Tag: pubmed

Neurol India. 2021 May-Jun;69(3):686-691. doi: 10.4103/0028-3886.319217.

ABSTRACT

BACKGROUND: Endothelial nitric oxide synthase (eNOS) is an enzymatic marker whose genetic polymorphism might predispose to acute ischemic stroke (AIS) via vascular endothelial dysfunction. It has a potential role in atherosclerosis, making it a plausible risk factor for stroke. Prior studies have failed to prove a conclusive relationship between eNOS polymorphism and AIS.

OBJECTIVE: The aim of this study is to find an association between the presence of eNOS polymorphism (Glu298Asp) and the risk of developing AIS.

MATERIALS AND METHODS: We recruited 307 subjects including 153 AIS cases and 154 healthy controls. The eNOS (Glu298Asp) polymorphism was identified in EDTA blood by PCR amplification of the target region followed by restriction enzyme digestion, and genotyping on Agarose gel. GG, GT and TT genotypes were obtained. Statistical analysis was done using SPSS software version 20.

RESULTS: A significant association was found between the presence of TT genotype and the risk of AIS (Odd’s ratio (OR): 2.43, P-value = 0.038). There was no significant association between the TT genotype and the traditional stroke risk factors. However, the TT genotype was significantly associated with the presence of altered consciousness (OR: 5.27, 95% CI: 1.59-17.04, P-value = 0.003) and with the occurrence of seizures at presentation (OR: 7.98, 95% CI: 1.99-32.09, P-value = 0.007).

CONCLUSIONS: There is a significant association between the presence of eNOSpolymorphism (Glu298Asp) and the risk of AIS, and the TT genotype may predispose to a more severe initial presentation of ischemic stroke.

PMID:34169869 | DOI:10.4103/0028-3886.319217

Indian J Pharmacol. 2021 May-Jun;53(3):207-212. doi: 10.4103/ijp.ijp_1013_20.

ABSTRACT

BACKGROUND: Meropenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa are the two most common nosocomial pathogens causing ventilator-associated pneumonia. To combat this resistance, different combinations of antibiotics have been evaluated for their efficacy in laboratories as well as in clinical situations.

AIM: The aim of the study was to investigate the effect of combined colistin and meropenem against meropenem-resistant isolates of A. baumannii and P. aeruginosa by checkerboard method.

MATERIALS AND METHODS: Fifty meropenem-resistant isolates of A. baumannii (n = 25) and P. aeruginosa (n = 25) from endotracheal aspirates were studied. The MIC of colistin and meropenem was found using the microbroth dilution method. The fractional inhibitory concentration was calculated for the combination of antibiotics by checkerboard assay and the antibiotic interactions were assessed. Fisher’s exact test was carried out for statistical comparison of categorical variables.

RESULTS: A synergistic effect between colistin and meropenem was observed in 18/25 (72%) and 6/25 (24%) isolates of Acinetobacter baumannnii and P. Aeruginosa, respectively, with fractional inhibitory concentration indices of ≤0.5. None of the tested isolates exhibited antagonism.

CONCLUSION: Our results showed that combinations of colistin and meropenem are associated with improvement in minimum inhibitory concentration and may be a promising strategy in treating meropenem-resistant A. baumannii respiratory tract infections.

PMID:34169905 | DOI:10.4103/ijp.ijp_1013_20

Indian J Pharmacol. 2021 May-Jun;53(3):229-233. doi: 10.4103/ijp.IJP_669_18.

