Nevin Manimala

J Metab Bariatr Surg. 2025 Apr;14(1):32-42. doi: 10.17476/jmbs.2025.14.1.32. Epub 2025 Apr 29.

ABSTRACT

PURPOSE: To evaluate inflammatory and biochemical parameters in the serum of patients with obesity before and after bariatric surgery.

MATERIALS AND METHODS: An epidemiological study of the prospective cohort type was conducted to follow patients classified with grade II or III obesity undergoing bariatric surgery. Body mass index (BMI), lipid profile, C-reactive protein (CRP), reactive oxygen species production using dichlorofluorescein (DCF), and antioxidant defenses superoxide dismutase (SOD) and reduced glutathione (GSH) were analyzed before and 3 months after Roux-en-Y bariatric surgery.

RESULTS: A paired analysis was conducted, evaluating 23 patients in the pre- and post-surgical period. A statistically significant reduction was observed after bariatric surgery in BMI (P value<0.001), total cholesterol (CT) (P value=0.0006), total triglycerides (P value=0.0025), high-density lipoprotein cholesterol (P value=0.0010), low-density lipoprotein cholesterol (P value=0.0189), CRP (P value=0.0130), DCF (P value=0.0069), and GSH (P value<0.0001), as well as an increase in SOD activity (P value=0.0005).

CONCLUSION: Bariatric surgery effectively reduced inflammatory and lipid markers and reversed oxidative stress, indicating that the procedure improves the health of bariatric patients across various parameters.

PMID:40351819 | PMC:PMC12059305 | DOI:10.17476/jmbs.2025.14.1.32

Plast Surg (Oakv). 2025 May;33(2):269-275. doi: 10.1177/22925503231214760. Epub 2023 Nov 22.

ABSTRACT

Background: Microbial colonization of burn wounds leads to infection, which is a major cause of morbidity/mortality, prolonged admission, and cost. This study aims to investigate the incidence of positive burn wound colonization and its associated risk factors in a provincial referral center within a single-payer system. Methods: We performed a retrospective review of all adult (≥18 years) patients admitted to a single, tertiary burn center, with a primary burn diagnosis between January 2011 and 2021. Microbiology records were screened to identify patients with culture-positive burn wounds. Univariable and multivariable logistic regression analyses were used to evaluate risk factors associated with burn site colonization. Results: The sample included N = 634 participants. Most were male (72.1%), with a flame injury (62%), and had a mean age of 47.6 (±18.0) years and a TBSA of 13.5% (±14.8). The incidence of positive burn wound colonization was 27.3%. Increasing participant age, diabetic status, larger burn TBSA, presence of full-thickness burns, inhalation injury, and lower limb and trunk involvement were associated with statistically significant (P ≤ .05) increased odds of a positive burn wound culture. Conclusion: This study provides an estimate of the incidence of primary burn wound colonization at a single, tertiary care, burn center as well as identifies potential risk factors associated with this outcome. Clinicians should consider closely monitoring patients with these risk factors for possible progression to clinical burn site infection. Future research should address strategies to mitigate colonization in patients with identified risk factors.

PMID:40351804 | PMC:PMC12062710 | DOI:10.1177/22925503231214760

Plast Surg (Oakv). 2025 May;33(2):218-221. doi: 10.1177/22925503231208450. Epub 2023 Oct 19.

ABSTRACT

Background: Social media has become a valuable platform for advertising. Instagram is one of the most popular platforms. Many plastic surgeons have utilized this platform to promote themselves and their practices. Having followers on Instagram can provide validity and expand the reach to potential clients. We aim to compare Instagram practices of top 10 plastic surgeon Instagram accounts to those with 10 to 100,000 followers. Methods: Top 10 plastic surgeon Instagram accounts were selected using Google and Instagram search features. Additional plastic surgeon Instagram accounts were selected using Instagram search feature. Each account was evaluated for average number of contents posted daily as well as media type (videos vs photos) of contents posted between November 1, 2022, and February 20, 2023. Statistical analysis was performed using double-tailed unpaired student t test to compare the top 10 account group to the 1000 to 10,000 follower group and 10,000 to 100,000 follower group. Results: When comparing the 1000 to 10,000 follower group and 10,000 to 100,000 follower group to the top 10 plastic surgeon Instagram accounts, there were no significant differences in average number of posts, number of pictures posts, number of video posts, and percentage of video posts. Conclusions: Although this study did not demonstrate a significant difference between Instagram account practices of plastic surgeons with millions of followers to those with 1000 to 100,000, it provides valuable information regarding posting practices of plastics surgeons on Instagram.

