Group Group1 Research Articles

Impact of COVID-19 on heart rate variability in post-COVID individuals compared to a control group

This study investigated the impact of mild COVID-19 on HRV in groups stratified by time after infection and to compare to a healthy group of the same age without previous virus infection and without need of hospitalization. This is a cross-sectional study. We divided the sample into four groups: control group (CG) (n = 31), group 1 (G1): ≤6 weeks (n = 34), group 2 (G2): 2–6 months (n = 30), group 3 (G3): 7–12 months (n = 35) after infection. For HRV analysis, we used the indices of linear (time and frequency domain) and non-linear analysis. For comparisons between groups, ANOVA one way test or Kruskal–Wallis was used according to the data distribution. The effect size was calculated based on Cohen’s d or η2. Simple and multiple linear regressions were performed to investigate the interaction between clinical outcomes and HRV parameters. A total of 130 individuals were included. Groups G1 and G2 showed less parasympathetic modulation when compared to CG (p < 0.05), while G3 showed an increase in parasympathetic modulation when compared to G1 (p < 0.05). Moderate to large effect sizes were found according to Cohen d or η2. The multiple linear regression models identified age and infection duration as significant predictors for RMSSD (adjusted R2 = 0.227) and SD1 (adjusted R2 = 0.242), while age was significant for SDNN (adjusted R2 = 0.213). BMI, hypertension, and dyslipidemia were non-significant in all models. For HF (n.u.), infection duration was consistently significant, with stress emerging as a predictor in Model 2 (adjusted R2 = 0.143). The recovery time since diagnosis and age influences recovery from HRV, suggesting a transient effect of the disease on the autonomic nervous system.

Assessment of dimensional stability of novel VPES impression material at different time intervals with standard disinfectants

BackgroundVinyl polyether silicone (VPES) is a novel impression biomaterial made of a combination of vinyl polysiloxane (VPS) and polyether (PE). Thus, it is significant to assess its properties and behaviour under varied disinfectant test conditions. This study aimed to assess the dimensional stability of novel VPES impression material after immersion in standard disinfectants for different time intervals.MethodsElastomeric impression material used –medium body regular set (Monophase) [Exa’lence GC America]. A total of 84 Specimens were fabricated using stainless steel die and ring (ADA specification 19). These samples were distributed into a control group (n=12) and a test group (n=72). The test group was divided into 3 groups, based on the type of disinfectant used - Group-A- 2% Glutaraldehyde, Group-B- 0. 5% Sodium hypochlorite and Group-C- 2% Chlorhexidine each test group was further divided into 2 subgroups (n=12/subgroup) based on time intervals for which each sample was immersed in the disinfectants – subgroup-1- 10 mins and Subgroup 2- 30 mins. After the impression material was set, it was removed from the ring and then it was washed in water for 15 seconds. Control group measurements were made immediately on a stereomicroscope and other samples were immersed in the three disinfection solutions for 10 mins and 30 mins to check the dimensional stability by measuring the distance between the lines generated by the stainless steel die on the samples using a stereomicroscope at x40 magnification.ResultsThe distance measured in the control group was 4397.2078 µm and 4396.1571 µm; for the test group Group-A- 2% Glutaraldehyde was 4396.4075 µm and 4394.5992 µm; Group-B- 0. 5% Sodium hypochlorite was 4394.5453 µm and 4389.4711 µm Group-C- 2% Chlorhexidine was 4395.2953 µm and 4387.1703 µm respectively for 10 mins and 30 mins. Percentage dimensional change was in the range of 0.02 – 0.25 for all the groups for 10 mins and 30 mins.Conclusions2 % Glutaraldehyde is the most suitable disinfectant for VPES elastomeric impression material in terms of dimensional stability and shows minimum dimensional changes as compared to that of 2% Chlorhexidine and 0.5% Sodium hypochlorite.

