Tag: pubmed

J Sports Sci. 2023 Sep 24:1-12. doi: 10.1080/02640414.2023.2260237. Online ahead of print.

ABSTRACT

Motor synergies are defined as central nervous system mechanisms which adjust participating degrees of freedom to ensure dynamic stability (control) of certain performance variables and have been identified during many motor tasks. The potential for synergistic control of individual segments during full-body tasks is often overlooked. Thus, this study compared individual differences in the potential stabilization of multiple performance variables on the basis of experience during a full-body sport activity. Normalized time series of synergy indices from Uncontrolled Manifold analyses on experienced (n = 9) and inexperienced (n = 19) participants were analysed using statistical parametric mapping during simulated Nordic skiing. Regardless of experience, hand, upper arm, and whole-body centre of mass (COM) kinematics were found to be stabilized by kinematic motor synergies. Only experienced Nordic skiers stabilized trunk COM position at all, while trunk COM velocity was stabilized for a longer duration than inexperienced participants. However, inexperienced participants stabilized hand velocity for a greater duration overall and to a greater magnitude during early pull phase than the experienced skiers. That motor synergies for hand and trunk COM velocity differed between experience groups suggests potential utility for these performance variables as indicators of motor skill development for full-body tasks such as Nordic skiing.

PMID:37742214 | DOI:10.1080/02640414.2023.2260237

Nicotine Tob Res. 2023 Sep 24:ntad182. doi: 10.1093/ntr/ntad182. Online ahead of print.

ABSTRACT

INTRODUCTION: Cigarette smoke increases peripheral white blood cell (WBC) count. However, the dose-dependent association between smoking and C-reactive protein (CRP), an important inflammatory marker, has been reported inconsistent. Here, we evaluated the associations between smoking and CRP using both smoking questionnaires and urine cotinine as exposure markers.

METHODS: The Korea National Health and Nutrition Examination Survey data were used for analyzing the associations. Multiple regression analyses were performed to examine the associations between cigarette smoke exposure, as assessed by questionnaires and urine cotinine, and health effects, as measured by CRP and WBC count, controlling for potential confounders. The confounders, including age, sex, body mass index, blood pressure, cholesterol, glucose, alanine aminotransferase, and uric acid, were selected a priori based on the literature.

RESULTS: A total of 11,435 participants were included for analysis. For the exposure-response relationship, the results indicated a significant increase in CRP levels in male smokers compared to male non-smokers (p=0.002), whereas no significant increase was found in female smokers compared to female non-smokers (p=0.680). For the dose-response relationship, a significant positive association was observed between urine cotinine and CRP in male smokers (p=0.018), whereas no significant association was found in female smokers (p=0.508). WBC count consistently showed significant exposure-response and dose-response relationships in both sexes.

CONCLUSIONS: WBC count was found to be a consistent effect marker of cigarette smoke exposure, while the association between CRP level and smoking was inconsistent and varied by sex. The sex-specific response to cigarette smoke exposure warrants further exploration in future studies.

IMPLICATION: Cigarette smoke exposure is known to increase inflammation and has been thought to increase C-reactive protein (CRP), a significant inflammation marker. However, recent studies have reported conflicting results regarding the dose-dependent association between cigarette smoke exposure and CRP. This study found that the association between smoking and CRP is inconsistent and varies by sex, showing significant exposure-response in men but not in women. Furthermore, the study suggests that white blood cell count is a more consistent marker for cigarette smoke exposure.

PMID:37742212 | DOI:10.1093/ntr/ntad182

Facts Views Vis Obgyn. 2023 Sep;15(3):259-268. doi: 10.52054/FVVO.15.3.081.

ABSTRACT

BACKGROUND: Endometrial Cancer (EC), the most common genital tract malignancy in women, is recognised to be associated with a high Body Mass Index (BMI).

OBJECTIVE: The aim of the study was to evaluate the impact of obesity on intra and post-operative morbidity for patients treated for EC.

MATERIALS AND METHODS: This was a retrospective observational study including patients with EC that were surgically treated at Hospital de la Santa Creu i Sant Pau during nine consecutive years. The patients were divided in groups according to BMI: <30 Kg/m2, ≥30-<40 Kg/m2 and ≥40 Kg/m2. Demographic and pathological characteristics, surgical outcomes, perioperative complications and long-term outcomes were recorded.

