Category: Nevin Manimala

J Anesth Analg Crit Care. 2026 Feb 7. doi: 10.1186/s44158-026-00351-5. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The incidence of diaphragmatic-palsy following interscalene brachial plexus block (IBPB) is almost 100% where the drug volume plays a significant role. We compared the incidence of hemidiaphragmatic paresis and the success rate following IBPB using three different volumes of local anaesthetics.

METHODS: Ninety patients undergoing shoulder and arm surgeries under ultrasound-guided IBPB were randomly allocated into three groups: Group A (10 ml), Group B (15 ml), and Group C (20 ml). The drug administered was 0.75% ropivacaine with 50 mcg dexmedetomidine. The diaphragm excursion was measured before and 30 min after the block on the side of surgery. The incidence of diaphragmatic palsy and its severity were noted. The success rate following block, the onset of sensory blockade, duration of postoperative analgesia, and adverse effects were observed in all three groups. The statistical analysis was done using SPSS software.

RESULTS: The demographic data, duration of surgery, and success rate following block were statistically insignificant. The hemidiaphragmatic paresis (< 25%, 25-75%, > 75%) in Group A (29,1,0), Group B (17,13,0), and Group C (15,8,7) was statistically significant (P value < 0.001). The onset of sensory blockade was Group A (7.06 ± 0.73 min), Group B (6.23 ± 0.72 min), and Group C (4.61 ± 0.63 min) with a P value < 0.001. The duration of postoperative analgesia in Group A (440 ± 48.42 min), Group B (429 ± 44.48 min), and Group C (411 ± 51.37 min) was statistically insignificant (P value-0.072). Five patients in Group C developed hoarseness of voice postoperatively, which was managed conservatively.

CONCLUSION: Low volume ultrasound guided interscalene block (10 ml) is associated with a lower incidence of hemidiaphragmatic paresis with a similar success rate and duration of postoperative analgesia. Higher volume of the drug yields a faster onset of the sensory blockade.

PMID:41654981 | DOI:10.1186/s44158-026-00351-5

Eur J Med Res. 2026 Feb 7. doi: 10.1186/s40001-026-04012-9. Online ahead of print.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a common and serious complication in the intensive care unit (ICU), and continuous renal replacement therapy (CRRT) is an important treatment option. However, there is no clear standard for the optimal time to stop CRRT. The cardiorenal interaction effect suggests that there may be a potential link between cardiac function and CRRT. This study aimed to investigate the left ventricular diastolic function for predicting CRRT discontinuation.

METHODS: This is a prospective cohort study.

RESULTS: The study included 154 AKI patients admitted to ICUs undergoing CRRT from February 2023 to August 2024, which were divided into the successful downtime group (87 patients) and the failure group (67 patients), and their baseline data, laboratory indices, and ultrasound parameters were analyzed. The results showed that serum creatinine, urea nitrogen, and E/e’ measured at the time of CRRT discontinuation were significantly lower in the successful group than in the unsuccessful group (all P < 0.05). A higher E/e’ measured at the time of CRRT discontinuation was associated with a lower likelihood of successful CRRT discontinuation (OR 0.71, 95% CI 0.61-0.83). Receiver operating characteristic analysis showed that E/e’ at the time of CRRT discontinuation had good discriminative ability for successful discontinuation (AUC 0.832), with an empirically derived cut-off value of 8.62.

CONCLUSION: Our findings suggest that left ventricular diastolic function is associated with successful CRRT discontinuation in patients with AKI, and that E/e’ may serve as a supportive, noninvasive parameter to complement clinical assessment at the time of CRRT discontinuation.

PMID:41654977 | DOI:10.1186/s40001-026-04012-9

Confl Health. 2026 Feb 7. doi: 10.1186/s13031-026-00761-w. Online ahead of print.

ABSTRACT

BACKGROUND: Armed conflict in Yemen has led to severe physical disabilities and profound psychological distress among survivors. Understanding how social support and psychological security interact to protect mental well-being is crucial for post-conflict rehabilitation. Therefore this study aimed to assess the levels and prevalence of post-traumatic stress disorder (PTSD), perceived social support, and psychological security among individuals with war-related disabilities in Yemen, and to examine the mediating role of psychological security in the relationship between social support and PTSD.

