Nevin Manimala

J Tehran Heart Cent. 2024 Apr;19(2):116-123. doi: 10.18502/jthc.v19i2.16201.

ABSTRACT

BACKGROUND: Cardiomyopathy, characterized by heart stiffness, can lead to heart failure. This study aimed to investigate aortic stiffness in children with dilated cardiomyopathy (DCM) to better understand its contribution to disease severity.

METHODS: This case-control study compared 48 children with DCM with 96 healthy children over a 10-year period starting in 2011. Aortic strain, aortic stiffness index, aortic distensibility, and pressure strain elastic modulus were measured. These parameters, along with several echocardiographic measures, were compared between the DCM and control groups. Statistical analyses were performed using SPSS 18, with a significance threshold set at a P value below 0.05.

RESULTS: The participants included 57.6% boys, with 58.3% in the DCM group and 57.35% in the control group (χ²=0.014, P=0.905). The age range was 2 to 18 years, with mean ages of 11.08±4.63 years for the DCM group and 10.77±2.82 years for the control group (P=0.691). Significant differences between groups were observed in aortic distensibility (P=0.004), aortic stiffness β index (P=0.001), and pressure strain elastic modulus (P=0.004). Post-treatment analyses based on ejection fraction and fractional shortening cutoffs indicated no changes in elasticity parameters except for the aortic stiffness β index, which varied according to the Ross classification.

CONCLUSION: Children with DCM exhibited reduced aortic strain and aortic distensibility, as well as elevated aortic stiffness β index and pressure strain elastic modulus.

PMID:40322760 | PMC:PMC12045314 | DOI:10.18502/jthc.v19i2.16201

J Tehran Heart Cent. 2024 Apr;19(2):96-101. doi: 10.18502/jthc.v19i2.16198.

ABSTRACT

BACKGROUND: Maintaining an optimal mean arterial pressure (MAP) is vital for cerebral blood flow and the overall health of patients undergoing coronary artery bypass graft (CABG) surgery. This study investigated the impact of low MAP on cerebral blood flow and in-hospital clinical outcomes in CABG candidates at our hospital.

METHODS: We compared a convenience sample of 55 patients with a low MAP (55 mmHg) and 54 patients with a high MAP (75 mmHg) who underwent CABG at Tehran Heart Center in 2023. We recorded the patients’ demographic and clinical characteristics by measuring cerebral oximeter readings and lactate levels pre- and post-operation. We then compared the baseline and postoperative characteristics between the 2 groups and determined the impact of MAP on their postoperative changes.

RESULTS: The groups were statistically similar at baseline, except for a lower pH in the low MAP group (55 mmHg) (P=0.016). The preoperative and postoperative measurements (including lactate levels and cerebral oximeter readings) did not differ between the groups. However, heart rate was significantly higher in the high MAP group (75 mmHg) (P=0.034). The adjusted effect of baseline MAP on selected postoperative characteristics showed that it could significantly but inversely influence heart rate (β coefficient=-5.952; P=0.017) and had a borderline effect on troponin (β coefficient=1.734; P=0.051) and HCO₃ (β coefficient=0.785; P=0.062).

CONCLUSION: MAP did not significantly influence clinical outcomes in our study. Nonetheless, maintaining an optimal MAP is essential for preventing cerebral injury and ensuring adequate cerebral oxygenation in CABG patients.

PMID:40322759 | PMC:PMC12045318 | DOI:10.18502/jthc.v19i2.16198

Orthop J Sports Med. 2025 May 1;13(4):23259671251334774. doi: 10.1177/23259671251334774. eCollection 2025 Apr.

ABSTRACT

BACKGROUND: Fencing has maintained sustained popularity in the United States and internationally. However, there is limited information regarding acute injury patterns among fencing athletes.

PURPOSE: To determine the prevalence of fencing injuries evaluated at emergency departments in the United States from 2013 to 2023 and analyze trends in diagnosis by demographics, mechanism of action, and disposition status.

STUDY DESIGN: Descriptive epidemiological study.

METHODS: The US Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) database was queried in June of 2024 using the product code 3260-Fencing (activity/apparel/equipment). The analysis included descriptive statistics for diagnosis prevalence and demographics, univariate analysis utilizing diagnosis and demographic data, and a text analysis of the narrative descriptions.

RESULTS: From 2013 to 2023, 129 fencing-related injuries were reported from US emergency departments, representing an NEISS national estimate of 3418 (95% CI, 2200-4636). The most common age group affected was 11 to 15 years (35.7%), followed by 16 to 20 years (29.5%), with a median age of 16 years. Most injured individuals were White (49.65%) and male (56.5%). However, there was an upward trend in injuries among female athletes throughout the study. The most frequent injuries were strains or sprains (26.4%), lacerations (15.5%), fractures (11.6%), and contusions/abrasions (10.9%). Fracture prevalence was higher in females than males (14.4% vs 9.6%; P1 = .04). Males experienced a higher laceration prevalence (21.9% vs 7.1%; P = .02). The most affected body part was the finger (14%), followed by the wrist (8.5%), leg (8.5%), and head (7.8%). Most injuries occurred in sports-specific facilities (70%), followed by personal homes. Regarding disposition, 97.7% of all patients were treated and released. Fencing injuries rose steadily until the COVID-19 pandemic caused a decline, but they have since rebounded.

