Category: Nevin Manimala

BMC Pregnancy Childbirth. 2025 May 3;25(1):526. doi: 10.1186/s12884-025-07613-0.

ABSTRACT

BACKGROUND: It is ambiguous whether the multiple COS with supraphysiologic hormonal doses impact ovarian reserve functions or pregnancy outcomes. The aim is to explore the effect of multiple COS during ART on ovarian reserve function and clinical pregnancy outcomes in infertile women.

METHODS: The retrospective study included 45,555 IVF/ICSI fresh cycles enrolled between January 2015 and March 2021 and were segregated into 5 different cycle cohorts. The participants were retrospectively grouped according to the number of repeated cycles. The primary observables symbolizing ovarian reserve function were antral follicle count (AFC) and anti-Müllerian hormone (AMH). We analyzed clinical pregnancy rate (CPR), live birth rates (LBR), and early miscarriage rate (EMR) to explore clinical pregnancy outcomes.

RESULTS: Among populations with different numbers of COS cycles, regression analyses found that the number of COS cycles had no significant impact on pregnancy outcomes (p > 0.05) after adjusting for confounding factors. However, factors such as age, BMI, and embryo transfer parameters showed significant associations with pregnancy outcomes. Intra-group analysis within same population revealed that, basal FSH, basal LH, AMH, and AFC exhibit no significant distinction (P > 0.05). Cycle 2 in Group B (aOR = 8.29; 95% CI, 6.80-10.12; P = 0.000), Cycle 3 in Group C (aOR = 6.05; 95% CI, 3.28-11.15; P = 0.000) and Cycle 4 in Group D (aOR = 20.46; 95% CI, 3.05-137.24; P = 0.002) had the highest CPR within each group; Cycle 2 in Group B and Cycle 3 in Group C had the highest LBR and lowest EMR within each group, and the differences did not reached statistical significance in the remaining groups.

CONCLUSION(S): The number of COS cycles did not significantly adversely affect pregnancy outcomes across different populations. In self-controlled comparisons within the same population, repeated COS (≤ 5 cycles) may not impair ovarian reserve function, while repeated COS (≤ 4 cycles) positively influenced clinical pregnancy outcomes, suggesting a potential cumulative effect.

PMID:40319269 | DOI:10.1186/s12884-025-07613-0

BMC Neurol. 2025 May 3;25(1):194. doi: 10.1186/s12883-025-04209-1.

ABSTRACT

BACKGROUND: Seeking medical attention promptly after an acute stroke is essential for effective treatment and improved patient outcomes. However, delayed medical intervention after acute stroke contributes to increased mortality and morbidity. This study explored factors that contribute to the delayed appearance of stroke patients at the emergency department.

METHODS: A prospective cross-sectional study was conducted for 9 months at a referral hospital in Addis Ababa. Data was collected using questionnaires administered to stroke patients or their caregivers upon their arrival at the emergency department. Electronic medical records were further reviewed, and the treating physicians described the subsequent management of the patient after their arrival at the emergency department. Data was analyzed using descriptive and analytic parameters.

RESULTS: Only 33.3% (n = 30) arrived at the emergency department within 4.5 h. Hemorrhagic stroke was a statistically significant predictor of early presentation to the emergency department (OR = 3.182; 95% CI (1.258-8.046); p = 0.036). The absence of any substance was another marginally significant predictor for early appearance (OR = 2.555; 95% (0.936-6.970); p = 0.067). One of the marginally significant predictors for late presentation was low drug adherence (OR = 0.224; 95% CI (0.48-1.044); p = 0.057). The other factors attributed to the time of arrival, though not statistically significant, were level of education, perception of stroke as a serious illness, and prior number of health visits before arrival to the emergency department.

CONCLUSION: The study found that many of the factors that cause delays in getting to the hospital can be changed, except for the type of stroke. Time spent in the hospital could also be positively impacted by the intervention from the appropriate authorities.

PMID:40319255 | DOI:10.1186/s12883-025-04209-1

BMC Public Health. 2025 May 3;25(1):1644. doi: 10.1186/s12889-025-22841-x.

ABSTRACT

BACKGROUND: Despite global efforts to mitigate COVID-19 infection through vaccination and therapeutic interventions, morbidity and mortality rates continued at variable rates. Although mortality risk and clinical features of COVID-19 are well-documented, recovery patterns and prognostic factors post-admission remain inconclusive, particularly in resource-limited settings like Ethiopia. This systematic review and meta-analysis (SRM) aimed to estimate the pooled incidence rate of recovery and predictors among hospitalized COVID-19 patients in Ethiopia.

