Category: Nevin Manimala

Int J Radiat Biol. 2026 Jan 12:1-14. doi: 10.1080/09553002.2025.2606998. Online ahead of print.

ABSTRACT

BACKGROUND: When the same energy is delivered to a cellular target, DNA damage and the resulting cellular response may vary depending on the density and distribution pattern of the energy delivered to the critical volume of each cell. DNA damage can be quantitated based on the pattern of dose distribution over the sub-micrometer volumes in nucleus. DNA double-strand breaks (DSBs) are considered the most critical events for cellular effects. Local effect model (LEM), DNA damage model (DDM), and Giant LOop Binary LEsion (GLOBLE) model have been used to predict cell survival under radiation exposure.

PURPOSE: This study aims to implement computational modeling for prediction of cell survival under radiation exposure, by quantitating radiation events on cellular targets, such as local energy deposition and DSB production, in a unified frame. The conceptual bases of LEM, DDM, and GLOBLE model were adopted to derive parameters for radiation events.

METHODS: The physics models of Geant4-DNA were used to simulate the interactions of X-rays and alpha particles with bio-matter. Cell nucleus was modeled to be a collection of ${(540\text{nm})}^3$ sub-volumes. Statistical variation of energy deposition to individual sub-volumes was analyzed to count DSB production and DSB multiplicity. Cell surviving fractions (SFs) were calculated by LEM based on the distribution of local doses to sub-volumes and by DDM and GLOBLE model based on the DSB production and their potential interactions in sub-volumes. Model parameters were derived by fitting the models to experimental data for rat diencephalon (RD) cells and rat gliosarcoma (RG) cells.

RESULTS AND CONCLUSIONS: The overkill effect was reflected in the models based on LEM and DDM by employing threshold local dose and threshold number of DSBs in sub-volumes, respectively. Results suggest that the number of sub-volumes impacted with DSBs rather than the DSB multiplicity within individual sub-volumes would be better parameter to predict cell killing effect, which complies with the GLOBLE model.

PMID:41525142 | DOI:10.1080/09553002.2025.2606998

Clin Ter. 2026 Jan-Feb;177(1):146-152. doi: 10.7417/CT.2026.1986.

ABSTRACT

AIMS: Acute abdomen is a common indication to surgery in paediatric emergency departments. Appendicitis is the most frequent diagnosis, followed by bowel obstruction and female genital conditions. Some rare aetiologies may lead to challenges in surgical management. Aim of this study is to analyse the distribution of rare causes of acute abdomen in patients undergoing emergency surgery in the past five years at our centre.

METHODS: Records of patients undergone urgent abdominal surgery were retrospectively reviewed from 2015 to 2019. Information relative to age, sex, underlying pathology, and surgery was recorded. The inclusion criteria were age <18 years and undergoing abdominal surgery. Neonates were excluded.

RESULTS: The study population consisted of 957 patients. Median age was 9.7 years. Surgical procedure was laparoscopic in 22%, open in 78%. Common diagnoses were appendicitis in 815 patients, bowel obstruction in 72, adnexal and gynaecological pathology in 43, trauma in 9, complicated Meckel’s diverticulum in 8. Rare findings included omental pathology (2), endometriosis (2), ectopic pregnancy (1), intestinal duplication (1), internal hernia (1), Amyand’s hernia (1), epiploic appendix torsion (1), accessory spleen torsion (1).

CONCLUSIONS: The aetiologies of acute abdomen in children vary depending on the age. Appendicitis is the most common surgical cause of acute abdomen, followed by other causes. Differential diagnosis, including rare pathologies, is required to predict the right surgical approach and to apply the proper treatment. Imaging techniques sometimes still result too invasive or insufficient, whereas the widespread use of laparoscopy may render surgical exploration acceptable in selected cases.

PMID:41525125 | DOI:10.7417/CT.2026.1986

Clin Ter. 2026 Jan-Feb;177(1):130-138. doi: 10.7417/CT.2026.1984.

ABSTRACT

BACKGROUND: Osteoarthritis (OA) is a pathological condition widely prevalent throughout the world. The inability to perform some physical functions was the main symptom of OA and it impacted the quality of life (QOL) of patients. Therefore, TKR surgery was necessary to improve their QOL. However, to our knowledge, no study addressed the assessment of physical health and improvement in QOL before and after TKA in Saudi Arabia.

OBJECTIVE: To assess the QOL of patients before and after TKA.

