Changes in symptoms of dry eyes in health professionals with increased duration of wearing the mask

: In normal population and patient, the significant increase in dry eyes manifestations have been observed. Similarly, aggravated symptoms and complaints of dryness have also been observed in clinical and hospital staff by using a face mask for an extended time period. The purpose of the study was to observe the association between symptoms of dry eyes and the duration of using masks in health professionals.: An unspecified questionnaire was distributed using Google Forms through different social media platforms, asking each respondent to contribute to the survey. Data were collected from December 2021 to January 2021. Statistical analysis was performed using SPSS software. Statistical significance was considered if p-value was less than 0.05. A total of 39 responses was included for analysis in the study. There was a positive correlation between the frequency of the symptoms of dryness and the duration of using the mask. Similarly, the severity of the symptoms for dry eyes was strongly correlated with an increase in the frequency of symptoms for dry eyes.The finding reflects that the frequency of the dryness along with the severity will increase with the increase in the duration of wearing a mask. Moreover, it also suggests that cloth mask is the probable predisposing factor for the increase in the dry eye symptoms in this study.

Evaluation of Intravenous Phenobarbital Pharmacokinetics in Critically Ill Patients With Brain Injury

Phenobarbital is still one of the drugs of choice in managing patients with brain injury in the intensive care unit (ICU). However, the impact of acute physiological changes on phenobarbital pharmacokinetic parameters is not well studied. This study aimed to evaluate the pharmacokinetic parameters of parenteral phenobarbital in critically ill patients with brain injury. Patients with severe traumatic or non-traumatic brain injury at high risk of seizure were included and followed for seven days. All patients initially received phenobarbital as a loading dose of 15 mg/kg over 30-minutes infusion, followed by 2 mg/kg/day divided into three doses. Blood samples were obtained on the first and fourth day of study at 1, 2, 5, 8, and 10 hours after the end of the infusion. Serum concentrations of phenobarbital were measured by high-pressure liquid chromatography (HPLC) with an ultraviolet (UV) detector. Pharmacokinetic parameters, including the volume of distribution (Vd), half-life (t1/2), and the drug clearance (CL), were provided by MonolixSuite 2019R1 software using stochastic approximation expectation-maximization (SAEM) algorithm and compared with previously reported parameters in healthy volunteers. Data from seventeen patients were analyzed. The mean value±standard deviation of pharmacokinetic parameters was calculated as follows: Vd: 0.81±0.15 L/kg; t1/2: 6.16±2.66 days; CL: 4.23±1.51 ml/kg/h. CL and Vd were significantly lower and higher than the normal population with the value of 5.6 ml/kg/h (P=0.002) and 0.7 L/kg (P=0.01), respectively. Pharmacokinetic behavior of phenobarbital may change significantly in critically ill brain-injured patients. This study affirms the value of early phenobarbital therapeutic drug monitoring (TDM) to achieve therapeutic goals.

Comorbidity of Mental Disorder in Patients with Chronic Dis-ease: A Comparative Study of Heroin Dependence Patients and Diabetes Mellitus Patients

Background: Chronic patients are at greater risk for a psychiatric problem than the normal population; yet, the increased rate of mental disorder among one chronic patient compared to another chronic patient is uncertain. We aimed to assess the rate of mental disorder among people with heroin dependence and diabetes mellitus in comparison with the healthy population. Methods: This cross-sectional study was carried out in Kuala Lumpur, Malaysia in 2017-2020. The study consisted of 648 participants including heroin dependence patients, diabetes mellitus patients, and healthy population. The GHQ-28 and SCL-90-R scales were used to assess mental disorder among the study populations. Results: The current study revealed the rate of mental disorder among heroin dependence patients, diabetes mellitus patients, and healthy population respectively at 52.1%, 49.5%, and 23.2% using SCL-90-R and GHQ-28. The rate of mental disorder in both heroin dependent (OR 95%= 3.59: 2.37-5.44) and diabetic groups (OR 95%=3.25: 2.14-4.92) were significantly more than the healthy population; however, the odds ratio of mental disorder was not significantly different between heroin dependent and diabetic groups. Furthermore, the results revealed an acceptable agreement between SCL-90-R and GHQ-28 to detect mental disorders (Kappa=0.60; P<0.001). Conclusion: People with diabetes mellitus and heroin dependence have significantly poorer mental health than healthy people in Malaysia have. Furthermore, the equivalent rate of mental disorder among such patients suggests that heroin dependence patients are not more distressed than diabetes mellitus patients are. However, further comparative studies are needed to prove these findings.

