Journal of Yeungnam Medical Science

Original article

Evaluation of periodontal status in women with polycystic ovary syndrome versus healthy women: a cross-sectional study: Sandhya Pavankumar, Pavan Kumar Yellarthi, Sandeep JN, Ramanarayana Boyapati, Trinath Kishore Damera, Naveen Vital Kumar G; J Yeungnam Med Sci. 2023;40(Suppl):S17-S22. Published online May 8, 2023; DOI: https://doi.org/10.12701/jyms.2023.00143

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Abstract PDF: Background
Polycystic ovary syndrome (PCOS) affects approximately 4% to 12% of females of reproductive age. Previous studies have shown an association between systemic and periodontal diseases. This study aimed to compare the prevalence of periodontal disease in women with PCOS and healthy women.
Methods
A total of 196 women aged 17 to 45 years were included in this study. Oral hygiene index-simplified (OHI-S), gingival index (GI), community periodontal index (CPI), and loss of attachment (LA) were assessed. Individuals who smoked, were pregnant, had any systemic disease (such as type 1 or type 2 diabetes mellitus, cardiovascular disease, malignancy, osteoporosis, and thyroid dysfunction), had a history of systemic antibiotic use in the past three months, or received any periodontal intervention in the past 6 months of screening were excluded. Student t-test was used to analyze the data. A p-value of <0.05 was considered statistically significant.
Results
Despite similar OHI-S scores (p=0.972) in the two groups, women with PCOS had significantly higher GI, CPI, and LA scores than healthy women (p<0.001).
Conclusion
Periodontal disease was more prevalent in women with PCOS than in healthy women. This finding may be due to the synergistic effects of PCOS and periodontitis on proinflammatory cytokines. PCOS may have an effect on periodontal disease, and vice versa. Hence, education on periodontal health and early detection and intervention for periodontal diseases is of paramount importance in patients with PCOS.

Communication

Some suggestions for pain physicians working in real-world clinical settings: Jung Hwan Lee, Min Cheol Chang; J Yeungnam Med Sci. 2023;40(Suppl):S123-S124. Published online May 23, 2023; DOI: https://doi.org/10.12701/jyms.2023.00255

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Musculoskeletal pain is a common reason for patients visiting hospitals or clinics. Various therapeutic tools including oral medications, physical modalities, and procedures have been used to alleviate musculoskeletal pain. Numerous clinical trials have been conducted to demonstrate the therapeutic effect of each treatment and compare the efficacy of different protocols. These trials were conducted under controlled conditions with specific endpoints and timeframes, and the individual constraints of each patient were not considered. We believe that the findings of such studies may not accurately reflect clinical reality in real-world settings. In this article, we propose treatment principles for patients in pain clinics. We propose two principles for pain treatment: first, “Healing, in the end, is not healing.” and second, “The patient’s job is not a patient.” The main role of pain physicians is to quickly and actively reduce pain and help patients focus on their work and lives.

Citations

Citations to this article as recorded by

Effectiveness of transcranial alternating current stimulation for controlling chronic pain: a systematic review
Min Cheol Chang, Marie-Michèle Briand, Mathieu Boudier-Revéret, Seoyon Yang
Frontiers in Neurology.2023;[Epub] CrossRef

Case reports

A rare pathogenic variant identified in a heart transplant recipient with hereditary transthyretin amyloidosis: a case report: Myeong Seop Kim, Soo Youn Lee, Kyung-Hee Kim; J Yeungnam Med Sci. 2023;40(Suppl):S98-S104. Published online May 30, 2023; DOI: https://doi.org/10.12701/jyms.2023.00241

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Abstract PDF: Hereditary transthyretin (ATTRv) amyloidosis is a rare and complex genetic disorder that can lead to life-threatening cardiac amyloidosis and rapid disease progression. Early diagnosis and treatment with disease-modifying drugs can improve patient outcomes; however, heart transplantation may be necessary in some patients. We present the unique case of a 65-year-old Korean woman diagnosed with ATTRv amyloidosis after experiencing progressive neurological symptoms, followed by heart failure. Despite the absence of significant symptoms of heart failure, subsequent screening revealed cardiac amyloid infiltration, which caused left ventricular hypertrophy and rapid disease progression. The patient underwent successful heart transplantation, and subsequent genetic testing revealed a pathogenic variant, NM_000371.3:c.425T>C (p.Val142Ala), which affects both the nerves and heart and has not been previously reported in Korea. Our report underscores the potential benefits of heart transplantation in managing advanced ATTRv amyloidosis and emphasizes the need for continued research on the genetic heterogeneity of the disease. Clinicians should consider ATTRv amyloidosis in the differential diagnosis of patients presenting with neurological symptoms and heart failure, particularly in those with a family history of the disease.

