Tag: statistics

J Nepal Health Res Counc. 2023 Mar 9;20(3):672-676. doi: 10.33314/jnhrc.v20i3.4070.

ABSTRACT

BACKGROUND: Acne causes significant impairment in the quality of life of patients, but clinicians in Nepal lack a simple validated tool to measure the psychological side of acne. We planned to translate and validate Cardiff Acne Disability Index, a five item questionnaire into Nepali language to address this need.

METHODS: A linguistic translation with semantic equivalence to the original English language Cardiff Acne Disability Index was achieved through standard forward and backward translation into Nepali language. All eligible patients were requested to fill the Nepali translated version of both Cardiff Acne Disability Index and Dermatology Life Quality Index questionnaires. Reliability and validity of the newly translated questionnaire were established, based on statistical analyses of factor structure, item correlations and concurrent correlations.

RESULTS: This validity study included 94 patients with male: female ratio of 1:3.27 and mean age 21.29 (±3.92) years. Reliability analysis revealed a Cronbach’s alpha of .72 and mean inter item correlation coefficient of .337. A single factor was extracted on Principal Component Analysis explaining 48.40% of variance. A strong correlation of Cardiff Acne Disability Index scores to the Dermatology Life quality Index score (rs>.7) indicated good concurrent validity.

CONCLUSIONS: The newly translated Nepali Cardiff Acne Disability Index is a valid tool to measure the impact of acne in Nepalese patients. This short and simple assessment tool will help clinicians understand the patient’s perspective of her acne.

PMID:36974855 | DOI:10.33314/jnhrc.v20i3.4070

J Nepal Health Res Counc. 2023 Mar 9;20(3):659-663. doi: 10.33314/jnhrc.v20i3.4283.

ABSTRACT

BACKGROUND: Left Ventricular Diastolic Dysfunction is considered a critical link between hypertension and heart failure, particularly in individuals with heart failure and preserved ejection fraction. The aim of this study is to assess the prevalence and factors associated with clinical parameters of left ventricular diastolic dysfunction in patients with essential hypertension.

METHODS: A hospital-based cross-sectional study was done among 68 newly diagnosed and known hypertensive patients visiting out patientdepartmentat Bir hospital. Patients who meet the inclusion criteria were chosen alternatively by referring OPD register. Patients with hypertension had undergone echocardiography to see whether left ventricular diastolic dysfunction was present and was compared to other clinical parameters like age, sex, body mass index, and dyslipidemia using the student t-test/chi-square test.

RESULTS: The prevalence of left ventricular diastolic dysfunction in essential hypertensive patients was 33.8%. About 25% patients had grade 1; 7.4% and 1.5% of patients had grade 2 and grade 3 diastolic dysfunction respectively. Patients who had a duration of hypertension of more than five years were more than nine times (OR 9.14; 2.89-28.87) more likely to have Left ventricular diastolic dysfunction. Age and Body Mass Index were found statistically significant with diastolic dysfunction (P<0.05).

CONCLUSIONS: Left ventricular diastolic dysfunction was found prevalent in hypertensive patients. Age, Body mass index, Dyslipidemia and Duration of hypertension were found to be statistically significant with diastolic dysfunction Keywords: Diastolic dysfunction; hypertension; Nepal; prevalence.

PMID:36974853 | DOI:10.33314/jnhrc.v20i3.4283

J Nepal Health Res Counc. 2023 Mar 9;20(3):653-658. doi: 10.33314/jnhrc.v20i3.3774.

ABSTRACT

BACKGROUND: We did this study to evaluate the prevalence of low birth weight among deliveries, adolescent pregnancy and advanced maternal age pregnancy. We also assessed the factors affecting the low birth weight among institutional deliveries at the level of primary hospital.

METHODS: A hospital-based retrospective cross-sectional study was done in Grahun Primary Hospital of Syangja, Nepal using data maintained in register book over last five years. We excluded all those deliveries with multiple pregnancy and incomplete records, and included 2473 participants in final analysis using convenient sampling. The relevant information was filled up in Microsoft Excel 2019 v16.0 and descriptive and inferential statistics was calculated using statistical package for social sciences, IBM SPSS® v21 (IBM, Armonk, New York).

