Category: Nevin Manimala

Cureus. 2025 Jan 26;17(1):e78007. doi: 10.7759/cureus.78007. eCollection 2025 Jan.

ABSTRACT

Many claims are made regarding the impacts of static magnetic fields (SMFs) on biological and physiological processes. Some of these are based on scientific underpinnings, and others appear to have less evidence to support them. The present report focuses on the evidence regarding SMF’s effects on blood flow. Fortuitously, the author has direct experimental experience in this area. The approach for this review was to search three major databases (Web of Science, PubMed, and Embase) for peer-reviewed articles written in English in which an SMF was used in humans or other animals and measurements of parameters related to blood flow or velocity before SMF application and either during or after application were reported. After screening the initial 1,954 articles, 108 studies were retrieved and evaluated for relevancy. Of these, 23 were found to satisfy the inclusion criteria and be relevant. This included 10 studies on humans and 13 studies on other animals. The methods employed in many of these studies are illustrated in this review to enhance understanding of the findings. With regard to human studies, none showed an increase in blood flow, and one showed a decrease in flow. With regard to the animal studies, one showed a transient post-exposure increase that was later explained as due to an actual reduction during SMF exposure. Four studies showed a decrease, four showed no change or difference from sham-exposed animals, and four reported an increase. Of these four, two were from the same author using a method that may not have reflected a blood flow change. Based on these findings, it is concluded that claims of an SMF providing an increase in blood flow or circulation are not supported by human studies and not well supported by animal studies. However, this does not close the door to a possible effect for at least four considerations or limitations that may have impacted the absence of a positive finding in human studies: (1) the number of subjects included is relatively small, which affects the study power; (2) the duration of the SMF application of most studies was relatively short; (3) most studies were done on healthy individuals; and (4) the SMF was delivered perpendicular to the body surface, so the effects of tangential field directions are unknown. Although these provisos may impact the detection of a possible SMF effect, they do not alter the current findings, as no reviewed human study has demonstrated a statistically significant increase in blood circulation attributable to an SMF. Thus, the clinical use of an SMF to improve blood circulation is not supported by experimental evidence.

PMID:40013215 | PMC:PMC11859515 | DOI:10.7759/cureus.78007

Cureus. 2025 Jan 26;17(1):e78019. doi: 10.7759/cureus.78019. eCollection 2025 Jan.

ABSTRACT

Introduction Hip fractures, particularly intertrochanteric femur fractures, pose a significant public health challenge, with the global incidence projected to rise. In India, the annual incidence of osteoporotic hip fractures is expected to increase due to the growing geriatric population. The choice of fixation for these fractures remains contentious, with proximal femoral nail (PFN) emerging as a preferred option due to its biomechanical advantages. This study evaluates the outcomes of long and short PFN in managing intertrochanteric fractures, focusing on anterior thigh pain and functional outcomes. Method A retrospective study was conducted on 100 patients treated with long PFN (n=50) or short PFN (n=50) at MAX Super Specialty Hospital, New Delhi, from January 2020 to December 2021. Data from medical records and radiographs were analyzed for fracture union, anterior thigh pain (Visual Analog Scale (VAS) score, Verbal Rating Scale), and functional outcomes (Harris Hip Score). Complications were also assessed. Statistical analyses were performed using SPSS v23 (IBM Corp, Armonk, NY), with significance at p<0.05. Result The incidence of anterior thigh pain was significantly higher in the short PFN group (18%) compared to the long PFN group (2%) (p=0.017). The mean VAS score was 2.26 ± 1.42 for the short PFN group versus 1.68 ± 0.91 for the long PFN group. While the Harris Hip Scores were comparable (short PFN: 76.18 ± 11.74, long PFN: 78 ± 11.52, p=0.436), complications such as femoral canal impingement (n=4) and varus collapse (n=3) were observed exclusively in the short PFN group. Conclusion Long PFN demonstrated advantages in reducing anterior thigh pain and minimizing complications, particularly in populations with shorter stature and bowed femurs, common in the Indian subcontinent. Although functional outcomes were similar for both groups, long PFN appears to be the preferred choice for intertrochanteric fractures in this demographic. Further studies with longer follow-up durations are recommended to validate these findings.

