2nd Visit Research Articles

COVID-19 Impacts the Mental Health and Speech Function in Spinocerebellar Ataxia Type 2: Evidences from a Follow-Up Study.

Limited evidence suggests that the SARS-CoV-2 infection can accelerate the progression of neurodegenerative diseases, but this has been not verified in the spinocerebellar ataxias (SCA). The objective of this study is to assess the impact of COVID-19 on the mental health and motor features of SCA2. A follow-up study was carried out in 170 Cuban SCA2 subjects and 87 community controls between 2020 and 2021. All subjects underwent a structured questionnaire to assess the risks of exposure to COVID-19, the confirmation of COVID-19 diagnosis, and the Hospital Anxiety and Depression Scale (HADS). Moreover, 36 subjects underwent the Scale for the Assessment and Rating of ataxia (SARA). The risk of exposure to SARS-CoV-2 and the frequency of COVID-19 were similar between the ataxia cohort and the community controls. Within the ataxia group, significantly increased HADS scores existed at the 2nd visit in both groups, but this increase was more evident for the infected group regarding the depression score. Moreover, a significant within-group increase of SARA score was observed in the infected group but not the non-infected group, which was mainly mediated by the significant increase of the speech item score in the infected group. Similar results were observed within the subgroup of preclinical carriers. Our study identified no selective vulnerability nor protection to COVID-19 in SCA2, but once infected, the patients experienced a deterioration of mental health and speech function, even at preclinical disease stage. These findings set rationales for tele-health approaches that minimize the detrimental effect of COVID-19 on SCA2 progression and identify SCA2 individuals as clinical model to elucidate the link between SARS-CoV-2 infection and neurodegeneration.

Statin use and longitudinal changes in quantitative MRI-based biomarkers of thigh muscle quality: data from Osteoarthritis Initiative.

To assess whetherchanges in MRI-based measures of thigh muscle quality associated with statin use in participants with and without/at-risk of knee osteoarthritis. This retrospective cohort study used data from the Osteoarthritis Initiative study. Statin users and non-users were matched for relevant covariates using 1:1 propensity-score matching. Participants were further stratified according to baseline radiographic knee osteoarthritis status. We used a validated deep-learning method for thigh muscle MRI segmentation and calculation of muscle quality biomarkers at baseline, 2nd, and 4th visits. Mean difference and 95% confidence intervals (CI) in longitudinal 4-year measurements of muscle quality biomarkers, including cross-sectional area, intramuscular adipose tissue, contractile percent, and knee extensors and flexors maximum and specific contractile force (force/muscle area) were the outcomes of interest. After matching, 3772 thighs of 1910 participants were included (1886 thighs of statin-users: 1886 of non-users; age: 62 ± 9 years (average ± standard deviation), range: 45-79; female/male: 1). During 4 years, statin use was associated with a slight decrease in muscle quality, indicated by decreased knee extension maximum (mean-difference, 95% CI: - 1.85 N/year, - 3.23 to - 0.47) and specific contractile force (- 0.04 N/cm2/year, - 0.07 to - 0.01),decreased thigh muscle contractile percent (- 0.03%/year, - 0.06 to - 0.01), and increased thigh intramuscular adipose tissue (3.06 mm2/year, 0.53to 5.59). Stratified analyses showed decreased muscle quality only in participants without/at-risk of knee osteoarthritis but not those with established knee osteoarthritis. Statin use is associated with a slight decrease in MRI-based measures of thigh muscle quality over 4 years. However, considering statins' substantial cardiovascular benefits, these slight muscle changes may be relatively less important in overall patient care.

