Significant P-value Research Articles

Factor Analysis of Development Identity for Graduates in the Faculty of Forestry, Kasetsart University

This study aims to analyze the identity components of graduates from the Faculty of Forestry at Kasetsart University using exploratory factor analysis and confirmatory factor analysis. Two sample groups were involved: Group 1 (400 individuals) for exploratory factor analysis and Group 2 (710 individuals) for confirmatory factor analysis. Both groups responded to a 5-point Likert scale questionnaire. The exploratory factor analysis results showed a strong Kaiser-Meyer-Olkin measure of .930 and Bartlett's Test of Sphericity with a chi-square value of 10437.275, 1770 degrees of freedom, and a significance level of .0001. Nine identity components were identified through factor rotation using the Varimax method: teamwork, commitment to task completion, application of knowledge, integrity towards oneself and others, adaptability to the environment, humility, willingness to help and share, non-egoism, and perseverance. The confirmatory factor analysis confirmed a good fit of the model to the observed data, indicated by indices such as p = .148, χ²/df = 1.314, RMSEA = .02, GFI = .991, AGFI = .98, CFI = .998, and RMR = .097. Notably, "teamwork" had the highest standardized weight of .825, followed by "willingness to help and share" (.749) and "commitment to task completion" (.739). The standardized weights ranged from .825 to .636. All variables had statistically significant p-values, and the coefficients of determination (R²) ranged from .680 to .405 when measured by Square Multiple Correlation.

A Study of the Clinical Profile and Respiratory Index of Severity in Children (RISC) Score in Infants Admitted With Acute Respiratory Infections at a Tertiary Care Hospital.

Background Pneumonia is a major infectious cause of mortality in young children worldwide. The Respiratory Index of Severity in Children (RISC) score was designed with the intent to provide an objective mean to quantify the severity of lower respiratory tract infection in young children based on their risk of mortality. Knowledge about the clinical profile of acute respiratory infections and the scoring system predicting the risk of mortality helps in modifying treatment strategies. This study was undertaken at a resource-limited, tertiary-care public hospital in southern India with the objectives of describing the clinical profile of infants admitted with acute respiratory infections and determining the association of the RISC score with mortality. Method This was a retrospective observational study conducted over six months. Case records of infants admitted with acute respiratory infections were reviewed. The socio-demographic and clinical details of each case were recorded. The RISC score was calculated using clinical parameters which included the history of refusal of feeds, oxygen saturation lower than 90%, chest in-drawing, wheezing, and low weight-for-age. The maximum score was six. Descriptive data was represented using mean, standard deviation, and percentage or proportion. The association between any two categorical variables was analyzed using the chi-square test. The differences between any two continuous variables were analyzed using the independent sample t-test. A p-value of < 0.05 was considered statistically significant. Results A total of 75 infants were admitted with a diagnosis of acute respiratory infection during the study period. Of these, 68 were included in the study. The mean age of infants was 6.69 ± 3.96 months; 58.8% were male, 41 (60%) were exclusively breastfed, and 51 (75%) were up-to-date immunized. Twenty (29.4%) infants had a history of exposure to indoor smoke. The majority (67.6%) had pneumonia. Nine (13.2%) were mechanically ventilated. The mean duration of hospital stay was 8.16 ± 5.45 days. Sixty-three (92.64%) infants recovered and there were five deaths. The presence of less than 90% oxygen saturation (p-value=0.004), a diagnosis of severe pneumonia (p-value <0.001), and the need for mechanical ventilation (p-value <0.001) were significantly associated with mortality. A statistically significant (p-value=0.001) association was observed between the RISC score and mortality. Conclusions Addressable factors like the absence of exclusive breastfeeding, partial-immunization status, exposure to indoor smoke, and malnutrition were observed in infants with acute respiratory infections, which reinforces the importance of protective and preventive strategies for the control of pneumonia. The RISC score was observed to be beneficial in predicting mortality in an infant with acute respiratory infection. Triaging and early identification of infants at risk of mortality using this score could be very helpful in initiating timely treatment to reduce mortality, especially in resource-limited settings.

