scholarly journals External Validation of Models to Predict Unsuccessful Endometrial Ablation: a Retrospective Study

2022 ◽  
Author(s):  
Kelly Stevens ◽  
Saskia Houterman ◽  
Steven Weyers ◽  
Iris Muller ◽  
Benedictus C. Schoot
Keyword(s):  
External Validation ◽  
Endometrial Ablation ◽  
P Value ◽  
Failure Model ◽  
Outcome Parameter ◽  
Intervention Model ◽  
Chi Square ◽  
Study Objective ◽  
Significant Difference ◽  
Lemeshow Test

Abstract Study Objective: External validation of our previously presented and locally established prediction models to help counsel patients for failure of endometrial ablation (EA) or surgical re-intervention within 2 years after EA, called ‘Failure model’ and ‘Re-intervention model’ respectively. Design: Retrospective external validation study, minimal follow-up time of 2 years.Setting: Two non-academic teaching hospitals in the Netherlands.Patients: Pre-menopausal women (18+) who had undergone EA for abnormal uterine bleeding problems between January 2010 and November 2012. A total of 329 patients were eligible for analysis.Interventions: Interventions used for EA were Novasure (Hologic, Marlborough, Massachusetts, US) and ThermaChoice III (Ethicon, Sommerville, US). Measurements and Main Results: The Area Under the Receiver Operating characteristics Curve (AUROC) for the outcome parameter of failure within 2 years after EA was 0.59 (95% CI 0.53 – 0.65). Variables in this model were dysmenorrhea, age, parity ≥5 and preoperative menorrhagia. The Hosmer-Lemeshow test showed no significant difference between the observed and predicted outcome. (Chi-square: 4.62, P-value: .80) The AUROC for the outcome parameter surgical re-intervention within 2 years was 0.62 (95% CI 0.53 – 0.70) Variables in this model were dysmenorrhea, age, menstrual duration> 7 days, parity ≥5 and a previous caesarean section. The Hosmer-Lemeshow test showed no significant difference between the observed and predicted outcome (Chi-square 11.34, P-value .18).Conclusion: Both the failure model and the re-intervention model can be used to predict unsuccessful endometrial ablation in the general population within two years after the procedure. It can be used prior to surgery to facilitate tailor-made shared decision-making, and help counsel patients with regards to the potential outcome of their treatment with the use of a personally calculated percentage.

scholarly journals External Validation of Models to Predict Unsuccessful Endometrial Ablation: A Retrospective Study

2021 ◽  
Author(s):  
Kelly Yvonne Roger Stevens ◽  
Saskia Houterman ◽  
Steven Weyers ◽  
Iris Muller ◽  
Benedictus Schoot
Keyword(s):  
External Validation ◽  
Endometrial Ablation ◽  
P Value ◽  
Failure Model ◽  
Outcome Parameter ◽  
Intervention Model ◽  
Chi Square ◽  
Study Objective ◽  
Significant Difference ◽  
Lemeshow Test

Abstract Study Objective: External validation of previously presented and locally established prediction models to help counsel patients for failure of endometrial ablation (EA) or surgical re-intervention within 2 years after EA, called ‘Failure model’ and ‘Re-intervention model’ respectively. Design: Retrospective external validation study, minimal follow-up time of 2 years. Setting: Two non-academic teaching hospitals in the Netherlands. Patients: Pre-menopausal women (18+) who had undergone EA for abnormal uterine bleeding problems between January 2010 and November 2012. A total of 329 patients were eligible for analysis. Interventions: Interventions used for EA were Novasure (Hologic, Marlborough, Massachusetts, US) and ThermaChoice III (Ethicon, Sommerville, US). Measurements and Main Results: The Area Under the Receiver Operating characteristics Curve (AUROC) for the outcome parameter of failure within 2 years after EA was 0.59 (95% CI 0.53 – 0.65). Variables in this model were dysmenorrhea, age, parity ≥5 and preoperative menorrhagia. The Hosmer-Lemeshow test showed no significant difference between the observed and predicted outcome. (Chi-square: 4.62, P-value: .80) The AUROC for the outcome parameter surgical re-intervention within 2 years was 0.62 (95% CI 0.53 – 0.70) Variables in this model were dysmenorrhea, age, menstrual duration> 7 days, parity ≥5 and a previous caesarean section. The Hosmer-Lemeshow test showed no significant difference between the observed and predicted outcome (Chi-square 11.34, P-value .18). Conclusion: Both the failure model and the re-intervention model can be used to predict unsuccessful endometrial ablation in the general population within two years after the procedure. It can be used prior to surgery to facilitate tailor-made shared decision-making, and help counsel patients with regards to the potential outcome of their treatment with the use of a personally calculated percentage.