The Impact of Different Anterior Cruciate Ligament Status on Unicompartmental Knee Arthroplasty: Short Term Clinical and Functional Results

Purpose: Purpose of this study is to compare the short-term results of unicompartmental knee arthroplasty applied stable knees regardless of the condition of the ACL and the application of unicompartmental knee arthroplasty and ACL reconstruction combined surgery applied to ACL deficient cases with anterior instability and to identify the condition and function of the ACL for success in this surgery. Patients and Methods: 80 out of the 105 patients who were operated in 2013-2015 and came for follow-up were included in the study and the patients were divided into four groups. The VAS pain score, KSS Score, WOMAC score, OKS questionnaires and joint range of motion measurements were conducted pre-operatively and post-operatively. One leg standing test, joint position sense measurement, and isokinetic muscle strength test were performed in post-operative controls. Results: There was no statistically significant difference between the demographic data and follow-up of the groups (p˃0.05). While there was a statistically significant difference in knee flexion between Group 2-Group 4 and Group 3-Group 4 in the pre-operative period, no difference was found in the post-operative period (p˃0.05). While there was no difference among the groups, knee joint range of motion in direction of extension declined in a statistically significant way in all four groups (p˂0.05). Pain felt postoperatively was the most in Group 1 and the least in Group 3. A statistically significant difference was found between Group 1 and Group 3 in the test performed with the eyes closed (p˂0.05). Conclusion: The presence of a functional anterior cruciate ligament is expected to make a positive contribution to surgical results especially in young patients with high activity expectation. Whether the patient’s ACL rupture is primary or secondary and his/her activity expectation should be effective in the choice of a surgical method.

Investigation of small fiber neuropathy in patients with diabetes mellitus by corneal confocal microscopy

ObjectivesCorneal confocal microscopy (CCM) is a non-invasive technique that examines the corneal cellular structure. Its use in the detection of small fiber neuropathy is being researched. In our study, we examined the role of CCM in the detection of small fiber neuropathy in diabetic patients, as well as the differences between CCM findings in diabetic patients with and without overt polyneuropathy with neuropathic symptoms. Methods56 Diabetes Mellitus (DM) patients and 18 healthy controls were included in the study. The individuals included in the study were divided into three groups. Patients with diabetes who were found to have polyneuropathy according to electrophysiological diagnostic criteria were classified as Group 1, patients with diabetes and neuropathic symptoms without overt polyneuropathy according to electrophysiological diagnostic criteria were classified as Group 2, and healthy individuals were classified as Group 3. Electrophysiological examination and corneal imaging with CCM were performed in all groups. ResultsThe CNFD and CNFL values of individuals in the diabetic group were discovered to be lower. CNFD values differ statistically between the groups (p = 0.047). Group 1-Group 3 differs from Group 2-Group 3 (respectively; p = 0.018, p = 0.048). ConclusionOur study demonstrates that CCM can be used in patients with neuropathic symptoms and no polyneuropathy detected in EMG and thought to have small fiber neuropathy. CCM provides an opportunity for early diagnosis in small fiber neuropathy.

Stress hyperglycemia increases short-term mortality in acute ischemic stroke patients after mechanical thrombectomy

Background and purposeGlucose-to-glycated hemoglobin ratio (GAR) is considered a more reliable marker of stress hyperglycemia by correcting for basal blood glucose levels. This study aimed to investigate the extent to which GAR is associated with 3 month and 1 year all-cause mortalities in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT).MethodsWe retrospectively followed 553 AIS patients who underwent MT. The degree of stress hyperglycemia was quantified as the GAR, defined as fasting plasma glucose (mmol/L)/hemoglobin A1c (HbA1c) (%) on the second day after admission. According to the GAR quartiles, the patients were further categorized into four groups (group 1-group 4). We assessed the association between GAR and all-cause mortalities, clinical outcomes during hospitalization and function outcomes at 3 months. The associations between stress hyperglycemia and all-cause mortalities were analyzed using a Cox proportional-hazards model, while other outcomes were analyzed using multiple logistic regression analysis.ResultsThe follow-up lasted a median of 18 months (range 0–66 months). The 3 month mortality rate was 9.58% (n = 53) and the 1 year mortality rate was 18.62% (n = 103). The Kaplan–Meier analysis revealed a significant inverse relationship between GAR and mortality (P < 0.001). In the Cox proportional-hazards model at 3 months, compared with group1, group 4 of GAR was associated with a significant increase in the risk of 3 month mortality (hazard ratio [HR] = 4.11, 95% confidence interval [CI] 1.41–12.0, P = 0.01) after adjusting for potential covariates. On multivariate logistic regression analysis, GAR was strongly associated with an increased risk of 3 month poor function outcome.ConclusionsStress hyperglycemia, quantified by a higher GAR, is associated with all-cause mortality and poor functional outcomes in patients with AIS who undergo MT. Furthermore, GAR may contribute to improving the predictive efficiency of all-cause mortality in patients with AIS after MT, especially short-term all-cause mortality.

