Category: Nevin Manimala

BMC Health Serv Res. 2026 Jun 27. doi: 10.1186/s12913-026-15042-8. Online ahead of print.

ABSTRACT

BACKGROUND: The global surge in cosmetic procedures has been accompanied by a rise in medical malpractice litigation. Cosmetic services differ fundamentally from therapeutic medicine in their elective nature, heightened patient expectations, and the growing participation of unlicensed providers, each contributing to distinct patterns of adverse outcomes and varying levels of judicial accountability. Therefore, clarifying the distinct risk patterns and legal consequences between medically qualified professionals and unauthorized providers is of critical importance; this research gap has been addressed in the present study.

METHODS: This retrospective cross-sectional study reviewed 525 medical malpractice complaint records registered at the Shahid Ghodosi Judicial Complex in Shiraz, Iran, between 2021 and 2023. Records were screened according to predefined inclusion and exclusion criteria. Data were extracted from judicial case files using a structured checklist including demographic, clinical, forensic, and legal variables. Descriptive statistics and the Fisher-Freeman-Halton Exact Test were performed using SPSS version 25.

RESULTS: Of the 525 medical malpractice records reviewed, 253 (48.1%) met the eligibility criteria and were included in the final analysis. Statistically significant differences were observed between licensed and unlicensed providers across clinical outcomes, service settings, and judicial penalties (p < 0.001). Licensed providers were involved in 74.3% of cases and were primarily associated with technical complications in surgical procedures, particularly rhinoplasty (27.1%), leading mainly to structural deformities (86.4%) and dissatisfaction with aesthetic outcomes. In these cases, “Diyah” (financial compensation) alone was the predominant judicial outcome (96.8%). In contrast, unlicensed providers (25.7%) were significantly associated with minimally invasive procedures such as fillers and Botox (40.0%), frequently performed in informal settings including private homes (53.8%). These interventions were mainly linked to infections and tissue necrosis (62.2%) and resulted in significantly harsher judicial penalties, including imprisonment (52.3%) (p < 0.001).

CONCLUSIONS: Licensed and unlicensed providers exhibited distinct malpractice patterns and judicial outcomes. Licensed providers were primarily associated with technical complications resulting in Diyah penalties, whereas unlicensed providers were linked to severe adverse events in informal settings and harsher sanctions, including imprisonment. These findings highlight the need for targeted regulatory and patient-safety interventions.

TRIAL REGISTRATION: Not applicable.

PMID:42365359 | DOI:10.1186/s12913-026-15042-8

BMC Res Notes. 2026 Jun 27. doi: 10.1186/s13104-026-07908-1. Online ahead of print.

ABSTRACT

OBJECTIVE: A major problem with reviewing the statistical methodology in published medical articles is that extracting the necessary details from large sample sets is time-consuming. This paper demonstrates how a novel automated procedure can extract information about statistical reporting from literature. To illustrate this, we searched the PubMed Central database for original research articles published in 2021 and 2023 to identify the statistical software packages used for data analysis. A key element in terms of transparency and reproducibility is the reporting of the software used for statistical analysis.

RESULTS: A freely available Shiny App was created with the help of generative artificial intelligence, and it was used to retrieve automatically information from randomly selected samples of articles indexed in PubMed Central. We analyzed a large sample of articles (n = 1740) to determine the reporting of statistical software for nine study designs. We found that, across different study types, proprietary software such as IBM SPSS Statistics still dominates. Despite multiple calls for greater use of open-source research software, these programs are not used as frequently. In addition, a surprising number of articles did not report the software used. Furthermore, this is the first application of the recent Vibe Coding concept to statistical research methods.

PMID:42365353 | DOI:10.1186/s13104-026-07908-1

BMC Res Notes. 2026 Jun 27. doi: 10.1186/s13104-026-07929-w. Online ahead of print.

ABSTRACT

AIM: The objective of this study is to compare the hemostatic efficacy of oxidised regenerated cellulose powder (Surgicel^® Powder) and fibrin glue (Tisseel^®) in a rat model of liver parenchymal haemorrhage, and to evaluate their effects on tissue healing.

RESULTS: Preoperative haemoglobin and haematocrit values were comparable among the groups (p > 0.05). At 24 h, postoperative haemoglobin and haematocrit values differed significantly among the three groups (p = 0.045 and p = 0.042, respectively), with lower values in the saline-compression control group and relatively preserved values in the Surgicel^® Powder and Tisseel^® groups. However, no statistically significant difference was identified between the two active treatment groups. Histopathological evaluation revealed no statistically significant between-group differences in necrosis, inflammation, fibrosis, haemorrhage, or granulation tissue formation (p > 0.05).