Legal-dogmatic controversies between civil law and criminal law: the case of the exercise of the right of possession in Colombia

Women’s unmet need of modern contraceptive in Cameroon has many gender specific health risks and development implications. This paper sought to examine the perceptions variation among men and women towards contraceptive use by employing a mixed method design to collect both quantitative and qualitative data from 248 participants using questionnaires and interview guides. The results showed that 86% of the participants had heard of contraceptives and a lesser proportion (8%) did not know the importance of contraceptives; 67% of respondents indicated that women were in greater need of contraceptives as opposed to 33 % who opined that men needed contraceptives and the relationship between gender perception and contraception use was statistically significant (p-value=0.04). This study contributes to the body of knowledge on contraceptive use and the predictors which may account for its weak uptake and the wide unmet need of contraceptives in African countries like Cameroon.

CD44 as a prognostic marker in early colorectal cancer: single center experience “South Egypt cancer institute”, Egypt

ABSTRACT Background Colorectal cancer (CRC) is a common and lethal disease; it remains the third most frequently occurring cancer among both genders. In Egypt, colon cancer represents the ninth most common cancer while rectal cancer ranks the 18th most common cancer by incidence. The application of cancer stem cells (CSC) as prognostic markers in CRC is now studied, among which is CD44, which is implicated in cellular growth, differentiation, survival as well as the metastatic behavior of cancer cells. The prognostic role of CD44 in CRC is still controversial. The study aims at inspecting CD44 immunoreactivity in the epithelium of colorectal cancer specimens and to detect its association with the patients’ clinicopathological features as well as its prognostic significance. Methods This retrospective cross-sectional study included 85 CRC specimens and 16 adenoma specimens collected from the Pathology Department, South Egypt Cancer Institute, during the period from 2018 to 2020. All specimens were stained by anti-CD44 antibody. Results CD44 epithelial expression in colon cancer tissue specimens was substantially higher than in normal mucosa. It was observed that 95% (n = 81) of the studied colorectal carcinoma cases showed positive CD44 epithelial expression compared to distant normal mucosa as controls as well as adenoma cases where only 43.8% (n = 7) of adenoma cases showed positivity with highly significant p-value P = 0.000 and it correlates with cancer progression and aggressiveness. Low H score expression H ≤ 150 had better 3 years disease-free survival DFS estimated by 83.3% compared to 79.6% with high H score expression with significant P-value (P = 0.041). Discussion Our current study showed a statistically significant association between CD44 expression and tumor size (T), lymph node metastasis (N) as well as disease stage with P-values (P = 0.009), (p = 0.000) and (p = 0.000), respectively. CD44 epithelial immunostaining showed to be of an adverse prognostic significance in early CRC associated with more aggressive behavior and worse survival.

Bronchiolitis in Infants; Five Years' Experience of a Teaching Hospital.

Bronchiolitis is a clinical syndrome affecting the lower respiratory tract of infants and toddlers <2 years old. Variability in clinical profile and response to therapy in children with Bronchiolitis calls for studying the different clinical aspects of local patient population. The goal of our study is to determine the clinical presentation, past medical history, hospitalization course and prognosis in children below two years of age who have been hospitalized in King Fahad University Hospital over the last five years. A retrospective chart review based on electronic health records of all Bronchiolitis-related hospitalization of infants and toddlers below two years of age, covering the period between January 1, 2015, to April 26, 2020. Out of a total of 446 children <2 years of age, 202 were female (45.4%), and 243 were male (54.6%). Although the length of hospital stay was almost equal between the sexes, there was a significant (p-value=0.01) increase in length of intensive care unit stay among females compared to males. Furthermore, there was a significant prolongation in the duration of ventilator usage among females (p value = 0.062). Out of fifty-five patients admitted to the ICU, 83.63% of them were 12 months of age and below. Our results show a significant increase in length of ICU and ventilator use among females compared to males. It also shows that infants younger than 12 months account for most ICU admissions. These findings, among many others, may help pediatricians formulate a better diagnostic and therapeutic pathways.

Association of Gastrointestinal Manifestations with Socio-demographic, Lifestyle &amp; Clinical Factors in HIV/AIDS Patients

