Category: Nevin Manimala

Indian J Palliat Care. 2026 Apr-Jun;32(2):190-197. doi: 10.25259/IJPC_245_2025. Epub 2026 May 12.

ABSTRACT

OBJECTIVES: Head-and-neck cancer (HNC) survivors undergoing concurrent chemoradiotherapy frequently experience treatment-related impairments such as trismus, cervical and shoulder dysfunction, and masticatory muscle weakness. This study aimed to develop and evaluate the feasibility of the CALORIE CARE programme, a tailored exercise intervention for HNC survivors undergoing concurrent chemoradiotherapy (CCRT). The secondary objective was to assess changes in mouth opening measured by maximal interincisal opening (MIO).

MATERIALS AND METHODS: A feasibility study was conducted at a tertiary care hospital in Karnataka, India, from January 2024 to January 2025. Eligible participants were HNC survivors with TNM (Tumor, Node, and Metastasis) stages III-IVb and MIO <35 mm undergoing concurrent chemoradiotherapy. The CALORIE CARE programme was developed using the Template for Intervention Description and Replication (TIDeR) checklist. The 8-week intervention included mobility, stretching, strengthening, swallowing exercises, and aerobic activity. Feasibility outcomes included recruitment rate, adherence rate, and withdrawal rate. Exercise adherence was assessed using the Exercise Adherence Rating Scale-Kannada (EARS-Kn). MIO was measured at baseline, week 4, and week 8.

RESULTS: Among 53 eligible patients, 37 consented to participate (recruitment rate 69.81%), and 35 completed the programme (withdrawal rate 5.4%). The adherence rate was 73.94%. The mean EARS score was 17.8, indicating good adherence. A statistically significant change in MIO was observed between baseline and week 4 (p < 0.001), whereas no significant difference was observed between week 4 and week 8 (p = 0.075).

CONCLUSION: The CALORIE CARE programme appears feasible, well tolerated, and demonstrates good adherence among HNC survivors undergoing chemoradiotherapy. Early implementation of multidomain rehabilitation may help delay functional deterioration during treatment; however, its efficacy for improving clinically meaningful outcomes requires confirmation in controlled trials.

PMID:42233138 | PMC:PMC13224306 | DOI:10.25259/IJPC_245_2025

Indian J Palliat Care. 2026 Apr-Jun;32(2):167-174. doi: 10.25259/IJPC_277_2025. Epub 2026 Mar 6.

ABSTRACT

OBJECTIVES: The most prevalent malignancy among women worldwide is breast cancer (BC). While evaluating the effectiveness of treatment, the quality of life (QoL) of BC patients is crucial. The purpose of this study was to assess patients’ QoL after receiving therapy for BC.

MATERIALS AND METHODS: This was a prospective study examining the QoL in BC patients following treatment completion, which included surgery, chemotherapy and radiation therapy. The study measured the QoL of 100 patients using the European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ-C30) and its BC supplementary measure (EORTC QLQ-BR23) at three different points in time: 3 months, 1 year and 2 years after completing treatment. The patients were selected for the study using a purposive sampling technique. The socio-demographic and clinical data collected included age, education, marital status, disease stage and initial treatment. Descriptive analysis was made using frequency and percentages. For inferential statistics, a non-parametric test (Friedman test) was used for non-continuous data.

RESULTS: The average age of the patients was 46.9 ± 10.1 years, and the majority (82%) underwent mastectomy, chemotherapy and radiotherapy. The results indicated significant differences in patient functioning and overall QoL at three different points in time (p < 0.001). While there were declines in patients’ scores for body image and sexual enjoyment, there were notable improvements in breast symptoms and systemic therapy side effects (p < 0.05). Across the functioning scale, physical, cognitive, emotional, social and role functioning all showed improvement. However, on the symptom scale, fatigue was the most common issue experienced by patients, even 2 years after treatment, followed by financial difficulties and arm symptoms.

CONCLUSION: There was a significant improvement in the QoL after receiving BC treatment. However, fatigue and arm symptoms need supportive treatment on follow-up.

PMID:42233137 | PMC:PMC13224243 | DOI:10.25259/IJPC_277_2025

Indian J Palliat Care. 2026 Apr-Jun;32(2):198-206. doi: 10.25259/IJPC_235_2025. Epub 2026 Apr 27.

ABSTRACT

OBJECTIVES: Despite the recent rise in cancer prevalence in India, psychological support is largely ignored. There is very less research on effectiveness of cognitive behavioural therapy (CBT) and pharmacotherapy (PT) as treatment options for psychological distress in cancer patients in India. So, this study was planned to evaluate the relative efficacy of PT, CBT, and their combination in reducing anxiety and depressive symptoms in newly diagnosed cancer patients referred for psychiatric evaluation at a tertiary care hospital in India.

