Category: Nevin Manimala

Clin Ophthalmol. 2025 Mar 20;19:985-991. doi: 10.2147/OPTH.S508993. eCollection 2025.

ABSTRACT

BACKGROUND: Deep anterior lamellar keratoplasty (DALK) has safety advantages over penetrating keratoplasty. However, one of the serious complications of DALK is Descemet membrane (DM) detachment, which can lead to double anterior chamber (DAC) and visual impairment. This study examines the incidence and factors related to the complication of DAC after DALK, including preexisting conditions such as atopic dermatitis (AD).

METHODS: This is a retrospective evaluation of all patients who underwent DALK from January 2019 to April 2024 in the Department of Ophthalmology, Fukuoka University Hospital. Cases with DAC postoperatively were analyzed statistically. A total of 85 eyes in 73 patients were included. We excluded eyes with preexisting corneal perforations that required grafts that were less than 6mm in diameter. A binomial logistic predictive model was used to determine factors associated with postoperative DAC. Collated variables were age, AD, preexisting corneal diseases, donor button size, intraoperative DM perforation, and cornea supply source.

RESULTS: Among 85 eyes that underwent DALK, 12 eyes (14.1%) developed postoperative DAC. Binomial regression analysis revealed preexisting corneal diseases (p=0.031) including preoperative DM perforation, infectious keratitis, keratoconus, corneal dystrophy, and corneal scar, intra-operative DM perforation (p=0.049), and AD (p=0.031) to be significant factors associated with DAC. This binomial regression model had 83.3% sensitivity and 78.0% specificity.

CONCLUSION: AD and preexisting corneal diseases were significant factors in DAC after DALK, and DALK during active infection predisposes to DAC, while intraoperative perforation was also significantly associated. Our study suggests that these factors could be of importance in considering the mechanism of pathogenesis of DM and DAC.

PMID:40130267 | PMC:PMC11932134 | DOI:10.2147/OPTH.S508993

Tob Induc Dis. 2025 Mar 24;23. doi: 10.18332/tid/201406. eCollection 2025.

ABSTRACT

INTRODUCTION: Tobacco farming plays a crucial role in the livelihoods of many rural communities in Pakistan, particularly in Khyber Pakhtunkhwa (KPK). However, this agricultural practice is associated with severe environmental degradation and significant health risks to workers during cropping.

METHODS: This study evaluates the ecological and health impacts of tobacco farming in Pakistan, employing both quantitative (surveys) including 200 respondents (farmers and field workers/laborers) and qualitative methods (in-depth interviews) involving 10 respondents (farmers, policy experts, agriculturist and environmental specialists). The research focuses on Swabi, a key tobacco-growing region, and highlights the negative effects of excessive pesticide use, fertilizer application, and deforestation, which contribute to soil erosion, water pollution, and biodiversity loss.

RESULTS: Regression analysis shows that pesticide use (β=0.65, p<0.001) and deforestation (β=0.82, p<0.001) are the leading contributors to ecological degradation. The relationship between tobacco yield and environmental degradation, although showing a trend (p=0.062), is statistically negligible and unlikely to have practical significance (β= -0.15). Health risks are equally concerning, with farmworkers (labor hired for farming, farmers, landlords) exposed to harmful agrochemicals and nicotine absorption leading to respiratory diseases, skin conditions, and green tobacco sickness (GTS). Pesticide exposure (β=0.71, p<0.001) and contact with tobacco leaves (β=0.53, p<0.001) significantly impact workers’ health, while using personal protective equipment (PPE) helps mitigate these risks (β= -0.43, p=0.001). The study also reveals that many farmers are interested in transitioning to alternative crops like maize or cotton, but they face financial and informational barriers.

CONCLUSIONS: The growing of tobacco in Pakistan entails significant ecological and health dangers, emphasizing the immediate need for the implementation of sustainable farming strategies to mitigate environmental harm and enhance the socio-economic conditions of farmers. Government support through financial incentives, educational programs, and sustainable farming techniques is essential to reduce the environmental damage and improve public health.

PMID:40130264 | PMC:PMC11931628 | DOI:10.18332/tid/201406

Front Med (Lausanne). 2025 Mar 10;12:1506575. doi: 10.3389/fmed.2025.1506575. eCollection 2025.

ABSTRACT

PURPOSE: We aimed to investigate the potential association between the aggregate index of systemic inflammation (AISI) and chronic kidney disease (CKD).

