Tag: statistics

Medicine (Baltimore). 2023 Oct 13;102(41):e35569. doi: 10.1097/MD.0000000000035569.

ABSTRACT

cerebrovascular accident (CVA) has contributed to a significant increase in the morbidity and mortality rates in lower middle-income counties like Nepal. Despite being a common noncommunicable disease in Nepal, little attention has been paid to it, in terms of formulating national health plans and policies by the concerned authorities. This was a descriptive cross-sectional study in patients diagnosed with cerebrovascular accidents at a tertiary care hospital in Eastern Nepal. We analyzed 128 diagnosed cases of cerebrovascular accidents from February 26, 2023 to June 26, 2023 after taking ethical clearance from the Institutional Review Committee (Reference no. IRC-PA-283/2078-79). Data were analyzed by Statistical Package for the Social Sciences version 23. The objective of this study was to explore the age and sex distribution of CVA, its association with medical co-morbidities, and known risk factors like Type-2-Diabetes Mellitus, hypertension, thyroid disorders, smoking and alcohol. Together with calculating the distribution of ischemic CVA and hemorrhagic CVA we had also staged the disease based on the National Institute of Health Stroke Scale.

PMID:37832119 | DOI:10.1097/MD.0000000000035569

Medicine (Baltimore). 2023 Oct 13;102(41):e35472. doi: 10.1097/MD.0000000000035472.

ABSTRACT

First, we want to find out whether computer-assisted surgery (CAS) for total knee arthroplasty (TKA), which does not require opening the femoral medullary canal, results in a lesser C-reactive protein (CRP) level increase postoperatively compared to manual TKA. Second, they seek to examine whether the CRP reduction in CAS TKA and manual TKA follows a similar pattern within the first 2 weeks after surgery. Third, the study aims to compare and analyze the CRP levels in 3 different groups: CRP levels in CAS TKA with surgeons who started TKA surgery by CAS, CRP levels in manual TKA by surgeons with little experience, and CRP levels in skillful manual TKA performed after conducting over 200 cases. The 3 patient groups were as follows. Group 1: Patients who underwent non expertized surgeon CAS TKA (N = 63). Group 2: Patients who underwent manual TKA after surgeon CAS TKA experience (N = 108). Group 3: Patients who underwent manual TKA after surgeon 200 cases or more of either CAS TKA or manual TKA experience (more skillful manual TKA) (N = 66). CRP levels were analyzed using electronic medical records for 3 time points: within 3 months before surgery, 5 days after surgery, and 11 days after surgery. There were no statistically significant differences in pre operative CRP values among the 3 groups. At 5 days after surgery, the CRP level were 48.59 ± 32.75 for CAS TKA, 69.82 ± 42.76 for early manual TKA, and 67.73 ± 44.00 for skillful manual TKA, indicating a statistically significant lower CRP level in the CAS TKA group compared to the manual TKA groups (P = .01). At 11 days after surgery, there were no statistically significant differences in CRP level among the 3 groups, with was 12.12 ± 9.74 for CAS TKA, 14.07 ± 13.18 for early manual TKA, and 11.43 ± 11.45 for skillful manual TKA. The degree of CRP elevation after TKA is related to bone and medullary injury rather than soft tissue.

PMID:37832115 | DOI:10.1097/MD.0000000000035472

Medicine (Baltimore). 2023 Oct 13;102(41):e35505. doi: 10.1097/MD.0000000000035505.

ABSTRACT

Vitamin D plays a role in regulating immune homeostasis, inflammation and has an impact on the pathogenesis of inflammatory bowel diseases (IBD). IBD has a multifactorial pathogenesis primarily associated with immune dysregulation, dysbiosis, structurally altered intestinal mucosa, and genetic factors. The immunomodulatory function of this vitamin is linked to its control over innate and adaptive immunity, facilitated through its nuclear vitamin D receptor, leading to the inhibition of nuclear factor kappa-B. This study aimed to investigate serum vitamin D levels in patients with IBD compared to healthy individuals and to evaluate the relationship between vitamin D and inflammatory markers. Cross-sectional study. The study included 106 participants divided into 2 groups: patients with IBD (92), and healthy controls (14). The diagnosis of IBD was based on clinical, laboratory, fecal, endoscopic, and histological findings, following the European guidelines for diagnosis and follow-up ECCO-ESGAR guidelines for diagnostic assessment of IBD from 2019. Serum vitamin D levels were measured along with laboratory tests, imaging, and endoscopic examinations. IBD activity was evaluated using the Montreal classification and clinical and endoscopic indices. Data analysis involved calculating the mean, minimum, and maximum values, standard deviation, and Pearson coefficient. The level of statistical significance for this study was set at P < .05. The study found a prevalence of vitamin D deficiency in 32.6% of patients with IBD, while 66.3% had insufficiency, as compared with healthy individuals. The mean levels of vitamin D in UC and CD were 16 ± 8.6 ng/mL, whereas in the control healthy group, they were 26 ± 9.73 ng/mL. A statistically significant reverse correlation was observed between lower vitamin D levels and higher levels of the inflammatory markers. The study concluded that IBD patients exhibit lower levels of vitamin D, which is associated with inflammation and may contribute to the pathogenesis of the disease.

