Longitudinal Intervention Study Research Articles

Improvement in appetite among stunted children receiving nutritional intervention in Bangladesh: results from a community-based study

Background/objectivesStunted children often have poor appetite, which may limit their response to nutritional interventions. We investigated the effect of a nutritional intervention on the appetite status of stunted children.MethodsA longitudinal prospective intervention study was conducted with 50 stunted (length for age; LAZ < −2) (age and sex matched) aged 12–18 months and their mothers in Bauniabadh slum of Dhaka city. The stunted children received the following intervention package: one boiled egg and 150 ml milk daily 6 days a week for 3 months; psychosocial stimulation including structured play activities and parental counseling for 6 months; routine clinical care. Appetite status was measured using an interview-based tool “Early Childhood Appetite and Satiety Tool.”ResultsOver the period of nutritional intervention, the mean appetite score increased from 49 to 60 in the stunted children and was associated with increased food consumption. Over the intervention period, both egg and milk consumption increased (40.3–49.6 g and 83.8–138.5 ml, respectively).ConclusionsAssessment of appetite status using EACST appears to be a useful tool for monitoring a nutritional intervention in stunted children. This tool may be useful for programs in managing child stunting in low-income countries and an important way to assess the efficacy of a nutritional intervention in these children.

Health-related quality of life in elderly, multimorbid individuals with and without depression and/or mild cognitive impairment using a telemonitoring application

PurposeMultimorbidity leads to decreasing health-related quality of life (HRQoL). Telemedicine may help to improve HRQoL. The present study was conducted to show (I) differences in HRQoL and changes in HRQoL over time in elderly, multimorbid individuals with and without depression and/or mild cognitive impairment (MCI) using a telemonitoring application (TMA) and (II) associations between engagement with measurements by study participants using a TMA and changes in their HRQoL.MethodsThe present feasibility study was part of a longitudinal intervention study. Recruited general practitioners (GPs) enrolled individuals and assigned them to risk groups according to absence/presence of depression and/or MCI. Depression was assessed using the Geriatric Depression Scale (GDS-15), MCI using the Mini-Mental State Examination (MMSE), and HRQoL using the SF-12. The TMA consisted of tablets, software, and measuring devices. Measured vital data were transferred to a care and case manager for monitoring and possible intervention.ResultsNine GPs recruited 177 individuals, 97 of whom were included in the HRQoL analysis. Significantly lower physical and mental component summary (PCS/MCS) scores were revealed in study participants with depression, and with both depression and MCI, compared to participants with no mental disorders. PCS scores did not differ between study dates, but MCS scores had significantly increased over time. Participants’ engagement with measurements was significantly associated with an increased MCS score, but not with the PCS score.DiscussionDepression and/or MCI are negatively associated with the HRQoL of elderly, multimorbid people using a TMA. Engagement of individuals with vital data measurements via a TMA may increase their mental HRQoL. Mentally impaired people should be closely involved as co-designers and experts in development processes of TMAs to benefit from tailored solutions. An individual’s increased mental HRQoL can be a decisive factor in their engagement with a GP treatment regimen and telemonitoring processes.

Can peer-tutored psychological flexibility training facilitate physical activity among adults with overweight?

ObjectiveAn increase in psychological flexibility has been found to be associated with health behavior changes. Peer-led interventions have been advantageous in improving physical activity among individuals at health risk. This study aimed to discover whether an ACT-based peer-tutored online intervention can increase self-reported physical activity participation and psychological flexibility among adults with overweight. DesignThe study was a non-randomized longitudinal intervention study. The intervention participants (N = 177) were primary health care clients with overweight. They participated in a 24-month program provided by health services, including three online modules of ACT of six week each, and tutoring by trained peers via five group meetings and four phone calls. Main outcome measures and resultsPhysical activity participation was measured with Kasari's FIT index concerning the frequency, intensity and time of the physical activity. Psychological flexibility was measured with AAQ-II, and thought suppression, as a dimension of psychological flexibility, with WBSI. Measures were taken at baseline, and at 6, 12, and 24 months. The statistical analysis was conducted with Mplus to identify latent groups with similar change patterns of physical activity, and to examine differences between the profiles. Two change profiles for physical activity participation were found: Low and High. At baseline in High profile group, physical activity and psychological flexibility were higher and thought suppression was lower than they were in Low profile group, as was expressing other psychological symptoms measured by DASS. During the intervention, physical activity increased significantly only within Low profile (within Cohen's d = .48). Psychological flexibility (AAQ-II) increased within High profile (within Cohen's d = .34), and thought suppression (WBSI) decreased in both profiles (within Cohen's d = .33). ConclusionThe ACT-based peer-tutored online intervention was promising especially for participants with low physical activity participation.