METHOD: A cross-sectional study was conducted at a rehabilitation center in Taiz City from January to September 2025. Participants (n = 117) with conflict-related physical disabilities completed the Multidimensional Scale of Perceived Social Support (MSPSS), the Psychological Security Scale (PSS), and the PTSD Checklist for DSM-5 (PCL-5). Mediation analysis was performed using the PROCESS macro.

RESULTS: The probable PTSD prevalence was 29.9% (95% CI 22.4%-38.7%). Perceived social support had a significant indirect effect on PTSD symptoms through psychological security (p < 0.05), but no significant direct effect. Psychological security statistically mediated the association between perceived social support and PTSD symptoms.

CONCLUSION: Psychological security may play a crucial role in the association between perceived social support and PTSD symptoms among war-disabled individuals. Rehabilitation programs should prioritize interventions that enhance both social support networks and psychological security to reduce PTSD symptoms.

PMID:41654968 | DOI:10.1186/s13031-026-00761-w

BMC Res Notes. 2026 Feb 8. doi: 10.1186/s13104-026-07700-1. Online ahead of print.

ABSTRACT

BACKGROUND: Female genital mutilation/cutting (FGM/C) is a harmful practice that is performed in various parts of the world, especially in Africa, the Middle East, and Asia. Although the Federal Government of Nigeria signed the Violence Against Persons Prohibition (VAPP) Act into law in 2015, little is known about the extent to which the law has contributed to reducing the practice of FGM/C in Nigeria. Therefore, this paper seeks to compare the prevalence of FGM/C before and after the enactment of legislation prohibiting it in Nigeria using data from the Multiple Indicator Cluster Surveys (MICS) of 2007, 2011, 2016/2017, and 2021 (individual recode file), which collected data from women aged 15-49 years across the 36 states of Nigeria, including the Federal Capital Territory (FCT).

RESULTS: The study findings showed that awareness of FGM/C was high across the four (4) rounds of MICS survey datasets, while the prevalence of mothers and their daughters being circumcised has declined. The prevalence of FGM/C practice is lowest in the northeastern region and has been declining steadily in the southwestern region. FGM/C practices are still relatively high in the southeast, southwest, north-central, and northwest, respectively. The findings indicate statistically significant differences in awareness and prevalence of FGM/C before and after the enactment of the VAPP Act, with heterogeneous patterns across geopolitical regions. While these trends are consistent with a potential policy effect, the results should be interpreted as associative rather than causal.

PMID:41654954 | DOI:10.1186/s13104-026-07700-1

Int J Equity Health. 2026 Feb 7. doi: 10.1186/s12939-026-02775-5. Online ahead of print.

ABSTRACT

BACKGROUND: Major depressive disorder (MDD) is a leading cause of global disability, yet systematic evaluations of quality of care disparities across regions are sparse. Leveraging data from the Global Burden of Disease (GBD) Study 2021, this study quantified the quality of care for MDD from 1990 to 2021 and examined socio-demographic inequities by age and sex.

METHODS: Data on MDD were extracted from the GBD 2021 study for the globe, 5 socio-demographic index (SDI) regions and 21 GBD regions. The quality of care index (QCI) is a composite, dimensionless index scaling from 0 to 100, with higher values indicating better quality of care. The age-standardized QCI was calculated using the Principal Component Analysis (PCA) method and further stratified by sex, age, and region. The gender disparity ratio (GDR) was used to characterize the sex disparities. The temporal trend of QCI and GDR by sex and age across SDI regions was further calculated.

