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Impact of Living Donor Liver Transplantation on COVID-19 Clinical Outcomes from a Quaternary Care Centre in Delhi

J Clin Transl Hepatol. 2022 Aug 28;10(4):770-777. doi: 10.14218/JCTH.2021.00303. Epub 2021 Oct 12.

ABSTRACT

BACKGROUND AND AIMS: The anticipated fear of serious outcomes in coronavirus infected liver transplant recipients led to disruption of transplant services globally. The aim of our study was to analyze COVID-19 severity in transplant recipients and to compare the difference of COVID-19 clinical outcomes in early (<1 year) vs. late (>1 year) post-transplant period.

METHODS: 41 post-living donor liver transplant recipients with COVID-19 infection were studied retrospectively from 1st April 2020 to 28th February 2021.

RESULTS: The median age was 49.00 years with a male preponderance (80.49%). Fifteen patients had infection within 1 year of transplant and 26 were infected after 1 year of transplant. The overall median interval between transplantation and COVID-19 diagnosis was 816.00 days. Fever and malaise were the common presenting symptoms. The most common associated comorbidities were diabetes mellitus (65.85%) and hypertension (46.34%). The severity of illness was mild in 28 (68.29%), moderate in 4 (9.76%), severe in 6 (14.63%) and critical in 3 (7.32%). To identify associated risk factors, we divided our patients into less severe and more severe groups. Except for lymphopenia, there was no worsening of total bilirubin, transaminases, alkaline phosphatase, and gamma-glutamyl transferase in the more severe group. Eight (19.51%) patients required intensive care unit admission and three (7.32%) died, while none suffered graft rejection. In recipients with early vs. late post-transplant COVID-19 infection, there were similar outcomes in terms of severity of COVID-19 illness, intensive care unit care need, requirement of respiratory support, and death.

CONCLUSION: Living donor liver transplantation can be performed during the COVID-19 pandemic without the fear of poor recipient outcome in cases of unfortunate contraction of severe acute respiratory syndrome coronavirus-2.

PMID:36062268 | PMC:PMC9396325 | DOI:10.14218/JCTH.2021.00303

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Postoperative Pain, Analgesic Choices, and Ileus: A Snapshot from a Teaching Hospital in a Developing Country

Surg J (N Y). 2022 Sep 2;8(3):e232-e238. doi: 10.1055/s-0042-1755623. eCollection 2022 Jul.

ABSTRACT

Background Pain relief can be achieved by diversity of methods with analgesics being the basic form of treatment. Analgesic safety and clinical effectiveness are the core factors in determining the analgesic of choice. One adverse effect of concern with opioids is the postoperative ileus (POI). Objective In this study, we looked at the severity of postoperative pain, the type of analgesics used to control the pain, and the incidence of POI at Baghdad Teaching Hospital. We hypothesized that we would find an association between the type of analgesia used and POI. Methods This observational study was conducted among 100 patients who were residents at the general surgery wards of Baghdad Teaching Hospital. A structured questionnaire was employed focusing on types of analgesics, degree of pain control, and the presence of ileus. Results Sixty-nine percent of patients received a combination of opioids and nonopioids. Moderate-to-severe pain was the most commonly reported category on pain scales. More than half of the patients (57%) were found to have POI during their hospital stay and there was a statistically significant association between the type of analgesia and POI development ( p =0.001). Conclusions A mix of analgesics (opioids and nonopioids) was the most common regimen at our center. The majority of the surgical inpatients reported having moderate-to-severe pain on both pain scales used in this study. Ileus incidence following abdominal surgeries (61%) was significantly higher than the reported incidence worldwide (10-30%). Postoperative ileus has multifactorial causes, one of which is the use of opioids for pain control. Considering the high incidence of ileus in our center and the association we found between the use of opioids and ileus, further studies should look at the doses of opioids used and whether alternative analgesic methods might result in less ileus.

PMID:36062183 | PMC:PMC9439878 | DOI:10.1055/s-0042-1755623

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Medication Regularity of Traditional Chinese Medicine in the Treatment of Aplastic Anemia Based on Data Mining

Evid Based Complement Alternat Med. 2022 Aug 25;2022:1605359. doi: 10.1155/2022/1605359. eCollection 2022.

ABSTRACT

OBJECTIVE: Aplastic anemia (AA) is an uncommon disease, characterized by pancytopenia and hypocellular bone marrow, but it is common in the blood system. The medication rules of traditional Chinese medicine (TCM) in the treatment of AA are not clear, for which it is worth exploring the medication rules by data mining methods.

