Nevin Manimala

Parasit Vectors. 2025 Apr 9;18(1):136. doi: 10.1186/s13071-025-06777-0.

ABSTRACT

BACKGROUND: Canine vector-borne pathogens (CVBP) are transmitted by arthropod vectors such as ticks, fleas, mosquitoes, and phlebotomine sand flies and are of global veterinary and medical importance. Dogs are important reservoir hosts, which may develop potentially life-threatening clinical signs. The Balkan area harbors diverse vector fauna and associated CVBPs, and data, particularly from the Republic of Kosovo, are scarce. Considering the high number of stray and privately owned dogs primarily kept outside, living in close contact with dogs might promote spillover of zoonotic pathogens to human populations. To combat these diseases, a One Health approach is required. Therefore, our study molecularly analyzed samples of dogs for CVBP.

METHODS: Blood samples of 276 dogs originating from all seven districts of Kosovo collected from 2021 to 2022 were screened using polymerase chain reaction (PCR) and sequencing for a substantial set of pathogens, including Anaplasma spp., Babesia spp., Bartonella spp., Ehrlichia spp., Filarioidea, Hepatozoon spp., Mycoplasma spp., Rickettsia spp., and Trypanosoma spp. Prevalence rates were statistically assessed on the basis of various factors such as sex, breed, age, and district.

RESULTS: In total, 150 (54.3%) dogs tested positive for at least one pathogen, comprising eight species of five genera. The most prevalent pathogens detected were Candidatus Mycoplasma haematoparvum (55; 19.9%), Hepatozoon canis (52; 18.8%), and Mycoplasma haemocanis (49; 17.8%). We also detected double (32; 11.6%) and triple (5; 1.8%) infections, with the latter involving combinations of Mycoplasma spp., Dirofilaria repens, Dirofilaria immitis, H. canis, or Babesia vulpes. In addition, prevalence rates were calculated and mapped by district. Of all included factors, significant prevalence differences were found for purebred/mixed breed dogs as well as between age groups.

CONCLUSIONS: This study provides the first comprehensive polymerase chain reaction (PCR)-based screening and detection of vector-borne pathogens in dogs from Kosovo and highlights the circulation of pathogens with high veterinary importance and zoonotic potential.

PMID:40205569 | DOI:10.1186/s13071-025-06777-0

J Health Popul Nutr. 2025 Apr 9;44(1):111. doi: 10.1186/s41043-025-00771-z.

ABSTRACT

OBJECTIVE: To investigate the clinical efficacy of the combined regimen of four drugs (drospirenone and ethinylestradiol tablets (II), mifepristone, misoprostol, and Xinshenghua granules) for the treatment of incomplete medical abortion (MA).

METHODS: 184 patients diagnosed with incomplete MA were recruited and divided into two groups: the combined medication group (n = 92) and the uterine curettage group (n = 92). Patients in the combined medication group were treated with a combined regimen of four drugs, while those in the uterine curettage group were treated with uterine curettage.

RESULTS: After treatment, the diameter of residue (0.00 VS 4.26 ± 2.34 mm, t=-3.359, P = 0.010), days of vaginal bleeding (9.79 ± 1.76 VS 11.92 ± 1.91 days, t=-4.688, P = 0.010) and return time of menses (28.58 ± 2.67 VS 31.24 ± 2.43 days, t=-4.238, P < 0.001) of the combined medication group were significantly lower than those of the uterine curettage group. The duration of menstruation (6.12 ± 1.12 VS 5.11 ± 0.98 days, t=-2.681, P = 0.007) and the proportion of menstrual volume equal to past menstruation after return of menses were higher in the combined medication group than in the uterine curettage group (80.43% VS 57.61%, χ² = 16.472, P < 0.001). No statistically significant difference was observed between the two groups in terms of serum β-HCG levels after treatment (P > 0.05); the overall response rate was higher in the combined medication group than in the uterine curettage group (97.83% VS 80.43%, χ² = 54.331, P < 0.001). No adverse reaction events occurred during the treatment.

CONCLUSION: The combined regimen of four drugs boasts favorable efficacy for the treatment of incomplete MA, and is equally efficient as compared to uterine curettage.

PMID:40205568 | DOI:10.1186/s41043-025-00771-z

Lipids Health Dis. 2025 Apr 9;24(1):134. doi: 10.1186/s12944-025-02550-5.

ABSTRACT

BACKGROUND: The association between remnant cholesterol (RC) with obesity phenotypes remains unclear.