Study on functional outcome of bimalleolar ankle fractures treated by open reduction and internal fixation

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Ankle injury is the most common weight bearing orthopaedic musculoskeletal trauma encountered in emergency medicine and practice. Ankle joint is highly congruous and any disturbance of normal articular relationship may result in some progressive arthrosis of biomechanical dysfunction. As with all intra-articular fractures it necessitates accurate reduction and stable internal fixation. The objectives were to study the functional outcome of surgical treatment of bimalleolar ankle fractures and to know the complications of open reduction internal fixation of bimalleolar fractures.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 45 patients with malleolar fractures were included in this prospective longitudinal interventional study. Patients who underwent operative treatment were followed up regularly for 6 months with OPD visits and X-ray imaging at each stage. Patient parameters were recorded at immediate post op period, 6 weeks, 12 weeks and 24 weeks. Baird and Jackson scoring system for ankle were used for the functional outcome measurement.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Most common type of injury pattern was supination-external rotation with 21 cases (47% of cases). The results are excellent to good in 65% of patients, 27% of patients had fair and 8% had poor result. Syndesmotic screw fixation was done with 4.5 mm cortical screw in 7 cases. Most common complication was surgical site infection in 3 cases (6.67%). 2 patients underwent implant removal due to unresolved infection at 3 months.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The results of operative fixation were satisfactory in 90% of patients. Most of the complications were minor and resolved within three weeks.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

Non-local Muscle Fatigue Effects on Muscle Strength, Power, and Endurance in Healthy Individuals: A Systematic Review with Meta-analysis.

The fatigue of a muscle or muscle group can produce global responses to a variety of systems (i.e., cardiovascular, endocrine, and others). There are also reported strength and endurance impairments of non-exercised muscles following the fatigue of another muscle; however, the literature is inconsistent. To examine whether non-local muscle fatigue (NLMF) occurs following the performance of a fatiguing bout of exercise of a different muscle(s). Systematic review and meta-analysis. A systematic literature search using a Boolean search strategy was conducted with PubMed, SPORTDiscus, Web of Science, and Google Scholar in April 2020, and was supplemented with additional 'snowballing' searches up to September 2020. To be included in our analysis, studies had to include at least one intentional performance measure (i.e., strength, endurance, or power), which if reduced could be considered evidence of muscle fatigue, and also had to include the implementation of a fatiguing protocol to a location (i.e., limb or limbs) that differed to those for which performance was measured. We excluded studies that measured only mechanistic variables such as electromyographic activity, or spinal/supraspinal excitability. After search and screening, 52 studies were eligible for inclusion including 57 groups of participants (median sample = 11) and a total of 303 participants. The main multilevel meta-analysis model including all effects sizes (278 across 50 clusters [median = 4, range = 1 to 18 effects per cluster) revealed a trivial point estimate with high precision for the interval estimate [- 0.02 (95% CIs = - 0.14 to 0.09)], yet with substantial heterogeneity (Q(277) = 642.3, p < 0.01), I2 = 67.4%). Subgroup and meta-regression analyses showed that NLMF effects were not moderated by study design (between vs. within-participant), homologous vs. heterologous effects, upper or lower body effects, participant training status, sex, age, the time of post-fatigue protocol measurement, or the severity of the fatigue protocol. However, there did appear to be an effect of type of outcome measure where both strength [0.11 (95% CIs = 0.01-0.21)] and power outcomes had trivial effects [- 0.01 (95% CIs = - 0.24 to 0.22)], whereas endurance outcomes showed moderate albeit imprecise effects [- 0.54 (95% CIs = - 0.95 to - 0.14)]. Overall, the findings do not support the existence of a general NLMF effect; however, when examining specific types of performance outcomes, there may be an effect specifically upon endurance-based outcomes (i.e., time to task failure). However, there are relatively fewer studies that have examined endurance effects or mechanisms explaining this possible effect, in addition to fewer studies including women or younger and older participants, and considering causal effects of prior training history through the use of longitudinal intervention study designs. Thus, it seems pertinent that future research on NLMF effects should be redirected towards these still relatively unexplored areas.