A Study to Evaluate the Effectiveness of Webinar on Knowledge Regarding the Strategies to Prevent Covid 19 among Nursing Students of SIIHS, Honavar, Uttara Kannada

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Sagaya Arockiya Mary. A ◽  
Susai Mari.A ◽  
Wincy. C ◽  
Thirumurugan. M ◽  
Verginia Dsouza ◽  
...  
Keyword(s):  
Nursing Students ◽  
Student Nurses ◽  
Sampling Technique ◽  
Knowledge Score ◽  
P Value ◽  
Sufficient Information ◽  
Knowledge Level ◽  
Chi Square ◽  
Significant Difference ◽  
Post Test

Background: The one virus stumbled the whole universe is the novel corona virus and impacted physical, emotional and social health status of almost every individual in the world irrespectively. Since the existence of Covid-19 till now it is been noticed that student nurses also affected by this fatal viral infection during their clinical practice. Objectives: The study focused on evaluating the effectiveness of webinar on knowledge regarding the strategies to prevent Covid -19 among student nurses of SIIHS, Honavar, Uttara Kannada. The study aimed at enhancing the knowledge level and influences others through effective health teaching at clinical areas and even in community settings. Methodology: An evaluative approach with pre- experimental, non-randomized, one group pre and post-test research design was adapted. The sample size was 294, purposive sampling technique was adapted. Data collected through testmoz web page and webinar was conducted by google meet app for one week. Data analysed by descriptive and statistical methods (chi-square and z-test) and interpreted by graphs. Results: The findings show that in pre-test 10(3.41%) had poor, 127(43.19%) had average, 157(53.40%) Good and 00% excellent knowledge level whereas in post-test 00% had Poor, 59(20.06%) Average, 176(59.86%) Good and 59 (20.06%) had excellent knowledge level. The pre-test mean score was 23.1 (46.2 %.) and of post-test was 35.6 (71.2%). The computed z’-test value showing significant difference in the pre (x?1=23.1) and post-test (x?2=35.6) knowledge score (p=1.18357, < z= -5.1679, critical z score=-1.6449 ? =0.05 level of significance). Hence the p value is greater than the z value (p(x?Z) = 1.18357e-7), it indicates the webinar was effective and the null hypothesis (H0) is rejected. Conclusion: The study was concluded as the webinar was highly effective and influenced the participant to gain sufficient information on prevention and the spread of Covid 19. Hopefully this enables them to apply

A Comparative Study between Ketamine and Lidocaine ro Decrease Propofol Injection Pain During Induction of Anesthesia

2021 ◽  
Vol 6 (1) ◽  
pp. 1304-1309
Author(s):  
Bikash Khadka ◽  
Nil Raj Sharma
Keyword(s):  
Comparative Study ◽  
Venous Occlusion ◽  
Verbal Response ◽  
Injection Pain ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Lidocaine Group ◽  
Mild Pain ◽  
Significant Difference

Introduction: Pain during the injection of anesthetic agents may be distressing and can reduce the acceptability of an otherwise useful agent such as propofol during daycare surgeries. Lidocaine and ketamine both are used as pre-treatment to decrease propofol induced pain. This study aims to compare the effectiveness of ketamine injection to decrease propofol-induced pain in comparison to lidocaine injection. Methodology: This is a prospective cross-sectional comparative study. Eighty-nine cases were divided into two groups where group K received ketamine 2 ml (0.2 mg/kg) whereas group L received lidocaine 2% 2ml (0.5 mg/kg) after venous occlusion with rubber tourniquet. One-fourth dose of propofol was injected 1 min after release of tourniquet and pain accessed at 0, 1, and 2 minutes of propofol injection with a verbal response and behavioral signs. Chi-square test and paired T-test were used and a p-value less than 0.05 was considered significant. Result: Regarding hemodynamic, oxygenation, and adverse effects there was no significant difference. Immediately after propofol injection, only 1 patient of the ketamine group had mild pain (2.22%) while 12 patients from the lignocaine group had mild pain (27.27%) with a p-value of 0.009. Also after 2 minutes of propofol injection, only 12 cases had mild pain i.e. 13.48% (1 from ketamine group i.e. 2.22% and 11 from lidocaine group i.e. 25%) with p-value of 0.002. Conclusion: Our study helps prove low-dose ketamine is more effective in reducing the incidence and severity of pain on injection of propofol in comparison to Lidocaine with better hemodynamic stability. 