METHODS: This study designed to evaluate the association between RC and obesity phenotypes using data from the National Health and Nutrition Examination Survey (NHANES). The classification systems for obesity phenotypes encompassed both preclinical/clinical obesity and obesity stages, which were assessed based on two authoritative obesity guidelines: the 2025 clinical obesity guideline, and the 2016 obesity guideline established by the American Association of Clinical Endocrinologists and the American College of Endocrinology (AACE/ACE). Participants were selected according to the diagnostic criteria for obesity proposed in the 2025 clinical obesity guideline and were categorized into tertiles based on their RC levels. Their obesity phenotypes, obesity-related clinical manifestations, obesity-related comorbidities, and characteristics were then described. Logistic regression analyses and restricted cubic spline (RCS) models were used to analyze the relationship between RC and adverse obesity phenotypes. Sensitivity analyses were conducted in patients not receiving lipid-lowering drugs.

RESULTS: This study comprised 3,207 adult participants, revealing distinct prevalence patterns: 47.80% exhibited preclinical obesity and 17.81% showed clinical obesity, while obesity stage stratification demonstrated 0%, 12.76%, and 21.63% prevalence for stage 0, 1, and 2, respectively. Multivariable regression analyses demonstrated dose-response relationship between RC levels and adverse obesity phenotypes, with individuals in the highest RC tertile showing significantly elevated risks of clinical obesity (OR 1.95, 95% CI 1.19-3.19) and obesity stage progression (OR 1.96, 95% CI 1.06-3.62) compared to the lowest tertile reference group. RCS analyses further revealed similar “J”-shaped association between RC levels and adverse obesity phenotypes (P for nonlinearity < 0.001), sharing a common inflection point at 0.51 mmol/L. The sensitivity analyses confirmed the consistency of the results among patients who were not receiving lipid-lowering therapy.

CONCLUSIONS: RC was found to be positively and independently associated with adverse obesity phenotypes, particularly when RC levels exceeded 0.51 mmol/L, demonstrating a similar “J”-shaped association. It is recommended that clinicians monitor RC levels for obese patients as a primary screening indicator for adverse phenotypes of obesity.

PMID:40205563 | DOI:10.1186/s12944-025-02550-5

BMC Endocr Disord. 2025 Apr 9;25(1):96. doi: 10.1186/s12902-025-01922-3.

ABSTRACT

OBJECTIVES: The aim of the study was to determine the correlation between insulin resistance (IR) indexes in children with overweight or obesity.

METHODS: A total of 276 children with overweight or obesity and 100 normal-weight children were enrolled in the study. IR indexes such as homeostasis model assessment insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), fasting glucose/insulin ratio (FGIR), Triglyceride glucose index (TyG), and lipid-derived ratios were determined.

RESULTS: The mean ages were 13.0 ± 2.6, 13.1 ± 2.7 and 12.72 ± 2.23 (range:6 – 18 years) for children with overweight, obesity and normal-weight, respectively. A statistically significant positive correlation was found between HOMA-IR and TyG index, and a negative correlation between QUICKI, FGIR and TyG index (r = 0.193, P < 0.001; r = – 0.456, P < 0.001 and r = – 0.392, P < 0.001, respevtively). TyG index, triglyceride (TG)/high-density lipoprotein (HDL), total cholesterol (TC)/HDL, and low-density lipoprotein (LDL)/HDL were higher in children with IR than those without IR (P < 0.05). In receiver operating characteristic curves analysis, cut-off points were found to be ≤ 0.31 for QUICKI (94.31% sensitivity and 97.58% specificity), ≤ 6.3 for FGIR (89.1% sensitivity and 93.94% specificity), and > 4.62 for TyG (49.29% sensitivity and 84.85% specificity).

CONCLUSION: HOMA-IR, FGIR, and QUICKI constitute stronger predictors of IR than TyG index in children with overweight and obesity.

PMID:40205558 | DOI:10.1186/s12902-025-01922-3

J Orthop Surg Res. 2025 Apr 9;20(1):352. doi: 10.1186/s13018-025-05779-z.

ABSTRACT

OBJECTIVE: To explore the clinical efficacy and advantages of Arthroscopic-assisted Uni-portal Spinal Surgery (AUSS)-Transforaminal Lumbar Interbody Fusion (TLIF) in the treatment of degenerative lumbar spinal stenosis (LSS).

METHODS: This study included 71 patients with lumbar spinal stenosis who underwent surgical treatment at the Department of Spine Surgery, Second Affiliated Hospital of Xi’an Medical University, between January 2022 and December 2023. Among these, 34 patients underwent AUSS-TLIF surgery, and 37 patients underwent minimally invasive TLIF (MIS-TLIF) surgery. Preoperative and postoperative Visual Analog Scale (VAS) scores for low back and leg pain, Oswestry Disability Index (ODI) scores, intervertebral disc height, anterior-posterior diameter of the canal (APDC), surgical-related parameters (such as operative time, intraoperative blood loss, postoperative drainage, postoperative C-reactive protein levels, and length of hospital stay), and surgical outcomes were compared and analyzed between the AUSS-TLIF and MIS-TLIF groups.