Athens multifamily therapy project

IntroductionThe Athens multifamily therapy project (A- MFTP) provides systemic multifamily group therapy to youths who experienced a first psychotic episode (FEP) and their families.ObjectivesThe participants were recruited from the ongoing longitudinal Early Psychosis Intervention Study –ELPIS, Athens FEP Project, which aims to investigate the involvement of genetic and environmental determinants on psychosis risk.MethodsA group of five families with a child who had experience FEP, attended two multifamily group sessions per month, in the time period from September 2017 to Jun 2018. Parents and offspring participated to the sessions, which were conducted by two co-therapists. Assessment of patients’ psychopathology was based on PANSS at baseline, end of therapy and 6-month follow-up. All participants fulfilled an instrument assessing family factors (SCORE-15) and the Reflective Functioning Questionnaire (RFQ) at the same three time points. Furthermore, participants were asked to give written opinions regarding the therapeutic process at the middle phase, the end of therapy and six months follow - up.ResultsA qualitative analysis identified the emerging themes and patterns, focusing on the language and the meaning constitutes. Communication techniques, emotional processing and problem solving were the main learnings for the members of the group. They highlighted the impact of the group processes on family communication and individual understanding, while the development of a “new family” emerged from the group relationships.ConclusionsA- MFTP seems to be a promising service aiming to improve mental health and wellbeing of participants, to contrast chronicity and to contribute to early intervention services for psychoses in Greece.

Frontolimbic alpha activity tracks intentional rest BCI control improvement through mindfulness meditation

Brain–computer interfaces (BCIs) are capable of translating human intentions into signals controlling an external device to assist patients with severe neuromuscular disorders. Prior work has demonstrated that participants with mindfulness meditation experience evince improved BCI performance, but the underlying neural mechanisms remain unclear. Here, we conducted a large-scale longitudinal intervention study by training participants in mindfulness-based stress reduction (MBSR; a standardized mind–body awareness training intervention), and investigated whether and how short-term MBSR affected sensorimotor rhythm (SMR)-based BCI performance. We hypothesize that MBSR training improves BCI performance by reducing mind wandering and enhancing self-awareness during the intentional rest BCI control, which would mainly be reflected by modulations of default-mode network and limbic network activity. We found that MBSR training significantly improved BCI performance compared to controls and these behavioral enhancements were accompanied by increased frontolimbic alpha activity (9–15 Hz) and decreased alpha connectivity among limbic network, frontoparietal network, and default-mode network. Furthermore, the modulations of frontolimbic alpha activity were positively correlated with the duration of meditation experience and the extent of BCI performance improvement. Overall, these data suggest that mindfulness allows participant to reach a state where they can modulate frontolimbic alpha power and improve BCI performance for SMR-based BCI control.

Effectiveness of personal communication strategy in motivating replacement donors to become voluntary blood donors

Background and objectivesBlood donation is very crucial for continuous supply of blood in blood banks for the appropriate patient management. This study was conducted to obtain information from replacement blood donors regarding barriers for voluntary blood donation, and for this, we assessed the effectiveness of personal communication strategy to convert them into voluntary blood donors.Materials and methodsProspective longitudinal interventional study with personal communication strategy as intervention, conducted on in‐house replacement blood donors, who never donated voluntarily, and to convert them into future voluntary blood donors. Enrolled blood donors were randomized into the case and the control arms, and a questionnaire regarding barrier for voluntary blood donation was administered. Personal communication strategy was applied in the case arm, and no intervention was done in the control arm. Six months after the enrolment, donors were contacted telephonically and the history of repeat donation in the last 3 months was asked.ResultsOf the selected 769 donors, 381 and 388 donors were randomized into the case and the control arms, respectively. Lack of awareness about voluntary blood donation, lack of time and convenience were the most common reasons for not donating blood voluntarily. In the post‐motivational period, 23·35% and 3·35% of the blood donors in the case and the control arms, respectively, donated blood voluntarily.ConclusionThis study revealed the factors for not donating blood voluntarily. We believe that our results can be used to convert the existing replacement donors into voluntary donors by applying the personal communication strategy, and future study can be planned, combined with some other effective tools to bring the maximum desired results.

