Category: Nevin Manimala

J Innov Card Rhythm Manag. 2025 Jun 15;16(6):6307-6328. doi: 10.19102/icrm.2025.16065. eCollection 2025 Jun.

ABSTRACT

Atrial fibrillation (AF) ablation is a common treatment for symptomatic AF. Remote magnetic navigation (RMN) and manual catheter navigation (MCN) are two predominant techniques employed in this procedure, each with advantages and limitations. This meta-analysis compares the efficacy, safety, and procedural outcomes of RMN versus MCN for AF ablation. A comprehensive search was conducted across PubMed, Google Scholar, and Embase to identify relevant studies comparing RMN and MCN for AF ablation. Statistical pooling was done using Review Manager 5.4.1 (Cochrane Collaboration, London, UK). The Newcastle-Ottawa scale was used for the evaluation of bias in observational studies. We evaluated the robustness of the evidence following the guidelines outlined by the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) working group. The primary outcomes of the study included freedom from AF, procedure time, fluoroscopy time, and total complication rate in patients undergoing AF ablation either using the RMN or MCN technique. A total of 22 studies involving 5361 patients were included in the meta-analysis. The pooled analysis demonstrated comparable freedom from AF between RMN and MCN (relative risk [RR], 0.94; 95% confidence interval [CI], 0.84-1.04; P = .23). However, RMN was associated with a significantly prolonged procedure duration (mean difference [MD], 48.58; 95% CI, 31.49-65.66; P < .00001) and reduced fluoroscopy time (MD, -12.52; 95% CI, -17.84 to -7.20; P < .00001) compared to MCN. Additionally, RMN showed a trend toward lower total complication rates (RR, 0.63; 95% CI, 0.45-0.88; P = .007). In AF ablation, RMN and MCN exhibit comparable efficacy in achieving freedom from AF. However, RMN is associated with a prolonged procedure duration compared to MCN. Nonetheless, RMN offers advantages in terms of reduced fluoroscopy times and lower total complication rates, highlighting its potential for improving procedural safety. The choice between RMN and MCN should be made considering individual patient factors and procedural objectives.

PMID:40630984 | PMC:PMC12233321 | DOI:10.19102/icrm.2025.16065

BMC Sports Sci Med Rehabil. 2025 Jul 8;17(1):186. doi: 10.1186/s13102-024-01046-6.

ABSTRACT

OBJECTIVES: Video-based decision-making training is considered a promising intervention to enhance the decision-making skills of football referees. This study conducted a systematic review and meta-analysis to validate the effectiveness of video-based training and evaluate its overall impact on improving referees’ decision-making skills, providing a scientific basis for the optimization and innovation of referee training methods.

METHOD: A systematic search was performed across four electronic databases (EBSCO, PubMed, Scopus, and Web of Science). Inclusion and exclusion criteria were defined using the PICOS framework. Relevant literature was independently screened, and key information was extracted. The revised Cochrane risk-of-bias tool (RoB 2) was employed to assess the risk of bias in the included studies, and statistical analyses were conducted using CMA 3.0 software.

RESULT: Six randomized controlled trials (RCTs) involving a total of 163 participants were included. The meta-analysis revealed that video-based training significantly improved referees’ decision-making skills (Hedges’ s g = 1.718, 95% CI [1.058, 2.377], P < 0.001, τ² = 0.464). The overall risk of bias across the included studies was assessed as low to moderate, indicating a generally reliable methodological quality. Sensitivity analysis confirmed the robustness of the overall effect size.

CONCLUSION: This meta-analysis demonstrates that video-based decision-making training is an effective and practical intervention for significantly enhancing the decision-making skills of football referees. Its convenience and cost-effectiveness make it an essential supplementary training tool for referees. However, the findings are limited by factors such as the small sample size of included studies, incomplete descriptions of participant characteristics, and insufficient gender representation. Future high-quality research is needed to comprehensively evaluate the effectiveness of video-based training across referees of different levels and genders.

