Tag: statistics

Monaldi Arch Chest Dis. 2023 Apr 12. doi: 10.4081/monaldi.2023.2500. Online ahead of print.

ABSTRACT

Tuberculosis (TB), at present, is the leading infectious aetiology of death globally. In Pakistan, there are approximately 510,000 new cases annually, with more than 15,000 of them developing into drug resistant TB, making the nation the fifth leading country in TB prevalence in the world. Due to the ongoing COVID-19 pandemic, focus has drifted away from TB screening, diagnostic, health awareness campaigns and therapeutic measures endangering KAP (knowledge, attitude and practices) towards TB in our population. We conducted a cross-sectional descriptive study in Pakistan to assess the knowledge, attitude and practices of Pakistani residents attending the adult outpatient departments of public hospitals for any health-related concern. Our sample size was of 856 participants, with a median age of 22 years. Occupation-wise, those who were employed had better knowledge of TB than those who were unemployed [odds ratio (OR): 1.011; 95% CI :1.005-1.8005]. No differences were observed in TB knowledge between those adherents to common preventive practices versus not adherent (OR 0.875, 95% CI: 0.757-1.403). More than 90 % of participants agreed that TB is dangerous for the community and a majority opted against stigmatising TB patients (79.1%). People who could read and write were 3.5 times more likely to have a good attitude towards TB compared to those who could not (OR: 3.596;95% CI: 1.821-70.230; p=0.037). Similarly, employed subjects had better attitude compared to unemployed ones (p=0.024), (OR: 1.125; 95% CI: 0.498, 1.852) and those having better knowledge of TB had a better attitude grade (OR:1.749; 95% CI: 0.832-12.350), p=0.020). Age, occupation, and educational status were statistically significant among the two groups (p=0.038, p=0.023, p=0.000) respectively. Literate subjects had thrice good practice towards TB than illiterate (OR: 3.081; 95% CI: 1.869-4.164; p=0.000). Future education and awareness programs should target specific groups such as the unemployed and illiterate with practice-focused approaches. Our study outcomes can enable the concerned officials and authorities taking appropriate evidence-based steps to direct the efforts in an efficient manner to curtail the burden of TB in Pakistan and to limit its progression that could potentially lead our nation to become an MDR-TB endemic territory.

PMID:37052048 | DOI:10.4081/monaldi.2023.2500

J Pak Med Assoc. 2023 Apr;73(4):763-766. doi: 10.47391/JPMA.1045.

ABSTRACT

OBJECTIVE: To determine the characteristics of patients, mortality-affecting factors and mortality rate in follow-up burn-injured patients in an intensive care setting at a burns treatment centre.

METHODS: The retrospective study was conducted between May and November 2014 at Kocaeli Derince Training and Research Hospital Burn Treatment Centre, Kocaeli, Turkey, and comprised data from January 2008 to January 2013 of in-patients who had been treated at the intensive care unit. The therapy outcomes and the follow-up processes were evaluated. Data was analysed using SPSS 17.

RESULTS: Of the 381 patients, 105(27.6%) were females and 276(72.4%) were males. The overall mean age was 28.4±21.1 years. There were 52(13.6%) mortalities, while 329(86.4%) survived. The mean total body surface area was 18.3±12.9% in those who survived compared to 52±24.3% in those who died (p<0.000). The highest rate of death was observed in those aged >66 years (p<0.000). The impact of flame burns on mortality was statistically significant (p<0.05). The impact of inhalation burns, suicide, abuse, operational requirements and systemic disease on mortality was statistically significant (p<0.05).

CONCLUSIONS: Older age, higher total body surface area, flame burns, presence of inhalation burn, third degree burn, suicide attempt, presence of systemic disease, duration of prolonged mechanical ventilation and operation requirements were found to be poor prognostic factors for survival in burn patients.

PMID:37051979 | DOI:10.47391/JPMA.1045

J Pak Med Assoc. 2023 Apr;73(4):755-758. doi: 10.47391/JPMA.922.

ABSTRACT

OBJECTIVE: To identify the incidence of medication error in a tertiary care hospital and to document the role of drug information centre to prevent such errors.