METHODS: We searched (N = 1,191) articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline from PubMed/MEDLINE (N = 755), Scopus (N = 137), Web of Science (N = 84), Science Direct (N = 148), Cochran (N = 25), and Google Scholar searching (N = 42) from December 2019 to February 2024. The data were extracted using a Microsoft Excel spreadsheet and exported to Stata TM version 17.0 for further analysis. The Article quality was assessed using the Joanna Briggs Institute checklist. The pooled incidence rate of recovery was estimated using a weighted inverse variance random-effects meta-regression. Heterogeneity among studies was evaluated using the I² statistic. Subgroup analyses and sensitivity tests were also conducted to explore publication bias. This file is registered in international Prospero with ID (CRD42024518569).

RESULT: Sixteen (N = 16) published studies with 7,676 hospitalized COVID-19 patients were included in the final report. The mean age of participants ranged from 29 (± 17) to 57.5 (± 3) years, with male patients constituting the largest proportion of participants, 4,491(58.5%). During recovery screening, 6,304(82.21%) cases were discharged as improved, 159 (2.1%) attriters, and 818 (10.6%) died during inpatient treatment. The pooled incidence of recovery, mortality, and attrition rates were found to be 82.32% (95% CI: 78.81-85.83; I² = 94.8%), 14.3% (I² = 98.45%), and 2.7% (I² = 81.34%), respectively. Incidence of recovery rate varied across regions and epidemic phases, with the highest rate observed in Addis Ababa (89.94%, I² = 78.33%) and the lowest reported in the Tigray region (59.7%, I² = 0.0%). Across epidemic phases, the recovery rate was 88.05% (I² = 29.56%) in Phase II, 84.09% (I² = 97.57%) in Phase I, and 78.92% (I² = 96.9%) in Phase III, respectively. Factors included being aged 15-30 years (pooled OR = 2.01), male sex (pooled OR = 1.46), no dyspnea (pooled OR = 2.4; I² = 79%), and no baseline comorbidities (pooled OR = 1.15; I² = 89.3%) were predictors for recovery. CONCLUSION AND RECOMMENDATION: In Ethiopia, more than eight out of ten hospitalized COVID-19 patients recovered after inpatient treatment. However, the incidence of recovery rates varied significantly across epidemic phases, study settings, and regions. Factors including younger age, male sex, no dyspnea (shortness of breathing), and no underlying comorbidity heightened recovery. It is highly recommended those inpatients cares should focus on high-risk groups (older adults) and implement standardized treatment protocols in each study setting. Regions with lower recovery rates need aid in logistical support and training for healthcare providers.

PMID:40319254 | DOI:10.1186/s12889-025-22841-x

BMC Geriatr. 2025 May 3;25(1):307. doi: 10.1186/s12877-025-05978-7.

ABSTRACT

BACKGROUND: Oxidative damage is the principal cellular disturbance in the skin aging. Missense polymorphisms strengthen or weaken detoxification enzyme activity. Determination of deleterious functional effects of polymorphisms in detoxification genes (NQO1 and EPHX1) in skin aging was the overall purpose of conducting this hospital-based research.

METHODS: Cases recruitment on dermatological examination-based evidence performed sequentially between November 2022, and April 2023 at the Motahari Hospital Dermatology Outpatient Clinic. Genotype analysis was performed using PCR-RFLP and T-ARMS -PCR. All statistical analyses were performed using SPSS software, and differences were taken as significant at P < 0.05.

RESULTS: This study results implicate that skin aging obtains on a genetic level and in particular the results suggest that His139Arg, Tyr113His and P187S represent true genetic susceptible loci for cutaneous aging related traits. We found that these new susceptibility loci exhibit sex- and age-specific effect on aging skin risk as well as implicated in interactions with modifiable risk factors including water intake, micronutrient care, sleeping habits, sun exposure and application of sunscreen cream, in the development of an increased risk of aging skin.

CONCLUSIONS: Molecular defects associated with the His139Arg, Tyr113His and P187S polymorphisms manifest as an observable change in the external appearance of the skin. This study underscores the need to move toward scrutinizing the ageing skin changes at molecular levels.

PMID:40319243 | DOI:10.1186/s12877-025-05978-7

BMC Gastroenterol. 2025 May 3;25(1):333. doi: 10.1186/s12876-025-03801-6.

