Nevin Manimala

Alpha Psychiatry. 2025 Dec 23;26(6):49375. doi: 10.31083/AP49375. eCollection 2025 Dec.

ABSTRACT

BACKGROUND: The objective of this study is to develop an easily applicable scale to measure the course of treatment and the level of recovery for mental problems in various dimensions, which can be used in clinical practice and research.

METHODS: The validity and reliability test of Moodist Outcome Inventory (MOI) were conducted with 293 participants. Criterion-related validity was investigated by assessment with the Brief Psychiatric Rating Scale (BPRS), Disability Assessment Schedule (WHO-DAS-II), and Psychological Distress Scale (K10-PDS). Factor analysis was investigated by assessment with clinical and non-clinical samples. The sample was followed for six clinical assessments and evaluated by repetitive analysis of Variance (ANOVA) measurement.

RESULTS: The Cronbach’s alpha coefficient of the total scale was noted to be 0.89 in the reliability analysis. In the exploratory factor analysis, the single factor explaining 75.64% of the total variance was attained, and all items were included in this factor. Forty cases completed six clinical assessments, and the change between the MOI scores during the time interval was noted to be statistically significant. The correlation of the MOI scale with the K-10, WHO-DAS-II, and BPRS scales was noted to be 0.62, 0.73, and 0.65, respectively. In six consecutive assessments, the mean scores of all scales dropped significantly. The cut-off point of the scale was recorded as 7.27, and the reliable change index (RCI) was noted as 2.5.

CONCLUSION: MOI was assessed as a valid and reliable scale for evaluating the course of treatment. The strengths of the scale are that it assesses both symptoms and well-being, is short, and can be implemented in clinical practice.

PMID:41523968 | PMC:PMC12781210 | DOI:10.31083/AP49375

Malays Fam Physician. 2025 Dec 11;20:78-100. doi: 10.51866/oa.880. eCollection 2025.

ABSTRACT

INTRODUCTION: Women with a history of gestational diabetes mellitus (GDM) have an increased risk of developing glucose intolerance. This study aimed to assess the prevalence of glucose intolerance and its associated factors among postpartum women with a history of GDM in Penang.

METHODS: This cross-sectional study was conducted at five government primary care clinics in Penang. Postpartum women with a history of GDM who underwent a 75-g oral glucose tolerance test (OGTT) at 6-12 weeks postpartum were recruited from August to October 2023. Data collected included sociodemographic details, clinical characteristics, physical activity levels measured using the International Physical Activity Questionnaire-Short Form and OGTT results. Descriptive and multiple logistic regression analyses were performed using IBM SPSS Statistics version 29.

RESULTS: A total of 204 women participated, with a mean age of 31.7 (SD=5.05) years. The prevalence of prediabetes and type 2 diabetes mellitus was 23.5% and 3.9%, respectively. Among the participants, 47.5% were inactive, while 27.5% were physically active. The participants on oral medication or insulin had higher odds of developing postpartum glucose intolerance. Conversely, the participants who were minimally active or active had a lower likelihood of developing glucose intolerance than those who were inactive.

CONCLUSION: Among women attending primary care clinics in Penang, 27.5% had abnormal glucose tolerance postpartum. Physical inactivity was a significant risk factor. This study highlights the need to promote physical activity during pre-pregnancy care to reduce postpartum glucose intolerance and its complications.

PMID:41523956 | PMC:PMC12789809 | DOI:10.51866/oa.880

Circ Rep. 2025 Nov 20;8(1):58-67. doi: 10.1253/circrep.CR-25-0156. eCollection 2026 Jan 9.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) after bioprosthetic valve (BPV) replacement is common in older patients with multiple comorbidities and is associated with a heightened risk of thromboembolism. Anticoagulation therapy is often indicated, but renal impairment and other comorbidities elevate bleeding risk, making clinical decisions complex. This study compared clinical outcomes between warfarin and direct oral anticoagulants (DOACs) in this high-risk population.

METHODS AND RESULTS: This subgroup analysis of the BPV-AF Registry included 612 patients treated with oral anticoagulants after BPV replacement, stratified by renal function: normal or mild impairment (creatinine clearance [CCr] ≥50 mL/min), mild-to-moderate impairment (30 mL/min ≤ CCr < 50 mL/min), and moderate-to-severe impairment (15 mL/min ≤ CCr < 30 mL/min). Baseline characteristics and outcomes were analyzed within each stratum. The composite outcome of stroke, systemic embolism, and cardiovascular events was numerically less frequent in the DOAC than warfarin group across all strata, although the differences were not statistically significant. Major bleeding also tended to be lower in the DOAC group.

CONCLUSIONS: In this study from a Japanese nationwide registry comparing outcomes of AF patients after BPV replacement with severe renal impairment between those treated with DOACs and those treated with warfarin, comparative conclusions between DOACs and warfarin cannot be drawn because of the small sample size. Nonetheless, both anticoagulants may be acceptable in clinical practice, highlighting the need for individualized decision-making based on patient risk.

PMID:41523933 | PMC:PMC12782906 | DOI:10.1253/circrep.CR-25-0156

Explor Asthma Allergy. 2025;3:100978. doi: 10.37349/eaa.2025.100978. Epub 2025 Apr 16.

ABSTRACT

AIM: Emerging epidemiological studies have reported a link between allergic diseases, including asthma, and depression. Evidently, the gut microbiota is involved in the pathogenesis of asthma and depression. Therefore, we investigated whether allergic lung inflammation in mice causes gut microbial dysbiosis, via the gut-brain axis, which is potentially associated with depression.