B-072 Analysis of Anti-SARS-Cov-2 S1-RBD and N IgG in Saliva and Serum

Abstract Background Mucosal antibody testing may be a significant and more practical tool for measuring humoral immunity since it is non-invasive. The aim of this study was to evaluate the SARS-CoV-2-specific antibody prevalence in saliva compared to serum in 2022. Methods From February to December 2022, the paired serum and saliva specimens were collected twice over a period. The saliva specimens were collected using a Salivette Cortisol (Sarstedt AG & Co. KG, Germany) device according to manufacturers’ instructions. Antibody tests were performed using nucleocapsid protein-based Elecsys anti-SARS-CoV-2 (anti-N IgG) and spike protein targeted SARS-CoV-2 IgG II Quant (anti-S1-RBD IgG). Results 162 (97.6%) of 166 had anti-S1-RBD IgG in their serum. At the 1st visit and 2nd visit, 79 (47.5%) and 97 (58.4%) patients, respectively, had anti-N IgG in their serum. At 1st visit and 2nd visit, respectively, 14 (8.4%) and 13 (7.8%) patients had anti-S1-RBD IgG in their saliva. Four (2.4%) and five (3.0%) patients had anti-N IgG in their saliva during the 1st visit and 2nd visit, respectively. The correlation coefficient of the results of anti-S1-RBD IgG and anti-N IgG quantitative results between at 1st visit and 2nd visit were low (r = 0.1721 to 0.6448). All patients in the anti-S1-RBD IgG seronegative group (N = 4) had anti-N IgG in their serum, but neither anti-S1-RBD IgG nor anti-N IgG were detected in their saliva. All anti-N IgG seronegative patients (N = 68) had anti-S1-RBD IgG in serum, while 3 patients had anti-S1-RBD IgG and 7 patients had anti-N IgG in saliva. Conclusion Mucosal antibodies were detected in certain seronegative patients. The assessment of SARS-CoV-2-specific saliva antibodies should be regarded as a supplemental non-invasive diagnostic to serum to evaluate the prevalence and transmission of COVID-19.

Uterocervical angle versus cervical length in the prediction of spontaneous preterm birth in women with history of spontaneous preterm birth: a prospective observational study

BackgroundPreterm delivery is a leading cause of neonatal mortality and morbidity. History of spontaneous preterm birth is the greatest risk factor for another preterm delivery. So, every effort should be made to prevent the recurrence of preterm delivery in this vulnerable group. This study aimed to evaluate the predictive ability of the anterior uterocervical angle and cervical length in preterm birth.Patients and MethodsThis was a prospective cohort study that included 70 patients with a history of spontaneous preterm birth. Ultrasound measurements of cervical length and anterior uterocervical angle were set to be measured for each patient at three visits; first between 16 0/7 and 24 0/7 weeks, second between 24 1/7 and 32 0/7 weeks, and the third was between 32 1/7 and 36 6/7 weeks. The correlation between both measures and the prediction of preterm birth among study participants was the primary outcome of the study. Neonatal outcome among the study patients was a secondary measure of outcome.ResultsThe incidence of preterm birth among study participants was 31.41%. Cervical length and uterocervical angle showed progressive decrease and increase respectively throughout pregnancy. At the 2nd visit, the two measures were significantly different between those who delivered at term and those with preterm delivery with the cervical length being significantly shorter in the preterm arm (3.0 ± 0.49 versus 3.38 ± 0.36, p < 0.001) and uterocervical angle being significantly bigger among the same arm (110.1 ± 18.48 versus 84.42 ± 12.24, p < 0.001). A uterocervical angle > 89.8° at the second visit predicted preterm birth with 81.8% sensitivity and 70.8% specificity while cervical length ≤ 3.22 cm at the second visit predicted preterm birth with 68.1% sensitivity and 62.5% specificity. Multivariant logistic regression analysis showed that uterocervical angle > 89.8° at the second visit increased the odds ratio for preterm birth by 9.ConclusionUterocervical angle can be a useful ultrasound marker for the prediction of preterm birth among high risk patients. A cutoff value of 89.8° can be used as a threshold above which prophylactic measures such as cervical cerclage or progesterone therapy can be provided.Trial registrationNCT05632003 (First posted date: 30/11/2022).

Üreteral stent ilişkli semptomlarda 4.0 Fr’e karşın 4.8 Fr double J stentler: ankete dayalı karşılaştırmalı bir çalışma

Purpose: The aim was to investigate the difference in Ureteral Stent-Related Symptom Questionnaire (USSQ) scores with the use of different stent diameters (4.0 Fr versus 4.8 Fr).&#x0D; Materials and methods: Between August 2022 and January 2023, patients with double J stent insertion after endoscopic ureteral stone and retrograde intrarenal surgery in two different centers were included in the study. The patients were divided into two groups according to stent size of 4.0 Fr and 4.8 Fr. All of the patients were called for check-up in the 2nd week after discharge and were questioned using the USSQ. &#x0D; Results: A total of 228 patients, 112 in the 4.0 Fr group and 116 in the 4.8 Fr group, were included in the study. At the 2nd week visit, the total USSQ scale scores were 73.9 ± 8.9, and 80.0 ± 9.8 for the 4.0 Fr and 4.8 Fr groups, respectively (p&lt; 0.001). Stent dislocation was detected in 10 (8.1%) patients in the 4.0 Fr group and in 3 patients (2.5%) in the 4.8 Fr group (p=0.049). The symptom score scale was analyzed separately based on subdomains. The mean value for the urinary index score was 24.5 ± 3.6 for the 4.0 Fr group and 27.6 ± 3.4 for the 4.8 Fr group (p&lt; 0.001). Body pain index score was 16.4±3.8 and 18.6±3.8 for the 4.0 Fr and 4.8 Fr groups, respectively (p

