Results: The mean age of patients in group 1 was 6.8 ± 2.1 years, group 2: 8.15 ± 2.27 years, group 3: 7.5 ± 2.3 years, and group 4: 7.27 ± 1.68 years. The intragroup comparisons of heart rate and facial image scores have shown a significant difference in before and after dental treatment procedures. Marked reduction in heart rate and facial image scale scores were found in patients belonging to group 1 (mobile applications) and group 2 (dental video songs). An increase in heart rate and facial image scale scores was seen in group 3 (tell-show-do) and the control group.
Conclusion: The paediatric dental anxiety is a common finding in dental clinics. Behavior modification techniques like smartphone applications, "little lovely dentist," and "dental songs" can alleviate dental anxiety experienced by paediatric patients. The "tell-show-do" technique although most commonly used did not prove to be beneficial in the reduction of the anxiety levels.
STUDY DESIGN: The present study was conducted on 151 women with gynecological cancers as the case group and 152 healthy women with no history of such cancers as control group. The dematographic details of participants from both control and case groups were collected using a checklist, and the pattern of their fingerprints was prepared and examined. The data were analyzed for their significance using chi-square test and t- test. Odds ratio with 95% confidence intervals were calculated.
RESULTS: Dermatoglyphic analysis showed that arch and loop patterns significantly changed in cases group as compared to control. However, the odds ratio suggested that loop pattern in 6 or more fingers might be a risk factor for developing gynecological cancers.
CONCLUSION: Our results showed that there is an association between fingerprint patterns and gynecological cancers and so, dermatoglyphic analysis may aid in the early diagnosis of these cancers.
AIMS AND OBJECTIVE: The aim of this study was to assess systematically the characteristics of patients and risk factors associated with nosocomial infections among ESRD patients undergoing hemodialysis.
METHODS: A systematic literature search was performed to identify eligible studies published during the period from inception to December 2018 pertaining to risk factors associated with nosocomial infections among hemodialysis patients. The relevant studies were generated through a computerized search on five databases (PubMed, EBSCOhost, Google Scholar, ScienceDirect and Scopus) using the Mesh Words: nosocomial infections, hospital acquired infections, healthcare associated infections, end stage renal disease, end stage renal failure, hemodialysis, and risk factors. The complete protocol has been registered under PROSPERO (CRD42019124099).
RESULTS: Initially, 1411 articles were retrieved. Out of these, 24 were duplicates and hence were removed. Out of 1387 remaining articles, 1337 were removed based on irrelevant titles and/or abstracts. Subsequently, the full texts of 50 articles were reviewed and 41 studies were excluded at this stage due to lack of relevant information. Finally, nine articles were selected for this review. Longer hospital stay, longer duration on hemodialysis, multiple catheter sites, longer catheterization, age group, lower white blood cell count, history of blood transfusion, and diabetes were identified as the major risk factors for nosocomial infections among hemodialysis patients.
CONCLUSION: The results of this review indicate an information gap and potential benefits of additional preventive measures to further reduce the risk of infections in hemodialysis population. Moreover, several patient-related and facility-related risk factors were consistently observed in the studies included in this review, which require optimal control measures.
METHODS: Overall, 612 patients (306 COVID-19 and 306 non-COVID-19 pneumonia) were recruited. Twenty radiological features were extracted from CT images to evaluate the pattern, location, and distribution of lesions of patients in both groups. All significant CT features were fed in five classifiers namely decision tree, K-nearest neighbor, naïve Bayes, support vector machine, and ensemble to evaluate the best performing CAD system in classifying COVID-19 and non-COVID-19 cases.
RESULTS: Location and distribution pattern of involvement, number of the lesion, ground-glass opacity (GGO) and crazy-paving, consolidation, reticular, bronchial wall thickening, nodule, air bronchogram, cavity, pleural effusion, pleural thickening, and lymphadenopathy are the significant features to classify COVID-19 from non-COVID-19 groups. Our proposed CAD system obtained the sensitivity, specificity, and accuracy of 0.965, 93.54%, 90.32%, and 91.94%, respectively, using ensemble (COVIDiag) classifier.