RESULTS: The prevalence of low birth weight at Grahun Primary Hospital was 11.08%. The prevalence of adolescent pregnancy and advanced maternal age pregnancy was 18.03% and 02.18% respectively. Male newborns had significantly higher mean birth weight as compared to the female newborns (3101.48 ± 506.60 v/s 2967.53 ± 484.97, P-value <0.001). Female newborns had higher odds of low birth weight as compared to those male newborns (11.99% v/s 8.29%, AOR=1.56, 95% CI= 1.17-2.07). Pregnant women with lower gestational age (<37 weeks or preterm) had a higher odds of low birth weight as compared to pregnant women with normal gestational age (37-42 weeks) (AOR = 11.59, 95% CI 8.49-15.83).

CONCLUSIONS: The low birth weight depends upon gestational age of mother and gender of newborn. Local organizations should work to bring down low birth weight, and adolescent pregnancy and advanced maternal age pregnancy of mother.

PMID:36974852 | DOI:10.33314/jnhrc.v20i3.3774

J Nepal Health Res Counc. 2023 Mar 9;20(3):623-629. doi: 10.33314/jnhrc.v20i3.3968.

ABSTRACT

BACKGROUND: Nurses play a vital role to handle the situation in the care of the patients especially for prioritizing and managing care of pain. Nursing competency attributes personal characteristics, professional attitude, values, knowledge and skills to demonstrate professional responsibility through practices. Nursing competency helps to provide high quality essential care to the patients at a right time. This study aimed to explore pain management competency and its associated factors among nurses in a tertiary hospital, Nepal.

METHODS: A cross- sectional survey with correlational predictive design was conducted with 203 staff nurses who had work experience related to pain for more than two months at Tribhuvan University Teaching Hospital in Nepal. They were working in medical, surgical, gynecology and obstetrics, pediatric and neonatal, emergency and intensive care departments. The participants were selected from inpatient departments by convenience sampling technique from December 2020 to February 2021. SPSS 18.0 version was used for data entry and analysis using descriptive statistics, chi-square and logistic regression. Significant factors reported at P<0.05.

RESULTS: In total participants, 67.5% of nurses were competent on pain management. Work experience [OR= 0.426 (95% CI: 0.205-0.887)] could significantly predict on nurses’ competency for pain management. However, there was no significant association educational level, working unit, nurse-physician relationship, and training on nurses’ competency.

CONCLUSIONS: Based on the findings, two third (67.5%) nurses are competent on pain management and work experience is a factor contributed to the nurses’ competency for pain management, the researcher recommends nurses with lower work experience should provide pre-service training on pain management.

PMID:36974848 | DOI:10.33314/jnhrc.v20i3.3968

J Nepal Health Res Counc. 2023 Mar 9;20(3):605-610. doi: 10.33314/jnhrc.v20i3.4311.

ABSTRACT

BACKGROUND: The age estimation of the individual by the forensic experts ascertains the chronological age of an individual. The possibility that the person being examined may be younger or older than a certain age threshold makes this process crucial, as it will establish whether or not the person is an adult under the law. The aim of this study was to test the applicability of the London Atlas of tooth development and eruption in Nepalese subset population.

METHODS: The London Atlas for age estimation was tested in 350 digital panoramic radiographs from the patients between four and twenty-four years visiting Tribhuvan University Teaching Hospital, Institute of Medicine, Nepal.

RESULTS: The mean values of the estimated age were higher in both the sexes, which was statistically not significant. Both the sexes showed an excellent positive correlation, and was significant with a p value of <0.001. The age estimation upto 10 years group classification was nearly accurate with less than 1 and 2.5 years variation in males and females respectively. The accuracy was good in 16-18 years group with maximum deviation of ±2.5 years. The accuracy was poor in more than 18 years group, as the variability was more than 5 years.

CONCLUSIONS: The London Atlas method was best suited for less than 18 years of age and was not very accurate in the age group of 13-14 and 14-15 years where most of the polymorphisms were noted.

PMID:36974845 | DOI:10.33314/jnhrc.v20i3.4311

J Nepal Health Res Counc. 2023 Mar 9;20(3):599-604. doi: 10.33314/jnhrc.v20i3.4153.

