Category: Nevin Manimala

Int J Colorectal Dis. 2026 Feb 2;41(1):54. doi: 10.1007/s00384-026-05098-7.

ABSTRACT

OBJECTIVE: This long-term follow-up study evaluates clinical and functional outcomes after ileocecal resection with either Kono-S or conventional anastomosis techniques in patients with Crohn’s disease. The goal was to determine whether the Kono-S approach confers a long-term advantage in preventing disease recurrence and improving quality of life. While the Kono-S anastomosis has shown promise in reducing recurrence rates in Crohn’s disease following surgery, most existing evidence stems from short- to medium-term follow-up. High-quality long-term data remain scarce, particularly in real-world clinical settings. This study aims to fill that gap.

METHODS: A retrospective-prospective cohort analysis was performed including patients who underwent ileocecal resection for Crohn’s disease between 2015 and 2017 at a single academic center. Patients were grouped according to anastomosis technique (Kono-S vs. conventional). Long-term follow-up data were obtained via chart review, imaging studies, and patient-reported questionnaires, including the Gastrointestinal Quality of Life Index (GIQLI). Primary outcomes included recurrence rates, postoperative complications, and quality of life.

RESULTS: Seventy patients were included in the final analysis (Kono-S: n = 31; conventional: n = 39). The median follow-up duration was 8.1 years (interquartile range = 6.9-8.8 years). No significant differences were observed between groups regarding endoscopic inflammation (Kono-S = 19.4%, conventional = 25.6%, p = 0.39), restenosis (Kono-S = 9.7%, conventional = 2.6%, p = 0.34), or GIQLI scores (Kono-S: median 116 vs. 110, p = 0.08). Rehospitalization rates were numerically higher in the Kono-S group (16.1% vs. 2.6%, p = 1.0), but not statistically significant. Importantly, approximately 40% of all patients retrospectively stated they would have preferred earlier surgical intervention, independent of the anastomotic technique.

CONCLUSION: After more than 7 years of follow-up, the Kono-S anastomosis demonstrates comparable long-term outcomes to conventional techniques in terms of recurrence, complications, and quality of life. Patient reflections suggest a potential benefit of earlier surgical intervention, highlighting the need for more proactive surgical referral in gastroenterological practice.

PMID:41629511 | DOI:10.1007/s00384-026-05098-7

Trop Med Int Health. 2026 Feb 2. doi: 10.1111/tmi.70090. Online ahead of print.

ABSTRACT

BACKGROUND: Shigellosis, a major cause of diarrhoea in low- and middle-income countries, presents a significant public health challenge due to its high morbidity and mortality, particularly among children under five. The local epidemiology and resistance patterns of Shigella species in Cameroon remain poorly characterised. This systematic review and meta-analysis aims to determine the prevalence and antibiotic resistance patterns of Shigella species in Cameroon.

METHODS: This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and was registered with the International Prospective Register of Systematic Reviews (PROSPERO). A comprehensive search of databases was performed up to June 2025 to identify observational studies reporting Shigella prevalence. Data were extracted using a pre-tested standardised form, and the risk of bias was assessed with the Hoy et al. checklist. Meta-analyses were performed using a DerSimonian-Laird random-effects model in R software to estimate the pooled prevalence of Shigella. Heterogeneity was assessed using Cochran’s Q test and the I² statistic.

RESULTS: A total of 23 studies were included, surrounding 24,847 total units of analysis (including humans, animals, food and environmental samples). The overall pooled prevalence across all sources was 9% (95% CI, 5.51%-14.76%; I² = 93.3%). When restricted to human patient populations (n = 24,464 individuals), the pooled prevalence was 6% (95% CI, 3%-12%; I² = 94.0%). Prevalence rates in non-human sources were 6% in animals (n = 358), 9% in food samples (n = 1371) and 6% in environmental samples (n = 610). Among identified species, S. flexneri was most common (36.4%).

CONCLUSION: Our findings indicate a significant burden of shigellosis in Cameroon, coupled with a concerning level of resistance to first-line antibiotics. This high prevalence of antimicrobial resistance (AMR) suggests that current empirical treatments may be ineffective, underscoring the critical need for a continuous surveillance program to guide clinical and public health interventions.

PMID:41629505 | DOI:10.1111/tmi.70090

Sci Rep. 2026 Feb 2. doi: 10.1038/s41598-026-37412-2. Online ahead of print.

NO ABSTRACT

PMID:41629477 | DOI:10.1038/s41598-026-37412-2

Aesthetic Plast Surg. 2026 Feb 2. doi: 10.1007/s00266-026-05615-7. Online ahead of print.