Cognitive and Socioaffective Predictors of L2 Microdevelopment in Late Adulthood: A Longitudinal Intervention Study

AbstractThe question of cognition in second language (L2) acquisition later in life is of importance inasmuch as L2 learning is largely mediated by domain‐general cognitive capacities. While a number of these capacities have been shown to decline with age, individual differences in cognition increase over the lifespan. This microdevelopment study investigates the L2 trajectories of 28 older German‐speaking adults (age 64+) who participated in a combined computer‐assisted and classroom‐instructed 7‐month Spanish training for beginners. We made use of generalized additive mixed models (GAMMs) to quantify linear and nonlinear learner trajectories as well as any predictors thereof. Participants were assessed on a range of behavioral, L2, socioaffective, and background variables. We found a significant (linear and nonlinear) increase across all measures of L2 proficiency. Between‐subject cognitive, socioaffective, and background variables significantly predicted the overall level of L2 proficiency as well as developmental patterns over time. Daily variances in cognitive performance and socioaffect had little impact on fluctuations in L2 performance. Findings are discussed against the backdrop of complex dynamic systems theory and highlight the necessity for dense longitudinal research designs to capture nonlinearity in third‐age L2 learning.

EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE

Background :To study the effect of phototherapy on serum calcium levels in neonates with unconjugated hyperbilirubinemia. Methods : This hospital based longitudinal interventional study was conducted on 100 neonates with neonatal hyperbilirubinemia admitted to Neonatal Intensive Care Unit at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. Total serum bilirubin and serum calcium levels of each participants were checked before and at the end of phototherapy. Neonates were also checked for the clinical signs of hypocalcemia i.e. jitteriness, irritability, lethargy, and convulsions. Results : Atotal of 100 neonates with neonatal jaundice were included with 55% boys and 45 % girls whose mean age was 3.0 ± 0.95 days. Mean S.Bilirubin level before phototherapy was 13.92 ± 2.32 mg/dl which was reduced to 8.87 ± 2.18 mg/dl. S.Calcium levels pre-phototherapy were 8.66 ± 0.65 mg/dl which were reduced to 7.94 ± 1.05 mg/dl. It was found that 32% of the participants in total exhibited symptoms related to hypocalcemia. More term neonates (56.3%) experienced symptoms related to hypocalcemia compared to pre-terms (43.8%). Conclusion : It can be deduced that phototherapy induced hypocalcemia is a signicant concern and hence, neonates requiring phototherapy may be considered for calcium supplementation.

Newly graduated nurses' evaluation of the received orientation and their perceptions of the clinical environment: An intervention study.

New graduate nurses (NGN) are the future of healthcare organizations where a shortage of nurses will soon be reality. The transition from a student to a registered nurse can be a demanding and challenging time, and in order to retain new graduate nurses, the transition should be as smooth as possible. The aim of this study was to examine preceptors' education intervention's impact on NGNs' orientation period and their clinical learning environment from NGNs' point of view. This survey was a part of a longitudinal quasi-experimental intervention study. Participating units were randomized into intervention group and control group. The intervention group's preceptors (n=174)were provided a face-to-face education about orientation. NGNs (n=72) were relatively satisfied with the received orientation. However, intervention group was more discontented with their orientation experiences than the control group. The control group's NGNs had longer orientation periods and more feedback discussions. They were also more satisfied with their preceptor's orientation skills and their working environment was more responsive. Even though the impact of the intervention was inconclusive, this study provided us important information about NGNs' first steps towards the nursing profession by giving us clear improvement targets. We need a culture of feedback, individualized orientation and understanding that orientation should be our common interest. Investing in orientation is investing for the future. This study indicated that the increase in knowledge did not translate into everyday practice. This finding will hopefully give rise to discussion within organizations on how to utilize employees' gained knowledge more effectively.

