Tag: pubmed

Health Soc Care Community. 2021 Jul 21. doi: 10.1111/hsc.13521. Online ahead of print.

ABSTRACT

This study identifies the key factors underlying the unmet dental care needs of South Korean homeless adults that obstructed their dental service access. We analysed data from 551 Korea Homeless Survey respondents (17 years and older) who reported having an oral disease in the previous 12 months. We conducted multiple logistic regression analyses to examine the factors associated with homeless individuals’ unmet dental care needs, using weights to make the data nationally representative. Approximately 43% of the homeless people reported having unmet dental care needs. Housing type (living in the street) was significantly associated with an increased odds ratio of unmet dental care needs. However, when social protection programs (housing benefits and Medical Aid [MA]) were included in the model, the statistical significance of the housing type disappeared. Homeless MA recipients were less likely to have unmet needs than those not covered by MA. On the other hand, homeless people who received housing benefits were more likely to receive dental care than people who do not receive these benefits. Consequently, policy makers should develop social protection programs influencing homeless individuals’ access to dental care and ensure the sustainable implementation of integrated community-based dental services for homeless adults.

PMID:34291516 | DOI:10.1111/hsc.13521

J Anim Physiol Anim Nutr (Berl). 2021 Jul 21. doi: 10.1111/jpn.13609. Online ahead of print.

ABSTRACT

Pre-weaning nutrition has significant influence on post-weaning performance of lambs. Strategic weaning management on milk replacer allowance at this phase can be a promising approach for harvesting desired carcass trait in finisher phase. Therefore, present experiment aimed economizing pre-weaning weight gain in lambs by feeding milk replacer and subsequently minimizing weaning age. A study of 90 days duration was conducted to determine the production performance, nutrient utilization and rumen fermentation of lambs on milk replacer allowance at different weaning age. Sixty-six Malpura lambs (10 days of age) were randomly divided into 3 equal groups. Lambs in control group were allowed conventional free suckling of dam up to 90 day of age, whereas lambs in the two treatment groups, that is W60 and W90 were offered milk replacer and weaned at 60 and 90 days, respectively. Lambs in all groups were offered ad-libitum creep mixture, Ziziphus nummularia leaves, Vigna unguiculata hay and fresh Ailanthus excelsa leaves. Overall weight gain was 12.7 per cent higher (p < 0.05) in W90 than control whereas in W60 group it was statistically comparable with both control and W90 groups. Overall average daily gain was 12.1 per cent higher (p < 0.05) in W90 group as compared to control. In case of nutrient digestibility, there was significant depression of dry matter (DM), organic matter (OM), crude protein (CP) and neutral detergent fibre (NDF) by 16.9, 17.2, 9.3 and 32.0 per cent in W60 than control; however, in W90, CP digestibility was higher (p < 0.05) than control and W60. Considering economic analysis, the net return obtained from W90 (90 days weaning plus milk replacer allowance) was more 20.0 per cent higher than control. Therefore, it can be concluded that lamb rearing on milk replacer and weaning at 90 days have a sustained positive effect on lambs’ production performance and is more profitable than the practice of milk replacer allowance and early weaning in semiarid conditions.

PMID:34291505 | DOI:10.1111/jpn.13609

SAGE Open Med. 2021 Jul 10;9:20503121211030837. doi: 10.1177/20503121211030837. eCollection 2021.

ABSTRACT

OBJECTIVES: To compare the characteristics and outcomes of patients presenting to hospital with alcohol-induced and gallstone-induced acute pancreatitis.

METHODS: Retrospective study of all patients with alcohol-induced or gallstone-induced pancreatitis during the period 1 June 2012 to 31 May 2016. The primary outcome measure was hospital mortality. Secondary outcome measures included hospital length of stay, requirements for intensive care unit admission, intensive care unit mortality, mechanical ventilation, renal replacement therapy, requirement of inotropes and total parenteral nutrition.

RESULTS: A total of 642 consecutive patients (49% alcohol; 51% gallstone) were included. No statistically significant differences were found between alcohol-induced and gallstone-induced acute pancreatitis with respect to hospital mortality, requirement for intensive care unit admission, intensive care unit mortality and requirement for mechanical ventilation, renal replacement therapy, inotropes or total parenteral nutrition. There was significant difference in hospital length of stay (3.07 versus 4.84; p < 0.0001). On multivariable regression analysis, Bedside Index of Severity in Acute Pancreatitis score (estimate: 0.393; standard error: 0.058; p < 0.0001) and admission haematocrit (estimate: 0.025; standard error: 0.008; p = 0.002) were found to be independently associated with prolonged hospital length of stay.