P539 Assessment of VEdolizumab aNd Ustekinumab in Elderly patients with Crohn’s disease (CD): the IG-IBD AVENUE study

Abstract Background Comparative data regarding ustekinumab (UST) and vedolizumab (VDZ) effectiveness and safety in elderly inflammatory bowel disease (IBD) patients are limited. The aim of the present nationwide multicenter cohort study was to compare persistence and safety of these drugs in elderly versus non-elderly Italian IBD patients. Methods Data from 20 Italian centers were retrospectively collected. Based upon age and treatment, IBD patients aged ≥65 years were allocated to group 1 (G1) and group 3 (G3) (cases) if treated with UST or VDZ, respectively, and to group 2 (G2) and 4 (G4) (controls) if they were aged &amp;lt; 65 years and treated with UST or VDZ, respectively. The primary outcome was drug persistence at week 52. Propensity score analysis was performed for primary outcome using the inverse probability of treatment weighting method. Secondary outcomes included: steroid free remission (SFR) at week 52 and frequency of adverse events (AEs) at the end of follow-up. Results A total of 439 patients (176 elderly and 260 non-elderly) were included in the study. Among elderly patients, 93 and 83 were included in the group G1 and G3, respectively. Among non-elderly patients, 147 and 116 were included in the group G2 and G4, respectively. Baseline characteristics are represented in Table 1. No differences were found in terms of persistence between G1 vs G3, G1 vs G2 and G3 vs G4 (Figure 1). Higher baseline Harvey-Bradshaw Index (HBI) (OR=2.09, 1.15 – 3.78; 0.015) and baseline steroid therapy (OR=1.10, 1.04 – 1.15; p&amp;lt;0.001) were identified as predictors of a lower drug persistence at Cox model. Steroid free remission at week 52 was achieved by 80% and 77% of elderly patients in G1 and in G3 (p=0.63), respectively. Similarly, no differences for SFR were found between G1 and G2 (p=0.73) and between G3 and G4 (p=0.68). Incidence rate for AEs were G1 and G2 were 7.85 and 7.90 respectively; for G3 and G4 IR were 5.81 and 12.50 respectively. No differences were found in the UST groups (IRR=0.99; p=0.98) while in VDZ-treated patients, non-elderly had a higher rate of AEs (IRR=0.46; p=0.006). Conclusion These data confirm that ustekinumab and vedolizumab are highly effective drugs in patients with IBD, associated with a good safety profile in both elderly and in non-elderly IBD patients.

Facial morphology analysis of Caucasian Brazilian adult women using stereophotogrammetry.

This cross-sectional observational study aimed to evaluate and compare facial metrics in women aged 20-65 years using a three-dimensional (3D) stereophotogrammetry system and to establish standardized values for facial metric variations in different age subgroups. This study included 84 Caucasian women divided into two groups based on their age: group 1 (G1) included women aged 20-40 years and group 2 (G2) included women aged 41-65 years. Twenty-one morphometric points on the face were identified, and the facial images were captured using a 3D stereophotogrammetry system, Twenty-three linear measures and 12 angular measures were evaluated, revealing statistically significant differences in 11 linear and 5 angular measures between the groups. In the G2 group, nasal and mouth width, lip philtrum height, Tragus-Nasion and Tragus-Pronasale lengths were increased, along with increased nasofrontal angle, decreased palpebral fissure inclination, and lip vermilion angles. However, palpebral fissure width and height, binocular width, and lip vermilion height were reduced. The aging process in women causes substantial changes in facial features, particularly in the middle and lower thirds of the face. Conversely, no major changes were observed in the upper third of the face. Our study findings provide potential insights for clinicians in developing facial rejuvenation procedures as well as for forensic purposes and surgical planning. The standardized facial metrics values in different age subgroups can guide clinicians in determining appropriate treatment plans for patients seeking facial rejuvenation.