ABSTRACT

The aim of this study was to assess the short-term cardiometabolic outcomes in type 2 diabetes patients receiving empagliflozin in a tertiary referral center. Three hundred and fifteen consecutive patients started on empagliflozin were followed for a 4-month period after local ethics committee approval for a range of outcomes. Data were recorded on Microsoft Excel and transposed to SPSS for further analysis. Empagliflozin treatment resulted in statistically significant reductions in weight, glycosylated hemoglobin, and systolic and diastolic blood pressures along with favorable lipid profile outcomes over a 4-month period. The rates of discontinuation of the medications due to genomycotic infections were extremely low at 0.6% with no episodes of severe hypoglycemia or euglycemic diabetic ketoacidosis. Empagliflozin therapy, either in addition to other oral agents or insulin, seems to result in favorable outcomes in cardiometabolic risk factors in the immediate short term. Long-term follow-up of this cohort will shed light on cardiovascular outcomes and adverse effects in our population in real-world clinical practice.

PMID:34169909 | DOI:10.4103/ijp.IJP_669_18

Dan Med J. 2021 Jun 11;68(7):A11200805.

ABSTRACT

INTRODUCTION: COVID-19 has disrupted normal life and resulted in an online transformation of teaching. Little is known about how these changes affected academic stress in students. This study examined the role of changes of teaching methods on academic stress among university students during the first lockdown in Denmark.

METHODS: The cross-sectional survey was part of the international “COVID-19 International Student Well-being Study” and included responses on socio-economic characteristics, infection worries, academic stress, work capacity and satisfaction with teaching from 1,541 Danish health and medical science university students in May-June 2020. Changes in academic stress were analysed using descriptive statistics and multi-variable analyses using stepwise logistic regression.

RESULTS: A considerable part (39%) of students reported academic stress due to COVID-19. One third reported that their study workload had increased significantly due to the COVID-19 outbreak and that they were concerned about their ability to complete the academic year. Factors associated with academic stress were female sex, young age, bachelor level, knowing a COVID-19 patient and being worried about becoming infected, whereas immigration background, sufficient financial resources and living arrangements were not.

CONCLUSIONS: Our findings suggest that the COVID-19 outbreak has influenced university students’ academic stress. It is important to set up structures to support students’ mental health and educational trajectory during the pandemic.

FUNDING: none.

TRIAL REGISTRATION: not relevant.

PMID:34169831

Neurol India. 2021 May-Jun;69(3):547-559. doi: 10.4103/0028-3886.317240.

ABSTRACT

BACKGROUND: Stroke is a heterogeneous disorder comprising of clinical subtypes and many risk factors, also alluded to as cerebrovascular disorders (CVDs). Increase in the global burden of stroke in developed and developing countries has been alarming. To galvanize the efforts towards the prevention and treatment, there is a need for robust data on the burden of stroke.

OBJECTIVE: The aim of this study was to estimate the burden of stroke, a systematic review of community-based studies was conducted.

MATERIAL AND METHODS: Systematic search of PubMed and Google Scholar for studies from January 1960 to December 2018 was done. The articles were screened and the data was retrieved and sorted into incidence, prevalence and mortality rates. Meta-analysis was done on Medcalc statistical software version 19.2.6.

RESULTS: Prevalence rate of stroke for total population inclusive of urban and rural population, varied from 44.54 to 150/100000.For the urban population prevalence rate was 45 to 487/100000 and 55 to 388.4/100000 for rural population. The incidence rate varied from 33 to 123/100000 in the urban population and in the rural population it was estimated to be 123.57/100000. The 30 days case fatality rate of stroke varied from 41.08% to 42.06% in urban population and 18% to 46.3%.in the rural population.

CONCLUSIONS: Systematic review and meta-analysis reveal that the stroke burden in India is quite high.

PMID:34169841 | DOI:10.4103/0028-3886.317240

Neurol India. 2021 May-Jun;69(3):665-669. doi: 10.4103/0028-3886.317239.

ABSTRACT

BACKGROUND AND PURPOSE: Dental implantation is thought to be associated with enhancement of neuro-cortical sensorimotor activity which has been lost due to an edentulous state. Such changes are either feeble or absent after the placement of a conventional denture. In the present study, we test this hypothesis using blood oxygen level-dependent (BOLD) activity on functional MRI (fMRI) as a bio-surrogate.

