Nigerian Journal of Clinical Practice最新文献

Background: Although dental caries is largely preventable, it remains a primary global health concern due to its high prevalence and incidence, as noted by the World Health Organization. Early detection is crucial for prevention, minimization of intervention, and oral health promotion.

Aim: This study aims to evaluate the most effective diagnostic method for detecting existing caries lesions in patients attending our clinic through a randomized clinical trial.

Methods: Fifty-four patients underwent both panoramic radiography and near-infrared reflectance imaging (NIRI) for caries detection. A maxillofacial radiologist and a prosthodontist independently assessed the images, each conducting two evaluations. Normality was assessed using the Shapiro-Wilk test and skewness and kurtosis values. Statistical tests were used to compare detection rates and interobserver agreement.

Results: Panoramic radiography revealed a mean of 3.26 (radiologist) and 3.30 (prosthodontist) carious lesions, with no significant difference (P = 0.914) and moderate agreement (P < 0.001). NIRI detected significantly more lesions: 6.59 (radiologist) and 6.00 (prosthodontist), showing excellent agreement (P < 0.001) with a small but significant difference (P = 0.023). Both clinicians identified nearly twice as many lesions with NIRI compared to radiography (P < 0.001).

Conclusion: NIRI showed superior performance in early caries detection. Compared to panoramic radiography, NIRI is more sensitive and avoids ionizing radiation, making it safer and more comfortable. Its reliability and patient-friendly nature support its use as a promising tool in routine preventive dental care.

Background: Type 2 diabetes (T2DM), as in the rest of the world, adversely affects the health of socioeconomically disadvantaged women. Yoga is an adaptable, low-cost, and side-effect-free intervention that may support glycemic control and self-care behavior.

Aim: The aim of this paper is to evaluate the effects of a 12-week yoga program on glycemic control and diabetes self-care among women with T2DM from low socioeconomic backgrounds.

Methods: A single-center randomized controlled trial was conducted with 70 women recruited from an endocrinology outpatient clinic in Turkey's Marmara Region. Participants were randomly assigned to either a yoga group (n = 35) or a control group (n = 35). The yoga group attended 1-h sessions twice weekly for 12 weeks. The control group received standard diabetes care and weekly follow-up calls. Glycemic values and self-care scores were measured at baseline and after 12 weeks.

Results: At week 12, the yoga group showed a significant reduction in fasting glucose (mean = 88 mg/dL) compared to the control group (130 mg/dL) (P < 0.001). Hemoglobin A1C decreased to 7.21% in the yoga group and increased to 8.39% in the control group (P = 0.008). Self-care improved in the yoga group (87.14) and declined in the control group (81.26) (P = 0.030). No adverse events were reported.

Conclusion: The 12-week yoga intervention was effective in improving glycemic control and diabetes self-care behaviors among socioeconomically disadvantaged women with T2DM. Yoga may serve as a feasible nonpharmacological adjunct to standard diabetes management.

Trial registration numbers: Clinical Trial Registry (https://clinicaltrials.go) NCT06318429. This study was registered on 30 March 2024.

Background: Suctioning is an essential yet invasive procedure to ensure airway patency in patients with artificial airways. Improper suctioning can cause severe complications. While intensive care nurses are well-studied, ward nurses managing such patients are underexplored.

Aims: This study evaluated ward nurses' knowledge and skills in endotracheal suctioning and assessed the impact of structured education on their performance using a partial-task trainer.

Setting and design: A quasi-experimental study was conducted with 45 ward nurses from surgical and medical departments in a university hospital.

Materials and methods: Data were collected using a Descriptive Characteristics Form, Suctioning Knowledge Questionnaire, and Suctioning Skills Evaluation Form. Nurses attended a four-hour training session, including theoretical and practical components, followed by post-training assessments. A paired-samples t-test was conducted to assess the differences in knowledge and skills before and after the education and practical skill sessions. Inter-rater agreement was measured using inter-item correlation and intra-class correlation.

Results: Nurses' knowledge and skills improved significantly after training. Self-assessed skills scores decreased post-training, indicating greater self-awareness. Post-training, knowledge improved in oxygenation, catheter size selection, positioning, and saline use. Skills showed significant improvement in monitoring hemodynamics, informing patients, catheter withdrawal, hyperoxygenation, and documentation. Inter-rater reliability was high, as measured by inter-item correlation and intra-class correlation.