scholarly journals Orthodontics-Awareness Amongst Medical Students

2020 ◽  
Vol 10 (3) ◽  
pp. 49-56
Author(s):  
Türkan SEZEN ERHAMZA ◽  
Kübra A ARSLAN ÇARPAR
Keyword(s):  
Medical Students ◽  
Statistical Evaluation ◽  
P Value ◽  
Chi Square ◽  
Level Of Education ◽  
Significant Difference ◽  
Chi Square Test ◽  
Treatment Procedures

Introduction: The study aimed to evaluate the knowledge and awareness of orthodontics, a specialty of dentistry,amongst Medical Students. Materials and Method: A sample of 550 students (279 female, 226 male aged between 18 and 36 years) were attented.Of the subjects, 58.6% (n = 296) were preclinical students, while 41.4% (n = 209) were clinical students. The students were informed about the questionnaire and asked to fill in the questionnaire forms. For the comparison of data between groups (gender, level of education), the chi-square test was used. A chi-square test was used for statistical evaluation and the p-value < 0.05 was considered statistically significant. Result: 385 students (76.2%) had heard the term orthodontics although 41.2% of the subjects knew that orthodonticswas concerned with malocclusions and their treatment. The question about treatment procedures was answeredas scaling by 35.8%, tooth polishing by 40%, tooth aligning by 89.9% of the students. The percentage of knowingorthodontics to be related to tooth aligning showed a significant difference between female and male (p = 0.006), andpreclinical and clinical students (p = 0.033). Of the participants, 42.8% thought that dentures, 83% brackets, 78.8% ofremovable appliances were used by orthodontists. Conclusion: Our results have shown that medical students should have more information about orthodontics, aspecialty of dentistry.

scholarly journals A double-blind randomized placebo-controlled study of low dose mirtazapine once daily in patients of major depressive disorders on escitalopram

2019 ◽  
Vol 8 (5) ◽  
pp. 1067
Author(s):  
Mallikarjuna Rao I. ◽  
Usha Kiran Prayaga ◽  
Dharma Rao Uppada ◽  
Ramachandra Rao E. ◽  
B. L. Kudagi
Keyword(s):  
Depressive Disorders ◽  
Low Dose ◽  
Rating Scale ◽  
Controlled Study ◽  
P Value ◽  
Chi Square ◽  
Double Blind ◽  
Increased Risk ◽  
Significant Difference ◽  
Chi Square Test

Background: The SSRIs being used as 1st line therapy in treatment of depression have delayed therapeutic effect which makes the patient vulnerable to an increased risk of suicide and decreased adherence to the treatment and will prematurely discontinue the therapy. The present study was conducted to evaluate if low dose mirtazapine-escitalopram combination therapy has any add on benefit over monotherapy with escitalopram.Methods: In a single-centered, comparative study involving patients with depression attending the out-patient after screening and exclusion, 60 eligible patients were randomly assigned to receive tablet mirtazapine 7.5 mg plus tablet escitalopram 10 mg intervention or tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week treatment phase. The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using Chi-Square test for adverse effects and independent t-test analysis for efficacy parameter.Results: In the analysis of results at 6th week the numbers of patients achieved remission in mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in mirtazapine group are also more which is statistically significant on chi-square test. There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.Conclusions: Adding low dose mirtazapine has an added benefit in terms of efficacy and getting remission early with more number of responders in the treatment of major depression.

scholarly journals Major clinical risk factors for seizures in febrile children aged 6 to 60 months.

