Tag: statistics

Niger J Clin Pract. 2022 Oct;25(10):1699-1703. doi: 10.4103/njcp.njcp_177_22.

ABSTRACT

BACKGROUND: Understanding the different skeletal relationships in orofacial clefts by using cone-beam computed tomography (CBCT) may eventually lead to developing better diagnosis and treatment protocols for facial deformities.

AIMS: The objective of this study was to investigate the different skeletal relationships in the cleft palate with or without cleft lip (CP ± L), using CBCT scans. This is a retrospective study conducted at the Orthodontics and Oral Radiology department, CMH-Lahore medical college and Institute of dentistry. In the current study, 4,152 CBCT scans (dcm format) were collected from a radiology center in Lahore, Pakistan between February 2015 and February 2018. All CBCT scans were imported to the Romexis Viewer, version 4.4.0 (Planmeca, Finland). Data sorting was performed to identify age, sex, cleft phenotype, unilateral cleft quadrant, sagittal skeletal relationship, and facial soft tissue involvement.

MATERIALS AND METHODS: Statistics were generated, using the Chi-square test. A P value <0.05 was considered statistically significant.

RESULTS: We identified 73 cases of CP ± L in the sample. The male-to-female ratio was 1.21:1. Bilateral cleft lip and palate (BCLP) mostly affected males (60%), whereas unilateral cleft lip and palate (UCLP) mainly affected females (57.6%), with a left-side female predominance. The different cleft phenotypes do not show any statistically significant difference regarding skeletal relationships and sex (P > 0.05).

CONCLUSIONS: Skeletal class III relationships were found to be predominant in both sexes, followed by class II, and class I skeletal relationships. Henceforth, such CP ± L patients should be pre-emptively screened in early life to avoid such skeletal complications.

PMID:36308242 | DOI:10.4103/njcp.njcp_177_22

Niger J Clin Pract. 2022 Oct;25(10):1693-1698. doi: 10.4103/njcp.njcp_173_22.

ABSTRACT

BACKGROUND: The optimal treatment for distal tibial fractures remains a matter of debate. Nonetheless, plate osteosynthesis produces favorable results to intramedullary stabilization in aspects of alignment restoration.

AIM: The aim of the study was to compare the radiologic and clinical outcomes of distal metadiaphyseal tibial fracture between a simple/wedge fracture (SWF) and a comminuted fracture (CF) using minimally invasive plate osteosynthesis (MIPO).

PATIENTS AND METHODS: This retrospective study analyzed patients with SWF or CF of the distal tibial metadiaphysis that was surgically treated with a locking compression plate. Postoperative radiographic assessments and the time to radiologic union were noted. Clinical assessments were evaluated using both the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the foot function index (FFI). Postoperative complications were documented.

RESULTS: Seventy-one cases were analyzed over a mean follow-up period of 20.9 months. Thirty-six patients had SWF and 35 patients presented with CF. The mean time to radiologic union, amounts of postoperative coronal angulation, and incidence of malunion showed no statistical differences. Fibular fixation was more applied in the CF group (P < 0.001). Moreover, the clinical scores revealed no differences. Nonetheless, in the valgus union group, the AOFAS ankle-hindfoot score was 90.9 compared to 84.1 in the varus union group (P = 0.042) and the FFI was 9.2% compared to 20.2% in the varus union group (P = 0.017).

CONCLUSION: Plate osteosynthesis for SWF or CF of the distal tibial metadiaphysis led to high union rates and good clinical outcomes. There was no significant difference in the radiologic and clinical results according to the presence of fracture comminution. Nonetheless, the valgus union group showed better clinical outcomes than the varus union group. Clinically, it would be preferred to avoid intraoperative varus reduction.

PMID:36308241 | DOI:10.4103/njcp.njcp_173_22

Niger J Clin Pract. 2022 Oct;25(10):1681-1686. doi: 10.4103/njcp.njcp_71_22.

ABSTRACT

BACKGROUND: In a pulpectomy, the eradication of microbes from the primary root canal is accomplished through biomechanical preparation, which could be carried out with either manual or rotary instruments.

AIMS: The objective of this clinical trial was to evaluate the efficiency of manual K-files, H-files, and Kedo-S Square rotary files in reducing microbial flora after canal preparation in primary molars.

