Category: Nevin Manimala

Eur J Cardiothorac Surg. 2026 Mar 14:ezag122. doi: 10.1093/ejcts/ezag122. Online ahead of print.

ABSTRACT

This statistical primer presents a comprehensive introduction to the use of inverse probability of treatment weighting (IPTW), a method for rebalancing group confounders at baseline in cardiovascular surgical outcomes research. We leveraged a retrospective study comparing the outcomes of two different surgical approaches to aortic arch pathology to illustrate the essential aspects of performing IPTW, including basic theories, application, extreme weights, underestimated variance, heterogeneity of treatment effect, and multicollinearity. The limitations of IPTW were discussed with examples of solutions. Ten practical recommendations are made on avoiding the pitfalls in the use of IPTW. Proper use of IPTW may effectively reduce confounding bias by balancing confounders between different groups at baseline, retain a relatively large sample size and allow for integration with other statistical methods. However, it is crucial to be fully aware of its limitations and carefully select appropriate methods to avoid improper use and data misinterpretation in cardiovascular outcomes research.

PMID:41830434 | DOI:10.1093/ejcts/ezag122

Ann Med. 2026 Dec;58(1):2628366. doi: 10.1080/07853890.2026.2628366. Epub 2026 Mar 14.

ABSTRACT

BACKGROUND: Early detection through screening is crucial for improving treatment outcomes and reducing disease burden. . This study investigates the predictors of previous prostate cancer screening among Saudi men attending primary healthcare centers (PHCs) in Riyadh, Saudi Arabia.

METHODS: A cross-sectional study was conducted from March to July 2023, involving 6,177 men attending 48 PHCs in Riyadh, selected via multistage cluster sampling. Unadjusted and adjusted logistic regression analyses were performed to identify significant predictors of screening, with statistical significance set at p < 0.05.

RESULTS: A total of 6,177 men participated in the study. Age distribution was 31% under 50, 48.4% aged 50-75, 20.5% 75+ years . Only 1.5% of participants reported having undergone previous prostate cancer screening. crude proportions of screening were 0.9%, 1.7%, and 1.3% for the <50, 50 – 75, and ≥75 age groups, respectively. In adjusted analysis, age 50-75 years (AOR: 3.07, 95% CI: 1.73-5.46), unemployment (AOR: 3.69, 95% CI: 2.33-5.85), health insurance coverage (AOR: 2.98, 95% CI: 1.93-4.61), smoking (AOR: 4.52, 95% CI: 2.73-7.49), and history of heart disease (AOR: 3.04, 95% CI: 1.44-6.42) were significant predictors of previous prostate cancer screening.

CONCLUSION: The extremely low prevalence of previous prostate cancer screening in this population underscores urgent need to improve access to PSA testing. Employment status, insurance coverage, smoking, and history of heart disease were significant predictors of screening uptake. These findings highlight need for both targeted and general interventions and support development of a national strategy for PSA testing among asymptomatic men in Saudi Arabia.

PMID:41830420 | DOI:10.1080/07853890.2026.2628366

Zoo Biol. 2026 Mar 14. doi: 10.1002/zoo.70060. Online ahead of print.

ABSTRACT

Ex-situ breeding programs often utilize pedigree-analysis to select breeding pairs with the goal of maximizing retention of genetic variation and establishing self-sustaining populations. These efforts are limited when selected pairs fail to reproduce successfully. Because mate-choice serves an important role in many mating systems, providing the opportunity to engage in this behavior could lead to greater pair compatibility and offspring survival. In this study, we investigated the impact of female mate-choice on reproductive success and animal welfare of two passerine species: blue-gray tanagers (Thraupis episcopus) and red-capped cardinals (Paroaria gularis). One group of females were allowed to demonstrate a preference between three potential males and were subsequently paired with their preferred mate. A second group of females were paired with their pedigree-assigned partner. We measured a variety of reproductive parameters (onset of nesting, number of eggs, and number of fledglings) and evaluated animal welfare using positive (behavioral diversity) and negative (fecal glucocorticoid metabolite) indicators of welfare. There was no statistically significant difference in reproductive success based on pairing method for either species. Females allowed to choose their mate had significantly higher behavioral diversity than those assigned a mate (p < 0.03), however there was no difference in male behavioral diversity between the two groups. These findings suggest that the opportunity for mate-choice may lead to greater welfare, but only for the individual expressing preference. Outcomes of the study highlight the many variables that can affect reproductive success and the considerable research still needed.

PMID:41830412 | DOI:10.1002/zoo.70060

Vet Radiol Ultrasound. 2026 Mar;67(2):e70152. doi: 10.1111/vru.70152.