PATIENTS AND METHODS: This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018. CKD was defined as either an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m² or the presence of albuminuria, defined as a urine albumin-to-creatinine ratio (ACR) of 30 mg/g or higher. Low eGFR is an eGFR of less than 60 mL/min/1.73 m². Multivariate regression analysis, smoothed curve fitting, and subgroup analyses were conducted to investigate the relationship between the Inflammatory status index (AISI) and CKD. The receiver operating characteristic (ROC) curve analysis was used to evaluate its ability to identify CKD and low eGFR. The AISI was transformed using the natural logarithm (Ln) for statistical analysis.

RESULTS: Of the 50,768 recruits, 49.86% were male. The prevalence of CKD and low eGFR was 20.31% and 8.57%, respectively. Ln-AISI was positively associated with CKD (OR = 1.24; 95% CI: 1.19, 1.28) and low eGFR (OR = 1.17; 95% CI:1.11, 1.24). Smooth curve fitting revealed a positive association between AISI and CKD and low eGFR. Subgroup analysis and interaction tests indicated that stratifications did not significantly alter the association between AISI and CKD and low eGFR. Threshold effect analysis indicated that this relationship became more pronounced when Ln-AISI exceeded 5.2 (AISI > 181.27). The ROC analysis showed that AISI had better discrimination and accuracy for identifying CKD and low eGFR compared to other inflammatory indicators [lymphocyte count (LYM), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and the product of platelet count and neutrophil count (PPN)].

CONCLUSION: AISI was significantly and positively correlated with the prevalence of CKD, and this relationship was more potent when AISI was greater than 181.27. Compared with other inflammatory indicators, AISI was more effective in identifying CKD.

PMID:40130253 | PMC:PMC11931135 | DOI:10.3389/fmed.2025.1506575

Front Med (Lausanne). 2025 Mar 10;12:1502456. doi: 10.3389/fmed.2025.1502456. eCollection 2025.

ABSTRACT

BACKGROUND: Safe perioperative nursing care is crucial to improving outcomes of surgical care. This is a report on the pilot implementation of a nursing training programme aimed at strengthening safe perioperative nursing care in Nigeria, aligning with the nation’s strategic framework for surgical, obstetric, anaesthesia, and nursing plan. The aim of this report is to highlight the need to incorporate perioperative nursing training into efforts to scale up access to surgical care in low resource settings.

METHODS: The Nursing Care Saves Lives (NCSL) training programme which was designed for training in perioperative nursing of cleft lip and palate patients, was adapted for perioperative nursing training. A 5-day intensive training was deployed, involving lectures, hands-on activities, simulations, and group problem-solving exercises. Pre- and post-training surveys were administered, and participant feedback and 3-months follow-up assessments obtained. The data has been analysed using descriptive statistics.

RESULTS: Twenty-six participants who were nurses involved in perioperative care, from both public and private hospitals, completed the training. Pre-training evaluation scores ranged from 23 to 72% (median 68%), increasing significantly to 61-98% (median 76%) post-training (p = 0.0001). Participants rated all training contents as useful, with high satisfaction in neonatal resuscitation and basic life support skills. Infection prevention and control, helping babies breathe, and effective communication were identified as key learnings. Recommendations for future training included facilitation skills, nutrition, and research. Although 10 (40%) participants organised step down trainings, limited funding and training materials were key barriers to step down.

CONCLUSION: The NCSL training programme has the potential for promoting and strengthening safe perioperative nursing care. Strategic efforts are needed to scale up and expand access to this training within the wider perioperative nursing community, to enhance patient safety and surgical outcomes in the setting.

PMID:40130251 | PMC:PMC11931009 | DOI:10.3389/fmed.2025.1502456

J Rural Health. 2025 Mar;41(2):e70018. doi: 10.1111/jrh.70018.

ABSTRACT

PURPOSE: Drug overdoses are now a leading cause of pregnancy-related deaths in the United States. Despite evidence of rural-urban disparities in substance use, there has not yet been a nationally representative examination of rural-urban differences in perinatal substance use. This study provides a comprehensive examination of rural-urban disparities in perinatal substance use.

METHODS: This study uses cross-sectional data to examine 3499 pregnant women from the 2015-2019 National Survey on Drug Use and Health (NSDUH). Rural (nonmetro)-urban (metro) differences in past-month tobacco use, alcohol use, binge drinking, illicit drug use, and marijuana use were examined using Rao-Scott chi-square tests and multivariable logistic regression using complex survey weights.