Unusual presentation of asymptomatic subacute lead-related ventricular perforation beyond the pericardium without pericardial effusion: a case report: Jihee Son, Lae-Young Jung; J Yeungnam Med Sci. 2023;40(Suppl):S105-S108. Published online May 31, 2023; DOI: https://doi.org/10.12701/jyms.2023.00171

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Abstract PDF: The clinical manifestations of subacute pacemaker lead-related cardiac perforations are highly variable. Patients with subacute perforations can present with a variety of symptoms, whereas those with acute perforations usually present with cardiac tamponade that necessitates emergent pericardiocentesis. A 32-year-old woman underwent pacemaker implantation for sick sinus syndrome. An active-fixation atrial lead was fixed to the right atrial appendage, and a ventricular lead was fixed to the right ventricle (RV) apex, with acceptable parameters. Two weeks postoperative, the patient visited the clinic for routine examination of the pacemaker parameters. Chest X-ray showed migration of the RV lead beyond the cardiac silhouette. Echocardiography revealed no evidence of pericardial effusion or tamponade. Computed tomography revealed that the RV lead was positioned beyond the RV and pericardium and into the anterior chest wall. Procedural lead revision was performed with cardiothoracic surgery backup. The lead was retracted after loosening the active-fixation screw and inserting the stylet. The lead was placed in the RV septum with active fixation. The procedure was completed without complications, and the patient was discharged after 3 days. Subacute lead perforations can present with various symptoms, and some patients may be asymptomatic without pericardial effusion. Altered lead parameters frequently provide the first indication for the diagnosis of cardiac perforation. Transvenous lead revision with surgical backup is an alternative to surgical extraction.

Original article

Surgical results of only antegrade del Nido cardioplegia infusion in conventional coronary artery bypass grafting: a retrospective study: Sang-Uk Park, Yo Han Bae, Yun Seok Kim, Kyungsub Song, Woo Sung Jang; J Yeungnam Med Sci. 2023;40(Suppl):S23-S28. Published online June 28, 2023; DOI: https://doi.org/10.12701/jyms.2023.00283

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Abstract PDF: Background
Additional retrograde cardioplegia infusion in conventional coronary artery bypass grafting (CABG) was introduced to address the concern of inappropriate cardioplegia delivery through the stenotic coronary artery. However, this method is complex and requires repeated infusions. Therefore, we investigated the surgical outcomes of only antegrade cardioplegia infusion in conventional CABG.
Methods
We included 224 patients who underwent isolated CABG between 2017 and 2019. The patients were divided into two groups according to the cardioplegia infusion method: antegrade cardioplegia infusion with del Nido solution (n=111, group I) and antegrade+retrograde cardioplegia infusion with blood cardioplegia solution (n=113, group II).
Results
The sinus recovery time after release of the aorta cross-clamp was shorter in group I (3.8±7.1 minutes, n=98) than in group II (5.8±4.1 minutes, n=73) (p=0.033). The total cardioplegia infusion volume was lower in group I (1,998.6±668.6 mL) than in group II (7,321.0±2,865.3 mL) (p<0.001). Creatine kinase-MB levels were significantly lower in group I than in group II (p=0.039). Newly developed regional wall motion abnormalities on follow-up echocardiography were detected in two patients (1.8%) in group I and five patients (4.4%) in group II (p=0.233). There was no significant difference in ejection fraction improvement between the two groups (3.3%±9.3% in group I and 3.3%±8.7% in group II, p=0.990).
Conclusion
The only antegrade cardioplegia infusion strategy in conventional CABG is safe and has no harmful effects.