METHODS: The retrospective cross-sectional study was conducted at the Security Forces Hospital, Riyadh, Saudi Arabia, and comprised review of secondary data collected from the Drug Information Centre from March 2013 to February 2016. The errors were categorised as under-prescribing, dispensing, administrating and transcription, while the received inquiries were classified according to the inquirer; physicians, pharmacists and nurses. The score was given according to the Grade of Severity scale. Data was analysed using IBM SPSS Statistics for Windows, version 20. Armonk, NY: IBM Corp. Categorical variables were presented as frequency and percentage.

RESULTS: Among the 2800 drug-related inquiries received, 238(8.5%) medication errors were detected. The inquirers of these queries included 108(45.4%) nurses. Administration errors were the highest 113(47.5%), while the least were transcription errors 31(13%). Majority of errors were committed by nurses 113(47.5%). Grade 2 errors were the most common 86(36.10%), while grade 4 life-threatening errors were minimal 2(0.8%). There were significant differences in the number of received questions based on the specialty (p˂0.05), staff having committed the error (p˂0.01) and the type of errors detected (p˂0.01).

CONCLUSIONS: The prevalence of medication errors committed by healthcare providers was high.

PMID:37051977 | DOI:10.47391/JPMA.922

Sex Med Rev. 2022 Oct 1;10(4):754-763. doi: 10.1016/j.sxmr.2022.01.002.

ABSTRACT

INTRODUCTION: In Erectile dysfunction (ED) patients, phosphodiesterase type 5 (PDE5) inhibitors are considered as the first-line therapy. However, 30-50% of ED patients fail to follow this therapeutic option because of adverse events, lack of efficacy, or drug costs. Antioxidant supplementation is widely applied in clinical practice and viewed as a potential therapeutic option for ED. Therefore, it is attractive to assess the effect of antioxidants supplementation on ED patients.

OBJECTIVES: To evaluate the effects of antioxidants supplementation on ED.

METHODS: Published randomized controlled trials of antioxidants in ED were searched in the PubMed, Embase, and Cochrane Library databases from inception to October 3, 2021. Meta-analyses were carried out using a random-effects model. The results were presented as standard mean differences (SMDs) with their 95% confidence intervals (CIs).

RESULTS: Eighteen studies with 1,331 ED patients were included in the study. Compared with placebo, antioxidants alone treatment showed a statistical increase in International Index of Erectile Function (IIEF) score (SMD = 1.93; 95% CI: 0.15, 3.72; P = .034). Compared with placebo, antioxidants compound treatment elicited a significant increase in IIEF score (SMD = 2.74; 95% CI: 1.67, 3.81; P < .001) as well as sexual satisfaction score (SMD = 1.61; 95% CI: 0.63, 2.59; P = .001). Compared with the PDE5 inhibitors alone, combination of PDE5 inhibitors and antioxidants showed a significant increase in IIEF score (SMD = 1.1; 95% CI: 0.51, 1.68; P < .001) and sexual satisfaction score (SMD = 1.28; 95% CI: 0.06, 2.51; P = .04).

CONCLUSION: This study found that the effect of antioxidant alone treatment on ED may be limited. However, antioxidant compound treatment, as well as combination of PDE5 inhibitors and antioxidants, were associated with improved ED, and can be considered as an accessary therapeutic option for ED.

PMID:37051969 | DOI:10.1016/j.sxmr.2022.01.002

Sex Med Rev. 2022 Oct 1;10(4):782-790. doi: 10.1016/j.sxmr.2022.08.003.

ABSTRACT

INTRODUCTION: The efficacy, safety, and postoperative outcomes of synchronous surgery for concomitant erectile dysfunction (ED) and stress urinary incontinence (SUI) remain unclear.

OBJECTIVES: We performed a systematic review and meta-analysis to evaluate the available synchronous surgical approaches for concomitant ED and SUI and to assess the reoperation rates compared to asynchronous surgery and surgery only for ED or SUI.

METHODS: We searched PubMed, Cochrane Library, and Embase databases until June 2022 for relevant studies. Based on data availability, we performed a meta-analysis of odds ratios (ORs) comparing reoperation rates after synchronous surgery in patients with concomitant ED and SUI versus asynchronous surgery, as well as surgery solely for ED or SUI (PROSPERO: CRD42022326941).

