Category: Nevin Manimala

Front Med (Lausanne). 2025 Apr 8;12:1524358. doi: 10.3389/fmed.2025.1524358. eCollection 2025.

ABSTRACT

BACKGROUND AND AIMS: The frailty index, based on laboratory assessments, helps identify individuals at risk for adverse health outcomes. However, its relationship with overall mortality in acute pancreatitis patients in ICUs remains unclear. This study aims to investigate the association between the frailty index and all-cause mortality and assess its prognostic value for these patients.

METHODS: We carried out a retrospective observational investigation utilizing data from the Medical Information Mart for Intensive Care IV (MIMIC-IV 2.2) database. Extract data from the database for all ICU patients (first-time ICU admissions, age ≥ 18 years) who meet the diagnostic criteria for acute pancreatitis. The frailty index derived from laboratory tests (FI-lab) encompassed three vital sign indicators and 30 laboratory test indicators. Patients were categorized into four groups based on quartiles of the FI-lab score. To assess the differences in 28-day all-cause mortality among these groups, we employed Kaplan-Meier analysis, whereas the relationship between FI-lab scores and 28-day mortality was explored through Cox proportional hazards analysis. In addition, we applied Harrell’s C statistic, Integrated Discrimination Improvement (IDI), and Net Reclassification Improvement (NRI) to assess the additional predictive capability of FI-lab scores compare to traditional disease severity metrics.

RESULTS: The study included a total of 741 patients (all age ≥ 18 years, 19.84% age > 75 years, 41.16% Female). The Kaplan-Meier analysis demonstrated that individuals with elevated FI-lab scores exhibited a significantly heightened risk of all-cause mortality (log-rank p < 0.0001). The multivariate Cox regression analysis suggested that treating FI-lab as a continuous variable (per 0.01 increment) was linked to an increased risk of 28-day all-cause mortality [hazard ratio (HR) 1.072, 95% confidence interval (CI) (1.055-1.089), p < 0.001]. Moreover, when FI-lab was analyzed as a categorical variable, patients in the fourth quartile of FI-lab had a notably greater risk of 28-day all-cause mortality in comparison to those in the first quartile [HR 9.933, 95% CI (4.676-21.104), p < 0.001]. Additionally, the integration of FI-lab scores with conventional disease severity scores improved the predictive performance for 28-day mortality.

CONCLUSION: In patients in the ICU who have been diagnosed with acute pancreatitis, the FI-lab score functions as a reliable indicator of short-term mortality. Early detection of patients at high risk for acute pancreatitis through the implementation of the FI-lab score, along with prompt interventions, is essential for enhancing these individuals’ prognoses.

PMID:40265180 | PMC:PMC12011769 | DOI:10.3389/fmed.2025.1524358

Front Endocrinol (Lausanne). 2025 Apr 8;16:1513904. doi: 10.3389/fendo.2025.1513904. eCollection 2025.

ABSTRACT

INTRODUCTION: The management of hypothyroidism during Ramadan represents a tangible challenge as levothyroxine (L-thyroxine), the first-line treatment for hypothyroidism, must be administered on an empty stomach at least 30 min before a meal in order to enhance its absorption.

AIM: The present study aimed to compare the thyroid-stimulating hormone (TSH) levels among patients with hypothyroidism treated with an extra dose of l-thyroxine (25 mcg L-thyroxine, treatment group) versus a standard/regular dose (1.6 mcg/kg) of l-thyroxine (control group) during the month of Ramadan.

METHODS: This study is a randomized controlled clinical trial that included patients with hypothyroidism. Eligible participants (n = 103) were randomly allocated to the treatment group and the control group. Both groups attended five visits before, during, and after Ramadan. Several tests were conducted, including thyroid function, lipid profile, HbA1c, and vitamin D.

RESULTS: One of the most significant findings of the present study is that the extra dose of 25 mcg of L-thyroxine during Ramadan maintained the TSH levels of patients within the normal reference range, i.e., 0.55-4.78 mIU/L, at each visit during and after Ramadan without the need to wait 30 min before the meal. The mean TSH values were comparable between the treatment group and the control group during the five visits (visit 1, 3.00 ± 2.44 and 3.45 ± 3.02; visit 2, 3.62 ± 3.21 and 3.74 ± 2.74; visit 3, 4.19 ± 3.85 and 4.89 ± 2.92; visit 4, 3.54 ± 2.96 and 5.15 ± 4.26; and visit 5, 3.61 ± 3.05 and 3.32 ± 2.57, respectively).

