Tag: pubmed

Craniomaxillofac Trauma Reconstr. 2021 Jun;14(2):150-156. doi: 10.1177/1943387520962280. Epub 2020 Sep 29.

ABSTRACT

STUDY DESIGN: A retrospective study was undertaken of a cohort of facially injured patients using matched 8-week periods: non-COVID (2019) and COVID (2020).

OBJECTIVE: To determine whether there were any changes to the frequency and characteristics of facial injury due to the imposition of COVID-19 social distancing measures.

METHODS: The primary predictor variable was an 8-week period of COVID-19 social distancing. The primary outcome variable was the sustaining of a facial injury. Demographic (age/gender) and injury characteristics (mechanism, site, and treatment) were also studied. Descriptive statistical analysis was undertaken and comparison made using Pearson χ² and Fisher’s exact tests.

RESULTS: The number of facial injuries decreased from 103 (2019) to 73 (2020). There were statistically significant differences in changes over time for the 8-week periods. There were some clinically apparent differences seen in the characteristics of facial injuries.

CONCLUSIONS: The imposition of COVID-19 social distancing changed the frequency and characteristics of facial injury.

PMID:33995836 | PMC:PMC8108105 | DOI:10.1177/1943387520962280

Pan Afr Med J. 2021 Feb 19;38:190. doi: 10.11604/pamj.2021.38.190.11650. eCollection 2021.

ABSTRACT

INTRODUCTION: road traffic injuries represent accounts for significant cause of morbidity and mortality around the globe, particularly in developing countries like Ethiopia. Poor pre-hospital care system and delays in hospitals before getting aids added to the woes of mortality. However, there are no study that determine the types of injury, management and outcome of road traffic accidents and associated factors in this study area.

METHODS: a hospital based retrospective cross sectional study was conducted among patients attending to Adama Hospital Medical College with accidental injuries from January to December 2015. Data were retrieved from 556 patients registry selected by systematic random sampling from 11,120 injuries visiting the hospital. Data were coded, cleaned and entered to SPSS version 20 for analysis. Factors associated with the management outcome of injury related to road traffic accident were analyzed and statistical significance was declared with p < 0.05 with CI of 95%.

RESULTS: out of 556 trauma victims, 304 (54.7%) were due to road traffic accidents followed by personal violence (24%) and falling accident (10.3%). The majorities (74.8%) of patients were male and urban residents (55%). Soft tissue injury was the most frequent type of injury (51%) followed by extremity fracture and dislocation (26%). Delay to come to hospital (over 24 hours), severity of injuries and management types were factors influencing management outcome of injuries related to traffic accidents. About 90.1%, 4.6% and 5.3% of the patients were discharged without any prominent disability, permanent disability and died respectively.

CONCLUSION: road traffic accidents are preventable causes of morbidity and mortality. Practices of strict road safety measures and appropriate use of roadways by pedestrians should be in place, while establishing and strengthening early access to hospital and pre-hospital care to save life of injuries.

PMID:33995796 | PMC:PMC8106795 | DOI:10.11604/pamj.2021.38.190.11650

Pan Afr Med J. 2021 Feb 22;38:195. doi: 10.11604/pamj.2021.38.195.27098. eCollection 2021.

ABSTRACT

INTRODUCTION: the treatment of large biliocystic fistulas is not unanimous among authors in the absence of consensus or a high level of evidence. There is a controversy over the use of a radical approach which allows the fistula to be sutured in a healthy area or conservative treatment that poses repair issues. The purpose of this study is to compare different conservative techniques to treat large biliocystic fistulas.

METHODS: we conducted a retrospective study of 54 patients with large fistulas in the Department of General Surgery at the Habib Bourguiba University Hospital in Sfax over a period of 9 years (2010 – 2018).