PMID:40013210 | PMC:PMC11859844 | DOI:10.7759/cureus.78019

J Surg Res. 2025 Feb 25;307:100-106. doi: 10.1016/j.jss.2025.01.017. Online ahead of print.

ABSTRACT

INTRODUCTION: The study experimentally evaluated the efficacies of different agents in treating pulmonary contusion.

METHODS: In our study, 42 Wistar albino rats were divided into six groups of seven animals each. A model of lung contusion with blunt chest trauma was performed in five groups, except for the control group. One group with pulmonary contusion was considered an untreated group, and saline was administered. For other groups, prednisolone, tranexamic acid, N-acetylcysteine, and vitamin E were applied to determine their efficacy in treatment. The rats were sacrificed 24 h after trauma, and their injured lungs were collected for histopathological examination and blood samples for blood gas analysis. Histopathologically, bronchial damage, alveolar hemorrhage, emphysema, and leukocyte infiltration were assessed using the scoring system.

RESULTS: In our study, statistically significant differences were detected between the rat groups in terms of intraalveolar hemorrhage, leukocyte infiltration, and bronchial damage. In post hoc analysis, intraalveolar hemorrhage was significantly higher in the untreated group compared to the control group (P = 0.012). A near-significant difference was observed between the untreated group and the N-acetylcysteine group (P = 0.061). Regarding leukocyte infiltration, the tranexamic acid group showed significantly higher values compared to both the prednisolone and control groups (P = 0.007; P = 0.016, respectively). For bronchial damage, the levels observed in the vitamin E and tranexamic acid groups were significantly higher than those in the control group (P = 0.08 and P = 0.037, respectively).

CONCLUSIONS: Many agents are used to treat pulmonary contusion, but no gold standard treatment exists. Prednisolone and N-acetylcysteine play significant roles in treatment. These two drugs contributed to the regression of the findings in pulmonary contusion treatment.

PMID:40009897 | DOI:10.1016/j.jss.2025.01.017

Semin Oncol. 2025 Feb 25;52(1):1-6. doi: 10.1053/j.seminoncol.2025.01.001. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the relationship between obesity and Microsatellite Instability (MSI) in endometrial cancer (EC), determine which mismatch repair (MMR) protein loss is influenced by obesity, and assess the correlation between BMI and MSI probability.

METHODS: This retrospective cohort study included 89 endometrial cancer patients treated at the Gynaecologic oncology unit of the University of Campania “Luigi Vanvitelli” from August 2023 to October 2024, and stratified by BMI: normal weight (n = 26), overweight (n = 31), obese (n = 26), and severely obese (n = 6). Microsatellite instability (MSI) was determined through immunohistochemical assessment of mismatch repair (MMR) protein expression: MLH1, PMS2, MSH2, and MSH6. Tumors were considered MSI if at least one of the four MMR proteins showed loss of expression. Univariate and multivariate logistic regression models were constructed to evaluate the correlation between BMI and MSI RESULTS: 89 patients were enrolled. Obese and severely obese groups showed significantly higher MSI rates (50 % each) compared to normoweight (12 %) and overweight (29 %) groups (P = .013). MLH1 and PMS2 loss of expression were significantly higher in obese and severely obese women (MLH1: P = .003; PMS2: P = .014). Univariate logistic regression showed a significant positive correlation between BMI and MSI (OR 1.02, 95 % CI 1.01-1.04, P = .007). In multivariate analysis, adjusting for grading, stage, histotype, and age, BMI maintained a significant positive correlation with MSI (OR 1.02, 95 % CI 1.01-1.04, P = .048).

CONCLUSIONS: This study demonstrates a significant association between obesity and MSI in EC, particularly affecting MLH1 and PMS2 expression. The findings suggest that obesity may contribute to EC development also through MMR deficiency.