MATERIALS AND METHODS: This randomized clinical trial consisted of 45 primary molars requiring pulpectomy. The teeth were randomly allocated to one of the three groups: Group I: Manual K-files, Group II: Manual H-files, and Group III: Kedo-S Square rotary files, based on the type of instrumentation. Pre-and Post-instrumentation sampling was performed using clean absorbent paper points and kept in a clean Eppendorf tube having thioglycolate broth as the transport medium. Culturing was performed on agar media from which both aerobic and anaerobic microbial counts were estimated. Collected data were statistically analyzed using one-way analysis of variance (ANOVA) and Wilcoxon signed-rank test. Following root canal preparation, 87-89% reduction of the aerobic and anaerobic microbial load was noted in group I, whereas it was an 89-92% reduction in group II and a 93-95% reduction in group III.

RESULTS: Biomechanical preparation with Kedo-S Square rotary file showed higher efficacy in microbial reduction compared to manual instrumentation.

CONCLUSION: Manual and rotary files were equally effective in removing root canal microbes. Biomechanical preparation with a KedoS Square rotary file resulted in greater microbial efficacy. Hence In children, effective root canal cleaning in a short period of time is a major consideration.

PMID:36308239 | DOI:10.4103/njcp.njcp_71_22

Niger J Clin Pract. 2022 Oct;25(10):1674-1680. doi: 10.4103/njcp.njcp_2050_21.

ABSTRACT

BACKGROUND: The hyperdense middle cerebral artery sign (HMCAS) on admission non-contrast computed tomography (NCCT) is a well-characterized phenomenon in acute ischemic stroke.

AIM: The purpose of this study is to determine the impact of HMCAS on the outcome of patients who underwent endovascular thrombectomy.

MATERIALS AND METHODS: A retrospective analysis of a prospectively collective database included 136 consecutive patients with anterior circulation acute ischemic stroke who underwent endovascular thrombectomy. We collected the demographics, and clinical and brain imaging as well as functional and imaging outcomes data at baseline. Patients were divided into two groups with hyperdense artery sign and those without the sign. The difference between the two groups in terms of mortality and prognosis was analyzed.

RESULTS: There were 136 patients, 50.7% of them were women. The mean age was 59.1 years. The subgroup with HMCAS present consisted of 93 patients. There were no differences in demographics and clinical characteristics between the two groups; however, tobacco use is more common in patients with HMCAS. No significant difference was observed in clinical outcomes and mortality between the two groups at 3 months. Patients with HMCAS had statistically more new territory emboli during the procedure (9.7%) compared to patients without HMCAS.

CONCLUSION: We showed that the presence of HMCAS in initial CT was not helpful in predicting good clinical outcomes in patients undergoing endovascular therapy patients. However, the presence of HMCAS is related to more new territory embolism during the procedure. Different endovascular strategies may be applied to these patients.

PMID:36308238 | DOI:10.4103/njcp.njcp_2050_21

Niger J Clin Pract. 2022 Oct;25(10):1666-1673. doi: 10.4103/njcp.njcp_2047_21.

ABSTRACT

BACKGROUND: The tooth movements were generally analyzed in two dimensions on cephalometric radiographs. Nowaday, 3D digital model analysis, which does not have any harmful effects on patients, can be used to evaluate the palatal morphology and coronal tooth movements in a very comfortable and easy way.

AIMS: To investigate the effect of palatal morphology on anchorage reinforcement during intraoral molar distalization with pendulum appliance using 3D model analysis.

MATERIALS AND METHODS: The material consisted of before (T0) and after (T1) dental plaster models of Class II malocclusion patients (17 females, 3 males) treated with pendulum appliance for molar distalization and Nance appliance for anchorage. T0 and T1 digital models were superimposed using the palatal area as a reference via three points and surface-matching software, and the changes in teeth movement were calculated for left and right central incisors, first premolars, and first and second molars. Palatal morphology was evaluated at T0 on digital models as palatal inclination, palatal depth angles, and anterior hard palate area. Wilcoxon test was used to evaluate the treatment results and Spearman’s correlation analysis was performed to evaluate the relationship between palatal morphology and dental movement. The upper limit for the level of significance was taken as 0.05.

RESULTS: Mesial movement of first premolars and distal movement of first and second molars were found to be statistically significant (P < 0.001). A weak negative correlation was found between the palatal inclination and the movement of first premolars (P < 0.045 and P < 0.003). Palatal depth angles and anterior hard palate area had no correlation with dental movements.

