Tag: statistics

BMC Health Serv Res. 2023 Mar 2;23(1):209. doi: 10.1186/s12913-023-09178-0.

ABSTRACT

BACKGROUND: Quality of care is fundamental to universal health coverage. Perceived quality of medical services is one of the most determining factors of modern health care service utilization. Between 5.7 and 8.4 million deaths are attributed to poor-quality care each year in low- and middle-income countries (LMICs), and up to 15% of overall deaths are due to poor quality. For instance, in sub-Saharan Africa (SSA), public health facilities lack basic facilities such as a physical environment. Hence, this study aims to assess the perceived quality of medical services and associated factors at outpatient departments of public hospitals in the Dawro zone, Southern Ethiopia.

METHODS: A facility-based cross-sectional study was conducted on the quality of care among outpatient department attendants of Dawro zone public hospitals from May 23 to June 28, 2021. A total of 420 study participants were included via a convenient sampling technique. An exit interview was used to collect data using a pretested and structured questionnaire. Then it was analyzed using the Statistical Package for Social Science (SPSS) version 25. Both bivariable and multivariable linear regressions were carried out. Significant predictors were reported at p < 0.05 with a 95% confidence interval.

RESULT: with a 100% response rate. The overall perceived quality was 51.15%. Fifty-six percent of study participants rated perceived quality as poor, 9% as average, and 35% of participants rated it as good perceived quality. The highest mean perception result was related to the tangibility (3.17) domain. Waiting time less than one hour (β = 0.729, p < 0.001), availability of prescribed drugs (β = 0.185, p < 0.003), having information on diagnoses (illness) (β = 0.114, p < 0.047), and privacy maintained (β = 0.529, p < 0.001) were found to be predictors of perceived good quality of care.

CONCLUSION: A majority of the study participants rated the perceived quality as poor. Waiting time, availability of prescribed drugs, information on diagnoses (illness), and provision of service with privacy were found to be predictors of client-perceived quality. Tangibility is the predominant and most important domain of client-perceived quality. The regional health bureau and zonal health department should understand the issue and work with hospitals to improve outpatient service quality by providing necessary medication, reducing wait times, and designing job training for health care providers.

PMID:36864413 | DOI:10.1186/s12913-023-09178-0

BMC Anesthesiol. 2023 Mar 2;23(1):66. doi: 10.1186/s12871-023-02023-1.

ABSTRACT

BACKGROUND: Different anesthetics may have opposite effects on the immune system, thus affecting the prognosis of tumor patients. Cell-mediated immunity forms the primary defense against the invasion of tumor cells, so manipulation of the immune system to produce an enhanced anti-tumor response could be utilized as an adjuvant oncological therapy. Sevoflurane has proinflammatory effects, while propofol, has anti-inflammatory and antioxidant effects. Therefore, we compared the overall survival (OS) and disease-free survival (DFS) of patients with esophageal cancer under total intravenous anesthesia and inhalation anesthesia.

METHODS: This study collected the electronic medical records of patients undergoing esophagectomy from January 1, 2014 to December 31, 2016. According to the intraoperative anesthetics, the patients were divided into total intravenous anesthesia (TIVA) group or inhalational anesthesia (INHA) group. Stabilized inverse probability of treatment weighting (SIPTW) was used to minimize differences. Kaplan-Meier survival curve was established to evaluate the correlation between different anesthesia methods in overall survival and disease-free survival of patients undergoing esophageal cancer surgery.

RESULTS: A total of 420 patients with elective esophageal cancer were collected, including 363 patients eligible for study (TIVA, n = 147, INHA, n = 216). After SIPTW there were no significant differences between two groups in overall survival and disease-free survival. However, the adjuvant therapy was statistically significant in improving OS, and the degree of differentiation was correlated with OS and DFS.

CONCLUSIONS: In conclusion, there were no significant difference in overall survival and disease-free survival between total intravenous anesthesia and inhalational anesthesia in patients undergoing esophageal cancer surgery.

PMID:36864402 | DOI:10.1186/s12871-023-02023-1

J Med Virol. 2023 Mar 2. doi: 10.1002/jmv.28630. Online ahead of print.