ABSTRACT

The lungs are a common site of metastasis, with recognized computed tomography (CT) features of different histotypes in humans. Little information is available for dogs. This retrospective, observational study compared the CT characteristics of pulmonary metastases from different primary cancers in dogs. CT studies of two groups of dogs with primary neoplasia and pulmonary metastases were reviewed. Group 1 (n = 271) included dogs with a definitive diagnosis of either the primary neoplasia, the metastases, or both, and Group 2 (n = 126) was a subgroup with both diagnoses confirmed. Six primary tumor histotypes were analyzed: epithelial cancer, bone sarcoma, soft tissue sarcoma, melanoma, hemangiosarcoma (HSA), and histiocytic sarcoma. Recorded features included nodule number, distribution, shape, size, margins, attenuation, pattern of enhancement, and the presence of other abnormalities. For both groups, CT features statistically correlated with tumor histotype (p < 0.0001) included ill-defined margins and cavitary lesions in carcinomas; bronchial thickening and pleural effusion in pulmonary carcinomas; a higher number of nodules, spotty postcontrast linear to amorphous strong hyperdensity (SPLASH) sign, halo sign, and extrapulmonary metastases in HSAs; and larger nodule size (>1 cm), air bronchograms, and thoracic lymphadenomegaly in histiocytic sarcomas and incomplete nodule mineralization in bone sarcomas. CT features of lung metastases help prioritize neoplasia histotype in dogs, aiding diagnosis if the primary tumor is not obvious, if two cancers are potential origins of the metastases, or when the pulmonary nodules cannot be sampled.

PMID:41830409 | DOI:10.1111/vru.70152

J Pak Med Assoc. 2026 Feb;76(2):284-288. doi: 10.47391/JPMA.23121.

ABSTRACT

OBJECTIVE: To identify and evaluate key barriers to medication adherence among diabetes mellitus patients.

METHODS: The descriptive, cross-sectional study was conducted at Nishtar Hospital, Multan, Pakistan, from November 5 to December 10, 2024, and comprised diabetic inpatients aged at least 20 years. Data was collected using a predesigned questionnaire based on the Hill Bone Medication Adherence Scale. Data was analysed using SPSS 23.

RESULTS: Of the 176 patients with mean age 51±8.6 years (range: 22-73 years), 92(52.3%) were females and 84(47.7%) were males. Factors having a significant association with non-adherence to anti-diabetes medication were age >60 years, monthly salary >50,000 Pak rupee, family history of diabetes, multiple doses, duration of diabetes 5 years or more, and education level beyond high school (p<0.05). Gender and the route of administration had no significant association with nonadherence (p>0.05).

CONCLUSION: Diabetic patients with higher income, family history and education were found to have better medication adherence, while advanced age and multiple doses decreased adherence.

PMID:41830381 | DOI:10.47391/JPMA.23121

J Pak Med Assoc. 2026 Feb;76(2):248-250. doi: 10.47391/JPMA.22109.

ABSTRACT

The study aimed to investigate the prevalence of imposter syndrome along with its relationship with self-esteem among medical and non-medical female university students. A cross-sectional study was conducted after informed consent from the 100 participants recruited with convenient sampling method from The University of Faisalabad. Data was collected through a self-administered questionnaire; Clance Imposter Phenomenon Scale (CIPS) to evaluate impostorism and the Rosenberg Self-esteem Scale (RSES) to evaluate self-esteem were used. The collected data was entered and analysed by IBM SPSS Version 23. The prevalence of impostor syndrome in medical students and non-medical students was 25(47.17%) and 19(40.43%) respectively. Whereas, the prevalence of low self-esteem in medical and non-medical was 14(26.42%) and 17(36.17%), respectively. This study revealed that there is no significant relationship between impostor syndrome and self-esteem with x2 (3) with p=0.994.

PMID:41830365 | DOI:10.47391/JPMA.22109

J Pak Med Assoc. 2026 Feb;76(2):246-247. doi: 10.47391/JPMA.30137.

ABSTRACT

A descriptive cross-sectional study was conducted at the Department of Gynaecology and Obstetrics, Services Hospital, Lahore, from January 15, 2023, to July 14, 2023, with the aim to evaluate the prevalence of domestic violence among pregnant women attending the antenatal clinic at a tertiary care hospital in Lahore, Pakistan. A total of 150 pregnant women aged 18-40 years, with gestational ages of 8-37 weeks, were included using non-probability consecutive sampling. Data was collected through structured interviews and analysed using the Statistical Package for the Social Sciences (SPSS) version 25. The prevalence of domestic violence was in 40(26.67%), with a significant association with the husband’s occupation (p=0.028). No significant associations were observed with maternal age, gestational age, body mass index (BMI), education level, or socioeconomic status. Regular screening for domestic violence during antenatal visits is essential to identify and support the affected women and improving maternal and foetal health outcomes.

