Category: Nevin Manimala

Cureus. 2025 Jul 12;17(7):e87759. doi: 10.7759/cureus.87759. eCollection 2025 Jul.

ABSTRACT

BACKGROUND AND OBJECTIVES: Diabetic neuropathy is a common microvascular complication of type 2 diabetes mellitus (T2DM), like diabetic retinopathy and nephropathy. The neutrophil count is raised during infection and inflammation, and the lymphocyte count is decreased in immunocompromised patients. The platelet count suggests the thrombotic and inflammatory conditions. Hence, the neutrophil-lymphocyte ratio (NLR) is the ratio of absolute counts of neutrophils to lymphocytes. The systemic immune-inflammation index (SII) is the product of NLR and platelet count. These indicate the immuno-inflammatory status of the patient. There is a dearth of literature assessing the SII of individuals with diabetic neuropathy. Hence, we mapped this study to evaluate and compare complete blood count (CBC), NLR, and SII of diabetic patients with and without neuropathy. We also correlated NLR and SII values of the study population.

METHODS: This cross-sectional study was conducted from April 2024 to March 2025 at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India. We included adult diabetic patients admitted to the KIMS medicine ward. Hemoglobin, total leucocyte count (TLC), neutrophil count, lymphocyte count, platelet count, length of T2DM, and glycated hemoglobin (HbA_1c) were all measured shortly after their hospitalization. NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. We obtained the SII value by multiplying the platelet count by NLR. R software version 4.4.3 (R Core Team, Vienna, Austria) was used for statistical analysis.

RESULTS: One hundred ninety-three diabetic patients were found eligible for this study. Their median age was 66 (55-73) years. Of them, 92 (47.7%) were women. The study population’s median white blood cell (WBC) was 9.88 (8.72-11.24) × 10⁹/L. The median counts of lymphocytes and neutrophils were 2214 (1720-2647)/µL and 6864 (5796-8256)/µL, respectively. The study population’s median platelet counts were 250 (189-293) × 10⁹/L. The study population’s median HbA_1c was 8.61 (7.57-9.31)%. The study population’s median duration of diabetes mellitus was 11 (6-18) years. The study population’s median SII and NLR were 755.3 (521.4-1002.2) × 10⁹ cells/L and 2.93 (2.40-4.21), respectively. NLR and SII values were positively correlated (r = 0.92, p < 0.001). Regardless of neuropathy, the association between NLR and SII was identical among the study subjects.

CONCLUSION: Diabetes patients without neuropathy and those with neuropathy had comparable CBC, NLR, and SII values. The results of our study cannot be extrapolated due to the limited sample size and failure to account for several variables, including concurrent medications, comorbidities, and length of hospital stay.

PMID:40792338 | PMC:PMC12336742 | DOI:10.7759/cureus.87759

Cureus. 2025 Jul 12;17(7):e87787. doi: 10.7759/cureus.87787. eCollection 2025 Jul.

ABSTRACT

Background Pulse oximetry is a vital tool for screening critical congenital heart disease (CCHD) in newborns. However, fixed thresholds may not account for physiological variations caused by altitude. This study evaluates the impact of elevation on normal neonatal oxygen saturation (SpO₂) in Jordan, spanning sites from moderate altitude to below sea level. Methods In a cross-sectional study, 149 healthy, full-term newborns were screened at three hospitals located at 1,050 m (Amman), sea level (Aqaba), and 420 m below sea level (Dead Sea). Preductal and postductal SpO₂ measurements were taken between 24 and 72 hours of life using standardized protocols. Statistical analyses, including analysis of variance (ANOVA) and Tukey’s honestly significant difference (HSD), were used to compare SpO₂ levels across altitudes. Results Mean upper-limb SpO₂ was significantly lower at 1,050 m (96.6%) compared to sea level (98.0%) and sub-sea level (97.8%) (p < 0.001). Similar trends were observed for lower-limb SpO₂. No significant differences were found between sea-level and sub-sea-level sites. Despite lower SpO₂ at moderate altitude, no newborns met the American Academy of Pediatrics (AAP) criteria for CCHD. Conclusion Moderate altitude results in a statistically significant, but modest, reduction in neonatal SpO₂, potentially increasing false-positive rates in CCHD screening. Our findings support the development of altitude-specific screening protocols to improve diagnostic accuracy and reduce unnecessary interventions. Further research with larger and more diverse populations is needed to inform altitude-adjusted guidelines, particularly in geographically varied regions like Jordan.

PMID:40792335 | PMC:PMC12338855 | DOI:10.7759/cureus.87787

Cureus. 2025 Jul 12;17(7):e87760. doi: 10.7759/cureus.87760. eCollection 2025 Jul.