Health-Related Quality Of Life And Clinical Outcome After Radiotherapy of Patients With Intracranial Meningioma

Purpose: This retrospective, single-institutional study investigated long-term outcome, toxicity and health-related quality of life (HRQOL) in meningioma patients after radiotherapy. Methods: We analyzed the data of 119 patients who received radiotherapy at our department from 1997 to 2014 for intracranial WHO grade I-III meningioma. Fractionated stereotactic radiotherapy (FSRT), intensity modulated radiotherapy (IMRT) or radiosurgery radiation was applied using a linear accelerator. A median total dose of 54.7 Gy (IQR 54.0-60.0 Gy) was prescribed in median single doses of 1.8 Gy (IQR 1.8-1.9 Gy). Overall survival (OS) and local control (LC) rates were obtained. In addition, the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core questionnaire (QLQ-C30) and the EORTC Brain Cancer Module (QLQ-BN20) were completed for assessment of HRQOL. Results were compared with normal population and with already published data. Results: OS for the entire cohort was 89.6% at 5 years and 75.9% at 10 years. LC at 5 and 10 years was 82.4% and 73.4%, respectively. Local recurrence was observed in 22 patients (18.5%). CTCAE grade ≥3 acute and chronic toxicities were observed in seven patients (5.9%) and five patients (4.2%), respectively. Global health status was rated with a mean of 59.9 points (SD 22.3) on QLQ-C30. HRQOL was lower after radiotherapy in comparison to normal population and to meningioma patients treated by surgery alone. Conclusion: Radiotherapy resulted in very good long-term survival and tumor control rates with low rates of severe toxicities. Nevertheless, long-term HRQOL may be negatively affected by radiotherapy.

Physical Performance and Non-Esterified Fatty Acids in Men and Women after Transcatheter Aortic Valve Implantation (TAVI)

Background: Men and women with valvular heart disease have different risk profiles for clinical endpoints. Non-esterified fatty acids (NEFA) are possibly involved in cardio-metabolic disease. However, it is unclear whether NEFA concentrations are associated with physical performance in patients undergoing transcatheter aortic valve implantation (TAVI) and whether there are sex-specific effects. Methods: To test the hypothesis that NEFA concentration is associated with sex-specific physical performance, we prospectively analysed data from one hundred adult patients undergoing TAVI. NEFA concentrations, physical performance and anthropometric parameters were measured before and 6 and 12 months after TAVI. Physical performance was determined by a six-minute walking test (6-MWT) and self-reported weekly bicycle riding time. Results: Before TAVI, NEFA concentrations were higher in patients (44 women, 56 men) compared to the normal population. Median NEFA concentrations at 6 and 12 months after TAVI were within the reference range reported in the normal population in men but not women. Men but not women presented with an increased performance in the 6-MWT over time (p = 0.026, p = 0.142, respectively). Additionally, men showed an increased ability to ride a bicycle after TAVI compared to before TAVI (p = 0.034). NEFA concentrations before TAVI correlated with the 6-MWT before TAVI in women (Spearman’s rho −0.552; p = 0.001) but not in men (Spearman’s rho −0.007; p = 0.964). No association was found between NEFA concentrations and physical performance 6 and 12 months after TAVI. Conclusions: NEFA concentrations improved into the reference range in men but not women after TAVI. Men but not women have an increased physical performance after TAVI. No association between NEFA and physical performance was observed in men and women after TAVI.

Vztahová vazba a copingové strategie u vězeňské populace

Objectives. The study is aimed at describing attachment and coping strategies in the prison population, and relations between these two variables were tested. Sample and setting. The sample consisted of 122 men serving middle-security sentences mainly for property crime. The attachment was determined by the Czech version of the Experiences in Close Relationships Scale, and coping strategies were measured by The Stress Coping Style Questionnaire SVF 78. Hypotheses. The prisoners’ attachment and coping strategies were expected to be different from those of the normal population. The attachment anxiety and avoidance were expected to be related to coping strategies. Statistical analyses. One sample t-test and Wilcoxon one sample test were used for analyzing the differences in scores between the prison and normal population while the Pearson correlation and linear regression were used to test relations between variables. Results. Inmates were significantly different from the normal population both in their attachment and coping strategies. They exhibited higher attachment anxiety and avoidance compared to the normative sample, fearful avoidant attachment prevailed. Prisoners demonstrated higher Play Down, Distraction from Situation, Substitutional Satisfaction, Flight Tendency, Self-accusation, and Active Avoidance, they exhibited lower Guilt Denial and Rumination. Relational avoidance correlated negatively with positive coping strategies, relational anxiety correlated positively with negative coping strategies. Limitations. The main limitation of this study is the use of a non-representative sample and the self-assessment form of the methods employed.