PMID:42365352 | DOI:10.1186/s13104-026-07929-w

J Orthop Surg Res. 2026 Jun 27. doi: 10.1186/s13018-026-07049-y. Online ahead of print.

ABSTRACT

OBJECTIVE: Imaging modalities play a critical role in determining surgical versus conservative management for distal radius fractures. This study aimed to evaluate the impact of two-dimensional (2D) and three-dimensional (3D) computed tomography (CT) on the decision to operate in distal radius fractures and to compare their influence between AO Type B and Type C fractures.

METHODS: This cross-sectional, survey-based study included 97 orthopedic and traumatology specialists. Twelve distal radius fracture cases classified according to the AO system (six Type B and six Type C) were selected. Participants were sequentially presented with plain radiographs, post-reduction radiographs in cast, 2D CT images, and 3D CT reconstructions for each case. After each imaging stage, participants were asked to indicate their decision to operate (surgical or conservative). Changes in the decision to operate were statistically analyzed.

RESULTS: Among AO Type B fractures, the addition of CT imaging to plain and post-reduction radiographs did not significantly change the decision to operate in most cases (p > 0.05). In contrast, among AO Type C fractures, the addition of 2D CT imaging significantly changed the decision to operate in favor of surgical management (p < 0.05), whereas the subsequent addition of 3D CT did not produce a further significant change (p > 0.05).

CONCLUSION: For AO Type B distal radius fractures, the addition of CT imaging to plain and post-reduction radiographs had limited impact on the decision to operate. In AO Type C fractures, 2D CT imaging significantly influenced the decision to operate, whereas the subsequent addition of 3D CT did not provide an additional impact on the decision to operate.

LEVEL OF EVIDENCE III: Descriptive survey study.

PMID:42365333 | DOI:10.1186/s13018-026-07049-y

BMC Med Inform Decis Mak. 2026 Jun 27. doi: 10.1186/s12911-026-03645-4. Online ahead of print.

ABSTRACT

BACKGROUND: Frailty in older adults is a multidimensional condition associated with physical, psychological, and sociodemographic factors that may affect functionality and quality of life during aging. The analysis of these factors often requires the management of heterogeneous information, which can represent a challenge for specialists during evaluation and follow-up processes. In this context, computational tools and data-driven approaches may support the organization and exploratory analysis of multidimensional health information. This study presents the development of a web-based computational system designed to support specialists in the collection, management, and analysis of health-related data from older adults in the State of Hidalgo, México.

METHOD: A web platform was developed to register and organize sociodemographic, psychological, and physical information from older adults. The system integrated questionnaires, physical measurements, statistical analysis tools, and computational intelligence techniques within a single environment. Data from 210 participants were collected and analyzed using exploratory statistical methods, feature selection techniques, and K-means clustering to identify patterns associated with functional and health-related characteristics. Internal validation metrics, including the Silhouette coefficient, Davies-Bouldin Index, and Calinski-Harabasz Index, were used to support cluster evaluation.

RESULTS: The proposed system facilitated the structured storage, visualization, and exploratory analysis of multidimensional health information. The clustering analysis identified two differentiated groups characterized by distinct physical and psychological profiles. Differences were observed in variables such as muscular strength, calf circumference, body mass index, gratitude, and functional self-perception. The interpretation of the obtained profiles considered the demographic composition of the groups, particularly the predominance of women in one cluster, which may influence physical measurements associated with aging. Additionally, the usability assessment conducted with specialists using the SUS instrument indicated an acceptable level of usability for exploratory and research support purposes.

CONCLUSIONS: The results suggest that integrating computational intelligence and statistical analysis techniques into a unified platform may support the exploratory assessment of multidimensional factors related to aging and frailty in older adults. The proposed system does not aim to establish clinical diagnoses, but rather to provide specialists with an additional resource for organizing and interpreting complex health-related information. This approach may contribute to the development of data-driven tools to support gerontological research and comprehensive evaluation processes in older populations.

TRIAL REGISTRATION: Not applicable.

PMID:42365325 | DOI:10.1186/s12911-026-03645-4

BMC Psychiatry. 2026 Jun 27. doi: 10.1186/s12888-026-08328-y. Online ahead of print.

ABSTRACT

BACKGROUND: Anxiety disorders have a significant impact on youth globally; however, data from low- and middle-income countries such as Kenya are scant. This study aimed to determine the frequency and patterns of anxiety symptoms among Kenyan youth, as well as assess the relationships between anxiety symptoms and sociodemographic, economic, and comorbid mental health factors.

METHODS: This was a cross-sectional study conducted in urban and peri-urban locations in the Nairobi Metropolitan area among 1,972 participants aged 14-25 years. The study used validated instruments, including the Anxiety Symptoms Questionnaire (ASQ), Beck Depression Inventory, and WHO-ASSIST. Descriptive statistics, t-tests, ANOVA, and Pearson correlations were used for statistical analysis, and a univariate GLM was used to determine the predictors of the anxiety symptoms.