PMID:37832114 | DOI:10.1097/MD.0000000000035505

Medicine (Baltimore). 2023 Oct 13;102(41):e34989. doi: 10.1097/MD.0000000000034989.

ABSTRACT

The previous research has found that human papillomavirus (HPV) infection is the main cause of cervical cancer, but it is still unclear whether HPV infection, as well as the HPV genotypes, are related to reproductive tract infections in the Chinese population. Patients who underwent HPV screening at Shandong Maternal and Child Health Hospital were selected, and the HPV infection status was analyzed among patients with cervical lesions, bacterial vaginosis, cervical inflammation, fungal vaginitis, and pelvic infections. SPSS 22 statistical analysis was used to analyze the differences in HPV infection types and rates between the control group and the experimental group. The HPV infection rate of bacterial vaginosis (χ2 = 13.4; P < .001) and fungal vaginitis (χ2 = 3.3; P < .045) are both significantly different from the control group. The single HPV infections reveals significant differences from control group in bacterial vaginosis (χ2 = 7.3; P = .004), fungal vaginitis (χ2 = 4.5; P = .023), and cervical lesions (χ2 = 58.8; P < .001). In the bacterial infection group, HPV51 (1.9%; χ2 = 6.0; P = .008) and HPV58 (4.7%; χ2 = 3.3; P = .044) showed significant differences in infection compared to the control group. In the fungal infection group, HPV39 (2.7%; χ2 = 4.7; P = .032) showed a significant difference in infection compared to the control group. Cervical lesions, bacterial vaginosis, fungal vaginitis, and cervical lesions among Chinese population exhibit age-specified distribution. HPV infection rate in bacterial vaginitis, fungal vaginitis and cervical lesions was higher than that in normal group. HPV52 and HPV16 infection are different, and HPV39 is different between bacterial vaginitis and fungal vaginitis.

PMID:37832113 | DOI:10.1097/MD.0000000000034989

Medicine (Baltimore). 2023 Oct 13;102(41):e35544. doi: 10.1097/MD.0000000000035544.

ABSTRACT

Most previous studies on the effects of multifocal intraocular lenses (MIOL) on Humphrey visual field (HVF) used presbyopic corrective lens (PC). There has been insufficient data from patients with MIOL performing HVF with and without PC. This study aimed to determine the effect of PC on HVF testing in patients with MIOL. This was a prospective, comparative crossover study at the Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University between June 2015 and July 2018. Early-stage glaucomatous and non-glaucomatous pseudophakic patients with 2 models of MIOL completed HVF testing with and without PC. Mean deviation (MD), pattern standard deviation (PSD), and reliability indices (fixation losses, false positives, and false negatives) were compared. Ninety-four eyes of 59 patients were enrolled. After excluding patients with confirmed unreliable visual field, 82 eyes of 51 patients (male, 22; female, 29) with a mean age of 65.4 years were included in the study. Forty-nine eyes were non-glaucoma and 33 eyes were early-stage glaucoma. Forty-four eyes received TECNIS ZM900 and 38 eyes received Acrysof IQ ReSTOR SN6AD1. The overall MD standard deviation was -3.5 (2.1) with PC and -3.1 (2.1) without PC (P = .01). The overall PSD standard deviation was 2.8 (1.5) with PC and 2.7 (1.5) without PC (P = .93). The reliability indices were not statistically significantly different with and without PC. There was a good intraclass correlation (ICC) of MD (ICC = 0.87) and PSD (ICC = 0.88) with and without PC. Eyes with TECNIS ZM 900 had significantly better MD when performing HVF without PC (mean difference -0.7, P < .01), but not with Acrysof IQ ReSTOR SN6AD1 (mean difference -0.1, P = .74). Pseudophakic eyes with MIOL may not require PC during HVF testing regardless of the MIOL model. Although eyes with TECNIS ZM900 performed HVF without PC resulted in a significantly better MD value compared with PC, the difference was not clinically significant.