ABSTRACT

OBJECTIVES: This study aimed to investigate the factors affecting effect of extracorporeal shock wave lithotripsy (ESWL) for pancreatic duct stones.

MATERIALS AND METHODS: The data of 160 patients who underwent ESWL for pancreatic duct stones in Department of Gastroenterology, First People’s Hospital of Hangzhou, Westlake University School of Medicine, from July 2017 to June 2023, were retrospectively analyzed. The age and sex of the patients were recorded. All patients underwent spiral computed tomography (CT) abdominal plain scan. The placement of the pancreatic duct stent was recorded. The maximum CT value of stones was manually measured. The regions of interest (ROI) was delineated using ITK-SNAP software, and the stone volume was recorded. According to the size of residual stones after lithotripsy, 99 patients were included in the complete lithotripsy group (CL Group) and 61 patients in the incomplete lithotripsy group (ICL Group). SPSS 26.0 software was used for processing and analysis. A P value < 0.05 was considered statistically significant.

RESULTS: The Sex, maximum CT value, and volume of pancreatic duct stones were statistically significant in both groups. Binary logistic regression analysis showed that female sex, maximum CT value, and volume of pancreatic duct stones were independent risk factors affecting incomplete ESWL fragmentation in pancreatic duct stones. ICL group had a higher mean number of treatments and mean number of impacts than CL group.

CONCLUSION: The Sex, maximum CT value, and volume of stones were related to the therapeutic effect of ESWL. Female sex, maximum CT value, and volume of stones were independent risk factors affecting incomplete stone fragmentation.

PMID:40319240 | DOI:10.1186/s12876-025-03801-6

BMC Pregnancy Childbirth. 2025 May 3;25(1):530. doi: 10.1186/s12884-025-07621-0.

ABSTRACT

BACKGROUND: While zygotes lacking pronuclei (0PN) or exhibiting a single pronucleus (1PN) may theoretically yield diploid embryos with developmental potential, current clinical protocols predominantly exclude these embryos from use. In the population undergoing preimplantation genetic testing for structural rearrangements (PGT-SR), there is a high rate of chromosomal aneuploidy abnormalities and needs a large number of embryos to obtain euploid embryos, so we will explore whether 0PN and 1PN embryos can be an option for them.

METHODS: This retrospective analysis examined pronuclear development in 4,868 zygotes derived from 4,902 injected metaphase II (MII) oocytes across 422 assisted reproductive cycles. In a subset of 54 cycles (12.8%), preimplantation genetic testing for structural rearrangements (PGT-SR) was implemented for blastocysts originating from 0PN and 1PN embryos that progressed to Day 5/6 development stage prior to vitrification. Comprehensive genomic haplotyping was performed on 343 embryos within this subgroup, including 33 0PN-derived, 36 1PN-derived, and 274 conventional 2PN-derived specimens. The investigation’s primary endpoint focused on neonatal survival outcomes, while secondary assessments evaluated both embryo transfer suitability and chromosomal normality rates.

RESULTS: Compared to 2PN embryos, the proportion of 0PN and 1PN embryos developing into blastocysts is significantly lower (5.41%, 21.56% vs. 56.51%, p-value < 0.001); the euploid rate of 0PN blastocysts is not statistically different from that of 2PN blastocysts (18.18% vs. 33.21%, p-value = 0.111), but significantly lower for 1PN blastocysts (11.11% vs. 33.21%, p-value = 0.004). In 54 cycles involving 0PN and 1PN blastocysts, the inclusion of 0PN and 1PN embryos resulted in an increase in the number of frozen embryos (5.81 ± 3.55 vs. 7.09 ± 3.52, p-value = 0.063), transferable embryos (1.59 ± 1.25 vs. 1.78 ± 1.30, p-value = 0.452), embryos transferred (0.98 ± 0.76 vs. 1.07 ± 0.75, p-value = 0.526), and patients undergoing transfer (74.07% vs. 79.63%, p-value = 0.494), although these changes were not statistically significant. The five 0PN and 1PN embryos transferred resulted in three live births, which was not a significant increase (56.36% vs. 56.67%, p-value = 0.974).

