Tag: statistics

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):398-403. doi: 10.4103/jisppd.jisppd_204_22.

ABSTRACT

BACKGROUND: To overcome some of the disadvantages of the current primary root canal obturating materials, there is a continued interest in search for chemical compounds with broader and more effective antibacterial action and less cytotoxicity.

AIM: This study aimed to evaluate and compare in vivo the clinical and radiographic success of mixtures of zinc oxide-Ocimum sanctum extract, zinc oxide-ozonated oil, and zinc oxide-eugenol (ZOE) as obturating materials in pulpectomy of primary molars.

SETTINGS AND DESIGN: This was an in vivo randomized controlled clinical trial.

MATERIALS AND METHODS: Ninety primary molars selected were randomly divided into three groups. Group A was obturated with zinc oxide-O. sanctum extract, Group B with zinc oxide-ozonated oil, and Group C with ZOE. All the groups were evaluated for success or failure based on clinical and radiographic criteria at the end of 1, 6, and 12 months.

STATISTICAL ANALYSIS USED: The intra- and inter-examiner reliability of the first and the second co-investigators was calculated by Cohen’s kappa statistic. The data were analyzed using Chi-square test, P ≤ 0.05 (indicates statistical significance).

RESULTS: By the end of 12 months, the overall clinical success rate was 88%, 95.7%, and 90.9% in Groups A, B, and C, respectively; whereas the radiographic success rate was found to be 80%, 91.3%, and 86.4% in Groups A, B, and C, respectively.

CONCLUSION: On the basis of the overall success rates of all the three obturating materials, the following order of performance can be concluded: zinc oxide-ozonated oil > ZOE > zinc oxide-O. sanctum extract.

PMID:36861556 | DOI:10.4103/jisppd.jisppd_204_22

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):377-382. doi: 10.4103/jisppd.jisppd_239_22.

ABSTRACT

BACKGROUND: Caries management in the modern era has shifted away from the traditional surgical method toward a medical paradigm, which often includes fluoride therapy. Fluoride used in various forms has been proven to be effective in dental caries prevention. Silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish are effective in arresting caries in primary molars.

AIM: This study aimed to evaluate the effectiveness of 38% SDF and 5% NaF varnish in arresting caries in primary molars.

SETTINGS AND DESIGN: This study was a split-mouth randomized controlled trial.

MATERIALS AND METHODS: The randomized controlled trial comprised 34 children aged 6-9 years with teeth having caries in both right and left primary molars without pulpal involvement. Teeth were randomly allocated into two groups. In Group 1 (n = 34), 38% SDF + potassium iodide was applied and in Group 2 (n = 34), 5% NaF varnish was applied. The second application was done after 6 months in both groups. Children were recalled at 6- and 12-month intervals and evaluated for caries arrest.

STATISTICAL ANALYSIS: Chi-square test was used to analyze the data.

RESULTS: Caries arresting potential was found to be higher in the SDF group compared to the NaF varnish group at both 6-month (SDF – 82% and NaF varnish – 45%) and 12-month intervals (SDF – 77% and NaF varnish – 42%) and the difference was found to be statistically significant (P = 0.002 and 0.004, respectively).

CONCLUSION: SDF was more effective in arresting dental caries in primary molars compared to 5% NaF varnish.

PMID:36861553 | DOI:10.4103/jisppd.jisppd_239_22

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):368-376. doi: 10.4103/jisppd.jisppd_27_23.

ABSTRACT

BACKGROUND: Molar Incisor Hypomineralization (MIH) affects about 14% of the population. MIH may lead to enamel breakdown, early tooth decay and is known to cause sensitivity, pain, discomfort, etc., Despite several studies reporting impacts of MIH on oral health-related quality of life (OHRQoL) in children; no systematic review has been reported till date.

OBJECTIVES: Our study aimed at assessing the impact of MIH on OHRQoL.

SEARCH METHODS: Two researchers, Ashwin Muralidhar Jawdekar and Shamika Ramchandra Kamath, independently searched articles using appropriate keyword combinations in three search engines – PubMed, Cochrane Library, and Google Scholar and conflicts, if any were resolved by Swati Jagannath Kale. Studies either reported in English or complete translations available in English were selected.

SELECTION CRITERIA: Observational studies on otherwise healthy 6-18-year-old children were considered. Interventional studies were included only to collect the baseline (observational) data.