ABSTRACT

Background Chronic rhinosinusitis (CRS) significantly impacts patients’ quality of life. Accurate diagnosis is crucial for effective management, with diagnostic nasal endoscopy (DNE) and computed tomography (CT) being primary tools. It significantly impacts patients’ quality of life, causing symptoms like nasal congestion, facial pain, decreased sense of smell, and nasal discharge. This study aimed to evaluate the sensitivity and specificity of DNE in comparison to CT, the gold standard, for CRS diagnosis. Methodology A prospective observational study was conducted at Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur. A total of 109 patients presenting with CRS symptoms for more than 12 weeks were included. All participants underwent both DNE and CT of the paranasal sinuses. Correlations between radiological and endoscopic findings were evaluated to identify patterns and inform treatment decisions. Results A statistically significant correlation was found between endoscopic and radiological findings (χ² = 55.20, p < 0.00000001), indicating strong diagnostic concordance. DNE achieved a sensitivity of 93.42%, specificity of 75.75%, positive predictive value (PPV) of 89.33%, and negative predictive value (NPV) of 83.33%. These findings highlight the diagnostic utility of DNE for detecting mucosal abnormalities, while also emphasizing the superior anatomical detail provided by CT imaging. Conclusion DNE is a valuable, minimally invasive tool for diagnosing CRS, offering high sensitivity in detecting mucosal inflammation. However, CT remains essential for a complete anatomical assessment, particularly in complex or refractory cases.

PMID:40792313 | PMC:PMC12336917 | DOI:10.7759/cureus.87760

Cureus. 2025 Jul 11;17(7):e87750. doi: 10.7759/cureus.87750. eCollection 2025 Jul.

ABSTRACT

The COVID-19 pandemic had a widespread impact on healthcare systems globally, particularly affecting older adults. This study was conducted to investigate long-term changes in hip fracture (HF) incidence before and during the COVID-19 pandemic in a rural and aged Japanese community. We retrospectively reviewed HF cases (femoral neck and trochanteric fractures) in patients aged ≥65 years at the Shonai Amarume Hospital in the Yamagata prefecture, Japan, from January 1, 2015, to December 31, 2024. Cases were divided into pre-pandemic (2015-2019) and pandemic (2020-2024) periods. Statistical analysis was performed using the Wilcoxon rank-sum and Kruskal-Wallis tests. A total of 78 HFs occurred in the pre-pandemic period and 134 during the pandemic. There were no significant differences in patient age or sex ratio between the two groups. Statistical analysis showed a significant increase in HF incidence during the pandemic (Wilcoxon p = 0.0461; Kruskal-Wallis p = 0.0495) in this rural and aged community. These findings suggest the need for targeted fall prevention and social support systems for older adults, particularly in aging regions, during public health crises.

PMID:40792309 | PMC:PMC12335979 | DOI:10.7759/cureus.87750

Front Med (Lausanne). 2025 Jul 28;12:1604280. doi: 10.3389/fmed.2025.1604280. eCollection 2025.

ABSTRACT

INTRODUCTION: As for global brachial plexus avulsion, the recoveries of intrinsic muscles are not satisfying after nerve transfers.

METHODS: A retrospective review of 31 patients treated with different CC7 transfers after GBPA was carried out. The modified group: CC7 transfer to median nerve and DBUN by medial antebrachial cutaneous nerve (MACN). The conventional group: CC7 transfer to median nerve. The mean follow-up period was 3 years.

RESULTS: After CC7 transfers, one patient got M3, one patient got M2 and two patients got M1 in abductor digiti minimi (ADM) in the modified group, while no patients had recovery in ADM in the conventional group. The recoveries of abductor pollicis brevis (APB) were similar between two groups. Motor unit potentials (MUP) of ADM and dorsal interosseous muscle (DIM) appeared in 4 and 2 patients respectively after surgery in the modified group. Nobody gained MUP of ADM or DIM in the conventional group. There were no statistical differences of MUP in APB, compound motor action potential (CMAP) in FDPI and FCR between two groups.

DISCUSSION: CC7 transfer to median nerve and DBUN by pedicled ulnar nerve and MACN could initially make intrinsic muscles regeneration in patients with GBPA, while not affect the recovery of median nerve.

PMID:40792305 | PMC:PMC12336263 | DOI:10.3389/fmed.2025.1604280

Sci Rep. 2025 Aug 11;15(1):29372. doi: 10.1038/s41598-025-04561-9.