Communication

Algorithm for multimodal medication therapy in patients with complex regional pain syndrome: Min Cheol Chang, Donghwi Park; J Yeungnam Med Sci. 2023;40(Suppl):S125-S128. Published online July 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00360

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Abstract PDF

Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a clinical entity characterized by classic neuropathic pain, autonomic involvement, motor symptoms, and trophic changes in the skin, nails, and hair. Although various therapeutic modalities are used to control CRPS-related pain, severe pain due to CRPS often persists and progresses to the chronic phase. In this study, we constructed an algorithm for multimodal medication therapy for CRPS based on the established pathology of CRPS. Oral steroid pulse therapy is recommended for initial pain management in patients with CRPS. Oral steroid therapy can reduce peripheral and central neuroinflammation, contributing to the development of neuropathic pain during the acute and chronic phases. If steroid pulse therapy offers poor relief or is ineffective, treatment to control central sensitization in the chronic phase should be initiated. If pain persists despite all drug adjustments, ketamine with midazolam 2 mg before and after ketamine injection can be administered intravenously to inhibit the N-methyl D-aspartate receptor. If this treatment fails to achieve sufficient efficacy, intravenous lidocaine can be administered for 2 weeks. We hope that our proposed drug treatment algorithm to control CRPS pain will help clinicians appropriately treat patients with CRPS. Further clinical studies assessing patients with CRPS are warranted to establish this treatment algorithm in clinical practice.

Citations

Citations to this article as recorded by

Problems of diagnosis and treatment of chronic pain syndrome in patients with variants of the structure of peripheral nerves. A series of clinical cases
Al'bert R. Bulatov, Tatyana A. Kolesnik, Александра A. Boykova, Igor' V. Litvinenko, Nikolay V. Tsygan
Russian Military Medical Academy Reports.2023; 42(4): 413. CrossRef
Experience from a single-center study on multimodal medication therapy for patients with complex regional pain syndrome
Donghwi Park, Jin-Woo Choi, Min Cheol Chang
Journal of Back and Musculoskeletal Rehabilitation.2023; : 1. CrossRef

Resident fellow section: Teaching images

Ultrasound-guided diagnosis/intervention for ischiofemoral impingement syndrome: Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar; J Yeungnam Med Sci. 2023;40(Suppl):S134-S136. Published online July 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00500

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PDF

Case report

Shunt fracture as a sequela of cervical spine manipulation: a case report: El Kim; J Yeungnam Med Sci. 2023;40(Suppl):S109-S112. Published online July 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00479

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Abstract PDF: Shunt disconnection is an unreported complication of spinal mobilization and manipulation. We present the case of a young adult who underwent cystoperitoneal (CP) shunt placement for an arachnoid cyst at the age of 6 years. The shunt remained functional during a follow-up period of 11 years. The patient was admitted with headache and diplopia that started after cervical manipulation by a chiropractor. Radiography revealed fracture of the distal catheter and resultant enlargement of the temporosylvian cyst. The patient required replacement of the disconnected tubing caudal to the shunt valve. The distal catheter ruptured immediately below the outlet connector of the valve. The symptoms and signs resolved completely after insertion of a new distal tube into the peritoneum. This case report demonstrates that chiropractic manipulation of the neck may be a cause of tubing breakage in patients with CP shunts.

Original article

Classification of dental implant systems using cloud-based deep learning algorithm: an experimental study: Hyun Jun Kong; J Yeungnam Med Sci. 2023;40(Suppl):S29-S36. Published online July 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.00465

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Abstract PDF

Background
This study aimed to evaluate the accuracy and clinical usability of implant system classification using automated machine learning on a Google Cloud platform.
Methods
Four dental implant systems were selected: Osstem TSIII, Osstem USII, Biomet 3i Os-seotite External, and Dentsply Sirona Xive. A total of 4,800 periapical radiographs (1,200 for each implant system) were collected and labeled based on electronic medical records. Regions of interest were manually cropped to 400×800 pixels, and all images were uploaded to Google Cloud storage. Approximately 80% of the images were used for training, 10% for validation, and 10% for testing. Google automated machine learning (AutoML) Vision automatically executed a neural architecture search technology to apply an appropriate algorithm to the uploaded data. A single-label image classification model was trained using AutoML. The performance of the mod-el was evaluated in terms of accuracy, precision, recall, specificity, and F1 score.
Results
The accuracy, precision, recall, specificity, and F1 score of the AutoML Vision model were 0.981, 0.963, 0.961, 0.985, and 0.962, respectively. Osstem TSIII had an accuracy of 100%. Osstem USII and 3i Osseotite External were most often confused in the confusion matrix.
Conclusion
Deep learning-based AutoML on a cloud platform showed high accuracy in the classification of dental implant systems as a fine-tuned convolutional neural network. Higher-quality images from various implant systems will be required to improve the performance and clinical usability of the model.