The impact of intimate partner violence on adverse birth outcomes in public health facilities. A prospective cohort study

BackgroundDuring pregnancy, intimate partner violence (IPV) is a health problem associated with severe adverse birth outcomes. The Ethiopian Demographic Health Survey showed that more than one-third of married women faced IPV. Therefore, this study aimed to investigate the effects of IPV during pregnancy on adverse birth outcomes. MethodsA prospective cohort study was conducted from September 1st, 2021 to April 30th, 2022. Using a systematic random sampling technique, participants were enrolled from 20 to 24 weeks of gestation at antenatal visits at the selected public health institutions. The validated and modified standards of the World Health Organization Domestic Violence Questionnaire were used to screen for IPV. Bivariate and multivariate logistic regression models were used in this study. The relative risk was also calculated to predict the occurrence of adverse birth outcomes. ResultsOverall, 701 pregnant women were followed from 20 to 24 weeks of gestation until delivery in a 1:2 ratio (244 exposed to 457 non-exposed). Preterm birth increased by 1.02 times (RR=1.02, 95 CI; 0.979–1.047), low birth weight with RR= 2.023, 95% CI; 1.201–3.407 and stillbirth (RR= 1.124, 95%CI; 0.43–3.055). Among the exposed groups, 167(23.8%), 83 (11.8%), and 51 (7.3%) had emotional, physical, and sexual violence, respectively. The odds of developing adverse birth outcomes from IPV exposure were [AOR=1.63,95% CI: [1.23, 3.75], emotional violence [AOR= 1.70:95% CI: [1.24, 4.24], and physical violence [AOR= 3.99:95% CI: [1.51, 10.52] times higher than those of their counterparts. No significant association was observed between sexual violence and adverse birth outcomes. Being unsupported by the husband and having previous adverse birth outcomes increased IPV by nearly four-fold [AOR=3.80:95% CI; 1.19, 12.09] and [AOR= 3.70:95% CI:1.49, 9.17], respectively. The odds of mothers with a 2nd visit MUAC measurement of < 23 cm were [AOR=2.81:95% CI; 1.20, 6.61]. ConclusionThe incidence of adverse birth outcomes was significantly higher in the physically IPV-exposed group than in the non-exposed group. Therefore, pregnant women should be screened for IPV during their antenatal period. Thus, IPV-exposed pregnant women should be counseled and closely followed up.

A Retrospective Study of Body Weight Changes in Patients Receiving Cyproheptadine in A Hospital-Based Outpatient Setting in Thailand

Cyproheptadine has been used as an appetite stimulant to increase body weight in various population. This study aimed to determine the effect of cyproheptadine on weight changes in Thai patients. A retrospective longitudinal study was conducted in adult patients who were prescribed with cyproheptadine, having body weight records at 2 times consecutively during 12-month period at the medical outpatient department, the Police General Hospital, Thailand. Of 125 participants, 69.6% were females and the mean age was 78.38 (SD ± 11.68) years. Hypertension, dyslipidemia and diabetes mellitus were the most common underlying conditions. The mean body mass index (BMI) at 1st visit was 21.16 (SD ± 3.64) kg/m2. The mean body weight at 1st and 2nd visit were 52.46 (SD ± 11.11) kg, and 52.61 (SD ± 10.98) kg, respectively. Overall, there was no significant change in body weight between two visits. In underweight patients (BMI &lt; 18.5 kg/m2), the mean BMI decreased significantly in the 2nd visit compared to 1st visit (p = 0.044). At the 2nd visit, older age and high-density lipoprotein cholesterol levels were negatively associated with body weight (p &lt; 0.05). The polypharmacy (odds ratio (OR), 0.778; 95% confidence interval (CI), 0.616 – 0.982), the presence of hypertension (OR, 0.022; 95%. CI, 0.001 – 0.390) and low-density lipoprotein cholesterol levels (OR, 0.969; 95% CI, 0.942 – 0.996) were also negatively associated with abnormal BMI. Cyproheptadine might not improve the body weight of patients in this population. The factors associated with lower body weight in this study may be helpful in further research.