METHODS: A cross-sectional study included 139 TKR patients with a mean age of 63.8±6.2 years. Data on sociodemographic characteristics, date of TKR surgery, and body mass index (BMI) were recorded. QOL was assessed (before TKR surgery and from 6 months to 3 years after surgery). The WOMAC, SF-12, and SF-36 physical health and QOL assessment scale questionnaires were sent to the participants and the results were obtained. Data and relationships were analyzed with SPSS, t-test, and ANOVA.

RESULTS: The mean WOMAC and SF-12 total scores after TKR surgery showed significant improvement compared to before surgery (14.3±5.7 vs. 61±6.1, p=0.001) and (56±4.8 vs. 38.5±7.4, p= 0.02) respectively. There was statistical significance for mean gender, educational level, date of surgery, and BMI with QOL scales.

CONCLUSIONS: Our results suggest that patients who had undergone TKR surgery at least six months prior reported improvements in physical health status and QOL according to the study scales WOMAC, SF-12, and SF-36, which are considered the most appropriate scales to evaluate the QOL of TKR patients.

PMID:41525123 | DOI:10.7417/CT.2026.1984

Clin Ter. 2026 Jan-Feb;177(1):123-129. doi: 10.7417/CT.2026.1983.

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder with both reproductive and metabolic manifestations. Subclinical hypothyroidism (SCH), is defined by elevated thyroid-stimulating hormone (TSH) with normal free thyroxine levels, is increasingly recognized in women with PCOS, yet its clinical impact remains debated. This study intended to explore the prevalence of SCH in PCOS and examine its influence on metabolic, hormonal, and anthropometric profiles in an Indian population.

METHODS: A cross-sectional study was conducted between January 2023 and January 2025 at a tertiary care center in South India. A total of 368 women with PCOS, diagnosed according to Rotterdam criteria, were enrolled and classified as either euthyroid (n = 316) or having SCH (n = 52). Comprehensive evaluations included anthropometry, blood pressure, glycemic indices, lipid profile, insulin resistance via HOMA-IR, and reproductive hormone levels. Statistical analyses included t-tests and Spearman correlation.

RESULTS: The prevalence of SCH among women (with PCOS) was 14.13%. Compared with the euthyroid group, SCH-PCOS patients exhibited significantly higher BMI, fasting blood glucose, HbA1c, serum insulin, HOMA-IR, and adverse lipid profiles (p < 0.05). No significant diffe-rences were observed in LH, FSH, or testosterone levels. TSH demonstrated positive correlations with BMI, Glycemic markers, and HOMA-IR, underscoring its association with metabolic risk.

CONCLUSION: SCH is a common and metabolically relevant comorbidity in women with PCOS, aggravating insulin resistance and dyslipi-demia without significantly affecting reproductive hormones. These findings highlight the need for routine thyroid function screening in PCOS management, especially among those with metabolic syndrome features. Further longitudinal studies are warranted to evaluate the benefits of targeted thyroid intervention in this subgroup.

PMID:41525122 | DOI:10.7417/CT.2026.1983

Clin Ter. 2026 Jan-Feb;177(1):100-103. doi: 10.7417/CT.2026.1980.

ABSTRACT

BACKGROUND: Hypertension is a major risk factor for cardiovascular disease. Despite pharmacologic interventions, a substantial proportion of patients exhibit poor blood pressure (BP) control. High sodium intake is a modifiable contributor to uncontrolled hypertension. This study eva-luates 24-hour urinary sodium excretion as an objective biomarker for sodium intake in controlled versus uncontrolled hypertensive patients.

OBJECTIVES: To compare 24-hour urinary sodium excretion between hypertensive patients with controlled and uncontrolled BP, and to assess its association with treatment response.

METHODS: This cross-sectional study was conducted at VMKV Medical College and Hospital, Salem, over 15 months. A total of 100 hypertensive patients aged 45-65 years were recruited and grouped into controlled (n=50) and uncontrolled (n=50) based on JNC VIII BP criteria. Data on demographics, clinical history, and 24-hour urine collections were analyzed. Sodium, potassium, and albumin levels were measured. Independent t-tests and Chi-square tests were used for statistical comparisons.

RESULTS: Mean 24-hour urinary sodium was significantly higher in the uncontrolled group (174.5 ± 32.1 mmol/day) compared to the controlled group (142.7 ± 28.3 mmol/day; p < 0.001). No significant differences were noted in urinary potassium levels (p = 0.42) or microalbuminuria prevalence (p = 0.31) between the groups.

CONCLUSION: Higher urinary sodium excretion is significantly associated with poor BP control, underscoring the importance of dietary sodium reduction even in patients under antihypertensive therapy. 24-hour urine sodium measurement can serve as a reliable biomarker in clinical management.

