Category: Nevin Manimala

BMC Womens Health. 2025 Aug 21;25(Suppl 1):398. doi: 10.1186/s12905-025-03945-3.

ABSTRACT

BACKGROUND: The self-administration of the subcutaneous depot medroxyprogesterone acetate (DMPA-SC) has the potential to empower women and improve contraceptive use. Several studies have demonstrated the acceptability of the provider-administered DMPA-SC, for private, public, or community-based health providers, but less is known about self-injection training from community pharmacists (CPs) and Patent and Proprietary medicine Vendors (PPMVs) (also known as drug shops). The purpose of this study was to examine the factors associated with the acceptance of DMPA-SC self-injection training when provided by trained CPs and PPMVs in Lagos and Kaduna states.

METHODS: A cross-sectional study was conducted among 186 women of reproductive age (18-49 years) who received self-injection training on DMPA-SC from trained CPs and PPMVs between August and September 2019, and between May 2022 and June 2023. Women who selected DMPA-SC, opted for self-injection, and were trained by a CP or a PPMV were invited to participate in the study. Quantitative telephone interviews were conducted with eligible clients within six (6) weeks of obtaining DMPA-SC commodities for self-injection from a trained CP or PPMV. Bivariate chi-square test and multivariate logistic regression were used to examine factors associated with acceptability and continued self-injection of DMPA-SC at home. The results were considered significant at a p value < 0.05.

RESULTS: More than half of the women had used a contraceptive in the past (55%), and 73% received information on DMPA-SC from a CP or PPMV. Using a family planning method prior to visiting the provider (Odds ratio (OR) = 4.31; 95% Confidence Intervals (CIs): 1.05, 17.69; p = 0.04), receiving information on DMPA-SC from friends/relative (OR = 5.08; 95% CI: 1.01, 25.62; p = 0.05), perceived high-quality care (OR = 7.72; 95% CI: 2.52, 23.61; p = 0.00) and middle-quality care (OR = 3.35; 95% CI: 1.16, 9.69; p = 0.03) were significantly associated with the likelihood of continued DMPA-SC self-injection at home. A high level of acceptance of training in DMPA-SC self-injection was significantly associated with service from PPMVs (OR = 4.94; 95% CI = 1.46, 16.75; p = 0.01) and perceived high-quality care (OR = 4.23; 95% CI = 1.62, 11.05; p = 0.00).

CONCLUSIONS: The results are promising for expanding DMPA-SC self-injection service delivery in Nigeria through increased method choice, and empowered users. The provision of counseling and DMPA-SC self-injection training by CPs and PPMVs is acceptable among women in Lagos and Kaduna states.

PMID:40842014 | DOI:10.1186/s12905-025-03945-3

Malar J. 2025 Aug 21;24(1):272. doi: 10.1186/s12936-025-05406-6.

ABSTRACT

BACKGROUND: Long-lasting insecticidal nets (LLINs) have been distributed and installed in the Dominican Republic since 2008, and they remain the main vector control intervention used to pursue malaria elimination in the country. However, LLIN performance remains unclear due to a lack of monitoring over the past decade.

METHODS: A cross-sectional household survey was conducted to monitor LLIN coverage, access, use, physical integrity, washing and drying practices, and the time people go to bed and wake up in the two main malaria foci of the country: Azua (4-6 months post-distribution and installation) and San Juan (one year post-distribution and installation).

RESULTS: The percentage of sleeping spaces that could be covered with a LLIN given the LLINs present in the household was 64% in Azua and 63% in San Juan; with any net, coverage was 75% in Azua and 80% in San Juan. Reported LLIN retention was 88.4% in Azua and 80.9% in San Juan. The percentage of people who had access to sleeping under an LLIN was 58.8% in Azua and 65.4% in San Juan. Among people with LLIN access (people with enough LLINs to cover all sleeping spaces in their household), use was 48.8% in Azua and 75% in San Juan; and overall, LLINs use was 32.3% in Azua and 50.5% in San Juan. Most LLINs remained in serviceable physical condition (Azua: 96.4%, San Juan: 88.9%) but those with holes were not repaired. Most LLINs were washed with aggressive products (Azua: 65%, San Juan: 86%), at a frequency that suggests they will be washed more than twenty times in three years (Azua: 52%, San Juan: 73%), and dried under the sun (Azua: 75%, San Juan: 90%).