Background: Gastrointestinal abnormalities in people with HIV/AIDS have been reported since the advent of AIDS. This study aimed to analyze the gastrointestinal manifestations in HIV/AIDS patients in terms of sociodemographic, lifestyle, and clinical characteristics with the association of GI manifestations. Material &amp; Methods: This observational cross-sectional analytical study was conducted at the ART corner and Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka among adult HIV-infected or AIDS patients aged more than 18 years. A total of 122 patients were taken as per inclusion criteria. The study took place from March 2018 to February 2019. Continuous variables were reported as the mean ± standard deviation. The correlation of several GI symptoms with CD4 count was done by the Spearman rank test. Sociodemographic variables (gender, age, income, and education level), lifestyle variables (smoking status, risk consumption of alcohol, and physical activity level), and clinical variables (antiretroviral therapy – duration and class, duration of HIV infection) were assessed through a pre-tested and standardized questionnaire. The chi-square test was used to test the statistical significance of associations, considering a p-value ≤0.05 as statistically significant. All of the data were analyzed and calculated using the Statistical Package for Social Sciences (SPSS version 20.0) and Microsoft Excel 2016. Results: Among the patients, male preponderance was seen with the frequency of 66% (31) and 61.3% (46) with and without GI symptoms respectively. Patients aged 40-49 years old were more frequent with (31.9%) and without (25.3%) GI symptoms. The patients of primary level of education had GI symptoms and had no GI symptoms were 61.7% and 45.3% respectively of the total. Statistically significant (p=0.03) indicating that low CD4+ cell count (≤ 350 cells/mm3) can be considered as an associated risk factor for the occurrence of GI manifestations in HIV infected patients. There was less statistically significant difference in other clinical characteristics between patients with current GI manifestations and without GI manifestations. Here, the statistically significant p-value ≤0.05 is considered. Conclusion: This study concluded that, smoking and low CD4 count (&lt;350cell/mm3) were found significantly associated with the occurrence of presenting GI symptoms. Other sociodemographic, lifestyle, and clinical factors were not significantly associated with the occurrence of GI manifestations.

Comparative Evaluation on the Effects of Three Pediatric Syrups on Microhardness, Roughness and Staining of the Primary Teeth Enamel: An In-Vitro Study.

​​​​​Introduction One of the most prevalent oral diseases is dental caries. Syrups are commonly used by children who have difficulty swallowing tablets and capsules. Some medications can make dental caries worse and cause the enamel to erode. Most of the time, parents are unaware that a number of foods, drinks, and syrup-formulated pediatric drugs include sugar, whichcan cause erosion of primary teeth, resulting in plaque accumulation and dental caries.Henceforth, theaim of this study is to assess the effects of pediatric syrups on the microhardness, roughness, and staining ability of primary tooth enamel as a result of daily intake of syrup. Methods Eighty primary teeth, including both anterior and posterior, that required extraction due to pre-shedding mobility were randomly divided into four groups of twenty samples each. Samples were exposed to multivitamin syrup (Rudimin), iron syrup (C Pink), and diuretic syrup (Furosemide). The samples were submerged in 10 mL of the respective medication once daily for five minutes for 21 days. On days 0 and 21, enamel surfaces were assessed for changes in microhardness, roughness, and staining. The microhardness was assessed using a Micro Vickers microhardness tester machine; the roughness was assessed using a Mitutoyo surface roughness tester; and the staining ability was assessed using a spectrophotometer, and data processing was done using the analysis of variance (ANOVA) test andTukey's post hoc analysis. Results The changes in enamel surface for microhardness, roughness, and staining were assessed twice, at days 0 and 21. Group 4 (Furoped) showed a significant difference in surface microhardnessand staining ability of enamel surfaces with a statistically significant p-value (<0.05). When roughness was compared, allthree interventions had a significant difference from the control group, whereas there was no statistically significant difference between the intervention groups. Conclusion This study concludes that pediatric syrups can significantly weaken the enamel of primary teeth, resulting in loss of enamel surface microhardness and roughness making them vulnerable to caries. Since frequent consumption of these syrups is correlated with tooth decay, certain precautions like oral hygiene maintenance and rinsingwith water after taking the syrup should be done to prevent dental caries, as consumption of medicinal syrups by children cannot be avoided.

Stone Clearance Rate Between Extracorporeal Shock Lithotripsy (ESWL) V/S Retrograde Intrarenal Surgery (RIRS) in Patients with Lower Calycx