ABSTRACT

Intensive mono-cropping and abiotic stresses in the tea (Camellia sinensis L.) growing areas caused soil nutrient degradation and low crop productivity. Site-specific management requires understanding the mechanism of the geographical setting and its variability that plays a pivotal role in the growth and quality of tea crops. The present study targeted the tea-growing soils of India to determine their nutrient status as well as profile mineralogical composition to establish soil and land use management strategies for the region. Collected surface soil samples were analyzed for soil parameters. Soil profile sampling was done for clay mineral characterization of the area by using X-ray diffraction method. The Geo-statistical approach was used in this study-A method for analyzing geographical distribution and variability that is evolved from classical statistics. Study revealed that soil reaction was acidic to normal (3.95-6.80); non-saline (0.05-0.47 dS m^-1) and soil organic carbon (SOC) range was low to medium (0.06-0.62%). Macronutrients, available nitrogen (N) status was low (62.5-237 kg ha^-1), whereas available phosphorus (P) (3.0-59 kg ha^-1) and potassium (K) (100-403 kg ha^-1) levels were low to high. Micronutrients, iron (Fe) and manganese (Mn) was deficient to sufficient, whereas, zinc (Zn) and copper (Cu) were sufficient in range. Descriptive statistics and geostatistical methods of the analysis revealed that soil pH, electrical conductivity (ECe), SOC, available K, Fe and Mn were strongly spatial dependent, whereas N, Zn, and Cu, were moderately spatial dependent, caused by both random factors as well as structural factors (soil texture, soil type, fertilization, and local ecological restoration management). Clay mineralogical characterization of soil profile (surface and subsurface) revealed the dominance of illite clay minerals followed by kaolinite and smectite and less concentration of chlorite and quartz showing greater forms of K presence in the soils. Therefore, the recommendation is that, application of balance fertilizers with combination of inorganic (macro and micronutrients) and organic sources of nutrients might be beneficial for sustainable tea production in this region. It will ultimately improve soil fertility, enhance tea yield and support the socio-economic well-being of tea growers.

PMID:40790121 | DOI:10.1038/s41598-025-04561-9

Nat Microbiol. 2025 Aug 11. doi: 10.1038/s41564-025-02084-7. Online ahead of print.

ABSTRACT

Antimicrobial resistance (AMR) is a global threat, especially in fungal pathogens. To optimize the use of available antifungals, we need rapid detection and monitoring tools that rely on high-quality AMR mutation data. Here we present FungAMR, a resource based on manual curation of 501 published studies on AMR mutations in clinically and agriculturally relevant fungal pathogens resulting in 35,792 entries covering 208 drugs, 246 genes and 95 fungal species. Each entry includes gene, mutation site and drug susceptibility data, with confidence scores indicating the strength of the supporting evidence. Data analysis revealed convergent mechanisms of resistance, indicating some potentially universal resistance mutations and mutations that lead to cross-resistance within and across antifungal classes. We also developed a computational tool, ChroQueTas, that leverages FungAMR to screen fungal genomes for AMR mutations. FungAMR is available as a web-searchable interface within the Comprehensive Antibiotic Resistance Database (CARD). These evolving resources promise to facilitate research on antifungal resistance.

PMID:40790106 | DOI:10.1038/s41564-025-02084-7

BDJ Open. 2025 Aug 11;11(1):73. doi: 10.1038/s41405-025-00360-6.

ABSTRACT

INTRODUCTION: This study aimed to compare two different approaches for palatal wound healing following free gingival graft (FGG) harvesting: one involving Nano Bio-Fusion (NBF) gingival gel used in conjunction with a palatal stent, and the other using a palatal stent alone. Outcomes were assessed in terms of wound healing, post-operative pain, and patient satisfaction.

METHODS: This parallel-grouped, two-arm, single-blinded, randomized controlled trial (RCT) included twenty-six patients with mucogingival defects that required harvesting an epithelialized free gingival graft (FGG). Patients were randomly allocated into either test group (NBF gingival gel and palatal stent; n = 13) or control group (palatal stent only; n = 13). Wound healing, the primary outcome, was evaluated over a 30-day period, while secondary outcomes included post-operative pain-measured using the Visual Analog Scale (VAS) and analgesic consumption-and patient satisfaction.

RESULTS: In the test group, wound healing showed statistically significant higher healing index score than control group after 3 days (P = 0.017), then no statistical significance was noted. Regarding post-operative pain, the test group showed statistically significantly lower pain scores (VAS) than control group in the first week, followed by no statistical significance in the second week. In the third day, the test group showed statistically significant lower analgesic consumption dose (P = 0.024) with overall statistically significant higher satisfaction score than control group (P = 0.002).