PMID:40629454 | DOI:10.1186/s13102-024-01046-6

Parasit Vectors. 2025 Jul 8;18(1):269. doi: 10.1186/s13071-025-06836-6.

ABSTRACT

BACKGROUND: Bed bugs (Cimex spp.) are obligate ectoparasites that have long been associated with human dwellings, causing discomfort and psychosocial distress. Conventional control strategies relying on insecticides are increasingly challenged by resistance, necessitating alternative interventions. Ivermectin, an endectocide known to impact various neglected tropical diseases and hematophagous arthropods, is currently being assessed for malaria vector control. This study aimed to evaluate the toxicity of ivermectin on Cimex hemipterus, the predominant bed bug species in Africa, within the framework of the Broad One Health Endectocide-based Malaria Intervention in Africa (BOHEMIA) project in Kwale, Kenya.

METHODS: A cross-sectional survey was conducted in 352 households to obtain information on self-reported bed bug infestations, socioeconomic status, and household characteristics. Bed bugs were collected from 40 infested households. After collection, bed bugs were acclimatized and exposed to blood meals spiked with ivermectin at five concentrations (85 ng/ml, 64 ng/ml, 43 ng/ml, 21 ng/ml, and 11 ng/ml), corresponding to expected serum levels 4 h to 6-7 days following a 400 µg/kg oral dose. Mortality and fecundity were monitored over a 14-day period. Statistical analyses, including Cox proportional hazard models and probit regression, were applied to assess dose-response relationships.

RESULTS: Bed bug infestation was common, with 75% of participating households reporting their presence, with infestations being strongly associated with the number of people residing in a household. Ivermectin exposure resulted in significant dose-dependent mortality in Cimex hemipterus, with the higher concentrations (43, 64, and 85 ng/ml) inducing over 90% mortality within 3 days postfeeding. Bed bugs that ingested blood meals containing sublethal doses of ivermectin did not lay eggs. Kaplan-Meier survival analyses demonstrated a clear inverse relationship between ivermectin concentration and bed bug survival.

CONCLUSIONS: These findings provide evidence that ivermectin, administered as part of a mass drug administration campaign, could contribute to bed bug control alongside its intended impact on other diseases or vectors. The results underscore the potential for integrated public health approaches leveraging endectocide interventions. Further field evaluations in diverse locations are needed to determine the optimal number of administrations and treatment intervals required for complete infestation elimination.

PMID:40629452 | DOI:10.1186/s13071-025-06836-6

Ital J Pediatr. 2025 Jul 8;51(1):213. doi: 10.1186/s13052-025-01927-7.

ABSTRACT

BACKGROUND: Intraventricular hemorrhage (IVH) is a serious complication of prematurity with a potential impact on morbidity and mortality particularly in very low birth weight neonates. Despite advances in neonatal care over recent years, there is no recent data regarding IVH in our setting. This study aimed to determine the proportion of IVH, its associated factors, and mortality at Muhimbili National Hospital (MNH).

METHODS: A hospital-based prospective cohort study was conducted among preterm very low birth weight neonates admitted at MNH. Data was obtained from interviews, physical examination, review of maternal antenatal cards, and neonatal records. Cranial ultrasound was done on day 3 and day 7 of life to determine the presence and severity of IVH. Mortality of neonates was determined on day 7. Data were summarised using frequencies, percentages, median, and interquartile range. Chi-square and Fisher’s exact were used to measure the association between categorical variables. Variables found to be significantly associated with IVH were analysed by Poisson regression. A p-value of 0.05 or less was considered statistically significant.

RESULTS: The proportion of VLBW neonates with IVH was 22.9% with grade 1 being the most prevalent. The majority of IVH (74.7%) occurred within the first 3 days of life. Factors found to increase the risk of IVH in the univariate analysis were gestational age, mode of delivery, respiratory distress syndrome, hypothermia, early-onset sepsis, use of inotropes, thrombocytopenia and mechanical ventilation. However, none of these factors were independent predictors of IVH in multivariate Poisson regression analysis. Mortality of VLBW neonates with IVH was significantly higher than their counterparts without IVH (RR = 2,95% CI (1.25-3.34).