RESULTS: Globally, the QCI of MDD increased from 56.26 (1990) to 62.95 (2021), with low SDI regions consistently exhibiting the highest QCI (71.90 in 1990; 71.19 in 2021) and high SDI regions the lowest (40.28 to 51.55). Sex disparities widened as female QCI rose by 14.0% (vs. 7.6% in males) and GDR increased from 1.02 to 1.08. The highest GDR (1.27) persisted in Oceania, while Tropical Latin America had the lowest (0.94 in 2021). Age-specific QCI peaked in adolescents (10-14 years) and declined with age, with notable improvements post-2019. Older adults (> 80 years) in high SDI regions saw higher QCI versus low-middle SDI regions. Trend analysis revealed that high and high-middle SDI regions maintained a lower QCI of MDD than the global average level but narrower sex gaps (GDR 1.04 in 2021) compared to low SDI regions (GDR 1.15).

CONCLUSIONS: While global quality of care for MDD improved, socioeconomic development inversely correlated with QCI, potentially reflecting systemic under-reporting in low-resource settings and overburdened systems in high-income regions. Persistent gender and age disparities necessitate targeted and equal policies, including sex-sensitive care models and geriatric mental health integration.

PMID:41654951 | DOI:10.1186/s12939-026-02775-5

Malar J. 2026 Feb 7. doi: 10.1186/s12936-026-05824-0. Online ahead of print.

ABSTRACT

BACKGROUND: Malaria remains a major global public health concern with the greatest burden in tropical and subtropical regions, particularly sub-Saharan Africa. Uganda ranks among the world’s highest burden countries, with its warm temperatures, abundant rainfall and diverse mosquito breeding habitats sustaining year-round malaria transmission in malaria endemic areas. This study assessed malaria incidence trends and their association with climate variables in Yumbe district, Uganda.

METHODS: A retrospective ecological time-series study analysed malaria incidence (2017-2021) in Yumbe district, Uganda, using District Health Information System reports and Uganda National Meteorological Authority climate data (daily temperature and rainfall). Data were cleaned in Excel and analysed in R software V4.5.1. Monthly/annual summaries, seasonal pattern graphs, Kendall’s tau correlations for non-linear associations, and Multiple Linear and Poisson regressions with lag effects were done. Time series analysis involved seasonal decomposition, cross-correlation, and ARIMAX modelling. A multivariable OLS regression on log(1 + cases) with best-lagged rainfall and minimum temperature further assessed climate influence.

RESULTS: Between 2017 and 2021, a total of 2,066,711 malaria cases were reported in Yumbe district. Malaria trends closely followed rainfall patterns, peaking during the period of high precipitation. Time-series analysis showed that rainfall was positively associated with malaria incidence at one-month lag (β = 0.38, p < 0.05), while minimum temperature was inversely associated (β = – 0.29, p < 0.05). Statistical analysis revealed rainfall (mm) strongly led malaria cases by 1 month (r = 0.759, p < 0.001). Maximum temperature showed no significant effect on malaria incidence.

CONCLUSION: Malaria incidence in Yumbe district is strongly influenced by rainfall and minimum temperature. This study highlights the role of climate variability in malaria transmission in malaria endemic areas. Integrating climate data into surveillance and early warning systems could enhance timely interventions in malaria endemic areas like Yumbe district.

PMID:41654939 | DOI:10.1186/s12936-026-05824-0

J Orthop Surg Res. 2026 Feb 7. doi: 10.1186/s13018-026-06710-w. Online ahead of print.

ABSTRACT

BACKGROUND: The endoscopic direct anterior approach (Endo-DAA) for total hip arthroplasty (THA) aims to minimize soft-tissue trauma and accelerate recovery. Whether adding a disposable wound protector can further reduce early muscle injury and enhance recovery remains unclear. This randomized controlled trial evaluated the impact of wound protector use on biological, clinical, and functional outcomes after Endo-DAA THA.

METHODS: Seventy-six patients undergoing primary Endo-DAA THA were prospectively randomized (1:1) to either a wound protector or control group. The only intraoperative difference between groups was the use of a wound protector. The primary outcome was serum creatine kinase (CK) at 24 h postoperatively. Secondary outcomes included serum myoglobin at 6 h, C-reactive protein at 24 h, pain visual analog scale (VAS) during activity, independent ambulation within 12 h, lateral femoral cutaneous nerve (LFCN) symptoms, wound complications and satisfaction, and functional scores using the Harris Hip Score (HHS) and Forgotten Joint Score-12 (FJS-12). Statistical significance was defined as P < 0.05.