MATERIALS AND METHODS: Between January 2022 and December 2024, newly diagnosed adult cancer patients referred for psychiatric evaluation were enrolled in the study. Of the 456 patients, 32 (6.9%) had a positive screening for generalised anxiety disorder and 75 (16.4%) for major depressive disorder. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition Disorders, Clinician Version was used to confirm the diagnosis for these patients. Patients selected (1) eight sessions of CBT, (2) selective serotonin reuptake inhibitors (SSRIs) (PT) or (3) both (combination therapy [COMB]). Depression and anxiety severity were assessed using the Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A), respectively. The minimal clinically important difference (MCID) was defined as a ≥3-point reduction in HAM-D and a ≥2-point reduction in HAM-A. A comparison of reductions in scale scores was made at baseline and at 6 weeks.

RESULTS: In the depression cohort (n = 75), for PT (n = 38), CBT (n = 19) and COMB (n = 18), mean HAM-D change was -2.8 ± 0.7 (standard error [SE] 0.12, 95% confidence interval [CI] [2.57, 3.03]), -0.8 ± 0.5 (SE 0.12, 95% CI [0.53, 1.01]) and -9.3 ± 8.9 (SE 2.10, 95% CI [5.14, 13.36]); baseline-adjusted Analysis of Covariance F(2,72) = 48.1, p < 0.001, partial h² = 0.57. COMB exceeded HAM-D MCID in every participant and achieved 33% remission. The mean change in HAM-A (n = 32) was -3.9 ± 1.9 (SE 0.56, 95% CI [2.79, 4.99]) (PT, n = 12), -3.8 ± 1.7 (SE 0.49, 95% CI [2.79, 4.71]) (CBT, n = 12) and -3.5 ± 1.4 (SE 0.50, 95% CI [2.52, 4.48]) (COMB, n = 8); the difference between the groups was not significant (F(2,29)=0.54, p = 0.59). All arms exceeded the HAM-A MCID threshold; however, response rates (≥50% reduction) remained ≤13%.

CONCLUSION: Combined PT (SSRI) and CBT showed the most significant improvement in depression symptoms, while all treatment approaches provided comparable relief for anxiety. The study underlines the importance of integrated care in oncology and advocates a combined approach to treating cancer patients with depression and anxiety. Further research is needed to optimise treatments for anxiety, particularly in settings with limited resources.

PMID:42233133 | PMC:PMC13224208 | DOI:10.25259/IJPC_235_2025

J Clin Imaging Sci. 2026 May 23;16:18. doi: 10.25259/JCIS_235_2025. eCollection 2026.

ABSTRACT

OBJECTIVES: The objective of this study is to assess cases of septic arthritis of the glenohumeral joint and its association with intravenous drug use.

MATERIAL AND METHODS: Retrospective data from the past 10 years were obtained from the University Hospital System in Appalachia. 53 shoulders in 50 patients fit the inclusion criteria for glenohumeral septic arthritis and are included in the study. Statistical analyses were carried out using statistical software R (version 3.6.3, R Foundation, Vienna, Austria). Comparisons were made between cases with intravenous drug use versus all other cases.

RESULTS: The mean age for intravenous drug users with glenohumeral septic arthritis is lower than non-users. Intravenous drug users with glenohumeral septic arthritis also had higher rates of sepsis, bacteremia, endocarditis, septic emboli, and involvement of other joints compared to non-users.

CONCLUSION: A younger age, the involvement of other joints, and presence of other severe infections should prompt the radiologist to further probe into any intravenous drug use, which may not always be previously divulged. Conversely, having a known history of intravenous drug use should prompt the radiologist to be on the lookout for other joint infections, endocarditis, and septic emboli.

PMID:42233124 | PMC:PMC13224242 | DOI:10.25259/JCIS_235_2025

J Lasers Med Sci. 2026 Feb 2;17:e3. doi: 10.34172/jlms.2026.03. eCollection 2026.