ABSTRACT

INTRODUCTION: The two main features that are important in defining the attractiveness of the nose include the projection and rotation of the tip of the nose. Among many techniques, Strat and SEG are much more efficient. The purpose of this study is to compare these two methods in preserving and maintaining of the tip of the nose.

RESEARCH METHOD: This study was conducted in two groups. Before, immediately after the operation and at intervals of six months and one year, distances and angles were measured with digital photo viewer software. Additionally, their satisfaction with the results of the operation was recorded on the basis of the prepared ROE questionnaire. Finally, the data were recorded in an Excel file and analyzed with statistical analysis software.

FINDINGS: There was no significant difference in rotation before surgery between the two groups, but there was a significant difference in average rotation immediately after surgery. In addition, there was no significant difference between the averages at six months and 12 months after surgery. On the other hand, the preoperative projection did not significantly differ between the two groups. In addition, the mean projection immediately after surgery and six months later did not significantly differ between the two groups, but a significant difference was observed 12 months later.

CONCLUSION: Therefore, the SEG method has greater durability than columellar strut does in the long term and can maintain the shape of the nose for a longer period.

LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:41629470 | DOI:10.1007/s00266-026-05615-7

Support Care Cancer. 2026 Feb 2;34(2):158. doi: 10.1007/s00520-026-10401-x.

ABSTRACT

PURPOSE: Breast cancer is the most common malignancy among women in India, with patients often experiencing high symptom burden and compromised quality of life (QoL). Despite evidence supporting early supportive care integration, significant implementation gaps persist in low- and middle-income countries (LMICs). This study addresses the lack of feasible intervention models for resource-constrained settings and inadequate characterization of mechanisms through which early supportive care improves outcomes-particularly symptom-specific contributions and financial burden reduction.

METHODS: This single-centre, randomised controlled trial at All India Institute of Medical Sciences, New Delhi, randomised 110 newly diagnosed adult female breast cancer patients (1:1) into intervention (early supportive care plus standard care) or control (standard care only) groups. Supportive care included symptom management, psychosocial counselling, and educational support. Outcomes were assessed at baseline and 3 months using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale (ESAS). Statistical analyses included t-tests, multivariate regression, and mediation modelling.

RESULTS: Both groups showed significant QoL improvement, but greater symptom reduction occurred in the intervention group (mean ± SD ESAS reduction: 30.69 ± 15.51 vs. 22.9 ± 15.99; p = 0.014). Fatigue and pain were significantly lower in the supportive care group (Cohen’s d = 0.55 [95% CI:0.17,0.94] and 0.38 [95% CI:0.00,0.75], respectively). Financial burden significantly reduced (p = 0.001), with higher patient and caregiver satisfaction (p = 0.032). Mediation analysis confirmed pain reduction as a key QoL predictor (p < 0.001).

CONCLUSIONS: Early supportive care integration significantly reduces symptom burden, enhances psychological well-being, and lowers financial stress, supporting its inclusion as standard adjunct cancer care in developing countries, providing actionable evidence for policymakers in LMICs.

PMID:41629457 | DOI:10.1007/s00520-026-10401-x

Nat Med. 2026 Feb 2. doi: 10.1038/s41591-025-04156-x. Online ahead of print.

ABSTRACT

Routine adolescent health check-ups can support healthy development and well-being, but evidence on the feasibility, acceptability and effectiveness of contextually relevant comprehensive check-ups in low- and middle-income settings is limited. We conducted a hybrid implementation-effectiveness study incorporating a mixed-methods pre-post design of Y-Check, a comprehensive health check-up intervention in Zimbabwe, as part of a multicountry study developed and coordinated by the World Health Organization. Eligible participants were 10-19-year-old adolescents attending school or community venues. We used self-administered digital questionnaires, provider-led clinical tests and nurse reviews to screen for 25 conditions/behaviors. We provided health promotion, on-site care and referral to relevant providers. From October 2022 to September 2023, 2,097 adolescents were enrolled, of whom 1,843 (87.9%) were seen at 6 months. The primary outcome of appropriate care and/or referral(s) for all identified issues was achieved for 70.8% (95% confidence interval: 68.7-72.9%) of 1,865 participants with at least one issue. At follow-up, there were improvements in nutrition, health-related quality of life, self-esteem, behaviors and educational outcomes. The intervention was feasible and largely acceptable. Uptake of referral services varied by issue. Y-Check cost US$47 per participant. Through Y-Check, we identified untreated conditions and risk behaviors and successfully treated and linked adolescents to services. Here we provide evidence on the potential of the intervention to positively impact health and well-being.

