Tag: statistics

Front Vet Sci. 2024 Jul 4;11:1380022. doi: 10.3389/fvets.2024.1380022. eCollection 2024.

ABSTRACT

The negative effects of pain are a constant concern in the surgical management of animals, leading to the search for new drugs or more effective analgesic protocols to control this negative emotion. This study aimed to evaluate the nociceptive response of cannabidiol (CBD) alone and in combination with meloxicam using infrared pupillometry in female dogs undergoing elective ovariohysterectomy (OVH) under isoflurane anesthesia. A total of 60 female dogs of different breeds were included. These dogs were randomly assigned to four study groups according to the treatment: Control Group (G₀: n = 15) receiving saline solution; group premedicated with meloxicam at a dose of 0.2 mg Kg^-1 IV (G_Melox: n = 15). Postoperatively this drug was used at 0.1 mg Kg^-1 IV every 24 h; the CBD-treated Group (G_CBD: n = 15) at a dose of 2 mg Kg^-1 orally in the preoperative. Postoperatively was administrated every 12 h; and the Group premedicated with the combination of meloxicam and CBD (G_Melox/CBD: n = 15) Meloxicam at a dose of 0.2 mg Kg^-1 IV preoperatively, and 0.1 mg Kg^-1 IV during the postoperative. CBD at a dose of 2 mg Kg^-1 orally in the preoperative, and every 12 h in the postoperative. Treatments were administered for 48 postoperative hours. After OVH, the pupillary neurologic index, pupillary size, minimum diameter (MIN), percentage change, constriction latency (Lat), constriction velocity, and maximum constriction velocity were recorded as pupillometric variables in both eyes during events (E): Baseline (30 min before drug administration), E_{30 min}, E_1h, E_2h, E_3h, E_4h, E_8h, E_12h, E_24h, and E_48h. The Short-Form of the Glasgow Composite Measure Pain Scale (GCMPS-SF) was used to assess pain during the same events. Overall, it was observed that the pupillometric variables Size, MIN., and Lat. were significantly higher in G₀ compared to the other groups during E_{30 min}, E_1h, and E_2h (p = 0.03), indicating greater pupil dilation in G₀ animals. Additionally, no statistically significant differences were observed in GCMPS-SF between G_Melox, G_CBD, and G_Melox/CBD during the postoperative period (p > 0.05). In contrast, the scores were statistically different compared to G₀ (p = 0.00001), where all animals in this group received rescue analgesia at 2 h post-surgery. According to pupillometry and scores on the GCMPS-SF scale, it was observed that monotherapy with cannabidiol provides a similar analgesic effect to meloxicam alone or in combination with cannabidiol to manage acute pain in dogs. Similarly, these findings suggest that infrared pupillometry could be a tool for recognizing acute pain in dogs.

PMID:39027908 | PMC:PMC11256235 | DOI:10.3389/fvets.2024.1380022

Plast Reconstr Surg Glob Open. 2024 Jul 18;12(7):e5996. doi: 10.1097/GOX.0000000000005996. eCollection 2024 Jul.

ABSTRACT

BACKGROUND: Nurtec, a versatile migraine medication, has gained popularity. However, the awareness of migraine surgery remains uncertain.

METHODS: Following a descriptive approach, this cross-sectional study used Google Trends data as of December 1, 2023, to analyze internet search patterns. Approval from Vanderbilt University’s institutional review board and adherence to Strengthening the Reporting of Observational Studies in Epidemiology guidelines were confirmed. Monthly relative search volume (RSV) data for “migraine surgery,” “Nurtec,” and “Rimegepant” were collected from January 1, 2004, to November 11, 2023, within the United States. Statistical analysis involved determining mean monthly RSV values and percentage changes for critical periods.

RESULTS: For “Nurtec,” a significant surge in RSV occurred from March 2020 to April 2020 (344%). Additional peaks were observed from June 2020 to July 2020 (66%), October 2020 to December 2020 (169%), May 2021 to June 2021 (33%), and May 2023 to June 2023 (14%). “Migraine surgery” exhibited a notable 400% increase in RSV, from March 2005 to May 2005. However, post-2006, RSV for “migraine surgery” consistently remained low without noticeable peaks.

CONCLUSIONS: The analysis of RSV trends for “Nurtec” and “migraine surgery” from 2004 to 2023 reveals the impact of pivotal events and marketing strategies on public interest. The distinct peaks in “Nurtec” RSV align with Food & Drug Administration approvals and marketing campaigns, highlighting the medication’s accessibility. Conversely, the consistently low RSV for “migraine surgery” indicates limited awareness, emphasizing the need for enhanced promotion and education regarding surgical interventions.