Abstract 17378: A Novel Strategy in the Sequencing of HFrEF Therapy: An Upfront and Prompt Approach

Introduction: The latest HF European guidelines recommend the use of four different classes of drugs for HFrEF. Despite advances in treatment, some gaps remain to be filled. In particular, sequencing and timing of HF therapy administration are not clarified and different strategies have been proposed. Hypothesis: An early, upfront novel approach, based on prompt administration of BB, SGLT2i, ACEi/ARNI, and MRAs may prove beneficial in terms of HF rehospitalization and CV death risk reduction. Aims: To compare early sequencing of HFrEF GDMT with the conventional, stepwise strategy. The primary endpoint was a composite of HF rehospitalization and CV death. Secondary endpoints were the single events of the primary endpoint. Methods: This prospective, observational study included consecutive patients with a HFrEF diagnosis from the Cardiology department. They were divided based on treatment strategy. Group 1 (G1) was treated with a novel GDMT sequencing (in-hospital start of BB and SGLT2i, ACE-i/ARNI, and lastly adding MRAs within 30 days from discharge). Group 2 (G2) was treated with the conventional, stepwise GDMT sequencing. Comparison between the two groups has been performed at 6-month follow up. Results: The study included a total of 302 patients. 278 patients underwent follow up: 139 in G1 group and 139 in G2 group. The two groups did not show significant differences at baseline. No significant differences have been observed for the primary composite outcome (p= 0.135) and for CV mortality (p=0.642) between the two groups. HF rehospitalization risk was significantly lower in G1 group compared to G2 group (p&lt;0.001). Conclusions: HFrEF patients treated with a novel GDMT sequencing, promptly initiated and completed within 30 days from discharge, have shown reduced risk of HF rehospitalization compared with the conventional strategy.

Analysis of Postural Control in Patients Diagnosed with Unilateral Knee Osteoarthrosis and Its Relationship with the Risk of Falls.

Knee osteoarthrosis, whether subtle or marked, appears to alter the stability and performance of the knee joint in activities of daily living that prevent the maintenance of bipedal posture. However, there is still a gap in the literature as to how knee osteoarthritis can affect static balance. To analyze the performance of postural control in elderly diagnosed with unilateral knee osteoarthrosis. 40 elderly people of both sexes participated in this study, divided into two groups containing 20 elderly each. Group 1 (G1) consists of elderly patients who have received a diagnosis of unilateral knee osteoarthritis. Despite undergoing conservative treatment, their condition has shown insufficient improvement, leading to a clinical recommendation for total knee arthroplasty (TKA). The G2 group was made up of 20 elderly with an average age of 71.09 years, considered active, who do not have a diagnosis of osteoarthritis in the knee joint and practice physical activity. With the aid of a Baroscan pressure platform, the center of pressure (COP) displacement in the anteroposterior (COPAP) direction and mediolateral direction (COPML) and the area of center of pressure displacement were evaluated during bipedal postural control with eyes open and eyes closed. During postural control with eyes open and eyes closed, the G1 group showed greater displacement of the COP in the anteroposterior direction-COPAP (p = 0.007)-and mediolateral direction-COPML (p = 0.033)-when compared to the G2 group. As for the area of displacement of the COP, group G1 presented a larger area of displacement (p = 0.002) than group G2 during bipedal postural control with open eyes. For the condition with eyes closed, both groups showed similar behaviors, which resulted in no present statistically significant differences. The results suggest that unilateral knee osteoarthritis influences bipedal postural control and activities of daily living that require this static balance, since information from the somatosensory system is reduced, resulting in stability of tasks that require body control and promoting the risk of falls. From a clinical perspective, the results suggest that the assessment of bipedal postural control can assist orthopedic physicians in assessing joint stability in patients with unilateral knee osteoarthrosis.

Evaluation of some Hematological and Inflammatory Factors in Iraqi Patients Suffering from COVID-19 and Type 2 Diabetes Mellitus

COVID-19 is a newly recognized sickness spreading rapidly worldwide and causing many consequences and deaths. Diabetes Mellitus(DM) is suggested as a risk factor that contributes to the severity and mortality of COVID-19. The present study investigates the levels of Lymphocytes, Neutrophils, C-reactive protein, D-dimer, and ferritin, in COVID-19 patients who suffer from type 2 diabetes mellitus (T2DM) and those without T2DM. 80 participants enrolled in this study, distributed into 4 groups; Group 1 (G1) included 20 patients with COVID-19 and T2DM; Group 2 (G2) comprised of 20 patients with COVID-19; Group 3(G3) included T2DM patients. In addition, 20 individuals were taken as a healthy control group. The patient samples were obtained from Ibn-AlKhateeb Hospital /Baghdad in the period between February to April 2022. A hematology automated device was utilized to count lymphocytes and neutrophils, while a biochemical automated device was employed to measure D-dimer, CRP, and ferritin. Regarding the blood immune cells, there was a significant decrease in lymphocyte counts and a significant increase in neutrophil counts in G1 and G2 groups compared to the healthy control group. The serum levels of the studying markers(CRP, D-dimer, and ferritin )were increased in the G1, G2, and G3 compared to the control group. Furthermore, patients in the G1 group had higher levels of these markers than in other groups, which are considered prognostic markers for COVID-19 infection.