Breast feeding Status of Infants Born in a Baby Friendly Hospital Up to 180 days of life

Background : Initiation of breast-feeding (BF) within 1 hour after birth has been associated with reduced neonatal mortality. Baby Friendly Hospital Initiative has profound effects on appropriate practice of BF and thus helps to reduce infant mortality and morbidity.&#x0D; Objective : This study was conducted in the Department of Gynae and Obstetrics and Department of Paediatrics of Shaheed Suhrawardy Medical College Hospital (ShMCH), Dhaka, to observe the rate of exclusive breast feeding and home-based compliance.&#x0D; Methodology : Hundred (100) term babies of normal birth weight irrespective of sex, born in ShSMCH by normal vaginal delivery (NVD) or caesarian section were included. Data was collected from the mother with a pretested questionnaire at the postnatal period, at 6th week, 14th week and 6th month (180 days) of age.&#x0D; Result : The mean age of studied newborn (100) was 20±19.5 hours. All the infants started breast feeding after birth and among them 56% initiated with in 1 hour. Difficulty in breast feeding was found in 36(36.0%) infants, which was resolved mostly (94%) by nurse. Exclusive breastfeeding (EBF) was found in 100% of infants during discharge from hospital. During 1st and 2nd follow up we found 95 (95.0%) and 89 (89.0%) infants respectively were exclusively breastfed. In 3rd follow up at completed 6th month (180 days) 78 (78.0%) infants were exclusively breast fed. In our study 5 (5%) and 6 (6%) infants received supplementary food in 1st follow up and in 2nd follow up respectively. In the last follow up the number were 11 (11%) and the total number was 22 (22%).&#x0D; Conclusion : Exclusive breast feeding up to completion of 6 months (180 days) was found in 78.0% of infants. Maternal and relative’s misperception of baby’s crying due to insufficient breast milk and joining to job outside home were the causes of introduction of formula milk in the 1st, 2nd and 3rd visit respectively.&#x0D; Northern International Medical College Journal Vol. 12 No.2 Jan 2021, Page 530-534

Discriminação racial prediz o aumento do peso corporal e do IMC em indivíduos pretos da coorte ELSA-Brasil

We investigated whether racial discrimination accelerates the weight and Body Mass Index (BMI) gain in Blacks and Browns participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) in four years of follow-up. We compared body weight and BMI between the 1st (2008-2010) and 2nd visit (2012-2014) of 5,983 Blacks and Browns participants. Exposure to racial discrimination and covariates (age, sex, education, and research center) were obtained at the 1st visit. Linear mixed effects models stratified by race/skin color were used. Report of racial discrimination was more frequent among Blacks (32.1%) than Browns (6.3%). During the follow-up period, Blacks and Browns gained an average of 1.4kg and 1.2kg, respectively. This increase was greater among those who reported discrimination when compared to those who did not, both in Blacks (2.1kg vs.1.0kg, p < 0.001) and Browns (1.9kg vs. 1.1kg, p < 0.05). The results of the interaction between racial discrimination and time showed that Blacks, but not Browns, who reported racial discrimination had greater weight and BMI gains between visits. Our results suggest that reducing racial discrimination would contribute to prevent and/or control obesity increase in the country.

Importance of patient related outcomes in diagnosing fatigue related to immunotherapy treatment in patients with lung cancer: A real life study.

e14709 Background: Lung cancer is a common cancer with a dismal prognosis that was improved with treatment with check-point inhibitors (CPI). Fatigue is the most frequent adverse event of CPI, often undervalued by physicians. Patient report outcomes may be a key to overcome underdiagnose of fatigue. Methods: The aim of this study is to identify whether the assessment Non-Small Cell Lung Cancer (NSCLC) patients report when answering the BFI questionnaire of fatigue is consistent with the one recorded by the clinical team at the pneumology consultation the during treatment with immunotherapy in monotherapy or in combination with chemotherapy. A prospective observational study was carried out during 8 months. The research was conducted through the collection of medical records from the patients clinical files and the application of the Brief Fatigue Inventory questionnaire before each one of the 4 treatment cycles. This questionnaire was validated and linguistically translated into Portuguese and assesses the severity and functional impact of fatigue in cancer patients. A 95% confidence interval was considered. Results: The 31 patients, 26 male (84%) and 5 female (16%) with a mean age of 68.5 years. The mean value of the BFI score before the first treatment, as well as in the following 3 evaluations, was higher for the participants who presented symptoms of asthenia/tiredness/fatigue recorded in the clinical files at the consultation and lower for those who did not. However, the differences were not statistically significant (pre 1st treatment - p=0.299, pre 2nd treatment - p=0.125, pre 3rd treatment - p=0.103 and pre 4th treatment - p=0.954). By comparing the BFI score with medical records, we found that fatigue remained underreported at the consultation in different assessment times (71% of sample participants were not identified as having fatigue at the 1st assessment time; 60% at the pre 2nd treatment visit; 54% at the pre 3rd treatment visit and 40% at the pre 4th treatment visit). Conclusions: In the present study, the BFI questionnaire allowed us to identify and stratify fatigue, showing greater sensitivity when compared to the medical records of the consultation alone.

