Nevin Manimala

Indian Pediatr. 2025 Feb 15;62(2):116-120. doi: 10.1007/s13312-025-3374-6.

ABSTRACT

OBJECTIVE: To compare the efficacy of a standard dose (1 mg) with 2 mg vitamin K administered by intramuscular (IM) route in reducing subclinical late-onset vitamin K deficiency bleeding (VKDB) assessed using serum protein induced by vitamin K absence (PIVKA II) levels.

METHODS: This was an open-labeled randomized controlled trial that enrolled healthy term neonates delivered vaginally. Neonates delivered to mothers receiving antiepileptics, anti-tuberculous drugs, or warfarin, and those with a family history of bleeding disorder were excluded. Participants were randomized to receive either 1 or 2 mg of vitamin K1 (Phytomenadione) IM at birth. PIVKA II was measured in the cord blood and at 30 and 72 days after birth by ELISA method. PIVKA II level >100 ng/mL was labeled as subclinical VKDB.

RESULTS: Forty-one neonates were recruited in each arm. On the 30 days follow-up visit 9 infants (4 in 1 mg group; 5 in 2 mg group) were lost to follow-up. All babies had PIVKA II levels >100 ng/mL at birth. The median PIVKA II values (ng/mL) in the 1 mg group were 827.68 (cord blood), 678.80 (30 days), and 644.10 (72 days). The corresponding levels (ng/mL) in the 2 mg group were higher, viz., 770.55, 726.35, and 693.14 ng/mL; P > 0.05 for all comparisons. PIVKA II level in the 1 mg group reduced significantly on 72 days of life compared to that observed at birth (cord blood) (P = 0.012). However, the fall in 2 mg group was not statistically significant.

CONCLUSION: There was no difference in PIVKA II levels between neonates receiving 1 mg or 2 mg vitamin K IM suggesting a similar risk for late-onset VKDB in both groups.

PMID:39912270 | DOI:10.1007/s13312-025-3374-6

West J Nurs Res. 2025 Feb 6:1939459251316810. doi: 10.1177/01939459251316810. Online ahead of print.

ABSTRACT

BACKGROUND: Perceived stress during pregnancy has been associated with adverse maternal health and birth outcomes. Compared to White pregnant women, Black pregnant women in the United States report higher levels of perceived stress and experience higher rates of maternal mortality and preterm birth. Mother-father relationship has been associated with perceived stress among pregnant women, though literature among Black pregnant women is limited.

OBJECTIVE: We aimed to examine the associations of mother-father relationship with perceived stress among Black pregnant women.

METHODS: Using a cross-sectional, correlational design, we conducted a secondary analysis of data obtained from 418 Black pregnant women enrolled in the Biosocial Impact on Black Births study. Participants completed questionnaires between 19- and 29 weeks gestation with items related to maternal characteristics, measures of the mother-father relationship, including the level of contact, involvement, closeness, support, and conflict with the father of the baby (FOB), and maternal perceived stress.

RESULTS: Participants who reported lower levels of support (ρ_[416] = -0.279, P < .001) and higher levels of conflict (ρ_[416] = 0.401, P < .001) with the FOB also reported higher levels of perceived stress. Levels of involvement, closeness, support, and conflict with FOB also predicted levels of maternal perceived stress after controlling for covariates.

CONCLUSIONS: These findings suggest that the mother-father relationship significantly influences perceived stress among Black pregnant women, thus warranting further study and intervention.

PMID:39912262 | DOI:10.1177/01939459251316810

Health Promot J Austr. 2025 Apr;36(2):e70010. doi: 10.1002/hpja.70010.

ABSTRACT

INTRODUCTION: Swimming and water safety skills are essential for reducing drowning. Swimming and water safety programs primarily focus on children, despite adults accounting for over 80% of fatal drowning in Australia. This study aims to identify types of adult swimming programs in Australia, who attends these programs, and measure their swimming skill achievement against national benchmarks.

METHODS: A retrospective cross-sectional study of adults attending swimming programs between 2018 and 2021 was conducted. Participant assessment records were analysed against the [Australian] National Swimming and Water Safety Framework and national benchmarks to be achieved by 6 and 12 years old. Descriptive statistics and Chi-square analysis were undertaken.

RESULTS: Of 4914 adults attending swimming lessons, 44% were female, median age was 38 years, and 40% were from high socioeconomic areas. On average, adults attended nine lessons, averaging 4.5 h in the water. At their final assessment, 69% could swim at least 5 m (6-year-old benchmark), and 8% could swim 50 m continuously (12-year-old benchmark).