CONCLUSION: Chromosome abnormalities did not increase the occurrence of abnormal fertilization. There were already a large number of embryos in the PGT-SR population, and routine inclusion of 0PN and 1PN embryos in the PGT-SR cycle is not recommended in this study. Priority should be given to the transfer of 2PN embryos. If a couple receives fewer than three 2PN embryos, or no 2PN embryos at all, it may be considered to include 0PN and 1PN embryos, with preference given to the use of 0PN. Furthermore, genome-wide ploidy and haplotyping are recommended for detection, and aneuploid and ploidy abnormalities are excluded.

PMID:40319238 | DOI:10.1186/s12884-025-07621-0

BMC Pulm Med. 2025 May 3;25(1):213. doi: 10.1186/s12890-025-03684-z.

ABSTRACT

BACKGROUND: As a cardiovascular health (CVH) assessment tool, Life’s Crucial 9 (LC9) is often associated with diverse chronic health indicators. However, no study has yet explored the association of LC9 with multifactorial components of lung health. Thus, this study aimed to investigate the correlation of LC9 with lung health.

METHODS: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES), which covers individuals aged 40 years and older with complete LC9 and lung health data. Multiple regression was employed in linear relationships investigation, while Restricted Cubic Spline (RCS) was used to explore nonlinear relationships. Subgroup analyses and interaction tests demonstrated the stability of associations. Combining LC9 to build a Light Gradient Boosting Machine (LightGBM) machine learning (ML) model to predict lung health, Shapley Additive Explanations (SHAP) sorted the contribution of LC9 components to the model.

RESULTS: From a total of 10,461 study participants, 1725 had low CVH, 7476 had moderate CVH, and 1260 had high CVH. There was a strong positive correlation between LC9 score and lung health. This association remained consistent across subcomponent strata. RCS analysis revealed non-linear associations between LC9 and respiratory outcomes, including cough, asthma, and COPD. The LightGBM model incorporating LC9 demonstrated excellent predictive performance for lung health, with favorable metrics in Area Under the Curve (AUC), accuracy, and specificity. SHAP analysis identified depression, nicotine exposure, and BMI scores as the predominant contributors among LC9 components to the model’s predictive capability.

CONCLUSION: Individuals with better CVH as assessed by LC9 tended to have better lung health. The combination of the LightGBM model could achieve better prediction results.

PMID:40319236 | DOI:10.1186/s12890-025-03684-z

J Agromedicine. 2025 May 3:1-12. doi: 10.1080/1059924X.2025.2498342. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study was to 1) explore perceptions of air quality (AQ) monitoring, hazard communication, health impacts of smoke exposure, protective controls and training needs among agricultural supervisors in alignment with the major elements of the wildfire smoke rule, and 2) compare survey responses by the language in which the survey was completed to identify training needs by group.

METHODS: Bilingual personnel administered a 29-question survey in Spanish and English to agricultural supervisors and crew chiefs at two industry trainings in Washington (WA) State (12/2023, 1/2024). Data were analyzed in SPSS. Descriptive statistics were used to summarize the data with chi-squared tests for group comparisons by language.

RESULTS: A total of 116 surveys were collected, with 61% completed in Spanish. Almost one-fifth (18%) of respondents reported “hypertension/cardiovascular disease” as a condition that impacts their own health, and 19% reported “asthma/respiratory disease.” Of respondents, 80% agreed they have been exposed to wildfire smoke at work, and 77% reported they supervised workers who have been exposed to smoke. A significantly greater proportion of completers in Spanish (90%) reported being concerned with their own health and their workers’ health in relation to smoke exposure than those completing in English (64%). Most (81%) respondents agreed they can recognize signs/symptoms when a worker is not feeling well due to smoke exposure, but only 63% reported having had training on managing workers with smoke-related symptoms. N95 masks were identified as the most realistic protective control to implement when wildfire smoke is present. There were significant differences by language group regarding what resources respondents identified as accurate for AQ monitoring at work. Most respondents (79%) had heard of the wildfire smoke rule in Washington.

CONCLUSION: Wildfire smoke is an occupational health threat for outdoors workers that is expected to increase. Supervisors who work in agricultural workplaces are required by law in Washington, Oregon, and California to monitor AQ, manage workers’ symptoms, and implement protective controls at certain AQ thresholds. Study findings identify gaps in these areas and will support ongoing training of a critical subsector of the agricultural workforce.

PMID:40319235 | DOI:10.1080/1059924X.2025.2498342

BMC Pregnancy Childbirth. 2025 May 3;25(1):528. doi: 10.1186/s12884-025-07609-w.