ОСОБЕННОСТИ ЭНДОДОНТИЧЕСКОГО ЛЕЧЕНИЯ ЗУБОВ С ЭНДОПАРОДОНТАЛЬНЫМ ПОРАЖЕНИЕМ КАК ЗАЛОГ КАЧЕСТВЕННОГО ПРОТЕЗИРОВАНИЯ

The problem of treatment of teeth with endoparodontal lesions remains relevant today. This article discusses a clinical case of treatment of a patient with chronic generalized periodontitis who has a combined lesion of the periodontal and apical periodontal in the lower premolar region. The purpose of the study is evaluation of the effectiveness of the treatment of endoparodontal tooth lesion and the further possibility of prosthetics of the tooth. Materials and methods. For the diagnosis of pathology and in the course of treatment, the following additional research methods were used: CT, OPTG and targeted radiography. Mechanical processing was carried out with manual steel tools. Drug treatment was carried out using solutions of 3% sodium hypochlorite and 17% EDTA For temporary obturation of the root canal, a material based on calcium hydroxide with the addition of a radiopaque substance was used. To further improve the quality of disinfection and adhesion of the filling material to the root canal wall, the method of photodynamic action on the root canal wall was applied in the 2nd visit. Permanent obturation of the root canal was carried out by the method of lateral condensation of gutta-percha in combination with a siler based on ecoxide resin. The reduction of the focus of bone tissue destruction was confirmed clinically and radiologically. Thus, we managed to avoid tooth extraction and it became possible to use this tooth as a support on a non-removable orthopedic structure.

The association of QTc prolongation with cardiovascular events in cancer patients taking tyrosine kinase inhibitors (TKIs)

ObjectiveTo investigate the association between stages of QTc prolongation and the risk of cardiac events among patients on TKIs.MethodsThis was a retrospective cohort study performed at an academic tertiary care center of cancer patients who were taking TKIs or not taking TKIs. Patients with two recorded ECGs between January 1, 2009, and December 31, 2019, were selected from an electronic database. The QTc duration > 450ms was determined as prolonged. The association between QTc prolongation progression and events of cardiovascular disease were compared.ResultsThis study included a total of 451 patients with 41.2% of patients taking TKIs. During a median follow up period of 3.1 years, 49.5% subjects developed CVD and 5.4% subjects suffered cardiac death in patient using TKIs (n = 186); the corresponding rates are 64.2% and 1.2% for patients not on TKIs (n = 265), respectively. Among patient on TKIs, 4.8% of subjects developed stroke, 20.4% of subjects suffered from heart failure (HF) and 24.2% of subjects had myocardial infarction (MI); corresponding incidence are 6.8%, 26.8% and 30.6% in non-TKIs. When patients were regrouped to TKIs versus non-TKIs with and without diabetes, there was no significant difference in the incidence of cardiac events among all groups. Adjusted Cox proportional hazards models were applied to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). There is a significant increased risk of HF events (HR, 95% CI: 2.12, 1.36–3.32) and MI events (HR, 95% CI: 1.78, 1.16–2.73) during the 1st visit. There are also trends for an increased incidence of cardiac adverse events associated with QTc prolongation among patient with QTc > 450ms, however the difference is not statistically significant. Increased cardiac adverse events in patients with QTc prolongation were reproduced during the 2nd visit and the incidence of heart failure was significantly associated with QTc prolongation(HR, 95% CI: 2.94, 1.73-5.0).ConclusionThere is a significant increased QTc prolongation in patients taking TKIs. QTc prolongation caused by TKIs is associated with an increased risk of cardiac events.