RESULTS: We included 18 studies in the systematic review (16,517 patients) and 5 in the meta-analysis. Comparing synchronous implantation of penile prosthesis and artificial urinary sphincter (AUS) versus asynchronous surgery, no statistically significant differences were observed in the reoperation rates [OR:0.98, 95% confidence interval (CI): 0.52-1.84, I2:0%). Comparing synchronous implantation of both penile prosthesis and AUS versus implantation of only a penile prosthesis or an AUS, combined surgery was associated with higher reoperation rates (OR:2.02, 95%CI: 1.29-3.16, I2:36% and OR:1.7, 95%CI: 1.25-2.32, I2:0%, respectively). Synchronous surgery led to high satisfaction rates and significant improvement in ED and SUI. Evidence for the combination of penile prosthesis with a male sling or the ProACT device is low, but data suggests it may be safe and effective. The synchronous placement of a Mini-Jupette sling and penile prosthesis represents a promising treatment modality for the correction of ED and mild SUI and/or climacturia.

CONCLUSIONS: Synchronous penile prosthesis and AUS implantation appears safe and effective in patients with severe ED and SUI. Further high-quality studies are mandatory to strengthen the current scarce evidence for synchronous surgery in patients with ED and SUI.

PMID:37051965 | DOI:10.1016/j.sxmr.2022.08.003

Aesthet Surg J. 2023 Apr 13:sjad102. doi: 10.1093/asj/sjad102. Online ahead of print.

ABSTRACT

BACKGROUND: Processed lipoaspirate grafting describes several techniques theorized to leverage the inflammatory and regenerative capacities of mechanically processed adipocytes to rejuvenate and correct skin pathology. While lipoaspirate grafting is typically leveraged to fill visible defects such as depressed scars and dermal lines, additional fat processing allows grafts to stimulate mechanisms of wound healing, including the promotion of fibroblast activation, neovascularization, and neocollagenesis.

OBJECTIVES: This study intends to assess the efficacy and tolerability of processed lipoaspirate grafting monotherapy to improve the clinical appearance of atrophic acne scars.

METHODS: Subjects underwent a single autologous processed lipoaspirate grafting procedure at the site of atrophic acne scars. Objective and subjective scar analysis was performed at 3- and 6-months post-treatment. Scars were assessed via standard photography, topographic analysis, and noninvasive skin measurements. In addition, microbiopsies were obtained before and after treatment to assess histological or genetic changes. Clinical improvement was assessed using Subject and Clinician Global Aesthetic Improvement Scales (GAIS) and blinded photographic evaluation.

RESULTS: Ten subjects between ages 18 and 60 completed the study. Clinical evaluation demonstrated that fat grafting improved the appearance of atrophic acne scars. CGAIS and SGAIS score showed clinical improvement at both 3- and 6-month follow-up compared to baseline (p<.05) Blinded CGAIS scores also showed statistically significant improvement when clinicians compared clinical photographs taken at 6-month follow-up to baseline (p<.0001). Attenuation coefficient increased at 6-month follow-up suggesting collagen remodeling and reorganization over the study period. Subjects experienced anticipated post-treatment symptoms including transient erythema and edema; however, no unexpected adverse events were reported.

CONCLUSIONS: Micronized lipoaspirate injection is a viable and effective option to improve the appearance of facial acne scarring. Favorable improvements in atrophic acne scarring were captured by objective analysis of skin ultrastructure as well as improvement in subjective assessments of scarring.

PMID:37051925 | DOI:10.1093/asj/sjad102

Ir J Psychol Med. 2023 Apr 13:1-8. doi: 10.1017/ipm.2023.17. Online ahead of print.

ABSTRACT

OBJECTIVES: To examine if the COVID-19 pandemic is associated with a differential effect over a 2-year time period in relation to its psychological and social impact on patients with established anxiety disorders.

METHODS: Semi-structured interviews were conducted with 21 individuals attending the Galway-Roscommon Mental Health Services in Ireland with an ICD-10 diagnosis of an anxiety disorder. Interviews occurred at three time-points over a 2-year period to determine the impact of the COVID-19 pandemic and associated restrictions on anxiety and depressive symptoms, social and occupational functioning, and quality of life.

RESULTS: No statistical difference in symptomatology was noted between the three time-points in relation to anxiety symptoms as measured utilising psychometric rating scales (Beck Anxiety Inventory (BAI), Hamilton Anxiety Rating Scale (HARS) or Likert Scale measures). The greatest impact of COVID-19 at all time-points related to social functioning and quality of life. Significant variability was noted for individual participants. Qualitative analysis noted a tentative optimism for the future in the setting of vaccination and societal re-opening. Fear of re-emerging anxiety symptoms with the removal of societal restrictions was noted.