ABSTRACT

OBJECTIVE: This study aimed to assess the incidence, trends, and adverse pregnancy outcomes associated with preeclampsia (PE), while further investigating whether these adverse outcomes differ by parity and the type of pregnancy-twin or singleton.

MATERIALS AND METHODS: A multicenter cross-sectional study was conducted in Hebei, China, spanning the years 2013 to 2022, enrolling a total of 455,456 women. The incidence rates and trends of PE and its subtypes were analyzed utilizing joinpoint regression analysis, while modified Poisson regression was employed to assess the association between PE and adverse pregnancy outcomes. Effect modification by parity, twin or singleton pregnancy was also evaluated.

RESULTS: The prevalence of PE and its stratification by singleton pregnancies and parity (primiparas versus multiparas) exhibited upward trends, with no statistically significant changes observed in the incidence of twins affected by PE from 2013 to 2022 in Hebei Province. After adjusting for sociodemographic characteristics and other comorbidities during pregnancy, patients with PE experienced significantly elevated risks of cesarean section (adjusted relative risk [aRR], 4.78; 95% confidence interval [CI], 4.54-5.02), postpartum hemorrhage (aRR, 1.97; 95% CI, 1.75-2.21), placental abruption (aRR, 1.52; 95% CI, 1.37-1.69), preterm birth (aRR, 5.35; 95% CI, 5.14-5.56), small for gestational age (SGA) newborns (aRR, 2.48; 95%CI, 2.38-2.58), maternal near-miss events (MNM) (aRR, 1.18; 95% CI, 1.01-1.38), and admission to the neonatal intensive care unit (NICU) (aRR, 1.27; 95% CI, 1.11-1.44). In contrast, the risk of placenta previa was significantly lower (aRR, 0.26; 95% CI, 0.21-0.32). The risks of cesarean section, postpartum hemorrhage, and preterm birth ascribable to PE were conspicuously augmented in twin pregnancies; conversely, the risk of placental abruption was more notable in singletons. The influence on cesarean delivery was pronounced in primiparas, while the risks of MNM, placental abruption, and preterm birth related to PE escalated in multiparas.

CONCLUSIONS: The incidences of PE in overall, singletons, primiparas and multiparas exhibited upward trends in Hebei from 2013 to 2022. Women afflicted with PE demonstrated a conspicuously augmented risk of adverse pregnancy outcomes and the magnitude of the influence of PE varied with singleton or twin pregnancies and parity.

PMID:40319233 | DOI:10.1186/s12884-025-07609-w

BMC Anesthesiol. 2025 May 3;25(1):227. doi: 10.1186/s12871-025-03106-x.

ABSTRACT

BACKGROUND: Pediatric patients undergoing upper gastrointestinal (GI) interventions frequently require sedation and analgesia due to the challenges associated with endoscopic probe placement, particularly the gag reflex. This study investigates the effects of nebulized dexmedetomidine as a premedication on the gag reflex in pediatric patients undergoing gastrointestinal endoscopy.

METHODS: We conducted a single-center, prospective, randomized controlled trial at the Pediatric Gastroenterology Clinic of Ondokuz Mayis University School of Medicine from January to April 2024. Participants aged 2-17 years scheduled for upper GI endoscopy were randomized to receive nebulized dexmedetomidine (2 µg /kg) or no premedication. The primary outcome measured was the severity of the gag reflex during the procedure. Secondary outcomes included cough incidence, separation anxiety, postoperative agitation, and endoscopist satisfaction. Statistical analyses were performed with significance set at p < 0.050.

RESULTS: A total of 120 patients were analyzed. The dexmedetomidine group demonstrated a significantly lower incidence of gag reflex (88.3% with no gag reflex vs. 30% in the control group, p < 0.001) and coughing (95% vs. 55%, p < 0.001). Separation anxiety scores were also significantly lower in the dexmedetomidine group (p < 0.005). Additionally, the need for additional anesthetics was reduced, and endoscopist satisfaction was significantly higher. No significant differences in complications were observed between the two groups (p = 0.600).

CONCLUSIONS: Nebulized dexmedetomidine is a safe and effective premedication for pediatric patients undergoing endoscopic procedures, significantly reducing gag and cough reflexes, decreasing anesthetic requirements, and enhancing endoscopist satisfaction. This approach improves the comfort and safety of pediatric endoscopy procedures.

TRIALS REGISTRATION: ClinicalTrials.gov: NCT06218797, date of registration 27/12/2023.

PMID:40319232 | DOI:10.1186/s12871-025-03106-x