Tag: statistics

J Coll Physicians Surg Pak. 2023 Apr;33(4):460-464. doi: 10.29271/jcpsp.2023.04.460.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and complications of subgaleal drain placement after two burr-holes evacuation of chronic subdural hematoma (CSDH).

STUDY DESIGN: Descriptive study.

PLACE AND DURATION OF STUDY: The Neurosurgical unit of the Lady Reading Hospital, Peshawar, from April to November 2021.

METHODOLOGY: Sixty-four consecutive patients diagnosed with surgically significant unilateral chronic subdural hematoma were prospectively included after obtaining informed consent. All the patients underwent two burr-holes craniectomies and evacuation, followed by subgaleal drain placement. Patient demographics, pre- and postoperative clinical information including hematoma resolution and complications were collected.

RESULTS: This study included 44 (69%) males and 20 (31%) females with a mean age of 70.1 ± 8 years. The most common presenting symptoms were headaches (70%) and confusion (68%). Eighteen patients (28%) were taking warfarin or other anticoagulants, whereas, 23 patients (36%) were taking antiplatelet medications at the time of presentation. Thirty-six (56.3%) patients had a history of head trauma. Warfarin use was statistically significant in the patients with no history of head injury. Fifty-five patients (85%) showed no significant recurrence on the 2 week postoperative computed tomography (CT) scan. None of the patients had intraparenchymal hematoma or contusion of iatrogenic origin on postoperative CT scans.

CONCLUSION: Subgaleal drain placement after two burr-holes craniectomy led to high-resolution rates. However, no parenchymal injuries were attributed to the procedure.

KEY WORDS: Chronic subdural hematoma, Subdural drain, Subperiosteal drain, Burr-hole craniostomy.

PMID:37190722 | DOI:10.29271/jcpsp.2023.04.460

J Coll Physicians Surg Pak. 2023 Apr;33(4):427-432. doi: 10.29271/jcpsp.2023.04.427.

ABSTRACT

OBJECTIVE: To use carotid intimal medial thickness as a marker of early atherosclerosis in patients with rheumatoid arthritis.

STUDY DESIGN: Cross-sectional descriptive study. Place and Duration of the Study: Rheumatology Unit of Federal Government Polyclinic Hospital, Islamabad, from 1st June 2019 till 30th January 2022.

METHODOLOGY: The study included 190 patients divided equally into cases of rheumatoid arthritis and healthy control groups. Carotid intimal medial thickness was measured using the carotid doppler ultrasound. The mean values of both the study groups were evaluated using the independent sample t-tests. Different statistical tests for correlation were also used where appropriate.

RESULTS: This study included a total of 190 patients, 95 each in case and control groups. There were 15 (15.8%) males and 80 (84.2%) females with mean age of 43.5±12.8 years among cases, while 27 (28.4%) males and 68 (71.6%) females with mean age of 43.1±10.1 years in the control group. A significantly higher number of cases had a carotid intima-media thickness of more than 0.6 mm as compared to controls (43.2% vs. 25.3%, p=0.009). Cases with seropositive status were 1.98 times more likely to have higher carotid intima-medial thickness compared with controls.

CONCLUSION: Carotid intima-media thickness measurement is important as a surrogate marker of atherosclerotic process in patients with rheumatoid arthritis.

KEY WORDS: Rheumatoid arthritis (RA), Carotid intimal medial thickness (CIMT), Atherosclerosis, Cardiovascular disease (CVD).

PMID:37190716 | DOI:10.29271/jcpsp.2023.04.427

J Coll Physicians Surg Pak. 2023 Apr;33(4):416-420. doi: 10.29271/jcpsp.2023.04.416.

ABSTRACT

OBJECTIVE: To investigate the effect of subclinical hyperthyroidism on voice quality using acoustic analysis.

STUDY DESIGN: Cross-sectional comparative study. Place and Duration of the Study: Department of Endocrinology and Metabolism, Ankara Diskapi Yildirim Beyazit Research and Education Hospital, Ankara, Turkey, from January to June 2020.