Association of Hidradenitis Suppurativa (HS) with Autoimmune Disease and Autoantibodies

Objective There is thought to be an association between Hidradenitis Suppurativa (HS) and autoimmune diseases. This retrospective longitudinal cohort study looked to identify whether certain autoimmune diseases or autoantibody specificities are more closely associated with HS than others and, whether such associations are related to severity of HS. Methods Patients were identified using the SlicerDicer search tool in Epic from January 1, 2010 through August 15, 2020. Search criteria included HS diagnosis by ICD-10 code and at least one visit in dermatology. Charts were reviewed to determine HS disease severity, treatment modalities, presence of autoimmune disease, and autoantibody positivity. Results 627 patients were identified. Most patients were females (75.3%) and had obese BMIs (71.1%), but there were no significant demographic differences between HS patients with and without autoimmune diseases. 101 (16.1%) patients in the total cohort had at least one autoimmune disease, most commonly, thyroid disease, lupus, psoriasis, and inflammatory bowel disease (IBD). 212 patients were also tested for the presence of autoantibodies. The most common positive autoantibody, found in 54 patients (28.4%), was antinuclear antibody (ANA). 54 patients with more severe HS disease manifestations required biologic medications to treat their HS. Neither HS severity nor biologic treatment was associated with presence of autoimmune disease or positive autoantibodies. Conclusion In a large cohort of patients with HS followed longitudinally, autoimmune disorders (especially lupus, psoriasis and IBD) and presence of autoantibodies were more commonly observed than expected in the normal population.

A Rare Presentation of Coeliac Disease; Intractable Itching with Recurrent Heart Attack and Dermatitis Herpetiformis

Coeliac disease (CD) is a systemic disease of the unwarranted immune reaction to gluten and is associated with a 10% increased risk of cardiovascular disease. Here we present a patient with recurrent myocardial ischemia and intractable itching who was eventually diagnosed with CD. A 53-year-old man presented to the allergy department due to intractable itching that was resistant to antihistamine therapy. In addition, despite successful percutaneous intervention with stent implantation to the right coronary artery, there was an ST segment elevation with myocardial infarction (MI) in the lower wall that had occurred three times. After dermatitis herpetiformis was reported as a result of the biopsy performed from the lesions, duodenal biopsy confirmed the diagnosis of CD. Diagnosis of CD with atypical presentation can be difficult. Cardiovascular risk is increased in patients with celiac disease compared to the normal population. Itching is an important symptom that needs to be evaluated in detail, even without the typical gastrointestinal manifestations of CD. Keywords: Allergy, coeliac disease, dermatitis herpetiformis, myocardial infarction, omalizumab, recurrent stenosis

Apathy as a Risky Neuropsychiatric Syndrome of Progression From Normal Aging to Mild Cognitive Impairment and Dementia: A Systematic Review and Meta-Analysis

Background: Apathy has been suggested as a potential predictor of mild cognitive impairment (MCI) progression to dementia. Whether it might predict the transition from normal cognitive function to cognitive impairment has been less studied. The current study aimed to provide a comprehensive summary of the evidence on the association between apathy and the transition from normal cognitive function to cognitive impairment.Methods: We searched the PubMed, Embase, and Web of Science databases for longitudinal prospective cohort studies that evaluated apathy at baseline in the cognitively normal population and had cognitive impairment as the outcome. Random effects models were used, and heterogeneity was explored with stratification. The stability of the synthesized result was indicated using sensitivity analysis by excluding one study each time and recalculating the overall effect.Results: Ten studies comprising 26,195 participants were included. Apathy status was available for 22,101 participants. Apathy was present in 1,803 of 22,101 participants (8.16%). Follow-up ranged from 1 to 13 years. The combined odds ratio (OR) of cognitive impairment for patients with apathy was 2.07 (95% CI: 1.43–2.99; I2 = 86%), and the combined hazard ratio was 2.70 (95% CI: 1.38–5.27; I2 = 94%). The OR meta-analyses for different conversion outcomes were MCI (OR = 3.38, 95% CI: 1.57–7.28; I2 =71%), cognitive decline (OR = 1.27, 95% CI: 0.81–2.00; I2 = 64%) and dementia (OR = 2.12, 95% CI: 1.32–3.41; I2 = 86%). Subgroup analysis suggested that the association between apathy and cognitive impairment changed with age, depression adjustments, apathy measurement, and follow-up time.Conclusions: Apathy was associated with a greater than 2-fold increased risk of progression to cognitive impairment in the cognitively normal population. Future interventions targeting apathy management in the general population may reduce the risk of cognitive impairment.

Impact of Measurement Error on the Power Function of Average Control Chart under Non-Normal Population

In the present article, effect of measurement error on the power function of control charts for mean with control limits is considered based on non-normal population. The non-normality is represented by the first four terms of an Edge-worth series. Tabular and visual comparison is also provided for the better comprehension of the significance of measurement error on power function under non-normality.