CONCLUSIONS: IVH is common among VLBW neonates most of which occurred by day 3 of life. The risk of Mortality was two times higher among VLBW neonates with IVH compared to those without IVH. Further research should be conducted to explore predictors of mortality and long-term outcome of VLBW neonates with IVH.

PMID:40629448 | DOI:10.1186/s13052-025-01927-7

J Orthop Surg Res. 2025 Jul 8;20(1):619. doi: 10.1186/s13018-025-06013-6.

ABSTRACT

BACKGROUND: This meta-analysis aimed to compare the radiological and clinical outcomes in patients who underwent total knee arthroplasty (TKA) using either NAVIO-assisted TKA or conventional TKA.

METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and meta-analysis criteria, a systematic review was carried out. We looked through the databases of PubMed, Web of Science, Cochrane Library, Embase, Scopus, ClinicalTrials.gov, China National Knowledge Infrastructure (CNKI), Wanfang, China Biology Medicine Disc (CBM), and China Science and Technology Journal (CSTD) databases in April 2025 to identify studies involving NAVIO-assisted TKA versus conventional TKA.

RESULTS: We identified 2483 TKAs assessed in 21 studies. There were no significant differences in terms of Visual Analogue Scale(VAS, P = 0.38), Knee Society Score (KSS, P = 0.68), KSS function(KSSF, P = 0.96), Forgotten Joint Score-12 (FJS-12, P = 0.73), Extension range of motion (EROM, P = 0.12), Flexion range of motion,(FROM, P = 0.28), Hip-knee-ankle angle(HKA, P = 0.66),Frontal femoral component angle (FFC, P = 0.22), Frontal tibial component angle (FTC, P = 0.18), Femoral rotation angle(FRA, P = 0.17), Medial tibial plateau angle(MPTA, P = 0.34), Lateral femoral component angle (LFC, P = 0.65), Lateral tibial component angle (LTC, P = 0.47), Change in joint line height(CJLH, P = 0.06), outlier of PTS(P = 0.18), Hospital stays (P = 0.07) and Complication rate(P = 0.32), However, in comparison to conventional TKA, NAVIO-assisted TKA was observed with less outlier of HKA (P = 0.00), less outlier of FFC (P = 0.05), less outlier of FTC (P = 0.04), less lateral distal femur angle (LDFA, P = 0.04), less posterior slope of the tibial component (PTS, P = 0.011), less decrease in Hb (P = 0.02) and longer operation time (P = 0.02).

CONCLUSION: This meta-analysis, specifically focused on the NAVIO system, suggests that NAVIO-assisted TKA is associated with improved accuracy in achieving target mechanical and anatomical alignment compared to traditional TKA. Nonetheless, the two groups demonstrated similar complication rates and short-to-intermediate-term clinical and functional results in this analysis. A statistically significant, though modest, benefit in terms of reduced blood loss was observed for the NAVIO group. Further adequately powered and rigorously designed long-term follow-up studies are essential to determine whether the observed improvements in radiological alignment accuracy translate into significant long-term clinical benefits.”

PMID:40629445 | DOI:10.1186/s13018-025-06013-6

BMC Sports Sci Med Rehabil. 2025 Jul 8;17(1):183. doi: 10.1186/s13102-025-01211-5.

ABSTRACT

BACKGROUND: The prevalence and impact of chronic ankle instability (CAI) is underreported among females participating in sports that are considered high risk for lateral ankle sprains. Identifying the prevalence and contextualising the impact may help reinforce the necessity of targeted rehabilitation and injury risk reduction strategies. The primary aim was to conduct an international study identifying the prevalence of CAI and impact on ankle function and quality of life of females participating in high-risk sports.