CONCLUSION: Hospital mortality did not differ between patients with alcohol-induced and gallstone-induced acute pancreatitis. The duration of hospital stay was longer with gallstone-induced pancreatitis. Bedside Index of Severity in Acute Pancreatitis score and admission haematocrit were independently associated with hospital length of stay.

PMID:34290866 | PMC:PMC8274077 | DOI:10.1177/20503121211030837

Pak J Med Sci. 2021 Jul-Aug;37(4):1161-1165. doi: 10.12669/pjms.37.4.4229.

ABSTRACT

BACKGROUND AND OBJECTIVES: It is known that the prevalence of obstructive sleep apnea (OSA) is increased in acromegaly. Craniofacial anomalies, macroglossia, and thickening of the laryngeal wall caused by the increase in soft tissue in these patients lead to OSA. Also, the increase in growth hormone can trigger central apnea by causing a decrease in respiratory drive. Determining the polysomnographic characteristics of acromegaly patients is important to reveal the effect of these mechanisms.

METHODS: The demographic and polysomnographic characteristics of 33 acromegaly patients who underwent polysomnography (PSG) with suspicion of sleep disorders between 2011 and 2018 in the sleep laboratory of our hospital were retrospectively analyzed. One of the patients was excluded from the analysis because PSG was performed in the postoperative period. The remaining 32 patients with active acromegaly were grouped according to their gender and the presence of OSA and compared with statistical methods in terms of polysomnographic and clinical features.

RESULTS: OSA (AHI>5) was detected in 78.1% of 32 active acromegaly patients (18 females, 14 males) who underwent PSG with suspicion of sleep-disordered breathing. Moderate-severe OSA (62.5%) was found in most patients, and there was no difference between the sexes in terms of OSA detection rate and OSA severity. Respiratory events appear to be predominantly obstructive hypopneas. Also, the polysomnographic features of female and male acromegaly patients with OSA were found to be similar. It is seen that the OSA group is similar to the group with simple snoring in terms of body mass index (BMI), but is statistically significantly older (p=0,007). A positive correlation was found between age and AHI in pairwise correlation analysis (r:0,426 p:0,015, respectively).

CONCLUSION: Considering that the prevalence of OSA in the population is approximately 5%, our results show that the risk of OSA in acromegaly increases, and obstructive pathways are effective in this increase. The probability of OSA occurrence and polysomnographic features between the genders are similar. Although the median BMI of the patients with and without OSA was similar, the median age was higher in the group with OSA, middle-aged acromegaly patients should be evaluated in terms of OSA even if there is no obvious obesity.

PMID:34290801 | PMC:PMC8281146 | DOI:10.12669/pjms.37.4.4229

Pak J Med Sci. 2021 Jul-Aug;37(4):1201-1205. doi: 10.12669/pjms.37.4.4124.

ABSTRACT

OBJECTIVE: Problematic cell phone use is common among young age groups which include university students, and may be accompanied by social anxiety and eating disorders. We aimed to examine the relationship between problematic cell phone use, social anxiety and eating disorders among university students.

METHODS: The universe of this cross-sectional study consists of 28,669 students receiving education at a Inonu University between October 2017 – November 2017. With a confidence interval of 95% and power of 80%, the sample size was calculated to be 308. The survey forms used in the study included students’ sociodemographic characteristics, data regarding cell phone usage, Problematic Mobile Phone Use Scale, Liebowitz Social Anxiety Scale and Eating Attitudes Test. The statistical analyses were conducted using Student t, One Way ANOVA, Spearman Correlation Test and Binomial Logistic Regression Analysis.

RESULTS: The students in the study group demonstrated a 46.1% rate of problematic cell phone use. The students’ Problematic Mobile Phone Use Scale total scores showed a significant correlation with smoking, and daily duration and purpose of cell phone use (p<0.05).

CONCLUSION: University students demonstrate high rates of problematic cell phone use; in addition, individuals who use cell phones for increased hours or for certain purposes display higher total scores on the Problematic Mobile Phone Use Scale. Students should be educated on limiting problematic cell phone use.

PMID:34290808 | PMC:PMC8281188 | DOI:10.12669/pjms.37.4.4124

Pak J Med Sci. 2021 Jul-Aug;37(4):1122-1127. doi: 10.12669/pjms.37.4.4023.