CONCLUSION: The present study demonstrated that the extra dose of L-thyroxine had a positive effect on keeping the TSH levels of patients in the normal reference range at each visit during and after Ramadan. However, in the control group, the mean TSH levels were higher than the normal range at visits 4 and 5.

PMID:40265165 | PMC:PMC12011575 | DOI:10.3389/fendo.2025.1513904

Front Physiol. 2025 Apr 8;16:1530195. doi: 10.3389/fphys.2025.1530195. eCollection 2025.

ABSTRACT

INTRODUCTION: This study examined the effects of 8-week interventions based on two variants of typical exercises, namely, high-intensity interval training (HIIT) and high-intensity plyometric training (HIPT), on body fat (BF%), blood pressure, and cardiorespiratory fitness (CRF). In addition, the sustainability of the effects after another 8 weeks was assessed.

METHODS: The project was designed as a randomized controlled trial with eight groups of participants (two variants, two sexes, and two groups (experimental and control)) and was conducted in a school physical education (PE) program. The outcomes analyzed were the BF%, systolic (SBP), diastolic blood pressure (DBP), and CRF expressed in terms of maximum oxygen uptake (VO_2max). A total of 307 healthy adolescents participated in this study and were randomly assigned into the two groups. During the 8 weeks, the participants completed two exercise sessions each week with progressively increasing volumes. For the first 2 weeks, the sessions involved four rounds of 20 s of intense effort followed by 10 s of rest; this increased to six rounds during weeks 3-4 and eight rounds during weeks 5-8. The HIPT program was based on plyometric exercises, whereas the HIIT was based on bodyweight resistance exercises.

RESULTS: Multidimensional analysis of variance (ANOVA) indicated a statistically significant second-order interaction (time × variant × group: Ʌ = 0.943, F = 2.20, p < 0.027, η² _pG = 0.057, d = 0.25), confirming the changes in the BF%, SBP, DBP, and VO_2max dependent on the type of intervention and group assignment. The ANOVA results revealed significant main and interaction effects for BF%, SBP, and DBP, with time and the HIIT variant as the main contributors (BF%: F = 3.911, p = 0.023, η² _pG = 0.001, d = 0.04 vs. F = 9.900, p < 0.001, η² _pG = 0.001, d = 0.03; SBP: F = 31.801, p < 0.001, η² _pG = 0.012, d = 0.16 vs. F = 8.939, p = 0.003, η ² _pG = 0.026, d = 0.16; DBP: F = 3.470, p = 0.033, η² _pG = 0.002, d = 0.06 vs. F = 4.982, p = 0.026, η² _pG = 0.014, d = 0.12). The second-order interaction for VO_2max (time × sex × group: F = 6.960, p = 0.001, η² _pG = 0.003, d = 0.05) indicated that the improvements over time were not related to the training variant. Although these effects were small (low eta values), post hoc tests (all comparisons in post-intervention, p > 0.05) showed that both the HIIT and HIPT groups exhibited beneficial changes compared to controls; however, no statistically significant differences were observed between the experimental and control groups. Furthermore, the observed improvements were maintained through the 8-week follow-up period, as demonstrated by no significant changes between the post-intervention and follow-up measurements (p > 0.05). Discriminant analysis showed that BF% and SBP were the key variables for the two exercise variants in men, with HIPT yielding greater reductions in SBP and HIIT resulting in more pronounced decreases in BF%.

DISCUSSION: In conclusion, both HIIT and HIPT interventions effectively improved health-related parameters, providing valuable enrichment to the PE lessons in schools. These benefits were also sustained for at least 8 weeks post-intervention.

PMID:40265155 | PMC:PMC12011756 | DOI:10.3389/fphys.2025.1530195

J Oral Biol Craniofac Res. 2025 May-Jun;15(3):638-644. doi: 10.1016/j.jobcr.2024.12.008. Epub 2025 Apr 10.

ABSTRACT

INTRODUCTION: Oral squamous cell carcinoma is a malignancy that is biologically aggressive.