PMID:40009888 | DOI:10.1053/j.seminoncol.2025.01.001

West Afr J Med. 2024 Oct 30;41(10):1054-1065.

ABSTRACT

BACKGROUND: Obstetric fistulas are a high burden globally, especially in developing regions. Despite their experiences, many affected women have a high fertility desire.

OBJECTIVES: This study aimed to assess fertility desires and associated factors among women with obstetric fistulas in Northwest Nigeria and explore their experiences.

METHODOLOGY: Using a cross-sectional mixed-method approach, quantitative data was gathered from 420 women of reproductive age via an interviewer-administered questionnaire, and qualitative data from 24 women using focus group discussions. Participants were selected from three hospitals using a two-stage sampling technique. The quantitative data was analyzed using SPSS version 21, employing descriptive and inferential statistics to identify predictors of fertility desire. Thematic analysis was used for the qualitative data.

RESULTS: Respondents’ mean age (± SD) was 26.4 (±8.4) years. The majority (88.8%) had only vesico-vaginal fistulas, while 3.3% had both vesico-vaginal and recto-vaginal fistulas. Although less than half (43.8%) had no surviving children, 74.3% desired more children. No protective association was found in the multivariable analysis. Age, number of surviving children, and family influence significantly predicted fertility desires. Qualitative findings highlighted cultural norms contrib uting to delayed treatment and poor home-based services, with social stigma, divorce, and lack of family and social support being common. However, some women received encouragement from their maternal family and community members.

CONCLUSION: Obstetric fistulas not only significantly affect women’s fertility desires but their social and personal lives. Integrating fertility counselling and community-based support into comprehensive fistula care is crucial for addressing these challenges effectively.

PMID:40009865

Crit Care Nurs Q. 2025 Apr-Jun 01;48(2):172-185. doi: 10.1097/CNQ.0000000000000554. Epub 2025 Feb 27.

ABSTRACT

This study aims to assess the crisis management and problem-solving skills of nurses caring for patients with COVID-19. The participants of this descriptive cross-sectional were 132 nurses who cared for patients with COVID-19 in a public hospital. The crisis management scale (CMS), problem-solving inventory (PSI), and Nurse Introduction Form were used to collect data. In this study, the nurses’ CMS total score average was 3.75 ± 0.442, the average PSI total score was 86.32 ± 24.420, and it was determined that their crisis management ability was at a good level and their problem-solving skills were at a medium level. A significant difference was found between the nurses’ descriptive characteristics of having children (P = .029), being informed about crisis management (P = .035), and their total average score on the CMS (P < .05). A statistically significant negative relationship was found between the nurses’ total CMS and PSI scores (P < .05).This study showed that the problem-solving skill levels of nurses caring for patients with COVID-19 affected their crisis management skills.

PMID:40009863 | DOI:10.1097/CNQ.0000000000000554

Crit Care Nurs Q. 2025 Apr-Jun 01;48(2):143-150. doi: 10.1097/CNQ.0000000000000544. Epub 2025 Feb 27.

ABSTRACT

It has been suggested that the use of statin pills beforehand could potentially influence the outcomes when individuals are hospitalized with COVID-19. In this study, we investigated how the prior use of statin medication could influence the COVID-19 severity parameters. In this retrospective cohort study, we categorized COVID-19 patients into 2 groups: statin users and non-users. Then, various data including age, gender, the patient’s need for ventilation support, the lowest oxygen blood saturation level, the length of hospitalization, receiving remdesivir treatment, and their COVID-19 vaccination status were collected. Out of 168 patients, 62 had taken statin medication before being admitted. Using statins decreased the patient’s need for ventilation support, length of hospitalization, ventilation duration, and oxygen saturation level (P < .001). Interaction effect analysis showed that receiving remdesivir statically affected the length of hospitalization, ventilation duration, and oxygen saturation level but did not significantly affect the association between statins and needing to ventilator. The use of statin pills before COVID-19 admission reduced the requirement for ventilator support.