METHODS: This study used SPSS Modeler 18.0 and SPSS statistics to analyze the cases of AA from Zhejiang Provincial Hospital of Chinese Medicine (ZJHCM) from March 1, 2019, to March 1, 2022. Data mining methods, including frequency analysis, cluster analysis, and association rule learning, were performed in order to explore the medication rules for AA.

RESULTS: (1) A total of 859 prescriptions, which met the inclusion criteria, consisted of 255 herbs. In descending order of the frequency of herbal medicine, we have Danggui, Huangqi, Shudihuang, Fuling, Gancao, Shanyao, Shanzhuyu, Baizhu, Dangshen, and Xianhecao. (2) Frequency analysis of herb properties: the Four Qi of 255 kinds of TCMs are mainly warm and neutral medicines. The Five Flavors are mainly sweet medicines, followed by bitter medicines. The main meridians are the liver, spleen, and kidney. (3) Clustering of medications: TCMs with the top 20 frequencies are classified into 9 groups by cluster analysis. (4) Association rule analysis of high-frequency herbs: using the Apriori algorithm, the results showed that there were 3 herb pairs with support of over 0.3 and 12 herb pairs with confidence above 0.85.

CONCLUSION: The basic pathogenesis of AA (Sui Lao) is spleen and kidney essence deficiency, Qi deficiency, and blood stasis. The main herbs have warm and neutral properties, sweet tastes, and liver, spleen, and kidney meridian tropisms, whose purpose is to tonify the kidney and invigorate the spleen, tonify Qi, and promote blood circulation.

PMID:36062179 | PMC:PMC9436587 | DOI:10.1155/2022/1605359

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Development of Korean Version of PTSD Checklist for DSM-5 (K-PCL-5) and the Short Form (K-PCL-5-S)

Psychiatry Investig. 2022 Aug;19(8):661-667. doi: 10.30773/pi.2022.0092. Epub 2022 Aug 24.

ABSTRACT

OBJECTIVE: This study presents the reliability and validity of the Korean version of the post-traumatic stress disorder (PTSD) checklist for the Diagnostic and Statistical Manual for Mental Disorders-fifth edition (DSM-5) (K-PCL-5) and the short form (K-PCL-5-S).

METHODS: Seventy-one subjects with PTSD, 74 subjects with mood or anxiety disorders, and 99 healthy controls were enrolled. The Korean version of the Structured Clinical Interview for DSM-5-research version was used to confirm the presence of PTSD. The Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Impact of Event Scale-Revised (IES-R), and Spielberger State Trait Anxiety Inventory (STAI) were used to evaluate the concurrent validity of the K-PCL-5 and K-PCL-5-S.

RESULTS: It presented good internal consistency (Cronbach’s α=0.93) and test-retest reliability (r=0.90). The K-PCL-5 and K-PCL-5-S were highly correlated with the BDI-II, BAI, IES-R, STAI-S, and STAI-T. The suggested cutoff score for PTSD was 33 for the K-PCL-5 with a sensitivity of 88.51 and specificity of 89.09, and 6 for the K-PCL-5-S with a sensitivity of 91.95 and specificity of 89.09. The data were best explained with a one-factor model.

CONCLUSION: These results demonstrated the good reliability and validity of the K-PCL-5 and K-PCL-5-S, and their suitability as simple tools for PTSD assessment.

PMID:36059055 | DOI:10.30773/pi.2022.0092

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Sleep and Mental Health Among Adolescents During the COVID-19 Pandemic

Psychiatry Investig. 2022 Aug;19(8):637-645. doi: 10.30773/pi.2021.0342. Epub 2022 Aug 24.

ABSTRACT

OBJECTIVE: This study aimed to investigate the association of sleep with mental health among Korean adolescents during the coronavirus disease (COVID-19) pandemic.

METHODS: Using data from the 16th Korea Youth Risk Behavior Web-Based Survey (2020) of 46,475 adolescents, we examined sleep duration and satisfaction and examined mental health for depressive symptoms, anxiety, and suicidal ideation. The data were analyzed using complex sample descriptive statistics and a multiple logistic regression model.

RESULTS: In 2020, the average sleep duration was 6.3 hours, and the sleep satisfaction rate was 30.8%. Depressive symptom and suicidal ideation rates were 24.2 and 10.3, respectively. These values are slightly better than those previously reported, before COVID-19. However, poor sleep was still associated with mental health. The likelihood of mental health problems was higher among those who slept for six hours or less than for those who slept for eight hours or more (p<0.05). Additionally, the results showed that the lower the sleep satisfaction, the higher the likelihood of mental health problems (p<0.05).

CONCLUSION: Even after the COVID-19 outbreak, poor sleep associated with mental health problems remained as high as before the outbreak of COVID-19.