PMID:40351790 | PMC:PMC12059406 | DOI:10.1177/22925503231208450

Front Oral Health. 2025 Apr 25;6:1569940. doi: 10.3389/froh.2025.1569940. eCollection 2025.

ABSTRACT

Oral health is intricately related to systemic health, with new worldwide research demonstrating vitamin D’s critical role in sustaining dental and periodontal health. Vitamin D regulates calcium and phosphate metabolism, which is required for the formation and maintenance of healthy teeth and bones. According to research, vitamin D deficiency may contribute to the etiology of periodontal disease by decreasing the host immune response, making it more susceptible to infections like gingivitis and periodontitis. Oral health in India is a tapestry of traditional practices, socioeconomic factors, lifestyle factors, and access to modern healthcare, all of which are intricately linked with the concept of habitus, which refers to deeply embedded habits, dispositions, and practices shaped by an individual’s social space. Deep-rooted social and cultural influences have a substantial impact on oral hygiene practices, food patterns, and health-seeking behaviours. Oral diseases are considered as a worldwide health issue. Though standard Western medicine has had effectiveness in preventing and treating periodontal diseases and other oral disorders, the hunt for alternative solutions continues, and natural phytochemicals extracted from plants used in traditional medicine are regarded as viable alternatives to synthetic chemicals. India’s traditional medical knowledge and practice, take a comprehensive approach to oral health, emphasizing the balance of physiological components and the use of natural treatments to maintain oral hygiene and treat oral disorders. However, the structural integrity of teeth and optimal oral health can be accomplished by combining Indian traditional medical practices with vitamin D supplementation, which has synergistic attributes for gum health, anti-inflammatory effects, and dental caries prevention. Nevertheless, the unique association of oral health, vitamin D deficiency and the habitus from Indian perspective is extremely underrepresented in academia. To the best of our knowledge, in the aforementioned context, the present narrative review is probably the maiden attempt to discern the crosstalk of oral health and Vitamin D from the perspectives of Indian habitus.

PMID:40351788 | PMC:PMC12062093 | DOI:10.3389/froh.2025.1569940

J Med Signals Sens. 2025 Apr 19;15:11. doi: 10.4103/jmss.jmss_29_24. eCollection 2025.

ABSTRACT

BACKGROUND: The global increase in diabetes prevalence necessitates advanced diagnostic methods. Machine learning has shown promise in disease diagnosis, including diabetes.

MATERIALS AND METHODS: We used a dataset collected from the Medical City Hospital laboratory and the Specialized Center for Endocrinology and Diabetes at Al-Kindy Teaching Hospital in Iraq. This dataset includes 1000 physical examination samples from both male and female patients. The samples are categorized into three classes: diabetic (Y), nondiabetic (N), and predicted diabetic (P). The dataset contains twelve attributes and includes outlier data. Outliers in medical studies can result from unusual disease attributes. Therefore, consulting with a specialist physician to identify and handle these outliers using statistical methods is necessary. The main contribution of this study is the proposal of two hybrid models for diabetes diagnosis in two scenarios: (1) Scenario 1 (presence of outlier data): Hybrid Model 1 combines the K-medoids clustering algorithm with a Gaussian naive Bayes (GNB) classifier based on kernel density estimation (KDE) to handle outliers and (2) Scenario 2 (after removing outlier data): Hybrid Model 2 combines the K-means clustering algorithm with a GNB classifier based on KDE with suitable bandwidth. We performed principal component analysis to minimize dimensionality and evaluated the models using fivefold cross-validation.

RESULTS: All experiments were conducted in identical settings. Our proposed hybrid models demonstrated superior performance in two scenarios, handling and rejecting outliers, compared to other machine-learning models in this study, including support vector machines (with radial-based, polynomial, linear, and sigmoid kernel functions), decision trees (J48), and GNB classifiers for diabetes prediction. The average accuracy for Scenario 1 with Hybrid Model 1 was 0.9743, and for Scenario 2 with Hybrid Model 2, it was 0.9867. We also evaluated precision, sensitivity, and F1-score as performance metrics.

CONCLUSION: This study presents two hybrid models for diabetes diagnosis, demonstrating high accuracy in distinguishing between diabetic and nondiabetic patients and effectively handling outliers. The findings highlight the potential of machine-learning techniques for improving the early diagnosis and treatment of diabetes.