CONCLUSIONS: Adults of all ages are learning to swim; however, only 8% are achieving the 12-year-old benchmark of swimming 50 m. An equity issue exists, with adults from lower socioeconomic areas and men less likely to be attending swimming programs. Developing and maintaining water safety skills throughout the lifespan is vital for reducing drowning risk among adults. SO WHAT?: Adults are spending time, money and effort learning to swim, however, more is needed to ensure that participants stay in lessons long enough to develop the necessary skills needed to be safe in the water.

PMID:39912253 | DOI:10.1002/hpja.70010

JMIR Hum Factors. 2025 Feb 5;12:e67036. doi: 10.2196/67036.

ABSTRACT

BACKGROUND: Rhinolaryngoscopes are one of the most widely used tools by otolaryngologists and speech-language pathologists in current clinical practice. However, there is limited data on adverse events associated with or caused by the use of rhinolaryngoscopes.

OBJECTIVE: In this study, we used the Manufacturer and User Facility Device Experience (MAUDE) database with the aim of providing insights that may assist otolaryngologists in better understanding the limitations of these devices and selecting appropriate procedures for their specific clinical setting.

METHODS: We characterized complications associated with the postmarket use of rhinolaryngoscope devices from the US Food and Drug Administration MAUDE database from 2016 through 2023.

RESULTS: A total of 2591 reports were identified, including 2534 device malfunctions, 56 injuries, and 1 death, from 2016 through 2023. The most common device problem with rhinolaryngoscopes was breakage (n=1058 reports, 40.8%), followed by fluid leaks (n=632 reports, 24.4%). The third most common problem was poor image quality (n=467 reports, 18%). Other device issues included contamination or device reprocessing problems (n=127 reports, 4.9%), material deformation or wear (n=125 reports, 4.8%), and device detachment (n=73 reports, 2.8%). Of the 63 reported adverse events, the most common patient-related adverse event was hemorrhage or bleeding, accounting for 18 reports, with the root causes including material deformation or wear, breakage, wrinkled rubber, or improper operation.

CONCLUSIONS: Our study offers valuable insights for endoscopists and manufacturers to recognize potential issues and adverse events associated with the use of rhinolaryngoscopes. It emphasizes the need for improving device reliability, training, and procedural protocols to enhance patient safety during diagnostic procedures.

PMID:39912248 | DOI:10.2196/67036

Knee Surg Sports Traumatol Arthrosc. 2025 Feb 6. doi: 10.1002/ksa.12613. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study is to investigate the impact of increased posterior tibial slope (PTS) on pressure distribution in the medial and lateral tibial plateau. The focus is on compartment-specific effects and potential correlations with cartilage damage, due to altered anterior tibial translation caused by increased PTS.

METHOD: Ten freshly frozen knee specimens were prepared and subjected to biomechanical testing. PTS was modified by inserting 5°, 10°, 15° and 20° polylactic acid wedges into osteotomy gaps. Pressure distribution was measured using Tekscan’s Pressure Mapping Sensor 5040™ beneath the menisci at varying PTS angles. The kinetic data were tracked using the Optotrak Certus® system. Statistical analyses were employed to evaluate the pressure shifts and their significance.

RESULTS: The study revealed that increased PTS significantly shifted the pressure point anteriorly on the lateral tibial plateau, while no significant changes were observed on the medial plateau. The analysis of tibial translation showed a corresponding rise in anterior translation with increasing PTS, especially at higher angles.

CONCLUSION: Increased PTS, particularly above 10°, induces significant anterior translation and altered pressure distribution, primarily affecting the lateral tibial plateau. These findings support the hypothesis that elevated PTS contributes to biomechanical stresses in the knee, potentially increasing the risk of lateral compartment cartilage degeneration. These results highlight the importance of considering PTS in clinical assessments and interventions aimed at optimizing knee joint health.

LEVEL OF EVIDENCE: Level IV.

PMID:39912244 | DOI:10.1002/ksa.12613

BMC Glob Public Health. 2025 Feb 6;3(1):11. doi: 10.1186/s44263-025-00126-0.

ABSTRACT

BACKGROUND: Malaria continues to be a major cause of illness and death worldwide, particularly affecting children under the age of five and those living in high-burden countries like Nigeria. Long-lasting insecticidal nets (LLINs) are one of the effective interventions for malaria control and prevention. In response to funding constraints in the Global Fund Grant Cycle 7, Nigeria’s National Malaria Elimination Programme (NMEP) aimed to develop an approach that maximizes the impact of limited malaria interventions by focusing on areas with the greatest need. We developed an urban LLINs distribution framework and a novel strategy, which was piloted in Ilorin, the capital of Kwara State.