RESULTS: All 71 patients were followed up. There were no significant differences in preoperative VAS scores or ODI index between the AUSS-TLIF and MIS-TLIF groups (P > 0.05). Three days postoperatively, both groups showed significant reductions in back and leg symptoms, with VAS scores significantly lower than preoperatively (P < 0.05). However, the AUSS-TLIF group had lower VAS scores at 3 days and 3 months postoperatively compared to the MIS-TLIF group, with a statistically significant difference (P < 0.05). At 12 months postoperatively, there was no significant difference in VAS scores between the two groups (P > 0.05). Both groups showed significant improvement in lumbar function at 3 and 12 months postoperatively, with ODI scores significantly lower than preoperatively (P < 0.05). However, the AUSS-TLIF group had a significantly lower ODI score at 3 months postoperatively compared to the MIS-TLIF group (P < 0.05), with no significant difference at 12 months (P > 0.05). There were no significant differences in preoperative intervertebral disc height or APDC between the two groups (P > 0.05). CT scans at 12 months postoperatively showed a significant increase in intervertebral disc height and APDC in both groups compared to preoperative values (P < 0.05), with no significant difference between the groups (P > 0.05). The AUSS-TLIF group had lower surgical blood loss, postoperative drainage, and postoperative inflammatory markers compared to the MIS-TLIF group (P < 0.05), but the AUSS-TLIF group had a significantly longer operative time compared to the MIS-TLIF group (P < 0.05).

CONCLUSION: Both AUSS-TLIF and MIS-TLIF achieve good clinical outcomes, but AUSS-TLIF, as an endoscopic surgery with an open surgical concept, offers advantages including greater flexibility, smaller trauma, less blood loss, shorter operative time, and shorter hospital stay. It provides a better perioperative experience for patients.

PMID:40205552 | DOI:10.1186/s13018-025-05779-z

BMC Infect Dis. 2025 Apr 9;25(1):485. doi: 10.1186/s12879-025-10873-y.

ABSTRACT

BACKGROUND: Monkeypox (Mpox) is an emerging infectious disease caused by the Mpox virus (MPX Virus). The outbreak of Mpox epidemic has caused global panic and is now a public health incident. Various approaches have been proposed in the recent literature to study and analyze the epidemiological dynamics of this infection and effective prevention and control measures. Using mathematical model to understand the transmission dynamics and control strategy is a useful way to understand the prevention of Mpox.

METHODS: A new compartment model is established to examine the effectiveness of vaccine on Mpox based on previous studies. Nonlinear least squares fitting is used for model’s parameter estimation. The impact of a series of preventive and control measures on the epidemic control is explored with optimal control theory in conjunction with the official data released by the authorities.

RESULTS: Firstly, a stability analysis of the developed model was carried out to show that, under certain circumstances, its equilibrium is both locally and globally stable. Secondly, based on the reported cases of Mpox infection in the United States between 2022 and 2023, the model’s optimal parameter values were obtained. A sensitivity analysis of the model parameters was then conducted to identify the key parameters that affect the development of Mpox epidemics in the United States. Lastly, the comparison of control effects under various control strategies showed that implementing the all suggested four control measures at the same time was the most effective way to curb the development of monkeypox epidemic in the United States.

CONCLUSIONS: This study has theoretical significance for understanding and controlling Mpox virus transmission.

PMID:40205551 | DOI:10.1186/s12879-025-10873-y

BMC Health Serv Res. 2025 Apr 9;25(1):523. doi: 10.1186/s12913-025-12523-0.

ABSTRACT

BACKGROUND: Despite many health benefits to infants, the overall breastfeeding rate remains low among Serbian women. The community pharmacists’ efforts aimed at supporting nursing mothers are important. The aim of the study was an evaluation of the pharmacists’ training for breastfeeding support and their perception about its usefulness. The second aim was an evaluation of the provided structured pharmaceutical care service (SPS) over four months, through a calculation of theoretical cost savings for counseled families in case of the risk for introduction of commercial milk formula (CMF).

METHODS: The continuation of breastfeeding instead of starting with CMF was theoretically monetized through cost savings analysis, which is based on energy equivalent human milk and CMF, regardless of the differences in health, social and ecology outcomes of breastfeeding. Cost savings for the counseled families were calculated as financial differences between continuing breastfeeding and switching to CMF.