PMID:39027895 | PMC:PMC11257674 | DOI:10.1097/GOX.0000000000005996

Plast Reconstr Surg Glob Open. 2024 Jul 18;12(7):e5995. doi: 10.1097/GOX.0000000000005995. eCollection 2024 Jul.

ABSTRACT

BACKGROUND: Closed incision negative-pressure therapy (ciNPT) has become increasingly used on surgical sites to attempt to minimize postoperative complications. The literature describing the benefits of ciNPT in reducing donor site morbidity after free tissue transfer is limited. This review compares the effectiveness of ciNPT and conventional dressings in reducing donor site complications after free tissue transfer.

METHODS: A systematic review of PubMed and Ovid (MEDLINE) utilizing the search terms ((flap) AND (donor)) AND ((negative pressure) OR (vacuum)) was conducted. Bibliographies of selected articles were also searched. Relevant outcomes were collected and analyzed.

RESULTS: After screening 156 articles, 12 studies were included in the study with a total of 1074 donor sites. The following postoperative complications at the donor site after a free tissue transfer were analyzed: wound dehiscence, infection, seroma, hematoma, and skin necrosis. Use of ciNPT was associated with lower incidence of wound dehiscence compared with conventional dressings (OR: 0.37; 95% CI, 0.23-0.58). The incidence of infection, seroma, hematoma, and skin necrosis were overall lower in the ciNPT group; although, this was not statistically significant.

CONCLUSIONS: Use of ciNPT was associated with a significantly lower incidence of free flap donor site wound dehiscence compared with conventional dressings. The use of ciNPT on free flap donor sites appears to have overall lower rates of other wound complications such as seroma, hematoma, skin necrosis, and infection.

PMID:39027894 | PMC:PMC11257675 | DOI:10.1097/GOX.0000000000005995

Ann Appl Stat. 2023 Mar;17(1):815-837. doi: 10.1214/22-aoas1652. Epub 2023 Jan 24.

ABSTRACT

The growing number of available treatment options has led to urgent needs for reliable answers when choosing the best course of treatment for a patient. As it is often infeasible to compare a large number of treatments in a single randomized controlled trial, multivariate network meta-analyses (NMAs) are used to synthesize evidence from trials of a subset of the treatments, where both efficacy and safety related outcomes are considered simultaneously. However, these large-scale multiple-outcome NMAs have created challenges to existing methods due to the increasing complexity of the unknown correlations between outcomes and treatment comparisons. In this paper, we proposed a new framework for PAtient-centered treatment ranking via Large-scale Multivariate network meta-analysis, termed as PALM, which includes a parsimonious modeling approach, a fast algorithm for parameter estimation and inference, a novel visualization tool for presenting multivariate outcomes, termed as the origami plot, as well as personalized treatment ranking procedures taking into account the individual’s considerations on multiple outcomes. In application to an NMA that compares 14 treatment options for labor induction, we provided a comprehensive illustration of the proposed framework and demonstrated its computational efficiency and practicality, and we obtained new insights and evidence to support patient-centered clinical decision making.

PMID:39027887 | PMC:PMC11257173 | DOI:10.1214/22-aoas1652

Open Med (Wars). 2024 Jul 17;19(1):20230815. doi: 10.1515/med-2023-0815. eCollection 2024.

ABSTRACT

To investigate the renal function and fibrosis indexes of conventional western medicine with Chinese medicine for dredging collaterals in the treatment of renal fibrosis (RF). We searched articles from databases (PubMed, Embase, The Cochrane Library, CNKI, and Wanfang data) and references of included studies. The quality of literature was evaluated and data were extracted in regard to the inclusion and exclusion criteria. RevMan5.3 software was applied for all statistical analyses. Eleven eligible RCTs with a total of 898 patients were included in this meta-analysis. Compared with conventional western medicine alone, conventional western medicine with Chinese medicine for dredging collaterals in the treatment of RF has lower BUN levels and SCr levels (P < 0.05). As for fibrosis indexes, conventional western medicine with Chinese medicine for dredging collaterals has lower HA, laminin (LN), IV-Col, and PC-III levels (P < 0.05). Conventional western medicine with Chinese medicine for dredging collaterals with lower BUN, Scr, HA, LN, PC-III, and IV-Col levels, has an advantage in the treatment of RF. These lower serum levels may not be associated with the presence of RF. Ideally, kidney biopsies should be performed to confirm that these markers reduce RF. This is a major limitation of this study.

PMID:39027883 | PMC:PMC11255556 | DOI:10.1515/med-2023-0815

J Family Med Prim Care. 2024 Jun;13(6):2221-2226. doi: 10.4103/jfmpc.jfmpc_497_23. Epub 2024 Jun 14.