OBJECTIVE: To investigate the correlation between various histopathological factors and the worst patterns of invasion at the tumor-host interface, which were classified as cohesive (1-3) and non-cohesive (4&5).

METHODS: Neck dissections were performed on 81 cases of oral squamous cell carcinoma those had been diagnosed. The selection was limited to paraffin-embedded blocks that contained sections from the tumor. Tumor staging, nodal staging and other factors such as lymphovascular invasion, perineural invasion, extra nodal extension, depth of invasion, margin status and tumor differentiation grades were documented.

RESULTS: The findings indicate a higher frequency of non-cohesive worst invasion patterns in numerous anatomical sites. A prediction accuracy of 69.1 % was obtained from the logistic regression analysis, suggesting that the predictive performance has also improved. The chi square test results demonstrated a statistically significant correlation between the variable of interest and extranodal extension showing a p value of 0.008 while lymph node status also showed significant with a p value of 0.000. Another factor that depicted a significance with worst pattern of invasion was tumor margin status having a p value of 0.046. Lymphovascular invasion and the worst pattern of invasion also exhibited a statistically significant correlation, with a p-value of 0.013.

CONCLUSION: The results of this investigation indicate that aggressive tumor biology is associated with non-cohesive worst pattern of invasion. Non-cohesive worst pattern of invasion is associated with moderate differentiation grade, lymphovascular invasion, perineural invasion, extranodal extension, closed or involved tumor margins and nodal metastases.

PMID:40265143 | PMC:PMC12013481 | DOI:10.1016/j.jobcr.2024.12.008

J Phys Chem C Nanomater Interfaces. 2025 Apr 4;129(15):7377-7386. doi: 10.1021/acs.jpcc.4c05199. eCollection 2025 Apr 17.

ABSTRACT

An Fe-deficient iron sulfide thin film with a nickeline (NiAs) type structure has been reported with a stoichiometry close to greigite (Fe₃S₄) [Davis E. M.; Phys. Chem. Chem. Phys.2019, 21, 20204-20210]. We have investigated the Fe-vacancy ordering in the nonstoichiometric iron sulfide with the NiAs-like structure using density functional theory calculations with a Hubbard Hamiltonian and long-range dispersion corrections [DFT + U – D3(BJ)]. We applied canonical statistical mechanics to study the thermodynamics of ordering and in the most stable configuration we found the same concentration of Fe deficiencies in each layer along the c axis. We discuss the probabilities of the configurations and the averages of observables, such as lattice parameters and magnetic moments, as a function of temperature. At equilibrium, the Fe-deficient iron sulfide is expected to be fully ordered. The predicted electronic properties of the most stable configuration suggest that this material is antiferromagnetic. The simulated electronic structure shows that the most stable configuration of the Fe-deficient iron sulfide has semimetallic properties.

PMID:40265134 | PMC:PMC12010426 | DOI:10.1021/acs.jpcc.4c05199

J Blood Med. 2025 Apr 17;16:187-195. doi: 10.2147/JBM.S521698. eCollection 2025.

ABSTRACT

PURPOSE: Blood transfusion is an essential component of healthcare systems, and blood donors play a critical role in saving lives and enhancing the well-being of others. This study explored blood donation practices among health profession students in northern Uganda.

PARTICIPANTS AND METHODS: We conducted an institutional-based, cross-sectional study with a quantitative approach from November 2023 to July 2024 across five healthcare institutions in Gulu. Attitude toward blood donation was assessed with seven questions, each scored from 0 (negative) to 2 (positive), yielding a total score per participant ranging from 0 to 28. The mean of these total scores across all 408 participants was calculated, with a mean total score of ≥5.0 indicating a positive group attitude, reflecting moderate favorability on average. Knowledge of blood donation practices was evaluated with 16 questions, each scored from 0 (incorrect) to 4 (fully correct), yielding a total score per participant ranging from 0 to 64. The mean of these total scores across all 408 participants was computed, with a mean total score of ≥12.0 signifying adequate group knowledge, representing a basic proficiency level. Willingness to donate blood was determined by a single question, with a “YES” response indicating willingness. Data were cleaned and analyzed using STATA 18.0, with descriptive statistics presented in tables. This study was approved by the Gulu University Research and Ethics Committee (GUREC-2023-619) on 11/11/2023.