ABSTRACT

SARS-CoV-2 infection leads to the accumulation of lipid droplet (LD), the central hubs of the lipid metabolism, in vitro or in type II pneumocytes and monocytes from COVID-19 patients and blockage of LD formation by specific inhibitors impedes SARS-CoV-2 replication. Here, we showed that ORF3a is necessary and sufficient to trigger LD accumulation during SARS-CoV-2 infection, leading to efficient virus replication. Although highly mutated during evolution, ORF3a-mediated LD modulation is conserved in most SARS-CoV-2 variants except the Beta strain and is a major difference between SARS-CoV and SARS-CoV-2 that depends on the genetic variations on the amino acid position 171, 193, and 219 of ORF3a. Importantly, T223I substitution in recent Omicron strains (BA.2-BF.8) impairs ORF3a-Vps39 association and LD accumulation, leading to less efficient replication and potentially contributing to lower pathogenesis of the Omicron strains. Our work characterized how SARS-CoV-2 modulates cellular lipid homeostasis to benefit its replication during virus evolution, making ORF3a-LD axis a promising drug target for the treatment of COVID-19. This article is protected by copyright. All rights reserved.

PMID:36861654 | DOI:10.1002/jmv.28630

Neurol India. 2023 Jan-Feb;71(1):44-48. doi: 10.4103/0028-3886.370484.

ABSTRACT

BACKGROUND AND OBJECTIVE: Superior turbinate manipulation is often required in cases of narrow cavities and expanded endonasal approaches with concern for olfaction. The objective of the study was to compare the pre- and postoperative olfactory function in patients undergoing endoscopic endonasal transsphenoidal pituitary excision with and without superior turbinectomy, using the Pocket Smell Identification Test and the quality of life (QOL) and Sinonasal Outcome Test-22 (SNOT-22) scores, irrespective of the extension (Knosp grading) of pituitary tumors. We also aimed to identify olfactory neurons in the excised superior turbinate with immunohistochemical (IHC) stains and correlate them with clinical findings.

MATERIALS AND METHODS: The study was a prospective, randomized study performed in a tertiary center. Two groups A and B, with superior turbinate preserved and resected, respectively, during endoscopic pituitary resection, were compared using pre- and postoperative Pocket Smell Identification Test and QOL and SNOT-22 scores. The superior turbinate was subjected to IHC staining to identify the presence of olfactory neurons in patients with tumors of pituitary gland requiring endoscopic trans-sphenoid resection.

RESULTS: Fifty patients with sellar tumors were enrolled. The mean age of patients in this study was 46.15 years. The minimum age was 18 years and the maximum was 75 years. Of the 50 patients in the study, 18 were female and 32 were male. Eleven patients had more than one presenting complaint. Loss of vision was the commonest and altered sensorium was the rarest symptom.

CONCLUSION: Superior turbinectomy is a viable option to gain wider access to sella without affecting the sinonasal function, quality of life, and olfaction. There was doubtful presence of olfactory neurons in superior turbinate. The extent of tumor resection and postoperative complications were unaffected and statistically nonsignificant in both the groups.

PMID:36861573 | DOI:10.4103/0028-3886.370484

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):453-458. doi: 10.4103/jisppd.jisppd_398_22.

ABSTRACT

BACKGROUND: Pit and fissure sealing is an evidence-based preventive measure against dental caries, especially in primary teeth which possess high caries risk, and to give the required benefits of the sealant, a good adaptation, and sealing ability should be present.

PURPOSE: This study aimed to assess and compare the microleakage score of Ionoseal^® pit and fissure sealant, when used either alone or with prior surface treatment of erbium-doped yttrium aluminum garnet (Er: YAG) laser, acid etching, or their combination, in primary teeth.

MATERIALS AND METHODS: Forty healthy human molar teeth were randomly chosen and allocated into four study groups according to the surface pretreatment: group I, no surface pretreatment; Group II, 2W Er: YAG laser etching, Group III, combined laser etching and acid etching group, and Group IV, 37% phosphoric acid etching. After surface pretreatment procedures were conducted, the teeth were sealed with Ionoseal^®. Subsequent microleakage was assessed through dye penetration under a stereomicroscope. One sample from each group was randomly selected, and scanning electron microscopy (SEM) was carried out on the central slice of the three obtained slices of the samples.