ABSTRACT

Introduction: This study aimed to assess the antimicrobial efficacy of propolis for an intracanal medicament in combination with an Nd:YAG laser against the biofilm of persistent endodontic pathogens: Enterococcus faecalis, Staphylococcus aureus and Candida albicans. Methods: One hundred and sixty-five extracted human premolars were included. Monospecies of four-week biofilms were cultured in root canals after the teeth were prepared chemo-mechanically. Specimens were treated with calcium hydroxide for 24 hours (G1), propolis for 24 hours (G2), Nd:YAG laser (1064 nm, 1.5 w, 15 Hz, 100 mJ/pulse, 200 µm endodontic fiber tip) (G3), propolis medicament followed by Nd:YAG laser (G4), and normal saline as the control group (G5). Dentin chips were obtained with Gates-Glidden #5, 6 and inoculated onto agar plates for microbial growth. The antimicrobial efficacy of each group was evaluated by quantifying the number of colony-forming units. Data were statistically analyzed using the Kruskal-Wallis and Mann-Whitney U test (P value<0.05). Results: All investigated groups reduced the bacterial count compared to normal saline (P value<0.05). Propolis (0.23±0.58, 0.00±0.00, 1.34±1.12 for E.f, S.a, and C.a., respectively) and Nd:YAG laser (3.19±0.51, 3.21±0.37, 3.29±0.52 for E.f, S.a, and C.a., respectively) were more effective in the reduction of all three pathogens during 24 hours, compared to calcium hydroxide (P value<0.05). The application of propolis followed by the Nd:YAG laser resulted in the complete elimination of E. faecalis and S. aureus and a significant reduction in C. albicans (0.60±0.96) (P value<0.05). Conclusion: Propolis alone or in combination with the Nd:YAG laser at low powers is highly effective against endodontic pathogens in comparison with conventional calcium hydroxide medicament.

PMID:42233115 | PMC:PMC13224327 | DOI:10.34172/jlms.2026.03

Am J Lifestyle Med. 2026 May 31:15598276261449749. doi: 10.1177/15598276261449749. Online ahead of print.

ABSTRACT

Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease globally, with increasing prevalence among adults. Despite its growing burden, limited research has examined the influence of psychosocial factors, including unhealthy behavior on NAFLD in the USA. Retrospective cross-sectional study was conducted using data from the 2013-2018 National Health and Nutrition Examination Survey. Descriptive statistics, stratified prevalence estimates, and Poisson regression models were used to assess unadjusted and adjusted associations. The results showed that among 5804 eligible participants, the overall prevalence of NAFLD was 42%. Higher prevalence was observed among males (48%), individuals with obesity (37%), those reporting unhealthy behaviors (48%), and those with depressive disorders (47%). In adjusted models, unhealthy behavior (PR = 1.35; 95% CI: 1.22-1.49; P < 0.001) and depression (PR = 1.13; 95% CI: 1.04-1.22; P = 0.005) were independently associated with an increased prevalence of NAFLD among young US adults and is independently associated with modifiable behavioral and psychological factors. These findings underscore the need for integrated public health strategies as well as nutritional interventions that could address lifestyle behaviors and mental health to mitigate the burden of NAFLD in this population.

PMID:42233096 | PMC:PMC13223074 | DOI:10.1177/15598276261449749

Environ Sci Ecotechnol. 2026 May 14;31:100707. doi: 10.1016/j.ese.2026.100707. eCollection 2026 May.

ABSTRACT

Current chemical exposures studies characterise chemical risk through mean-based concentrations, treating individual-level variability as statistical noise. However, this variability may carry structured ecological information that mean-based approaches systematically overlook. Here, we propose that individual per- and polyfluoroalkyl substance (PFAS) exposure variability constitutes a structured ecological signal, shaped by habitat use across oceanographic gradients and individual foraging behaviour, one that mean-based approaches are not designed to capture. To test the variability-as-signal hypothesis, we integrated two independent indices of individual stability using two sympatric guillemot species (Uria aalge, n = 67 and Uria lomvia, n = 45) sampled across five Icelandic colonies during the 2018 breeding season. We paired PFAS variability scores, derived from plasma PFAS concentrations, with isotopic consistency scores derived from dual-tissue stable isotopes (δ¹³C and δ¹⁵N in plasma and red blood cells). These consistency scores represent individual foraging stability across the breeding season, enabling a reconstruction of foraging histories and oceanographic habitat use. Our results reveal that PFAS variability is highly structured by compound class, dominated by long-chain perfluoroalkyl carboxylic acids (PFCAs; 79% of variance) and perfluorooctane sulfonate (PFOS; 13%). Cluster analysis identified two main divergent exposure states: constrained PFOS variability versus constrained PFCA variability. Bivariate segmented regression revealed a hierarchical structure to contaminant acquisition: oceanographic regime (proxied by δ¹³C_consist) functioned as the primary driver, with PFOS variability intensifying in Atlantic-influenced waters. Within these regimes, trophic sources (proxied by δ¹⁵N_consist) emerged as a secondary, conditional modulator, specifically constraining PFCA variability among high-trophic individuals. At the colony scale, fine-scale niche partitioning, such as vertical foraging strategies and individual specialisation using glacial fjords and ice margins, produced compound-specific patterns that diverged from regional hierarchies. As climate change continues to redistribute Arctic and Atlantic water masses and reshape the food web structures, approaches that treat contaminant variability as ecological signal will be increasingly valuable for anticipating exposure regime shifts.

PMID:42233095 | PMC:PMC13223959 | DOI:10.1016/j.ese.2026.100707

Front Psychol. 2026 May 18;17:1843623. doi: 10.3389/fpsyg.2026.1843623. eCollection 2026.