PMID:41525119 | DOI:10.7417/CT.2026.1980

Clin Ter. 2026 Jan-Feb;177(1):93-99. doi: 10.7417/CT.2026.1979.

ABSTRACT

INTRODUCTION: Women are vulnerable to depression, with evidence of MAO-A and HTTP gene variations’ impact. We studied depression in women at a UAE hospital to analyze hormonal changes, psychological symptoms severity, and gene variations related to MAO and HTTP promoter region polymorphism.

METHODS: This prospective analytical study included 100 participants (50 depressed, 50 non-depressed women aged 18-60 years). Women with thyroid diseases, abnormal mammograms, organic causes, cardiovascular diseases, or atherosclerotic conditions were excluded. Depression severity was assessed using Beck Depression Inventory. Cortisol, serotonin, and leptin levels were measured using ELISA kits. Saliva samples were collected for DNA polymorphism detection using PCR and gel electrophoresis. Statistical analysis used SPSS software.

RESULTS: Participants showed simple depression (20%), moderate (13%), severe (10%), and very severe (7%). HTTP cases were L/L (41%), L/S (39%), and S/S (20%). MSP distributions were SA/SG (32%), SA/SA (29%), LA/SA (25%), and SA/LG(14%); MAO were 3/4 (57%), 3/3 (32%), and 4/4 (11%).

CONCLUSION: This UAE study demonstrates hormones and gene variations’ influence. HTTP genotyping revealed three groups: S/S, S/L, and L/L alleles. MAO variants were 3/4, 3/3 and 4/4. Genetic factors can guide treatment planning for severe depression.

PMID:41525118 | DOI:10.7417/CT.2026.1979

Clin Ter. 2026 Jan-Feb;177(1):74-82. doi: 10.7417/CT.2026.1977.

ABSTRACT

BACKGROUND: Dynamic contrast enhancement-magnetic resonance imaging (DCE-MRI) is becoming increasingly significant for identifying and characterizing breast lesions. It can also provide insight into functional parameters, such as enhancement kinetics and tissue perfusion parameters, including Ktrans, Ve, and Kep.

AIM: This study explores the role of both qualitative and quantitative analyses of DCE-MRI in enhancing diagnostic accuracy for distin-guishing between benign and malignant breast lesions, contributing to more precise breast cancer diagnosis and management.

MATERIALS AND METHODS: This single-center cross-sectional study was performed on 47 patients with breast lesions. MRI Breast was performed on a closed 3T MRI scanner equipped with a dedicated 18-channel breast coil. MRI study protocol included conventional Breast MRI and DCE sequences. Statistical analysis was performed using the SPSS statistics software package version 28.0.

RESULTS: A total of 47 patients, with an age range of 17 to 70 years old, were included in the study. The sensitivity of kinetic curve analysis was 94.74 %, specificity of 75%, positive predictive value of 72 %, and negative predictive value of 95.45 % to distinguish benign and mali-gnant breast lesions. The mean Ktrans value of benign breast lesions was 0.447+1.55/min and 0.496+1.08 / min (p-value <0.04) for malignant lesions. The mean Kep value of benign breast lesions was 2.984+8.27/ min, and for malignant lesions was 3.424+8.70/ min (p-value <0.008). The mean Ve value did not show a significant value in distinguishing benign and malignant breast lesions (p-value <0.386). Kep cut-off value at 0.279 and Ktrans cut-off value at 0.73 depicted the highest area under the curve (AUC).

CONCLUSIONS: Integrating qualitative and quantitative data provides a more comprehensive understanding of breast lesions, ultimately leading to more accurate diagnoses and tailored treatment strategies.

PMID:41525116 | DOI:10.7417/CT.2026.1977

Clin Ter. 2026 Jan-Feb;177(1):45-54. doi: 10.7417/CT.2026.1974.

ABSTRACT

OBJECTIVE: To evaluate the osteogenic potential of dental pulp mesenchymal stem cells in extraction sockets of mandibular third molars by objective assessment of bone density and resorption.

MATERIALS AND METHODS: This human study, a randomized clinical trial included twenty bilaterally symmetrical impacted third molars on each side of the lower jaw. The cohorts were divided in to two groups. Group A in which stem cells extracted from the pulp chamber were placed in the extraction socket. The stem cells were wrapped with a collagen membrane in a ependorph tube and roiled on a dental vibrator. In Group B, the extraction socket was closed without the placement of stem cells. CBCT was performed on the day of the surgery and 6 months post-surgery. CBCT data was analyzed by 2 radiologists individualistically, determining bone density and bone resorption post extraction and 6 months thereafter.