CONCLUSION: Poor washing and drying practices are prevalent in both areas, low LLIN use was observed in Azua and some LLIN coverage gaps were measured in both foci. Urgent behavioural change strategies are needed to improve LLIN care in both foci and to increase LLIN use in Azua, alongside revisions to LLIN quantification methods to ensure full coverage of all sleeping spaces in use during installation. Heterogeneities in LLINs use across foci suggest the need for monitoring use in each distribution area to identify individual gaps and promptly address them.

PMID:40842007 | DOI:10.1186/s12936-025-05406-6

BMC Endocr Disord. 2025 Aug 21;25(1):198. doi: 10.1186/s12902-025-02018-8.

ABSTRACT

BACKGROUND: Diabetes screening is one of the simpler methods for preventing and lowering the disease’s morbidity and mortality. Screening for gestational diabetes is a crucial component of obstetric care, as it negatively affects the life of both the mother and the fetus. There is a high prevalence of obesity, diabetes, high blood pressure, and tobacco use in Lesotho. This highlights the significance of bolstering prevention and treatment initiatives in the country. Therefore, this study is intended to assess diabetes screening and its associated factors among women aged 15-49 years using the 2023-24 Lesotho demographic and health survey dataset.

METHODS: A cross-sectional study was employed using data from the most recent national representative dataset. A total sample of 3,297 women aged between 15 and 49 years was included in the study. Data extracted from the Lesotho Demographic and Health Survey 2023-24 data sets were cleaned, recoded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel logistic regression was used to determine the factors associated with the outcome variable. Finally, variables with a p-value less than 0.05 were declared statistically significant.

RESULTS: In the current study, 29.18% (95% CI: 27.65%-30.75%) of women aged 15-49 years in Lesotho were screened for diabetes mellitus. Of these, 1.40% of them had high blood sugar or diabetes, and 54.35% of women were diagnosed in the last twelve months. Age of respondents [AOR = 3.53; 95% CI (2.80, 4.46)], maternal occupation [AOR = 1.38; 95% CI (1.15, 1.65)], wealth status [AOR = 1.43; 95% CI (1.07, 1.91)], and visiting a healthcare facility in the last 12 months [AOR = 1.31; 95% CI (1.09, 1.57)] were statistically significantly associated with diabetes screening.

CONCLUSION: Less than one in three women aged 15 to 49 years were screened for diabetes in Lesotho. Advanced age, working women, wealthier households, and visiting a healthcare facility in the last 12 months were associated with higher odds of diabetes screening. Therefore, women’s empowerment, regular visits to healthcare facilities, and awareness creation for young women are recommended to improve diabetes screening practices among women.

PMID:40842005 | DOI:10.1186/s12902-025-02018-8

BMC Pregnancy Childbirth. 2025 Aug 21;25(1):870. doi: 10.1186/s12884-025-08009-w.

ABSTRACT

BACKGROUND: The association between unplanned pregnancy and perinatal depression is understudied in racially and ethnically diverse and low-income populations. The present study was compromised of a secondary analysis of data from a low-income and 70% racially and ethnically minoritized sample to examine associations between unplanned pregnancy and perinatal depressive symptoms and to explore potential moderation by social factors.

METHODS: Pregnant individuals (n = 808) were enrolled in a larger study evaluating the effectiveness of a preventative intervention for postpartum depression, and self-reported depressive symptoms were collected prenatally and at 12 weeks postpartum using the 16-item Quick Inventory of Depressive Symptomatology. Multiple linear regression examined the relationship between unplanned pregnancy and maternal depressive symptoms, and the potential interactions between unplanned pregnancy and (1) race/ethnicity (2), education level (3), first-time parent status, and (4) a prenatal mental healthcare utilization. Analyses were conducted both within the sample as a whole and within racial/ethnic subgroups.