DATA COLLECTION AND ANALYSIS: From 52 studies, a total of 13 studies could be included in the systematic review and 8 in meta-analysis. Total scores of OHRQoL measures reported in the child perceptions questionnaire (CPQ) 8-10, CPQ 11-14, and parental-caregiver perception questionnaire (P-CPQ) scales were used as variables.

MAIN RESULTS: Five studies (2112 subjects) showed an impact on OHRQoL (CPQ); the pooled risk ratio (RR) confidence interval (CI) were 24.70 (13.93-35.47), showing statistically significant value (P < 0.001). The Three studies (811 participants) showed an impact on OHRQoL (P-CPQ); the pooled RR (CI) was 16.992 (5.119, 28.865) showing statistically significant value (P < 0.001). Heterogeneity (I²) was high (99.6% and 99.2%); hence, random effect model was used. Sensitivity analysis of two studies (310 subjects) showed impact on OHRQoL (P-CPQ); the pooled RR (CI) was 22.124 (20.382, 23.866) showing statistically significant value (P < 0.001); the heterogeneity was low (I² = 0.0). The risk of bias across studies assessed using the appraisal tool for cross sectional studies tool was found to be moderate. The reporting bias assessed using the dispersion on the funnel plot was found to be minimal.

AUTHORS’ CONCLUSIONS: Children with MIH are about 17-25 times more likely to have impacts on the OHRQoL compared to children with no MIH. Evidence is of low quality due to high heterogeneity. The risk of bias was moderate and publication bias was low.

PMID:36861552 | DOI:10.4103/jisppd.jisppd_27_23

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):356-367. doi: 10.4103/jisppd.jisppd_462_22.

ABSTRACT

RESEARCH QUESTION: To estimate the pooled prevalence of molar incisor hypomineralization (MIH) in children from India.

RESEARCH PROTOCOL: The PRISMA guidelines were followed.

LITERATURE SEARCH: An electronic search of the databases was performed to find prevalence studies of MIH in children above age 6 years in India.

DATA EXTRACTION: Two authors independently extracted the data from the 16 included studies.

QUALITY APPRAISAL: The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale adapted for cross-sectional studies.

DATA ANALYSIS: The pooled prevalence estimate of MIH was calculated using logit transformed data with inverse variance approach in a random-effects model with 95% confidence interval (CI). Heterogeneity was assessed with the I² statistic. The subgroups were analyzed to assess the pooled prevalence of MIH according to sex, arch-wise proportion of MIH-affected teeth, and proportion of children with the MIH phenotypes.

RESULTS AND INTERPRETATION OF RESULTS: Sixteen studies included in the meta-analysis represented 7 states of India. A total of 25,273 children were included in the meta-analysis. The pooled prevalence of MIH in India was estimated to be 10.0% (95% CI: 0.07, 0.12) with significantly high heterogeneity between the included studies. The pooled prevalence did not vary according to sex. The pooled proportions of MIH-affected teeth were similar in the maxillary and mandibular arches. The pooled proportion of children with MH phenotype was higher (56%) than those with M + IH phenotype (44%). Further studies with standardized criteria for recording MIH are needed to ascertain the prevalence of MIH in India.

PMID:36861551 | DOI:10.4103/jisppd.jisppd_462_22

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):349-355. doi: 10.4103/jisppd.jisppd_359_22.

ABSTRACT

OBJECTIVES: This study aimed to determine the mean oxygen saturation values (SpO₂) in primary teeth using pulse oximetry.

MATERIALS AND METHODS: This comprehensive literature search on pulse oximeter used for primary teeth in determining pulp vitality using MeSH terms in four electronic databases, including PubMed, Scopus, Cochrane Library, and Ovid^SP, from January 1990 to January 2022. Studies reported the sample size and the mean SpO₂ values (with standard deviations) for each tooth group were included. The quality assessment of all the included studies was done using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa Scale. The meta-analysis included studies reporting means and standard deviations of SpO₂ values. The I² statistics were used to determine the degree of heterogeneity among the studies.

RESULTS: A total of 90 studies were identified, of which five met the eligibility criteria that were qualified for the systematic review, and among them, three were included in the meta-analysis. All five included studies were of low quality due to the high risk of bias related to the patient selection, index test, and uncertainties about outcome valuation. In the meta-analysis, the mean fixed-effect measure of oxygen saturation in the pulp of primary teeth was 88.45% (confidence interval: 83.97%-92.93%).