METHODS: The cross-sectional study across Australia, New Zealand, the United Kingdom (UK), and United States of America (USA), invited females (≥ 18 years old) participating in netball, soccer, basketball, or volleyball to complete an online survey about their ankle health. A convenience sample was recruited online via each of the researchers covering their respective region. The survey comprised questions related to general demographic/health information, and validated questionnaires-Cumberland Ankle Instability Tool (CAIT)/Foot and Ankle Ability Measure-Sport (FAAM-S)/Health-Related Quality of Life Score (HRQOL). Participants were classified with CAI if an ankle sprain and CAIT score of < 25 were recorded on the same ankle. A CAIT score of > 24 identified either a potential coper (someone reporting a previous ankle sprain) or healthy participant (no previous ankle sprains). An alpha level of p < 0.05 denoted statistical significance.

RESULTS: Five-hundred seventy-eight responses were received. Of those, 258 had complete datasets from across the UK (44%,n = 170), Australia (27%,n = 106), New Zealand (19%,n = 75), and USA (7%,n = 29). Ankle sprains were the most common ankle injury (77%). 73% reported CAI of their left ankle and 54% reported CAI of their right ankle. The FAAM-S (p < 0.05) and HRQOL (p > 0.05) scores were reduced for the CAI group, compared to both the potential copers and individuals with no ankle injury. When stratified by sport there were no differences across outcome measures.

CONCLUSION: Chronic ankle instability is prevalent in females who participate in sports determined as high risk of ankle sprains. The results diversify knowledge of CAI in women across a broader participation level and distribution of sports than previously reported. Prevention strategies must be implemented globally to minimise the impact of CAI on performance and quality of life.

PMID:40629426 | DOI:10.1186/s13102-025-01211-5

J Orthop Surg Res. 2025 Jul 8;20(1):626. doi: 10.1186/s13018-025-05990-y.

ABSTRACT

BACKGROUND: Acute Achilles tendon rupture (AATR) is one of the most common sports injuries, however, the optimal treatment remains controversial. The purpose of this study was to compare the effectiveness of surgical and conservative treatment on clinical outcomes.

METHODS: The PubMed, Web of Science, Embase, and Cochrane Library databases were searched to identify relevant studies published from database inception up to April 2025. Two reviewers independently screened titles and abstracts using specified criteria. Included studies compared differences between surgical and conservative treatment in terms of re-rupture rate, incidence of other complications, rate of return to sports, and Achilles Tendon Total Rupture Score (ATRS), and to examine the effect of platelet-rich plasma (PRP) on clinical outcomes. Dichotomous outcomes are expressed as odds ratio (OR), and continuous data are expressed as mean difference (MD) with corresponding 95% confidence interval (CI). Heterogeneity was assessed using the I2 statistic, A fixed effects model was used when I2 ≤ 50%; otherwise, the random effects model was used. Statistical analysis was performed using Review Manager version 5.4.1.

RESULTS: Thirty-three studies comprising 35896 patients were included. Compared with the nonoperative group, the operation group exhibited lower re-rupture rates (risk ratio [RR] 0.44 [95% confidence interval (CI), 0.34-0.57], P < .00001), a higher rates of return to sport (RR 1.32 [95% CI, 1.03-1.69], P = .03), higher infection rates (RR 2.54 [95% CI, 1.62-3.98], P < .0001), including deep infection (RR 1.91 [95% CI, 1.15-3.16], P = .01) and superficial infection (RR 4.89 [95% CI, 1.57-15.24], P = .006) and higher nerve injury rates (RR 3.67 [95% CI, 1.34-10.06], P = .01). Surgery reduced re-rupture rates by 3.52%, increased the rates of return to sport by 14.44%, conservative treatment reduced the nerve injury rates by 3.33%, and the infection rates by 0.53%. There was no statistical difference between the 2 treatments in the incidence of other complications, such as deep venous thrombosis (RR 0.93 [95% CI, 0.77-1.12], P = .43) and pulmonary embolism (RR 1.63 [95% CI, 0.49-5.48], P = .43), nor effect on ATRS (mean difference [MD] 7.02 [95% CI, -1.35-15.38], P = .10). Regardless of surgical or conservative treatment, there was no difference in the effects of PRP on the re-rupture rate, rate of return to sports, ATRS, and ankle range of motion.

