Analysis of COVID-19 Prevention and Control Modes and Effects

This study evaluates COVID-19 prevention and control policies. Based on the simulation, we compare the effects of two major policies: contact restriction and active treatment. Through regression and cluster analysis, we classified 169 countries and regions in the world into 10 groups, among which five groups accounted for the major proportion: the ones with the labels “CHN (China) mode,” “SE (South Europe) mode,” “ENE-SSA (East & North Europe and Sub-Saharan Africa) mode,” “US (United States) mode,” and “DEU (Germany) mode”). Differences in the effects of the prevention and control of COVID-19 in typical countries in each mode are comprehensively investigated. The conclusions of this study can be summarized as follows: First, contact restriction outperforms active treatment in curbing the spread of COVID-19. Second, “CHN mode” ranks the highest level of epidemic control and emphasizes epidemic prevention and control more than economic stimulus, which is the opposite of the “US mode”. Regression analysis reveals that the differences in epidemics worldwide are caused by policy differences among modes.

Comparison of Two Protocols for the Treatment of Class 2 Malocclusion

Purpose: The purpose of this study was to compare the outcomes of the treatment with the twin block and modified twin block appliances in growing patients with Class 2 malocclusion. Materials and Methods: A cephalometric analysis was performed in 51 patients. The twin block sample consisted of 23 patients, 10-girls and 13-boys (mean age 10.46±0.71 years at the start of treatment, T1, and 12.84±0.78 years at the end of active treatment, T2). The modified twin block sample consisted of 28 patients, 18 girls and 15 boys (mean age 11.78±0.91 years at T1, and 13.32±0.56 years at T2). The twin block activators were used during the day, except for eating time, and the modified ones were used only at night. Duration of the treatment was 16-20 months. The changes from T2 to T1 and the differences between the groups were compared with the analysis of variance. Results: SNB angle in the twin block group showed 1.25±1.39 degrees change and in the modified twin block group, it exhibited 3.69±1.01 degrees change. Overjet in the group with twin block decreased 4.58±1.59 mm, and in the group with modified twin block it decreased 4.43±1.41 mm. In the modified twin block group, there was more retrusion of upper incisors in comparison with the twin block group. Accordingly, under the effect of modified twin block, retrusion of the upper lip was observed. Conclusion: Through modifying the twin block appliance, it is possible to ensure the comfort of the patients by reducing the daily usage, to reposition the mandibula forward and to correct overjet and sagittal dento-skeletal relationships without increasing facial height and to improve positions of upper incisors and lips.

Outcomes of active surveillance for clinically localized prostate cancer in a middle eastern tertiary care center

Background: The aim of our study was to evaluate the outcome of active surveillance (AS) for prostate cancer for a cohort of patients at our institution. Methods: A total of 43 patients with low risk prostate cancer were enrolled in an active surveillance pilot program at our institution between 2008 and 2018. Follow up protocols included: periodic prostate specific antigen (PSA), digital rectal examination (DRE), multiparametric MRI, and prostate biopsy at one year. Pertinent parameters were collected, and descriptive statistics were reported along with a subset analysis of patients that dropped out of the protocol to receive active treatment for disease progression. Results: Out of 43 eligible patients, 46.5% had a significant rise in follow up PSA. DRE was initially suspicious in 27.9% of patients, and none had any change in DRE on follow up. Initially, prostate MRIs showed PIRADS 3, 4, and 5 in 14%, 37.2%, and 11.6% respectively, while 23.2% had a negative initial MRI. 14% did not have an MRI. Upon follow up, 18.6% of patients had progression on MRI. Initial biopsies revealed that 86% were classified as WHO group 1, while 14% as WHO group 2. With regards to the follow up biopsies, 11.6% were upgraded. 20.9% of our patients had active treatment; 44.4% due to upgraded biopsy results, 22.2% due to PSA progression, 22.2% due to strong patient preference, and 11.1% due to radiologic progression. Conclusions: For selected men with low risk prostate cancer, AS is a reasonable alternative. The decision for active treatment should be tailored upon changes in PSA, DRE, MRI, and biopsy results.