ABSTRACT

BACKGROUND: Every year, millions of children around the world face sexual abuse and exploitation. Sexual and reproductive health education is an important form of health promotion action against it. This study aims to assess the impact of health education program in improving knowledge of the children on child sexual abuse.

METHODS: A school based pre-experimental study was done among 120 lower secondary level students of a private school in Bharatpur municipality of Chitwan District, Nepal during March 2021. An interventional health education program imparting knowledge on child sexual abuse and its preventive measures was given to the children. Their knowledge was assessed and compared before and after intervention using paired t-test. Data analysis was done using SPSS version 17 software.

RESULTS: The mean age of children was 13.77±0.65 years with 1:1.18 girls to boys ratio. The level of knowledge of the children on child sexual abuse and its preventive measures increased significantly post-intervention as compared to pre-intervention. The mean scores of post-test (29.80±4.53) was higher than pre-test (17.04±6.96). The intervention was proved effective with statistically significant t-test values (t=20.996, p=<0.001). About 6.7% children disclosed an experience of child abuse post-intervention.

CONCLUSIONS: The school based health education program effectively increased the knowledge of the children on child sexual abuse, thus helping in preventing and protecting them from child sexual abuse and its harmful effects.

PMID:36974844 | DOI:10.33314/jnhrc.v20i3.4153

Anticancer Res. 2023 Apr;43(4):1675-1680. doi: 10.21873/anticanres.16319.

ABSTRACT

BACKGROUND/AIM: Serum thymidine kinase 1 (STK1) is a proliferation biomarker that has been used as a diagnostic marker of several malignant diseases. However, there are limited data for prostate cancer (PCa).

PATIENTS AND METHODS: In this study, we retrospectively analysed serum samples from 169 patients with biopsy confirmed PCa, who had been indicated for radical prostatectomy (RP) between 2013-2016. The results were compared with those in serum samples from 39 healthy men. We used commercially available enzymatic immunoassay to determine the levels of STK1. The patients were divided into groups according to the Gleason score (GS) and risk factors for adjuvant radiotherapy (aRT), which were defined as GS 8-10, pT3, and a positive surgical margin.

RESULTS: The median serum level of STK1 in PCa patients was 0.289 pmol/l. In the control group, the median value was 0.0116 pmol/l (p<0.001). By comparing the patients with GS≤6 vs. 7 vs. ≥8 (p=0.01), we found statistically significant differences. In the correlation of STK1 values with risk factors, we found statistically significant differences both in comparison of 0 vs. 1 vs. 2 vs. 3 risk factors (p=0.021), as well as ≤1 vs. 2≥ risk factors (p=0.009).

CONCLUSION: The levels of STK1 are significantly higher in patients with PCa than those in healthy controls. Furthermore, STK1 values correlate with GS and predefined risk factors for aRT. Therefore, STK1 can be considered as a potential tumour marker of PCa diagnosis and risk stratification.

PMID:36974824 | DOI:10.21873/anticanres.16319

Anticancer Res. 2023 Apr;43(4):1449-1454. doi: 10.21873/anticanres.16293.

ABSTRACT

BACKGROUND/AIM: Loss of differentiation of breast cancer cells in association with a down-regulated class I human leukocyte antigen (HLA) expression can lead to proliferation unhampered by cytotoxic T lymphocytes, which has been proven to be of prognostic relevance. The objective of this study was to determine the levels of HLA-A and HLA-B/C expression in metastatic breast cancer (MBC) cells and their usefulness for predicting 5-year survival.

MATERIALS AND METHODS: This prospective double-blinded cohort study analyzed patients starting a new line of therapy for MBC. RT-qPCR was used to determine the levels of HLA-A and B/C expression in MBC cells and the mRNA-based tumor intrinsic subtype. Two receiver operating characteristic curves (ROC) were constructed in order to determine whether HLA-A and HLA-B/C expression levels can be used for predicting 5-year survival. Youden J points, and sensitivity and specificity optimized cut-off points were determined for both ROC curves.