ABSTRACT

BACKGROUND: Severe Cognitive Impairment (CI) is a major cause of disability and dependency among the elderly worldwide, and it has a significant impact not only on individuals but also on families, communities, and societies. Early identification and management of CI are critical in geriatric medicine. Prevalence data is often scarce, and this hinders the ground-level implementation of preventive health programs.

OBJECTIVES: The objective was to find the prevalence of CI and its covariates among the urban geriatric population of Haryana.

MATERIALS AND METHODS: This was a community-based cross-sectional study conducted among 300 geriatric participants residing in an urban area of Rohtak district, Haryana. Hindi Mental State Examination (HMSE) tool was used to assess CI. Data were analyzed using IBM Corp, released 2020, IBM SPSS statistics for windows Ver 20, Armonk, NY.

RESULTS: The prevalence of geriatric CI was found to be 27.3% and was found to be significantly associated with age, female gender, scheduled and backward caste (BC), widowhood, and low educational status and is not engaged in any occupation, low socioeconomic status, teetotalism, economic dependency, physical dependency on others, and chronic morbidity.

CONCLUSION: Age, female gender, scheduled and backward caste, widowhood, low educational status, nil employment status, low socioeconomic status, teetotalism, economic dependency, physical dependency on others, and chronic morbidity were found to be important correlates of CI. Further analytical studies can focus on these aspects for an early targeted preventive approach.

PMID:39027874 | PMC:PMC11254047 | DOI:10.4103/jfmpc.jfmpc_497_23

J Family Med Prim Care. 2024 Jun;13(6):2397-2403. doi: 10.4103/jfmpc.jfmpc_1785_23. Epub 2024 Jun 14.

ABSTRACT

CONTEXT: Dengue is one of the important vector-borne viral diseases affecting humans with diverse manifestations. Toll-like receptors (TLR) are pattern recognition receptors and play an important role in innate immunity against microbes. TLR3 plays a critical role in controlling the innate immune response mediated by flaviviruses such as dengue.

AIM: We attempted to study the susceptibility of single nucleotide polymorphism of the TLR3 gene in dengue encephalitis (DE) patients and determine the association in terms of genotype, allele, and haplotype distribution along with the clinical outcome.

SETTINGS AND DESIGN: It was a case-controlled observational study in a tertiary care hospital.

METHODS AND MATERIAL: We investigated the single nucleotide polymorphism in the TLR3 Leu412Phe gene using real-time polymerase chain reaction in 29 cases of DE and compared them with equal number of age- and sex-matched dengue patients without neurological features.

STATISTICAL ANALYSIS USED: The genotype and allele frequencies were compared using a two-sided Chi-square or Fisher’s exact test.

RESULTS: The findings revealed that the genotypic distribution of TLR3 Leu412Phe polymorphism for the mutant genotype Phe/Phe (TT) demonstrated increased association of DE (31.03% vs 6.8%, P 0.019, odds ratio 6.075, 95% confidence interval 1.181-31.245). However, the number of heterozygous (H) genotype (Leu/Phe-CT) and mutant Phe allele (T) did not show any statistically significant association. TLR3 gene polymorphism did not show any correlation with mortality outcome at 1 month.

CONCLUSION: The presence of mutant TLR3 Leu412Phe polymorphism may confer the propensity to have DE in patients with dengue infection in the Indian population. TLR3 polymorphism did not affect mortality outcome at 1 month.

PMID:39027870 | PMC:PMC11254067 | DOI:10.4103/jfmpc.jfmpc_1785_23

J Family Med Prim Care. 2024 Jun;13(6):2449-2454. doi: 10.4103/jfmpc.jfmpc_1107_23. Epub 2024 Jun 14.

ABSTRACT

CONTEXT: The aim of the study was to identify and monitor the circulating strains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the samples received at our center and update the existing national and international genomic surveillance data.

INTRODUCTION: SARS-CoV-2 is no exception to the basic nature of the viruses ability to change and evolve. Since its first report in December 2019 from Wuhan, China, multiple variants of the virus have emerged and been reported. Five variants of concern have been recognized and reported by the Centers for Disease Control and Prevention, which are associated with variable degrees of transmissibility and mortality.

MATERIALS AND METHODS: Nasopharyngeal and oropharyngeal swabs received in viral transport medium at the Viral Research Diagnostic Laboratory were processed for reverse transcription-polymerase chain reaction for SARS-CoV-2. Whole genome sequencing (WGS) was performed for selective positive samples using Oxford Nanopore sequencing technology, using MinKNOW software for data acquisition.