RESULTS: fourty-four patients were enrolled in the study. Abdominal ultrasound suggested opening of the bile ducts in 18 cases (47.4%) while computed tomography (CT) scan suggested opening in 28 patients (68.3%). The treatment of fistulas was based on DITFO (internal trans-fistulary drainage) in 18 cases (33.3%), cystobiliary disconnection (PERDROMO) in 11 cases (20.4%) and bipolar drainage in 25 cases. Specific surgical morbidity rate was 31.5% and it was dominated by postoperative biliary fistula in 18.5% of cases. DITFO technique was associated with shorter hospital stay (p=0.028) and lower morbidity rates (22.2%) with no statistically significant difference.

CONCLUSION: DITFO technique is the gold standard technique in the treatment of biliocystic fistula because it is associated with lower morbidity rates and the shortest hospital stay.

PMID:33995801 | PMC:PMC8106792 | DOI:10.11604/pamj.2021.38.195.27098

Pan Afr Med J. 2021 Feb 22;38:197. doi: 10.11604/pamj.2021.38.197.26752. eCollection 2021.

ABSTRACT

INTRODUCTION: isoniazid preventive therapy for people living with HIV is an essential public health intervention in low-income countries with high tuberculosis and HIV burden. Despite available evidence that it is efficacious, its implementation is still low in many countries. This study was designed to determine its implementation coverage and explore barriers for suboptimal implementation in Songea municipality in Tanzania.

METHODS: a cross-sectional descriptive study design using both quantitative and qualitative approaches of data collection was employed. A review of 2148 records of people living with HIV eligible for isoniazid preventive therapy (IPT) was done to determine its implementation coverage. Twenty-one (21) in-depth interviews and 5 observations were conducted to explore barriers in the implementation. Quantitative data was analyzed using Statistical Package for the Social Science (SPSS) for windows version 20 statistical software. Descriptive statistics (frequencies and percentage) were employed and data were visualized using tables and bar graphs. All interviews were audio-recorded and analyzed using thematic analysis approach.

RESULTS: overall, isoniazid preventive therapy coverage at Songea municipality was estimated to be 45%. Insufficient drug supply and stock out, shortage of staff, lack of service privacy, long waiting time, drug side effects, pills burden, distance and cost of transport were the main reported barriers hindering full scale implementation of isoniazid preventive therapy.

CONCLUSION: implementation of isoniazid preventive therapy in Songea municipality had low coverage. The study recommends that tuberculosis and HIV stakeholders must be part of the solutions by ensuring that the identified barriers are addressed.

PMID:33995803 | PMC:PMC8106798 | DOI:10.11604/pamj.2021.38.197.26752

Pan Afr Med J. 2021 Feb 12;38:159. doi: 10.11604/pamj.2021.38.159.27143. eCollection 2021.

ABSTRACT

INTRODUCTION: the new coronavirus (COVID-19) that emerged from Wuhan, Hubei Province of China in December 2019, causing severe acute respiratory syndrome (SARS) has fast spread across the entire globe, with most countries struggling to slow and reduce the spread of the virus through rapid screening, testing, isolation, case management, contact tracing, implementing social distancing and lockdowns. This has been shown to be a major factor in countries that have been successful in containing COVID-19 transmission. Early detection of cases is important, and the use of geospatial technology can support to detect and easily identify potential hotspots that will require timely response. The use of spatial analysis with geographic information systems (GIS) had proved to be effective in providing timely and effective solutions in supporting epidemic response and pandemics over the years. It has developed and evolved rapidly with a complete technological tool for representing data, model construction, visualization and platform construction among others.

METHODS: we conducted a geospatial analysis to develop a web mapping application using ArcMap and ArcGIS online to guide and support active case search of potential COVID-19 cases, within 500m radius of COVID-19 confirmed cases to improve detection and testing of suspected cases.

RESULTS: the web mapping application tool guides the active case search teams in the field, with clear boundaries on the houses to be visited within 500-meter radius of confirmed positive cases, to conduct active case search of all cases of severe acute respiratory illnesses (SARI), acute respiratory illnesses (ARI), pneumonia etc, to detect and test for COVID-19 towards containing the pandemic.