CONCLUSIONS: This study proposed a COVIDiag model obtained promising results using CT radiological routine features. It can be considered an adjunct tool by the radiologists during the current COVID-19 pandemic to make an accurate diagnosis.
KEY POINTS: • Location and distribution of involvement, number of lesions, GGO and crazy-paving, consolidation, reticular, bronchial wall thickening, nodule, air bronchogram, cavity, pleural effusion, pleural thickening, and lymphadenopathy are the significant features between COVID-19 from non-COVID-19 groups. • The proposed CAD system, COVIDiag, could diagnose COVID-19 pneumonia cases with an AUC of 0.965 (sensitivity = 93.54%; specificity = 90.32%; and accuracy = 91.94%). • The AUC, sensitivity, specificity, and accuracy obtained by radiologist diagnosis are 0.879, 87.10%, 88.71%, and 87.90%, respectively.
METHODS: In this prospective, randomised, proof-of-concept study, patients with diabetes, and with peripheral neuropathy and a recent history of plantar foot ulceration were recruited from two multidisciplinary outpatient diabetic foot clinics in the UK, and were randomly assigned to either intervention or control. All patients received an insole system, which measured plantar pressure continuously during daily life. The intervention group received audiovisual alerts via a smartwatch linked to the insole system and offloading instructions when aberrant pressures were detected; the control group did not receive any alerts. The primary outcome was plantar foot ulcer occurrence within 18 months. This trial is registered with ISRCTN, ISRCTN05585501, and is closed to accrual and complete.
FINDINGS: Between March 18, 2014, and Dec 20, 2016, 90 patients were recruited and consented to the study, and 58 completed the study. At follow-up, ten ulcers from 8638 person-days were recorded in the control group and four ulcers from 11 835 person-days in the intervention group: a 71% reduction in ulcer incidence in the intervention group compared with the control group (incidence rate ratio 0·29, 95% CI, 0·09-0·93; p=0·037). The number of patients who ulcerated was similar between groups (six of 26 [control group] vs four of 32 [intervention group]; p=0·29); however, individual plantar sites ulcerated more often in the control group (ten of 416) than in the intervention group (four of 512; p=0·047). In an exploratory analysis of good compliers (n=40), ulcer incidence was reduced by 86% in the intervention group versus control group (incidence rate ratio 0·14, 95% CI 0·03-0·63; p=0·011). In the exploratory analysis, plantar callus severity (change from baseline to 6 months) was greater in re-ulcerating patients (6·5, IQR 4·0-8·3) than non-re-ulcerating patients (2·0, 0·0-4·8; p=0·040).
INTERPRETATION: To our knowledge, this study is the first to show that continuous plantar pressure monitoring and dynamic offloading guidance, provided by an innovative intelligent insole system, can lead to a reduction in diabetic foot ulcer site recurrence.
FUNDING: Diabetes UK and Orpyx Medical Technologies.
Materials and Methods: Twenty-four pregnant rats were randomly grouped into a control group (C), a stress group (S), and a stress group treated with TH. Eight male pups from each group were randomly chosen and they were sacrificed at eight or ten weeks of age following the novel object recognition test. Their brains were removed and histological changes and levels of MDA and NMDA receptors in the hippocampus were determined.
Results: The offspring from TH group showed significantly increased preference index (p<0.05) with higher neuronal number compared to S group. A significantly lower level of MDA and NMDA receptors were shown in TH group (P<0.01; P<0.05 respectively) compared to S group. The parameters investigated were not significantly different between C and TH groups.
Conclusion: The study has shown that memory alteration, changes in hippocampus histology, MDA and NMDA receptor levels could be prevented by TH administration during prenatal stress. The results suggest the beneficial effects of Tualang honey in prenatally stressed rat offspring.