RESULTS: We enrolled 34 patients. The ROC curve for HLA-B/C had the highest AUC compared to HLA-A (0.55 vs. 0.42). High levels of HLA-A and HLA-B/C expression (40-ΔΔCT of 33.5 and 31.9, respectively) were highly specific (reaching 87.5% for HLA-A and even 100% specificity for HLA-B/C) yet insensitive for five-year survival in our study.

CONCLUSION: High expression of certain class I HLA molecule subtypes by MBCs, in particular high HLA-A or B/C expression by MBC cells seems very specific in predicting the 5-year survival. We determined cut-off values for these HLA molecule clusters with high specificity, which might help identify patients with a favorable prognosis as prognosticators of a 5-year overall survival if their sensitivity is improved in larger prospective cohorts.

PMID:36974778 | DOI:10.21873/anticanres.16293

Anticancer Res. 2023 Apr;43(4):1681-1688. doi: 10.21873/anticanres.16320.

ABSTRACT

BACKGROUND/AIM: This study aimed to assess the effectiveness and safety of nivolumab versus cetuximab in patients with Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck (R/M HNSCC), as well as to analyze possible prognostic factors for response to treatment with nivolumab.

PATIENTS AND METHODS: We conducted an observational, retrospective, descriptive study of patients with R/M HNSCC who initiated treatment with nivolumab or cetuximab monotherapy in two periods of equivalent duration. Overall efficacy was measured in terms of progression-free survival (PFS) and overall survival (OS). Safety was evaluated using the Common Terminology Criteria for Adverse Events classification version 5.0 of the National Cancer Institute.

RESULTS: Median OS was 9.1 months with nivolumab (n=34) and 6.3 months with cetuximab (n=12). PFS was 4.3 months for nivolumab and 4.65 months for cetuximab. Any grade adverse events (AEs) were reported in 97% and 100% of the patients treated with nivolumab and cetuximab. Serious AEs were observed in 26% and 58% of the patients, respectively. Elevated albumin values, lymphocytosis, neutropenia, and elevated neutrophil/lymphocyte ratio values were found to have positive prognostic value on the response to nivolumab in R/M HNSCC.

CONCLUSION: Effectiveness of nivolumab in terms of OS remains superior to cetuximab. OS, PFS and severe or any grade AEs were superior in both arms of our study compared to those in clinical trials. The AEs profile of nivolumab differed in our study from that in the clinical trials’ observations. We have identified four statistically significant prognostic variables on the response to nivolumab in R/M HNSCC.

PMID:36974777 | DOI:10.21873/anticanres.16320

J Small Anim Pract. 2023 Mar 27. doi: 10.1111/jsap.13604. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the accuracy and interobserver agreement of tele-ultrasonography for the diagnosis of gastrointestinal obstruction in small animals by radiologists with different levels of experience.

MATERIALS AND METHODS: A retrospective cross-sectional study including dogs and cats admitted with gastrointestinal signs, between 2017 and 2019, that had abdominal ultrasonographic (US) examination performed and images saved for review. Patients were classified into two categories based on final diagnosis: animals with or without complete or partial gastrointestinal obstruction. Observers with four experience levels interpreted the archived ultrasound examinations, simulating a tele-ultrasonography consultation. Analyses of accuracy, sensitivity, specificity, positive and negative predictive values were obtained for each observer for detection of gastrointestinal obstruction. Agreement between observers for the gastrointestinal obstruction diagnosis was assessed using Fleiss’s Kappa statistics.

RESULTS: Ninety patients with gastrointestinal signs were included. Of these, 23 of 90 had partial or complete gastrointestinal obstruction. Interpretation of the images by observers via tele-ultrasonography showed intervals of accuracy, sensitivity, specificity, positive and negative predictive values, respectively, of 78.9% to 87.8%, 73.9% to 100%, 77.6% to 89.6%, 55.9% to 70.8% and 90.9% to 100% for diagnosis of gastrointestinal obstruction. Agreement for the gastrointestinal obstruction diagnosis across all reviewers was moderate (Kappa 0.6).

CLINICAL SIGNIFICANCE: Tele-ultrasonography had good accuracy for detection of gastrointestinal obstruction, however had a rather low positive predictive value and only moderate interobserver agreement. Therefore, this technique should be used with caution in this clinical context, given the potential surgical decision at hand.

PMID:36973863 | DOI:10.1111/jsap.13604