Tag: statistics

Ann Afr Med. 2021 Jan-Mar;20(1):14-18. doi: 10.4103/aam.aam_7_20.

ABSTRACT

CONTEXT: Urological diseases vary from one geographical location to another worldwide. The knowledge of their distribution in each location could determine local workforce and facility needs and as well guide the areas of subspecialization.

AIMS: The aim of this study is to document the annual frequency and distribution of urological diseases at the Usmanu Danfodiyo University Teaching Hospital, Sokoto.

SETTINGS AND DESIGN: A cross-sectional retrospective study from January 2016 to December 2016 of all new patients seen at the urology outpatient clinic, emergency department as well as inpatient referrals from other departments of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

MATERIALS AND METHODS: The relevant records were extracted from the patient’s case notes and entered into a semistructured questionnaire.

STATISTICAL ANALYSIS USED: Data were analyzed using the SPSS software version 20.

RESULTS: A total of 607 new patients were seen over the study period. There were 576 (94.9%) males and 31 (5.1%) females, with a male-to-female ratio of 18.6:1. The median age was 45 years, with age range of 1-106 years. Urological emergencies were seen in 35.0% patients. Ninety-one percent of cases were acquired, whereas 8.2% were of congenital etiology. Overall, the most commonly diagnosed urologic diseases among new patients in order of decreasing frequency were benign prostatic enlargement (BPE) (18.6%), bladder tumor (11.8%), upper tract urinary calculi (10.3%), urethral stricture (8.9%), and prostate adenocarcinoma (7.4%).

CONCLUSIONS: BPE, bladder tumor, upper tract urinary calculi, urethral stricture, and prostate adenocarcinoma are common in our environment. Knowledge of these diseases distribution may guide service expansion and workforce needs, inspire subspecialization as well as direct research and government policy in this community. Nongovernmental organizations wanting to have impact will be suitably directed.

PMID:33727506 | DOI:10.4103/aam.aam_7_20

Ann Afr Med. 2021 Jan-Mar;20(1):31-36. doi: 10.4103/aam.aam_11_20.

ABSTRACT

BACKGROUND: Currently, the main goal for the use of tocolytic therapy is to delay the birth so as to allow the use of corticosteroids for accelerating fetal lung maturity and maternal transfer to a tertiary care center and thereby reducing neonatal morbidity and mortality.

AIMS AND OBJECTIVES: The aims amd objectives were to compare the safety and efficacy of transdermal nitroglycerine patch with oral nifedipine as a tocolytic agent to arrest preterm labor and prevent preterm birth.

MATERIALS AND METHODS: Based on the selection criteria, 50 patients were selected randomly in Group A and Group B. Group A women were given transdermal nitroglycerin patch, which delivered 10 mg Nitroglycerin (NTG) over 24 h and it was applied to the woman’s abdomen followed by another patch of 10 mg after 1 h if contractions persisted. After 24 h, it was replaced by a fresh patch. Group B women were given an oral loading dose of nifedipine 20 mg followed by a similar dose if contractions persisted after 1 h. A maintenance dose of 10 mg thrice daily was given if contractions were suppressed. Patients were monitored from the time of admission to the time of discharge.

RESULTS: The mean duration of prolongation of pregnancy in Group B (3.68 ± 1.91 days) was significantly more than Group A (2.78 ± 1.39 days). Headache was seen significantly more in Group A (42%) than group B (6%). Tachycardia, hypotension, and palpitation showed no statistically significant difference between them. There was no statistically significant difference in the birth weight of the babies in both the groups.

CONCLUSION: Nifedipine is a safe and effective drug in prolonging preterm labor and has minimal maternal and neonatal side effects.

PMID:33727509 | DOI:10.4103/aam.aam_11_20

Indian J Ophthalmol. 2021 Apr;69(4):871-875. doi: 10.4103/ijo.IJO_1390_20.

ABSTRACT

PURPOSE: To study the agreement of findings of glaucoma screening between trained vision center (VC) technicians and glaucoma specialists in patients referred from VC to the glaucoma services of a tertiary eye care hospital in south India.

METHODS: This was a retrospective study comparing the findings of the VC technicians and the specialists of the glaucoma services in the base hospital, in patients referred from 13 VCs between January and June 2019. Medical records of 277 referred patients (out of 533 referrals) who attended the glaucoma clinic were analyzed.