ABSTRACT

OBJECTIVE: To evaluate the clinical effect of high-dose intravenous immunoglobulin (HDIVIG) single dose and pulse therapy combined with small-dose prednisone acetate in the treatment of patients with Kawasaki disease (KD).

METHODS: Eighty patients with KD from Baoding Children’s Hospital, China, were randomly divided into two groups: the experimental group and the control group, each with 40 cases. Patients in the experimental group were treated with HDIVIG single dose, pulse therapy combined with low-dose prednisone acetate, while patients in the control group were treated with conventional-dose immunoglobulin. Patients in both groups were treated with aspirin orally, and given symptomatic treatment including anti-inflammatory, nutritional support, correction of water and electrolyte disturbance and acid-base balance. Peripheral venous blood samples were drawn from all patients at the time of admission, Day-1, Day-7 and Day-14 after treatment, and in the basic state of getting up in the morning, and then the levels of tumor necrosis factor (TNF-a), C-reactive protein (CRP), interleukin-6 (IL-6) and other inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). The time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, mucosal hyperemia regression after treatment in the two groups was recorded, and the treatment effect of the two groups was comprehensively evaluated.

RESULTS: After treatment, the levels of inflammatory factors such as TNF-a, CRP, IL-6 in the experimental group were significantly lower than those in the control group, with a statistically significant difference (P<0.05). In addition, the time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, and mucosal hyperemia regression in the experimental group was significantly shorter than that in the control group (p=0.00). The effective rate of the experimental group was 95% and that of the control group was 80%, with a statistically significant difference (p=0.04).

CONCLUSION: HDIVIG single dose, pulse therapy combined with small-dose prednisone acetate has a favourable therapeutic effect in the treatment of patients with KD, by which the inflammatory factors can be significantly improved, clinical symptoms and weight can be quickly ameliorated, and therapeutic effect can be enhanced.

PMID:34290794 | PMC:PMC8281197 | DOI:10.12669/pjms.37.4.4023

Pak J Med Sci. 2021 Jul-Aug;37(4):1133-1138. doi: 10.12669/pjms.37.4.3851.

ABSTRACT

OBJECTIVES: To analyze the prevalence & characteristics of sudden sensorineural hearing loss.

METHODS: This cross sectional study including n=377 cases of sensorineural hearing impairment, using non-probability convenience sampling, who fulfilled the selection criteria was conducted from 1^st July 2019 to 31^st October 2019. Study was conducted at Audiology section of ENT department, Lahore General Hospital, Pakistan. Sample included both genders, aged 17-70 years. Cases suffering from inflammatory or obstructive conditions of the external or middle ear and those who could not undergo pure tone audiometry were excluded from the study. Following consent for inclusion in study, data was collected using basic demographic and medical history sheet followed by Audiometric evaluation. Statistical Software for Social Sciences Version 20.0 was used for data analysis.

RESULTS: The prevalence rate of sudden sensorineural hearing loss of 14(3.7%) being significantly more common in males 11(78%) than females 3(22%) (p=0.05) & age group 15-35 years (p=0.001). It is commonly of severe or profound degree with downward sloping audiogram (p<0.05), however it is not associated with vertigo (p=0.32), tinnitus (p=0.08) with no side predilection (p=0.27).

CONCLUSION: We conclude that the prevalence of SSNHL is 3.7% being significantly more prevalent in males and those aged15-25 years. It is mostly characterized by severe to profound degree of hearing loss with downward sloping audiogram with no associated vertigo, tinnitus and side predilection.

PMID:34290796 | PMC:PMC8281165 | DOI:10.12669/pjms.37.4.3851

Pak J Med Sci. 2021 Jul-Aug;37(4):1099-1103. doi: 10.12669/pjms.37.4.3892.

ABSTRACT

OBJECTIVES: To assess the effect of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) on various domains of female sexual functions in patients before and after reconstructive surgery for these pelvic floor disorders.

METHODS: We conducted a quasi-experimental study of 126 women aged 25-65 years, presenting with POP / SUI, from January 1^st 2019 to December 31^st 2019 at Aga Khan University Hospital. POP surgery was performed only in patients with symptomatic POP ≥ stage 2 according to POP-Q (quantification). Sexual functions were assessed using Female Sexual Function Index (FSFI) questionnaire, among sexually active women at baseline and 18 months after surgery.