PMID:37832110 | DOI:10.1097/MD.0000000000035544

Medicine (Baltimore). 2023 Oct 13;102(41):e35245. doi: 10.1097/MD.0000000000035245.

ABSTRACT

Renal cell carcinoma is the 10th most common type of cancer, accounting for 3.7% of all cancers. Our study examines patients with metastatic renal cell carcinoma who received Axitinib or Nivolumab as second-line treatment. This study was designed as a retrospective analysis. Patients who received Axitinib or Nivolumab as second-line treatment for metastatic renal cell carcinoma at the Istanbul University Oncology Institute Medical Oncology outpatient clinic were included in the study. A total of 81 patients were included in the study, with a median follow-up period of 18.5 months (2-260 months). Of these patients, 29 (35.8%) received Axitinib as second-line treatment, while 52 (64.2%) received Nivolumab. The median duration of second-line treatment was 14 months (6-52) for Axitinib and 13.5 months (3-77) for Nivolumab. In our study, Nivolumab was found to have statistically better PFS and OS outcomes than Axitinib in male patients, patients diagnosed with metastatic disease, those with a favorable or intermediate International Metastatic Renal Cell Carcinoma Database Consortium risk score, patients diagnosed with metastatic disease or who developed metastasis within 12 months of diagnosis, those who developed metastasis ≥ 24 months after diagnosis, and patients with metastasis in a single organ. Both drugs are recommended as monotherapy for second-line and later treatments in the current NCCN guidelines for kidney cancers. Although there is no study in the literature showing that axitinib is more effective than nivolumab, nivolumab was found to be much more effective than axitinib in our study. Prospective studies with higher number of patients are needed on this subject.

PMID:37832108 | DOI:10.1097/MD.0000000000035245

Medicine (Baltimore). 2023 Oct 13;102(41):e35586. doi: 10.1097/MD.0000000000035586.

ABSTRACT

This study aimed to examine the frequency of fibromyalgia (FM) in patients with lung cancer and evaluate its effect on patients’ pain, sleep quality, fatigue, and quality of life parameters. The study was designed as a prospective cross-sectional and a total of 116 lung cancer patients were included. FM classification was made according to the 2016 ACR criteria. All patients were evaluated using a visual analog scale, fibromyalgia impact questionnaire, multidimensional assessment of fatigue, EuroQol 5D scale, Jenkins sleep scale, and Beck depression inventory. Patients were divided into FM-positive and negative groups according to the presence of FM. Demographic and clinical parameters were investigated between the groups. FM was detected in 14 (12.2%) patients. The mean age of the patients was 62.2 ± 8.4 years. There was a male predominance in 93 (80.2%) patients. No statistical difference was found between the groups in terms of body mass index, age, symptom duration, chemotherapy, and radiotherapy history. A statistically significant difference was found between FM positive and negative groups in FIQ, multidimensional assessment of fatigue, JSS, EQ-5D, visual analog scale, and Beck depression inventory scores. FM is seen more frequently in patients with lung cancer and has a negative effect on sleep, quality of life, fatigue, and mental functions. We think that physicians should not ignore the presence of FM when treating patients diagnosed with lung cancer.

PMID:37832106 | DOI:10.1097/MD.0000000000035586

Medicine (Baltimore). 2023 Oct 13;102(41):e33199. doi: 10.1097/MD.0000000000033199.

ABSTRACT

BACKGROUND: To evaluate the effectiveness and safety of Xingnaojing combined with naloxone in the treatment of carbon monoxide poisoning.

METHODS: By retrieving the literatures published in the databases of PubMed, Cochrane Library, Web of Science, Embase, Wanfang Database, Weipu Database, and China National Knowledge Infrastructure from January 2010 to September 2021, the data of randomized controlled trials (RCTs) of Xingnaojing combined with naloxone in the treatment of carbon monoxide poisoning were extracted. The methodological quality of the included RCTs was evaluated by using the tools of bias risk evaluation of Cochrane Collaboration, and the data were statistically analyzed by using RevMan 5.3 software.