Insecticide-impregnated netting: A surface treatment for killing Lutzomyia longipalpis (Diptera: Psychodidae), the vector of Leishmania infantum

The sand fly Lutzomyia longipalpis is the main vector of Leishmania infantum in Brazil. Synthetic male-produced sex/aggregation pheromone co-located with micro-encapsulated λ-cyhalothrin in chicken sheds can significantly reduce canine infection and sand fly densities in a lure-and-kill strategy. In this study, we determined if insecticide-impregnated netting (IN) could replace insecticide residual spraying (IRS). We compared numbers of Lu. longipalpis attracted and killed in experimental and real chicken sheds baited with pheromone and treated with a 1 m2 area of either insecticide spray or netting. First, we compared both treatments in experimental sheds to control mortality established from light trap captures. We then compared the long-term killing effect of insecticide spray and netting, without renewal, in experimental sheds over a period of 16 weeks. Finally, a longitudinal intervention study in real chicken sheds compared the numbers and proportions of Lu. longipalpis collected and killed before and after application of both treatments. In Experiment 1, a higher proportion of males and females captured in IRS- and IN-treated sheds were dead at 24 h compared to controls (P < 0.05). No difference was found in the proportion of females killed in sheds treated with IN or IRS (P = 0.15). A slightly higher proportion of males were killed by IRS (100%) compared to IN (98.6%; P < 0.05). In Experiment 2, IN- and IRS-treated traps were equally effective at killing females (P = 0.21) and males (P = 0.08). However, IRS killed a significantly higher proportion of females and males after 8 (P < 0.05) and 16 (P < 0.05) weeks. In Experiment 3, there was no significant difference between treatments in the proportion of females killed before (P = 0.88) or after (P = 0.29) or males killed before (P = 0.76) or after (P = 0.73) intervention. Overall, initially the IN was as effective as IRS at killing female and male Lu. longipalpis in both experimental and real chicken sheds. However, the relative lethal effect of the IN deteriorated over time when stored under prevailing environmental conditions.

Feasibility of Prophylactic Bilateral Salphingectomy during Vaginal Hysterectomy- A Prospective Longitudinal Cohort Study

Introduction: Fallopian tubes are not commonly removed during vaginal hysterectomy because of inadequate surgical training or fear of increased morbidity. Aim: The primary objective of this study was to estimate the proportion of planned bilateral salpingectomies successfully completed vaginally. Materials and Methods: This was a prospective, interventional longitudinal cohort study conducted in the Department of Obstetrics and Gynaecology at ESI, PGIMSR, Basaidarapur, New Delhi. From December 2018 to November 2019, all women undergoing vaginal hysterectomy for benign conditions were offered prophylactic salpingectomy. Operative time, blood loss and reason for non completion for salpingectomy were recorded. Patients were followed-up for six weeks. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) 17.0. Continuous variables were described with mean and the categorical variables were described with frequencies and percentages. Results: Thirty-five patients were enrolled in the study. The most common indications for vaginal hysterectomy for benign conditions included uterovaginal prolapse in 21 (60%) patients and adenomyosis and fibroids in 10 (30%) and 4 (10%) patients respectively. Of the 35 patients, vaginal salpingectomy was successful in 31 (88.5%) patients. Factors which led to non completion of salpingectomy were pelvic adhesions and atrophic ovaries in 2 (5.7%) patients each. Mean operating time for bilateral vaginal salpingectomy was 14.05±2.75 minutes. Mean Estimated Blood Loss (EBL) for bilateral salpingectomy was 19.86±6.88 mL. Conclusion: Bilateral prophylactic salpingectomy with vaginal hysterectomy for benign conditions is feasible in most of the patients. Routine salpingectomy should be offered to women undergoing vaginal hysterectomy for benign conditions to prevent risk of ovarian carcinoma in future.

Effect of testosterone replacement therapy on insulin sensitivity and body composition in congenital hypogonadism: A prospective longitudinal follow-up study.