RESULTS: Mean age of the participants was 51.6, with a mean parity of four. Out of 126 patients, 31 patients underwent vaginal hysterectomy, pelvic floor repair and mid-urethral sling (MUS), 55 had vaginal hysterectomy with pelvic floor repair, 12 women had only pelvic floor repair and 10 patients had uterine suspension surgery for prolapse, while 18 patients underwent MUS operation alone for SUI. There was a statistically significant difference in female sexual functions after surgery for POP and/or SUI (p<0.01). This improvement was observed in both total and individual scores of each domain of FSFI with an overall improvement in sexual function from a mean of 18.5 pre-surgery to 20.8 post-surgery.

CONCLUSIONS: This study reveals that women sexual functions are affected by POP and SUI and improve remarkably after reconstructive surgeries for these pelvic floor disorders.

PMID:34290790 | PMC:PMC8281190 | DOI:10.12669/pjms.37.4.3892

Pak J Med Sci. 2021 Jul-Aug;37(4):1104-1110. doi: 10.12669/pjms.37.4.4328.

ABSTRACT

OBJECTIVES: We designed this prospective observational study to clarify the associations between dialysate IL-6, a marker of ongoing peritoneal inflammation, Tie2, an important factor in angiogenesis in the peritoneum, and a high peritoneal solute transport rate (PSTR) in patients undergoing peritoneal dialysis (PD) and to investigate their outcome predictive roles.

METHODS: A total of 60 stable continuous ambulatory peritoneal dialysis (CAPD) patients from a single center in China were analyzed in this prospective study. We measured dialysate levels of IL-6 and Tie-2 using ELISAs. Our primary study endpoint was all-cause mortality with 10 years’ follow-up.

RESULTS: For the evaluation of PSTR, we used the Dialysis/Plasma creatinine (D/Pcr) ratio. We subdivided the patients into two groups for statistical evaluation: low and low average D/Pcr (<0.64; L/A), and high and high average D/Pcr (≥0.65; H/A) transporters. The mean levels of dialysates IL-6 (21.71 ± 8.88 pg/mL) and Tie-2 (1.23 ± 0.43 ng/mL) were significantly higher in the H/A (high and high average, group than those in the L/A group (13.94 ± 5.43 pg/mL, p<0.001 and 0.95 ± 0.43 ng/mL, p=0.019; respectively). Moreover, IL-6 and Tie-2 were positively correlated with D/Pcr (r=0.366, p=0.004 and r=0.402, p=0.001; respectively). Both dialysates IL-6 and Tie-2 were independent determinants of a high peritoneal solute transport rate. After follow-up for 42.65±18.08 months, 30 patients (50.0%) had died. An increased D/Pcr increased the risk of all-cause mortality in patients with CAPD (p=0.018), but the dialysates IL-6 and Tie2 were not independent predictors of all-cause mortality (p>0.05).

CONCLUSION: Our results suggest that patients undergoing CAPD have a high peritoneal solute transport status with local peritoneal inflammation and angiogenesis. Increased D/Pcr is a relative risk factor for mortality and technique failure in patients undergoing CAPD.

PMID:34290791 | PMC:PMC8281163 | DOI:10.12669/pjms.37.4.4328

Pak J Med Sci. 2021 Jul-Aug;37(4):1075-1079. doi: 10.12669/pjms.37.4.3476.

ABSTRACT

OBJECTIVES: The current study aimed to determine the Spontaneous Bacterial Peritonitis (SBP) risk due to increased use of Proton Pump Inhibitors (PPIs) among cirrhotic patients with ascites.

METHODS: This retrospective case-control study was conducted at Chandka Medical College & Hospital, Larkana from March 2013 to February 2014, involving 215 cirrhotic patients with ascites. Paracentesis was performed to distinguish cirrhotic patients with SBP and Polymorphonuclear Neutrophil (PMN) count ≥ 250 neutrophils/mm³ (cases) and non-SBP with PMN count < 250 neutrophils/mm³ (controls). The demographic details, history of PPIs use before admission and duration of Chronic Liver Disease (CLD) were inquired and statistical analysis was carried through SPSS Version 23.0.

RESULTS: Increased pre-hospital PPI intake was observed among cirrhotic patients with SBP (69.8%) as compared to those without SBP (48.8%; p = 0.014). The mean duration of PPI use was 19.16 ± 4.772 days, and it was more significant among older cirrhotic patients (p < 0.05). Increased duration of CLD was observed among PPI users, i.e. 20.47 ± 6.305 months vs. 18.95 ± 5.527 months among non-PPI users (p < 0.05).

CONCLUSIONS: Our results show that cirrhotic patients with ascites consuming PPIs are more likely to develop SBP as compared to non-PPI users.

PMID:34290786 | PMC:PMC8281193 | DOI:10.12669/pjms.37.4.3476