Serum levels of oxidative stress biomarkers is changed in pharmacoresistant mesial temporal lobe epilepsy patients with or without psychiatric disorders

The objective of the present study was to assess the levels of oxidative stress biomarkers (OSB) in patients with pharmacoresistant temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) in order to investigate a possible role of oxidative stress (OS) in the pathophysiology of such disease. Ninety-eight participants were included and distributed in three groups: group 1 (G1) - 25 patients with pharmacoresistant TLE-MTS, without comorbid PD; Group 2 (G2) - 21 patients with pharmacoresistant TLE-MTS with PD; Group 3 (G3) - 52 healthy control subjects. Serum levels of catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), reduced glutathione plus oxidated glutathione (total GSH), glucose-6-phosphate dehydrogenase (G6PD), Trolox-equivalent antioxidant capacity (TEAC), and thiobarbituric acid reactive substances (TBARS) were analyzed through spectrometry. The significance level was set at P<0.05. Sociodemographic data were similar in all groups (P>0.05). A family history of epilepsy was more frequent among G1 and G2 groups when compared to G3 (P = 0.0002). Compared to controls, G1 and G2 presented higher CAT (P<0.0001) and TBARS levels (P = 0.001), as well as lower GPx (P<0.0001), G6PD (P = 0.005) and total GSH levels (P = 0.04). The presence of psychiatric disorders (PD), analyzed both separately and together, was not associated with significant differences in OSB levels (P>0.05). The lower levels of GPx, G6PD, and total GSH, as well as the higher CAT and TBARS levels observed in pharmaco-resistant TLE-MTS patients can indicate an imbalance between oxidizing agent production and elimination, supporting the hypothesis of a possible role of OS in the pathogenesis of this condition.

Forskolin Improves Male Reproductive Complications Caused by Hyperglycemia in Type 2 Diabetic Rats.

In many diabetic patients, spermatogenesis complications are frequent causing infertility problems. This study aimed to demonstrate the effect of Forskolin on male reproductive dysfunction caused by type 2 diabetes. In this experimental study, type 2 diabetes was induced by a high-fat diet (HFD) for one month and then a low single dose injection (35 mg/kg) of streptozotocin (STZ) in Wistar rats. After 72 hours, rats with more than 200 mg/dl of blood glucose were considered type 2 diabetic rats. Forty rats (200-250 g) were divided into four groups (n=10) including group 1 (G1): rats with normal diet and buffer citrate (STZ solvent) injection, group 2 (G2): control type 2 diabetic rats with HFD and STZ injection, group 3 (G3): type 2 diabetic rats received phosphate buffer saline (PBS) as Forskolin solvent, and group 4 (G4): Forskolin treated diabetic rats (10 mg/kg) for 1 month. In comparison to control group, in diabetic groups (G2 and G3) some parameters are increased significantly: The blood glucose (P=0.00078), testicular malondialdehyde (MDA) level and body weight (P=0.00009) and Bax gene expression (P=0.00007). Unlike, some parameters are decreased significantly: The serum level of testosterone (P=0.0009), testicular superoxide dismutase (SOD, P=0.00007) and glutathione peroxidase (GPX) levels (P=0.00008), sperm concentration (P=0.00008), motility (P=0.00009), normal morphological sperm (P=0.00008) and Bcl-2 gene expression (P=0.00009). However, in Forskolin treated group (G4) the parameters stayed close to control values that was significantly (P=0.00007) higher than in G2 and G3 groups. Therefore, treatment with Forskolin significantly improved these abnormal changes in Forskolin-treated group. Our study demonstrates that Forskolin is an effective antidiabetic agent, which significantly improves sperm concentration, testosterone levels, and antioxidant activity in diabetic rats.