One of the techniques used most frequently to treat urolithiasis is shockwave lithotripsy (SWL). Extracorporeal shock wave lithotripsy (ESWL) and retrograde intra-renal surgery (RIRS) are recommended treatments for inferior calyceal (IC) calculi measuring 1-2cm. Objective: To compare the rate of stone clearance between extracorporeal shock wave lithotripsy (ESWL) and Retrograde Intrarenal Surgery (RIRS) in patients with lower calycx calculi. Methods: The randomized control trial of six months was conducted at LUH Jamshoro. Informed consent was gained when the procedure, risks, and advantages of the study were explained. The patients were divided into one of two groups at random: group A (ESWL) or group two (RIRS). A week later, the patient underwent a contrast-enhanced computed tomography (CT) scan, and the kidney stone was noted as having been removed. Results: The group A's mean age (SD) was 46.50 ± 14.73 whereas group B's mean age (SD) was 42.37 ± 16.07. The stone clearance was observed in 13 (43.3%) of group A's cases compared to 1 (3.3%) of group B's, with a highly significant p-value of (p=0.0001). Conclusions: In terms of stone removal among patients with lower calycx, a significantly significant difference among the use of extracorporeal shock wave lithotripsy and retrograde intrarenal lithotripsy was seen.

The Relationship Between Body Image and Quality of Life in Breast Cancer Patients at H. Adam Malik Center General Hospital Medan City

&lt;p&gt;&lt;em&gt;Quality of life and body image is one of the most important outcomes to monitor in breast cancer patients. A better understanding of the quality of life and body image in women with breast cancer can assist in developing and improving therapeutic and treatment interventions in service delivery and care. This study aims to analyze the relationship between body image and quality of life in breast cancer patients. The research design used was a cross-sectional study. The research sampling technique used total sampling. The sample in this study amounted to 105 respondents. The instrument used to measure body image is the BIS (Body Image Scale) and quality of life using the EORTC QLQ BR-45 instrument (The European Organization For Research and Treatment of Cancer Quality of Life Questionnaire). Data analysis in this study used the Spearman statistical test. The results of this study indicate that 65 respondents (61.9%) have a negative body image and 61 respondents (58.1%) have a moderate quality of life. The Spearman Rank test results obtained a correlation coefficient = 0.626 with a significance p-value = 0.000 &amp;lt;0.05 (significance level). Based on this study, it can be concluded that there is a relationship between body image and quality of life in breast cancer patients. It is recommended to room nurses at the H. Adam Malik Medan General Hospital to pay attention to patient feelings by increasing their knowledge of holistic nursing concepts in nursing care and being able to provide information about the patient's condition and condition and provide motivation to breast cancer patients undergoing treatment to patients are more accepting of their body image.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords: Body Image, Breast cancer, Quality of life&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

Synthesizing the role of technological innovation on sustainable development and climate action: Does governance play a role in sub-Saharan Africa?

The present study draws motivation from United Nation Sustainable Development Goals (UN-SDGs) and its impact by 2030. To this end, the current study explored the nexus between energy consumption (SDG-7), climate action (SDG-13), and economic growth (SDG-8) while controlling for role of government apparatus such as like voice of accountability, rule of law, control of corruption and technology innovation in a balanced panel of 46 Sub-Saharan African (SSA) economies from 1996 to 2020. For a robust study, the present study leverages on second-generation estimator such as cross-sectional SUR, two-stage least square (2SLS), 2SLS is referred to as the superior estimators to traditional pool OLS due to its capabilities of including endogenous regressors and efficiency. Empirical findings show that all the coefficients associated with mobile subscription (lnTI) are negative and statistically significant at 1% level of significance (P-value <0.01). This indicates that higher (lower) mobile cellular subscriptions results in the reduction (rise) of renewable energy consumption, implying that technological innovation in terms of the expansion of mobile cellular subscription hinders access to clean energy in SSA. Conclusively, the present study presents interesting outcomes concerning technology innovation, Governance, and SDGs goal 7 (clean energy) and 13 (climate action) in Sub-Saharan African blocs. Policy strategies are outlined in the concluding section.

Comparing the efficacy of plasma exeresis and cryotherapy for the treatment of seborrheic keratosis: A randomized controlled trial.

