Nevin Manimala

Euro Surveill. 2025 Jun;30(23). doi: 10.2807/1560-7917.ES.2025.30.23.2400682.

ABSTRACT

BackgroundDuring the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) such as social distancing, lockdowns and enhanced hygiene led to a decrease in respiratory pathogens. However, as NPIs were relaxed, a resurgence in several respiratory pathogens was observed including one local Chlamydia pneumoniae outbreak in Switzerland, prompting the need for a better understanding of C. pneumoniae epidemiology.AimTo assess temporal and geographical variations in C. pneumoniae detection before, during and after the COVID-19 pandemic.MethodsData on C. pneumoniae PCR detection ratios (number of positive tests/ total number of tests) across pre-pandemic (2018-2019), pandemic (2020-2022) and post-pandemic (2023) periods were collected via a global survey disseminated through various professional networks.ResultsC. pneumoniae detection ratios were analysed across 28 sites (27 in Europe, one in Taiwan) in 2023 (Dataset A, n = 172,223 tests) and 20 sites from 2018 to 2023 (Dataset B, n = 693,106 tests). Twenty-seven sites were laboratories (hospital or clinical) and one a surveillance system (Denmark). A significant decrease in detection ratios was observed during the pandemic period (from 1.05% to 0.23%, p < 0.001). In 2023, detection ratios increased to 0.28% (p < 0.002). Notable regional variations were found, with statistically significant increases in detection ratios at six sites located in Switzerland and Slovenia, where ratios ranged from 0.52% to 3.25%.DiscussionThe study highlights how NPIs influenced C. pneumoniae epidemiology, with reduced detection during the pandemic and partial resurgence afterwards. Regional variations suggest differing NPI impacts and underscore the need for continued surveillance.

PMID:40511472 | DOI:10.2807/1560-7917.ES.2025.30.23.2400682

Hong Kong J Occup Ther. 2025 Jun 10:15691861251339211. doi: 10.1177/15691861251339211. Online ahead of print.

ABSTRACT

Objective: This study examined the associative relationships among age, cognition, anxiety, and participation in explaining the number of Assistive Technology Devices (ATDs) used by stroke survivors through path analysis. Methods: A cross-sectional study was conducted with 196 community-dwelling stroke survivors. Data on ATD usage, cognitive function (Montreal Cognitive Assessment), anxiety (Beck Anxiety Inventory), and participation (Utrecht Scale for Evaluation of Rehabilitation-Participation) were analyzed using SPSS 22.0 and Amos 24.0. Results: The modified path model demonstrated a good fit to the data. Age, anxiety, and participation had direct effects on the number of ATDs used, while cognition did not show a statistically significant effect. Anxiety also had an indirect effect through participation, indicating a dual role of participation in either increasing or reducing ATD reliance. Age influenced anxiety and participation both directly and indirectly. Conclusions: This study identified the pathways through which age, anxiety, and participation influence ATD usage among stroke survivors. Given the complexity of interplay of psychological and functional factors, ATD prescriptions should adopt a user-centered approach, considering participation levels, psychological responses, and environmental factors to optimize effectiveness and long-term use.

PMID:40511445 | PMC:PMC12151998 | DOI:10.1177/15691861251339211

Indian J Community Med. 2025 May-Jun;50(3):506-511. doi: 10.4103/ijcm.ijcm_834_23. Epub 2025 Jan 30.

ABSTRACT

BACKGROUND: Neck pain is characterized by symptoms of a nonspecific nature of the pain, which is of mechanical origin.[12] Frequently observed manifestations of neck discomfort encompass muscle pain, muscle spasms, headaches, facet joint pain, nerve pain, referred pain, and bone pain.[3] Instrument-assisted soft-tissue mobilization (IASTM) stands as a proficient myofascial intervention used for the treatment of soft tissues. Here, using instruments typically crafted from stainless steel featuring beveled edges and anatomically contoured designs to accommodate various body regions, this technique allows for enhanced depth of penetration.[4] Primarily used for the identification and therapeutic management of soft-tissue disorders, the approach involves the application of these specialized instruments.[5] Dry cupping, alternatively recognized as air cupping or suction cupping, constitutes a therapeutic methodology, wherein a vacuum is generated within cups and subsequently applied to targeted regions of the body. These cups, fabricated from diverse materials such as glass, silicone, or plastic, induce suction effects. Through the application of this suction, dry cupping serves to promote circulation, alleviate muscle tension, and facilitate the energetic flow within the treated areas.