CONCLUSION: the use of GIS and spatial statistical tools have become an important and valuable tool in decision-making and, more importantly, guiding health care professional and other stakeholders in the response being carried out in a more coherent and easy manner. It has proven to be effective in supporting the active case search process to rapidly detect, test and isolate cases during the process, towards containing the COVID-19 pandemic.

PMID:33995766 | PMC:PMC8077638 | DOI:10.11604/pamj.2021.38.159.27143

Pan Afr Med J. 2021 Feb 15;38:169. doi: 10.11604/pamj.2021.38.169.22405. eCollection 2021.

ABSTRACT

INTRODUCTION: malignant pleural effusion occurs as a consequence of a primary or metastatic malignant process involving the pleura. The aim of pleurodesis is to prevent re-accumulation of the effusion and avoid the need for repeated hospitalization. Povidone iodine has been used in other climes for pleurodesis with good results. The aim of this study is to assess the efficacy and safety of povidone iodine in producing pleurodesis as compared to tetracycline.

METHODS: the study is a prospective experimental study. The patients are randomized into two groups A (tetracycline-control) and B (povidone iodine). All patients are assessed with chest X-ray after 1 week and 1 month. The responses were ascribed as complete, partial or failure.

RESULTS: thirty patients were recruited into this study, 15 patients in each group A (tetracycline) and B (povidone iodine). The mean age was 45.7±14.24 years. The commonest primary malignancy was Breast cancer (70%) followed by bronchogenic cancer (10%). Seventy three (73%) of the patients in this study had complete response and in 7% pleurodesis failed whilst 20% has partial response. In the povidone group the success rate was 93.4% and in the tetracycline group was 93.3% with a p-value of 0.716. There was no statistical difference in the responses based on the agents used.

CONCLUSION: malignant pleural effusion is a devastating condition as it heralds the end-of-life processes of a primary malignancy. Povidone iodine is a safe, cheap, effective, widely available and effective pleurodesing agent for use in patients with malignant pleural effusion.

PMID:33995776 | PMC:PMC8077678 | DOI:10.11604/pamj.2021.38.169.22405

Turk J Med Sci. 2021 May 16. doi: 10.3906/sag-2009-323. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: The purpose of this study was to determine the effects of the Supplemental Feeding Tube Device (SFTD) and bottle methods on weight gain, transition to full breastfeeding, breastfeeding success, and duration of discharge in preterm infants.

METHODS: This randomized controlled trial was conducted with a total of 46 preterm infants including 23 infants in study (SFTD) and control (bottle) groups. An information form, an infant follow-up form for feeding, and LATCH breastfeeding assessment instrument were used to collect the data.

RESULTS: The gestation week of the infants in the study group was 31.22 ± 2.76, and in the control group it was 30.52 ± 2.47. The birth weight of the infants in the study group was 1586.3 ± 525.35 gr and 1506.09 ± 454.77 gr in the control group. The daily weight gain of the infants was 24.09 ± 15.21 gr in the study group and 27.17 ± 17.63 gr in the control group. The infants in the study group (4.70±2.44days) transitioned to full breastfeeding earlier than those in the control group (6.00±4.10days). LATCH 2nd measurement scores were significantly higher in both groups than LATCH 1st measurement scores (p <0.01). Although it was not statistically significant (p> 0.05), the infants in the study group (10.22 ± 5.20days) were discharged earlier than those in the control group (13.48 ± 8.78days).

CONCLUSION: The SFTD and bottle methods were determined to be similar in terms of daily weight gain, transition to full breastfeeding, breastfeeding success, and duration of hospitalization.

PMID:33992038 | DOI:10.3906/sag-2009-323

J Knee Surg. 2021 May 15. doi: 10.1055/s-0041-1729967. Online ahead of print.