Seborrheic keratoses (SK) is a benign epithelial skin tumor and plasma exeresis is a new technique. To compare the efficacy and safety of plasma exeresis and cryotherapy for treating SK. This study is a randomized controlled trial (RCT). One side of each patient was randomly treated with plasma exeresis (peak-to-peak voltage of 3.44kV and a frequency of 62.5kHz) and the other side with cryotherapy. Thirty-five males were enrolled. At week 3, 37.1 % (N=13) of lesions treated by plasma exeresis were clear, which was higher than those treated by cryotherapy 17.1% (N=6). However, this difference was not significant (p-value: 0.06). At week 6, 16 (57.1 %) out of 28 remaining lesions, treated by plasma exeresis were clear, which was significantly higher (p-value: 0.005) than those completely cleared by cryotherapy in 6 out of 29 remaining lesions (20.7%). The mean physician assessment scale score was significantly reduced in both groups in the second follow-up (plasma group first follow-up 0.91±0.89vs. second follow-up 0.5±0.64 and p-value: 0.0031; cryo group first follow-up 1.4±0.84vs. second follow-up 1.1±0.72 and p-value: 0.0002). Regarding side effects, no significant difference was seen (p=0.438). The most common complications in the plasma and cryotherapy groups were erythema (10/19, 52.63%) and hypo pigmentation (5/13, 38.46%). Both cryotherapy and plasma exeresis are effective. We observed a significantly higher cleared lesions treated with plasma exeresis in 6weeks and after two sessions.

Recurrent Subdural Hematoma: An Institutional Experience.

Background Chronic subdural hematoma (CSDH) is a common neurosurgical problem, which offers a good outcome following surgery. In many cases, burr hole irrigation and drainage under local anesthesia can provide satisfactory results. However,recurrencecan be a cause for concern for both the surgeon and the patient. While recurrence is not a frequent phenomenon, studies have reported rates of up to 31.6%. Aims and objectives In this study, our objective is to examine a comprehensive range of potential risk factors and provide valuable insights into identifying patients at a higher risk of recurrence to aid in surgical decision-making. Methodology This study employed a prospective and retrospective design, conducted between 2017 and 2021, at Sri Ramachandra Institute of Higher Education and Research. The study received ethical approval from the Institutional Ethics Committee. The research aimed to assess patients who underwent surgery for CSDH, with a particular focus on those who experienced recurrence. Results The average age of patients with recurrence was 71.5 years compared to 65.2 years in the no-recurrence group, but this difference did not show a significant statistical correlation. A significant male predominance was observed, with 27 men and four women affected (out of a total of 147 men and 73 women in the study), resulting in a statistically significant p-value of 0.01.On multivariate analysis, heterogenous subtypes were a significant predictor of recurrence (OR: 8.88, 95% CI: 6.96-16.54, p = 0.01).The mean midline shift in those with recurrence was 11.4 mm compared to 7.09 mm in those without recurrence. This was a statistically significant correlation with a p-value of 0.02.Regarding those with recurrence, 24 patients underwent evacuation using two burr holes, with one placed in the frontal region and another in the parietal region. All of these patients had a subdural drain placed, which was removed on postoperative day 2. The remaining eight patients underwent a mini-craniotomy for evacuation.We had four cases of refractory CSDH, all of whom underwent the second evacuation using burr holes. Three of them underwent evacuation via craniotomy, while the family of the fourth patient did not give consent for the procedure. Conclusion Patient-related factors such as gender, bilateral presentation, and the presence of hypertension and radiological factors such as the presence of heterogenous subtype and a significant midline shift are clues towarda higher chance of recurrence.

A Comparison of Nifedipine Versus a Combination of Nifedipine and Sildenafil Citrate in the Management of Preterm Labour.

Background Preterm delivery is a significant contributor to neonatal and infant morbidity and mortality. Preventive methods are preferable to treatment protocols for reducing perinatal mortality and morbidity. The calcium channel blocker nifedipine has the potential to be employed as a tocolytic, whereas the phosphodiesterase inhibitor sildenafil citrate promotes smooth muscle relaxation. Objective This study aims to examine the tocolytic effect of nifedipine in combination with sildenafil citrate in managing preterm labour (PTL). Methods After approval from the ethical board, 160 patients fulfilling the selection criteria were enrolled in the study from the outpatient and emergency department of obstetrics and gynaecology, University of Lahore, Pakistan. After taking written informed consent, their demographic profile, i.e., name, age, gestational age at presentation, parity, and expected date of delivery was noted. Patients were randomly assigned in a 1:1 ratio to two study groups (Group A: sildenafil citrate + nifedipine) and (Group B: nifedipine) using a computer-generated random number table to obtain a trial sequence. In group A, each patient was given nifedipine 20 mg orally, followed by 10 mg orally every eight hours for 48 hours and vaginal administration of sildenafil citrate, 25 mg at eight-hour intervals, for 48 hours. In group B, females were given nifedipine 20 mg orally, followed by 10 mg orally every 8 hours for 48 hours. They were kept admitted for 72 hours.SPSS Statistics version 21.0 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) was used to enter and analyse the collected data. Mean and standard deviation was calculated for quantitative variables like age, gestational age at presentation, gestational age at delivery, and BMI. Frequency and percentage were calculated for parity and preterm delivery. Results The study involved 160 patients, with the average age in Group A being 29.60±4.9 years and in Group B being 30.96±4.98 years. In terms of gestational age at delivery, Group A had an average of 34.16±1.7 weeks, while Group B had an average of 33.5±1.8 weeks (p-value<0.05). Preterm delivery was observed in 68.5% of Group A and 41.3% of Group B, with a significant p-value of 0.001. The study also discovered that the duration of prolonged pregnancy was significantly higher in Group A compared to Group B, with averages of 14.96±10.37 days and 10.24±8.97 days, respectively (p-value=0.002). Conclusion The results of this study suggest that the combination of sildenafil citrate and nifedipine may offer a promising new approach to improving pregnancy outcomes in cases of PTL. In the present study, sildenafil citrate plus nifedipine showed a significant effect in the management of PTL and prolongation in mean gestational age at delivery.