Effect of age, gender and type of varicosity on the post-operative pain score after seven-day compression dressing after varicose vein surgery

Great saphenous vein insufficiency is linked to 80% of all remarkable lower limb varicosities. A total of 30 patients were enrolled from OPD fulfilling the inclusion criteria after the approval of the hospital’s ethical committee. Patients had compression dressing for seven days after surgery. The patients were divided into two groups—Group-A (Compression dressing for two days) and Group-B (Compression dressing for seven days). Stratification of pain score was done against age, gender, and grades of varicose veins, and after dividing into groups t- test was put into use. A p-value 0.05 was contemplated to be remarkable. Thirty patients with primary varicose vein were enrolled in this study. The mean age of patients was 35.4±9.9 years. Mean pain score in these patients was 2.9±0.8 years. ---Continue

Should Redo Surgery be Offered to Patients with Relapsed Glioblastoma? - Outcome Analyses of a Single Institution Comparative Cohort Study

Glioblastoma multiforme (GBM) is the predominant malignant brain tumor originating intracranially. The established first-line treatment postsurgery is concurrent chemoradiation as a definitive measure. However, recurrent GBM's pose a challenge for clinicians who rely on institutional experience to determine the most suitable course of action. Second-line chemotherapy may be administered with or without surgery depending on the institution's practice. This study aims to present our tertiary center institution's experience with recurrent GBM patients who underwent redo surgery. In this retrospective study we analyzed the surgical and oncological data of patients with recurrent GBM who underwent redo surgery at the Royal Stoke University Hospitals between 2006 and 2015. The group 1 (G1) comprised the reviewed patients, while a control group (G2) was randomly selected, matching the reviewed group by age, primary treatment, and progression-free survival (PFS). The study collected data on various parameters, including overall survival, PFS, extent of surgical resection, and postoperative complications. This retrospective study included 30 patients in G1 and 32 patients in G2, matched based on age, primary treatment, and PFS. The study found that the overall survival for the G1 group from the time of first diagnosis was 109 weeks (45-180) compared to 57 weeks (28-127) in the G2 group. The incidence of postoperative complications after the second surgery was 57%, which included hemorrhage, infarction, worsening neurology due to edema, cerebrospinal fluid leak, and wound infection. Furthermore, 50% of the patients in the G1 group who underwent redo surgery received second-line chemotherapy. Our study found that redo surgery for recurrent GBM is a viable treatment option for a select group of patients with good performance status, longer PFS from primary treatment, and compressive symptoms. However, the use of redo surgery varies depending on the institution. A well-designed randomized controlled trial in this population would help establish the standard of surgical care.

Epidemiological profile of congenital hypothyroidism at a southern Brazilian state.

To determine the incidence of congenital hypothyroidism (CH) over a 10-year period at the Reference Service in Neonatal Screening of the state of Rio Grande do Sul (RSNS-RS). Historical cohort study including all newborns screened for CH by the RSNS-RS from January 2008 until December 2017. Data of all newborns with neonatal TSH (neoTSH; heel prick test) values ≥ 9 mIU/L were collected. According to neoTSH values, the newborns were allocated into two groups: Group 1 (G1), comprising newborns with neoTSH ≥ 9 mIU/L and serum TSH (sTSH) < 10 mIU/L, and Group 2 (G2), comprising those with neoTSH ≥ 9 mIU/L and sTSH ≥ 10 mIU/L. Of 1,043,565 newborns screened, 829 (0.08%) had neoTSH values ≥ 9 mIU/L. Of these, 284 (39.3%) had sTSH values < 10 mIU/L and were allocated to the G1 group, while 439 (60.7%) had sTSH ≥ 10 mIU/L and were allocated to the G2 group, and 106 (12.7%) were considered missing data. The overall incidence of CH was 42.1 per 100,000 newborns screened (95% confidence interval [CI] 38.5-45.7/100,000) or 1:2377 screened newborns. The sensibility and specificity of neoTSH ≥ 9 mIU/L were 97% and 11%; of neoTSH 12.6 mUI/L, 73% and 85% respectively. In this population, the incidence of permanent and transitory CH was 1:2377 screened newborns. The neoTSH cutoff value adopted during the study period showed excellent sensibility, which matters for a screening test.

Assessment of Hydrogeochemical Characteristics and Seawater Intrusion in Coastal Aquifers by Integrating Statistical and Graphical Techniques: Quaternary Aquifer, West Nile Delta, Egypt