RESULTS: A total of 20 literatures were included, involving in 771 cases treated by Xingnaojing combined with naloxone and 761 cases in the control group. The effective rate of the experimental group is higher than that of the control group [risk ratio (RR) = 1.20, 95% confidence interval (CI) (1.14, 1.26)]. The average awake time (STD mean difference = -2.08, 95% CI [-2.60, -1.56]), physical recovery time (STD mean difference = -2.94, 95% CI [-3.59, -2.28]), delayed encephalopathy (RR = 0.44, 95% CI [0.31, 0.62]), and adverse reactions (RR = 0.23, 95% CI [0.10, 0.54]) was lower than that of the control group.

CONCLUSION: Xingnaojing combined with naloxone in the treatment of carbon monoxide poisoning is significantly superior to naloxone, but it still needs to be further verified by high-quality large samples of RCTs.

PMID:37832102 | DOI:10.1097/MD.0000000000033199

Medicine (Baltimore). 2023 Oct 13;102(41):e35320. doi: 10.1097/MD.0000000000035320.

ABSTRACT

BACKGROUND: This study aimed to provide a clinical basis for the therapy of diabetic ketoacidosis (DKA) complicated with acute pancreatitis (AP) through exploring the clinical efficacy of dexamethasone.

METHODS: A total of 106 DKA patients complicated with AP admitted to Wuxi People’s Hospital Affiliated to Nanjing Medical University from January 2020 to December 2022 were selected and randomly divided into a study group (n = 53) and a placebo group (n = 53) according to the random number table method. The study group patients were given dexamethasone, while the placebo group patients were treated using placebos. Subsequently, changes of laboratory indexes and clinical symptoms before and after treatment were compared between the 2 groups, as well as adverse events after treatment.

RESULTS: There was no significant difference between the 2 groups in terms of general information (P > .05), indicating that the 2 groups patients were comparable. Before treatment, laboratory indexes and clinical symptoms between the 2 groups were not significantly different (P > .05). After treatment, compared with the placebo group, patients in the study group exhibited lower levels of indicators such as random venous blood glucose, serum sodium, serum chlorine, urea nitrogen, urine glucose, urine ketone, serum amylase, and triglyceride and higher levels of PH value and serum potassium, with a statistically significant difference (P < .05); also, the study group patients were improved significantly in clinical symptoms such as abdominal pain, nausea and vomiting, polydipsia and polyuria, diarrhea, disorders of consciousness and hypotension or shock (P < .05). Moreover, the possibility of adverse events in the study group after treatment was much lower than that in the control group (17.0% vs 58.5%) (P < .05).

CONCLUSION: Dexamethasone has a good clinical effect on DKA patients complicated with AP.

PMID:37832092 | DOI:10.1097/MD.0000000000035320

Medicine (Baltimore). 2023 Oct 13;102(41):e35054. doi: 10.1097/MD.0000000000035054.

ABSTRACT

In recent years, the incidence of hepatitis B has been serious in Hainan Province of China. To construct a statistical model of the monthly incidence of hepatitis B in Hainan Province of China and predict the monthly incidence of hepatitis B in 2022. Simple central moving average method and seasonal index were used to analyze the trend and seasonal effects of monthly incidence of hepatitis B. Based on the time series of reported monthly incidence of hepatitis B in Hainan Province from 2017 to 2020, a multiplicative seasonal model (SARIMA), multiplicative seasonal model combined with error back propagation neural network model (SARIMA-BPNN), and a gray prediction model were constructed to fit the incidence, and the time series of monthly incidence of hepatitis B in 2021 was used to verify the accuracy of models. The lowest and highest monthly incidence of hepatitis B in Hainan Province were in February and August, respectively, and MAPE of SARIMA, SARIMA-BPNN, and gray prediction models were 0.089, 0.087, and 0.316, respectively. The best fitting model is the SARIMA-BPNN model. The predicted monthly incidence of hepatitis B in 2022 showed a downward trend, with the steepest decline in March, which indicates that the prevention and control of hepatitis B in Hainan Province is effective, and the study can provide scientific and reasonable suggestions for the prevention and control of hepatitis B in Hainan.

PMID:37832091 | DOI:10.1097/MD.0000000000035054