RESULTS: The response variable were bone density and bone resorption. Bone density variable BDD for Group A by radiologist 1 and radiologist 2 was 136 and 136.50(Median Inter quartile range) with p value (0.0001) and for Group B by radiologist 1 and 2 was 47.0 and 52.0(Median Interquartile range) with p value (0.0001). Bone resorption variable (BRV) for Group A by radiologist 1 and radiologist 2 was -0.885 and -0.845(Median IQR) with p value (0.001) and for Group B it was -0.325 and -0.330(Median IQR) with p value (0.001). With a p value less than 0.05 our results were statistically significant.

CONCLUSION: The results of our study suggest an increase in bone density and reduced bone resorption in the extraction sockets that were infused with dental pulp stem cells before closure, as opposed to the controls.

PMID:41525113 | DOI:10.7417/CT.2026.1974

Clin Ter. 2026 Jan-Feb;177(1):38-44. doi: 10.7417/CT.2026.1973.

ABSTRACT

BACKGROUND: Upper gastrointestinal endoscopy (UGIE) is a widely used procedure for the diagnosis and treatment of upper gastrointestinal diseases. The use of lidocaine as a topical pharyngeal anesthetic has been shown to facilitate endoscopy intubation and reduce pharyngeal mucosa injury. Lidocaine gel and spray are two common forms of topical pharyngeal anesthesia used to reduce discomfort and pain during these procedures.

METHODS: In This prospective, randomized, single-blinded clinical trial, 180 patients eligible for UGIE were randomly allocated into 2 groups. The first Group S (Lidocaine Spray) received 6 puffs of 10% lidocaine spray each puff delivering 10mg of lidocaine, sprayed to the pharynx distributed as 2 puffs in left, right and middle portion after tongue depression in 2 consecutive 30-second intervals. After each spray, patients were asked to swallow to maximize the anesthetic effect on the hypopharynx. The second Group G (Lidocaine Gel) received 10g of 2% lidocaine gel (gently applied 3-5 minutes before the endoscopy at three consecutive 30-second intervals on the palate and peritonsillar areas. Patients were informed to spread the gel within their mouth by the tongue and then swallow it to cover the oropharynx and esophagus. Outcome parameters included incidence of gag reflex as a primary outcome with the ease of esophageal entrance during endoscopy were com-pared. onset of numbness, Total propofol consumption, recovery time, Endoscopist and Patient Satisfaction and complications as a secondary outcome during UGIE.

RESULTS: Comparison between the groups studied regarding the outcome parameters. The Lidocaine gel groups achieved better performance and better scores in reducing gag reflex (6.67%) compared to (21.11%) Spray group, and ease of 1st attempt esophageal intubation is statisti-cally significant better (96.67%) compared to (85.56%) in spray group as well as reducing total patient number of propofol needs 8/90 (8.89%) compared to 23/90 (25.56%) in Spray group as well as increase patient and endoscopist satisfaction.

CONCLUSION: Lidocaine Gel is considered safe, suitable and effective option and exhibiting better performance in reducing the incidence of gag reflex, with the ease of esophageal entrance shortening recovery time and improving patient and endoscopist satisfaction. Decrease total propofol consumption in patients undergoing UGIE compared to lidocaine spray.

PMID:41525112 | DOI:10.7417/CT.2026.1973

Clin Ter. 2025 Jan-Feb;177(1):23-30. doi: 10.7417/CT.2026.1971.

ABSTRACT

PURPOSE: This study examines how demographic factors such as parental age, education, occupation, intervention training, family income, and psychotropic drug use impact Autism Spectrum Disorder (ASD) intervention outcomes in southern Vietnam. Identifying significant demographic influences can help clinicians personalize treatment plans, potentially improving the effectiveness of interventions for ASD.

APPROACH: Sixty-three children with ASD were analyzed using DSM-5 criteria. Intervention outcomes were measured through the Childhood Autism Rating Scale (CARS), Autism Treatment Evaluation Checklist (ATEC), Vineland Adaptive Behavior Scales-II (VABS-II), and Communication Matrix (CM). Statistical analyses used the General Linear Model to assess associations between demographic factors and intervention effectiveness.

FINDINGS: Results show that specific factors, particularly paternal age, occupation, family income, and psychotropic drug usage, correlate significantly with certain intervention outcomes. Notably, psychotropic drugs positively affected communication, while other variables like paternal age and income impacted adaptive behaviors.

ORIGINALITY/VALUE: This study emphasizes the value of demographic-informed, tailored intervention approaches for ASD. These findings highlight how specific demographic factors can serve as predictors of treatment response, providing insights for developing more personalized ASD intervention strategies.

PMID:41525110 | DOI:10.7417/CT.2026.1971