CONCLUSION: Surgical treatment significantly reduced the risk for re-rupture and increased the rate of return to sports compared with conservative treatment; however, the incidence of complications, including nerve injury and infection, was lower with conservative treatment. Regardless of surgical or conservative treatment, PRP did not yield superior clinical or functional outcomes.

PMID:40629410 | DOI:10.1186/s13018-025-05990-y

Malar J. 2025 Jul 8;24(1):220. doi: 10.1186/s12936-025-05474-8.

ABSTRACT

BACKGROUND: Malaria remains a significant public health challenge in Ghana, with haematological alterations being a common feature of infection. Understanding these changes is crucial for improving disease management, particularly in endemic regions where resource limitations may affect diagnostic capabilities. This study aimed to evaluate variations in haematological and inflammatory biomarkers and their association with Plasmodium falciparum malaria in a Ghanaian setting.

METHODS: A cross-sectional comparative study was conducted at the Ghana Ports and Harbours Authority Clinic from January to May 2018, involving 200 participants (100 P. falciparum-infected and 100 malaria-negative participants). Full blood count parameters and derived inflammatory indices were analysed. Kruskal-Wallis and Mann-Whitney U tests were used to determine the variations in haematological and inflammatory biomarkers across malaria and non-malaria groups. Logistic regression was also used to find the haematological and inflammatory biomarkers associated with malaria. A p-value less than 0.05 was considered statistically significant.

RESULTS: Significant differences were observed in several haematological parameters between P. falciparum malaria and non-malaria groups. Plasmodium falciparum malaria patients showed markedly lower white blood cell counts (4.88 vs. 5.84 × 10⁹/L, p < 0.001), lymphocyte counts (0.91 vs. 2.10 × 10⁹/L, p < 0.001), and platelet counts (117.50 vs. 224.50 × 10⁹/L, p < 0.001). Inflammatory indices revealed elevated neutrophil-to-lymphocyte ratio (3.49 vs. 1.43, p < 0.001) and systemic inflammatory response index (1.83 vs. 0.73, p < 0.001) in P. falciparum malaria patients. Notably, the platelet-monocyte ratio was significantly reduced in malaria patients (207.45 vs. 457.78, p < 0.001). Haemoglobin levels showed significant variation across parasite densities, particularly between moderate and low parasitaemia groups (p = 0.026). The logistic regression also revealed that the odds of malaria decreased with increasing haematocrit (aOR: 0.77,95% CI 0.60-0.97, p = 0.032), platelets (aOR:0.96, 95% CI 0.94-0.99, p = 0.013) and platelets-monocyte ratio (aOR:0.98, 95% CI 0.97-0.99, p = 0.004), and increased with increased platelets-lymphocyte ratio (aOR:1.04, 95% CI 1.00-1.07, p = 0.031).

CONCLUSION: This study demonstrated significant alterations in haematological and inflammatory biomarkers during P. falciparum malaria infection. These findings reveal the importance of haematological parameters in malaria diagnosis and severity assessment, with potential implications for improving early detection, risk stratification, and clinical management of P. falciparum malaria patients.

PMID:40629396 | DOI:10.1186/s12936-025-05474-8

Ital J Pediatr. 2025 Jul 9;51(1):216. doi: 10.1186/s13052-025-02071-y.

ABSTRACT

BACKGROUND: To analyze the clinical characteristics and explore the risk factors for airway mucus plugs in children with community-acquired refractory Mycoplasma pneumoniae pneumonia (ca-RMPP).