STATISTICAL ANALYSIS: The clades were assigned using Nextclade v2.4.1 software. The statistical analysis was calculated using OpenEpi version 3, an open-source calculator, and two by two.

RESULTS: Variants reported over the study period included Alpha, Kappa, Delta, and Omicron. Delta dominated in the year 2021, while Omicron was the dominant variant in 2022. In both the dominant variants, asymptomatics contributed to around 30-40% of positives. Intensive care unit admissions and mortality were higher in the Delta variant, while vaccination history and travel history were higher in the patients with Omicron variant.

CONCLUSION: The trend tracking of these variants has been important in view of public health, enabling early interventions to control the spread of the disease and foresight in preparation for the situation.

PMID:39027869 | PMC:PMC11254030 | DOI:10.4103/jfmpc.jfmpc_1107_23

J Family Med Prim Care. 2024 Jun;13(6):2300-2304. doi: 10.4103/jfmpc.jfmpc_733_23. Epub 2024 Jun 14.

ABSTRACT

CONTEXT: The efficacy of the combination of albendazole and praziquantel has not been thoroughly studied in multiple neurocysticercosis in children.

OBJECTIVE: To compare the efficacy and safety of albendazole and praziquantel combination versus albendazole alone in the treatment of children with multiple neurocysticercosis in terms of proportion of cysts undergoing complete resolution or calcification at 6-month follow-up.

MATERIALS AND METHODS: A total of 52 children, aged 1-14 years, with newly diagnosed two or more active neurocysticercosis were randomized to either group A or B. Group A (n = 26) received albendazole plus praziquantel, and Group B (n = 26) received albendazole alone. At the end of 6 months, a repeat MRI brain was performed to see for the resolution of cysts and was classified as complete resolution, calcified, or persistence of viable and noncalcified cysts.

RESULTS: The proportion of cysts undergoing complete resolution was higher in Group A (23/60 [38.33%]) than in Group B (19/65 [29.23%]), but the difference was not statistically significant. The proportion of cysts undergoing calcification was also comparable in Group A (20/60 [33.33%]) and Group B (20/65 [30.77%]). Both groups had comparable safety profiles.

CONCLUSION: Albendazole and praziquantel combination therapy is as effective as albendazole alone in terms of complete resolution of viable cysts and calcification of cysts.Trial registration: CTRI/2021/12/038492.

PMID:39027868 | PMC:PMC11254057 | DOI:10.4103/jfmpc.jfmpc_733_23

J Family Med Prim Care. 2024 Jun;13(6):2455-2461. doi: 10.4103/jfmpc.jfmpc_1884_23. Epub 2024 Jun 14.

ABSTRACT

INTRODUCTION: During the 2 years and 9 months from March 2020 to December 2022, the SARS-CoV-2 virus raged across the country. Cases occurred in three particular time clusters recognised by World Health Organisation as coronavirus disease 2019 (COVID-19) waves. In this study, we compare the clinical parameters of adult non-obstetric COVID-19 patients admitted to our rural tertiary care hospital during the three distinct waves of the pandemic.

MATERIALS AND METHODS: Retrospective chart analysis of 272, 853 and 97 patients admitted with SARS-CoV-2 infection to the only rural medical tertiary care centre in the Sunderbans of West Bengal in the first, second and third waves, respectively, was done after obtaining ethical and scientific clearance. Clinical [vital parameters, oxygen requirement, mental status, risk factor assessment, duration of hospital stay, modified-emergency warning score (m-EWS), quick Sequential Organ Failure Assessment (qSOFA), confusion, uraemia, respiratory rate, blood pressure, age ≥ 65 years (CURB65)], epidemiological variables (age, gender, and vaccination status), laboratory parameters and in-hospital outcome were recorded and analysed statistically.

RESULTS: Statistically significant (P < 0.05) m-EWS and qSOFA scores were recorded during the second wave of the pandemic. The second wave also recorded the highest mortality (14.89%) compared to the first (12.87%) and third (11.96%) waves, though this was not statistically significant. The highest duration of hospital stay was recorded in the first wave of the pandemic (mean = 9.99 days, P < 0.01). The difference in mortality rates between patients with and without co-morbidity (P < 0.05) was observed during Wave-1, across any pandemic wave, and overall but not in Wave-2 and Wave-3.

CONCLUSION: The second wave of the COVID-19 pandemic was the most severe in comparison with the other two waves, while the outcome was poorer in those with co-morbidities, especially in the first wave.

PMID:39027859 | PMC:PMC11254042 | DOI:10.4103/jfmpc.jfmpc_1884_23