CONCLUSION: Fencing injuries decreased significantly during the COVID-19 pandemic but have since become more prevalent. Fractures were more prevalent among females, whereas males had a higher prevalence of lacerations. Understanding the epidemiology and nature of fencing injuries can help inform coaches, athletes, and health care providers about potential risks and injury prevention strategies.

PMID:40322752 | PMC:PMC12049607 | DOI:10.1177/23259671251334774

Bioinformation. 2025 Feb 28;21(2):155-158. doi: 10.6026/973206300210155. eCollection 2025.

ABSTRACT

Menopause is one of the most important phases of a woman’s life. Therefore, it is of interest to conduct a randomized-controlled trial approach and three hundred post-menopausal volunteers were split into two groups randomly and quality of life was evaluated using the Nottingham Health Profile (NHP). The exercise group engaged in a program consisting of submaximal weight-bearing and breathing exercises for eight weeks, five times a week. The quality of life in the two groups was compared after eight weeks. The NHP’s quality of life improved in the exercise group, with a statistically significant difference (P < 0.05). Thus, an 8-week regimen of consistent, supervised exercise could enhance the quality of life for post-menopausal women.

PMID:40322714 | PMC:PMC12044177 | DOI:10.6026/973206300210155

Bioinformation. 2025 Feb 28;21(2):253-256. doi: 10.6026/973206300210253. eCollection 2025.

ABSTRACT

Efficient and safe blood donation procedures are critical for maintaining an adequate and reliable blood supply. Needle priming, a pre-donation procedure aimed at preventing clot formation, is hypothesized to improve blood flow and reduce donation time. A case-control study was conducted with 340 participants to evaluate the impact of needle priming on whole blood donation. The case group underwent needle priming before donation, while the control group followed standard procedures without priming. The study found a statistically significant reduction in blood collection time in the needle priming group compared to the control group (p < 0.05). Needle priming prior to blood donation significantly enhances procedural efficiency, reduces clotting risks and improves donor satisfaction.

PMID:40322704 | PMC:PMC12044171 | DOI:10.6026/973206300210253

Bioinformation. 2025 Feb 28;21(2):205-209. doi: 10.6026/973206300210205. eCollection 2025.

ABSTRACT

The correlation between placental thickness, gestational age and fetal weight across different stages of pregnancy is of interest. Hence, 187 women (11-40 weeks gestation) at Maa Vindhyavasini Autonomous State Medical College and SMMH Medical College in India participated in this study. Results showed that mean placental thickness increased with gestational age (2.083 cm at 11-20 weeks, 2.623 cm at 20-30 weeks and 3.29 cm at 30-40 weeks), while fetal weight also increased (172.05g, 746.67g and 2584.49g, respectively). A strong positive correlation was found between gestational age and both fetal weight and placental thickness, except during early pregnancy (11-21 weeks), with statistical significance at the 5% level. Thus, the correlation between placental thickness, fetal weight and gestational age in 187 pregnant women, showing strong positive correlations, especially in later stages of pregnancy is reported.

PMID:40322697 | PMC:PMC12044164 | DOI:10.6026/973206300210205

Bioinformation. 2025 Feb 28;21(2):132-136. doi: 10.6026/973206300210132. eCollection 2025.

ABSTRACT

Premenstrual Syndrome (PMS) is a prevalent condition among adolescent girls, causing significant physical and emotional distress. Therefore, it is of interest to evaluate the impact of Qi Gong therapy on alleviating PMS symptoms among adolescent girls in North Gujarat. A quasi-experimental pretest-posttest design was implemented with 231 adolescent girls aged 13-17 years. Participants underwent a 4-week Qi Gong therapy program, with five 45-minute sessions weekly. Data were collected using a demographic questionnaire and Modified PMS Scale, analysing pre – and post-intervention symptoms through descriptive statistics, paired t-tests and chi-square tests. The intervention significantly reduced PMS severity, with mild PMS cases increasing from 48 (20.78%) to 166 (71.86%) post-intervention. Paired t-tests revealed a highly significant mean difference in PMS scores (T = 12.251, p < 0.001).

PMID:40322693 | PMC:PMC12044180 | DOI:10.6026/973206300210132

Clin Kidney J. 2025 Feb 17;18(5):sfaf045. doi: 10.1093/ckj/sfaf045. eCollection 2025 May.

ABSTRACT

BACKGROUND: Postoperative acute kidney injury (PO-AKI) is a critical complication of adverse kidney outcomes, both short and long-term. We aimed to expand our pre-existing PO-AKI prediction model to predict mid-to long-term adverse kidney outcomes.

METHODS: We included patients who underwent major non-cardiac surgeries from the original SPARK cohort, two external validation cohorts, and a temporal validation cohort. Mid-to-long-term adverse kidney outcomes were defined as end-stage kidney disease progression or death within 1 or 3 years after surgery. We verified and tuned the original Simple Postoperative AKI RisK (SPARK) model to predict mid-to-long-term adverse kidney events.