PMID:40009860 | DOI:10.1097/CNQ.0000000000000544

JMIR Aging. 2025 Feb 26;8:e68957. doi: 10.2196/68957.

ABSTRACT

BACKGROUND: Injuries from falls are a major concern among older adults. Targeted exercise has been shown to improve fall risk, and recommendations for identifying and referring older adults for exercise-based interventions exist. However, even when very inexpensive or free, many do not use available fall prevention programs, citing barriers related to convenience and safety. These issues are even greater among older adults residing in rural areas where facilities are less abundant. These realities highlight the need for different approaches to reducing falls in novel ways that increase reach and are safe and effective. Web-based delivery of exercise interventions offers some exciting and enticing prospects.

OBJECTIVE: Our objective was to assess the efficacy of the Strong Foundations exercise program to change markers of physical function, posture, balance, strength, and fall risk.

METHODS: Strong Foundations is a once weekly (60 minutes), 12-week iterative program with 3 core components: postural alignment and control, balance and mobility, and muscular strength and power. We used a quasi-experimental design to determine changes in physical function specific to balance, postural control, and muscular strength among older adults at low or moderate risk of falling.

RESULTS: A total of 55 low-risk and 37 moderate-risk participants were recruited. Participants significantly improved on the 30-second Chair Stand (mean change of 1, SD 3.3 repetitions; P=.006) and Timed Up and Go (mean change of 0.2, SD 0.7 seconds; P=.004), with the moderate-risk group generally improving to a greater degree than the low-risk group. Additionally, Short Physical Performance Battery performance improved significantly in the moderate-risk category (P=.02). The majority of postural measures showed statistically significant improvement for both groups (P<.05). Measures of “relaxed” posture showed improvements between 6% and 27%. When an “as tall as possible” posture was adopted, improvements were ~36%.

CONCLUSIONS: In this 12-week, iterative, web-based program, we found older adults experienced improvement not only in measures used in clinical contexts, such as the 30-second Chair Stand and Timed Up and Go, but also contextualized gains by providing deeper phenotypical measurement related to posture, strength, and balance. Further, many of the physical improvements were attenuated by baseline fall risk level, with those with the highest level of risk having the greater gains, and, thus, the most benefit from such interventions.

PMID:40009847 | DOI:10.2196/68957

J Med Internet Res. 2025 Feb 26;27:e57730. doi: 10.2196/57730.

ABSTRACT

BACKGROUND: In this era of digitalization, eHealth interventions are used to engage patients in health care and help them manage their health. Previous studies showed that this can be particularly interesting for chronic disease self-management and self-care in older adults. Despite older adults becoming increasingly active on the internet, they continue to struggle in using eHealth information due to inadequate eHealth literacy. Thus, assessing and monitoring eHealth literacy is critical to support eHealth interventions.

OBJECTIVE: This study aimed to describe the translation, adaptation, and validation process of the eHealth Literacy Scale (eHEALS) in Portuguese older adults.

METHODS: The cross-cultural adaption followed the steps of forward and blinded backward translations, evaluation of the translations by a committee of judges, pilot-testing, and full psychometric testing. We tested the psychometric properties of the eHEALS by carrying out two studies: general psychometric analysis (study 1) and confirmatory factor analysis (study 2). Study 1 included 80 older adults conveniently selected from a Health Family Unit. Data were collected by in-person questionnaires between May and July 2022. Study 2 included 301 older adults randomly selected from two distinct Health Family Units. Data were collected by in-person questionnaires between May and July 2023.