CONCLUSION: Presented results supported that the mesial movement of premolar teeth decreased as the inclination of the palate increased.

PMID:36308237 | DOI:10.4103/njcp.njcp_2047_21

Niger J Clin Pract. 2022 Oct;25(10):1647-1653. doi: 10.4103/njcp.njcp_1684_21.

ABSTRACT

BACKGROUND: Most educational institutions in Nigeria were shut down for a long while at the onset of the COVID-19 pandemic as a preventive measure, and this affected dental students’ academic and clinical training.

AIM: To determine the influence of the pandemic on the academic, clinical training, and psychosocial well-being of dental students in Nigeria.

SUBJECTS AND METHODS: This cross-sectional survey was conducted among undergraduate dental students in clinical years in Nigerian dental schools. Participants received the questionnaire through an online platform, it had four sections; socio-demographics, impact on academic training, psychosocial well-being, and an open-ended segment for participants’ suggestions to challenges. A mixed method was utilized to analyze the data. The statistical significance level was P < 0.05.

RESULTS: One hundred two dental students from nine dental schools participated, with a mean age of 25.3 ± 2.4 years. There were 56 (54.9%) males. Most students, 80 (78.4%) reported that their stay-at-home had not been rewarding academically. The majority, 90 (88.2%) were worried about contracting COVID-19 on school resumption. Participants’ psychosocial well-being had significant associations with gender (P = 0.001) and self-directed learning during their stay-at-home (P = 0.001). More female students, 33 (71.7%) were severely worried compared to males 20 (35.7%). Their major suggestions were to commence online teaching and examinations (40.1%) and be provided with adequate personal protective equipment (18.6%).

CONCLUSION: Most undergraduate students in Nigeria were anxious about COVID-19, and females were more affected. This negatively impacted their academic and clinical training. This underscores the importance of adequate psychological support for undergraduate dental students by school authorities.

PMID:36308234 | DOI:10.4103/njcp.njcp_1684_21

Niger J Clin Pract. 2022 Oct;25(10):1635-1640. doi: 10.4103/njcp.njcp_1371_21.

ABSTRACT

BACKGROUND: Congenital diaphragmatic hernia (CDH) is an anomaly with significant morbidity in neonates. It has been traditionally managed by an open approach with a recent trend toward a minimally invasive approach.

AIM: This is a retrospective study of our institutional experience with neonatal thoracoscopic management of CDH, with the impact of few technical nuances.

PATIENTS AND METHODS: The data was collected on neonatal thoracoscopic CDH repair between January 2015 and December 2018, in terms of the demographics, intra-operative parameters, post-operative status, recurrence, and mortality. While analyzing data, we found few technical modifications adopted by the surgeon such as trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO₂, maximal use of muscle relaxant, extra-corporeal corner hitch stitch at some point, and continuation for further cases. An internal comparison was made to analyze the technical modifications influencing the outcomes, by dividing them into two groups, those with (group A) and without modifications (group B). The data was analyzed using SPSS software (IBM, Version 23). A P value of <0.05 was considered statistically significant.

RESULTS: Out of 45 newborns 64.4% were males with an average birth weight of 2.6 kg. Baseline variables were comparable between the groups. The operating time significantly reduced after a higher-level camera port was used (P-value: 0.0001). The mean follow-up was 30.8 months. There were totally seven recurrences (6 in group A and 1 in group B), all within 12 months. Seven parents gave the overall post-treatment feedback as “unsatisfied”. The operating time, recurrence rate, and parental satisfaction feedback were significantly less in group B (P-value: 0.001).

CONCLUSION: We recommend trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO₂, maximal use of muscle relaxant, extra-corporeal corner hitch stitch to reduce the operating time, and recurrence after thoracoscopic CDH repair.

PMID:36308232 | DOI:10.4103/njcp.njcp_1371_21

Niger J Clin Pract. 2022 Oct;25(10):1624-1628. doi: 10.4103/njcp.njcp_63_21.

ABSTRACT

BACKGROUND: Renal angiomyolipoma is the commonest benign solid kidney neoplasm though rare in clinical practice. The advent of radiological imaging techniques, refinement in surgical approach and techniques and availability of mammalian target of rapamycin have improved the outcome in these cohort of patients.

AIM: To report our experience with the surgical management of renal angiomyolipoma in the sub-Saharan Africa.