MATERIALS AND METHODS: fMRI was performed in 12 consecutive edentulous subjects (mean age = 59.2 years) after the placement of a conventional complete denture (CD) and subsequently after intraoral dental implantation (IOD). The semi-quantitative data of the BOLD activity was compiled to depict the activation seen in both scenarios in six anatomical regions. Statistical analysis was done to evaluate the significance of enhancement in BOLD activity in these regions in patients having an IOD as compared to those having a CD.

RESULTS: The enhancement of BOLD activity on fMRI after placement of an IOD was much more significant as compared to that noted with CD. Using Wilcoxon’s signed-rank test the nonparametric data showed a significant positive elevation in global and regional assigned mean ranks of BOLD activity.

CONCLUSION: Intraoral implantation leads to a significant elevation in the BOLD activity of the sensorimotor cortex as compared to the placement of a conventional CD.

PMID:34169865 | DOI:10.4103/0028-3886.317239

J Nutr Educ Behav. 2021 Jun 21:S1499-4046(21)00607-2. doi: 10.1016/j.jneb.2021.04.466. Online ahead of print.

ABSTRACT

OBJECTIVE(S): Assess the quality of water language in California school district wellness policies and examine how language quality relates to school drinking water access.

DESIGN: Cross-sectional study.

PARTICIPANTS: Random sample of 240 schools selected from all California public schools, stratified by geography and grades served.

VARIABLES MEASURED: Policies (2016-2018) were coded for quality (strength and comprehensiveness) using an adapted school wellness policy tool. School administrators completed phone interviews about drinking water access on their campus.

ANALYSIS: Descriptive statistics (eg, means, standard deviations) summarized school-level characteristics and main outcomes. Mixed-effects linear regression models were used to examine the relationship between the strength and comprehensiveness of water policy language and water access.

RESULTS: On a scale of 0-100, mean strength was 11.3 (SD, 5.7), and mean comprehensiveness was 28.8 (SD, 8.7). There was an inverse association between the quality of water language in policies and excellence in drinking water access in schools.

CONCLUSIONS AND IMPLICATIONS: The strength and comprehensiveness of water language in California school district wellness policies were low. Districts would benefit from improving the quality of water language in their wellness policies and examining challenges to implementing policies.

PMID:34167919 | DOI:10.1016/j.jneb.2021.04.466

Aust Crit Care. 2021 Jun 21:S1036-7314(21)00071-0. doi: 10.1016/j.aucc.2021.05.005. Online ahead of print.

ABSTRACT

BACKGROUND: People with burn injury experiencing hypothermia are at risk of serious complications such as shock, multisystem organ failure, and death. There is limited information available for health professionals with regard to factors that contribute to restoration of normothermia after hypothermia in people with a major burn injury.

OBJECTIVE: The aim of the study was to identify factors that contribute to normothermia restoration after hypothermia in people with 10% or more total body surface area (TBSA) burn in the first 24 h of admission to a burn care hospital.

METHODS: The study was guided by the Gearing Framework for retrospective chart audit. The sample comprised medical charts of all adult people (n = 113) with a burn injury more than 10% of their TBSA admitted to a single-site burn care hospital intensive care unit in Victoria, Australia, between May 31, 2013, and June 1, 2015. Descriptive statistics were used to describe the sample, and logistic regression was conducted to predict variables contributing to return to normothermia in people with burn injury. Charts with incomplete data were excluded.

FINDINGS: The sample (n = 50) recorded a median initial temperature on admission to the emergency department (ED) of 35.4°C (range = 31.9-37.2°C) and took on an average of 6.2 (standard deviation [SD] = 4.96) hours to return to normothermia (36.5°C). Women took around 6 h longer than men to return to normothermia (mean = 11.14 h, SD = 5.58; mean = 5.38 h, SD = 4.41). Positive correlations were noted between TBSA%, the length of time between admission to the ED and the intensive care unit, and the hours taken to reach normothermia. Regression analysis suggests the initial recorded temperature on admission to the ED was the main predictor of the time body temperature takes to return to normothermia (β = .513, p < .001).