METHODOLOGY: A total of 115 participants, with 60 patients with subclinical hyperthyroidism and 55 healthy volunteers, were evaluated and compared. Healthy volunteers with similar age and gender distributions were also evaluated and compared. Acoustic variables including average fundamental frequency (F0), relative average perturbation (RAP), jitter, shimmer, noise-to-harmonic ratio (NHR), and voice turbulence index (VTI) were measured and recorded.

RESULTS: In the patient group, acoustic voice analysis results were obtained for F0 224.97%, jitter 0.85%, RAP 0.51%, shimmer 3.16%, NHR 0.12 dB, and VTI 0.047, respectively. In the control group, these respective values were 219.60%; 0.74%; 0.46%; 3.11%; 0.12 dB; and 0.045, respectively. There was no statistically significant difference between the groups (p>0.05).

CONCLUSION: Subclinical hyperthyroidism does not cause a significant change in voice quality.

KEY WORDS: Acoustic analysis, Subclinical hyperthyroidism, Voice, Frequency.

PMID:37190714 | DOI:10.29271/jcpsp.2023.04.416

J Coll Physicians Surg Pak. 2023 Apr;33(4):406-410. doi: 10.29271/jcpsp.2023.04.406.

ABSTRACT

OBJECTIVE: To determine the frequency of skin manifestations found in end-stage renal disease (ESRD) patients undergoing dialysis, while assessing their effect on the quality of lives of the same patients.

STUDY DESIGN: Descriptive cross-sectional study. Place and Duration of the Study: Benazir Bhutto Hospital, Holy Family Hospital, and Hussain Lakhani Hospital, from 12th December 2021 to 13th October 2022.

METHODOLOGY: Seventy-three Patients undergoing hemodialysis were enrolled in the study. Skin manifestations were defined as “cutaneous signs and symptoms related to ESRD unrelated to the symptoms resulting from any primary dermatological disorder or other systemic diseases”. Data on the skin manifestations of their disease and their effect on patients’ quality of life were collected by using a 2-part questionnaire. The first part consisted of demographic details along with the type of skin disorders faced by the patient and the second part of the questionnaire comprised of the dermatology life quality index (DLQI). The data were entered and analysed using the statistical package for social sciences (SPSS) version 23.0.

RESULTS: Xerosis and pruritus were most commonly reported (83.7%), followed by nail changes (18.6%) and skin discolouration (16.3%). The median duration of dialysis was 36 (1-180) months and there was no significant increase in skin symptoms with the increase in the duration of dialysis (p=0.082). The median DLQI score was 3 (range:0-10) A significantly higher number of females (n=14) reported associated mental discomfort with their skin symptoms of pruritis as compared to males (n=5, p=0.008).

CONCLUSION: Cutaneous manifestations have variable effects on the quality of life of ESRD patients. Adopting a multidisciplinary approach early in the management may help to minimise the mental discomfort of these patients and bring an improvement in their quality of life.

KEY WORDS: End-stage renal disease (ESRD), Hemodialysis, Skin manifestations, Pruritus, Quality of life.

PMID:37190712 | DOI:10.29271/jcpsp.2023.04.406

Eur J Hosp Pharm. 2023 May 15:ejhpharm-2023-003680. doi: 10.1136/ejhpharm-2023-003680. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to assess the impact of pharmacist interventions on injectable chemotherapy prescription and the safety of early prescription practice in an adult daily care unit.

METHODS: Prescription errors were recorded before and after implementing corrective measures. Errors identified from the pre-intervention period (i) were analysed to identify areas for improvement. During the post-intervention period (ii) we compared the errors in anticipated prescription (AP) with those in real-time prescriptions (RTP). We performed Chi-square statistical tests (α=0.05).

RESULTS: Before implementing corrective measures (i), 377 errors were recorded (ie, 3.02% of prescriptions). After the implementation of corrective measures (ii), there was a significant decrease in errors, with 94 errors recorded (ie, 1.20% of prescriptions). The error rate in AP and RTP groups was 1.34% and 1.02%, respectively, without a significant difference between the two groups.

CONCLUSIONS: This study highlights the importance of prescription review, as well as collaboration between pharmacists and physicians, in reducing prescription errors, whether these prescriptions were anticipated or not.