METHODS: A retrospective study was conducted on hospitalized children diagnosed with ca-RMPP from October 2023 to October 2024. The patients were divided into airway mucus plugs group and non-airway mucus plugs group based on the imaging findings under fiberoptic bronchoscopy. The differences in general data’s, clinical manifestations, imaging changes, pathogens, and laboratory data’s between the two groups were compared. Multivariate logistic regression was applied to analyze the independent risk factors for airway mucus plugs in children with ca-RMPP, and the Receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of risk factors.

RESULTS: Length of hospital stay(LOS), Duration of fever, Duration of steroid treatment, Pleural effusion, Neutrophil percentage (NEU%), C-reactive protein (CRP), Procalcitonin (PCT), D-Dimer, Serum amyloid A (SAA), Lactate dehydrogenase (LDH), Ferritin, T8 lymphocyte percentage (CD8+%), Interleukin-1 β (IL-1 β), Interleukin-6 (IL-6), Interleukin-8 (IL-8) in the airway mucus plugs group were all higher than those in the non-airway mucus plugs group, While, the Lymphocyte percentage (LYM%) and CD4/CD8 ratio were lower than those in the non-airway mucus plugs group, and the differences were statistically significant ( p < 0.05). LOS ≥ 7.5 days, Duration of fever ≥ 6.5 days, CRP ≥ 13.11 mg/L, SAA ≥ 256.205 mg/L, and Ferritin ≥ 97.7ng/mL were independent risk factors.

CONCLUSION: LOS, Duration of fever, CRP, SAA, and Ferritin are independent risk factors for airway mucus plugs in children with ca-RMPP and the combined test can improve the diagnostic value.

PMID:40629384 | DOI:10.1186/s13052-025-02071-y

BMC Health Serv Res. 2025 Jul 8;25(1):939. doi: 10.1186/s12913-025-13098-6.

ABSTRACT

BACKGROUND: Congenital impairments, arising from a range of genetic, environmental, dietary, and teratogenic factors, are a significant public health concern. Pharmacists play a key role in preventing these conditions by ensuring pharmaceutical safety and providing maternal health education. However, there is limited research on the knowledge, attitudes, and practices of pharmacists in Saudi Arabia regarding the causes of congenital impairments.

OBJECTIVES: This study aimed to assess pharmacists’ awareness, perceptions, and practices related to these factors and identify key demographic influences on their knowledge and engagement.

METHODS: A cross-sectional survey was conducted among licensed pharmacists based in Saudi Arabia, including those working in clinical, academic, hospital, and community settings. A standardized and validated questionnaire comprising 30 items divided across knowledge, attitude, and practice domains was used to assess pharmacists’ perspectives. The data were analyzed using descriptive statistics and multivariate linear regression to identify the key demographic factors associated with knowledge, attitudes, and practice scores.

RESULTS: The study included a total of 424 pharmacists, the majority of whom held a master’s degree (60.4%), were male (73.6%), and were aged between 25 and 34 years old (41.5%). Hospital pharmacists achieved significantly higher knowledge (4.39 ± 1.48, P < 0.001), attitude (29.20 ± 5.49, P = 0.000), and practice (33.16 ± 6.84, P < 0.001) scores than community pharmacists. The knowledge gaps identified concerned the impact of environmental contaminants (28.5%) and maternal obesity (30.9%) on fetal development. However, pharmacists showed strong positive attitudes toward preventive measures, with 49.1% supporting increased training and 52.8% endorsing genetic screening as essential interventions.

CONCLUSION: The study highlights significant gaps in pharmacists’ understanding and practice concerning congenital impairments, particularly regarding lifestyle and environmental risk factors. Despite strong support for pharmacist training, participation in public health campaigns and patient counseling on teratogenic risks remains limited. To enhance congenital disability prevention efforts in Saudi Arabia, these findings emphasize the need for improved pharmacist knowledge, structured training programs, and more extensive integration of pharmacists within maternal healthcare teams.

PMID:40629378 | DOI:10.1186/s12913-025-13098-6