Conclusion: Structured education effectively enhances ward nurses' knowledge and skills in suctioning, improving critical practices like oxygenation and hemodynamic monitoring. The decline in self-assessment scores highlights increased critical evaluation of practices. Regular training is crucial for maintaining competency, ensuring patient safety, and minimizing complications.

Background: Ambient air pollution (AAP) is an emerging risk factor for kidney disease.

Aim: To evaluate the perceived and actual air pollution risk in oil and gas-situated communities and whether long-term exposure to AAP is associated with kidney-related non-communicable diseases (NCDs).

Subjects and methods: This was an exploratory mixed methods study. Three focus groups and one individual interview were used to first explore the perception of AAP health risks in one community situated near a petrochemical refinery. The findings informed a survey instrument administered to 1460 participants from four communities situated at varying distances from the refinery. Clinical and laboratory parameters were obtained to determine the prevalence of chronic kidney disease (CKD), diabetes, hypertension (HTN), and obesity. A citizen science inquiry was embedded to monitor air pollutant levels in partnership with community volunteers.

Results: Participants perceived their ambient air was polluted. There was poor knowledge and concern about AAP health risks, which was crowded out by socioeconomic needs. The mean PM2.5, PM10, and volatile organic compounds concentrations exceeded the World Health Organization acceptable limits in all four communities. The overall prevalence of HTN, obesity, CKD, and diabetes was 33.4%. 27.0%, 12.3%, and 6.5% respectively. Proximity to the refinery was significantly associated with CKD and HTN (P ≤ 0.0001). Public perception correlated with actual air pollution in communities near to the refinery than in farther communities.

Conclusion: Air pollution health risk literacy is low and probably contributes to the persistence of air pollution and NCDs in vulnerable communities. A multifaceted and inclusive approach to air pollution and NCD control is required.

Mycoplasma-induced rash and mucositis (MIRM), a new distinct entity, demonstrates a unique presentation in contrast to other mucocutaneous eruptions. Its clinical features include prominent mucositis, limited body surface area involvement, and confirmation of infection with Mycoplasma pneumoniae. Despite its infrequency, MIRM demands prompt recognition and management due to its significant morbidity and mortality. A 13-year-old female had been reported with a high fever, mild productive cough, bilateral eyelid swelling, severe conjunctival erythema, eye discharge, a rash on her palms and soles, and mouth mucositis caused by Mycoplasma pneumoniae. Despite initial antibiotic treatment, the patient was not improving, necessitating the administration of intravenous methylprednisolone, which resulted in significant clinical improvement. This case report indicates the significance of investigating Mycoplasma pneumoniae as a possible etiology in patients with blistering skin and mucosal involvement, even in the absence of respiratory symptoms. It also highlights the diagnostic dilemma and significant ocular morbidity associated with MIRM, which necessitated ophthalmological management.

Background: Recent advancements in digital dentistry have facilitated the widespread use of both CAD/CAM milling and 3D printing technologies for the fabrication of indirect restorations. Despite their increasing clinical application, comparative data regarding their surface characteristics and bonding performance with resin cements remain limited.

Aim: This study aims to investigate the surface properties and micro-shear bond strength (µSBS) to resin cement of digitally produced permanent indirect resin composites.

Methods: Three different CAD/CAM milling materials, vita enamic (VE), cerasmart (CE), lava ultimate (LU), and 3D-printed materials saremco-els (ELS), varseo smile crown plus (VSC), and formlabs permanent crown (FLP) were used. Seventy-two test samples (n = 12; 6 groups) were prepared with dimensions 15 × 4 × 1.5 mm. The surface roughness of the test materials was evaluated by a contact profilometer. Surface properties, topographies, and elemental composition were examined by scanning electron microscopy (SEM), atomic force microscopy (AFM), and EDS. After dual-cure resin cement was condensed into the samples, a µSBS test was performed, and fracture modes were determined under a stereomicroscope. The Mann-Whitney U test and the Kruskal-Wallis test were utilized for statistical analysis. P < 0.05 was considered statistically significant.

Results: The surface roughness values for the 3D-printed composite resin materials were generally higher than those of the CAD/CAM groups. When the measurements were examined, the surface roughness values of the 3D-printed groups ranged from 0.37 ± 0.05 μm to 0.51 ± 0.27 μm, while the CAD/CAM milling groups' values were from 0.36 ± 0.36 μm to 0.29 ± 0.08 μm. The highest µSBS value was observed in the FLP group (32.15 ± 14.29 MPa), whereas the lowest was found in the VE group (18.06 ± 5.47 MPa). There was no statistically significant difference in the µSBS results except for the FLP-VE and CE-VE groups (P < 0.05). Cohesive and mixed failures were only found in the 3D-printed groups.