RESULTS: Chi-square test revealed a high statistically significant difference between groups (P = 0.00). Similarly, all pairwise comparisons revealed a statistically significant difference. Group I showed the greatest mean of microleakage score (1.5), followed by Group IV (1.4), Group II (0.7), and Group III which showed the least microleakage score (0.6). These findings were supported by the SEM examination results.

CONCLUSIONS: Using Ionoseal with prior surface treatment by combined 2 W Er: YAG laser etching and 37% phosphoric acid etching can result in the best sealing ability which would significantly enhance the long-term success of pit and fissure sealing in primary teeth.

PMID:36861564 | DOI:10.4103/jisppd.jisppd_398_22

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):437-444. doi: 10.4103/jisppd.jisppd_382_22.

ABSTRACT

CONTEXT: Early childhood caries is a major health problem affecting children worldwide. Although incorrect feeding practices hold a prime position in the etiology, there are gaps in the literature pertaining to the physical properties of milk.

AIM: To assess the viscosity of human breast milk (HBM) versus infant milk formulae, with and without the addition of sweetening agents.

MATERIALS AND METHODS: All commercially available infant milk formulae (60 samples) and breast milk from 30 donor mothers were assessed for viscosity using Brookfield DV2T viscometer. The study period was from April 2019 to August 2019. Viscosity of infant milk formulae sweetened with sugar, honey, and brown sugar was further investigated and compared with that of HBM.

STATISTICAL ANALYSIS: Inter-group and intra-group mean viscosity was compared using independent t-test and repeated-measures ANOVA.

RESULTS: Viscosity of HBM ranged from 18.36 centipoise (cP) to 91.30 cP, the mean viscosity being 45.7 cP. Viscosity values varied for each formula group, the least being as low as 5.1 cP and the highest being 89.3 cP. The mean viscosities of each group were in the range of 33 to 49 cP.

CONCLUSIONS: HBM was found to have a tendency toward higher viscosity than most of the infant milk formulae. Also, varied viscosity values were obtained when commonly used sweetening agents were added to infant milk formulae. Greater viscosity of HBM might increase its adherence to enamel surface leading to prolonged demineralization and potentially altering the caries risk, needs to be investigated further.

PMID:36861562 | DOI:10.4103/jisppd.jisppd_382_22

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):430-436. doi: 10.4103/jisppd.jisppd_442_22.

ABSTRACT

BACKGROUND: Despite the high prevalence of traumatic dental injuries (TDIs), parents generally lack awareness about dental trauma emergency management. This preliminary study’s goal was to assess parents’/guardians’ awareness of the treatment of tooth fractures/avulsion.

MATERIALS AND METHODS: A preformed questionnaire in e-format was sent to parents of school-going children. Kolmogorov-Smirnov test and Shapiro-Wilks’s test were employed to test the normality of data. In addition, a Chi-square test was performed for quantitative variables. P ≤ 0.05 was considered statistically significant.

RESULTS: A response rate of 82.1% was achieved. Approximately 19.6% of parents reported dental injuries, with the majority (51.9%) occurring at home. In avulsion, 54.8% of parents believed that reinserting the tooth back into the socket was possible. For tooth fractures, 36.2% of parents believed that the fractured tooth could be glued. Tap water was preferred as a storage medium (43.3%). An insignificant association was observed with regard to storage media (P > 0.05).

CONCLUSION: Inadequate understanding of the treatment of TDI by the primary caregiver leads to ineffective interventions at the scene of the accident and a poor prognosis for otherwise treatable cases.

PMID:36861561 | DOI:10.4103/jisppd.jisppd_442_22

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):417-422. doi: 10.4103/jisppd.jisppd_414_22.

ABSTRACT

BACKGROUND: Emojis are used to communicate emotional content as conversational indicators. Emojis of human faces are unrivaled in communication since they can discern between several basic emotions with great precision while also being universal.

AIM: Assessment of children’s emotions before, during, and after the dental treatment procedure: An emoji-based study.