RESULTS: The 256 pharmacists showed high satisfaction rates with the quality and the usefulness of the training (mean scores: content value 4.89 ± 0.51, technical value 4.91 ± 0.41, program value 4.96 ± 0.20, and usefulness value 4.94 ± 0.25, respectively), as well as a statistically significant higher level of knowledge (p < 0.001 for each of the 10 questions). The prospective observational study enrolled 256 community pharmacists who voluntarily underwent training aimed to breastfeeding support. Of all the trained pharmacists, 151 (59%) actively provided 1,243 SPS focused on breastfeeding support. Of all, 599 mothers of children under 6 months of age received SPS, while 590 provided full data In 275 cases (22.1%), a risk for early breastfeeding cessation was identified. The average age of children whose mothers had undergone SPS was 2.83 months, and the total average potential cost savings until 6 months of children age was 35,884.80 RSD (approximately 306 EUR) for average of 3.17 months.

CONCLUSIONS: The training of pharmacists adds significant value to their knowledge and skills for breastfeeding support, which may lead to potential cost savings for families.

PMID:40205538 | DOI:10.1186/s12913-025-12523-0

J Health Popul Nutr. 2025 Apr 9;44(1):113. doi: 10.1186/s41043-025-00736-2.

ABSTRACT

BACKGROUND: While existing studies conducted in South Asian countries have provided valuable insights into the nutritional status of the marginalized third-gender population and highlighted suboptimal nutritional conditions, regrettably such data is lacking in Bangladesh. Addressing this data gap is crucial to understanding and improving the nutritional condition of the third-gender community. Therefore, this study was conducted to estimate their nutritional status, dietary protein intake, lifestyle, social behavior, nutritional knowledge, and prevalence of diseases.

METHODS: The cross-sectional study was conducted in Dhaka City, Bangladesh. Fifty participants from the third-gender community were selected. Study subjects were individually interviewed through a structured questionnaire to gather specific data. SPSS was used for statistical analysis. Logistic Regression, Shapiro-Wilk Test, Kruskal-Wallis Test, and Chi-square tests were carried out to measure the associations among the variables.

RESULTS: The average age of the participants was 32.74 ± 9.30 years, with 26% lacking formal education and 72% engaged in money collection as a primary occupation. 36% earned less than BDT 5,000 monthly, with only 2% exceeding BDT 20,000. The mean height and mean body weights were 163 ± 5.21 cm and 60.64 ± 13.61 kg (mean ± SD) respectively. Mean Body Mass Index (BMI) was 23.02 ± 5.04 kg/m², among whom 14% were underweight, 56% were normal, 20% were overweight, and 10% were obese. 48% of the participants had poor nutritional knowledge, and 46% had average. 50% of the participants had smoking habits and 34% of the participants consumed alcohol. Nutritional intake was skewed towards plant proteins (72%), with inadequate access to healthcare reported by 56% of subjects. Two-thirds (66%) of the respondents had no illness, and non-communicable diseases (NCDs) affected 34% of participants, with diabetes (12%) and low pressure (8%) prevalent. Smoking significantly correlated with lower normal BMI (AOR = 0.26, 95% CI: 0.07-0.84, p < 0.05). Unhealthy food intake was significantly associated with underweight risks (AOR = 0.17, 95% CI: 0.03-0.92, p < 0.05). When compared with male and female Bangladeshi populations, third-gender individuals had higher overweight prevalence, moderate normal BMI rates, and lower malnutrition than males.

CONCLUSION: The research identified suboptimal nutritional status among the third-gender population in Bangladesh, highlighting higher rates of both obesity and underweight, as well as a prevalence of non-communicable diseases, particularly diabetes.

PMID:40205527 | DOI:10.1186/s41043-025-00736-2

BMC Res Notes. 2025 Apr 9;18(1):152. doi: 10.1186/s13104-025-07237-9.

ABSTRACT

OBJECTIVE: Cerebral edema is a severe and potentially fatal complication of diabetic ketoacidosis (DKA), particularly in pediatric patients. Despite its clinical significance, limited data exist on its incidence and associated risk factors in resource-limited settings. This study aimed to determine the incidence of cerebral edema in pediatric patients with DKA and investigate potential contributing factors. This retrospective study analyzed data from 270 pediatric DKA patients admitted to the Children’s Medical Center Hospital, Tehran, between March 2018 and March 2020. Patients aged 1 day to 18 years were included based on standard DKA diagnostic criteria (blood glucose > 250 mg/dL, pH < 7.3, bicarbonate < 18 mEq/L, and ketonemia/ketonuria). Patients with incomplete records or pre-existing neurological conditions were excluded. The statistical analyses included independent t-tests and Fisher’s exact tests.

RESULTS: The incidence of cerebral edema was 6.67%. Elevated blood glucose levels at admission were significantly associated with cerebral edema (P = 0.01), suggesting a potential role in its pathophysiology. Additionally, a strong correlation was observed between cerebral edema and ICU admission (P < 0.001), indicating a more severe disease course. The results suggest that early glucose control and neurological monitoring are critical for preventing adverse outcomes such as cerebral edema in pediatric DKA patients.

PMID:40205526 | DOI:10.1186/s13104-025-07237-9