RESULTS: Anxiety symptoms were common, with the most reported cognitive symptoms being worry and nervousness. Females and participants from urban areas had significantly higher anxiety scores (p < 0.001), with mean differences ranging from 6 to 15 points across frequency, intensity, and total scores compared to males and peri-urban participants. Anxiety scores had a negative correlation (p < 0.01) with lower wealth index and moderate positive correlations with psychosis and bipolar disorder. Depression (r = 0.51; p < 0.01), PTSD, and substance use (i.e., alcohol and cannabis) were comorbid conditions.

CONCLUSIONS: The study unearths the complexity of anxiety among Kenyan youth, with a nexus of social, economic, and psychological factors involved. These findings call for comprehensive mental health strategies focusing on reducing socioeconomic disparities and addressing comorbid conditions. Longitudinal trends and the efficacy of such interventions should be explored in future research for similar populations.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42365324 | DOI:10.1186/s12888-026-08328-y

BMC Health Serv Res. 2026 Jun 27. doi: 10.1186/s12913-026-14683-z. Online ahead of print.

ABSTRACT

BACKGROUND: Moral distress is a relevant occupational health issue in hospital settings, particularly in high-complexity environments such as surgical units, where organizational constraints, ethical dilemmas, and interprofessional dynamics shape professionals’ experiences. Comparative evidence is needed to understand how moral distress manifests across professional groups working within the same clinical context.

METHODS: This cross-sectional comparative study examined moral distress among physicians and nursing staff working in surgical settings at a public university hospital in southern Brazil. Data were collected from 245 healthcare professionals (167 physicians and 78 nursing staff) using the Brazilian Moral Distress Scale – Short Version (EDME-BR-VR). Group differences in moral distress dimensions were assessed using descriptive statistics and Mann-Whitney U tests. Comparative structural analyses were conducted using Partial Least Squares Structural Equation Modeling (PLS-SEM), with separate models estimated for each professional group to examine similarities and differences in structural relationships.

RESULTS: Significant differences between physicians and nursing staff were observed in selected moral distress dimensions, particularly Safe and Qualified Care, Defense of Values and Rights, and Working Conditions. Across both groups, Recognition, Power, and Professional Identity emerged as a central antecedent of moral distress, showing significant associations with teamwork, working conditions, safe and qualified care, and ethical violations. Comparative PLS-SEM results indicated similar overall relational patterns across groups, with differences in the magnitude of specific structural paths reflecting profession-specific dynamics.

CONCLUSIONS: Moral distress among physicians and nursing staff in surgical settings is shaped by shared organizational factors as well as profession-specific ethical pressures. Comparative analysis highlights the central role of professional recognition and identity while underscoring the need for differentiated organizational strategies to address moral distress across professional groups. These findings provide actionable insights for healthcare managers seeking to promote ethical practice, psychological safety, and sustainable work environments in surgical care.

PMID:42365313 | DOI:10.1186/s12913-026-14683-z

BMC Public Health. 2026 Jun 27. doi: 10.1186/s12889-026-28173-8. Online ahead of print.

ABSTRACT

BACKGROUND: Vaccination remains one of the most effective public health measures, yet many children in Nigeria continue to miss essential vaccines, leaving them exposed to preventable diseases. Understanding the geographic and temporal patterns of missed vaccinations is important for designing targeted and equitable immunization strategies. This study investigates the geospatial variations in the prevalence of children who missed diphtheria-pertussis-tetanus vaccination in Nigeria.

METHODS: Data were obtained from the Nigeria Demographic and Health Surveys conducted between 2003 and 2023/2024. Bayesian geostatistical models were fitted within the Integrated Nested Laplace Approximation (INLA) framework to estimate the prevalence of zero-dose and under-immunized children across states and survey periods. Exceedance probability maps were used to identify states with a high likelihood that the prevalence of zero-dose children exceeded ten percent.

RESULTS: The results show clear geographic clustering, with persistently higher prevalence of missed vaccinations in the northern regions compared to the south. Dropout between consecutive DPT doses has decreased over time, indicating improved follow-through once children start vaccination; however, each successive dose still shows a higher prevalence of missed vaccinations than the preceding one. Exceedance probability maps further highlight states such as Kebbi, Sokoto, Zamfara, and parts of Niger, Kwara, Borno, Yobe, Taraba, and Kogi, where the likelihood of zero-dose prevalence surpassing 10% remains high.