The Quaternary aquifer in the western Nile Delta is threatened by seawater intrusion. Few studies have integrated diverse techniques for the assessment of seawater intrusion in this aquifer. The present study aims to determine the geochemical processes and impact of seawater intrusion on this aquifer. To accomplish this investigation, the integration of hydrogeochemical, statistical, multivariate statistical, and graphical tools were implemented on 75 groundwater samples and 5 soil samples. The physicochemical variables were analyzed using hierarchical cluster analysis (HCA), saturation index (SI), ionic ratios, ionic relationships, the seawater intrusion index (SWI) and the correlations among 16 hydrochemical parameters, to identify the influencing processes of groundwater quality in the study area. According to the statistical study, the groundwater is divided into four groups. Those are distributed, from north to south: Group1 (G1), Group2 (G2), Group4 (G4), and Group3 (G3). The samples of G1 and G2 are distinguished by Na–Cl chemical type. While G4 has two main ion associations, HCO3–Ca–Mg and Cl–SO4–Na, G3 is characterized by HCO3–Cl–SO4–Ca–Na type. The processes that affect the chemistry of the groundwater are the seawater intrusion, ion exchange, silicate and Ca-rich mineral weathering, and mineral deposition. G1 and G2 groups are primarily influenced by seawater incursion, evaporation, and the ion exchange mechanism. In addition, the weathering of silicate minerals has a substantial effect on G3 and G4 groups, resulting in the creation of carbonate minerals.

Ubiquitin C-terminal hydrolase 1 is increased in migraine attack.

This study aimed to determine the serum level of Ubiquitin C-terminal hydrolase 1 enzyme during a migraine attack and after its treatment. Blood samples of 43 patients and 30 healthy controls who presented to the emergency department with migraine attacks were analysed. Study sample was classified into three groups: Group 1 (patients presenting with migraine attack), Group 2 (4thhour after dexketoprofen treatment) and Group 3 (healthy control). Demographic data of patients, visual analogue scale and Ubiquitin C-terminal hydrolase 1 levels were analysed. Median (IQR) Ubiquitin C-terminal hydrolase 1 levels were 13.70 (10.75-18.92) in Group 1, 9.45 (6.95-11.56) in Group 2 and 6.04 (3.88-8.72) ng/mL in Group 3; the Kruskal-Wallis test result showed a significant difference between the groups (P<0.001). Following the Kruskal-Wallis test, the post-hoc Dunn test was performed for binary comparison between the groups, which revealed significant differences between all groups (Group 1-Group 2, Group 1-Group 3 and Group 2-Group 3 with P=0.001, P<0.001 and P=0.008, respectively). Moreover, a significant positive correlation was found between VAS score and UCHL1 levels before treatment (r=0.884, P<0.001). UCHL1 levels of patients with migraine increase during acute attack and they can be used to assess the severity of attack and response to treatment.

Assessment of the Effectiveness of Aerobic Exercise Versus Billig’s Exercise Among Nursing Students with Dysmenorrhoea in Selected Nursing Colleges in Bangalore

Introduction Dysmenorrhea afflicts millions of women all over the world and is considered the most common gynecological condition in women regardless of age and nationality. The notion that exercise is effective in preventing and treating symptoms has prevailed for many years and led to the promotion of anecdotal belief that exercise is beneficial. Behavioral interventions such as exercise may not only reduce dysmenorrhoea but also eliminate or reduce the need for medication to control menstrual cramps and other associated symptoms. Objectives 1. To assess the perceived levels of pain among dysmenorrhoeic students of Group-A and Group-B before intervention. 2. To assess the perceived levels of pain among dysmenorrhoeic students of Group-A and Group-B after intervention. 3. To evaluate the effectiveness of aerobic exercise in Group-A and Billigrsquos exercise in Group-B. 4. To compare the effectiveness of aerobic exercise Group-A and Billigrsquos exercise Group-B among nursing students with dysmenorrhea. 5. To determine the association of the perceived levels of pain after intervention in aerobic exercise group Group-A and Billigrsquos exercise group Group-B with their selected demographic variables.Methodology The design used in this study was true experimental pre-test post-test research design. The selected settings for the study were nursing students of SJB and RajaRajeshwari College of Nursing Bangalore. The total number of students at SJB College was around 180 and at RajaRajeswari College of Nursing was around 200. Among them 85-95 students in each college were suffering with dysmenorrhoea. Investigator had selected 30 subjects using lottery method from each college. On Day-1 demographic questionnaire checklist and numerical pain scale were used to collect the data. On the same day aerobic exercise was taught for subjects in Group-A at SJB College of Nursing and Billigrsquos exercise for Group-B subjects at RajaRajeswari College of Nursing using computer assisted instruction method. The phone numbers of participants were collected to maintain contact with them. Investigator maintained a record of their menstrual dates and contacted them over phone to remind and motivate them to do exercise during the time of menstruation. The post-test scores were collected once they attained the menstrual cycle and performed the exercise.Results The mean post test scores were calculated in each group and the lsquotrsquo value was calculated. Since the computed lsquotrsquo 5.6 was greater than lsquotrsquo value lsquotrsquo 58 1.96 at 0.05 level it infers the post test score of aerobicnbspnbspexercise group as 12.857 and that for Billigrsquos exercise group as 12.26. Hence it can be concluded that aerobic exercise was as effective as Billigrsquos exercise.Conclusion Aerobic exercise and Billigrsquos exercise can reduce pain in those suffering with dysmenorrhoea and are effective.