PMID:37188505 | DOI:10.1136/ejhpharm-2023-003680

BMJ Open Qual. 2023 May;12(2):e002058. doi: 10.1136/bmjoq-2022-002058.

ABSTRACT

AIM: Aim of this study was to describe and analyse associations of incidents and their improvement actions in hospital setting.

METHODS: It was a retrospective document analysis of incident reporting systems’ reports registered during 2018-2019 in two Estonian regional hospitals. Data were extracted, organised, quantified and analysed by statistical methods.

RESULTS: In total, 1973 incident reports were analysed. The most commonly reported incidents were related to patient violent or self-harming behaviour (n=587), followed by patient accidents (n=379), and 40% of all incidents were non-harm incidents (n=782). Improvement actions were documented in 83% (n=1643) of all the reports and they were focused on (1) direct patient care, (2) staff-related actions; (3) equipment and general protocols and (4) environment and organisational issues. Improvement actions were mostly associated with medication and transfusion treatment and targeted to staff. The second often associated improvement actions were related to patient accidents and were mostly focused on that particular patient’s further care. Improvement actions were mostly planned for incidents with moderate and mild harm, and for incidents involving children and adolescents.

CONCLUSION: Patient safety incidents-related improvement actions need to be considered as a strategy for long-term development in patient safety in organisations. It is vital for patient safety that the planned changes related to the reporting will be documented and implemented more visibly. As a result, it will boost the confidence in managers’ work and strengthens all staff’s commitment to patient safety initiatives in an organisation.

PMID:37188481 | DOI:10.1136/bmjoq-2022-002058

BMJ Open. 2023 May 15;13(5):e070869. doi: 10.1136/bmjopen-2022-070869.

ABSTRACT

INTRODUCTION: Sustained viral suppression, an indicator of long-term treatment success and mortality reduction, is one of four strategic areas of the ‘Ending the HIV Epidemic’ federal campaign launched in 2019. Under-represented populations, like racial or ethnic minority populations, sexual and gender minority groups, and socioeconomically disadvantaged populations, are disproportionately affected by HIV and experience a more striking virological failure. The COVID-19 pandemic might magnify the risk of incomplete viral suppression among under-represented people living with HIV (PLWH) due to interruptions in healthcare access and other worsened socioeconomic and environmental conditions. However, biomedical research rarely includes under-represented populations, resulting in biased algorithms. This proposal targets a broadly defined under-represented HIV population. It aims to develop a personalised viral suppression prediction model using machine learning (ML) techniques by incorporating multilevel factors using All of Us (AoU) data.

METHODS AND ANALYSIS: This cohort study will use data from the AoU research programme, which aims to recruit a broad, diverse group of US populations historically under-represented in biomedical research. The programme harmonises data from multiple sources on an ongoing basis. It has recruited ~4800 PLWH with a series of self-reported survey data (eg, Lifestyle, Healthcare Access, COVID-19 Participant Experience) and relevant longitudinal electronic health records data. We will examine the change in viral suppression and develop personalised viral suppression prediction due to the impact of the COVID-19 pandemic using ML techniques, such as tree-based classifiers (classification and regression trees, random forest, decision tree and eXtreme Gradient Boosting), support vector machine, naïve Bayes and long short-term memory.

ETHICS AND DISSEMINATION: The institutional review board approved the study at the University of South Carolina (Pro00124806) as a Non-Human Subject study. Findings will be published in peer-reviewed journals and disseminated at national and international conferences and through social media.

PMID:37188476 | DOI:10.1136/bmjopen-2022-070869

BMJ Open. 2023 May 15;13(5):e068860. doi: 10.1136/bmjopen-2022-068860.

ABSTRACT

BACKGROUND: Cervical cancer ranks as the second most frequent cancer among all women in Ethiopia and the second most frequent cancer among women between 15 and 44 years of age, resulting in over 4884 moralities annually. Although there is a focus on health promotion through teaching and screening in Ethiopia’s intended transition toward universal healthcare, there is little information available on baseline levels of knowledge and screening uptake related to cervical cancer.