ABSTRACT

INTRODUCTION: In an increasingly interconnected and contextually fluid digital era, this study investigates how Metalinguistic Awareness (MAS) relates to Cross-Contextual Communication Effectiveness (CCC), framed from an instructional intervention design perspective.

METHODS: A quantitative survey was conducted among 709 participants using validated MAS and CCC scales to explore the correlations and predictive power of various language domains.

RESULTS: The analysis revealed a strong positive correlation (r = 0.739, p < 0.001) between the two constructs. Multiple regression analysis further showed that the six dimensions of MAS collectively account for 59.1%of the variance in CCC. Critically, higher-order dimensions emerged as the strongest statistical predictors: pragmatic awareness (β = 0.231), reflective awareness (β = 0.215), and discourse awareness (β = 0.176). Additionally, extensive cross-cultural experience was significantly associated with higher levels of both MAS and CCC.

DISCUSSION: The research empirically suggests that higher-order metalinguistic awareness is a key cognitive correlate of effective communication. To genuinely empower learners, language pedagogy should consider shifting from traditional formalism toward an integrated paradigm centered on fostering pragmatic, discourse, and reflective awareness through authentic, practice-based methods.

PMID:42233082 | PMC:PMC13223158 | DOI:10.3389/fpsyg.2026.1843623

Front Psychol. 2026 May 18;17:1757864. doi: 10.3389/fpsyg.2026.1757864. eCollection 2026.

ABSTRACT

INTRODUCTION: Numerous studies have shown that consonants play a more crucial role than vowels in lexical recognition and learning, a phenomenon known as the C-Bias or C-advantage. While traditionally considered universal, recent findings suggest it may depend on language-specific phonotactic properties. This study examines whether the C-Bias is modulated by phonotactic constraints in Spanish, where vowels may have a discriminative advantage due to their distinctiveness.

METHODS: Seventy-seven native Spanish-speaking university students completed a Cross-Situational Word Learning task with pseudowords in two syllabic structures: monosyllabic (CVC) and disyllabic (CVCV).

RESULTS: The results revealed a vowel bias in monosyllabic pseudowords and a partial consonant bias in disyllabic pseudowords.

DISCUSSION: These findings indicate that phonotactic structure shapes the relative salience of consonants and vowels in lexical processing, challenging the assumption of a universal C-Bias. This study highlights the role of language-specific phonological constraints in word learning and suggests that phonological processing is more flexible than previously assumed.

PMID:42233081 | PMC:PMC13223176 | DOI:10.3389/fpsyg.2026.1757864

Front Psychol. 2026 May 18;17:1837689. doi: 10.3389/fpsyg.2026.1837689. eCollection 2026.

ABSTRACT

The expansion of social media as a dominant infrastructure of social interaction has raised important questions regarding its impact on cognitive, emotional, and identity-related processes. While prior research has predominantly relied on exposure-based models, increasing attention is directed toward the ways through which digitally mediated environments influence psychological functioning. At the same time, emerging interdisciplinary frameworks in neurolaw and neurorights highlight concerns related to mental integrity, cognitive liberty, and mental privacy, emphasizing the need to understand how algorithmically structured environments interact with internal psychological processes. The present study examines the psychological ways linking social media addiction to academic performance and psychological flourishing, while providing an empirically grounded perspective relevant to digital governance. A cross-sectional sample of 940 participants (aged 18-72 years; M = 31.00, SD = 11.35) completed validated measures of social media addiction, affectivity, authenticity, self-image, academic performance, and flourishing. A path analysis with observed composite scores was used to test a mediation model. Results indicate that social media addiction, distinct from general usage, was associated with higher negative affect, lower positive affect, and lower authenticity. These associations were statistically mediated through self-image in a cross-sectional covariance model, with self-image emerging as the strongest indirect pathway linking compulsive digital engagement to lower academic performance and reduced psychological flourishing. Among the mediating variables, authenticity represented the strongest indirect association, followed by affective processes, whereas non-compulsive use showed no significant associations. These findings support a mechanism-based model in which the impact of social media operates through affective dysregulation and identity-related processes rather than direct exposure. From an interpretative perspective, the results are conceptually consistent with concerns raised in neurorights discourse regarding cognitive autonomy and mental integrity. These findings should be understood as psychological correlates that may be relevant to such debates; they do not constitute direct evidence of rights violations or neuropsychological harm, and no neurocognitive variables were assessed in this study. Overall, the study contributes to a more precise understanding of digital behavior by integrating psychological statistical mediators with broader frameworks of digital governance and provides a foundation for interventions targeting internal processes while preserving fundamental freedoms such as expression and privacy.

PMID:42233075 | PMC:PMC13223112 | DOI:10.3389/fpsyg.2026.1837689