Citations

Citations to this article as recorded by

Accuracy of Artificial Intelligence Models in Dental Implant Fixture Identification and Classification from Radiographs: A Systematic Review
Wael I. Ibraheem
Diagnostics.2024; 14(8): 806. CrossRef
A Comparative Analysis of Deep Learning-Based Approaches for Classifying Dental Implants Decision Support System
Mohammed A. H. Lubbad, Ikbal Leblebicioglu Kurtulus, Dervis Karaboga, Kerem Kilic, Alper Basturk, Bahriye Akay, Ozkan Ufuk Nalbantoglu, Ozden Melis Durmaz Yilmaz, Mustafa Ayata, Serkan Yilmaz, Ishak Pacal
Journal of Imaging Informatics in Medicine.2024;[Epub] CrossRef
Advancements in artificial intelligence algorithms for dental implant identification: A systematic review with meta-analysis
Ahmed Yaseen Alqutaibi, Radhwan S. Algabri, Dina Elawady, Wafaa Ibrahim Ibrahim
The Journal of Prosthetic Dentistry.2023;[Epub] CrossRef

Case report

Classical Hodgkin lymphoma following follicular lymphoma: a case report: Bomi Kim; J Yeungnam Med Sci. 2023;40(Suppl):S113-S122. Published online August 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00584

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Abstract PDF: The simultaneous, composite, or sequential occurrence of follicular lymphoma (FL) and classical Hodgkin lymphoma (HL), both of which originate from germinal center B-cell, is rare. Questions have been raised with regard to the type of tests that pathologists should perform when observing the presence of a “large-cell lymphoma” following an FL and what are the most critical pathological points for diagnosis. Here, we present a case of a classical HL following an FL after administering rituximab-bendamustine (R-Benda) chemotherapy. Furthermore, we also summarized the literature and compared this case with other HLs that followed FLs. A 55-year-old woman was diagnosed with a grade 3A FL of the breast and axillary lymph node masses. She completed six R-Benda chemotherapy cycles for stage IV FL. Twenty-three months after the diagnosis, follow-up image studies showed an increase in the size and number of the lesions. Biopsies of the neck lymph node and liver were performed, and the diagnosis was classical HL. Sequential or composite FL and HL may sometimes develop from the same clone because they share the same genetic alterations, such as B-cell lymphoma (Bcl)-2 or Bcl-6 translocation. When a large-cell lymphoma is found after the treatment of FL, classical HL should be considered a pathological differential diagnosis, and histological, immunohistochemical, or molecular investigations must be considered during the diagnostic process.

Original articles

Diagnostic performance of F-18 FDG PET or PET/CT for detection of recurrent gastric cancer: a systematic review and meta-analysis: Chang In Choi, Jae Kyun Park, Tae Yong Jeon, Dae-Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S37-S46. Published online August 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00220

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Abstract PDF: Background
This systematic review and meta-analysis investigated the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT) for the detection of disease recurrence after curative resection of gastric cancer.
Methods
The PubMed and Embase databases, from the earliest available date of indexing through November 30, 2019, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT to detect recurrent disease after gastric cancer surgery.
Results
Across 17 studies (1,732 patients), the pooled sensitivity for F-18 FDG PET or PET/CT was 0.82 (95% confidence interval [CI], 0.74–0.88) with heterogeneity of I2=76.5 (p<0.001), and the specificity was 0.86 (95% CI, 0.78–0.91) with heterogeneity of I2=94.2 (p<0.001). Likelihood ratio (LR) tests gave an overall positive LR of 6.0 (95% CI, 3.6–9.7) and negative LR of 0.2 (95% CI, 0.14–0.31). The pooled diagnostic odds ratio was 29 (95% CI, 13–63). The summary receiver operating characteristic curve indicates that the area under the curve was 0.91 (95% CI, 0.88–0.93).
Conclusion
The current meta-analysis showed good sensitivity and specificity of F-18 FDG PET or PET/CT for detecting recurrent disease after curative resection of gastric cancer despite heterogeneity in ethnicity, recurrence rate, histology, and interpretation method.