FINDINGS: In 2015-2019, past-month tobacco use varied geographically, as rural pregnant participants were more likely to have used tobacco than those in small and large urban areas (24.7% vs. 15.2% and 8.2%, respectively, p < 0.0001). After controlling for sociodemographic and health care needs, rural pregnant women were more likely to report tobacco use (adjusted odds ratio [aOR]: 2.32, 95% confidence interval [CI]: 1.66, 3.25) but were less likely to report alcohol use (aOR: 0.58, 95% CI: 0.34, 0.98) than their large urban counterparts. There were no rural-urban differences in the odds of binge drinking, illicit drug use, or marijuana-only use in the past month.

CONCLUSIONS: Geographic variations in perinatal substance use highlight the need for tailored interventions targeting substance use prevention during pregnancy, prioritizing tobacco in rural areas and alcohol in urban areas.

PMID:40128129 | DOI:10.1111/jrh.70018

Anal Chem. 2025 Mar 24. doi: 10.1021/acs.analchem.4c05962. Online ahead of print.

ABSTRACT

This work presents the first indirect immunoassay performed on a paper-based microfluidic platform for the diagnosis of canine visceral leishmaniasis (CVL). The IgG antibody biomarker, which signifies the presence of this infectious disease, was captured with a recombinant K39 antigen and detected with secondary antibodies that were conjugated with cleavable ionic probes. The use of ionic probes enabled direct analysis of the assay results through an on-chip paper spray mass spectrometry (MS) technology. This MS-based immunoassay was developed to allow for early detection of CVL in asymptomatic dogs. The sensitivity required for such a diagnostic method was demonstrated through internal standard calibration in which sample dilution as low as 1/4000 was achieved. Aside from high sensitivity, the ionic probes are stable, which allowed the paper device to be stored at room temperature and under ambient conditions for 30 days without affecting the diagnostic outcome. Our method was used to analyze 20 clinical canine serum samples, where we detected a 2 orders of magnitude higher signal for CVL-positive samples compared to negative samples. MS signal derived from the 10 CVL-positive serum clinical samples showed a strong correlation with antibody titers determined by immunofluorescence assay. This correlation was confirmed through Pearson’s statistical analysis. Overall, the high sensitivity and positive results from stability tests observed for our platform are expected to enable large-scale CVL screening in asymptomatic dogs in remote areas, especially when combined with portable mass spectrometers.

PMID:40128119 | DOI:10.1021/acs.analchem.4c05962

Medicine (Baltimore). 2025 Mar 21;104(12):e41851. doi: 10.1097/MD.0000000000041851.

ABSTRACT

The COVID-19 pandemic has brought a significant increase in the incidence of acute respiratory distress syndrome (ARDS). This retrospective study aims to compare the differences in demographic, clinical, and biochemical variables and predictive factors in 2 situations of ARDS cause (COVID-19 vs NON-COVID-19) in patients admitted to the intensive care unit. The Mann-Whitney rank-sum test was performed for quantitative variables, and Fisher exact test for qualitative variables. 115 patients with ARDS were enrolled (53 patients with COVID-19 ARDS and 62 NON-COVID-19 ARDS). The COVID-19 ARDS group consisted of 33 male patients (66.2%), whereas the NON-COVID-19 ARDS group had 25 male patients (40.3%) (P = .0248). The median and interquartile age difference of the COVID-19 ARDS group was 64.0 [52.0-69.5], and non-COVID-19 ARDS was 49.0 [34.0-63.0] (P = .0011). Body mass index, simplified acute physiology score, sequential organ failure assessment, and intensive care unit length of stay, with P-values of .0061, .0002, .0003, and <.0001, respectively (COVID-19 vs NON-COVID-19 ARDS). Diabetes, arterial hypertension, venous thrombosis, and chronic obstructive pulmonary disease had values of <.0001, .0234, .0358, and .0001, respectively. On the other hand, the NON-COVID-19 ARDS group had a greater need for dialysis (P = .0109). The stepwise logistic regression showed that relevant clinical, and demographic characteristics associated with ARDS due to COVID-19, such as male gender, diabetes, chronic obstructive pulmonary disease, and body mass index, were independent prognostic factors of severity in patients with COVID-19 ARDS, compared to NON-COVID-19 ARDS. The overall mortality rate was 62.9% for COVID-19 ARDS and 77.4% for the non-COVID-19 ARDS group (P = .2950). Ventilatory parameters of COVID-19 ARDS and NON-COVID-19 ARDS were similar.

PMID:40128087 | DOI:10.1097/MD.0000000000041851

Medicine (Baltimore). 2025 Mar 21;104(12):e41937. doi: 10.1097/MD.0000000000041937.