RESULTS: The study included 290 patients; 164 patients with BMI <30 Kg/m2(56.5%), 107 patients with ≥30-<40 Kg/m2 36.9%) and 19 patients with ≥40 Kg/m2(6.65%). Patients with BMI ≥40Kg/m2 were younger, presented a higher percentage of endometrioid histology (84.2%, p<0.01), well-differentiated tumours (73.7%, p<0.01) and were more frequently in the initial stages at diagnosis (94.7%) compared to the other groups. A significant percentage of the patients were operated on laparoscopically (88.7%, 88.8%, 94.7% respectively). No significant differences were found in the evaluation of the surgical outcomes. The results relative to complications showed an overall tendency toward increase in the ≥40 Kg/m2 BMI group but no statistical differences were identified among the groups in terms of complications or long-term outcomes.

CONCLUSIONS: There was a rising trend towards increased complications with increasing BMI in the study population, however, this was found not to be statistically significant. Therefore, the optimisation of co-morbidities and the adaptation of surgical treatment is important for the management of obese patients with endometrial cancer.

WHAT IS NEW?: The study allows the comparison between groups with different BMI in patients with endometrial cancer. Different surgical outcomes, intra operative, early, and late complications are clearly identified, and survival outcomes are also investigated in our study.

PMID:37742203 | DOI:10.52054/FVVO.15.3.081

Facts Views Vis Obgyn. 2023 Sep;15(3):197-214. doi: 10.52054/FVVO.15.3.094.

ABSTRACT

BACKGROUND: Management of endometriosis should be based on the best available evidence. The pyramid of evidence reflects unbiased observations analysed with traditional statistics. Evidence-based medicine (EBM) is the clinical interpretation of these data by experts. Unfortunately, traditional statistical inference can refute but cannot confirm a hypothesis and clinical experience is considered a personal opinion.

OBJECTIVES: A proof of concept to document clinical experience by considering each diagnosis and treatment as an experiment with an outcome, which is used to update subsequent management.

MATERIALS AND METHODS: Experience and knowledge-based questions were answered on a 0 to 10 visual analogue scale (VAS) by surgery-oriented clinicians with experience of > 50 surgeries for endometriosis.

RESULTS: The answers reflect the collective clinical experience of managing >10.000 women with endometriosis. Experience-based management was overall comparable as approved by >75% of answers rated ≥ 8/10 VAS. Knowledge-based management was more variable, reflecting debated issues and differences between experts and non-experts.

CONCLUSIONS: The collective experience-based management of those with endometriosis is similar for surgery-oriented clinicians. Results do not conflict with EBM and are a Bayesian prior, to be confirmed, refuted or updated by further observations.

WHAT IS NEW?: Collective experience-based management can be measured and is more than a personal opinion. This might extend EBM trial results to the entire population and add data difficult to obtain in RCTs, such as many aspects of surgery.

PMID:37742197 | DOI:10.52054/FVVO.15.3.094

J Nepal Health Res Counc. 2023 Sep 10;21(1):159-164. doi: 10.33314/jnhrc.v21i1.4668.

ABSTRACT

BACKGROUND: Viral load assessment is the preferred method for diagnosing and confirming virologic failure for patients on antiretroviral therapy. This study aimed to assess the proportion of viral load suppression and identify associated factors among HIV-positive patients receiving antiretroviral therapy at the Pokhara academy of health science in Nepal.

METHODS: This institution-based retrospective cohort study was conducted at Pokhara academy of health science in Pokhara, Nepal. The study included 567 HIV patients who were enrolled between January 2016 and December 2019 and had their viral load measured within a one-year period. Statistical analysis was performed using STATA version 13.0. The proportions of viral load suppression and non-suppression were determined. Bivariate and multivariate logistic regressions were performed to identify factors associated with viral load suppression. Statistical significance was determined at a 95% confidence interval and p < 0.05 Results: Out of the 567 HIV patients, 95.76 % (95% CI: 94.10-97.42) achieved viral suppression. In multivariate analysis, longer duration of antiretroviral therapy treatment (> 3 years) was independently associated with higher odds of achieving viral suppression compared to those on antiretroviral therapy for less than 6 months (adjusted odds ratio [aOR] = 11.98, 95% confidence interval: 1.32-108.81, p < 0.0027). Conversely, individuals in second-line treatment had significantly lower odds of viral suppression compared to those in first-line treatment (aOR = 0.19, 95% CI: 0.05-0.66, p < 0.009).