PMID:41629426 | DOI:10.1038/s41591-025-04156-x

Nat Med. 2026 Feb 2. doi: 10.1038/s41591-025-04181-w. Online ahead of print.

ABSTRACT

Retrospective studies suggest that early time-of-day (ToD) infusions of immunochemotherapy may improve efficacy. However, prospective randomized controlled trials are needed to validate it. In this randomized phase 3 LungTIME-C01 trial, 210 patients with treatment naive stage IIIC-IV nonsmall cell lung cancer (NSCLC) lacking driver mutations were randomly assigned in a 1:1 ratio to either an early or late ToD group, defined by the administration of the first four cycles of an anti-PD-1 agent before or after 15:00 h. The primary endpoint was progression-free survival (PFS), while secondary endpoints included overall survival (OS) and objective response rate (ORR). After a median follow-up of 28.7 months, the median PFS was 11.3 months (95% confidence interval (CI) = 9.2-13.4) in the early ToD group and 5.7 months (95% CI = 5.2-6.2) in the late ToD group, corresponding to a hazard ratio (HR) for earlier disease progression of 0.40 (95% CI = 0.29-0.55; P < 0.001). The median OS was 28.0 months (95% CI = not estimable (NE)-NE) in the early ToD group and 16.8 months (95% CI = 13.7-19.9) in the late ToD group, corresponding to an HR of an earlier death of 0.42 (95% CI = 0.29-0.60; P < 0.001). Treatment-related adverse events were consistent with the established safety profile, with no new safety signals observed. No significant differences in immune-related adverse events were observed between the two groups. Over the first four cycles, morning circulating CD8⁺ T cells increased in the early ToD group, whereas they declined in the late ToD group (P < 0.001). Furthermore, the ratio of activated (CD38⁺ HLA-DR⁺) versus exhausted (TIM-3⁺PD-1⁺) CD8⁺ T cells was higher in the early ToD group (P < 0.001) compared with the late ToD group (P < 0.001). In summary, our study indicates that early ToD immunochemotherapy substantially improves PFS and OS and is associated with enhanced antitumor CD8⁺ T cell characteristics compared with late ToD treatment. ClinicalTrials.gov registration: NCT05549037 .

PMID:41629425 | DOI:10.1038/s41591-025-04181-w

Sci Rep. 2026 Feb 2. doi: 10.1038/s41598-026-38210-6. Online ahead of print.

ABSTRACT

Residual cholesterol (RC) is associated with an increased risk of atherosclerosis. High levels of RC have been shown to be associated with unstable plaque in healthy populations. However, the association between RC and unstable carotid plaque in specific populations with carotid stenosis has not been investigated. In this study, the association between RC and unstable carotid plaque in patients with carotid stenosis was investigated. Carotid ultrasound was used to determine the stability of carotid plaque. The relationship between RC levels and unstable carotid plaque was analyzed using logistic regression. The relationship between RC levels and unstable carotid plaque was assessed according to the degree of carotid stenosis. In addition, the predictive efficacy of RC levels for unstable plaques was determined by receiver operating characteristic (ROC) curves. A total of 507 patients with carotid stenosis were included in the study. 271 with stable carotid plaque and 236 with unstable carotid plaque. Multiple logistic regression analysis revealed that RC (OR, 1.44 [95% CI 1.09-1.91]) remained a risk factor for carotid artery unstable plaque after adjusting for statistically significant variables identified via LASSO regression. The OR was significantly greater for severe stenosis (OR, 2.16 [95% CI 1.49-3.15]) than for mild-moderate stenosis (OR, 1.03 [95% CI 1.00-1.07]). The area under the curve (AUC) of the RC in patients with unstable carotid plaque was 0.694. The cutoff value of the RC was 0.435 mmol/L. RC levels were significantly associated with unstable carotid plaque in patients with carotid stenosis. The association was stronger in severe stenosis than in mild-moderate stenosis, and patients with carotid stenosis whose RC level was greater than 0.435 mmol/L had an increased risk of developing unstable plaque.

PMID:41629388 | DOI:10.1038/s41598-026-38210-6

Sci Rep. 2026 Feb 2. doi: 10.1038/s41598-025-33630-2. Online ahead of print.