Assessment of gut microbial β-glucuronidase and β-glucosidase activity in women with polycystic ovary syndrome

PCOS is a prevalent endocrine disorder among women of reproductive age, characterized by hormonal imbalances and metabolic disturbances. This study explores the correlation between gut microbial β-glucuronidase and β-glucosidase and PCOS, focusing on their association with hormone levels and other clinical parameters. In this case-control study, fecal samples were collected from women of reproductive age, both with and without PCOS. The analysis of gut β-glucuronidase and β-glucosidase enzymes was conducted with the other clinical parameters, including body mass index, hormone levels, and hirsutism. These factors were then subjected to correlation analysis. PCOS women showed significantly higher levels of β-glucuronidase activity with a statistically significant P-value (0.05 ± 0.1 vs. 0.04 ± 0.1; P = 0.006) as well as β-glucosidase activity (0.13 ± 0.08 vs. 0.09 ± 0.05; P = 0.06) compared to the controls. This study also revealed intriguing connections between the selected enzymes and hormone levels, particularly testosterone and estradiol. Gut microbial enzymes β-glucuronidase and β-glucosidase may be used as biomarkers for early detection and monitoring of PCOS in women with metabolic challenges. It could lead to improved diagnostic tools and treatment options.

Comparing biological and physical cost functions in VMAT planning for pediatric nasopharyngeal cancer

BackgroundVolumetric Modulated Arc Therapy (VMAT) is an option for the delivery of Radiotherapy treatment technique for pediatric nasopharyngeal cancer, VMAT is the most common treatment technique for pediatric nasopharyngeal cancer. The use of a combination of both biological and physical parameters in VMAT planning optimization may produce better target coverage and sparing of critical organs. This work was to compare Biological Cost Functions (BCFs) and Physical Cost Functions (PCFs) in the VMAT of pediatric nasopharyngeal cancer patients. MethodVMAT plans for 20 nasopharyngeal pediatric cancer patients were created using Monaco 5.11® treatment planning system (TPS). Three VMAT plans were retrospectively generated for each patient using BCFs, PCFs and mixed plan with a total dose of 61.2 Gy in 34 fractions to planning target volume (PTV). All plans were adjusted to deliver 95% of the prescribed dose to 95% of the PTV. The calculated plans were qualitatively and quantitatively evaluated using the dose-volume histogram (DVH). ResultsThe coverage of the target and the maximum dose for the three plans were nearly the same, and better sparing was achieved in the serial organs (spinal cord and brain stem) with PCFs. On the contrary, more dose spring was observed using the BCFs in the organs at risk (OARs) that were not involved in the dose optimization, such as the optic nerve maximum dose, with a significant p-value (0.035 and 0.0001) respectively. Using the PCFs, both parotids received a lower mean dose, but not for the oral cavity, which had a lower mean dose using BCFs (p=<0.0001). The same values of tumor control probability (TCP) were found for both cost functions in PTVs and normal tissue complications probability (NTCP) (99%). The values reported were as follows: spinal cord = 0.5%, brain stem = 19.1%, and brain = 90.7% for BCFs, compared to spinal cord = 0.3%, brain stem = 14.9%, and brain = 90.7% for PCFs. The delivery time was found to be less in BCFs (p=0.005). ConclusionThe BCFs are superior to the PCFs in conformity index and time of radiation delivery. However, PCFs were better at dose sparing for the serial organs and achieving a sharper falloff dose around the involved volumes. A patient-specific clinical compromise is recommended to gain the best plan that meets the clinical goals.