METHODS: A participatory action research approach, combined with abductive inquiry, was employed to co-design a framework for guiding bed net distribution. The final framework consisted of three phases: planning, data review and co-decision-making, and implementation. During the framework’s operationalization, malaria risk scores were computed at the ward level using four key variables, including malaria case data and environmental factors, and subsequently mapped. A multistakeholder dialogue facilitated the selection of the final malaria risk maps. Additionally, data from an ongoing study were analyzed to determine whether local definitions of formal, informal, and slum settlements could inform community-level stratification of malaria risk in cities.

RESULTS: Akanbi 4, a ward located in Ilorin South and Are 2, a ward in Ilorin East consistently had lower risk scores, a finding corroborated during the multistakeholder dialogue. A map combining malaria test positivity rates among children under five and the proportion of poor settlements was identified as the most accurate depiction of ward-level malaria risk. Malaria prevalence varied significantly across the categories of formal, informal, and slum settlements, resulting in specific definitions developed for Ilorin. Thirteen communities classified as formal settlements in Are 2 were de-prioritized during the bed net distribution campaign.

CONCLUSIONS: The framework shows promise in facilitating evidence-based decision-making under resource constraints. The findings highlight the importance of stakeholder engagement in evaluating data outputs, particularly in settings with limited and uncertain data. Enhancing surveillance systems is crucial for a more comprehensive approach to intervention tailoring, in alignment with WHO’s recommendations.

PMID:39910663 | DOI:10.1186/s44263-025-00126-0

J Orthop Surg Res. 2025 Feb 6;20(1):142. doi: 10.1186/s13018-025-05524-6.

ABSTRACT

BACKGROUND: An iatrogenic lateral hinge fracture is a common intraoperative problem that may occur during medial open wedge high tibial osteotomy (MOWHTO). This study aims to assess the significance of using additional crossing lateral K-wires and their advantage in protecting the lateral hinge during MOWHTO procedures.

METHODS: The data of patients fulfilling the inclusion criteria who underwent MOWHTO between May 2021 and August 2022 were retrospectively evaluated. One group had additional lateral hinge crossing K-wires (+ MOWHTO group), while the other did not (-MOWHTO group). Both groups were assessed for rate of intraoperative lateral hinge fractures, knee injury and osteoarthritis outcome score – 12 (KOOS-12), medial proximal tibial angle (MPTA), time of union, and time to return to work. The outcomes were compared using the independent T-test for continuous variables and the Fisher Exact test for nominal variables. A p-value of < 0.05 was considered statistically significant for both tests.

RESULTS: The study included forty-eight patients; twenty-four in each treatment group. The mean follow-up durations were 30.5 ± 3.6 months for + MOWHTO and 31.6 ± 3.2 months for -MOWHTO (p = 0.26). There was no statistically significant difference regarding mean age, sex, KOOS-12, MPTA, and time of surgery between both groups. The + MOWHTO group had a faster time of union (p = 0.001), an earlier return to work (p = 0.002), and a lower rate of intraoperative lateral hinge fractures (p = 0.04).

CONCLUSION: This study demonstrated that using additional crossing lateral K-wires during MOWHTO had a beneficial effect on reducing the rate of iatrogenic lateral hinge fractures, with a faster time of union, and an early return to work. The KOOS-12, MPTA, and mean operative time did not reveal significant differences between treatment groups.

LEVEL OF EVIDENCE: retrospective cohort comparative study; level III.

PMID:39910661 | DOI:10.1186/s13018-025-05524-6

Eur J Med Res. 2025 Feb 6;30(1):82. doi: 10.1186/s40001-025-02318-8.

ABSTRACT

BACKGROUND: Adherence to dietary guidelines is a fundamental aspect of diabetes management; however, it poses a significant challenge for patients with diabetes. Our research aims to assess the level of dietary compliance among individuals with type 2 diabetes (T2DM) and to identify the factors that influence their adherence to dietary advice.

METHODS: This study was a cross-sectional survey. The patients with T2DM undergoing treatment at our hospital from March, 2023, to June, 2024 were included. Compliance with dietary recommendations was assessed using the validated dietary compliance scale for type 2 diabetes mellitus patients (DCS-T2DM). Spearman correlation and logistic regression analyses were conducted to evaluate the factors influencing dietary compliance in patients with T2DM.