PMID:36059052 | DOI:10.30773/pi.2021.0342

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Small Bowel Obstruction in Patients without Prior Abdominal Surgery: To Operate or Not?

World J Surg. 2022 Sep 4. doi: 10.1007/s00268-022-06719-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Surgical exploration is still considered mandatory in the setting of small bowel obstruction (SBO) in patients without prior intra-abdominal surgery. However, recent studies have challenged this ‘classic’ approach describing success with conservative non-surgical treatment. The aim of this study is to identify clinical, radiological and biochemical variables that may be associated with the absence of intra-abdominal pathology in patients with SBO who have not undergone previous surgery.

METHODS: This is a retrospective cohort study of prospectively recorded data. Patients with SBO without prior abdominal surgery who presented to a single tertiary referral medical center between 2009 and 2019 were included.

RESULTS: Eighty-seven patients were included of whom 61(70.0%) were allocated to the ‘therapeutic exploration’ group and 26 (30.0%) to the ‘non-therapeutic exploration’ group. Forty-eight patients (55.0%) had adhesions, 17.2% had closed-loop obstruction, 10.0% had an internal hernia, 27.6% had bowel ischemia and 5.7% had bowel necrosis. Although multiple clinical, laboratory, radiological and preoperative factors were examined, none were significantly associated with pathological findings during surgical exploration. There was no statistically significant difference in the incidence of complications when comparing between those groups.

CONCLUSIONS: In this series, no variables were associated with intra-abdominal pathology in patients who underwent surgery for SBO with no history of prior abdominal surgery. However, the fact that 27.0% had ischemic bowel upon surgical exploration suggests that this approach is still mandatory for this specific group of patients. Furthermore, clinicians and patients should be aware that negative exploration may be expected in up to 30.0%.

PMID:36059038 | DOI:10.1007/s00268-022-06719-2

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Eco-friendly acid dyeing of silk and wool fabrics using Acid Violet 49 dye

Environ Sci Pollut Res Int. 2022 Sep 5. doi: 10.1007/s11356-022-22781-8. Online ahead of print.

ABSTRACT

The effluent load from textile industries has forced traders and industrialists to use sustainable tools that not only save energy, money, and labor but also make the process cleaner. The purpose of this study is to improve the dyeing of proteinous fabrics using Acid Violet 49 dye under microwave radiation. Aqueous and acidic dye solutions were prepared and treated with MW radiations for up to 10 min. MW treated and untreated dye solutions were used to color treated and untreated fabrics to observe color yield. It has been found that dyeing of irradiated silk at 65 °C for 35 min, using 55 mL of irradiated dye solution containing 1 g/100 mL salt, has given excellent results. Whereas good color characteristics are obtained if irradiated wool fabric is dyed at 85 °C for 55 min, using 55 mL irradiated dye solution using 1 g/100 mL salt. Physicochemical analysis reveals that MW rays have physically modified the fabric without altering its chemistry. ISO standard methods employed for colorfastness show that under optimal conditions, the color developed is fast; statistical analysis shows that the dyeing process has given significant results. It is concluded that MW rays have excellent potential to improve acidic dyeing of proteinous fabric under mild conditions which show that the utilization of MW rays is a cost-, time-, and energy-effective process.

PMID:36059013 | DOI:10.1007/s11356-022-22781-8

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Fyn and Lyn gene polymorphisms impact the risk of thyroid cancer

Mol Genet Genomics. 2022 Sep 4. doi: 10.1007/s00438-022-01946-7. Online ahead of print.

ABSTRACT

Thyroid cancer is the most common malignancy of the endocrine glands, and during last couple of decades, its incidence has risen alarmingly, across the globe. Etiology of thyroid cancer is still debatable. There are a few worth mentioning risk factors which contribute to initiation of abnormalities in thyroid gland leading to cancer. Genetic instability is major risk factors in thyroid carcinogenesis. Among the genetic factors, the Src family of genes (Src, Yes1, Fyn and Lyn) have been implicated in many cancers but there is little data regarding the association of these (Src, Yes1, Fyn and Lyn) genes with thyroid carcinogenesis. Fyn and Lyn genes of Src family found engaged in proliferation, migration, invasion, angiogenesis, and metastasis in different cancers. This study was planned to examine the effect of Fyn and Lyn SNPs on thyroid cancer risk in Pakistani population in 500 patients and 500 controls. Three polymorphisms of Fyn gene (rs6916861, rs2182644 and rs12910) and three polymorphisms of Lyn gene (rs2668011, rs45587541 and rs45489500) were analyzed using Tetra-primer ARMS-PCR followed by DNA sequencing. SNP rs6916861 of Fyn gene mutant genotype (CC) showed statistically significant threefold increased risk of thyroid cancer (P < 0.0001). In case of rs2182644 of Fyn gene, mutant genotype (AA) indicated statistically significant 17-fold increased risk of thyroid cancer (P < 0.0001). Statistically significant threefold increased risk of thyroid cancer was observed in genotype AC (P < 0.0001) of Fyn gene polymorphism rs12910. In SNP rs2668011 of Lyn gene, TT genotype showed statistically significant threefold increased risk of thyroid cancer (P < 0.0001). In case of rs45587541 of Lyn gene, GA genotypes showed statistically significant 11-fold increased risk in thyroid cancer (P < 0.0001). Haplotype analysis revealed that AAATAG*, AGACAG*, AGCCAA*, AGCCAG*, CAATAG*, CGCCAG* and CGCCGA* haplotypes of Fyn and Lyn polymorphisms are associated with increased thyroid cancer risk. These results showed that genotypes and allele distribution of Fyn and Lyn are significantly linked with increased thyroid cancer risk and could be genetic adjuster for said disease.