RESULTS: A total of 408 participants were recruited, with a median age of 23 years (IQR: 21-24). Half of the participants identified as male, comprising 56.4% (n=230). Most participants demonstrated adequate knowledge about blood donation 73% (n=298). The overall positive attitude towards blood donation was 93.6% (n=382). Nearly all participants considered donating blood (99.0%, n=404), and 83.8% (n=342) expressed a willingness to donate blood in the future. However, only 48.8% (n=199) of respondents reported having donated blood in the past.

CONCLUSION: While health profession students in northern Uganda exhibit adequate knowledge and positive attitudes towards blood donation, actual blood donation practices remain suboptimal. These findings highlight the need for interventions to translate knowledge and attitudes into consistent donation practices among this population.

PMID:40265123 | PMC:PMC12012627 | DOI:10.2147/JBM.S521698

Acta Med Indones. 2025 Jan;57(1):11-17.

ABSTRACT

BACKGROUND: Inflammation plays a role in ST-segment elevation myocardial infarction (STEMI), especially in reperfusion injury (RI). Colchicine, an anti-inflammatory drug, can suppress inflammation during RI. We assessed the effectiveness of administering colchicine to STEMI patients undergoing primary percutaneous coronary intervention (PPCI) in suppressing RI events.

METHODS: This study was a randomized, double-blind, placebo-controlled clinical trial conducted in a multicenter manner at two hospitals in Jakarta with IKPP facilities from December 2022 to April 2023. STEMI patients that underwent PPCI received 2 mg of colchicine as a loading dose and a maintenance dose of 0.5 mg every 12 hours for two days or amylum at a similar dose. Patients were observed for RI events (low-flow thrombolysis in myocardial infarction (0-2) during angiography procedure, reperfusion arrhythmia, cardiogenic shock, or persistent chest pain).

RESULTS: Seventy-seven STEMI patients with a mean age of 55.2 ± 9.9 years underwent PPCI. Of these patients, 37 received colchicine, and 40 received a placebo. Most subjects were male (77.5%), suffered three-vessel disease (44.15%), and occlusion in left anterior descending coronary artery (53.24%). Colchicine was found to fail to reduce the incidence of ischemia-RI (51.5% vs. 42.4%; p = 0.437). Analysis of comorbidities (hypertension, chronic kidney disease, diabetes mellitus, and obesity) and angiography results (vessel disease, lesion diameter, and culprit artery) failed to demonstrate a statistical difference in RI. Side effects were similar in the colchicine and placebo groups (21.6% vs. 15%).

CONCLUSION: Colchicine administration in STEMI patients undergoing PPCI failed to reduce RI.

PMID:40263680

Acta Med Indones. 2025 Jan;57(1):3-10.

ABSTRACT

BACKGROUND: Heart disease is one of the non-communicable diseases that cause the highest mortality. Its symptoms affect the patient’s functional capacity and activities. The six-minute walking test can be done to assess a person’s functional ability, response to therapy, and prognosis of chronic heart-lung conditions. The study aims to determine the safety of the six-minute walking test in inpatients after percutaneous coronary intervention by assessing the response of vital signs, Borg scale, and angina scale.

METHODS: This study was a one-group pre-and post-test design study with subjects of inpatients after percutaneous coronary intervention at the Integrated Cardiac Service in Cipto Mangunkusumo General Hospital Jakarta. Research subjects conducted a six-minute walking test twice with a five-minute break in between. Examination of vital signs, Borg scale, and angina scale before and after walking test. The number of subjects was 30 (27 male and 3 female) with the majority classified as a low-risk stratification.

RESULTS: The six-minute walking test was performed over two days or more in 56.7% of the subjects. The mean covered distance was 294.68 ± 57.02 meters. Vital signs of systolic and diastolic blood pressure, pulse rate, respiratory rate, and Borg rating of perceived exertion (RPE) scale increased during the test. They decreased to baseline after resting for five minutes with p-value <0.05 in the Wilcoxon Signed Rank test. Changes in saturation, dyspnea, and leg fatigue of the Borg scale, and angina scale were not statistically significant. All study subjects did not have major adverse events.

CONCLUSION: The six-minute walking test is safe to do in inpatients after percutaneous coronary intervention with vital signs, Borg scale, and angina scale change accordingly to physiological response.