Conclusion: The 3D-printed permanent composite resins exhibited higher surface roughness. However, they demonstrated comparable micro-shear bond strength and favorable failure types, suggesting their clinical potential as alternatives to CAD/CAM milling composites.

Background: Despite recent attention on spousal labor companionship as a component of a positive childbirth experience, only a few studies have evaluated the issue from the male perspective.

Aim: To evaluate husbands' perceptions and practices of spousal labor companionship in Ondo city, South-west Nigeria.

Methods: This was a descriptive, cross-sectional study conducted among 500 consenting husbands whose spouses had at least one previous delivery. Data were obtained from respondents via self-administered questionnaires on socio-demographic characteristics as well as perceptions and practices of spousal labor companionship. Data analysis utilized Statistical Package for Social Sciences Version 26 and was summarized as means, standard deviations, and percentages before tabular presentation. Logistic regression analyses were applied for relationships between variables and to identify determinants of support for spousal labor companionship, with a P value of ≤0.05 considered statistically significant.

Results: Of 497 responses analyzed, 33% had practiced spousal labor companionship predominantly in private hospitals. In addition, 67% of practitioners expressed satisfaction with the experiences, and 49% of respondents supported a hospital policy promoting spousal labor companionship. Furthermore, there was a statistically significant association between higher educational status and support for the concept.

Conclusion: Almost half of husbands in the study population are positively disposed toward spousal labor companionship, though only about a third have practiced it. Recommendations include increasing sensitization on the issue among healthcare professionals in hospitals, formulating policies promoting the practice, and providing individualized suites to facilitate privacy for couples.

Background: Obstructive sleep apnea syndrome (OSAS) has been increasingly associated with mood disturbances, particularly depression, through mechanisms involving neuroinflammation, altered neurotransmitter activity, and impaired sleep quality. It has been suggested that changes in sleep patterns may serve as effective biomarkers of depression.

Aim: To assess the frequency of depressive symptoms and their association with excessive daytime sleepiness (ES), sleep quality, and hypoxemia in individuals diagnosed with OSAS.

Methods: The study population included all consecutive individuals who were newly diagnosed with OSAS in the Sleep Disorders Center between April and June 2024. All 150 patients included in the study sample underwent polysomnography (PSG) and were administered the Epworth Sleepiness Scale (ESS), the Geriatric Depression Scale, Long Form (GDS-LF), and the Pittsburgh Sleep Quality Index (PSQI). Hypoxemia burden was determined primarily based on the time spent with oxygen saturation below 90% during the night (TST 90).

Results: The mean age of the study participants was 54.8 ± 7.7 years, and 33.3% were females. About 84% of the study participants had poor sleep quality, and 45.3% and 38% had depressive symptoms. In univariate analysis, female gender (P = 0.002), higher PSQI score (P < 0.001), higher oxygen desaturation index (P = 0.040), and lower AHI (P = 0.048) were associated with depression. In multivariate analysis, male gender (OR: 0.307, 95% CI: 0.133-0.708, P = 0.006) and higher PSQI score (OR: 1.290, 95% CI: 1.146-1.453, P < 0.001) remained significant independent predictors of depression, whereas AHI and hypoxemia burden were not significantly associated.

Conclusions: Poor sleep quality and female gender are independent predictors of depression in OSAS patients, while AHI and hypoxemia burden do not appear to have a significant effect. These findings highlight the importance of assessing and addressing sleep quality, particularly in female OSAS patients, to improve mental health outcomes.

Objective: This study aims to investigate the effects of short-term propofol application on the electrophysiological properties of ventricular myocytes under the stress conditions.

Methods: A stress model was established in adult guinea pig ventricular myocytes using isoproterenol. Whole-cell patch clamp techniques were used to systematically assess the dose-dependent effects of propofol at concentrations of 30 μM, 100 μM, and 200 μM on action potential characteristics, triggered activity, and key ionic currents (INa-L, ICa-L, and IKr).

Results: Propofol dose-dependently suppressed the ICa-L, significantly shortened the plateau phase of the action potential, and reduced the frequency of early afterdepolarization. Propofol showed no significant effect on INa-L or IKr.

Conclusion: These findings indicate that propofol may exert potential anti-arrhythmic effects against stress-induced ventricular arrhythmias by inhibiting triggered activity.