MATERIAL AND METHODS: The purpose of the study to effectiveness of instrument-assisted soft-tissue mobilization versus dry cupping on pain and cervical range of motion in treatment of neck pain. The study is comparative in nature, and total subjects were 15 subjects in each group. The assessment of pain and range of motion of cervical flexion and lateral flexion were taken before starting the treatment of both the groups. The patients were randomly assigned by lottery method for both the groups, and assessments were taken on 0 day and at the end of 4^th week by VAS and ROM by a goniometer.

RESULTS: In IASTM treatment, the P value is 0.031. This suggests that there is a statistically significant difference between the pre-treatment and post-treatment values for the IASTM group. But, in dry cupping, the P value is 0.001. This indicates a highly significant difference between the precupping and postcupping values for this treatment group. The scores of variables VAS and ROM were improved significantly better in the subjects treated with dry cupping as compared to the group variables treated with instrument-assisted soft-tissue mobilization.

CONCLUSION: The study conclude that the dry cupping is more beneficial for the treatment of neck pain and range of motion.

PMID:40511444 | PMC:PMC12156098 | DOI:10.4103/ijcm.ijcm_834_23

Indian J Community Med. 2025 May-Jun;50(3):445-452. doi: 10.4103/ijcm.ijcm_469_23. Epub 2024 Oct 8.

ABSTRACT

BACKGROUND: Cancer is one of the leading causes of death worldwide, and in order to prevent it, it is vital to understand cancer patients’ health-seeking behavior that contributes to patient delays in receiving cancer treatment globally; however, no similar studies have been conducted in India. Therefore, this study made an effort to know health-seeking behavior among delayed cancer patients receiving treatment at a tertiary care hospital, Varanasi.

METHODS: A cross-sectional study was conducted at the Department of Surgical Oncology OPD, Sir Sunder Lal Hospital, IMS, BHU, Varanasi. Randomly selected 440 registered patients were interviewed with the help of semi-structured questionnaire. Binary logistic regression analysis and 2-test were used in this study.

RESULTS: Out of total 440 patients included in this study, 207 (47.05%) were males and 233 (52.95%) were females. The majority (59.32%) of patients were more than 45 years of age group. Most (80%) of the patients had delay in cancer treatment of more than 60 days from onset of symptoms. Only 29.55% of patients were aware of any symptoms of Cancer. Those patients who were doing self-medication (P=0.03) and did not attend any cancer screening program (P=0.04) showed a statistically significant association with delayed initiation of treatment. Patients referred from another centre (P = 0.03) also show a significant association with delayed treatment initiation. Cancer patients who visited the screening program (AOR= 0.22, P=0.003) were significantly associated with a lower likelihood of delayed treatment initiation.

CONCLUSION: The study showed that 80% of patients were delayed in seeking treatment for Cancer and highly influenced by low awareness, self-medication and visiting multiple health centres for diagnosis and treatment. Therefore, there is a strong need to address the reasons for the delay in seeking treatment.

PMID:40511434 | PMC:PMC12156084 | DOI:10.4103/ijcm.ijcm_469_23

Indian J Community Med. 2025 May-Jun;50(3):530-534. doi: 10.4103/ijcm.ijcm_772_22. Epub 2024 Oct 8.

ABSTRACT

Malignant non-odontogenic tumors of the oral cavity remain understudied in India, despite their global prevalence. This retrospective analysis examined cases from a single institution in Maharashtra between 1990 and 2021, focusing on patient demographics, clinical presentations, and histopathological features. Oral squamous cell carcinoma (OSCC) emerged as the predominant malignancy, with epithelial malignancies accounting for 98.6% of cases. A slight male predominance was observed. Buccal mucosa was the most frequent site of occurrence, with tobacco chewing identified as the primary risk factor. This study underscores the need for increased attention to oral malignancies in routine medical examinations and calls for more comprehensive statistical analysis to inform clinical practice and public health strategies.

PMID:40511429 | PMC:PMC12156099 | DOI:10.4103/ijcm.ijcm_772_22

Indian J Community Med. 2025 May-Jun;50(3):428-436. doi: 10.4103/ijcm.ijcm_810_23. Epub 2025 Feb 1.

