scholarly journals Ivermectin for COVID-19 in Peru: 14-fold reduction in nationwide excess deaths, p=.002 for effect by state, then 13-fold increase after ivermectin use restricted

2021 ◽  
Author(s):  
Juan Chamie-Quintero ◽  
Jennifer A. Hibberd ◽  
David Scheim
Keyword(s):  
Fold Increase ◽  
P Value ◽  
Mobility Data ◽  
Confidence Threshold ◽  
Fold Reduction ◽  
Viral Mutant ◽  
Maximal Mass ◽  
Clinical Benefits ◽  
The Mean ◽  
Excess Deaths

Introduction. On May 8, 2020, Peru’s Ministry of Health approved ivermectin (IVM), a drug of Nobel Prize-honored distinction, for inpatient and outpatient treatment of COVID-19. As IVM treatments proceeded in that nation of 33 million residents, excess deaths decreased 14-fold over four months through December 1, 2020, consistent with clinical benefits of IVM for COVID-19 found in several RCTs. But after IVM use was sharply restricted under a new president, excess deaths then increased 13-fold. Methods. To evaluate possible IVM treatment effects suggested by these aggregate trends, excess deaths were analyzed by state for ages ≥ 60 in Peru’s 25 states. To identify potential confounding factors, Google mobility data, population densities, SARS-CoV-2 genetic variations and seropositivity rates were also examined.Results. The 25 states of Peru were grouped by extent of IVM distributions: maximal (mass IVM distributions through operation MOT, a broadside effort led by the army); medium (locally managed IVM distributions); and minimal (restrictive policies in one state, Lima). The mean reduction in excess deaths 30 days after peak deaths was 74% for the maximal IVM distribution group, 53% for the medium group and 25% for Lima. Reduction of excess deaths is correlated with extent of IVM distribution by state with a p value of 0.002 using the Kendall τb test, well below the confidence threshold of 0.05 for an established clinical effect.Conclusion. Mass treatments with IVM, a drug safely used in 3.7 billion doses worldwide since 1987, most likely caused the 14-fold reductions in excess deaths in Peru, prior to their 13-fold increase under reversed IVM policy. This strongly suggests that IVM treatments can likewise effectively complement immunizations to help eradicate COVID-19. The indicated biological mechanism of IVM, competitive binding with SARS-CoV-2 spike protein, is likely non-epitope specific, possibly yielding full efficacy against emerging viral mutant strains.

Mir-99 Is a Regulator of Hematopoietic and Leukemic Stem Cell Differentiation

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3063-3063 ◽  
Author(s):  
Mona Khalaj ◽  
Wenhuo Hu ◽  
Christopher Y. Park
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Cell Growth ◽  
Fold Increase ◽  
Negative Regulator ◽  
Myeloid Differentiation ◽  
P Value ◽  
Leukemic Stem Cells ◽  
Hematopoietic Stem ◽  
Fold Reduction