RESULTS: We tested stability, reliability, construct validity (exploratory and confirmatory factor analyses and known groups), and model fit. Study 1 had 58.8% (47/80) male and 41.3% (33/80) female respondents (mean age 71.20, SD 5.26 years). Study 2 had 56.5% (170/301) male and 43.5% (131/301) female respondents (mean age 71.77, SD 5.15 years). Moderate and strong correlations were identified in the scale items (study 1: 0.42≤r≤0.91 and study 2: 0.81≤r≤0.96; P<.001). The scale showed good internal consistency for study 1 (α=.92) and study 2 (α=.98), with high correlations between items. The exploratory factor analysis yielded a single-factor structure, explaining 58.3% of the variance in study 1 and 86.4% in study 2. In the confirmatory analysis (study 2), the model fit was mixed (χ²₂₀=265, P<.001; comparative fit index=0.94; Tucker-Lewis Index=0.91; root mean square error of approximation=0.20). Thus, we compared 1-, 2-, and 3-factor structures, deciding on the unidimensional one. In study 1, the eHEALS-PT24 (Portuguese version of the eHealth Literacy Scale for older adults) mean score was 27.25 (SD 5.61), with 43.8% (35/80) and 11.3% (9/80) of participants showing low and high eHealth literacy levels, respectively. In study 2, the eHEALS-PT24 mean score was 23.31 (SD 9.53), with 38.2% (115/301) and 23.6% (71/301) of participants showing low and high eHealth literacy levels, respectively. The known-groups analysis showed statistically significant differences between eHealth literacy and demographic variables (P<.001).

CONCLUSIONS: The findings suggest that the eHEALS-PT24 is a reliable and valid tool to assess eHealth literacy in Portuguese older adults. Therefore, this instrument can be integrated to support the implementation process of eHealth interventions.

PMID:40009846 | DOI:10.2196/57730

JMIR Res Protoc. 2025 Feb 26;14:e51502. doi: 10.2196/51502.

ABSTRACT

BACKGROUND: Optimal anticoagulation using vitamin K antagonists prevents strokes associated with atrial fibrillation and heart valve replacements. Preparedness for self-monitoring and self-management could improve outcomes, but this remains a challenge.

OBJECTIVE: This study aimed to outline the methodology for developing and validating the PERSONAE scale, a self-report measure designed to assess the preparedness for self-monitoring and self-management of oral anticoagulation in adult patients.

METHODS: This study comprises 2 main phases, and it adheres to the “COnsensus-based Standards for the selection of health Measurement INstruments” (COSMIN) guidelines for instrument development. The first phase involved the conceptualization of the PERSONAE scale, where a comprehensive literature review and a consensus meeting among experts were conducted to draft the initial items. Face and content validity were then established through an expert panel review. In the second phase (ongoing), a detailed sampling methodology will be used, targeting adult Italian patients on long-term oral anticoagulation. According to a performed simulation-based power analysis, the study aims to recruit a sample size of approximately 500 participants by using a combination of convenience and snowball sampling. Data collection will be facilitated through web-based surveys distributed through social media and patient networks, ensuring a wide and representative sample. Analytical procedures will include Mokken scaling analysis for item selection and confirmatory factor analysis to validate the scale’s structure. In addition, internal consistency will be assessed using Molenaar Sijtsma statistics.

RESULTS: The scale’s content derived from phase 1 (process completed in December 2023) is grounded in a comprehensive literature review and based on the assessments of a panel of 12 health care expert professionals. The PERSONAE scale derived from phase 1 encompasses 20 items reflecting essential behaviors needed to assess the preparedness for self-monitoring and self-management of oral anticoagulation. Each item obtained a content validity ratio higher than 0.67, which is the critical content validity ratio indicating the minimum level of agreement among the experts for an item to be considered essential beyond the level of chance at a significance level of .05 for a 1-tailed test. From January 2024 to May 2024, we conducted the initial round of data collection and use Mokken scaling analysis to select items. A second round of data collection for confirmatory factor analysis was scheduled from June 2024 to September 2024, which will validate the scale’s unidimensional structure. We expect to achieve robust psychometric properties, including high internal consistency and validated constructs.

CONCLUSIONS: The PERSONAE scale will be a valuable tool to assess patients’ preparedness for self-monitoring and self-management of oral anticoagulation. The study’s insights into technology-assisted learning preferences will inform the design of future educational interventions to enhance preparedness in adult patients.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05973240; https://clinicaltrials.gov/study/NCT05973240.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51502.

PMID:40009845 | DOI:10.2196/51502