MATERIALS AND METHODS: A total of 85 children, ranging in age from 6 to 12 years, were separated into four groups. Group 1 required local anesthetic for restoration, while Group 2 required extraction. Pulp treatment was in Group 3 and oral prophylaxis was in Group 4. All groups used an animated emoji scale (AES) to quantify anxiety before, during, and after the dental treatment procedure.

RESULTS: There was a statistically significant difference when the mean scores of the four treatment groups were compared before, during, and after the procedure. When Group 2 was compared to Groups 1, 3, and 4 there was a statistically significant difference in the anxiety of the research participant before, during, and after the procedures (P = 0.01). Groups 2, 3, and 4 were statistically significant after the treatment procedure (P = 0.01).

CONCLUSION: The findings of this study suggest that the AES can be a useful tool in tracking a patient’s emotions during the dental treatment procedure to initiate appropriate behavior management.

PMID:36861559 | DOI:10.4103/jisppd.jisppd_414_22

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):410-416. doi: 10.4103/jisppd.jisppd_409_22.

ABSTRACT

BACKGROUND: Age estimation is an important approach in the field of forensics and medical sciences to assists in clinical practice, medico-legal cases, and in criminal cases of judicial punishment.

AIM: This study aim the applicability and comparison of four-teeth method and the alternate four-teeth method of Demirjian’s approach among the Varanasi population.

SETTINGS AND DESIGN: This is a cross-sectional prospective study on the population of Varanasi region children and adolescents.

MATERIALS AND METHODS: Four hundred and thirty-two panoramic images of children and adolescents (237 boys and 195 girls) aged 3-16 years, from the population of Varanasi region oriental was assessed using the four-teeth method and the alternate four-teeth method of Demirjian’s approach, for the estimation of dental age.

STATISTICAL ANALYSIS: Pearson’s two tailed test was applied to establish the correlation between chronological age and estimated dental age and Paired t-test was applied to check the statistical significance between mean chronological age and mean estimated dental age.

RESULTS: The dental age of boys was overestimated by 0.39 ± 1.15 years (P < 0.001) and dental age was underestimated by – 0.34 ± 1.15 years (P < 0.001) among girls using the Demirjian’s four teeth method. According to Demirjian’s alternate four teeth method, the sample of boys overestimated the dental age by 0.76 ± 1.00 years (P < 0.001) with the statistically significant difference. While the sample of the girls had negligible overestimation of 0.04 ± 1.03 years (P = 0.580) with no statistically significant difference.

CONCLUSION: Demirjian’s four teeth method is better to estimate dental age in boys, whereas Demirjian’s alternate four teeth method in girls of Varanasi region.

PMID:36861558 | DOI:10.4103/jisppd.jisppd_409_22

J Indian Soc Pedod Prev Dent. 2022 Oct-Dec;40(4):404-409. doi: 10.4103/jisppd.jisppd_439_22.

ABSTRACT

BACKGROUND: Placement of intraoral appliances such as space maintainers (SMs) may be associated with the alteration of microbial and nonmicrobial parameters of saliva which may lead to the initiation of incipient caries.

AIM: The aim of this study was to compare and evaluate the changes in salivary flow rate, pH, and Streptococcus mutans levels in children undergoing fixed and removable SM therapy.

MATERIALS AND METHODS: The study participants comprised 40 children aged 4-10 years divided into two groups of 20 each. Children undergoing fixed (Group I = 20) and removable SM therapy (Group II = 20). Salivary flow rate, pH, and S. mutans levels were recorded just before and 3 months after the placement of SMs. Data were compared for both groups.

STATISTICAL ANALYSIS: It was analyzed using SPSS software version 20. The level of significance was kept at 5%.

RESULTS: A significant increase in salivary flow rate (<0.05) and S. mutans level (<0.05) was evident, however, no significant difference in pH was found in both the groups from baseline to 3 months after appliance placement. Group I showed a significant increase (<0.05) in S. mutans level as compared to Group II.

CONCLUSION: SM therapy allied both favorable and unfavorable changes in salivary parameters, thus emphasizing the importance of parent and patient education about maintaining proper oral hygiene during SM therapy.

PMID:36861557 | DOI:10.4103/jisppd.jisppd_439_22