Abstract MicroRNAs play an important role in the regulation of normal and malignant stem cells of the hematopoietic system. Analysis of microRNA-Seq data from 168 acute myeloid leukemia (AML) patients in the TCGA database reveals widespread dysregulation of miRNA expression, including miR-99b. Interestingly, miR-99b expression inversely correlates with differentiation status of the AMLs as determined by the French-American-British classification scheme, suggesting miR-99 is a negative regulator of differentiation. We also have shown that miR-99a and miR-99b are highly expressed in mouse hematopoietic stem cells (HSCs) compared to their more differentiated progeny. Thus, we hypothesized that miR-99 is a regulator of differentiation in normal and leukemic stem cells. To test the function of miR-99 in normal hematopoiesis, we knocked down miR-99a or miR-99b in mouse HSCs (Lin-cKit+Sca1+CD34-SLAM+) using lentiviral vectors, resulting in ~3.5 fold reduction in the number of colonies formed in methylcellulose assays upon secondary plating (P=0.01), with the average colony being approximately 2 times smaller as measured by the number of cells (P=0.03). Consistently, transplantation assays demonstrated >10-fold reduction in long-term engraftment capacity of HSCs upon miR-99 knockdown (KD) at 16 weeks (P=0.0004). Analysis of peripheral blood of the transplanted mice revealed ~3-fold increase in the proportion of donor-derived myeloid cells, suggesting that miR-99 may regulate the self-renewal and/or limit differentiation of HSPCs (P=0.01). Consistent with these observations, gene set enrichment analysis (GSEA) using the RNA-sequencing data generated from hematopoietic stem and progenitor cells (HSPCs) with miR-99 KD revealed significant enrichment for the myeloid differentiation gene signature (Lindstedt-dendritic-cell-maturation, Nominal p value =0.0, FDR q value=0.02). Moreover, analysis of GFP+ miR-99 KD cells after second plating revealed a 3-fold increase in apoptosis as measured by caspase 3 activation. To better understand the mechanism mediating the reduced reconstitution capacity of miR-99 KD HSCs, we analyzed the composition of progenitors in the bone marrow of transplanted mice. miR-99 KD resulted in a highly significant decrease in the percentage of myeloid progenitors of donor-derived cells 16 weeks post transplantation (60% decrease, P=0.01), consistent with miR-99 KD inducing HSPC differentiation. Overall, these data suggest that miR-99 is a negative regulator of HSPC differentiation. Consistent with a role in maintaining LSCs, miR-99 KD in the AML cell lines MonoMac6 and U937 induced expression of myeloid differentiation markers including CD15, CD14 and CD13. This was accompanied by a 2-50 fold reduction in cell growth depending on the AML cell line tested and a significant increase in apoptosis; the levels of miR-99 expression correlated with the degree of the growth defect. In addition, concomitant expression of miR-99b KD and MLL-AF9 overexpression vectors in HSPCs followed by serial methocult assays lead to decreased colony formation in third platings. We also observed a 50% reduction in the percentage of Lin-Sca-1-c-Kit+ myeloid progenitors in secondarily plated cells (P value=0.01). These data suggest in MLL-AF9+ leukemia, miR-99 acts to restrain cell growth and maintain the undifferentiated state of leukemic blasts. Together, these data indicate that miR-99a/b regulates the proliferation of normal and leukemic stem cells by negatively regulating apoptosis and maintaining the stem cell state. Disclosures No relevant conflicts of interest to declare.

scholarly journals Effects OF Mulligan’s Mobilization With Movement On First Rib To Reduce Pain And Improve Cervical Rotation In Mechanical Neck Dysfunction

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Irfan Ahmad ◽  
Saima Riaz ◽  
Uzma Faiz ◽  
Muhammad Sulaman ◽  
Muhammad Zeeshan ◽  
...  
Keyword(s):  
Exercise Program ◽  
P Value ◽  
Time Duration ◽  
First Rib ◽  
Quasi Experimental ◽  
Clinical Benefits ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Cervical Rotation

Mechanical Neck Pain(MNP)  is  a  term  used  to  describe  pain  that results from stress or strain on  the structures of the vertebral  column. Factors such       as alteration in the anatomical structures, sprain or strain of the muscles or ligaments, and adaptation to a faulty posture can result in First rib dysfunction has been identified as a potential cause for faulty dynamic,  static,  traumatic  or  congenital  factors, may contribute to the development of elevated first rib dysfunction. Objective: Was to determine the effects of Mulligan’s mobilization with movement on first rib to reduce pain and improve cervical rotation in mechanical neck dysfunction. Material and methods: This study Quasi-experimental trial was done at PT CARE MM Alam road Lahore. The study was completed within the time duration of six months (July-Dec 2019) after the approval of synopsis. A total of 26 cases (13 in each group) were divided into 2 groups. Group A and Group B were treated with conventional exercise program and with Mulligan’s mobilization with movement on first rib and conventional exercise program only respectively. Bubble inclinometer and NPRS tools were used to measure cervical rotation and Pain respectively. Data analysis was done by SPSS 21. Results: The mean change in NPRS was statistically higher in group-B (5.46 ± 0.78) as compared to group-A (2.62 ± 0.87), p-value < 0.001. The mean change in cervical rotation (ROM) was statistically higher in group-B (17.46 ± 5.19) as compared to group-A (31.23 ± 4), p-value < 0.001. Conclusion: It is concluded that Mulligan’s mobilization with movement on first rib and conventional exercise program had statistically significant change in reduction of pain and had higher improvement in cervical rotation (ROM) right and left. Hence, by combining conventional treatment and Mulligan’s mobilization , maximum clinical benefits to reduce pain and improve cervical rotation can be attained in mechanical neck dysfunction