PATIENTS AND METHODS: This was a retrospective review of the records in the operating theatre book of urology division of patients who underwent radical nephrectomy over a 7-year-period (January 2013 to December 2019). The histologically confirmed renal angiomyolipoma information were retrieved from the records in the Department of Pathology. The clinical data were obtained from the patients’ case files by identifying the patient with their registration number and not their names. The clinical features, investigations done, treatment offered, and the outcome of management were recorded in an SPSS version 20. The data was analyzed using statistics of central tendency and percentage.

RESULTS: Only 3 females with symptomatic renal angiomyolipoma were managed. This represented 4.9% of 61 patients with solid renal masses managed in the study period. The mean age was 51.2 (ranged 40-70) years. The mean tumor size was 18.9 cm. All the patients underwent radical nephrectomy. The pre- and postoperative urea and creatinine remained normal. The median follow-up period was 21 (16.5-30) months and were asymptomatic.

CONCLUSION: The incidence of renal angiomyolipoma among solid renal masses is 4.9% in our environment. Open radical nephrectomy is still the preferred method of treatment with satisfactory outcome.

PMID:36308230 | DOI:10.4103/njcp.njcp_63_21

Indian J Pathol Microbiol. 2022 Oct-Dec;65(4):873-878. doi: 10.4103/ijpm.ijpm_1475_20.

ABSTRACT

BACKGROUND: For the management of connective tissue disorders (CTDs), antinuclear antibody (ANA) testing is essential, both from diagnostic and prognostic points of view. Usually, patterns obtained by ANA-IIF testing correlates to specific autoantibodies as obtained from the test for ENA (by LIA/ELISA, etc.). But to apply these data from western studies, we may need validation in the local population like our subjects in sub-Himalayan (Garhwal region) area where CTDs are common. Also, suppose ANA-IFA pattern’s correlation is reliably known in our population, it can minimize the cost of managing CTDs by limiting ENA testing, which is 10 times costlier than ANA-IIF. Hence, this study was undertaken to know the specific autoantibody targets (ENA by LIA) against ANA-IIF patterns in our local population.

MATERIALS AND METHODS: In this retrospective cross-sectional work, serum samples of CTDs were tested for ANA by IIF (Euroimmune AG) and ENA by LIA (Euroline ANA-3G) continuously for 36 months. The manufacturer’s kit insert was followed, and results were analyzed applying appropriate statistical methods.

RESULTS: Major ANA-IIF patterns were found to be associated with specific autoantibodies, for example, Nuclear homogenous with dsDNA, nucleosomes, histones; speckled pattern with nRNP/Sm, Sm, SSA/Ro-52, SSB; nucleolar pattern with Scl-70, Pm-Scl 100 and centromere pattern with CENP-B. Anticytoplasmic (ACA) are found to be linked with some ANA negative (by IIF) samples, emphasizing the need for careful observation for ACA especially where ANA is not found.

CONCLUSIONS: In most subjects, specific ENA targets correlated well with ANA-IIF patterns, implying effective cost minimization in CTD management. Similar future prospective studies (with clinical data) can provide a database and reference for our population.

PMID:36308197 | DOI:10.4103/ijpm.ijpm_1475_20

Indian J Pathol Microbiol. 2022 Oct-Dec;65(4):856-859. doi: 10.4103/ijpm.ijpm_223_21.

ABSTRACT

OBJECTIVES: CD47 is a membrane protein that belongs to the immunoglobulin superfamily and regulates macrophage phagocytosis negatively. As CD47 expression at the cancer cell membrane would inhibit the phagocytic activity of immune cells, it is connected to an unfavorable prognosis in leukemia and malignancies of various solid organs. Materials and.

METHODS: In this study, retrospectively evaluated 72 patients who had been diagnosed with endometrial carcinoma at Pathology Department and had undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO) and/or lymphadenectomy. CD47 expression was evaluated in tumorous and nontumor areas in all patients considering cytoplasmic and membranous brown staining in cells. The proportion of expression was evaluated as well as the intensity and an “h score” was obtained. This score was compared with known prognostic parameters.

RESULTS: CD47 expressions showed a statistically significant correlation with tumor grade (P < 0.05); however, no significant relationship was observed with myometrial invasion depth and lymph vascular invasion status (P = 0.923 and P = 0.754, respectively).

CONCLUSIONS: As with other tumors, anti-CD47 antibody may be an alternative treatment option in patients with high-grade endometrial carcinoma.

PMID:36308193 | DOI:10.4103/ijpm.ijpm_223_21