RESULTS: A total of 308 T2DM patients were included in our study. The results revealed that 46.10% of the participants had suboptimal dietary compliance. There were significant correlations between dietary compliance and several demographic and clinical factors, including age (r = 0.501), gender (r = 0.447), education level (r = 0.610), average monthly household per capita income (r = 0.627), and the duration, since T2DM diagnosis (r = 0.552), all of which were statistically significant (p < 0.05). Logistic regression identified age (OR = 1.705, 95%CI 1.262 ~ 1.987), gender (OR = 2.401, 95%CI 1.909 ~ 3.134), education level (OR = 3.083, 95%CI 2.434 ~ 3.957), average monthly household per capita income (OR = 3.721, 95%CI 2.553 ~ 4.405), and the time since T2DM diagnosis (OR = 2.470, 95%CI 1.755 ~ 3.262) as significant predictors of dietary compliance.

CONCLUSIONS: 46.10% of patients with T2DM exhibited suboptimal dietary adherence, with age, gender, education, income, and diabetes duration significantly predicting compliance. It is imperative for healthcare providers to devise individualized intervention strategies that incorporate these pivotal factors to enhance dietary adherence in patients with T2DM.

PMID:39910637 | DOI:10.1186/s40001-025-02318-8

BMC Rheumatol. 2025 Feb 6;9(1):12. doi: 10.1186/s41927-024-00445-z.

ABSTRACT

BACKGROUND: Currently, there is no standard therapy for idiopathic retroperitoneal fibrosis, so a systematic review was undertaken to assess the effectiveness of different treatment approaches.

METHODS: A comprehensive search of English and German literature from 1980 to 2021 was conducted using PubMed, Embase, and PreMedline. To be included, studies must have had a minimum of two patients employing the same treatment approach and reporting relevant treatment outcomes. A meta-analysis with a subgroup analysis was conducted for the primary outcomes “regression of fibrosis,” “freedom from ureteric stents” and “relapse rate,” and the secondary outcome “clinical improvement.” The lack of homogeneous data prevented a subgroup analysis for the primary outcome “improvement in renal function.”

RESULTS: The search resulted in a total of 3818 articles, of which 108 were selected for qualitative analysis involving a total of 1408 patients. For the meta-analysis 83 studies were included involving 1044 patients. The summary effect size of the outcomes “regression of fibrosis,” “freedom from ureteric stent” and “clinical improvement” was high with values between 80-97.9%. The summary relapse rate across studies was 18.1%. Subgroup analysis revealed no statistically significant differences in the effectiveness of treatment approaches for the outcomes “regression of fibrosis” (QM = 2.72, p = 0.74), “freedom from ureteric stent” (QM = 7.21, p = 0.13), “relapse rate” (QM = 11.34, p = 0.08) and “clinical improvement” (QM = 9.54, p = 0.15).

CONCLUSIONS: Considering the lack of clear evidence indicating that one drug is more effective than the other, the treatment choice should depend on factors such as the potential side effects of different drug therapies, patient comorbidities, and clinician expertise. The review protocol is registered on PROSPERO under the identification number CRD42019115744.

PMID:39910636 | DOI:10.1186/s41927-024-00445-z

BMC Public Health. 2025 Feb 5;25(1):461. doi: 10.1186/s12889-025-21653-3.

ABSTRACT

Diagnosed hypertension stands out as a prominent global cause of mortality, prompting recent efforts to understand not only treatment options but also determinants across diverse age and occupational groups. However, the literature on the impact of environmental factors on diagnosed hypertension is limited, especially in rural areas with restricted access to health infrastructure. Geographical determinants research has often focused on spatial variations across different units, potentially masking individual environmental contributions. Data on diagnosed hypertension patients and their behaviours were gathered during the ARISE project, complemented by geographical data (elevation, vegetation, road network, population density, and nighttime light exposure) from secondary sources. Spatial patterns were analyzed using the Nearest Neighbour Statistic, Ripley K Function, and Kernel Density Estimation, while Binomial logistic regression identified predictors. Diagnosed hypertension patients exhibit spatial clustering, and are mainly comprised of elderly individuals, residing closer to roads, at higher elevations, in areas with higher population distribution, and with little or no green vegetation. Socio-economic, health-related, behavioural, and environmental factors collectively drive diagnosed hypertension. Spatial clustering of diagnosed hypertension in the Igbo Ora community is localized, indicating potential spatial factors influencing its prevalence. Beyond identified behavioural and medical history factors, geographical elements like nighttime light exposure and normalized vegetation index contribute to the observed clustering. Understanding these dynamics is crucial for targeted interventions in the community.

PMID:39910619 | DOI:10.1186/s12889-025-21653-3