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
Cross Sectional Study ◽  
P Value ◽  
Pattern Reversal ◽  
Cross Sectional ◽  
The Mean ◽  
Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

Employing Personal Reading Logs through Short Stories to Enhance Students’ L2 Reading Comprehension Achievement

2019 ◽  
Vol 3 (2) ◽  
pp. 1
Author(s):  
Eliyas Sulaiman Mohandas ◽  
Nik Mastura Nik Ismail Azlan ◽  
Salwa Othman ◽  
Muhammad Aizat Azhari
Keyword(s):  
Short Stories ◽  
Reading Comprehension ◽  
P Value ◽  
L2 Reading ◽  
Reading Score ◽  
Paired Samples ◽  
Significant Difference ◽  
Post Test ◽  
The Mean ◽  
L2 Reading Comprehension

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.

DAMPAK PENERAPAN BEA MASUK ANTI-DUMPING ATAS IMPOR PRODUK TINPLATE

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Marsanto Adi Nurcahyo ◽  
Aditya Subur Purwana
Keyword(s):  
Free Trade ◽  
Descriptive Analysis ◽  
Secondary Data ◽  
P Value ◽  
Import Duty ◽  
Domestic Production ◽  
The Mean ◽  
Mean Equality ◽  
Equality Test

ABSTRACT:Anti-dumping on tinplate products aim to protect domestic industries. Still, some industries want tinplate products not to be subject to anti-dumping because domestic production is not sufficient. This research examines the application of anti-dumping import duties on tinplate products from China, Taiwan, and Korea from 2014 to 2018, to know whether there are differences in the value of imports before and during the anti-dumping import duty. Use secondary data sourced from UN-Comtrade. Samples are selected by countries that have continuously sent tinplate products to Indonesia from 2010 to 2018, namely China, Taiwan, Korea, Japan, Germany, India, and Malaysia. Using the Mean Equality Test, it is known that there are differences in the import value before and during the anti-dumping import duty, with a p-value of 0.0114 less than α (0.05), so it is concluded that there is a difference in the import value of the tinplate product before and during anti-dumping duty. Descriptive analysis results illustrate imports from China and Taiwan tend to decrease. In contrast, imports from Korea tend to increase despite being subjected to anti-dumping duties because they can compete by using preferential tariffs based on free trade schemes.Keywords: Antidumping, Import duty, TinplateABSTRAK:Anti-dumping terhadap produk tinplate bertujuan melindungi industri dalam negeri, akan tetapi terdapat ìndustri yang menginginkan produk tinplate tidak dikenakan anti-dumping karena produksi dalam negeri belum mencukupi. Penelitian ini menguji penerapan bea masuk anti-dumping terhadap produk tinplate dari China, Taiwan dan Korea selama tahun 2014 s.d. 2018, dengan tujuan mengetahui apakah ada perbedaan nilai importasi sebelum dan selama dikenakan bea masuk anti-dumping. Menggunakan data sekunder yang bersumber dari UNComtrade. Sampel dipilih negara yang secara kontinyu mengirim produk tinplate ke Indonesia sejak 2010 s.d. 2018, yaitu China, Taiwan, Korea, Jepang, Jerman, India dan Malaysia. Menggunakan Mean Equality Test, diketahui terdapat perbedaan nilai importasi sebelum dengan selama dikenakan bea masuk anti-dumping. Hasil penelitian menunjukkan bahwa nilai-P (p-value) adalah 0,0114 lebih kecil dari alpha (α=0,05), sehingga disimpulkan terdapat perbedaan pada nilai importasi produk tinplate sebelum dengan selama dikenakan bea masuk anti-dumping. Hasil analisis deskriptif menggambarkan importasi dari China dan Taiwan cenderung menurun sedangkan importasi dari Korea cenderung naik walaupun dikenakan bea masuk anti-dumping karena mampu bersaing dengan menggunakan tarif preferensi berdasarkan skema perdagangan bebas.Kata Kunci: Anti-dumping, Bea Masuk, tinplate