OBJECTIVES: This study explored the levels of knowledge and screening rates of cervical cancer along with its associated factors among women of reproductive age in Assosa Zone, Benishangul-Gumuz, Ethiopia in 2022.

METHODOLOGY: A facility-based cross-sectional study was conducted. A systematic sampling technique was used to select 213 reproductive-age women from selected health institutions, from 20 April 2022 to 20 July 2022. A validated and pretested questionnaire was used for data collection. Multi-logistic regression analyses were done to identify factors independently associated with cervical cancer screening. Adjusted OR with 95% CI was estimated to measure the strength of association. The level of statistical significance was declared at a p value of <0.05. The results were presented in tables and figures.

RESULT: Knowledge of cervical cancer screening in this study was 53.5%, and 36% of respondents had practised cervical cancer screening. Family history of cervical cancer (AOR)=2.5, 95% CI (1.04 to 6.44)), place of residence (AOR=3.68, 95% CI (2.23, 6.54)) and availability of health services at nearby (AOR=2.03, 95% CI (1.134, 3.643)) were significantly associated with knowledge of cervical cancer screening, while educational status (AOR=2.811, 95% CI (1.038 to 7.610)), knowing someone diagnosed with cervical cancer (AOR=8.3, 95% CI (2.4, 28.69)), Knowledge of cervical cancer(AOR=2.17, 95%CI(1.077, 4.384) and feeling feeling at risk (AOR=3.26 95% CI (1.52, 5.04)) were associated with the practice of cervical cancer screening.

CONCLUSION AND RECOMMENDATION: Knowledge and practice of cervical cancer screening in this study were low. Therefore, the reproductive women must be encouraged to have early cervical cancer screening at precancerous stage by informing their susceptibility to cervical cancer.

PMID:37188474 | DOI:10.1136/bmjopen-2022-068860

BMJ Open. 2023 May 15;13(5):e063363. doi: 10.1136/bmjopen-2022-063363.

ABSTRACT

OBJECTIVES: We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic.

DESIGN: Cross-sectional online survey.

SETTING: Community cohort study in Japan.

PARTICIPANTS: The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20-59 years.

MAIN OUTCOME MEASURES: The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis.

STATISTICAL METHODS: Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected.

RESULTS: Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation.

CONCLUSION: Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.

PMID:37188470 | DOI:10.1136/bmjopen-2022-063363

Taiwan J Obstet Gynecol. 2023 May;62(3):402-405. doi: 10.1016/j.tjog.2023.01.006.

ABSTRACT

OBJECTIVE: To explore the effects of labor analgesia for primiparae with different stages of cervical dilation on parturition and neonates.

MATERIALS AND METHODS: In the past three years, 530 cases of primiparae who had delivered in the Second People’s Hospital of Hefei and were eligible for a vaginal trial of parturition were enrolled as the research subjects. Of these, 360 puerperae had labor analgesia, and the remaining 170 were taken as the control group. Those given labor analgesia were divided into three groups based on the different stages of cervical dilation at that time. There were 160 cases in Group I (cervical dilation <3 cm), 100 cases in Group II (cervical dilation of 3-4 cm), and 100 cases in Group III (cervical dilation of 4-6 cm). The labor and neonatal outcomes were compared among the four groups.

RESULTS: The first, second, and total stages of labor in the three groups receiving labor analgesia were all longer than in the control group, and the differences were statistically significant (p < 0.05 in all). Group I had the longest duration of each stage and the total stage of labor. The differences in labor stages and the total stage of labor were not statistically significant between Group II and Group III (P > 0.05). In the three groups with labor analgesia, the usage rate of oxytocin was higher than in the control group, and the differences were statistically significant (P < 0.05). The differences in the incidence of postpartum hemorrhage, the incidence of postpartum urine retention, and the episiotomy rate were not statistically significant among the four groups (P > 0.05). The differences in the neonatal Apgar score were not statistically significant among the four groups (P > 0.05).

CONCLUSION: Labor analgesia might prolong the stages of labor but does not affect the neonatal outcomes. It would be optimal to conduct labor analgesia when cervical dilation reaches 3-4 cm.

PMID:37188443 | DOI:10.1016/j.tjog.2023.01.006