ABSTRACT

The posterior tibial slope (PTS) is usually adjusted by less than 5 degrees, without considering its individual difference, during posterior cruciate-substituting (PS) total knee arthroplasty (TKA). The effect of these individual changes of PTS would be important because clinical results depending on postoperative PTS were reported conflictingly. We investigated the effect of the change in PTS on the postoperative range of motion (ROM) and clinical scores after PS TKA. We retrospectively reviewed 164 knees from 107 patients who underwent PS TKA with a 2-year follow-up. We analyzed the preoperative and postoperative PTS, ROM, visual analog scale pain scale, Western Ontario and McMaster University Index (WOMAC), Hospital for Special Surgery Knee Score, Knee Society Score, and Forgotten Joint Score (FJS). The association of the absolute change in PTS with ROM and clinical scores was analyzed using correlation analysis and multiple regression analysis. As a result, the mean PTS and mean ROM changed from 9.6 ± 3.4 and 120.1 ± 15.4 degrees preoperatively to 2.0 ± 1.3 and 128.4 ± 9.3 degrees postoperatively, and the mean PTS change was 7.6 ± 3.5 degrees. The PTS change had no statistically significant association with the postoperative ROM and clinical scoring systems, although it did have a weak positive correlation with WOMAC function, No 10 (difficulty in rising from sitting) (correlation coefficient = 0.342, p = 0.041), and moderate positive correlation with the FJS, No. 6 (awareness when climbing stairs) (correlation coefficient = 0.470, p = 0.001). The authors concluded that the amount of change in PTS did not affect the postoperative ROM and clinical scores, although proximal tibial resection with a constant target of PTS resulted in individually different changes in the PTS after PS TKA.

PMID:33992035 | DOI:10.1055/s-0041-1729967

Res Dev Disabil. 2021 May 12;114:103984. doi: 10.1016/j.ridd.2021.103984. Online ahead of print.

ABSTRACT

High levels of stress in parents of children with a developmental disability have been extensively documented. These heightened stress levels seem independent of diagnosis and are better explained by the level of challenging behavior of the children. Furthermore, the relationship between stress level and difficult behavior appears reciprocal. The negative impact of stress on parents’ skill development, response to difficult behavior, sense of competence, well-being and the child’s developmental outcomes have also been thoroughly detailed. The Parent Child Relationally Informed – Early Intervention (PCRI-EI) aims to expand the response repertoires of parents to help address the challenges of parenting a child with a developmental disability, including through reducing parental stress. The current study presents a quasi-experimental assessment of the efficacy of PCRI-EI in reducing stress levels and increasing sense of competency and psychological well-being in a sample of 22 parents of children with a variety of disabilities presenting to a community early childhood development service. Statistically and clinically significant changes in overall stress levels (Parenting Stress Index), psychological well-being (K6) and sense of competence (PSOC) were observed across time.

PMID:33991930 | DOI:10.1016/j.ridd.2021.103984

Surg Oncol. 2021 May 5;38:101595. doi: 10.1016/j.suronc.2021.101595. Online ahead of print.

ABSTRACT

BACKGROUND: There are no clinicopathological criteria or test to predict peritoneal metastasis either in primary or recurrent gastric cancer. The early prediction will help in altering or adding other adjuvant potential therapy modalities like HIPEC and maintenance chemotherapy.

METHODS: Paraffin based blocks of 110 gastric tumor specimens were subjected to IHC staining to assess VEGF, Her 2 neu, E cadherin, bcl 2 and p 53 expression and its association with peritoneal disease evaluated.

RESULTS: Her 2 neu uptake was present in 17.3%, bcl-2 expression in 19.1%, P53 expression in 40.9%, VEGF in 41.8% and E cadherin expression in 49.1% patients. On univariate analysis, a younger age(p = .029), female sex(p = .026), positive VEGF expression (p = .001) and p53 expression(p = .015) were significantly associated with peritoneal disease. A binomial logistic regression was performed to ascertain the effects of independent variables evaluated on univariate analysis. Of the 10 predictors variables, only three were statistically significant: tumor type, P53, and VEGF. Positive VEGF expression had 48.7, E cadherin 2.6 and Her2neu 1.5 times higher odds of exhibiting peritoneal disease.

CONCLUSION: A younger age, female sex, distal 2/3rd, diffuse variant, VEGF staining in >10% cells and decrease p53 expression were associated with peritoneal disease.

PMID:33991942 | DOI:10.1016/j.suronc.2021.101595