2020 ◽  
Vol 27 (05) ◽  
pp. 891-894
Author(s):  
Shahid Ishaq ◽  
Ejaz Mazari ◽  
Fazal ur Rehman
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Febrile Seizures ◽  
Study Groups ◽  
Clinical Risk Factors ◽  
P Value ◽  
Chi Square ◽  
Clinical Risk ◽  
Significant Difference ◽  
History Of

Objectives: Febrile seizures (FS) are the most common type of seizures and typically transpire in children with ages from 6 to 60 months. This study was planned to find out major clinical risk factors for seizures in febrile children who were aged 6 to 60 months. A total of 100 febrile children aged 6 to 60. Study Design: Analytical Study. Setting: Department of Neurology, Children’s Hospital and the Institute of Child Health, Multan. Period: From 1st April 2018 to 31st December 2018. Material & Methods: Group A had 40 children with febrile seizures while group B had 60 febrile children but without seizures. Demographic features along with family history of (H/O) epilepsy as well as family history of febrile seizure, types of seizure and infection diseases were noted and analyzed using SPSS version 20. Odds ratio was calculated for various risk factors. Chi square test was applied and P value < 0.05 was considered as significant. Results: Out of a total of 100 children, there were 54 (54.0%) male and 46 (46.0%) female. There was no statistical difference in terms of gender between the two groups (p value = 0.566). Overall, mean age of the children was 26.02 months with standard deviation of 13.4 months. There were 28 (70.0%) children who reported with simple seizures while complex seizures were found in 12 (30.0%) cases. Statistically significant difference (p value = 0.001) was seen in terms of types of infections between the two study groups. When risk of seizures for various risk factors was calculated, family H/O FS, family H/O epilepsy, and upper RTI were as 14, 7 and 3 times respectively and turned out to be the major risk factors for seizures in febrile children. Conclusions: Family H/O FS, family H/O epilepsy and upper RTIs are the major risk factors related with seizures in febrile children. Measures to prevent these risk factors can decrease the burden of FS in our population.

scholarly journals The Effect of the Covid-19 Free Operation Path Protocol on the Incidence of Lung Complications in Postoperative Elective Patients at dr. Moewardi Hospital Surakarta

2021 ◽  
Vol 5 (11) ◽  
pp. 1030-1036
Author(s):  
Galih Aktama ◽  
Henky Agung Nugroho ◽  
Muhammad David Perdana Putra
Keyword(s):  
Cancer Patients ◽  
Elective Surgery ◽  
Pulmonary Complications ◽  
P Value ◽  
Chi Square ◽  
Elective Surgical Procedures ◽  
Significant Difference ◽  
Before And After ◽  
Chi Square Test ◽  
Elective Patients

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.

scholarly journals Variation in lip print pattern between two ethnic groups, Oraon tribals and Bengalee Hindus, residing in West Bengal, India

2019 ◽  
Vol 82 (4) ◽  
pp. 405-415
Author(s):  
Archita Dey ◽  
Mahua Chanak ◽  
Kaustav Das ◽  
Koel Mukherjee ◽  
Kaushik Bose
Keyword(s):  
Ethnic Groups ◽  
West Bengal ◽  
Personal Identification ◽  
P Value ◽  
Type Ii ◽  
Ethnic Variation ◽  
Criminal Cases ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test

Abstract Lip print pattern (LPP) is unique to each individual. For decades, forensic experts have used LPP for personal identification to solve criminal cases. However, studies investigating ethnic variation in LPP are scanty. Our study wanted to investigate variation in LPP between two ethnic groups, Oraon tribals and Bengalee Hindus, residing in West Bengal, India. A total of 280 participants included 112 Oraons and168 Bengalee Hindus of both. Prints were taken using dark shaded lipstick and transparent cellophane tape and recorded into white A4 sheet. Prints were divided into four quadrants and examined by magnifying glass. For analysis of results, classification of Suzuki and Tsuchihashi was followed. A p value of 0.05 was considered to be statistically significant. It was observed that Type II pattern was dominant in first and second quadrants in both ethnic groups, irrespective of sex. Combination of Type II+III was found to be the most common pattern in males among both Oraons (16.2%) and Bengalee Hindus (12.2%) whereas in females Type II pattern (25.0%) among Oraons and Type III pattern among Bengalee Hindus (11.4%) was the most common. Chi square test showed statistically significant difference among females (p<0.05) and in third and fourth quadrants among males (p<0.01) of both ethnic groups. Our investigation clearly demonstrated sex and ethnic variations in LPP. Further studies are required to investigate ethnic variation in LPP among the various populations groups, both tribal as well as non-tribal, from different regions of India.