ABSTRACT

Fanconi anemia (FA) is an inherited disorder characterized by congenital malformations, bone marrow failure, and malignancies. Hematopoietic cell transplant (HCT) is the only proven cure for the hematological complications. FA patients have increased chromosomal instability and aberrant deoxyribonucleic acid repair and thus can only tolerate low doses of chemotherapy or radiation as part of conditioning prior to HCT. Yet, they are still prone to severe regimen related toxicities including hemorrhagic cystitis (HC) from cyclophosphamide (CY). As CYP2B6 is a primary enzyme responsible for the catalyzation of the prodrug form of CY, understanding the association between CYP2B6 genetic variants and HC in FA patients may predict which patients will be more susceptible to developing HC. A descriptive genetic association study was performed to identify genetic variants associated with HC in patients with FA who underwent HCT between 1999 and 2017. All patients received a CY-based preparative regimen and had pretransplant recipient deoxyribonucleic acid available for genomic analysis. Forty FA pediatric patients were eligible for this analysis. They had received HCT from matched sibling donors (n = 6) or alternative donors (n = 34) for marrow failure (n = 38) or myelodysplastic syndrome (n = 2). The incidence of HC was 32.5% which occurred at a median of 32 days (range 20-180) after HCT. 9 patients had a concomitant viral infection (BK virus, n = 8 both adenovirus and BK virus, n = 1). No genetic variants were significantly associated with HC. The top variants were rs2279343 (g.23060A > G), and rs2279344 (g.23280G > A) in the CYP2B6 gene. The incidence of HC among FA patients with the rs2279343 variant was 42% (CI 22%-62%) compared to 20% (CI 0%-40%) among those without the variant (P = .19). The incidence of HC among patients with the variant in rs2279344 was 40% (CI 22%-58%) compared to 10% (CI 0%-28%) among those without (P = .11). No variants in our analysis were statistically associated with HC. The data suggest that CYP2B6 variants may increase the risk for HC in FA patients who received a CY based preparative therapy but these risk variants must be further evaluated in a larger population.

PMID:40128086 | DOI:10.1097/MD.0000000000041937

Medicine (Baltimore). 2025 Mar 21;104(12):e41891. doi: 10.1097/MD.0000000000041891.

ABSTRACT

Febrile seizures (FS) are among the most common neurological disorders in childhood, and their pathogenesis may be influenced by multiple factors. As scientific research progresses, the significant role of B vitamins in the nervous system has become progressively clearer. In this study, children clinically diagnosed with FS were selected as the experimental group, and febrile children without a history of convulsions or a family history of seizures were selected as the control group to investigate the potential correlation between FS and whole-blood B vitamin levels. The concentrations of B vitamins in whole blood were measured using liquid chromatography-mass spectrometry, and statistical analyses were conducted using SPSS 25.0, followed by significance testing. The levels of vitamins B1, B2, B5, B6, B7, and B12 in the experimental group were significantly higher than those in the control group, particularly vitamins B5 and B7 (P < .05). Additionally, statistically significant differences were observed between sodium and calcium ion levels. These results suggest that febrile convulsions are the complex outcome of multiple factors, including known ion channel defects. Vitamin B may play a role in febrile convulsions and warrants further investigation.

PMID:40128085 | DOI:10.1097/MD.0000000000041891

Medicine (Baltimore). 2025 Mar 21;104(12):e41914. doi: 10.1097/MD.0000000000041914.

ABSTRACT

Indoor air pollution (IAP) is a risk factor leading to cataracts. The disease burden of cataracts due to IAP is currently greater in low- and middle-income countries, an in-depth analysis is necessary to track the current time trend of cataracts caused by IAP in low- and middle-income countries. Our data from the global burden of disease 2021 study. In our study, disability-adjusted life years (DALYs) and DALYs rate were used to assess the disease burden of cataracts due to IAP across 17 low- and middle-income countries. The contribution of IAP exposure to the associated burden of cataracts was quantified by using population attribution fractions. Additionally, the estimated annual percentage change was calculated to quantify the long-term trend in the burden of cataracts due to IAP from 1990 to 2021. An age-period-cohort model was used to estimate the effects of age, period, and cohort on time trend of disease burden. In 2021, age-standardized DALY rates (ASDR) values varied widely across the 17 countries. Pakistan had the highest ASDR 122.5 (-35.3 to 247.4). ASDR declined in all 17 countries. For all countries, the age effect increases rapidly after about age 55. South Africa, Brazil, and Mexico have made great progress in the period and cohort effects. The situation of burden for IAP-related cataracts varies across countries, and it is necessary to set targeted public health strategies and interventions.

PMID:40128084 | DOI:10.1097/MD.0000000000041914