PMID:40351779 | PMC:PMC12063970 | DOI:10.4103/jmss.jmss_29_24

Adv Med Educ Pract. 2025 May 5;16:729-748. doi: 10.2147/AMEP.S491271. eCollection 2025.

ABSTRACT

PURPOSE: Metabolic dysfunction-associated steatotic liver disease (MASLD) and its inflammatory subtype, metabolic dysfunction-associated steatohepatitis (MASH), are associated with cardiometabolic risk factors, including obesity and type 2 diabetes. The prevalence of both conditions is rising rapidly and is underdiagnosed (<5%). We aimed to gather qualitative and quantitative insights from program leaders in US medical education training on their experience with MASH-related training and education.

PARTICIPANTS AND METHODS: A cross-sectional study consisting of a quantitative survey and qualitative discussions with individuals in primary care (internal medicine and family medicine) and specialty programs (hepatology, gastroenterology, and endocrinology) were held from February 21 to August 28, 2023. Descriptive statistics were used for data analysis.

RESULTS: A total of 190 leaders participated in the online survey and 11 leaders joined the focus groups. Almost all respondents reported that MASLD (96%) and MASH (92%) were included in their program’s curricula. However, many believed that little time was devoted to discussing MASH in their program. Most respondents agreed that MASH is extremely underdiagnosed. Program leaders agreed that the interconnectedness of MASH with other cardiometabolic conditions necessitates instruction time on MASH beyond that of its dedicated curriculum time. All participants believed that emergence of regulatory-approved drugs for MASH will drive a decision to increase the time allotted for MASH in the curriculum.

CONCLUSION: Although program leaders agreed that MASH has an important place in medical education curricula, the relative paucity of treatment options reduces its coverage in training, thereby limiting healthcare practitioners’ understanding of MASH.

PMID:40351776 | PMC:PMC12063625 | DOI:10.2147/AMEP.S491271

Front Vet Sci. 2025 Apr 25;12:1486786. doi: 10.3389/fvets.2025.1486786. eCollection 2025.

ABSTRACT

Transitional cell carcinoma (TCC) is the most prevalent cancer of the urinary tract in dogs. The prognosis is often poor, and the optimal standard treatment has not been established. The objectives of this study were to (1) describe the clinical outcomes of dogs with TCC, and (2) determine the potential effects of tumor locations and treatment modalities on the survival times of patients. Electronic records of client-owned dogs with TCC treated with different modalities in a large veterinary hospital in Hong Kong (2005-2024) were evaluated. Of 84 confirmed cases included in the study, 49 (58.3%) died or were euthanized due to TCC. Tumors were located in the bladder neck or trigone region (41), apex (26), prostate (10), and urethra (7). Metastases were detected in 10 patients (12%) at diagnosis, including 4 peripheral lymph nodes, 4 lungs, and 2 in the lumbar spine. Of 84 cases, 4 (4.8%) did not receive any treatments, 14 (16.7%) underwent surgery, 25 (29.7%) received metronomic chemotherapy with chlorambucil with/without methotrexate, 27 (32.1%) received COX-2 inhibitors alone, and 14 (16.7%) received conventional chemotherapy, of which, 5 were later switched to metronomic chemotherapy. The overall median survival time was 233 days. There was no statistically significant difference in patients’ survival between tumor locations (p > 0.05), aside from tumors involving the prostate that had the shortest MST (88 days). Metronomic chemotherapy led to a significantly longer survival time (median of 303 days) than the other treatment groups (p < 0.05), with the lowest incidence of adverse events. Metronomic chemotherapy using chlorambucil was well-tolerated and can be considered as a single modality treatment or as adjunctive therapy to conventional chemotherapy in dogs with TCC.

PMID:40351774 | PMC:PMC12063355 | DOI:10.3389/fvets.2025.1486786

Front Vet Sci. 2025 Apr 25;12:1527167. doi: 10.3389/fvets.2025.1527167. eCollection 2025.

ABSTRACT

BACKGROUND: Although metastasis-associated protein 1 (MTA1) is known to play a role in cancer invasion and metastasis of various cancers, the clinical significance of its expression in canine urothelial carcinoma (UC) has not been explored. We sought to evaluate the expression of MTA1, cyclooxygenase 2 (COX2) and E-cadherin (E-cad) in association with clinicopathological parameters in clinical samples of canine UC.