METHODS: Pregnant rats were divided into three groups: control, stress, and stress treated with Tualang honey. The stress and stress treated with Tualang honey groups were subjected to restraint stress from day 11 of pregnancy until delivery. Ten week old male offspring (n = 9 from each group) were given formalin injection and their nociceptive behaviours were recorded. After 2 h, the rats were sacrificed, and their spinal cords were removed to assess oxidative stress activity and morphology. Nociceptive behaviour was analysed using repeated measures analysis of variance (ANOVA), while the levels of oxidative stress parameters and number of Nissl-stained neurons were analysed using a one-way ANOVA.
RESULTS: This study demonstrated that prenatal stress was associated with increased nociceptive behaviour, changes in the oxidative stress parameters and morphology of the spinal cord of offspring exposed to prenatal stress; administration of Tualang honey reduced the alteration of these parameters.
CONCLUSION: This study provides a preliminary understanding of the beneficial effects of Tualang honey against the changes in oxidative stress and neuronal damage in the spinal cord of the offspring of prenatally stressed rats.
METHOD: A randomized controlled open-label study was performed at the cardiothoracic intensive care unit of Penang Hospital, Malaysia. A total of 28 patients who underwent cardiac surgeries were randomly assigned to receive either dexmedetomidine or morphine. Both groups were similar in terms of preoperative baseline characteristics. Efficacy measures included sedation scores and pain intensity and requirements for additional sedative/analgesic. Mean heart rate and arterial blood pressure were used as safety measures. Other measures were additional inotropes, extubation time and other concurrent medications.
RESULTS: The mean dose of dexmedetomidine infused was 0.12 [SD 0.03] μg kg⁻¹ h⁻¹, while that of morphine was 13.2 [SD 5.84] μg kg⁻¹ h⁻¹. Dexmedetomidine group showed more benefits in sedation and pain levels, additional sedative/analgesic requirements, and extubation time. No significant differences between the two groups for the outcome measures, except heart rate, which was significantly lower in the dexmedetomidine group.
CONCLUSION: This preliminary study suggests that dexmedetomidine was at least comparable to morphine in terms of efficacy and safety among cardiac surgery patients. Further studies with larger samples are recommended in order to determine the significant effects of the outcome measures.
METHODS: A cross-sectional study was conducted among 134 geriatric patients with a mean age of 68.9 ± 8.4 who stayed at acute care wards in Hospital Tuanku Ampuan Rahimah, Klang from July 2017 to August 2017. The SGA, MNA, and GNRI were administered through face-to-face interviews with all the participants who gave their consent. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GNRI and MNA were analyzed against the SGA. Receiver-operating characteristic (ROC) curve analysis was used to obtain the area under the curve (AUC) and suitable optimal cutoff values for both the GNRI and MNA.
RESULTS: According to the SGA, MNA, and GNRI, 26.9%, 42.5%, and 44.0% of the participants were malnourished, respectively. The sensitivity, specificity, PPV, and NPV for the GNRI were 0.622, 0.977, 0.982, and 0.558, respectively, while those for the MNA were 0.611, 0.909, 0.932, and 0.533, respectively. The AUC of the GNRI was comparable to that of the MNA (0.831 and 0.898, respectively). Moreover, the optimal malnutrition cutoff value for the GNRI was 94.95.
CONCLUSIONS: The prevalence of malnutrition remains high among hospitalized elderly patients. Validity of the GNRI is comparable to that of the MNA, and use of the GNRI to assess the nutritional status of this group is proposed with the new suggested cutoff value (GNRI ≤ 94.95), as it is simpler and more efficient. Underdiagnosis of malnutrition can be prevented, possibly reducing the prevalence of malnourished hospitalized elderly patients and improving the quality of the nutritional care process practiced in Malaysia.