RESULTS: While bivariate regression revealed a significant association between unplanned pregnancy and prenatal depressive symptoms (β = 0.88, 95% CI [0.27, 1.49], p = 0.005), unplanned pregnancy was not significantly associated with prenatal or postpartum depression in adjusted models in the full sample. Analyses suggested different trends in racial/ethnic subgroups. Specifically, endorsing prenatal mental healthcare utilization and unplanned pregnancy was associated with higher prenatal depressive symptoms in the Latine subgroup compared to those whose pregnancies were planned (β = 4.59, 95% CI [0.60, 8.59], p = 0.025). Additionally, unplanned pregnancy was associated with higher depressive symptoms at 12 weeks postpartum compared to those with planned pregnancy also in the Latine sample (β = 1.06; 95% CI [0.10, 2.03], p = 0.031). Unplanned pregnancy was not found to be associated with prenatal depressive symptoms in the adjusted models of any other racial/ethnic subgroups.

CONCLUSIONS: These secondary analyses from a larger study suggest potentially important differences in the association between unplanned pregnancy and perinatal depressive symptoms by racial/ethnic subgroups. Future research should acknowledge the myriad stressors and protective factors experienced by low-income and racially and ethnically diverse perinatal populations when evaluating differences in outcomes among racial/ethnic subgroups.

PMID:40842004 | DOI:10.1186/s12884-025-08009-w

Glob Health Res Policy. 2025 Aug 21;10(1):36. doi: 10.1186/s41256-025-00439-5.

ABSTRACT

BACKGROUND: Optimizing the cultural accessibility of digital healthcare tools requires understanding user perspectives on usability features and cultural appropriateness.

METHODS: A cross-sectional survey of 3,030 caregivers (mean age 44.0, 52.9% female) and 2,108 inpatients (mean age 49.7, 54.0% female) at a Guangxi medical center (July-October 2024) assessed experiences with digital tools, support needs, and preferences for culturally adaptive features.

RESULTS: Caregivers reported a higher adoption of digital tools than patients (caregivers: 87.1% vs. patients: 62.0%, P-value < .001), yet 81.1% of caregivers reported unmet needs. Both groups (caregivers: 67.0%; patients: 64.0%) prioritized integrating traditional medicine over other cultural factors (language diversity, traditional medicine, folk customs, and medical resource availability). Caregivers valued interactive health management tools (73.3% vs. 66.7% among patients, P-value < .001) and user feedback mechanisms (61.2% vs. 55.0% among patients, P-value < .001) more than patients.

CONCLUSIONS: Despite high adoption, caregivers report significant gaps in culturally relevant support. Digital health interventions should prioritize user-centered designs, incorporating traditional medicine and addressing the divergent preferences of caregivers and patients.

PMID:40841989 | DOI:10.1186/s41256-025-00439-5

BMC Sports Sci Med Rehabil. 2025 Aug 21;17(1):244. doi: 10.1186/s13102-025-01299-9.

ABSTRACT

BACKGROUND: The lunge is a critical movement in badminton, facilitating rapid and efficient court coverage and enabling players to promptly reach the hitting position. While previous studies have examined the influence of lunge direction on lower limb biomechanics, the effects of gender have yet to be explored. Therefore, the purpose of this study was to investigate the combined effects of direction and gender on lower limb biomechanics during forehand and backhand forward lunges in amateur badminton players.

METHODS: 16 male and 16 female amateur players were recruited. Kinematic and kinetic data were measured synchronously using a Vicon motion capture system and a Kistler force plate. A two-way mixed-design ANOVA was used to explore the effects of different lunge directions, gender, and the interaction between the two factors on each parameter. Joint angles during the stance phase were analyzed using the statistical nonparametric mapping method.

RESULTS: Interaction effects between gender and direction were observed for the second impact of vertical ground reaction force (VGRF), knee peak external rotation moment, ankle sagittal angles and knee frontal and transverse moments during the stance phase. Compared with the females, the males showed significantly greater loading rate and impulse of VGRF, peak flexion, sagittal range of motion (ROM) and abduction moment of knee joint. The sagittal ROM of hip and knee joint and the knee flexion moment around 84% of the stance phase during backhand lunge was significantly greater than during forehand lunge. In contrast, the sagittal ROM of ankle joint and peak abduction moment of knee joint was significantly lower during backhand lunge.