CONCLUSIONS: Our study demonstrated a high rate of viral suppression among HIV patients receiving antiretroviral therapy, exceeding the UNAIDS 90-90-90 target. Longer duration of antiretroviral therapy and being in second-line treatment were identified as factors influencing viral load suppression. These findings emphasize the importance of early initiation and adherence to first-line treatment for optimal outcomes.

PMID:37742166 | DOI:10.33314/jnhrc.v21i1.4668

J Nepal Health Res Counc. 2023 Sep 10;21(1):145-152. doi: 10.33314/jnhrc.v21i1.4635.

ABSTRACT

BACKGROUND: Coronavirus disease-2019 (COVID-19) severely affects patients with chronic diseases. Adequate knowledge, attitudes, and practice related to COVID-19 is associated with decrease morbidity and mortality. Therefore, this aimed to assess knowledge, attitudes, and practice toward COVID-19 disease among chronic diseases patients visiting tertiary hospitals in Kathmandu.

METHODS: A cross-sectional study was conducted among chronic disease patients who visited Tribhuvan University Teaching Hospital and Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu. Structured questionnaire was used to collect patients’ socio-demographic data and perspectives on COVID-19.

RESULTS: Four hundred chronic disease patients participated in the study, with 53.2% female and 46.8% male, and 56.8% of age ≥50 years. Overall, 55.5% of the participants had good knowledge, 56.2% had good practice, and 30.7% had positive attitude towards COVID-19. Younger patients, 18-34 years, were found to have higher odds of having good knowledge compared to other age groups (aOR: 2.5; 95% CI: 1.3-6.0). The patients with less than average family income and those unable to read and write had lower odds of having positive attitude towards COVID-19 (aOR: 0.6; 95% CI: 0.4-0.9 and aOR: 0.4; 95%CI: 0.2-0.9, respectively). A statistically significant correlation was found between the patients’ knowledge and practice, knowledge and attitude, and attitude and practice (p <0.001).

CONCLUSIONS: Nearly half of the chronic disease patients in Nepal had poor knowledge and practice whereas more than two-third had negative attitude towards COVID-19 disease. Older age of the patient was significantly associated with poor knowledge and practice.

PMID:37742164 | DOI:10.33314/jnhrc.v21i1.4635

J Nepal Health Res Counc. 2023 Sep 10;21(1):129-135.

ABSTRACT

BACKGROUND: One of the main complications of chronic kidney disease is anemia. Disorders of iron homeostasis seen in such patients make the management of anemia more challenging and risky. To obtain the desired result, erythropoietin and iron dose must be carefully regulated. The aim of the study is to find out the prevalence of anemia and level iron indices in patients of chronic kidney disease at a tertiary care hospital.

METHODS: A cross-sectional descriptive study was conducted on chronic kidney disease patients at a tertiary care center. Demographic data like age, sex, height and weight were collected with the help of using Performa. The hematological and biochemical study variables were assayed by blood sample of the patients in the clinical laboratory services. Data were analyzed by statistical package for the social sciences Version 20.0 Results: Out of 171 patients with chronic kidney disease, 162 (94.7%) were anemic, with the highest percentage 54 (31.5%) having hypertension. The median value with inter-quartile range of hemoglobin, serum iron, serum ferritin, TIBC and transferring saturation were 8.9 gm/dl (6.7-10.0), 115.0 (µg/dl) (60.0-140.0), 599.0 ng/ml (142.6-973.0), 279.0 µg/dl (250.0-342.0) and 41.0 % (22.0-53.0) respectively. Serum creatinine and eGFR were significantly correlated with hemoglobin and iron indices.

CONCLUSIONS: The current study showed that anemia was more prevalent in patients of chronic kidney disease in our setting as compared to similar studies. Hypertension was the most common disease among them. The median value of parameters of iron profile except ferritin among them was within the reference limit.

PMID:37742162

J Nepal Health Res Counc. 2023 Sep 10;21(1):122-128. doi: 10.33314/jnhrc.v21i1.4603.

ABSTRACT

BACKGROUND: Human oral cavity contains many microorganisms, the habitat of which may be changed by complete denture among edentulous people. The complete dentures favor aggregation of microorganism. The aim of this study was to identify the microorganisms present in the complete dentures of old age people of Chitwan and assess the sensitivity pattern of the microorganisms to the common antibiotics.