PMID:36058999 | DOI:10.1007/s00438-022-01946-7

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Comparison of intratesticular and intramuscular administration of zolazepam-tiletamine combination on sedation, induction, and recovery qualities and vital variables in cats undergoing castration: a prospective, randomized, clinical study

Vet Res Commun. 2022 Sep 5. doi: 10.1007/s11259-022-09993-6. Online ahead of print.

ABSTRACT

This study was aimed to compare the effects of intratesticular (IT) and intramuscular (IM) administration of the zolazepam-tiletamine (ZT) combination on sedation, induction, and recovery qualities and vital variables in cats undergoing castration. Fourteen clinically client-owned healthy cats were randomly assigned to receive 10 mg/kg ZT by either IT or IM routes. Temperament score, injection reaction score, induction time, intubation time, surgical length, anesthesia time, recovery time, and full recovery time were evaluated. Sedation score, heart rate (HR), respiratory frequency (fR), peripheral hemoglobin oxygen saturation (SpO2), mean arterial pressure (MAP), and rectal temperature (RT) variables were assessed at baseline (T0), T5, T10, T15, and T30. Median temperament score and injection reaction score were not different between groups. Induction time was significantly (p = 0.0244) shorter for the IT group (142.6 ± 29.9) than IM (290 ± 48.7 seconds). Length of anesthesia was longer in the IM group (median 290; ranged 120-540 minutes) than the IT group (median 140; ranged 98-180 minutes) (p = 0.0279). Time to standing and time to full recovery were significantly shorter in IT than IM. A recovery quality score did not significantly differ between groups (p = 0.2268). No statistically significant differences were detected between IT and IM administration regarding sedation score, HR, SpO2, MAP, and RT. The IT administration of 10 mg/kg ZT induces shorter onset of sedation and recovery time than IM administration, thereby it can be suggested for cats undergoing castration. Both administration routes produce effective sedation with limited physiological changes in anesthesia variables.

PMID:36058950 | DOI:10.1007/s11259-022-09993-6

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Vaginal delivery effects on 3D morphology of the bladder, urethra, and vagina: a pilot study comparing women with different numbers of deliveries

Arch Gynecol Obstet. 2022 Sep 5. doi: 10.1007/s00404-022-06622-0. Online ahead of print.

ABSTRACT

PURPOSE: To explore 3D morphological changes of the bladder, urethra, and vagina following different numbers of vaginal deliveries.

METHODS: Sampled patients had undergone magnetic resonance imaging for gynecological diseases in Nanfang Hospital. A total of 167 patients who met the study inclusion and exclusion criteria were enrolled and divided into four groups. Mimics and UG software packages were used for reconstructions and measurements, and data were compared with one-way analyses of variance.

RESULTS: A total of 167 3D models were constructed, and eight parameters related to the bladder and urethra were measured (5 angles, 2 lengths, and 1 thickness). No statistically significant differences were found between subgroups, although mean plot figures of urethra pubic and α angles showed trends to increase with more deliveries, and the opposite trend was seen for the urethra tilt angle. There were no obvious trends between other parameters and delivery number. There were seven vaginal parameters (6 lengths and 1 shape). Mid-urethral and vaginal gap measurements tended to become wider as delivery number increased, and the opposite was seen for the distal gap. Mid-vaginal 2D cross-sectional shape and the proportion of shallow concave types also tended to significantly increase with more deliveries, especially after the third birth.

CONCLUSION: As the number of deliveries through the vagina increases, the lateral support function of this organ and the urethra become relatively weaker. These fine anatomical changes are related to delivery numbers and become most obvious after the third birth.

PMID:36058944 | DOI:10.1007/s00404-022-06622-0