Evaluation of the corneal biomechanical properties and corneal thickness in patients with Graves' orbitopathy.

To evaluate the corneal biomechanical properties and central corneal thickness in patients with Graves' orbitopathy (GO). A total of 132 eyes of 66 patients with GO and 108 eyes of 54 healthy subjects were enrolled. Eyes with GO were classified as high score clinical activity score (CAS, ≥ 3) (Group 1, n = 64) and low CAS score (< 3) (Group 2, n = 68). Corneal biomechanical parameters [corneal hysteresis (CH), corneal resistance factor (CRF)], Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) levels were measured with Ocular Response Analyzer (ORA, Reichert Ophthalmic Instruments, Buffalo, NY) and compared between the groups. The mean CH values were found as 9.6 ± 1mmHg in Group 1, 10.2 ± 0.9mmHg in Group 2, and 11.4 ± 1.7mmHg in the Control Group (p < 0.001). In post hoc analysis the mean CH was significantly lower in Group 1 than Group 2 and Control Group (Group 1-Group 2, p < 0.001; Group 1-Control Group, p < 0.001). The mean CRF was found as 10.5 ± 2.1 in Group 1, 10.4 ± 2.2 in Group 2, and 10.43 ± 2.0 in the Control group. There was no statistically significant difference between the groups in CRF measurements (p = 0.959). The mean IOPcc values were found as 17.1 ± 3.6mmHg in Group 1, 15.8 ± 4.0mmHg in Group 2 and 15.2 ± 4.1mmHg in the Control Group. The IOPcc and IOPg measurements between all groups were statistically significant (p = 0.009, p = 0.027, respectively). Corneal biomechanical measurements were different in the GO patients with varying CAS scores compared to healthy individuals.

To compare the early patency and survival rate of coronary grafts in On-Pump vs Off-pump CABG

Introduction: A large number of patients with coronary artery disease (CAD) encounter surgical cardiopulmonary bypass [on-pump coronary artery bypass (ONCAB) or off-pump coronary artery bypass (OPCAB)]. Since two techniques have been commenced, the doubt of which one is more convincing and efficacious has always been discussed and is still controversial. Objective: The purpose of this study was to determine the early patency and survival rate of coronary grafts after CABG in On-Pump vs Off-pump groups. Material and methods: This retrospective cross sectional study was conducted in the Cardiac surgery department of Punjab Institute of Cardiology, Lahore in year 2020 using the data of previous surgeries done from 01-01-2009 to 01-03-2010 (14 months). Total 792 patients fulfilling inclusion criteria were included. The data consisted of two groups Group-A ONCAB (341) and Group B OPCAB (451), with total number of grafts (2333). Out of 792 patients only 315 were followed up the same year and in 2020, 135 were followed up for survival rate. The sampling technique used in this study was non probability sampling. Results: The mean age of the patients in Group A was 56.13 ±9.305 years and in Group B was 53.9 ± 9.382 years. In 315 followed up patients the number of grafts applied were 949. The mean number of grafts applied in Group A was 3.11±0.949 and in Group B was 2.95±0.959. There was no statistically significant difference seen between these groups. Out of 949 grafts 795 were patent from which 410 were applied in group A and 385 were applied in group B. 154 were blocked out of which 67 were applied in group A and 87 were applied in group B. After 10 years, only 135 were followed for survival rate, out of which 22.22% had angioplasty done, 51.85% reported events of shortness of breath, 13.33% had another attack of myocardial infarction, 30.37% had angiography done and mortality rate was 14.07%. There were 85.4% patients still alive in Group A and 86.8% in Group B. The overall survival rate is 85.9%. Conclusion: In overall comparison there is no significant difference in patency and occlusion rate. However, the survival rate is 85.9%. So we can say both groups are equally safe and no procedure is preferred over another, entailing an identical caliber of anastomosis.