RESULTS: Of the 277 patients, 111 (40%) were confirmed having glaucoma, 133 (48%) were suspects, 29 (10.4%) were normal, and four (1.4%) had other pathology. The mean age of the patients was 59.7 ± 13 years and 60.6% were females. There was no statistically significant difference between the mean intraocular pressure (IOP) measured (17 ± 7.2 mmHg at the VC and 18 ± 8.7 mmHg at the clinic, p = 0.16) and the cup-to-disc ratio (CDR) (0.7 ± 0.13 at the VC and 0.6 ± 0.18 at the clinic, p = 0.57). Bland-Altman plots with 95% limits of agreement supported that mean differences were close to zero, and the intraclass correlation coefficient at 95% CI showed good consistency between the measurement of IOP (0.78 [0.74 to 0.81]) and CDR (0.90 [0.88 to 0.92]) at the base hospital and vision center.

CONCLUSION: There is good agreement between the findings of VC technicians and glaucoma specialists. VC technicians can help in detecting glaucoma in the community.

PMID:33727450 | DOI:10.4103/ijo.IJO_1390_20

Indian J Ophthalmol. 2021 Apr;69(4):890-894. doi: 10.4103/ijo.IJO_1269_20.

ABSTRACT

PURPOSE: To assess patient experience of intravitreal injections using vital-signs, visual-experience, pain-rating and emotional response during intravitreal anti-VEGF injections.

METHODS: A prospective observational study of patient experience of intravitreal anti-VEGF injections done following metrics were collected pre-injection, during injection, and post-injection: pain assessment using visual analog score, fear-response rating, visual-experience questionnaire, and vital-signs.

RESULTS: A total of one-hundred-and-seventy-four patients undergoing intravitreal anti-VEGF injections for retinal pathologies were included in the study. Mean age was 58.8 ± 10.4 years in <5 injection group (n = 133) and 59.02 ± 9.0 years in ≥5 injection group (n = 41) (P = 0.90).During injection, 90.2% of patients in <5 injection group reported moderate or severe pain compared to 78% of patients in ≥5 injection group. In pre and post-injection phases, mild-to-moderate pain was reported in both groups (P = <0.001). Ninety-two (52.9%) patients reported having a mild frightening experience. There was no statistical significance in patients assessment of fear with respect to age, sex, or number of injections. The Systolic Blood Pressure (SBP) during and following injection ((SBP 171.7 ± 21.1,150.8 ± 16.2) procedures was significantly higher in cases with <5 injections when comparing to cases with >5 injections (SBP 159.7 ± 26.4, 143.2 ± 17.0) (P = 0.003), (P = 0.011). DBP, heart rate, pulse rate measurements were similar among patients in all phases of the study.

CONCLUSION: We report a large sample size with comprehensive assessments of the patient experience. Higher pain ratings in the <5 injection group, the increase in the SBP in the pre-and during injection phases, and the overall rating of mild-to-moderate fear during the procedure.

PMID:33727454 | DOI:10.4103/ijo.IJO_1269_20

Indian J Ophthalmol. 2021 Apr;69(4):923-926. doi: 10.4103/ijo.IJO_1019_20.

ABSTRACT

PURPOSE: This study compares the vital parameters and pain experienced during phacoemulsification under peribulbar and topical anesthesia to determine the incidence of OCR.

METHODS: One hundred six patients are enrolled for phacoemulsification in a prospective and randomized study. Fifty-two patients undergo surgery in a peribulbar block (Group PB) and 54 in topical anesthesia (Group TA). Mean arterial pressure (MAP) and pulse rate are recorded during a preoperative check-up and at four other steps of surgery. Pain experienced during surgery and on a postoperative day, 5, is graded with a verbal analogue scale. OCR defined as a decrease in pulse rate by greater than 20% is calculated. Chi-square test, Fisher’s exact test, paired t test and the comparison of means give the statistical analysis. A value of P < 0.05 was taken as significant.

RESULTS: MAP readings at baseline versus MAP at other steps of surgery show a trend towards rising with a P value of < 0.05 in both groups. Pulse rate measured at all steps of surgery versus baseline pulse rate in Group TA shows P < 0.05. OCR is present in nine patients in peribulbar block verses eleven patients in topical anesthesia with P value of 0.687. The pain scores using verbal analogue scale were higher in Group TA compared with Group PB with a P < 0.0001.

CONCLUSION: Oculocardiac reflex can occur during phacoemulsification under both peribulbar block and topical anesthesia, and the difference is not significant.