Being a Cancer Patient during the Time of COVID-19: Impact of the Pandemic on the Anxiety and the Sleeping Quality of Oncology Patients

<b><i>Objective:</i></b> In this study, we aimed to assess anxiety and sleep quality in cancer patients treated or followed up at our clinic at the time of the outbreak of the COVID-19 pandemic. <b><i>Methods:</i></b> Seven hundred and sixty-one patients who were either treated or followed up at our oncology clinic between April 2020 and May 2020 were included. Patients were assessed with the State-Trait Anxiety Inventory (STAI) and the Pittsburgh Sleep Quality Index (PSQI). <b><i>Results:</i></b> Mean scores of the 761 participants were STAI, 43.45 ± 9.34 (range, 23–75), and PSQI, 5.67 ± 4.24 (range, 0–19). Quality of sleep was found bad in 447 (58.7%) (global score ≥5). Univariate analyses demonstrated statistical differences by stage of cancer, status of treatment, subgroup of treatment, monthly income, and levels of education in anxiety and sleep quality levels. Multivariate analyses showed active treatment (OR: 21.4; 95% CI: 9.08–50.4; <i>p</i> &#x3c; 0.001) as the major independent variable that affected sleep quality; the major independent variable associated with anxiety was low income (OR: 4.43; 95% CI: 1.69–11.5; <i>p</i> = 0.002). <b><i>Conclusion:</i></b> Anxiety and sleep quality levels were found comparable to pre-pandemic reports, and the pandemic was not observed to have additional negative impact on cancer patients. Also, universal basal anxiety and sleep disorder that accompany cancer or active treatment were observed in our study. The accurate effects of the pandemic can be analyzed in further studies using repeated data obtained from the same patient group.

Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo

Background: Balance training with vibrotactile neurofeedback (VNF) can improve balance and subjective impairment in age-related vertigo and dizziness. Ginkgo biloba dry extract EGb 761 has been shown to improve subjective impairment in chronic vertigo and the efficacy of conventional balance training. The combination was expected to work synergistically in this difficult-to-treat population.Objectives: To demonstrate the efficacy of VNF added to EGb 761 for age-related vertigo and dizziness.Design: Multicenter, prospective, controlled, randomized, single-blind, two-arm trial (German Clinical Trials Register https://www.drks.de No. DRKS00007633).Setting: Specialist offices and tertiary care outpatient department.Participants: One hundred and twenty subjects aged 60+ years with chronic dizziness for over 3 months, a Dizziness Handicap Inventory (DHI) Sum Score &gt;25 and fall risk in balance-related situations as measured by the geriatric Standard Balance Deficit Test Composite Score (gSBDT-CS)&gt;40. Patients with other distinct vestibular pathology (e.g., Meniére's disease, stroke, BPPV) were excluded.Intervention: EGb 761 (80 mg twice daily for 12 weeks) plus 10 days of individually adapted balance training with VNF, randomized 1:1 to sensitive (active) or non-sensitive (sham) neurofeedback.Measurements: The change in gSBDT-CS after 6 weeks (primary), other gSBDT outcomes, DHI, cognition, hearing, and safety.Results: One hundred nine of 120 enrolled subjects received both treatments at least once. Over 12 weeks, the gSBDT-CS improved by 6.7 (active) vs. 4.5 (sham). There was a difference in favor of the active treatment of −2.4 (95% CI −5.4; 0.6) after 6 weeks. Under active treatment, more pronounced effects occurred in all secondary analyses and in nearly all secondary endpoints. The DHI sum score decreased from 44.1 to 31.1 in the total sample with a treatment group difference after 6 weeks of −3.1, 95% CI (−7.1; 0.9). No safety issues were reported.Conclusion: Over 12 weeks, the combination of balance training with VNF and Ginkgo biloba dry extract EGb 761 reached a clinically relevant improvement of age-related vertigo and dizziness with a good pharmacological safety profile.