CONCLUSION: Within the limitations of this study, the results suggest that NBF gingival gel may promote early-stage palatal wound healing, reduce postoperative pain and analgesic consumption during the first week, and enhance overall patient satisfaction.

CLINICAL TRIAL REGISTRATION: (NCT05442359 | | https://www.

CLINICALTRIALS: gov/ 30-June-2022).

PMID:40790022 | DOI:10.1038/s41405-025-00360-6

J Gen Intern Med. 2025 Aug 11. doi: 10.1007/s11606-025-09793-z. Online ahead of print.

ABSTRACT

BACKGROUND: Over half of Medicare beneficiaries are enrolled in Medicare Advantage (MA), with Black and Hispanic beneficiaries disproportionately in MA versus traditional Medicare (TM).

OBJECTIVE: To examine Black-White and Hispanic-White disparities in preventive and chronic disease care by MA vs. TM.

DESIGN: Cross-sectional propensity-score-weighted difference-in-disparities analyses compared Black-White and Hispanic-White disparities in MA and TM using the Medicare Current Beneficiary Survey (2015-2020).

PARTICIPANTS: Medicare beneficiaries with cardiovascular disease or risk factors (N = 68,788 person-years).

MAIN MEASURES: Influenza vaccine, pneumococcal vaccine, blood pressure check, cholesterol test, colorectal cancer screening, preventive care index (count of above; 0-5), mammogram, annual wellness visit; hemoglobin A1C and eye exam.

KEY RESULTS: Black and Hispanic, compared to white, beneficiaries were less likely to receive annual wellness visits, influenza vaccines, pneumococcal vaccines, and colorectal cancer screening. Black beneficiaries in MA vs. TM had higher overall preventive care use (preventive care index, 3.67 vs. 3.44) and higher rates of all preventive services examined. Hispanic beneficiaries in MA vs. TM had higher preventive care use (index, 3.67 vs. 3.56), including annual wellness visit, blood pressure check, colorectal cancer screening, and breast cancer screening. Preventive care use was higher among White beneficiaries in MA than TM (index, 3.88 and 3.79). Black-White disparities were smaller in MA than TM for preventive care use (difference-in-disparities: + 0.13 index points, 95% CI 0.04-0.22), blood pressure check (+ 2.2 percentage points [p.p.], 95% CI 0.1-4.4), cholesterol check (+ 2.2 p.p., 95% CI 0.2-4.2), and eye exam (+ 5.0 p.p., 95% CI 1.4-8.7). Hispanic-White disparities were not statistically different in MA vs. TM.

CONCLUSIONS: Although MA was associated with smaller Black-White disparities in preventive care compared to TM, these differences were modest, and MA was not associated with smaller Hispanic-White disparities.

PMID:40790002 | DOI:10.1007/s11606-025-09793-z

Cogn Affect Behav Neurosci. 2025 Aug 11. doi: 10.3758/s13415-025-01336-7. Online ahead of print.

ABSTRACT

Cognitive control processes, specifically interference control and error monitoring, are often impaired across neuropsychiatric disorders and have been proposed as transdiagnostic markers of psychopathology and important treatment targets. Accurately probing them, however, requires understanding the psychometric properties of the measures used to assess cognitive control, including their intra- and interindividual stability over time. Using an Eriksen Flanker Task, we tested behavioral and electrophysiological readouts of cognitive control in 36 healthy individuals (26 females, 10 males; mean age ± standard deviation = 33.18 ± 14.49, range = 19-68) and evaluated their test-retest reliability across 48 hours by calculating Spearman correlations and Intraclass Correlation Coefficients to assess group-level stability. Moreover, we assessed repeatability through Coefficients of Variation and Bland-Altman statistics to investigate the degree of change in participants’ absolute scores. We found moderate-to-excellent test-retest reliability for most cognitive control measures, with condition-specific metrics generally being more reliable than difference scores. Regarding repeatability, we observed considerable intraindividual variability in absolute scores over time, which differed widely between participants. These results demonstrate that measurements of cognitive control may display substantial intraindividual variability across sessions despite demonstrating high test-retest reliability and vice versa. Our findings expand the current literature by providing novel information about the stability of behavioral and physiological markers of cognitive control over time. Moreover, they may have important implications for the application and evaluation of clinical interventions by highlighting the usefulness of considering repeatability measures in addition to the more commonly reported test-retest reliability metrics, when tracking changes over time in clinically relevant processes within single individuals.

PMID:40790001 | DOI:10.3758/s13415-025-01336-7