Aims:To evaluate the prevalence of metabolic syndrome (MS) and whole-body composition in patients with congenital hypogonadism and investigate the effects of replacement therapy with testosterone undecanoate on MS, insulin resistance (IR), and whole-body composition in subset of patients.Methods:In a single arm prospective longitudinal intervention study, 33 patients with congenital hypogonadism, ages 20–39 years, were recruited and their parameters of MS, whole-body composition by DXA were compared with age and BMI matched healthy controls. In 21 patients, after 9 months we prospectively studied the effect (pre–post difference) of injection testosterone undecanoate (1,000 mg) replacement on MS, IR, and whole-body compositions.Results:The prevalence of MS was similar in patients and controls (27.3% vs. 9.1%, P = 0.05). Hypogonadism patients had higher prevalence of hypertension (33% vs. 3%, P < 0.01). Patients had decrease in lean body mass (P < 0.05) as compared to controls. After testosterone replacement, there was significant decrease in waist circumference (88.6 ± 13.1 cm vs. 83.9 ± 12.9 cm, P < 0.01), truncal fat (25.9 ± 7.3% vs. 24.0 ± 6.3%, P < 0.05), fasting C-peptide (2.1 ± 0.79 ng/ml vs. 0.68 ± 0.23 ng/ml, P < 0.01), serum proinsulin [1.43 (0.32– 13.4) vs. 0.5 (0.5–3.2) pmol/l, P < 0.001] and a significant increase in lean body mass (46,906 ± 8,876 gm vs. 50,083 ± 7,590 gm, P < 0.001). Homeostasis model assessment of insulin resistance (HOMA-IR) (4.6 ± 1.7 vs. 0.5 ± 0.2, P < 0.001) and homeostatic model for assessment of insulin sensitivity (HOMA%S) [21 (12–65) vs. 206 (125–714), P < 0.001] were improved significantly following testosterone replacement.Conclusion:In this study, 36 weeks of testosterone replacement resulted in significant decrease in waist circumference, IR, truncal fat, total body fat and improvement in lean body mass, and insulin sensitivity.

Adaptive response triggered by the repeated SCUBA diving is reflected in cardiovascular, muscular, and immune biomarkers.

It has been shown that one recreational SCUBA (rSCUBA) diving session is sufficient to cause changes in plasma level of cardiovascular (CV) and muscular biomarkers. To explore whether repetitive rSCUBA diving triggers an adaptive response of the CV, muscular, and immune system, we measured the cardiac damage (NT‐proBNP, hs‐TnI, and CK‐MB), muscle damage (myoglobin (Mb), galectin‐3, CK, and LDH), vascular endothelial activation (ET‐1 and VEGF), and inflammatory (leukocyte count (Lkc), CRP, and IL‐6) biomarkers. A longitudinal intervention study included divers (N = 14) who conducted one dive per week over 5 weeks at the depth of 20–30 m for 30 min after a non‐dive period of 5 months. The blood samples were collected before and after the first, third, and fifth dives and specific biomarkers were measured in plasma or serum by the standard laboratory methods. The concentrations of the majority of measured biomarkers increased after every single dive; the exception was ET‐1 concentration that decreased. The cumulative effect of five dives has been reflected in diminishing changes in hs‐TnI, Mb, galectin‐3, ET‐1, VEGF, and IL‐6 levels, and more pronounced increases in NT‐proBNP and hs‐CRP levels. The median values of all measured biomarkers in all time points, except Mb, remained within the corresponding reference range. Repeatedly performed rSCUBA diving activates an adaptive response of the CV, muscular, and immune system that is reflected in changes in the specific biomarker concentration.

Effect of single intravitreal triamcinolone acetonide injection on intraocular pressure and retinal nerve fibre layer thickness

Purpose: To investigate the intraocular pressure (IOP) changes following intravitreal triamcinolone acetonide (IVTA) injection for inflammatory, proliferative and edematous diseases of posterior segment of eye. Design: Prospective longitudinal interventional study. Methods: The prospective longitudinal study included 30 with posterior uveitis (n=12), retinal vascular occlusive diseases (n=10), Eales’ disease (n=6), pseudophakic cystoid macular edema (n=1) and idiopathic cystoid macular edema (n=1). 4 mg of IVTA injection IOP increased significantly from baseline IOP of 14.27±3.53 mm Hg to mean IOP of 16.54± 4.29, 18.54± 5.50, 19.00± 5.98, 18.82± 5.00 and 22.50±0.71 mm Hg at 2, 4, 6, 8 and 12 weeks follow up respectively. In study group IOP elevation of ≥6 mm Hg from baseline was seen in 17 out of 30 eyes (64.71% males and 35.29%females). The majority of patients belonged to younger age group. An IOP elevation was seen in 58.82% and 88.24% eyes upto 4 and 6 weeks follow up respectively. In 15 out of 17 eyes, IOP was controlled with topical anti-glaucoma medications while 2 eyes required filtering glaucoma surgery. Conclusions: After 4 mg of IVTA injection 57.67% of eyes developed IOP elevation ≥6 mm Hg from baseline. In 88.24% eyes raised IOP was controlled with topical anti-glaucoma medications. There was no statistically significant change observed in retinal nerve fibre layer thickness upto 12 weeks follow up, despite elevated IOP. Besides glaucoma no other complication was observed upto 12 weeks of follow up.