Association Between Awareness of Informal Caregivers and Falls in Elderly Patients with Uncontrolled Diabetes Mellitus

2020 ◽  
Vol 13 (1) ◽  
pp. 658-666
Author(s):  
Tossapon Chamnankit ◽  
Parichat Ong-artborirak ◽  
Jukkrit Wangrath
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patients ◽  
Elderly People ◽  
Informal Caregivers ◽  
Multivariable Analysis ◽  
P Value ◽  
Uncontrolled Diabetes ◽  
Risk Of Falls ◽  
The Mean ◽  
Falls In Elderly

Background: Elderly people with uncontrolled diabetes mellitus (DM) are at risk of falls, which can lead to injury and disability. Not much is known of informal caregivers’ awareness of falls in elderly patients with DM. Objective: This study aims to identify an association between caregiver’s awareness and falls in elderly patients with DM. Methods: A total of 136 pairs of DM patients and their respective family caregivers were recruited from a clinical service center at Chiang Mai University, Thailand. The questionnaire regarding the caregiver’s awareness of the risk of falls in elderly patients was given via a face-to-face interview. Each elderly patient was asked about their history of falls in the prior year, and the risk of falls was assessed by Time Up & Go (TUG) test. Logistic regression analysis was performed to determine association. Results: The mean age of the DM patients was 65.7 years. Sixty-two patients (45.6%) had fallen at least once in the prior year. The mean TUG test result was 12.67±1.83 second. Most caregivers demonstrated a high level of awareness regarding the risk of falls in elderly patients. The results of the multivariable analysis showed that three variables – balance problems, risk of falls assessed by TUG test, and scores of caregiver’s awareness of risk of falls – were significantly related to falls in the previous year among elderly patients with DM (p-value<0.05). Conclusion: The caregivers’ awareness of fall risk may influence fall occurrence among older adults with DM. An intervention program to improve awareness among informal caregivers should be considered for fall prevention in elderly people.

Correlation of AGR2 expression with the incidence of metastasis in luminal breast cancer

2021 ◽  
pp. 1-5
Author(s):  
David Samuel Kereh ◽  
John Pieter ◽  
William Hamdani ◽  
Haryasena Haryasena ◽  
Daniel Sampepajung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Mean Value ◽  
Rank Test ◽  
Luminal Breast Cancer ◽  
P Value ◽  
Strong Positive Correlation ◽  
Breast Cancer Patients ◽  
The Mean ◽  
Spearman Test

BACKGROUND: AGR2 expression is associated with luminal breast cancer. Overexpression of AGR2 is a predictor of poor prognosis. Several studies have found correlations between AGR2 in disseminated tumor cells (DTCs) in breast cancer patients. OBJECTIVE: This study aims to determine the correlation between anterior Gradient2 (AGR2) expression with the incidence of distant metastases in luminal breast cancer. METHODS: This study was an observational study using a cross-sectional method and was conducted at Wahidin Sudirohusodo Hospital and the network. ELISA methods examine AGR2 expression from blood serum of breast cancer patients. To compare the AGR2 expression in metastatic patients and the non-metastatic patient was tested with Mann Whitney test. The correlation of AGR2 expression and metastasis was tested with the Rank Spearman test. RESULTS: The mean value of AGR2 antibody expression on ELISA in this study was 2.90 ± 1.82 ng/dl, and its cut-off point was 2.1 ng/dl. Based on this cut-off point value, 14 subjects (66.7%) had overexpression of AGR2 serum ELISA, and 7 subjects (33.3%) had not. The mean value AGR2 was significantly higher in metastatic than not metastatic, 3.77 versus 1.76 (p < 0.01). The Spearman rank test obtained a p-value for the 2 tail test of 0.003 (p < 0.05), which showed a significant correlation of both, while the correlation coefficient of 0.612 showed a strong positive correlation of AGR2 overexpression and metastasis. CONCLUSIONS: AGR2 expression is correlated with metastasis in Luminal breast cancer.