Utility of Bispectral Index Monitoring during Deep Sedation in Pediatric Dental Patients

2014 ◽  
Vol 39 (1) ◽  
pp. 291-296 ◽  
Author(s):  
C Dag ◽  
T Bezgin ◽  
N Özalp ◽  
G Gölcüklü Aydın
Keyword(s):  
Dental Treatment ◽  
Deep Sedation ◽  
Pediatric Dentistry ◽  
P Value ◽  
Chi Square ◽  
Mean Values ◽  
Dental Patients ◽  
Physiological Variables ◽  
Paired Samples ◽  
Significant Difference

Objective: The aim of this study was to compare the total medicament doses and recovery profiles of patients for whom Bispectral Analysis (BIS) monitor was used to monitor sedation. Study design: Thirty-four uncooperative paediatric patients aged 3-6 years who attended to the Department of Pediatric Dentistry for dental treatment were enrolled in the study. Patients were randomly divided into 2 groups of 17 patients each. Physiological variables including oxygen saturation, blood pressure and heart rate were recorded. In one group (BIS-monitored group), drugs were administered to maintain patients’ BIS values between 60-70, while the other group (Non-BIS-monitored Group) was not monitored using BIS. Data was evaluated by Chi-square, Mann Whitney U, Independent Samples t, Paired Samples t and Wilcoxon signed tests, with a p-value of &lt;0.05 considered to be statistically significant. Results: There was no significant difference in total anesthetic doses, incidence of adverse events or recovery profiles of patients between non- BIS-monitored and BIS-monitored groups (p≯0.05). However, distinct correlation was determined among mean values of UMSS and BIS values (p&lt;0.05). Conclusion: BIS represents no advantage over the current commonly accepted methods for monitoring sedation depth in children.

scholarly journals Housing Condition of Coastal Area in Bangladesh: A Case Study of Kutubdia, Cox’s Bazaar

2015 ◽  
Vol 6 (1) ◽  
pp. 15-20 ◽  
Author(s):  
M Mohiuddin ◽  
MB Latif
Keyword(s):  
Type A ◽  
P Value ◽  
Type B ◽  
Laboratory Examination ◽  
Chi Square ◽  
E Coli ◽  
Significant Difference ◽  
Different Types ◽  
Hygienic Measures

This study was conducted to determine the contamination of E. coli and Salmonella for different types of foods in Chittagong city area. In case of laboratory examination, almost half (49.58%) of the samples were contaminated where 28.75% positive for E. coli. and 20.83% for Salmonella. The positive cases for type A sample was 20 out of 96 constituting 20.83% whereas the positive cases for type B sample was 49 out of 144 constituting 34.03% for E. coli. The positive cases of type A sample was 15 out of 96 making up 15.63% and for type B sample was 35 out of 144 making up 24.31% for Salmonella.A chi-square (?2) test was used to examine the equality of observed proportions for E. coli and Salmonella of each item of both types of food where significant difference among the observed proportion for E. coli (p-value<0.01) and Salmonella (p-value=0.032) for different items of A type and for E. coli (p-value<0.01) for different items of B type were observed and an odds ratio (OR) was measured for association between exposure and outcome where the probability of contaminated by E. coli of type B food is higher than contaminated of type A food (OR= 1.96 and CI:1.07-3.58). The probability of contaminated by Salmonella of type B food was higher than type A food (OR= 1.73 and CI: 0.89-3.39).The comparatively high bacteria in type B samples indicated contamination from water, practice of inadequate hygienic measures, mishandling, improper storage, inadequate cooking and above all unhygienic condition of the retail shops.DOI: http://dx.doi.org/10.3329/jesnr.v6i1.22034 J. Environ. Sci. & Natural Resources, 6(1): 15-20 2013

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