Study on Impact of Tertiary Care Baby Friendly Hospital on Exclusive Breast Feeding and Child Health

Background: Initiation of breast-feeding within 1hour after birth has been associated with reduced neonatal mortality. Baby Friendly Hospital Initiative has profound effects on appropriate practice of BF and thus helps to reduce infant mortality and morbidity. Objective: This study was conductedin the dept.Gynae &amp; Obs and Dept of Paediatrics of Shaheed Suhrawardy Medical College Hospital,Dhaka, to observe the rates of exclusive breast feeding and child health status after cancelling from Baby Friendly Hospital Methodology: 100 term babies of normal birth weight irrespective of sex, born in Sh.SMCH by NVD or caesarian section were included. Data was collected from the mother with a pretested questionnaire at postnatal period, at 6th week, 14th week &amp; 6th month of age. Result: The mean age of studiednewborn (100) was 20.02±19.54 hours. All the infants started breast feeding after birth and among them fifty six percent initiated with in 1 hour. Fifty five percent mothers were fed breast milk more than 8 times of her baby in last 24 hours. Difficulty in breast feeding was found in 36(36.0%) infants, which was resolved mostly (94%) by nurse. Exclusive breastfeeding was found in 100% of infants during discharge from hospital. In 1st and 2nd follow up 95(95.0%) and 89(89.0%) infants were exclusively breastfed. In 3rd follow up at last week of 6th month 78(78.0%) infants were exclusively breast fed. Five(5%) and six(6%) infants received supplementary food in 1st and 2nd follow up respectively. In last follow up the number were eleven (11%) and the total number was 22(22%).The causes of supplementation were crying of baby due to perceived insufficient breast milk and job of the mother in 1st&amp; 2nd and 3rd visit respectively. Weight was significantly (p&lt;0.05) higher in exclusive breast feeding group than the non EBF group and sickness were also more in non EBF group. Conclusion: Exclusive breast feeding was found in 78.0% of infants upto last week of 6 months. Crying of baby due to perception of insufficient breast milk and joining in outside job of the mother were the causes of introduction of formula milk in the 1st,2nd and 3rd visit respectively. Weight gain and sickness were significantly less in EBF group than in non EBF group. J Shaheed Suhrawardy Med Coll 2021; 13(2): 164-170

Non-damaging retinal laser therapy in chronic central serous chorioretinopathy.

To investigate the functional and anatomical outcomes of non-damaging retinal laser therapy (NRT), in cases with chronic central serous chorioretinopathy (CSCR). Twenty-three eyes of 23 treatment-naïve chronic CSCR patients were included in this study. The irradiation of 577nm yellow light was conducted on the serous detachment area after switching over to the NRT algorithm. Anatomical and functional changes after treatments were investigated. The mean age of the subjects was 48.68 ± 5.93years (41-61). The mean best-corrected visual acuity (BCVA) and the mean central macular thickness (CMT) values were 0.42 ± 0.12logMAR (0.20-0.70) and 315.69 ± 61.25µm (223-444) before NRT; and 0.28 ± 0.11logMAR (0.10-0.50) and 223.26 ± 60.91µm (134-336) at the 2nd month follow-up visit (p < 0.001, for both). At the 2nd-month follow-up visit after NRT, complete resorption of subretinal fluid was observed in 18 eyes (78.3%) and incomplete resorption in five eyes (21.7%). Worse values of BCVA and CMT before NRT were found as increased risk for incomplete resorption (p = 0.002 and ρ = 0.612 for BCVA, and p < 0.001 and ρ = 0.715 for CMT). Significant functional and anatomical improvements can be observed in the early period after NRT in patients with chronic CSCR. Patients having worse baseline BCVA and CMT have increased risk for incomplete resorption.

Motor Unit Number Estimation in Spastic Biceps Brachii Muscles of Chronic Stroke Survivors Before and After BoNT Injection.

The study aims to characterize the motor unit (MU) loss in spastic biceps brachii muscle (BBM) of chronic stroke survivors before and after botulinum neurotoxin (BoNT) injection. High-density weighted average (HDWA) motor unit number estimation (MUNE) was employed to estimate the number of functioning motor units of BBMs of eight chronic stroke survivors 1-week before (1st visit) and 3-week after (2nd visit) BoNT injection based on the surface electromyography (sEMG) signals recorded during voluntary contraction and supramaximal electrical stimulation. Significant lower MUNE was estimated from the spastic BBMs compared to the non-spastic MUNEs during two visits. A surprisingly higher MUNE was obtained from the spastic side during the 2nd visit after BoNT injection. The HDWA MUNE technique can be employed to characterize the motor unit loss in spastic muscle caused by upper motor neuro lesions at contraction level up to 30% MVC, but may fail to detect the MU loss caused by the chemodenervation effect of BoNT due to the non-uniform denervation of small and large size MUs. This study presents the first effort to evaluate the applicability of HDWA MUNE technique to characterize the MU loss in the spastic muscle following stroke and the subsequent BoNT injection for the treatment of post-stroke spasticity. The finding of this study suggests that HDWA MUNE can be a sensitive approach to detect the MU loss in spastic muscles after stroke, but the large inter-subject MUNE variability after the BoNT injection should be interpreted with caution.