A Clinical Study on the Efficacy and Tolerability of a New Topical Gel and Toothpaste in Patients with Xerostomia: A Randomized Controlled Trial

Objective: xerostomia is a very common problem in the general population. The objective of this study was to determine the efficacy of a new gel and toothpaste in patients with xerostomia, analyze the role of salivary cytokines as biomarkers of xerostomia and assess the possible changes in salivary cytokines following treatment. Materials and methods: A randomized, controlled double-blind clinical study was carried out in 73 patients with xerostomia divided into two groups: placebo and active treatment (cymenol; tocopheryl acetate; D-panthenol; Aloe barbadensis; citrate tribasic dihydrate; fluoride) with oral gel and toothpaste three times a day for four consecutive weeks. The Thomson Xerostomia Inventory was applied, with the assessment of oral quality of life (OHIP-14) at baseline and after four weeks of application of the product. Sialometry was also performed in both groups, with analysis of the IL-1b, IL-6, IL-8 and TNFa levels in saliva. Results: In the active treatment group, the xerostomia scores decreased significantly at the end of the study versus baseline, from 33.47 to 27.93 (p < 0.001). No significant decrease was recorded in the placebo group (34.5 to 32.75; p = 0.190). There were no adverse effects in either group. Regarding the saliva samples, the active treatment group showed significant differences in IL-6 concentration versus the control group (18.55 pg/mL (8–38.28) and 5.83 pg/mL (1.19–12.04), respectively; p = 0.002). No significant differences in salivary cytokines were observed in either the treatment group or the control group. Conclusions: The use of a new toothpaste and gel developed for patients with xerostomia proved effective, with greater symptom relief than in the placebo group. Further clinical studies involving longer time periods and larger samples are advisable in order to confirm the benefits of the described treatment.

Impact of Probiotic (Saccharomyces Boulardii) Administration in Prevention and Management of Chronic Diarrhea

Background: Diarrheal disease is the second leading cause of death in children under five years old, and is responsible for killing around 525 000 children every year. Though many treatment modalities exist, chronic diarrheal conditions demand a safer alternative modality (with lesser side effects) and thus, role of probiotics in prevention and management of chronic diarrhea merits exploration. Objective: To study the impact of probiotic (Saccharomyces Boulardii) in prevention and management of chronic diarrhea. Methodology: This experimental study comprised of a sample of 178 (chosen via non-probability, consecutive sampling) children aged 2 months to 12 years, presenting to the study setting with chronic diarrhea (from November 05, 2019, to May 04, 2020) to the Dept. of Pediatrics at Liaquat University Hospital, Hyderabad. After taking written consent, data was recorded onto a structured questionnaire containing inquiries about the socio-demographic details, diarrheal disease history, medication history and eventual treatment outcome. The study population was divided into 2 equal groups (S. Boulardii group & Control Group) of 89 each. The active treatment period was 5 days. All study participants were examined on day 0 (inclusion day) and followed up on day 3 and day 6 during active treatment phase and in the following month thereafter for observation. The data obtained was analyzed through SPSS version 20. Results: The mean age of the sample stood at 6.5 (SD ± 1.5) years. Baseline characteristics such as mean age and the average frequency of stools were comparable in S. boulardii and control group at the time of inclusion in the trial. By day 3 it reduced to 2.8 and 4.4 stools per day respectively and by day 6 it reduced to 1.4 (S. boulardii Group) and 3.7 (control group). The duration of diarrhea was 3.2 days in S. boulardii group whereas it was 5.2 day in control group (P = 0.001). In the following month, S. boulardii group had a significantly lower frequency of 0.46 episodes as compared to 1.28 episodes in control group. Conclusion: After careful consideration, it can be concluded that average frequency of stools is significantly reduced and brought down to normal in the S. boulardii group as compared to the control group The drug was well accepted and tolerated. There were no reports of the side effects during treatment period.