PMID:41830364 | DOI:10.47391/JPMA.30137

J Pak Med Assoc. 2026 Feb;76(2):212-219. doi: 10.47391/JPMA.21838.

ABSTRACT

OBJECTIVE: To develop functional balance training tasks for stroke rehabilitation to enhance recover y outcomes for stroke patients.

METHODS: A cross-sectional study employing a two-phase structured Delphi technique was conducted in Rawalpindi and Islamabad, Pakistan, from August to December 2023, following approval from the ethics review committee of Riphah College of Rehabilitation and Allied Health Sciences, Islamabad. In the first phase, a list of functional balance tasks was generated through literature review and semi-structured interviews with experts. In the second phase, iterative three-round Delphi survey was conducted with a larger panel. Descriptive statistics were used at the end of each round to finalise the list of functional tasks based on pre -set consensus criteria. Data was analysed using SPSS 25.

RESULTS: Of the 10 experts in Phase 1, there were 8(80%) females and 9(90%) had postgraduate qualification in Neuromuscular Physical Therapy, while the mean professional experience was 6.1±5.17 years. The corresponding values for the 30 experts in Phase 2 were 34(80%), 29(96%) and 5.48±5.08. In Phase 1, 100 functional balance tasks were generated. In Round 1 of Phase 2, 76 tasks met the consensus criteria of ≥60% agreement. In Round 2 of the phase, 52 tasks reached consensus criteria of ≥75% agreement, while in Round 3 of the phase, 50 tasks achieved consensus of ≥80% agreement.

CONCLUSION: An evidence-based list of functional balance tasks for stroke rehabilitation was deemed suitable by local experts for stroke patients in Pakistan.

PMID:41830359 | DOI:10.47391/JPMA.21838

J Pak Med Assoc. 2026 Feb;76(2):206-211. doi: 10.47391/JPMA.22658.

ABSTRACT

OBJECTIVE: To evaluate the medical educational environment of an institution using integrated medical curriculum.

METHODS: The cross-sectional study was conducted from September 1 to November 1, 2024, at Gujranwala Medical College, Gujranwala, Pakistan, and comprised of medical students regardless of age, gender and academic year. Data was collected using the validated Dundee Ready Education Environment Measure questionnaire, covering five domains of the educational environment. Data was analysed using SPSS 28.

RESULTS: Of the 265 students, 88 (33.2%) were males and 177 (66.8%) were females. By year of study, 89 (33.6%) were first year, 77 (29.1%) second year, 32 (12.1%) third year, 34 (12.8%) fourth year, and [n=33 (12.5%)] final year. Regarding residence, 77 (29.1%) were day scholars and 188 (70.9%) were hostelites. The total mean DREEM score was 120.2±22.2 (60%), reflecting moderately positive perceptions. Subscale analysis revealed highest scores in Students’ Perception of Learning (28.6±6.2) and lowest in Social Self-Perception (15.9±4.4). Significant differences across academic years were observed for all subscales (p<0.05). Regression analysis demonstrated that progression through academic years was significantly associated with declining scores in SPL, SASP, SPA, and SSSP (R²=0.06-0.15). No significant differences were noted by gender or residence status. Internal consistency was acceptable (Cronbach’s alpha=0.86; standardized=0.89).

CONCLUSIONS: The evolving educational needs of students must be acknowledged through curricular adjustments to enhance student engagement, social support and professional competence.

PMID:41830358 | DOI:10.47391/JPMA.22658

J Pak Med Assoc. 2026 Feb;76(2):196-200. doi: 10.47391/JPMA.21020.

ABSTRACT

OBJECTIVE: To analyse the birth characteristics and maternal risk factors associated with preterm infants.

METHODS: The retrospective study was conducted at the Jinshan Branch of Shanghai Sixth People’s Hospital, China, and comprised data related to mothers and their preterm infants delivered between January 1, 2011, and December 31, 2020. Information on maternal age, pregnancy complications, number of births, gestational age at delivery and neonatal outcomes was collected from hospital records to assess risk factors for preterm birth. Data was analysed using SPSS 25.

RESULTS: Among 9,953 total births, 454 (4.56%) were preterm. Of these, 57 (12.56%) were early preterm and 397 (87.44%) were late preterm. The mean gestational age was 34.97±1.60 weeks and the average birth weight was 2,596.87 ± 502.28 g. Independent risk factors included gestational hypertension 56 (12.30%), cholestasis 17 (3.74%), premature rupture of membranes (PROM) 134 (29.52%), hormone use during pregnancy 105 (23.13%), and twin pregnancies 80 (17.62%) (p<0.01).

CONCLUSION: Key maternal risk factors included gestational hypertension, intrahepatic cholestasis of pregnancy, premature rupture of membranes, and multiple gestations.

PMID:41830356 | DOI:10.47391/JPMA.21020