RESULTS: Baseline characteristics were comparable between groups. The wound protector group had significantly lower postoperative CK (422.5 vs. 665.5 U/L; median difference: -228.0; 95% CI: -354.0 to -109.0; P < 0.001), myoglobin (299.9 vs. 481.2 ng/mL; P < 0.001), and C-reactive protein levels (30.3 vs. 45.1 mg/L; P = 0.024). Pain scores were lower at 12 and 24 h, and more patients achieved independent ambulation within 12 h (86.8% vs. 55.3%; risk ratio [RR]: 1.57; 95% CI: 1.14 to 2.16; P = 0.002). Fewer wound complications (7.8% vs. 34.2%; RR: 0.23; 95% CI: 0.07 to 0.75; P = 0.005) and LFCN symptoms (36.8% vs. 65.7%; P = 0.012) were observed. Early functional scores were higher in the protector group, while midterm outcomes were similar.

CONCLUSIONS: In Endo-DAA THA, the use of a disposable wound protector significantly reduced early muscle injury and systemic inflammation, alleviated immediate postoperative pain, facilitated earlier mobilization, and enhanced early wound healing and functional recovery without increasing operative time or hospital stay. These benefits were primarily observed during the early postoperative phase, which aligns with the principles of enhanced recovery after surgery.

TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2300076225. Registered on September 27, 2023.

PMID:41654929 | DOI:10.1186/s13018-026-06710-w

BMC Nurs. 2026 Feb 7. doi: 10.1186/s12912-026-04413-5. Online ahead of print.

ABSTRACT

BACKGROUND: As a critical form of proactive behaviors, taking charge plays a central role in facilitating hospitals’ improvement and development. Although prior research has extensively examined how to encourage nurses to engage in taking charge, the relationship between the concept of “spirit at work” and taking charge remains insufficiently understood. This study was designed to examine the impact of spiritual leadership on the nurses’ taking charge and its internal mechanism.

METHODS: Drawing on the conservation of resources (COR) theory, we developed a moderated mediation model to elucidate how spiritual leadership fosters nurses’ taking charge through spiritual well-being, and how this effect is contingent on nurses’ pay-for-performance perceptions. We conducted a field study in China to test our theoretical model, with data collected from 353 nurses and 88 head nurses across three different time points. Data analysis was run using descriptive statistics and confirmatory factor analyses. And regression analyses were used to examine the hypotheses.

RESULTS: The regression results revealed that spiritual leadership was positively associated with nurses’ taking charge. Spiritual well-being significantly mediated the relationship between spiritual leadership and nurses’ taking charge. Moreover, we observed that the indirect effect of spiritual leadership on taking charge through spiritual well-being was stronger for nurses who perceived higher levels of pay-for-performance than for those with lower perceptions.

CONCLUSIONS: These findings highlight the essential role of spiritual leadership in promoting nurses’ positive psychological states and proactive behaviors. Hospital administrators may consider strengthening head nurses’ spiritual leadership to enhance nurses’ spiritual well-being and their propensity to take charge. Additionally, implementing performance-based compensation practices can cultivate a climate that reinforces distributive fairness and further encourages proactive behavior.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41654904 | DOI:10.1186/s12912-026-04413-5

Biomed Eng Online. 2026 Feb 7. doi: 10.1186/s12938-026-01528-3. Online ahead of print.

ABSTRACT

BACKGROUND: Machine learning (ML) applied to diffusion tensor imaging (DTI) has emerged as a promising tool for detecting microstructural brain alterations in movement disorders. However, existing studies vary widely in design, sample size, imaging pipelines, and analytic rigor, resulting in high methodological heterogeneity that limits quantitative comparability.

OBJECTIVES: This exploratory meta-analysis and narrative synthesis aimed to characterize performance trends, methodological diversity, and sources of variability among ML models trained on DTI data for classifying movement disorders, rather than to infer a single pooled diagnostic effect. This was designated exploratory because extreme heterogeneity prevented confirmatory pooled effect inference, so the analysis focused on describing performance distributions and methodological patterns rather than estimating a unified diagnostic effect.