ABSTRACT

INTRODUCTION: Quality antenatal care (QANC) is an important health care indicator of the public health structure of the country. Causal mediation analysis is a statistical model that can model the complex path that determines the QANC received by women. The objective of the study was to assess the proportion of women receiving QANC in India and to ascertain its determinants using causal mediation analysis.

METHODOLOGY: The dataset for study was obtained from the NFHS-4 survey. The outcome variable QANC was formulated based on a set working definition. The potential determinants of QANC at individual and population levels were identified by literature search, expert opinion, and availability in the NFHS dataset. The effect estimates of the determinants were estimated by multiple logistic regression. The potential determinant variables were categorized as independent and mediating variables. A schematic path analysis model was conceptualized by plausibility and expert opinion. The direct, indirect, and total effects of independent and mediating variables were estimated by generalized causal path analysis.

RESULTS: We found that region, education, wealth, religion, working status, husband’s education, and age were significant independent factors influencing QANC. Additionally, we found that husband’s alcohol status, pregnancy awareness month, presence of husband during antenatal care (ANC) visit, pregnancy registration month, emotional violence, and timing of the first ANC visit were significant mediating variables.

CONCLUSION: Understanding the factors associated with QANC is statistically more robust using causal path analysis, which would help us better shape policies for improved maternal health care in India.

PMID:40511427 | PMC:PMC12156105 | DOI:10.4103/ijcm.ijcm_810_23

Clin Transl Allergy. 2025 Jun;15(6):e70064. doi: 10.1002/clt2.70064.

ABSTRACT

OBJECTIVES: The evidence regarding the efficacy of probiotics in improving allergic rhinitis (AR) remains inconsistent. This study aimed to evaluate the potential effects of Bifidobacterium animalis subsp. lactis A6 (A6) on perennial AR.

METHODS: A randomized, double-blind, placebo-controlled trial was conducted involving 70 adults with perennial AR receiving either probiotic (A6, 5 × 10¹⁰ CFU/sachet per day) or placebo intervention for 8 weeks. Nasal symptoms and quality of life (QoL) were recorded using total nasal symptom scores (TNSS) and the rhinitis quality of life questionnaire (RQLQ). Blood eosinophil count, total immunoglobulin E (IgE), allergen-specific IgE, and immunological parameters were also assessed.

RESULTS: After 8 weeks of intervention, the probiotic group showed a statistically significant greater reduction in TNSS total score compared with the placebo group [-3.11 (3.53) vs. -1.29 (3.34), p = 0.029, Cohen’s d = 0.68]. Similar results were noted for serum total IgE and interleukin-13 (IL-13). Comparable findings were seen for RQLQ score only at week 4 but not at week 8.

CONCLUSIONS: In conclusion, A6 could statistically significantly alleviate rhinitis symptoms and improve QoL in adults with perennial AR. The effect size, as measured by Cohen’s d, suggests that A6 may provide clinically meaningful benefits for AR patients to a certain degree.

CLINICAL TRIAL REGISTRATION: Chictr.org.cn Identifier no. ChiCTR2200064158.

PMID:40506807 | DOI:10.1002/clt2.70064

Asia Pac J Clin Oncol. 2025 Jun 12:e14201. doi: 10.1111/ajco.14201. Online ahead of print.

ABSTRACT

AIM: Cervical cancer is caused by persistent infection with the human papillomavirus. This study aimed to investigate whether the changes in serum inflammatory markers between baseline and posttreatment can predict survival in cervical cancer undergoing definitive chemoradiotherapy (CCRT).

METHODS: Eighty-one Stage IB-IVA cervical cancer patients treated with definitive CCRT, with serum inflammatory markers obtained at diagnosis and after completion of pre-planned therapy, were included. The percent changes of post-/pretreatment levels × 100% were calculated for neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII). The cutoffs were obtained with the maximal chi-square statistics.

RESULTS: At a median follow-up of 28 months, the 2-year overall survival (OS) was 75.4%. The 2-year OS for patients with low versus high percent change was as follows: post-/pre-NLR (87.7% vs. 67.8%), post-/pre-MLR (75.9% vs. 71.1%), post-/pre-SIRI (76.5% vs. 61.7%), and post-/pre-SII (91.7% vs. 67.2%) (all p < 0.05). The hazard ratios (HR) in multivariate analysis were as follows: post-/pre-NLR (5.53, 95% confidence interval [CI]: 1.65-18.52), post-/pre-MLR (3.39, 95% CI: 1.39-8.26), post-/pre-SIRI (5.11, 95% CI: 1.92-13.57), and post-/pre-SII (6.57, 95% CI: 1.77-24.36) (all p < 0.05).