scholarly journals Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Salma S. Al Sharhan ◽  
Mohammed H. Al Bar ◽  
Shahad Y. Assiri ◽  
Assayl R. AlOtiabi ◽  
Deemah M. Bin-Nooh ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Endoscopic Sinus Surgery ◽  
T Test ◽  
Sinus Surgery ◽  
Symptom Improvement ◽  
P Value ◽  
Psychological Dysfunction ◽  
Significant Difference ◽  
The Mean ◽  
Snot 22

Abstract Background Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients. Methods This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS. Results The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value =  < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value =  < 0.001); ear/facial symptoms (t-test = 6.34, p-value =  < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value =  < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035). Conclusion Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life. Level of evidence Prospective observational.

scholarly journals Environmental Cadmium Exposure and Dental Indices in Orthodontic Patients

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 413
Author(s):  
Hui-Ling Chen ◽  
Jason Chen-Chieh Fang ◽  
Chia-Jung Chang ◽  
Ti-Feng Wu ◽  
I-Kuan Wang ◽  
...  
Keyword(s):  
Cadmium Concentration ◽  
Class Ii ◽  
Cadmium Exposure ◽  
Class I ◽  
P Value ◽  
Tooth Decay ◽  
Class Iii ◽  
Orthodontic Patients ◽  
Urine Cadmium ◽  
The Mean

Background. Previous studies have shown that environmental cadmium exposure could disrupt salivary gland function and is associated with dental caries and reduced bone density. Therefore, this cross-sectional study attempted to determine whether tooth decay with tooth loss following cadmium exposure is associated with some dental or skeletal traits such as malocclusions, sagittal skeletal pattern, and tooth decay. Methods. Between August 2019 and June 2020, 60 orthodontic patients with no history of previous orthodontics, functional appliances, or surgical treatment were examined. The patients were stratified into two groups according to their urine cadmium concentrations: high (>1.06 µg/g creatinine, n = 28) or low (<1.06 µg/g creatinine, n = 32). Results. The patients were 25.07 ± 4.33 years old, and most were female (female/male: 51/9 or 85%). The skeletal relationship was mainly Class I (48.3%), followed by Class II (35.0%) and Class III (16.7%). Class I molar relationships were found in 46.7% of these patients, Class II molar relationships were found in 15%, and Class III molar relationships were found in 38.3%. The mean decayed, missing, and filled surface (DMFS) score was 8.05 ± 5.54, including 2.03 ± 3.11 for the decayed index, 0.58 ± 1.17 for the missing index, and 5.52 ± 3.92 for the filled index. The mean index of complexity outcome and need (ICON) score was 53.35 ± 9.01. The facial patterns of these patients were within the average low margin (26.65 ± 5.53 for Frankfort–mandibular plane angle (FMA)). There were no significant differences in the above-mentioned dental indices between patients with high urine cadmium concentrations and those with low urine cadmium concentrations. Patients were further stratified into low (<27, n = 34), average (27–34, n = 23), and high (>34, n = 3) FMA groups. There were no statistically significant differences in the urine cadmium concentration among the three groups. Nevertheless, a marginally significant p-value of 0.05 for urine cadmium concentration was noted between patients with low FMA and patients with high FMA. Conclusion. This analysis found no association between environmental cadmium exposure and dental indices in our orthodontic patients.

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