Study of Knowledge and Attitudes towards Respiratory Hygiene and Respiratory Exercise in School-Aged Children, According to Gender: A Cross-Sectional Survey Study

Background: As the COVID-19 epidemic began in 2019 in Wuhan, China, and spread quickly to numerous nations.Therefore, in order to curb the spread of this disease, the government has implemented various preventativemeasures, such as social distance, using napkins when sneezing or coughing, avoid hand contact with thosewho are ill, etc. Children attending large gatherings since schools have resumed operations as per governmentdirectives, making them susceptible to the transmission of Covid-19. In order to stop the spread of the pandemicamong children, it is important to evaluate how school-aged children understand the respiratory exercises andpreventative measures recommended by the Government of India.Methodology: The knowledge and attitudes of school-going youngsters were evaluated using a cross-sectionalsurvey research. A thorough assessment of the literature led to the formulation of the survey’s google formquestionnaire, which included 17 questions in the knowledge and attitude domains. Snowball sampling was usedto distribute the survey questionnaire to 800 students in North Indian schools. Only 673 students were included inthe survey due to the inclusion and exclusion criteria.Results: Among 673 students, 404 students were females (22.965±2.899) and rest were males (22.186±3.772). Ourstudy shows that both the domains’ knowledge (t-stat 3.024) and attitude (t-stat 3.420) are highly significant asthe p-value is &lt;0.001. The correlation between both domains shows that both domains are positively and highlysignificantly correlated as the r-value is 0.44.Conclusion: The precautionary steps that the Indian government implemented have had a positive influence onstudents’ lives and knowledge, and they are taking excellent care of themselves

Sex-Specific Genetic Determinants of Asthma-COPD Phenotype and COPD in Middle-Aged and Older Canadian Adults: An Analysis of CLSA Data

The etiology of sex differences in the risk of asthma-COPD phenotype and COPD is still not completely understood. Genetic and environmental risk factors are commonly believed to play an important role. This study aims to identify sex-specific genetic markers associated with asthma-COPD phenotype and COPD using the Canadian Longitudinal Study on Aging (CLSA) Baseline Comprehensive and Genomic data. There were a total of 1,415 COPD cases. Out of them, 504 asthma-COPD phenotype cases were identified. 20,524 participants without a diagnosis of asthma and COPD served as controls. We performed genome-wide SNP-by-sex interaction analysis. SNPs with an interaction p-value < 10−5 were included in a sex-stratified multivariable logistic regression for asthma-COPD phenotype and COPD outcomes. 18 and 28 SNPs had a significant interaction term p-value < 10−5 with sex in the regression analyses of asthma-COPD phenotype and COPD outcomes, respectively. Sex-stratified multivariable analysis of asthma-COPD phenotype showed that 7 SNPs in/near SMYD3, FHIT, ZNF608, RIMBP2, ZNF133, BPIFB1, and S100B loci were significant in males. Sex-stratified multivariable analysis of COPD showed that 8 SNPs in/near MAGI1, COX18, OSTC, ELOVL5, C7orf72 FGF14, and NKAIN4 were significant in males, and 4 SNPs in/near genes CAMTA1, SATB2, PDE10A, and LINC00908 were significant in females. An SNP in the ZPBP gene was associated with COPD in both males and females. Identification of sex-specific loci associated with asthma-COPD phenotype and COPD may offer valuable evidence toward a better understanding of the sex-specific differences in the pathophysiology of the diseases.

Scrub Typhus in Children: A Prospective Observational Study in a Tertiary Care Hospital in Eastern India.