Association between total body muscle percentage and prevalence of non-alcoholic fatty liver disease in Korean adults findings from an 18-year follow-up: a prospective cohort study: Byoung Chan Ahn, Chul Yong Park, Jung Hee Hong, Ki Ook Baek; J Yeungnam Med Sci. 2023;40(Suppl):S47-S55. Published online August 29, 2023; DOI: https://doi.org/10.12701/jyms.2023.00605

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Abstract PDF Supplementary Material: Background
This study aimed to elucidate the association between total lean muscle mass and the incidence of non-alcoholic fatty liver disease (NAFLD) in the adult Korean population.
Methods
Utilizing data derived from the 18-year prospective cohort of the Korean Genome and Epidemiology Study, NAFLD was diagnosed via the hepatic steatosis index with an established cutoff value of 36. Lean muscle mass was assessed via bioelectrical impedance analysis and subsequently divided into tertiles. A generalized mixed model with a logit link was employed for repeated measures data analysis, accounting for potential confounders.
Results
Analysis encompassed 7,794 participants yielding 49,177 measurements. The findings revealed a markedly increased incidence of NAFLD in the lower tertiles of muscle mass, specifically, tertile 1 (odds ratio [OR], 20.65; 95% confidence interval [CI], 9.66–44.11) and tertile 2 (OR, 4.57; 95% CI, 2.11–9.91), in comparison to tertile 3. Age-dependent decreases in the OR were observed within the tertile 1 group, with ORs of 10.12 at age of 40 years and 4.96 at age of 80 years. Moreover, each 1%-point increment in total muscle mass corresponded with an estimated OR of 0.87 (95% CI, 0.82–0.93) for NAFLD resolution.
Conclusions
The study demonstrates a significant association between total muscle mass and NAFLD prevalence among Korean adults. Given the potential endocrine role of muscle mass in NAFLD pathogenesis, interventions aimed at enhancing muscle mass might serve as an effective public health strategy for mitigating NAFLD prevalence.

Comparison of serum anti-Müllerian hormone between unilateral and bilateral ovarian endometriomas during follicular, luteal, and random menstrual phases: a retrospective study: Juhun Lee, Jong Mi Kim, Gun Oh Chong, Dae Gy Hong, Yoon Hee Lee; J Yeungnam Med Sci. 2023;40(Suppl):S65-S72. Published online September 22, 2023; DOI: https://doi.org/10.12701/jyms.2023.00661

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Abstract PDF

Background
Over the last two decades, serum levels of anti-Müllerian hormone (AMH) have been shown to be reliable markers of ovarian reserve. This study aimed to compare baseline serum AMH levels and well-controlled clinical factors between patients with unilateral and bilateral ovarian endometriomas during the menstrual phase.
Methods
We conducted a retrospective study. We enrolled 136 patients aged 18 to 36 years who were diagnosed with unilateral or bilateral ovarian endometriomas. Serum AMH levels of all patients and their latest two to three menstrual cycles were measured before surgery for ovarian endometriomas. The latest menstrual cycle length ranged from 26 to 30 days. Patients with irregular menstruation, a recent medication history of hormonal drugs other than oral contraceptive pills, a previous history of ovarian surgery, or any medical history influencing ovarian function were excluded.
Results
Of the 136 patients, 76 (55.9%) had unilateral ovarian endometriomas and 60 (44.1%) had bilateral ovarian endometriomas. Serum AMH levels were not significantly different between the two groups in the follicular phase, luteal phase, or at any random time point.
Conclusion
Serum AMH levels were not significantly different between unilateral and bilateral ovarian endometriomas in the follicular and luteal phases, or at any random time during the menstrual cycle when various confounding factors were excluded.