CONCLUSIONS: Gender-specific biomechanical strategies influence knee loading patterns during badminton lunges, contributing to direction-dependent variations in injury risk. These findings underscore the importance of incorporating directional biomechanical demands and sex-specific neuromuscular adaptations into training and injury prevention programs to mitigate injury risks.

PMID:40841982 | DOI:10.1186/s13102-025-01299-9

BMC Public Health. 2025 Aug 21;25(1):2868. doi: 10.1186/s12889-025-24220-y.

ABSTRACT

OBJECTIVE: To create and verify a machine learning model that integrates social determinants of health (SDoH) for assessing post-stroke depression (PSD) and examining the association between SDoH and disease outcomes.

METHODS: Data were acquired from the National Health and Nutrition Examination Survey. Logistic regression was employed to analyse the association between SDoH and PSD, whereas Cox regression was utilized to assess the correlation between SDoH and all-cause mortality in PSD. The Boruta algorithm was employed for feature selection, and four machine learning models were constructed (CatBoost, Logistic, Multilayer Perceptron, and Random Forest) to evaluate the predictive effectiveness, calibration, and clinical applicability of these ML models. SHAP values were computed to ascertain the predictive significance of each feature in the model that exhibited the highest predictive performance.

RESULTS: Logistic regression analysis revealed a significant positive correlation between SDoH and PSD prevalence(p for trend < 0.0001). Compared to the other three models, CatBoost (AUC = 0.966) demonstrated the best overall predictive performance. Moreover, the decision curve analysis (DCA) and calibration curve findings demonstrated that the CatBoost model possessed considerable clinical utility and consistent predictive efficacy. The ten-fold cross-validation method further confirmed the model’s robustness and generalization ability.

CONCLUSIONS: A linear relationship exists between SDoH and PSD, with CatBoost demonstrating the best performance in predicting PSD. SHAP values emphasize the importance of SDoH.

PMID:40841950 | DOI:10.1186/s12889-025-24220-y

BMC Public Health. 2025 Aug 21;25(1):2878. doi: 10.1186/s12889-025-24252-4.

ABSTRACT

OBJECTIVE: This study aimed to investigate the impact of physical activity (PA) on emotional management ability (EMA) in college students and to analyze the chain mediating roles of psychological resilience (PR) and health literacy (HL) in the relationship between PA and EMA.

METHODS: Demographic information was collected using a stratified, cluster, and multi-stage sampling method. Data on PA, PR, HL, and EMA among college students were collected using an online questionnaire. A total of 13,590 valid questionnaires were obtained.

RESULTS: A significant positive correlation was found between PA and EMA in college students (r = 0.177, P < 0.01). PR and HL played significant mediating roles in the relationship between PA and EMA. The mediation effect consisted of independent mediation by PR and HL and a chain mediation effect between the two. The values of the independent mediation effects and the chain mediation effect were 0.011, 0.010, and 0.004, respectively. The chain mediation effect was lower than each of the individual mediation effects and showed a statistically significant difference compared to the mediation effect of HL (P < 0.05).

CONCLUSION: PA significantly enhances college students’ EMA through direct effects and a chain mediation pathway involving PR and HL. Coordinated interventions, including regular exercise, PR training, and health education, are recommended to optimize college students’ psychological health.

PMID:40841939 | DOI:10.1186/s12889-025-24252-4

BMC Gastroenterol. 2025 Aug 21;25(1):608. doi: 10.1186/s12876-025-04177-3.

ABSTRACT

BACKGROUND: Advanced gastric cancer frequently leads to severe complications, such as bleeding, which severely impacts patients’ quality of life and prognosis. Traditional approaches for hemostasis include endoscopic treatments and surgery, but their invasive nature and potential for significant morbidity have made less invasive options like radiation therapy (RT) and transarterial embolization (TAE) appealing. Nonetheless, studies comparing the therapeutic effects and prognosis of RT and TAE are limited, underscoring a significant gap in research and clinical practice.