CONCLUSION: This study provides information for practice changes by highlighting the need for guidelines and education programs for health professionals to ensure the delivery of optimum care to people with burn injury.

PMID:34167888 | DOI:10.1016/j.aucc.2021.05.005

Aust Crit Care. 2021 Jun 21:S1036-7314(21)00070-9. doi: 10.1016/j.aucc.2021.05.004. Online ahead of print.

ABSTRACT

BACKGROUND: Hyperkalaemia is a complication in patients with chronic kidney disease or acute kidney injury and occurs frequently in the intensive care unit. One treatment approach includes intravenous (IV) insulin to shift potassium intracellularly.

OBJECTIVES: The primary outcome was hypoglycaemia (blood glucose <70 mg/dL) after insulin administration. Secondary outcomes included change in serum potassium levels and incidence of severe hypoglycaemia.

METHODS: This was a single-centre, retrospective study evaluating critically ill adult patients with chronic kidney disease stage III-V, end-stage renal disease, or acute kidney injury who received IV insulin for treatment of hyperkalaemia from March 2008 to September 2018. Patients were divided into two insulin-dosing regimen groups: 5 units or 10 units.

RESULTS: Of the 174 patients included, hypoglycaemia after insulin administration occurred in eight of 87 patients (9.2%) in the 5-unit group and 17 of 87 patients (19.5%) in the 10-unit group (p = 0.052). There was no difference in rates of severe hypoglycaemia or change in serum potassium levels.

CONCLUSIONS: In critically ill patients requiring treatment for hyperkalaemia, a lower dose of IV insulin does not result in lower statistically significant rates of hypoglycaemia. However, lower insulin doses provide a similar potassium-lowering effect and cause a meaningful decrease in hypoglycaemic episodes. Intensive care unit providers may consider 5 units of IV insulin over 10 units although further larger controlled studies are needed.

PMID:34167889 | DOI:10.1016/j.aucc.2021.05.004

J Perianesth Nurs. 2021 Jun 21:S1089-9472(20)30319-1. doi: 10.1016/j.jopan.2020.10.004. Online ahead of print.

ABSTRACT

PURPOSE: The present study aimed to determine the prevalence and coping strategies for postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) in patients undergoing outpatient surgery.

DESIGN: A descriptive research design was used.

METHODS: This descriptive study was carried out with 350 patients who were admitted within the scope of outpatient surgery of the ear, nose, and throat; orthopaedics, urology, and general surgery departments of a university hospital between July 3, 2017 and March 6, 2018. A patient diagnosis form consisting of 34 items developed by the researcher and nausea-vomiting diary were used to collect data.

FINDINGS: The results showed that 30.6% of the patients had PONV and 26.3% had PDNV. Of the 92 patients with postdischarge nausea, 26.1% experienced mild, 44.6% moderate, 20.7% high, and 8.7% severe nausea. Among the strategies for coping with PDNV, the patients preferred resting (49%), going outdoors (23.4%), eating something (17%), and drinking something (10.6%). A statistically significant difference was found between postdischarge nausea and risk factors for nausea-vomiting, such as female gender, history of nausea-vomiting, nausea in the postanesthesia care unit, and opioid use in the postanesthesia care unit (P < .05).

CONCLUSIONS: This study shows that approximately a quarter of patients who undergo outpatient surgery will experience nausea and vomiting immediately after surgery as well as at home after discharge. Assessment of risk factors for PONV/PDNV was discovered to be an important factor in the care of perioperative patients. Therefore, the risk scoring system is expected to contribute to reducing PONV/PDNV incidence and improving patient coping strategies and satisfaction.

PMID:34167895 | DOI:10.1016/j.jopan.2020.10.004