The Impact of the COVID-19 Pandemic on the Management of Patients with Oral Potentially Malignant Disorders in a Tertiary Care Hospital, Sri Lanka

Introduction: Oral potentially malignant disorders (OPMD) have a higher risk to develop into oral cancer, which is the comments cancer in males in Sri Lanka. The covid-19 pandemic had significant ill effects on the health care systems, worldwide. Objective: To retrospectively investigate the management of OPMD patients presented to the oral medicine clinic of the University Dental Teaching Hospital Peradeniya, Sri Lanka before and during the pandemic. Methods: This was a hospital-based cross-sectional study using medical records. The pre-pandemic group included patients diagnosed with OPMD presenting between Jan 2018 - Dec 2019; the pandemic group from Jan 2020 to Dec 2021. Results: There were 321 eligible medical records. Of these, 247 belong to the pre-pandemic group and 74 in the pandemic (3:1). In the pre-pandemic group, 32% of biopsies were performed within the first week, while it was 56% in the pandemic group. We found a significant increase in the loss of follow-up in the pandemic group compared to the pre-pandemic group (p=0.01). The average delay for the 2nd visit was 27 days, for the 3rd visit it was 127 days in the pre-pandemic; and 89 and 152 days respectively in the pandemic group.Conclusions: We recommend following evidence-based practices for the management of OPMD in anticipated pandemics. Strategies to diagnose patients at home must be developed and implemented. There is a higher need for the prevention of habit-related risk factors. Biopsy at the first visit or first week is recommended. Patients should be monitored using digital technologies in the absence of physical follow-up.

The influence of mother's attitude on neonate visits in the working area of Lambale health center, North Buton district, Southeast Sulawesi Province, Indonesia

Neonatal visits are basic health services provided for neonates at least 3 times, namely 1st neonatal visit at 6 hours to 48 hours after birth, 2nd neonatal visit on days 3 to 7 days, 3rd neonatal visit on days 8 – 28 days. The aim of the study was to determine the effect of respondents' attitudes on neonatal visits in the working area of the Lambale Health Center, North Buton Regency. This type of survey research uses a cross sectional study approach. The research population is 144 people, the sample is 105 people. Data collection was carried out using questionnaires and interviews. Data analysis was performed using univariate and bivariate. The results showed that there was a significant influence on the attitude of the respondents towards neonatal visits, with a p value = 0.000. Conclusion; There is an influence on the mother's attitude towards neonatal visits in the working area of the Lambale Health Center, North Buton Regency in 2022. Suggestion; Health workers and health cadres are expected to maximize education regarding the importance of neonatal visits after mothers give

Comparative analysis of effect of life style modification with and without isoflavones for menopausal symptoms

Background: Natural or spontaneous menopause is a transition period in a woman&#39;s life from the reproductive to the non-reproductive phase. It happens with the final menstrual period, which is known to happen after 12 months of amenorrhea with no obvious pathological or physiological causes.1,2 It promotes aging and hastens the progression of non-communicable diseases. Menopause occurs between the ages of 45 and 55 worldwide.2 Menopause symptoms manifest not only in the female genital tract, but also in the skeletal, cardiovascular, and psychological systems. With rising life expectancy, women are more likely to experience long periods of menopause, accounting for roughly one-third of their age. As a result, the morbidity burden has increased. Aim and Objectives: To compare the effects of lifestyle modification with & without isoflavones supplementation for menopausal symptoms. Methods: The study was conducted in Department of Obstetrics and Gynaecology, Upper India Sugar Exchange Maternity Hospital, GSVM Medical College in Kanpur of Uttar Pradesh state. This hospital is a tertiary care teaching hospital. The study was conducted in obstetrics department of the hospital. Postmenopausal women who had at least 1 year history of cessation of menses were included. Availability of subjects for the entire study period and willingness to adhere to protocol requirements as evidence by written informed consent. Perimenopausal females of age >40 years. Perimenopausal is the period immediately prior to and up to 1 year after the final menstrual period. Conclusion: The present study was a triple arm randomized clinical trials study conducted to determine the comparative analysis of effect of lifestyle modification with and without Isoflavanis for menopausal symptoms was performed at the department of Obstetrics and gynaecology, Upper India Sugar Exchange Maternity Hospital, GSVM Medical College, Kanpur. The following are the important conclusion drawn from the study. In our study majority of the women were 50 - 69 years age group from urbon population and housewives in occupation in all three groups respectively. In our study majority of the patients had normal BMI and blood pressure in all groups Isoflavanis life style modification and lifestyle Isoflavanis respectively. In our study Vasomotor symptoms psychological and urogenital symptoms reduce after the lifestyle dietary and yoga with Isoflavane and intervention which is shown by reduction in MRS score after the intervention. The results of the present study strongly recommend lifestyle modification dietary supplementation yoga and Isoflavane supplementation resulted in reduction of menopausal symptoms. Thus importance of life-style management yoga and Isoflavane to be incorporated in daily routine under the supervision and motivation / adherence can be mandatory. The mean, Vasomotor symptoms were significantly lower in lifestyle mod which Isoflavane group III group at 2nd visit and 3rd visit. In our study regarding the safety profile of phyto-estrogen Isoflavane no majoride effect, were found and only minor side effect like headache, nausea, vomiting were present. No breakthrough bleeding (every women with hormone therapy).