Citations

Citations to this article as recorded by

The Relationship Between Serum Anti-Müllerian Hormone and Basal Antral Follicle Count in Infertile Women Under 35 Years: An Assessment of Ovarian Reserve
Ummey Nazmin Islam, Anwara Begum, Fatema Rahman, Md. Ahsanul Haq, Santosh Kumar, Kona Chowdhury, Susmita Sinha, Mainul Haque, Rahnuma Ahmad
Cureus.2023;[Epub] CrossRef

Incidence and risk factors of deep vein thrombosis and pulmonary thromboembolism after spinal cord disease at a rehabilitation unit: a retrospective study: Yoonhee Kim, Minjae Jeong, Myung Woo Park, Hyun Iee Shin, Byung Chan Lee, Du Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S56-S64. Published online September 20, 2023; DOI: https://doi.org/10.12701/jyms.2023.00689

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Abstract PDF

Background
Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are major complications of spinal cord disease. However, studies of their incidence in Korean patients are limited. Thus, this study investigated the incidence and risk factors of DVT and PTE in Korean patients with spinal cord disease.
Methods
We retrospectively analyzed the medical records of 271 patients with spinal cord disease who were admitted to a rehabilitation unit within 3 months of disease onset at a tertiary hospital. The presence of DVT and PTE was mainly determined using Doppler ultrasonography and chest embolism computed tomography. Risk factor analysis included variables such as sex, age, obesity, completeness of motor paralysis, neurological level of injury, cause of injury, lower extremity fracture, active cancer, and functional ambulation category (FAC) score.
Results
The incidences of DVT and PTE in the patients with spinal cord disease were both 6.3%. Risk factor analysis revealed that age of ≥65 years (p=0.031) and FAC score of ≤1 (p=0.023) were significantly associated with DVT development. Traumatic cause of injury (p=0.028) and DVT (p<0.001) were significant risk factors of PTE.
Conclusion
Patients with spinal cord disease developed DVT and PTE within 3 months of disease onset with incidence rates of 6.3% and 6.3%, respectively. Age of ≥65 years and an FAC of score ≤1 were risk factors for DVT. Traumatic cause of injury and DVT were risk factors for PTE. However, given the inconsistent results of previous studies, the risk factors for DVT and PTE remain inconclusive. Therefore, early screening for DVT and PTE should be performed in patients with acute-to-subacute spinal cord disease regardless of the presence or absence of these risk factors.

Citations

Citations to this article as recorded by

Coagulation parameters correlate to venous thromboembolism occurrence during the perioperative period in patients with spinal fractures
Yong Jiao, Xiaohong Mu
Journal of Orthopaedic Surgery and Research.2023;[Epub] CrossRef

Performance evaluation of Barozen Lipid Plus for point-of-care testing of lipid profiles: a method comparison study: Soojoung Yu, Hwa Yeon Sun, Byungwook Yoo; J Yeungnam Med Sci. 2023;40(Suppl):S73-S80. Published online October 20, 2023; DOI: https://doi.org/10.12701/jyms.2023.00528

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Abstract PDF Supplementary Material: Background
The quick and easy nature of point-of-care (POC) testing devices allows regular monitoring of serum lipid levels to increase efficiency. The purpose of this study was to assess a POC lipid analyzer, Barozen Lipid Plus (MICO Biomed Co., Ltd.), which uses capillary blood to measure total cholesterol (TC), triglycerides (TGs), and high-density lipoprotein cholesterol (HDL-C).
Methods
Capillary and venous blood samples were collected from 110 participants at a single center in Korea between June 10 and June 26, 2021. TC, TG, and HDL-C measurements using Barozen Lipid Plus were compared with measurements using our reference device, the Roche-Hitachi Cobas 8000 c702 (Hitachi High-Technologies Corporation). This study followed the guidelines of the Clinical and Laboratory Standards Institute and the Clinical Laboratory Improvement Amendments. We surveyed participants regarding the convenience of the POC device using a questionnaire following the completion of blood collection.
Results
When compared to the reference equipment, the measurements obtained using Barozen Lipid Plus were more than 95% satisfactory within TC±10%, TG±25%, and HDL-C±30%. The coefficient of variation in the repeatability testing was within 5% for TC, 5% for TGs, and 7% for HDL-C. The survey results indicated high levels of satisfaction. No adverse events were reported.
Conclusion
These findings suggest that Barozen Lipid Plus is reliable for measuring lipid profiles and can therefore be used to monitor lipid levels at the time and place of patient care.

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