Background Scrub typhus is a reemerging, acute, undifferentiating febrile illness and one of the most neglected tropical diseases, calling for an in-depth investigation into its clinical diversity, complications, and mortality, which drives us to carry out this research work. Methods Over a year, prospective observational research was carried out after gaining parental consent and institutional ethical clearance, 206 children of either gender aged between one month and 12 years who had been hospitalized with a fever for at least five days and subsequently tested positive forOrientia​​​​tsutsugamushiwere included in the study. Basic demographic information, clinical characteristics, laboratory findings, complications, related coinfections, and results were gathered and analyzed.A P-value of 0.05 was set as the statistical benchmark. Results The current study found that boys outnumbered girls. The ratio of boys to girls was 1.22:1, and the average age was 5.18 years. All had a fever (100%), and the other most frequently occurring clinical signs and symptoms were abdominal pain (16.99%), vomiting (22.33%), hepatosplenomegaly (49.51%), facial puffiness (39.32%), edema (27.18%), lymphadenopathy (19.90%), eschar (19.90%), macular-erythematous rash (17.96%), cough (21.84%), conjunctival congestion (25.24%), and headache (13.59%). Anemia (81.55%), leucocytosis (20.39%), leucopenia (6.8%), thrombocytopenia (49.51%), thrombocytosis (2.43%), and elevated serum levels of alanine aminotransferase (ALT, 57.28%) and aspartate aminotransferase (AST, 63.59%) were characteristic laboratory results. The coinfections were dengue, enteric fever, urinary tract infections, and malaria.Children who also had dengue were more likely to develop thrombocytopenia, which was statistically significant (P-value = 0.008). With doxycycline medication, early defervescence of fever occurred earlier than with azithromycin, and it was statistically significant (P-value = 0.000). The complications were hepatitis (63.59%), lower respiratory tract infections (LRTIs, 22.82%),scrub typhus meningoencephalitis (STME, 3.88%), acute kidney injury (AKI, 2.91%), myocarditis (1.46%), and acute disseminated encephalomyelitis (ADEM, 0.49%). Except for one who had ADEM, everyone was sent back home after receiving the best care possible. The average duration of hospital stay was 6.89 days. Conclusions Even in the absence of eschar, scrub typhus should be suspected in any febrile child who experiences clinical signs of meningoencephalitis syndrome, capillary leakage, skin rash, conjunctival congestion, LRTI, AKI, lymphadenopathy, hepatosplenomegaly, thrombocytopenia, and liver dysfunction in the post-monsoon season. Strong clinical suspicion and prompt anti-scrub drug administration go a long way in preventing or decreasing the morbidity and mortality of the same.

Accuracy of imaging modalities (CBCT/conventional radiography) in maxillofacial fractures - A cross sectional study

Maxillofacial trauma refers to any injury to the face or jaw caused by physical force, foreign objects, or burns. For all traumatic events imaging examination is an essential component which is done both pre-operatively and post-operatively. This study was to assess the accuracy of CBCT imaging and the conventional imaging in evaluation of maxillofacial fracture. To assess the maxillofacial fracture using conventional radiography and CBCT. To compare the diagnostic acurracy of cone beam computed tomography (CBCT) with conventional radiography. To validate the best method for assessment of maxillofacial trauma.: Depending on type of fracture conventional imaging and CBCT imaging was done. Following which fracture was assessed using AOCMF classification.The most common fracture was zygomatic complex fracture of about 76.9%. CBCT showed significant P-value in assessment of level-2 fracture evaluation, extension of fracture and in Level-3, number of fragment, angulations, displacement, inferior obital fissure, crown root fracture assessment. The sensitivity and specificity of CBCT was better than conventional imaging. CBCT assess the maxillofacial fracture more precisely than conventional imaging.

Implementation of Online Problem-Based Learning And Nursing Students' Engagement With Modified Online Discussion With Seven Jumps (MOODS7)

The problem-Based Learning method is a problem-oriented case-based learning approach recommended for nursing education This study describes the trial application of the Problem-Based Learning learning method in the online system. The seven jumps discussion, usually done face-to-face and conventionally, in this study, was changed to an online forum by going through the same seven stages. The purpose of this study is to describe and assess the effectiveness of the online discussion process using Modified Online Discussion With Seven Jumps (MOODS7) application. The quasi-experimental method was carried out on 47 students of the DIII Nursing study program. They were given seven jumps online discussion discussing the case scenario of diabetes mellitus in the medical-surgical nursing field. The mood7 application is a medium for inputting cases, dividing small groups, and discussing via chat. Data analysis using T-Test counted every good discussion at each stage of the seven jumps. Student’s involvement was identified through the Online Student Engagement Scale. The MOODS7 obtained 273 valid chats conducted by five small groups during the discussion. The intervention group showed an increased ability to think critically in solving vignette problems with a significant mean pre-post p-value (0.001&gt;0.005). Online discussions with the Mood7 application are suffucient to help students understand learning content better, be more active, and participate in making learning more enjoyable. The implementation of seven jumps with MOODS7 can be applied to nursing students. An online discussion is an option for increasing engagement and in accordance with the characteristics of learners in era of information and technology.