CONCLUSION: Though most of the available studies were of poor quality, the SpO₂ in the healthy pulp can be established (minimum saturation, 83.48%) in primary teeth. Reference values established might help clinicians to assess changes in pulp status.

PMID:36861550 | DOI:10.4103/jisppd.jisppd_359_22

J Postgrad Med. 2023 Feb 23. doi: 10.4103/jpgm.jpgm_107_22. Online ahead of print.

ABSTRACT

BACKGROUND: The term “Telemedicine” is being used in the medical and health sector to treat patients and to provide medical guidance remotely. The intellectual output from India in terms of publications was harvested from Scopus^® with the keyword “Telemedicine” and analyzed by using bibliometric techniques.

METHODS: The source data was downloaded from the Scopus^® database. All the publications on telemedicine and indexed in the database up to the year 2021 were considered for scientometric analysis. The software tools VOSviewer^® version 1.6.18 to visualize bibliometric networks, statistical software R Studio^® version 3.6.1 with the Bibliometrix package Biblioshiny^® were used for analysis and data visualization, and EdrawMind^® was used for mind mapping.

RESULT: India contributed 2,391 (4.32%) publications on telemedicine to a total of 55,304 publications worldwide until 2021. There were 886 (37.05%) papers that appeared in open access mode. The analysis revealed that the first paper was published in the year 1995 from India. Steep growth in the number of publications was observed in 2020 with 458 publications. The highest, 54 research publications, appeared in the “Journal of Medical Systems.” The All India Institute of Medical Sciences (AIIMS), New Delhi, contributed the highest number of publications (n = 134). A considerable overseas collaboration was observed (USA: 11%; UK: 5.85%).

CONCLUSIONS: This is the first such attempt to address the intellectual output of India in the emerging medical discipline of telemedicine and has yielded useful information such as leading authors, institutions, their impact, and year-wise topic trends.

PMID:36861544 | DOI:10.4103/jpgm.jpgm_107_22

Indian J Med Res. 2023 Feb 27. doi: 10.4103/ijmr.IJMR_1835_19. Online ahead of print.

ABSTRACT

BACKGROUND & OBJECTIVES: The National Tuberculosis (TB) Control Programme has transitioned from thrice-weekly to daily drug treatment regimens in India. This preliminary study was conceived to compare the pharmacokinetics of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA) in TB patients being treated with daily and thrice weekly anti-TB treatment (ATT).

METHODS: This prospective observational study was undertaken in 49 newly diagnosed adult TB patients receiving either daily ATT (n=22) or thrice-weekly ATT (n=27). Plasma RMP, INH and PZA were estimated by high-performance liquid chromatography.

RESULTS: The peak concentration (C_max) of RMP was significantly higher (RMP: 8.5 μg/ml vs. 5.5 μg/ml; P=0.003) and C_max of INH was significantly lower (INH: 4.8 μg/ml vs. 10.9 μg/ml; P<0.001) in case of daily dosing compared to thrice-weekly ATT. C_max of drugs and doses was significantly correlated. A higher proportion of patients had subtherapeutic RMP C_max (8.0 μg/ml) during thrice-weekly compared to daily ATT (78% vs. 36%; P=0.004). Multiple linear regression analysis showed that C_max of RMP was significantly influenced by the dosing rhythm, pulmonary TB and C_max of INH and PZA by the mg/kg doses.

INTERPRETATION & CONCLUSIONS: RMP concentrations were higher and INH concentrations were lower during daily ATT, suggesting that INH doses may need to be increased in case of a daily regimen. Larger studies are, however, required using higher INH doses when monitoring for adverse drug reactions and treatment outcomes.

PMID:36861539 | DOI:10.4103/ijmr.IJMR_1835_19

J Minim Access Surg. 2023 Feb 3. doi: 10.4103/jmas.jmas_309_22. Online ahead of print.

ABSTRACT

AIMS: This study aims to evaluate comparative outcomes following midline versus off-midline specimen extractions following laparoscopic left-sided colorectal resections.

METHODS: A systematic search of electronic information sources was conducted. Studies comparing ‘midline’ versus ‘off midline’ specimen extraction following laparoscopic left-sided colorectal resections performed for malignancies were included. The rate of incisional hernia formation, surgical site infection (SSI), total operative time and blood loss, anastomotic leak (AL) and length of hospital stay (LOS) was the evaluated outcome parameters.