Comparative evaluation of audio-visual and verbal education method on OHRQoL, dental anxiety, dental neglect of diabetes mellitus patients attending a teaching hospital in India.

The aim of this study was to compare audio-visual and verbal education on oral health related quality of life, dental anxiety and dental neglect, on diabetes mellitus patients attending Teerthanker Mahaveer Hospital, Moradabad. The current longitudinal interventional study was conducted to check the efficiency of audio-visual and verbal education on OHRQoL, Dental anxiety and dental neglect, on diabetes mellitus patients attending Teerthanker Mahaveer Hospital, Moradabad, U.P., India. A 14-item questionnaire, OHIP-14, with emphasis on seven proportions of impact was used to collect information on OHRQoL. Corah Dental Anxiety Scale (DAS) will be used to collect data on Dental Anxiety. A prevalidated revised proforma of Dental Neglect Scale (DNS) was used to gather information on Dental Neglect. The questionnaire was a six-question instrument related to dental problems. After collecting the initial baseline data, the sample was divided into two groups: verbal education group (n = 1030) and audio-visual education group (n = 1030). Then oral health education (OHE) was provided verbally to Group I patients and OHE with audio-visual aids was given to Group II patients visiting Teerthanker Mahaveer Hospital. OHE was repeated every 2 months. At every 6, 12 and 18 months, questionnaire was repeated to evaluate the effectiveness of OHE. Inspection will be conducted under natural daylight in hospital premises. To avoid the disruption while conducting the examination, adequate supply of instruments was taken. Instruments were sterilized by autoclaving in the college. A total of 1926 patients attended all the follow-up and review examinations. Subject dropout for Group I was 2% with 1009 at 6th month; 3% with 978 at 12th month and 1% with 967 at 18th month. Subject dropout rate for Group II was 3% with 999 at 6th month; 0% with 999 at 12th month and 4% with 959 at 18th month. The difference of subject dropout among the groups was not statistically significant (P = 0.23). Group mean total OHIP-14 score after 18 months was recorded as 15.36 ± 8.61, whereas in Audio-visual education group mean total OHIP-14 score after 18 months was recorded as 14.42 ± 7.59. At the end of study mean DAS score for DAS ≥15 (severe anxiety) was found to be 1.95 ± 2.18 in verbal education group, whereas in audio-visual education group mean DAS score for DAS ≥15 (severe anxiety) was found to be 2.24 ± 1.98. At the end of the study mean DN score for DNS ≥15 (severe Dental Neglect) was found to be 3.54 ± 2.63 in verbal education group, whereas audiovisual education group mean DN score for DNS ≥15 (severe Dental Neglect) was found to be 2.59 ± 2.75. The quality of life is a factor that can be considerably affected by oral health, which in turn reflects the general health of an individual. The main part of oral disease prevention is done by use of personal oral hygiene measures and maintaining oral hygiene. It is the duty of dental professionals to motivate, show and instruct patients to maintain appropriate oral health and oral hygiene. The study concludes that the program of this kind may be beneficial in improving many dimensions of dental health of an individual that includes physical health, emotional well-being, OHRQoL, inter-personal relationship and the fear related to dental treatment.

Impact of root canal treatment on high-sensitivity C-reactive protein levels in systemically healthy adults with apical periodontitis - a preliminary prospective, longitudinal interventional study.