METHODS: This retrospective study analyzed patients with advanced gastric cancer who experienced uncontrollable bleeding and were treated with RT or TAE. The efficacy of these treatments was assessed based on the achievement of hemostasis, defined as the absence of the need for blood transfusion within 14 days post-treatment and no requirement for additional intervention for bleeding. Furthermore, the study evaluated the post-treatment course, including survival outcomes and re-bleeding rates, to compare the prognostic implications of treatment success or failure.

RESULTS: This study encompassed 28 patients, of whom 19 underwent RT and 9 received TAE. RT was associated with a superior rate of immediate hemostasis (94.7% versus 66.7%, p = 0.047). Nonetheless, the incidence of re-bleeding in the RT cohort was 15.8%, compared to 44.4% in the TAE group, a difference that did not reach statistical significance (p = 0.11). Furthermore, the occurrence of adverse events was comparable between the two treatment modalities (21.1% for RT versus 33.3% for TAE, p = 0.48). An examination of long-term outcomes underscored the initial treatment’s effectiveness and the potential transition to additional therapies as critical determinants of the re-bleeding risk. Groups achieving favorable initial outcomes (p < 0.001) and those for whom subsequent interventions were viable (p = 0.014) demonstrated a significant enhancement in re-bleeding-free survival. Despite the discrepancy in rates of immediate hemostasis, the comparison between the RT and TAE groups revealed no statistically significant difference in re-bleeding-free survival (p = 0.55).

CONCLUSION: RT exhibited superior hemostasis in advanced gastric cancer bleeding compared to TAE, yet both treatments showed similar re-bleeding-free survival rates. The success of the initial treatment, along with potential for further interventions, critically influenced outcomes, emphasizing the importance of effective initial hemostasis.

PMID:40841936 | DOI:10.1186/s12876-025-04177-3

BMC Urol. 2025 Aug 21;25(1):208. doi: 10.1186/s12894-025-01879-4.

ABSTRACT

OBJECTIVES: We aimed to examine the association between patient age and procedural intervention, especially nephrectomy, in patients with renal trauma in the National Trauma Data Bank (NTDB).

MATERIALS AND METHODS: We queried the 2013-2020 NTDB for adult renal trauma patients with an American Association for the Surgery of Trauma (AAST) grade. Patients without AAST grade or with no sign of life were excluded. We constructed a multinomial logistic regression model to demonstrate the association between age and procedural interventions (renal angioembolization, renorrhaphy and nephrectomy). Models were adjusted for patient, hospital, and clinical factors.

RESULTS: Our cohort was comprised of 49,884 patients with renal trauma aged 18-89 years, of which 691 (1.4%), 995 (1.9%), and 3,366 (6.8%) underwent angioembolization, renorrhaphy, and nephrectomy, respectively. After adjusting for relevant variables, the risks of nephrectomy and angioembolization were positively associated with patient age, particularly in those 40 years of age and older. Adjusted risk of nephrectomy (OR 0.07 per 10 years of age, 95% CI 0.03-0.11, p < 0.001) and angioembolization (OR 0.19 per 10 years of age, 95% CI 0.14-0.24, p < 0.001) ranged between ≈ 0.6% and ≈ 1%, and between ≈ 0.3% and ≈ 1% across the patient age range, respectively. Plots depicting marginal effect of age is demonstrated that in patients above 35-40 years of age, a 1-year increase in age is associated with a progressively higher increase in risk of both nephrectomy and angioembolization. The adjusted risk of Renorrhaphy (OR -0.003 per 10 years of age, 95% CI -0.06-0.06, p = 0.92) did not vary substantially with age and the marginal effect of age was negligible across all ages.

CONCLUSIONS: Older patients with renal trauma are more likely to receive procedural intervention namely nephrectomy and renal angioembolization. These results suggest possible age-related cognitive bias in renal trauma management.

PMID:40841903 | DOI:10.1186/s12894-025-01879-4