RESULTS: Five comparative observational studies reporting a total of 1187 patients comparing midline (n = 701) and off-midline (n = 486) approaches for specimen extraction were identified. Specimen extraction performed through an off-midline incision was not associated with a significantly reduced rate of SSI (odds ratio [OR]: 0.71; P = 0.68), the occurrence of AL (OR: 0.76; P = 0.66) and future development of incisional hernias (OR: 0.65; P = 0.64) compared to the conventional midline approach. No statistically significant difference was observed in total operative time (mean difference [MD]: 0.13; P = 0.99), intraoperative blood loss (MD: 2.31; P = 0.91) and LOS (MD: 0.78; P = 0.18) between the two groups.

CONCLUSIONS: Off-midline specimen extraction following minimally invasive left-sided colorectal cancer surgery is associated with similar rates of SSI and incisional hernia formation compared to the vertical midline incision. Furthermore, there were no statistically significant differences observed between the two groups for evaluated outcomes such as total operative time, intra-operative blood loss, AL rate and LOS. As such, we did not find any advantage of one approach over the other. Future high-quality well-designed trials are required to make robust conclusions.

PMID:36861535 | DOI:10.4103/jmas.jmas_309_22

J Minim Access Surg. 2023 Feb 3. doi: 10.4103/jmas.jmas_281_22. Online ahead of print.

ABSTRACT

INTRODUCTION: One-anastomosis gastric bypass (OAGB) presents a satisfactory long-term outcome in terms of weight loss, amelioration of comorbidities and low morbidity. However, some patients may present insufficient weight loss or weight regain. In this study, we tackle a case series evaluating the efficiency of the combined laparoscopic pouch and loop resizing (LPLR) as a revisional procedure for insufficient weight loss or weight regain after primary laparoscopic OAGB.

MATERIALS AND METHODS: We included eight patients with a body mass index (BMI) ≥30 kg/m² with a history of weight regain or insufficient weight loss after laparoscopic OAGB, who underwent revisional laparoscopic intervention by LPLR between January 2018 and October 2020 at our institution. We conducted a 2 years’ follow-up. Statistics were performed using International Business Machines Corporation^® SPSS^® software for Windows version 21.

RESULTS: The majority of the eight patients were males (62.5%), with a mean age of 35.25 at the time of the primary OAGB. The average length of the biliopancreatic limb created during the OAGB and LPLR were 168 ± 27 and 267 ± 27 cm, respectively. The mean weight and BMI were 150.25 ± 40.73 kg and 48.68 ± 11.74 kg/m² at the time of OAGB. After OAGB, patients were able to reach an average lowest weight, BMI and per cent of excess weight loss (%EWL) of 89.5 ± 28.85 kg, 28.78 ± 7.47 kg/m² and 75.07 ± 21.62%, respectively. At the time of LPLR, patients had a mean weight, BMI and %EWL of 116.12 ± 29.03 kg, 37.63 ± 8.27 kg/m² and 41.57 ± 12.99%, respectively. Two years after the revisional intervention, the mean weight, BMI and %EWL were 88.25 ± 21.89 kg, 28.44 ± 4.82 kg/m² and 74.51 ± 16.54%, respectively.

CONCLUSION: Combined pouch and loop resizing is a valid option for revisional surgery following weight regain after primary OAGB, leading to adequate weight loss through enhancement of the restrictive and malabsorptive effect of OAGB.

PMID:36861534 | DOI:10.4103/jmas.jmas_281_22

Indian J Cancer. 2022 Oct-Dec;59(4):457-461. doi: 10.4103/ijc.IJC_22_21.

ABSTRACT

In the Cox proportional hazards regression model, which is the most commonly used model in survival analysis, the effects of independent variables on survival may not be constant over time and proportionality cannot be achieved, especially when long-term follow-up is required. When this occurs, it would be better to use alternative methods that are more powerful for the evaluation of various effective independent variables, such as milestone survival analysis, restricted mean survival time analysis (RMST), area under the survival curve (AUSC) method, parametric accelerated failure time (AFT), machine learning, nomograms, and offset variable in logistic regression. The aim was to discuss the pros and cons of these methods, especially with respect to long-term follow-up survival studies.

PMID:36861518 | DOI:10.4103/ijc.IJC_22_21