CONCLUSION: This study demonstrates the impact of the dynamics of serum inflammatory markers on survival. It has been consistently demonstrated across the markers. To adopt these markers for personalized treatment decisions, a better understanding of their relation with the actual tumor microenvironment is warranted.

PMID:40506804 | DOI:10.1111/ajco.14201

Arthritis Rheumatol. 2025 Jun 12. doi: 10.1002/art.43272. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the efficacy of abatacept to placebo for the treatment of relapsing, non-severe granulomatosis with polyangiitis (GPA).

METHODS: In this multicenter trial, eligible patients with relapsing, non-severe GPA were randomized to receive abatacept 125 mg subcutaneously once a week or placebo, both together with prednisone 30 mg/day (or equivalent), tapered and discontinued at week 12. Patients already taking methotrexate, azathioprine, mycophenolate, or leflunomide continued this medication at a stable dose. Patients achieving remission remained on their randomized assignment until relapse, early termination, or the common close date 12 months after enrollment of the last patient. Those who had a non-severe relapse, non-severe worsening, or were not in remission by month 6 had the option to receive open-label abatacept. The primary endpoint was the rate of treatment failure, defined as relapse, disease worsening, or failure to achieve a BVAS/WG=0 or 1 by 6 months.

RESULTS: Sixty-five patients were randomized, 34 received abatacept and 31 placebo. No statistical difference in the treatment failure rate was found between those who received abatacept compared to placebo (p= 0.853). Treatment with abatacept did not demonstrate any statistical difference from placebo in key secondary endpoints, including time to full remission (BVAS/WG=0), duration of glucocorticoid-free remission, relapse severity, prevention of damage, or patient-reported quality-of life outcomes. There was no difference in the frequency or severity of adverse events between treatment arms, including infection.

CONCLUSIONS: In patients with relapsing, non-severe GPA abatacept did not reduce the risk of relapse, severe worsening, or failure to achieve remission.

PMID:40506793 | DOI:10.1002/art.43272

Infect Dis Poverty. 2025 Jun 12;14(1):47. doi: 10.1186/s40249-025-01316-6.

ABSTRACT

BACKGROUND: Echinococcosis remains highly endemic in some nomadic communities on the Qinghai-Tibet Plateau, China, where alveolar echinococcosis (AE) and cystic echinococcosis (CE) exhibit notably high prevalence rates of 3.64% and 2.37%, respectively. Recent settlement expansion in the region has raised concerns, as smaller, remote settlements often lacked waste disposal and sewage systems, potentially facilitating echinococcosis transmission. The aim of this study is to investigate how settlement characteristics influence echinococcosis transmission.

FINDINGS: The study was conducted from 2022-2024 in nomadic communities of Shiqu County in China. The overall prevalence rate of echinococcosis in 51 settlements was found to be 2.34% (321/13,701; 95% CI: 2.10-2.61), which included a prevalence rate of 1.62% (222/13,701; 95% CI: 1.42-1.85) for AE and a prevalence rate of 0.72% (99/13,701; 95% CI: 0.59-0.88) for CE. The prevalence rate of AE was significantly (χ² = 49.57, P < 0.01) higher than that of CE. Settlements with a smaller population size (Z = -4.27, P < 0.01), a greater distance to the township center (Z = 2.66, P < 0.01) and a higher density of owned dogs (Z = 5.90, P < 0.01) were associated with higher prevalence rates of CE. These associations were also observed for AE prevalence, except for the density of owned dogs.

CONCLUSIONS: This study indicates that the transmission of AE was more active than that of CE in the nomadic communities. Smaller, remote settlements had higher prevalence rates for both CE and AE. The density of owned dogs was a significant risk factor for CE prevalence but not for AE prevalence. Targeted interventions are needed in these high-risk settlements. Future research should investigate how settlement characteristics interact with hygiene practices, the infection status of intermediate and definitive hosts, and their population dynamics to better understand combined effects on echinococcosis prevalence.

PMID:40506786 | DOI:10.1186/s40249-025-01316-6