ABSTRACT

Vulvar Lichen Sclerosus (VLS) is a chronic inflammatory dermatosis of unknown etiology affecting the external genitalia. In pediatric patients, it can lead to significant discomfort and progressive structural changes in tissues. In recent years, there has been increasing interest in the participation of immune checkpoints and inflammatory mediators in the pathogenesis of chronic diseases, including VLS. Immune checkpoints, such as PD-1, PD-L1, CTLA-4, CD200, and CD200R, play a crucial role in modulating the immune response and may serve as potential diagnostic markers and therapeutic targets. This study aimed to evaluate the expression of PD-1, PD-L1, CTLA-4, CD200, and CD200R molecules on CD4+ T cells, CD8+ T cells, and CD19+ B lymphocytes in prepubertal girls diagnosed with VLS. Additionally, the concentrations of their soluble forms and the levels of proinflammatory cytokines, including IL-2, IL-6, and TNF-α, in serum were determined to assess their potential as diagnostic biomarkers. The study included patients with VLS (study group) and healthy children (control group). The expression of checkpoints was analyzed using flow cytometry, while the concentrations of soluble forms and cytokines were determined using the enzyme-linked immunosorbent assay (ELISA) technique. Statistical significance tests and Spearman’s rank correlation analysis were used. Patients with VLS showed markedly higher serum C-reactive protein (CRP) levels compared with healthy controls (49.99 ± 6.09 mg/L vs. 2.70 ± 0.96 mg/L, p < 0.001). A significant increase in checkpoint expression was observed on lymphocyte subsets, including CD4+ T cells expressing PD-1 (4.90 ± 1.67% vs. 0.85 ± 0.56%, p < 0.001) and CTLA-4 (11.58 ± 4.70% vs. 0.96 ± 0.48%, p < 0.001), as well as CD8+ T cells expressing PD-1 (17.31 ± 4.81% vs. 0.76 ± 0.67%, p < 0.001) and CD19+ B cells expressing PD-L1 (16.10 ± 9.50% vs. 1.41 ± 0.45%, p < 0.001). Soluble checkpoint molecules were consistently elevated, for example, sPD-1 (26.69 ± 3.88 pg/mL vs. 4.40 ± 0.75 pg/mL, p < 0.001) and sCTLA-4 (43.96 ± 3.77 pg/mL vs. 5.09 ± 1.09 pg/mL, p < 0.001). Similarly, cytokine levels were significantly increased in VLS patients, including interleukin-2 (28.80 ± 6.36 pg/mL vs. 4.32 ± 1.33 pg/mL, p < 0.001), interleukin-6 (25.35 ± 7.52 pg/mL vs. 2.35 ± 0.78 pg/mL, p < 0.001), and tumor necrosis factor alpha (31.26 ± 3.10 pg/mL vs. 12.80 ± 1.30 pg/mL, p < 0.001). Correlation analyses confirmed significant positive associations between cytokine concentrations and checkpoint expression, highlighting their interdependence in VLS immunopathogenesis. The obtained results confirm an increased immunoactivation profile in children with VLS, characterized by elevated checkpoint expression and increased levels of proinflammatory cytokines. The studied parameters show potential as diagnostic and prognostic biomarkers, which may constitute the basis for the development of new diagnostic tools and targeted therapeutic strategies in VLS in pediatric patients.

PMID:41629379 | DOI:10.1038/s41598-025-33630-2

Sci Rep. 2026 Feb 2. doi: 10.1038/s41598-025-33191-4. Online ahead of print.

ABSTRACT

The development of environmentally friendly analytical methods is important in the current scientific landscape. This study presents an investigation into several green spectrophotometric methods for the determination of amlodipine besylate and hydrochlorothiazide in both their pure binary mixtures and pharmaceutical formulations. A spectrophotometric method is proposed for the selective determination of amlodipine besylate in the presence of hydrochlorothiazide at 366 nm, where no interference from hydrochlorothiazide was observed. Additionally, a novel five different spectrophotometric approaches were applied for the determination of hydrochlorothiazide: the dual wavelength method, first derivative method, ratio difference method, and ratio derivative method, as well as Fourier Self-Deconvolution method. Amlodipine besylate’s linearity range was 5-30 µg/mL, whereas hydrochlorothiazide’s was 3-18 µg/mL reaching limits of detection of 1.238, 0.906, 0.825, 0.540, 0.779 and 0.805 µg/mL, respectively for all the proposed methods. The proposed methods were validated in accordance with ICH international guidelines, including full statistical analysis and comprehensive environmental evaluation using multiple assessment tools as The Analytical GREEnness Calculator, the Modified Green Analytic Procedure Index, spider diagram, and green analytical selection tool.

PMID:41629378 | DOI:10.1038/s41598-025-33191-4