additionally, news agencies/organizations had higher PEMAT understandability scores than individuals (P=.01). Videos focused on disease knowledge scored higher in GQS (P<.001), PEMAT understandability (P<.001), and PEMAT actionability (P<.001) compared with videos covering surgical cases. PEMAT actionability scores were higher for outpatient cases compared with surgical cases (P<.001). Additionally, videos focused on surgical techniques had lower PEMAT actionability scores than those about disease knowledge (P=.04). The strongest correlations observed were between thumbs up and comments (r=0.92, P<.001), thumbs up and favorites (r=0.89, P<.001), thumbs up and shares (r=0.87, P<.001), comments and favorites (r=0.81, P<.001), comments and shares (r=0.87, P<.001), and favorites and shares (r=0.83, P<.001). Stepwise regression analysis identified “length (P<.001),” “content (P<.001),” and “physicians (P=.004)” as significant predictors of GQS. The final model (model 3) explained 50.1% of the variance in GQSs. The predictive equation for GQS is as follows: GQS = 3.230 – 0.294 × content – 0.274 × physicians + 0.005 × length. This model was statistically significant (P=.004) and showed no issues with multicollinearity or autocorrelation.

CONCLUSIONS: Our study reveals that while most MR-related videos on TikTok were uploaded by certified physicians, ensuring professional and scientific content, the overall quality scores were suboptimal. Despite the educational value of these videos, the guidance provided was often insufficient. The predictive equation for GQS developed from our analysis offers valuable insights but should be applied with caution beyond the study context. It suggests that creators should focus on improving both the content and presentation of their videos to enhance the quality of health information shared on social media.

PMID:39163110 | DOI:10.2196/55403

Clin Toxicol (Phila). 2024 Aug;62(8):533-535. doi: 10.1080/15563650.2024.2378091. Epub 2024 Aug 20.

ABSTRACT

INTRODUCTION: Carbamazepine causes dose-dependent toxicity in overdose. Resources commonly state that severe toxicity occurs with ingestions >50 mg/kg without supporting evidence. We aimed to compare ingested dose with clinical toxicity.

METHODS: This was a retrospective series of patients reportedly ingesting carbamazepine >2,000 mg referred to a clinical toxicology unit and state poisons information centre. Medical records were reviewed to extract patient demographics, ingestion details, clinical effects and management. Severe toxicity was defined as the presence of coma (Glasgow Coma Scale <9), seizure, or hypotension (systolic blood pressure <90 mmHg).

RESULTS: There were 69 presentations in 42 patients with a median ingested carbamazepine dose of 113 mg/kg (IQR: 71-151 mg/kg). Coma occurred in 10 cases, eight having ingested >200 mg/kg and the remaining two ingesting 113 mg/kg and 151 mg/kg, respectively. Seizures occurred in four cases (lowest ingested dose 143 mg/kg). Hypotension occurred in five cases (lowest ingested dose 113 mg/kg).

DISCUSSION: Severe carbamazepine toxicity did not occur with reported ingestions <100 mg/kg and was uncommon in ingestions <200 mg/kg.

CONCLUSION: Severe toxicity was common in ingestions >200 mg/kg. Using the suggested threshold of severe toxicity of >50 mg/kg appeared overly conservative in this series.

PMID:39163090 | DOI:10.1080/15563650.2024.2378091

J Assoc Physicians India. 2024 Aug;72(8):e26-e30. doi: 10.59556/japi.72.0428.

ABSTRACT

INTRODUCTION: Unlike conventional management protocols, like dressings, wound debridement, and skin grafting that do not facilitate healing, platelet-rich plasma (PRP) directly feeds growth factors to enhance wound healing.

MATERIALS AND METHODS: An open randomized controlled trial with a sample size of 60 was carried out on patients with a wound surface area ≤10 × 10 cm² with 30 participants in each. The PRP group (PRPG) was given autologous PRP using the infiltration technique, and the control group (CG) was treated using conventional dressings.

RESULTS: The PRPG showed a reduction from 1421 to 661 mm², whereas the CG showed a decrease from 1710 to 1478 mm² on day 30. The PRP group had a decreased hospital stay (n = 14) in comparison to the CG (n = 17.5 days). The rate of epithelization (mean) is 11.12 mm²/day in the CG and 34.026 mm²/day in the PRPG.

CONCLUSION: Platelet-rich plasma (PRP) can be considered a primary modality for wound management because of decreased length of hospital stay, analgesic effects, fastened rate of healing, and absence of adverse reactions.

PMID:39163067 | DOI:10.59556/japi.72.0428

J Assoc Physicians India. 2024 Aug;72(8):40-43. doi: 10.59556/japi.72.0598.

ABSTRACT

OBJECTIVES: The objectives of the study were to (1) study risk factors of thrombotic complications in coronavirus disease 2019 (COVID-19) pneumonitis, and (2) study progression of thrombotic complications after COVID-19 pneumonitis and its outcome.