PMID:40263674

Nurs Open. 2025 Apr;12(4):e70232. doi: 10.1002/nop2.70232.

ABSTRACT

AIM: Bilevel positive airway pressure (BiPAP) management is a cornerstone in treating acute hypercapnic respiratory failure, with varying outcomes depending on the care model. This retrospective cohort study aims to compare the effectiveness of nurse-led versus physician-led BiPAP management in this context.

DESIGN: Retrospective cohort study.

METHODS: We analysed medical records of 189 patients with acute hypercapnic respiratory failure treated with BiPAP between January 2020 and December 2022. Patients were divided into nurse-led (n = 101) and physician-led (n = 88) groups based on their BiPAP management leadership. Outcomes measured included arterial blood gas (ABG) parameter improvements, intubation rates, length of hospital stay and 30-day readmission rates. Statistical analysis involved chi-squared tests, t-tests, Mann-Whitney U tests and multivariable regression to adjust for confounders.

RESULTS: Both groups demonstrated significant improvements in ABG parameters, with no significant differences between groups. The nurse-led group exhibited a lower intubation rate (9.9% vs. 21.6%, p = 0.026) and higher patient satisfaction scores (median 8 vs. 6, p < 0.001). Mortality rates, complication rates and 30-day readmission rates were similar between the groups. Multivariable logistic regression confirmed the nurse-led group had a lower likelihood of intubation (AOR: 0.401, p = 0.032) and higher patient satisfaction (AOR: 7.770, p < 0.001).

PATIENT OR PUBLIC CONTRIBUTION: Our findings indicate that nurse-led and physician-led BiPAP management strategies for acute hypercapnic respiratory failure are equally effective in terms of ABG improvement, intubation rates, hospital stay length, and readmission rates. This suggests that with adequate training and supervision, nurse-led BiPAP management can be as effective as physician-led management, offering a viable alternative in healthcare settings where physician resources are limited.

PMID:40263671 | DOI:10.1002/nop2.70232

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 May;39(5):476-481. doi: 10.13201/j.issn.2096-7993.2025.05.015.

ABSTRACT

Objective:To analyze the clinical characteristics of malignant lymphoma of the head and neck in children, and to improve the understanding and diagnosis and treatment of this type of disease by otolaryngologists. Methods:Clinical data of 49 children with malignant lymphoma of the head and neck hospitalized in the Department of Otorhinolaryngology, Head and Neck Surgery of Kunming Children’s Hospital from 2013-2021 were retrospectively analyzed and statistically analyzed according to gender, age distribution, duration of the disease, site of onset, type of pathology and survival status. Results:A total of 49 cases of malignant lymphoma of the head and neck in children were collected, of which, 39 were male and 10 female. The minimum age was 3 years, the maximum was 14 years and 4 months, the median age of onset was 7 years, and the largest percentage （51.02%） of children was in the school age（6-12 years）. The duration of the disease ranged from 5 days to 2 years, with a median of 1 month, and the site of the lesion was located in the neck in the majority of cases, 41（83.67%）. The pathologic types of hodgkin lymphoma（HL） were 25 cases（51.02%） and non-hodgkin lymphoma（NHL） were 24 cases（48.98%）, and among hodgkin lymphomas, mixed-cell classical hodgkin lymphoma was the most common, with 9 cases（18.37%）; among non-hodgkin lymphomas,originated from B-cells in 16 cases （32.65%） and from T-cells in 7 cases （14.29%）, with Burkitt’s lymphoma being the most numerous of B-cell origin in 13 cases （26.53%）, and T-cell lymphoblastoid lymphoma being the most common of T-cell origin in 4 cases （8.16%）. The follow-up period was from 22 days to 6 years and 10 months, with 3 cases losing, 43 cases surviving, 3 cases dying, with a survival rate of 93<unk> 5%, and 3 cases relapsing, with a relapse rate of 6<unk> 5%. Conclusion:Children’s head and neck malignant lymphoma has its own characteristics in terms of age of onset, gender distribution, site of onset, pathological type and treatment prognosis, which should be comprehensively assessed, diagnosed as early as possible, and multidisciplinary joint treatment actively carried out to propose personalized treatment plans.

PMID:40263660 | DOI:10.13201/j.issn.2096-7993.2025.05.015