METHODS: A descriptive cross-sectional study was conducted at Chitwan Medical College, Chitwan, Nepal among 45 old age people who have been wearing dentures above one year. The duration of the study was from 18th Nov 2021 to 12th May 2022. Swab was taken from the polished and tissue surfaces of both maxillary and mandibular dentures in the Department of Prosthodontics while the laboratory-based experiments were conducted in the Department of Microbiology. Antibiotic sensitivity was also done. The data was analyzed using Statistical Package for Social Science (SPSS) version 16.0. Descriptive statistics were used. The data was presented in form of frequency, percentage, mean and standard deviation.

RESULTS: Streptococcus spp. was predominant microorganism followed by Coagulase-negative Staphylococci and Staphylococcus aureus. The highest sensitivity pattern was observed to Amikacin, Nalidixic acid and Ciprofloxacin while the most resistant antibiotics were Amoxicillin/clavulanic acid and Cefixime. Escherichia coli was sensitive to all the tested antibiotics.

CONCLUSIONS: In this study, Streptococcus spp. followed by Coagulase-negative Staphylococci and Staphylococcus aureus were the most frequently identified microorganisms from the dentures of old age people. Amikacin, Nalidixic acid and Ciprofloxacin were highly sensitive among the people of old age.

PMID:37742161 | DOI:10.33314/jnhrc.v21i1.4603

J Nepal Health Res Counc. 2023 Sep 8;21(1):92-98. doi: 10.33314/jnhrc.v21i1.4429.

ABSTRACT

BACKGROUND: Childbirth is a most welcomed and positive life experience for the majority of women, despite the pain. Most of them manage it well with minimal assistance while few of them require some intervention to reduce the pain. The objective of this study was to find out the effect of music therapy on intensity of labor pain among primigravid women.

METHODS: A quasi-experimental pre-test post-test non-equivalent control group design was used. Sample consisted of 42 primigravid women admitted in labor room of a teaching hospital in Kathmandu. The intensity of labor pain was measured using Visual Analogue Scale and Behavior Rating Scale in latent and active phase of labor in both experimental and control groups. Then 30 minutes of music therapy was provided to the experimental group in the latent and active phase of labor. The post-test was carried out in both groups after the music therapy to experimental group during the latent and active phase using the same instruments. The collected data was entered in Statistical Package for Social Sciences version 16. Descriptive statistics and inferential statistics were used to describe the findings.

FINDINGS: The mean difference of total pain between experimental and control groups during latent phase was 1.9 (t=2.31, p=0.023) in pre-test and 6.57 (t=3.91, p=0.000) in post-test. The mean difference of total pain between experimental and control groups during active phase was 1.00 (t=1.08, p=0.286) during pre-test and 6.95(t=3.744, p=0.001) during post-test.

CONCLUSIONS: Music therapy tends to reduce labor pain both during the latent and active phase of labor.

PMID:37742156 | DOI:10.33314/jnhrc.v21i1.4429

J Nepal Health Res Counc. 2023 Sep 8;21(1):86-91. doi: 10.33314/jnhrc.v21i1.4361.

ABSTRACT

BACKGROUND: Prolapse is among the most common indication for gynaecological surgery. It is difficult to estimate prevalence of pelvic organ prolapse even in developed countries due to lack of epidemiological studies. This study was done to find the prevalence, risk factors and common presenting complaints of women with pelvic organ prolapse.

METHODS: Women with pelvic organ prolapse visiting Paropakar Maternity and Women’s Hospital during 4 months duration in 2021 were approached and after obtaining an informed consent, all the patient information on various risk factors and clinical profile(age,parity,body mass index,smoking etc.) for pelvic organ prolpase were collected in a pre-developed proforma. Pelvic Organ Prolapse was classified by Pelvic Organ Prolapse Quantification system. Data analysis was done using statistical package for the social sciences-25. Ethical approval was taken from Institutional Review Committee- National Academy of Medical Sciences.

RESULTS: Out of 58 cases enrolled in the study, prevalence of pelvic organ prolapse was found to be 1.28%. Women belonging to age group ≥ 49 years was 91.4%. Bulge symptom was the most common presenting complain among the women, 98.3%. 50% of women (n=29) were grand multipara. 53.4% (n=31) of women had delivered their first baby before 20 years of age. Multiparity,vaginal birth and menopausal age were the common risk factors.

CONCLUSIONS: Menopausal age, multi-parity, vaginal births, age at first vaginal delivery of less than 20 years were significant risk factors for development of prolapse. Bulge symptom was the most common presenting complaint. However,Smoking habit, overweight were not related to pelvic organ prolapse.

PMID:37742155 | DOI:10.33314/jnhrc.v21i1.4361