CONCLUSION: Despite improvements in childhood vaccination coverage, large geographic disparities persist, especially in northern states. The continued presence of states with a high probability of zero-dose prevalence suggests that national progress has not resulted in equitable gains. Strengthening local immunization systems, addressing regional barriers, and prioritizing targeted interventions are needed to ensure that all children benefit from routine vaccination services.

PMID:42365312 | DOI:10.1186/s12889-026-28173-8

BMC Oral Health. 2026 Jun 27. doi: 10.1186/s12903-026-08993-1. Online ahead of print.

ABSTRACT

BACKGROUND: The evaluation of three-dimensional fracture mapping may offer significant benefits for clinicians, as well as for engineers involved in the design of advanced implants. The specific objectives of this study were to perform three-dimensional mapping of mandibular fractures based on the unique fracture morphologies of a defined cohort and to assess fracture distribution according to demographic variables, etiological factors, mandibular third molar impaction status, and fracture characteristics.

METHODS: This retrospective single-center cohort study included patients with mandibular fractures who were admitted to the Department of Oral and Maxillofacial Surgery at a tertiary healthcare center between January 2018 and February 2025. The primary outcome was the three-dimensional mapping of mandibular fracture distribution, visualized as fracture line density using color-coded heat maps. Covariates included demographic, etiological, mandibular third molar-related, and fracture-related variables. Fracture mapping was performed at the fracture level, whereas statistical analyses evaluating the association between impacted third molars and fracture location were conducted at the patient level.

RESULTS: One hundred fifty eight patients with mandibular fractures were analyzed, including 103 males (65.2%) and 55 females (34.8%) patients. The mean age of the patients was 36.8 ± 13.7 years. A total of 239 fractures were identified, and 267 fracture lines were delineated. In three-dimensional mapping, mandibular fractures most frequently clustered in the retromolar area, condylar neck, canine socket, and mental foramen regions. Mandibular fractures were most frequently observed in young male patients. The angle/ramus region was the most commonly fractured anatomical site, and assault was the predominant etiological factor. Impacted mandibular third molars were associated with a higher frequency of angle/ramus fractures, whereas condylar process fractures were more common in patients without impacted third molars. (OR = 2.04, 95% CI = 1.08-3.85, p = .027; and OR = 0.40, 95% CI = 0.20-0.80, p = .015, respectively).

CONCLUSIONS: Three-dimensional fracture mapping revealed clustering of mandibular fractures in the retromolar area, condylar neck, canine socket, and mental foramen regions, indicating areas of higher observed fracture-line density in this cohort.

PMID:42365309 | DOI:10.1186/s12903-026-08993-1

BMC Womens Health. 2026 Jun 27. doi: 10.1186/s12905-026-04595-9. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to investigate the factors associated with the use of different modern contraceptives (MCs) by Nigerian married or in-union women of reproductive age with a demand for family planning (DFP). These MCs are permanent methods and long-acting reversible contraceptives (PLARCs), medium-acting reversible contraceptives (MARCs), and short-acting reversible contraceptives (SARCs).

METHODS: An unweighted sample size of 9,983 women nested in a total of 1,118 communities was extracted from the 2024 Nigeria Demographic and Health Survey. A multilevel multivariable multinomial logistic regression analysis was carried out using Stata 17.0. Two levels of analysis were utilised: the individual and the community level, with the accompanying variables adjusted for.

RESULTS: The DFP satisfied by modern methods (DFPSM) was approximately 33.9%, with the DFP satisfied by PLARCs, MARCs, and SARCs estimated as approximately 17.1%, 9.1%, and 7.8%, respectively. We found large remaining significant between-community variances in the odds of women satisfying their DFP with the different MCs. This was shown by the various estimated median odd ratios for the DFP satisfied by PLARCs, MARCs, and SARCs: approximately 3.870, 4.830, and 4.532, respectively. These remaining between-community variances were of greater relevance than the associated effects of most of the adjusted individual and household-level variables. This was with the exception of only the regression effects on DFP satisfied with MARCs of women in households with 1 to 2 dejure children at most 5 years old (aOR = 5.514, 95%CI = 2.226 to 13.658, p < 0.001); and those in households with no children at most 5 years old (aOR = 9.359, 95%CI = 3.656 to 23.954, p < 0.001). However, other variables that significantly increased the use of the different types of MCs by women with a DFP were their formal education level and women being usual residents of communities with high age at first marriage/cohabitation, low fertility clusters, and low polygyny clusters.

CONCLUSION: To increase the very low DFPSM in Nigeria using different types of MCs, government policies/interventions aimed at improving the educational level of girls beyond the primary level should be implemented. A greater concentration should be within communities with low age at first marriage/cohabitation, high polygyny, and high fertility clusters.

PMID:42365305 | DOI:10.1186/s12905-026-04595-9