PMID:33727460 | DOI:10.4103/ijo.IJO_1019_20

Indian J Ophthalmol. 2021 Apr;69(4):865-870. doi: 10.4103/ijo.IJO_936_20.

ABSTRACT

PURPOSE: Obtaining a better understanding of the pathogenesis of primary angle-closure disease (PACD) still requires studies that provide measurements of anterior and posterior biometric characteristics together and that assess the relationship between them.

METHODS: In total, 201 eyes were enrolled in this cross-sectional study: 50 normal controls, 49 primary angle-closure suspect (PACS), 38 primary angle closure (PAC), and 64 primary angle-closure glaucoma (PACG) eyes. The anterior and posterior structural features were measured by anterior segment optical coherence tomography and swept-source optical coherence tomography.

RESULTS: All PACD groups had smaller anterior chamber depth (ACD), anterior chamber area (ACA), anterior chamber volume (ACV), angle opening distance at 750 μm from the scleral spur (AOD750), trabecular-iris space area at 750 μm from the scleral spur (TISA750), and angle recess area (ARA), as well as a larger lens vault (LV), than controls (all P < 0.001). The PACS and PAC groups had thicker iris thickness at 750 μm from the scleral spur (IT750) than controls (P = 0.017 and P = 0.002, respectively). Choroidal thickness (CT) was not statistically different among normal, PACS, PAC, and PACG eyes. Univariate and multivariate linear regression analysis revealed a significant association between thinner IT750 and increased CT in PACD eyes (P = 0.031, univariate analysis; P = 0.008, multivariate analysis).

CONCLUSION: Thinner iris thickness was associated with increased CT in PACD eyes; however, the underlying mechanism needs further investigation.

PMID:33727449 | DOI:10.4103/ijo.IJO_936_20

Chin Med J (Engl). 2020 Dec 16;134(6):655-661. doi: 10.1097/CM9.0000000000001300.

ABSTRACT

BACKGROUND: The antioxidant effects of bilirubin in Parkinson’s disease (PD) have recently gained much attention from the research community. However, results from these studies have been conflicting. This meta-analysis is conducted to assess the relationship between the serum bilirubin concentration and the risk of PD.

METHODS: Two reviewers performed a systematic literature search across five databases (MEDLINE, PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials). The case-control studies regarding bilirubin levels in PD patients published up to April 2020 were included. These studies were subjected to rigorous scrutiny and data extraction to determine the standard mean difference (SMD) and the 95% confidence interval (CI), which were analyzed using the Stata V.12.0 statistical software.

RESULTS: A total of eight studies which included 1463 PD cases and 1490 controls were incorporated into our meta-analysis. SMD analysis showed that there was a higher total bilirubin (TBIL) and direct bilirubin (DBIL) levels in PD patients compared with controls (for TBIL, SMD: 0.300, 95% CI: 0.050-0.549, P = 0.018; for DBIL, SMD: 0.395, 95% CI: 0.102-0.688, P = 0.008). However, no significant relationship was found between the serum indirect bilirubin and PD patients (SMD: -0.223, 95% CI: -0.952-0.505, P = 0.548). A subgroup analysis based on ethnicity indicated that the serum TBIL was higher in PD patients of Caucasian descent in contrast to matched healthy controls (SMD: 0.511, 95% CI: 0.324-0.698, P = 0.000, I2 = 58.0%).

CONCLUSION: Higher serum bilirubin levels in PD patients suggest that bilirubin might play a role in the pathogenesis of PD and have the potential to be utilized as a biochemical marker for PD diagnosis and treatment.

PMID:33725704 | DOI:10.1097/CM9.0000000000001300

Nurs Crit Care. 2021 Mar 16. doi: 10.1111/nicc.12606. Online ahead of print.

ABSTRACT

BACKGROUND: Because of the coronavirus disease 2019 (COVID-19) pandemic, the use of prone positioning has dramatically increased in the intensive care unit (ICU). Because this manoeuvre is related to several complications, it must be performed in a protocolized manner by the appropriate personnel.

AIM: To determine the prevalence of adverse events (AEs) in patients admitted to the ICU with a diagnosis of COVID-19-related acute respiratory distress syndrome (C-ARDS) undergoing mechanical ventilation in prone position (PP).