METHODS: A systematic search of PubMed, Web of Science, and Scopus identified human studies applying ML algorithms to DTI for diagnostic or classification purposes. Accuracy, sensitivity, specificity, and the area under the curve (AUC) were extracted, with multiple imputation used for incomplete metrics with missingness rates below 40%. Random-effects modeling was employed to provide descriptive summaries, and subgroup analyses were conducted to explore trends across disorders, model architectures, and imaging modalities. Study qualities were assessed with JBI tools.

RESULTS: Forty-six studies (2016-2024) were included, spanning Parkinson’s disease, Tourette syndrome, and essential tremor. Reported performance was generally high (median AUC ≈ 0.91), but between-study heterogeneity was extreme (I² = 94.7%), indicating that studies were estimating distinct effects. Disorder-specific subgroup AUCs varied markedly: Essential Tremor (0.95), Parkinson’s (0.90), Tourette’s (0.88), and Other (0.79). Deep learning and radiomics-based models have reported higher accuracies, but they were often trained on small, single-center cohorts (37-139 participants), which limits their external validity. Pooled statistics were presented descriptively to illustrate performance ranges despite high heterogeneity, and were not interpreted as confirmatory effect sizes.

CONCLUSIONS: ML models using DTI demonstrate high internal performance across studies, although generalizability remains limited across multiple movement disorders; however, current evidence remains exploratory due to small sample sizes, methodological fragmentation, and a lack of standardized imaging pipelines. Rather than confirmatory inference, these findings provide a descriptive map of emerging trends in ML-DTI diagnostics. Future progress will depend on data harmonization initiatives, multicenter collaborations, and federated learning frameworks that can support reproducible, generalizable, and clinically interpretable models.

PMID:41654900 | DOI:10.1186/s12938-026-01528-3

Harm Reduct J. 2026 Feb 7. doi: 10.1186/s12954-026-01411-3. Online ahead of print.

ABSTRACT

INTRODUCTION: In response to the overdose epidemic, novel strategies including Overdose Response Hotlines and Applications (ORHAs) have been introduced to help mitigate the crisis. These technologies enable individuals with a phone to access harm reduction support via smartphones and applications. Such supports include overdose monitoring, access to social services, mental health referrals, and more. This study analyzed data from the Canadian National Questionnaire on Overdose Monitoring (CNQOM), a large bilingual national survey, to evaluate the perspectives of people who use unregulated substances currently (PWUS-C), people who used unregulated substances previously (PWUS-P), and addiction service provider (ASP) on the importance of specific ORHA features.

METHODS: One component of the CNQOM pertained to the importance of specific ORHA service elements. Examined categories included accessibility and technological features, overdose response functionality, data privacy and philosophies of care, additional support services, and substance usage. Each group responded to 33 questions on a 5-point Likert scale, and the data was analyzed using descriptive statistics involving percentages and ordinal logistical regression analysis.

RESULTS: The study involved 971 participants: 840 PWUS-C, 298 PWUS-P, and 169 ASP. The majority of respondents from the key groups considered all ORHA elements important. Generally, the groups ranked the elements in a similar order of importance, with only minor variations. The highest-ranked elements in each element category with regards to importance were: 24/7 availability (84% of PWUS-C, 88% of PWUS-P, and 90% of ASP), the ability of EMS to resuscitate individuals during an overdose (81% of PWUS-C, 83% of PWUS-P, 85% ASP), non-judgmental support (87% of PWUS-C, 87% of PWUS-P, and 91% of ASP), access to mental health support (82% of PWUS-C, 84% of PWUS-P, and 90% of ASP), and feeling safer when using substances (80% of PWUS-C, 81% of PWUS-P, and 88% of ASP).

CONCLUSION: This paper highlights the importance multiple groups place on various elements of ORHAs, reflecting critical elements that should be considered when standardizing these virtual harm reduction technologies. The results of this study provide insight into opportunities to enhance virtual platforms, making them more responsive, accessible, and trusted as harm reduction resources.

PMID:41654899 | DOI:10.1186/s12954-026-01411-3