To assess the influence of root canal treatment on serum high-sensitivity C-reactive protein (hsCRP) levels in systemically healthy human adults. Fifteen individuals aged 20-40years diagnosed with apical periodontitis [Periapical Index (PAI) score ≥3] who were otherwise healthy took part in this prospective interventional study. Patients with moderate to severe periodontitis, systemic diseases and traditional cardiac risk factors (hypertension, diabetes, dyslipidemia and smoking) were excluded. Root canal treatment was completed in two visits with an inter-appointment calcium hydroxide intracanal medicament. After 6months, healing of apical periodontitis was evaluated clinically and radiographically, and serum hsCRP levels were recorded. A paired sample T-test was used to compare the mean hsCRP values between the pre- and post-treatment groups. The Mann-Whitney U test was used to compare hsCRP values between patients with PAI scores of 3 and 4, and the Wilcoxon signed-rank test was used to compare pre- and postoperative PAI scores. The mean preoperative baseline serum hsCRP level was 2.88±1.06mgL-1 which can be associated with a moderate risk for cardiovascular disease (CVD). Based on the preoperative hsCRP levels, eight of the 15 patients were categorized as high risk (hsCRP>3mgL-1 ) and the other seven as medium risk (hsCRP 1-3mgL-1 ) for CVD. The mean preoperative hsCRP value of patients with a PAI score of 3 was 2.88±1.19mgL-1 , and the mean preoperative hsCRP of patients with a PAI score of 4 was 2.87±0.15mgL-1 , which was not significantly different (P=0.942). Six months after root canal treatment, the mean PAI score had significantly reduced from 3.2±0.42 to 1.4±0.69 (P=0.003). The PAI score had reduced to ≤2 in 87% of the patients, and the mean serum hsCRP levels had significantly reduced to 1.34±0.52mgL-1 (P<0.001). Ten of the 15 patients had a reduction in their CVD risk status. This study suggests that root canal treatment can reduce serum hsCRP levels in systemically healthy individuals with apical periodontitis.

SURG-43. APPLICATIONS AND RESTRICTION OF 980NM DIODE LASER FOR BRAIN TUMOR MICROSURGERY - A PIONEER CASE SERIES AND A CRITICAL REVIEW

Abstract BACKGROUND Quality of life is essential for oncological patients. There are several tools that help surgery become more precise with less morbidity. Diode laser can cut and coagulate through thermal effect being helpful during surgery. It is a precise and useful technology that improves outcomes in neurooncology. OBJECTIVES To describe a pioneer case series of oncological use of diode laser and main applications of several types of laser in neurooncology. METHODS Detailed description of a pioneer case series of oncological patients that undergone to neurosurgical laser assisted procedures. An interventional longitudinal prospective study was conducted. Patients that had as mainly hypothesis the diagnosis of glioma or meningioma were selected. Also it was performed an extensive literature review about lasers in neurosurgery with special focus in diode laser. RESULTS There was not any paper describing the use of diode laser in neurooncology. The 980nm diode laser was used in 15 patients. The device had an easy handling. Decreased intra-operative time for hemostasis, lesser blood loss requiring less blood transfusion was observed. No post-operative complications occurred. CONCLUSIONS Diode laser is a useful tool for brain tumor surgery especially concerning hemostasis, providing decreased blood loss with lesser intra-operative duration. Surgical site coagulation is more effective causing less damage to adjacent structures specially in gliomas near eloquent regions. We consider this technique as a suitable adjuvant therapy for brain tumor surgeries providing an excellent hemostasis and helping cutting and vaporize lesion. This device makes surgery safer and decrease oncological morbidity.

Effects of a 10-week running-retraining programme on the foot strike pattern of adolescents: A longitudinal intervention study

BackgroundThe purpose of this study was to analyse the effects of ten weeks of different running-retraining programmes on rearfoot strike (RFS) prevalence in adolescents. Research questionit is possible to change foot strike pattern in adolescents? MethodsA total of 180 children (45.3% girls), aged 13–16 years, participated in this intervention study. The children were randomly assigned to one of three experimental groups (EGs) that each carried out a different retraining programme, based on running technique (n = 39), a 15% increased step frequency (SF) (n = 37) and barefoot training (n = 30), performed for three days each week. A control group (CG) (n = 43) did not perform any retraining. A 2D video-based analysis (240 Hz) was used to determine the RFS. ResultsAt baseline, no significant differences in RFS prevalence were found between the EGs and the CG in either the left (χ2 = 2.048; p = 0.559) or the right foot (χ2 = 0.898; p = 0.825). In the post-test, no significant differences were found for the left foot (χ2 = 7.102; p = 0.069), but there were significant differences for the right foot (χ2 = 9.239; p = 0.025) were observed. In the re-test, no significant differences were found for either the left foot (χ2 = 2.665; p = 0.273) or the right foot (χ2 = 2.182; p = 0.325). In addition, no group displayed significant changes in RFS prevalence from the pre-test to the re-test. There was a trend towards a reduction in the RFS prevalence in both the increased SF group and the barefoot group. MeaningThe main finding of this study was that certain running-retraining programmes performed three times per week for ten weeks are not enough to modify the adolescent foot strike pattern (FSP).