DESIGN: Descriptive ambispective study of patients admitted to the ICU diagnosed with C-ARDS undergoing mechanical ventilation who were in the PP at least once. The number of PP manoeuvres and the time spent in the PP were recorded for each subject. AEs proportions and frequencies were calculated, and analysis of variance was used to assess mean differences in the number of manoeuvres and total hours in PP stratified by the number of facial pressure ulcers. IBM SPSS Statistics v.25.0. and EPIDAT 4.1 software were used.

RESULTS: Forty-four patients were analysed, and 130 PP manoeuvres were performed. The most frequently observed AEs were facial oedema in 26 patients (80.3%) and facial pressure ulcers in 20 (60.6%). There was a significant positive association between the time spent in PP and the development of facial pressure ulcers (P < .001). Enteral nutrition was well tolerated, and no serious AEs or sentinel events were noted.

DISCUSSION: Despite the stressful, demanding situation during the peak of the pandemic, the large number of PP manoeuvres, and long duration spent in this position, no serious AEs occurred. This study highlights the need to implement preventive measures to avoid the development of pressure ulcers secondary to prone positioning.

RELEVANCE TO PRACTICE: Prone positioning requires a nursing protocol to prevent the occurrence of AEs that may reduce the quality of nursing care.

PMID:33725746 | DOI:10.1111/nicc.12606

J Clin Virol. 2021 Mar 10;138:104791. doi: 10.1016/j.jcv.2021.104791. Online ahead of print.

ABSTRACT

BACKGROUND: Cycle threshold (Ct) values can be used in an attempt to semiquantify results in the qualitative real-time polymerase-chain-reaction (PCR) for the new coronavirus SARS-CoV-2. The significance of Ct values in epidemiological studies and large cohorts is still unclear.

OBJECTIVE: To monitor Ct values in a long-term study and compare the results with demographic data of patients who tested positive for SARS-CoV-2 by real-time PCR.

STUDY DESIGN: S gene SARS-CoV-2 Ct values were analyzed retrospectively from consecutive patients between March 15th to September 15th 2020 with special regard to age, gender, and in- or outpatient status.

RESULTS: In total, 65,878 patients were tested, 1103 (1.7 %) of whom were positive for SARS-CoV-2. Twenty-six positive patients were excluded, because the respective PCR runs did not meet the stability requirements (Ct value of the positive controls between 26 and 29). Of the remaining 1077 patients, females (n = 566; 53 %) were significantly older than males (n = 511; 47 %) (50.9 versus 45.1 years; p = 0.006) and had slightly higher mean Ct values than males (25.4 vs. 24.8; p = 0.04). Patients in the age groups >80 years had significantly higher Ct values than the remaining age groups (p < 0.001). Children (0-19 years) showed Ct values in the range of those found in adults (25.2 vs. 25.1, p = 0.9). There were no statistically different Ct values between in- and outpatients (p = 0.1), however, SARS-CoV-2 positive inpatients were significantly older than outpatients (p < 0.0001).

CONCLUSIONS: CT values are suitable for more detailed monitoring of the SARS-CoV-2 pandemic. Age is an important cofactor in SARS-CoV-2 positive patients and may have influence on Ct values in SARS-CoV-2-PCR.

PMID:33725648 | DOI:10.1016/j.jcv.2021.104791

Nanotechnology. 2021 Mar 16. doi: 10.1088/1361-6528/abef2d. Online ahead of print.

ABSTRACT

Producing defect-free and large-lateral-size 2D materials via cost-effective methods is important for mass application. Recently, shear exfoliation showed great promise for large-scale production due to its simple operation, environmental-benignity, and wide adaptability. However, a long-standing challenge is that with more nanosheets produced, a ceiling yield and shattered products are encountered, which significantly limit their wider application. The way and efficiency of energy transfer in fluid is undoubtedly the key point in determining the exfoliation efficiency, yet there has no in-deep mechanism elucidation so far. Thus, a thorough investigation regarding the turbulence energy transfer is critically necessary. Herein, we identify two main factors which critically determine the exfoliation yield and provide a statistical analysis on the relationship between these factors and exfoliation yield. In the initial shearing process, the coexistence of the 2D nanosheets and raw particles is the dominant factor; with time passes by, the dimensional change of raw materials gradually shows more influence on the energy transfer. These factors together lead to attenuated efficiency and a power function relationship between yield and exfoliation time. This investigation gives a statistical explanation regarding shear exfoliation technology for 2D materials preparation and provides valuable insights for mechanical exfoliating high-quality 2D materials.

PMID:33725678 | DOI:10.1088/1361-6528/abef2d