METHODS: We retrospectively analyzed UC tissues from 28 canine patients using immunohistochemistry for Ki67, CD31, MTA1, COX2, and E-cad staining. Statistical significance for marker staining intensities was evaluated by ANOVA or Student’s t-test. The correlation between molecular markers in canine UC samples detected by IHC and clinicopathological features was calculated by the Wilcoxon (Mann-Whitney) and Kruskal-Wallis tests. Western blot analysis was performed for detection of EMT markers in canine cell lines.

RESULTS: We show that MTA1 and COX2 are overexpressed in canine UC samples compared to normal canine bladder samples, whereas E-cad levels are higher in normal bladder. The results demonstrated that MTA1 expression correlated with aggressive clinicopathological features such as high tumor-grade, muscular/vascular invasion, and metastasis. The expression of MTA1 differed in tumors depending on their localization, with the highest being in the urethra adjoining the prostate. Unexpectedly, higher E-cad levels were detected in metastatic tumor cells compared to primary tumor cells.

CONCLUSION: These findings suggest that MTA1 may represent a key upstream effector tightly associated with COX2 and E-cad-mediated events in canine UC. Accordingly, MTA1 may be considered a feasible interceptive and therapeutic target for canine UC treatment.

PMID:40351767 | PMC:PMC12062746 | DOI:10.3389/fvets.2025.1527167

Patient Prefer Adherence. 2025 May 5;19:1305-1316. doi: 10.2147/PPA.S524090. eCollection 2025.

ABSTRACT

PURPOSE: Insomnia and perceived stress are among the most prevalent health concerns in primary care, yet their complex relationship remains underexplored. This study examines the association between perceived stress and insomnia severity, while considering the potential moderating or mediating effects of lifestyle factors and medication use.

METHODS: A cross-sectional study was conducted with 300 consecutive primary care patients who completed validated questionnaires assessing insomnia severity (Insomnia Severity Index, ISI) and perceived stress (Perceived Stress Scale, PSS). Logistic regression models were employed to identify predictors of clinical insomnia and explore key relationships.

RESULTS: A moderate but statistically significant correlation (r = 0.460, p < 0.001) was observed between perceived stress and insomnia severity. In logistic regression analysis, higher perceived stress scores (OR = 1.134, p < 0.001) and hypnotic medication use (OR = 3.220, p < 0.001) were significant predictors of clinical insomnia. Interestingly, alcohol consumption was unexpectedly associated with insomnia (OR = 0.551, p = 0.048), warranting further exploration. No significant associations were found for caffeine intake, tobacco use, or demographic variables. The model explained 33% of the variance in insomnia (Nagelkerke R² = 0.328).

CONCLUSION: These findings highlight the significant role of perceived stress in insomnia severity and underscore the complex interplay between pharmacological interventions and sleep disturbances. While hypnotic medications are commonly used, their long-term impact and potential dependence require careful consideration. Integrating stress-reduction strategies into primary care may improve insomnia management while reducing reliance on pharmacological treatments. Future research should employ longitudinal designs to clarify causality and further explore additional factors influencing sleep disturbances.

PMID:40351739 | PMC:PMC12063695 | DOI:10.2147/PPA.S524090

J Patient Exp. 2025 May 9;12:23743735251342125. doi: 10.1177/23743735251342125. eCollection 2025.

ABSTRACT

The COVID-19 pandemic influenced dental care behaviors, with increased concern over virus transmission. This study provides insights into Thai patient behaviors and attitudes about dental care during the Omicron wave. A cross-sectional survey was conducted via Google Forms in June 2022, collecting sociodemographic data, attitudes, and behaviors related to dental care during the pandemic. Nine hundred and seventy-eight responses were analyzed using descriptive statistics, the Mann-Whitney U-test, and multiple linear regression. Nearly half of the respondents expressed high to extreme concerns about delayed dental care affecting oral health (49.3%) and the risk of contracting COVID-19 in dental settings (45.7%). Individuals who avoided dental visits increased from 8.1% before the pandemic to 36.3% during the pandemic. However, 59.4% of respondents reported confidence in avoiding COVID-19 when dental workers strictly followed preventive measures. The study highlights concern over delayed dental care and COVID-19 risks, leading to increased avoidance of visits. However, strict preventive measures by dental workers boosted confidence, emphasizing the need for effective infection control to ensure continued access to dental care.

PMID:40351734 | PMC:PMC12065987 | DOI:10.1177/23743735251342125