CONCLUSIONS: No significant overall change in symptomatology or functioning over time was noted for individuals with pre-existing anxiety disorders, however variability was demonstrated, with some individuals describing ongoing anxiety, social isolation and concern for their future. A strong theme of hope for the future and less concern regarding the COVID-19 pandemic was evident; however tailored supports including the utilisation of tele-psychiatry is suggested, particularly for those experiencing increased anxiety with the removal of societal restrictions.

PMID:37051901 | DOI:10.1017/ipm.2023.17

Otolaryngol Head Neck Surg. 2023 Apr 13. doi: 10.1002/ohn.348. Online ahead of print.

ABSTRACT

OBJECTIVE: The medial sural artery perforator (MSAP) flap has gained popularity in head and neck reconstruction primarily as a less morbid alternative to the radial forearm free flap (RFFF). However, no direct comparison of thickness exists among the MSAP, RFFF, and anterolateral thigh (ALT) flaps, which together represent the commonly utilized nonosseus-free flaps in head and neck reconstruction. Thus, this study aimed to compare these flap sites and identify predictors of thickness that will aid in reconstructive surgical planning.

STUDY DESIGN: Cross-sectional study.

SETTING: Tertiary referral hospital.

METHODS: The thickness of skin and subcutaneous tissue at the RFFF, MSAP, and ALT donor sites were measured in 54 adult patients using Doppler ultrasound. General linear models were generated to identify predictors of flap thickness.

RESULTS: The mean thickness of the RFFF, MSAP, and ALT flaps was 3.8 ± 2.2 mm, 7.4 ± 3.8 mm, and 9.6 ± 4.7 mm. Body mass index (BMI) was the only statistically significant contributing factor (p < .0001, coefficient: 0.15) for the RFFF. MSAP was affected by age (p = .006, coefficient = 0.06), female gender (p < .0001, coefficient = 3.2), and BMI (p < .001, coefficient = 0.25), while the ALT was affected by female gender (p = .0005, coefficient = 3.3) and BMI (p < .0001, coefficient = 0.35). Thus, the ratio of increase for flap thickness with respect to BMI is 3:5:7 for the RFFF, MSAP, and ALT flaps, respectively.

CONCLUSION: The MSAP is about twice the thickness of the RFFF and 2 mm thinner than the ALT; however, 22% of patients had thicker MSAP than ALT flaps. As the strongest predictors of flap thickness, female gender, and BMI may be taken into consideration during surgical planning for reconstruction.

PMID:37051889 | DOI:10.1002/ohn.348

Cogn Sci. 2023 Apr;47(4):e13262. doi: 10.1111/cogs.13262.

ABSTRACT

Humans can learn complex functional relationships between variables from small amounts of data. In doing so, they draw on prior expectations about the form of these relationships. In three experiments, we show that people learn to adjust these expectations through experience, learning about the likely forms of the functions they will encounter. Previous work has used Gaussian processes-a statistical framework that extends Bayesian nonparametric approaches to regression-to model human function learning. We build on this work, modeling the process of learning to learn functions as a form of hierarchical Bayesian inference about the Gaussian process hyperparameters.

PMID:37051879 | DOI:10.1111/cogs.13262

Bone Jt Open. 2023 Feb 21;4(2):110-119. doi: 10.1302/2633-1462.42.BJO-2022-0152.R1.

ABSTRACT

The aim of this study is to report the implant survival and factors associated with revision of total elbow arthroplasty (TEA) using data from the Dutch national registry. All TEAs recorded in the Dutch national registry between 2014 and 2020 were included. The Kaplan-Meier method was used for survival analysis, and a logistic regression model was used to assess the factors associated with revision. A total of 514 TEAs were included, of which 35 were revised. The five-year implant survival was 91%. Male sex, a higher BMI, and previous surgery to the same elbow showed a statistically significant association with revision (p < 0.036). Of the 35 revised implants, ten (29%) underwent a second revision. This study reports a five-year implant survival of TEA of 91%. Patient factors associated with revision are defined and can be used to optimize informed consent and shared decision-making. There was a high rate of secondary revisions.

PMID:37051858 | DOI:10.1302/2633-1462.42.BJO-2022-0152.R1