Опыт применения препарата Актитропил при хронической ишемии головного мозга: результаты наблюдательной клинической программы

Background: chronic cerebral ischemia (CCI) is one of the most common diseases in modern medical practice. The possibility of using effective drug therapy is the research subject. Aim: to study the efficacy and safety of Actitropil in patients with CCI in clinical practice. Patients and Methods: 30 patients with CCI were examined within the framework of the program. The diagnosis was established on the basis of generally accepted clinical practice guidelines with verification of changes in brain structures during imaging diagnostics. During follow- up (before and after the treatment course), changes in the parameters of the MoCA Test, the EQ-5D, MFI-20 scales, the Rivermead Mobility Index, and the neurologic symptom severity were evaluated. To assess the safety of the studied drug, adverse events (AE) were recorded. Results: by the time the treatment was completed, a significant improvement was obtained with normalization of cognitive functions: the number of points scored in the MoCA Test increased statistically significantly from 25 (24;25) to 28 (27;28.5), p=0.000004. There was a significant increase in the values on the EQ-5D scale by the 2nd visit from 45 (37;53) to 86 (79;90) points, p&lt;0.0001. Less marked, but statistically significant results were also achieved when assessing neurological manifestations according to the Rivermead Mobility Index (p=0.002). According to the results of comprehensive testing, there was a statistically significant decrease in the asthenia severity on the MFI-20 scale (total score) from 44 (37;47) to 22 (20;25), p=0.000002. The subjective severity scoring of neurological symptoms showed a decrease from 4 (3;5) (submaximal) to 2 (1;2) (minimum) points, p=0.000002. During therapy with the studied drug, AE which required dose reduction or drug withdrawal, as well as serious adverse events were not registered. Conclusions: therapy with Actitropil in a daily dose of 200 mg (divided into two doses), for 30 days led to a significant regression in the severity of CCI clinical manifestations: cognitive, motor and asthenic. The studied drug has a favorable safety profile. KEYWORDS: chronic cerebral ischemia, cognitive functions, life quality, Rivermead Mobility Index, nootropics. FOR CITATION: Andreyev V.V. Experience of using Actitropil in chronic cerebral ischemia: clinical follow-up results. Russian Medical Inquiry. 2023;7(10):620–624 (in Russ.). DOI: 10.32364/2587-6821-2023-7-10-2.

Влияние кистевого теппинга на частоту эпилептических приступов и качество жизни у 30-летнего мужчины со структурной фокальной эпилепсией

Aim: To present a clinical case of the use of the wrist tapping method in a 30-year-old patient with structural focal epilepsy (SFE). Key points. During 4 visits, we examined patient N., 30 years old, suffering from SFE, which developed against the background of a gunshot wound to the skull, with frequent focal seizures (FS) and bilateral tonic-clonic seizures (BTCS). After 6 months from the start of wrist tapping sessions (4th visit), using the application, the patient noted a 55% increase in quality of life due to the ability to stop AF and prevent the development of BTK. In 87.5% of cases, he was able to stop incipient motor hemifacial FS and prevent its transformation into BTCS. With regular use of the application by the patient, the incidence of FS decreased by 65.4% on the 4th visit compared to that on the 2nd visit. The patient highly rated the effectiveness and safety of the wrist tapping method (97.6%). Conclusion. The use of the application allowed a young man with treatment-resistant post-traumatic SFE, without changing the dosage regimen and dose of the antiepileptic drug, to reduce the frequency of FS by 65.4% from baseline and significantly reduce the number of BTCS, significantly improving the quality of life. Keywords: structural focal epilepsy, wrist tapping.