MATERIALS AND METHODS: A total of 50 COVID-19-positive admitted patients were studied using a purposive random sampling method. A questionnaire was used to collect data from patients’ case records.

RESULTS: Diabetes (42%) and hypertension (40%) were common comorbidities. The most common presentation of patients was thromboembolism, followed by cerebrovascular accident (CVA) and myocardial infarction (MI). Around 32% of patients died during the course of treatment. Deaths were more commonly seen in the age-group of 56 years or above than in those below 56 years. Death rates were higher among the group of patients with diabetes, hypertension, and ischemic heart diseases than the group of patients without those diseases, respectively. Patients in whom intubation was needed had a higher death rate than those without the need for it. The mean C-reactive protein (CRP) value was higher in patients who died than in those who survived. The death rate was lower in patients who were thrombolysed than in those who were not, in both pulmonary embolism and MI cases.

CONCLUSION: The most common age-group admitted to the hospital was 46-55 years. The two most common underlying risk factors were diabetes and hypertension. Three common presentations of patients were thromboembolism, followed by CVA and MI. Around 32% of patients died during the course of treatment. Deaths were more commonly seen in the age-group of 56 years or above than in those below 56 years. Death rates were higher among the group of patients with diabetes, hypertension, and ischemic heart diseases than the group of patients without those diseases, respectively. Patients in whom intubation was needed had a higher death rate than those without the need for it. The mean CRP value was higher in patients who died than in those who survived.

PMID:39163061 | DOI:10.59556/japi.72.0598

J Assoc Physicians India. 2024 Aug;72(8):36-39. doi: 10.59556/japi.72.0575.

ABSTRACT

INTRODUCTION: Oxidative stress (OS) may have a role in the pathogenesis and severity of the coronavirus disease 2019 (COVID-19) disease. The present study was conducted to estimate the association of inflammatory markers, total antioxidant status (TAS), and malondialdehyde (MDA) levels with the severity of the disease and to identify their trends after recovery.

MATERIALS AND METHODS: Adult patients admitted with moderate or severe COVID-19 were included after obtaining written informed consent from patient or next of kin. Patients who were critically ill, on ventilator, or in sepsis/septic shock were excluded. Levels of inflammatory markers, TAS, and OS as measured by MDA were estimated within 24 hours of admission and reevaluated at 12 weeks following discharge.

RESULTS: The mean age of the 40 patients (42.5% females) was 55 ± 15 years. TAS values (in trolox equivalents/L) were significantly reduced in severe compared to moderate COVID-19 patients at admission (7.2 ± 4.19 vs 12.3 ± 5.21). These increased at 12 weeks after discharge. The MDA levels (in nmol/mL) were significantly higher in severe in comparison to moderate disease (7.1 ± 2.68 vs 4.1 ± 1.81). These values showed a downward trend 12 weeks after discharge in severe disease group. Admission levels of interleukin-6 (IL-6), D-dimer, and lactate dehydrogenase (LDH) were statistically higher in severe COVID-19 patients in contrast to moderate disease.

CONCLUSION: Moderate and severe COVID-19 are associated with a state of high OS and a low total antioxidant levels which tend to recover at 3 months following discharge.

PMID:39163060 | DOI:10.59556/japi.72.0575

J Assoc Physicians India. 2024 Aug;72(8):26-29. doi: 10.59556/japi.72.0526.

ABSTRACT

OBJECTIVE: In this study, we tried to analyze the utility of the HACOR score in the acute exacerbation of post-tuberculosis obstructive airway disease (post-TB-OAD).

MATERIALS AND METHODS: The HACOR score for patients in acute exacerbation of post-TB-OAD who needed noninvasive ventilation (NIV) support was calculated at 1, 12, 24, and 48 hours. The history of NIV success or failure was noted. Using a cutoff score of >5, the sensitivity, specificity, positive predictive value, and negative predictive value were calculated. The receiver operating characteristic (ROC) curve was plotted based on the HACOR score 1 hour after the NIV trial. In subjects requiring NIV for up to 2 days, the trend in the HACOR score was analyzed using a paired t-test.

RESULTS: A total of 38 out of 100 patients belonged to the NIV failure group. The mean HACOR score at 1 hour was 9.47 in the NIV failure group. The sensitivity was 89.47%, and the specificity was 87.09% for a score of >5. The positive predictive value and negative predictive value were 80.95 and 93.10%, respectively. The area under the curve (AUC) for the ROC was 0.853. The mean score showed an upward trend in the NIV failure group and a downward trend in the NIV success group. The change in the score in the NIV success group was statistically significant (t = -4.290, p-value = 0.00044).

CONCLUSION: The HACOR score can predict NIV failure in patients with acute exacerbation of post-TB-OAD.

PMID:39163058 | DOI:10.59556/japi.72.0526