RESULTS: We included 33 636 patients in development, 71 232 patients in external validation, and 33 944 patients in temporal validation cohorts, respectively. One- and 3-year adverse kidney events occurred in 5.5% and 13.2% in the development cohort, respectively. The original SPARK score demonstrated an acceptable discriminative power for 1-year and 3-year adverse outcome risks with C indices mostly >0.7. However, the power was relatively poor when restricted to high-risk patients or those who actually developed PO-AKI. When we re-calculated the regression coefficients from a Cox model, the discriminative performances were better, especially for those with high-risk characteristics (e.g. 1-year outcome, C-index 0.72 in developmental and 0.73‒0.77 in validation datasets). Furthermore, when the model integrated the PO-AKI stage and history of malignancy with the SPARK variables, the performance was significantly enhanced (1-year, C-index 0.86 in development and 0.86‒0.88 in validation results). With the above findings, we constructed an online postoperative risk prediction system (https://snuhnephrology.github.io/postop/).

CONCLUSIONS: The addition of two clinical factors and recalibration of SPARK variables significantly improved mid-to-long-term postoperative risk prediction for mortality or dialysis after non-cardiac surgery. Our calculator helps clinicians easily predict a mid-to-long-term risk and PO-AKI occurrence by entering a few variables.

PMID:40322677 | PMC:PMC12044331 | DOI:10.1093/ckj/sfaf045

Int J Womens Health. 2025 Apr 30;17:1193-1201. doi: 10.2147/IJWH.S496137. eCollection 2025.

ABSTRACT

OBJECTIVE: Tumor markers such as CA125 are highly beneficial in predictive ovarian malignancy; however, this advanced test is not always available in remote areas. To address this issue, the author aimed to explore the use of systemic inflammatory biomarkers as complementary modalities for diagnosis of ovarian malignancy.

METHODS: This diagnostic study utilized a cross-sectional approach, with outcomes measured by AUC and sensitivity. A total of 132 patients with adnexal tumors were consecutively included and measured a complete blood count. From this, the MLR (Monocyte Lymphocyte Ratio), NLR (Neutrophil Lymphocyte Ratio), PLR (Platelet Lymphocyte Ratio), SII (Systemic Immune Inflammation Index), and SIRI (Systemic Inflammatory Response Index) biomarkers were calculated. After surgery, histopathological examination was performed as the gold standard and the biomarker predictions were then compared to it, followed by statistical analysis.

RESULTS: The AUC values for MLR, NLR, PLR, SII, and SIRI were 0.70, 0.731, 0.696, 0.743, and 0.722, respectively. The p-values were MLR (0.005), NLR (0.001), PLR (0.001), SII (<0.001), and SIRI (<0.001), respectively. In multivariate analysis, only SII was significant (p = 0.015). The Exp(B) and 95% CI were 5.472 (1.383-21.655). The validity test for SII showed satisfactory results: sensitivity 71.64%, specificity 73.84%, PPV 73.84%, NPV 71.64%, accuracy 72.72%, LR+ 2.74%, and LR- 0.38%.

CONCLUSION: Systemic inflammatory biomarkers, particularly SII may aid in the predictive markers of early ovarian with diagnostic values nearly as good as CA125 (sensitivity 71.64% vs 75.97%). These biomarkers can serve as complementary predictive markes modalities for ovarian malignancy, especially when advanced tumor marker tests like CA125 are not available in remote areas.

PMID:40322664 | PMC:PMC12050043 | DOI:10.2147/IJWH.S496137

JAMIA Open. 2025 May 2;8(3):ooaf027. doi: 10.1093/jamiaopen/ooaf027. eCollection 2025 Jun.

ABSTRACT

OBJECTIVE: Electronic patient portals (PP) allow for targeted and efficient research recruitment. We assessed pre- and postnatal women’s recruitment methods preferences, focusing on PP.

MATERIALS AND METHODS: We conducted 4 in-person focus groups with new and expecting mothers. Participants reported demographics, health status, and comfort with technology including PP. We used descriptive statistics to characterize quantitative data and a quasi-deductive approach to analyze qualitative data.

RESULTS: Participants (n = 32) were an average age of 31.9 years, mostly White (65.6%), married (90.6%), and had a 4-year degree or higher (71.9%). Although they preferred PP for research recruitment over other methods (eg, in-person, physical mail), participants suggested potential barriers, including high message frequency, messages feeling like spam, and concerns about confidentiality. Participants suggested solutions, including enhancing autonomy through opt-in methods; integrating their healthcare provider’s feedback; sending personal and relevant messages; and assuring their PP data are confidential.

DISCUSSION: PPs are a promising recruitment method for pre- and postnatal women including for maternal-child health studies. To ensure engagement with the method, researchers must respond to known patient concerns and incorporate their feedback into future efforts.

CONCLUSION: Although PP were generally viewed as an acceptable recruitment method, researchers should be mindful of barriers that may limit its reach and effectiveness.

PMID:40322631 | PMC:PMC12047077 | DOI:10.1093/jamiaopen/ooaf027