METHODS: Wild-type C57BL/6J female mice were sensitized with intranasal house dust mite (HDM) antigen or phosphate-buffered saline (PBS) for 6 weeks to induce chronic allergic lung inflammation. Sucrose preference tests were performed for assessing depression. Fecal samples were collected, and 16S ribosomal RNA gene sequencing was performed to detect differences in gut microbiota composition between the HDM and PBS groups. The distance calculation, clustering of operational taxonomic units, rarefaction analysis, and estimator calculation (α- and β-diversity) were performed.

RESULTS: There was a significant difference in β-diversity (Bray-Curtis dissimilarity, F-statistics = 6.16, p = 0.001) of the gut microbiota between HDM and PBS groups. However, there was no difference in the α-diversity. We observed multiple differentially abundant bacteria in the HDM and PBS groups. The order class Clostridia (p = 0.0036) and genus Faecalibaculum (p = 0.028) were more abundant in the HDM group, whereas the phylum Firmicutes (p = 0.037) and genera Dubosiella (p = 0.00024) and Turicibacter (p = 0.037) were more abundant in the PBS group. Notably, the relative abundance of some bacteria was correlated with the sucrose preference test results.

CONCLUSIONS: Six weeks of intranasal HDM administration to mimic the chronic status of lung inflammation in asthma changed the gut microbiome in mice and was associated with depression-like behavioral changes.

PMID:41523930 | PMC:PMC12781662 | DOI:10.37349/eaa.2025.100978

Plast Reconstr Surg Glob Open. 2026 Jan 9;14(1):e7375. doi: 10.1097/GOX.0000000000007375. eCollection 2026 Jan.

ABSTRACT

BACKGROUND: Surgical intervention, particularly sentinel lymph node and lymph node dissection, is essential in managing melanoma, targeting locoregional disease. Our aim was to elucidate risk factors for postoperative lymphatic complications in melanoma patients undergoing lymph node surgery in Peru.

METHODS: A retrospective cohort study was conducted, reviewing records of melanoma patients who underwent lymphatic surgery at the Instituto Nacional de Enfermedades Neoplásicas from 2010 to 2019. Descriptive statistics and logistic regression analyses were performed to identify predictors of lymphatic complications.

RESULTS: The study included 699 melanoma patients (mean age 60.70 y, 51.4% women). Most patients were Hispanic (99.3%) and from Lima (52.8%), with lower extremity involvement being common. Surgical interventions included wide local excision (56.9%), sentinel lymph node surgery (67%), and lymph node dissection (32.3%). Complications at the site of lymph node dissection included wound dehiscence (1.6%), infection (6.2%), lymphoceles (5.7%), and lymphedema (2.7%). Multivariate analysis identified lymphatic invasion (odds ratio [OR] = 2.601, 95% confidence interval [CI]: 1.232-5.491) and positive lymph node pathology (OR = 2.066, 95% CI: 1.034-4.127) as risk factors, whereas primary lesion location in the upper extremity (OR = 0.055, 95% CI: 0.007-0.408) and trunk (OR = 0.106, 95% CI: 0.014-0.818) were protective factors.

CONCLUSIONS: Key risk factors for postoperative lymphatic complications in melanoma patients undergoing lymph node surgery include lower extremity involvement, lymph node dissections, lymphatic invasion, and positive lymph nodes. Understanding these risk factors can help clinicians optimize management strategies to reduce postoperative lymphatic complications.

PMID:41523920 | PMC:PMC12788895 | DOI:10.1097/GOX.0000000000007375

Ther Adv Med Oncol. 2026 Jan 9;18:17588359251411133. doi: 10.1177/17588359251411133. eCollection 2026.

ABSTRACT

BACKGROUND: Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have become a cornerstone in the treatment of HR+/HER2- advanced breast cancer. While their efficacy is well-established, emerging reports of nephrotoxicity warrant further investigation into its incidence, risk factors, and potential impact on survival outcomes.

OBJECTIVES: This study aimed to evaluate the incidence and risk factors for nephrotoxicity in patients receiving CDK4/6 inhibitors (palbociclib or ribociclib) and to analyze its association with progression-free survival (PFS) and overall survival (OS).

DESIGN: This was a single-center, retrospective cohort study.

METHODS: We reviewed the medical records of 120 patients with advanced breast cancer treated with palbociclib or ribociclib between October 2018 and July 2024. Nephrotoxicity was defined as a ⩾20% decline in creatinine clearance (CKD-EPI 2021) from baseline. Statistical analyses included descriptive statistics, chi-square tests, t-tests, Kaplan-Meier survival analysis, and Cox regression models.

RESULTS: Nephrotoxicity occurred in 28 patients (23.3%). Older age (⩾65 years) and higher baseline urea and creatinine levels were significant risk factors (p < 0.001). Paradoxically, patients who developed nephrotoxicity showed a trend toward better survival outcomes: median PFS was 30 months versus 20 months (p = 0.188), and the 3-year OS rate was 77.9% versus 63.8% (p = 0.801), though these differences were not statistically significant. In multivariate Cox analysis, the development of nephrotoxicity showed a trend toward a 71% reduction in mortality risk (HR = 0.293, p = 0.078), but it was not statistically significant.

CONCLUSION: Nephrotoxicity is relatively common in patients treated with CDK4/6 inhibitors, particularly in older individuals and those with elevated baseline renal parameters. Contrary to conventional expectations, its occurrence may be associated with a trend toward improved survival, possibly reflecting higher drug exposure or effective target inhibition. These findings highlight the need for careful renal monitoring and suggest that nephrotoxicity could serve as a potential surrogate marker for treatment efficacy, warranting validation in larger prospective studies.

PMID:41523909 | PMC:PMC12789390 | DOI:10.1177/17588359251411133

OTO Open. 2026 Jan 8;10(1):e70190. doi: 10.1002/oto2.70190. eCollection 2026 Jan-Mar.

ABSTRACT

OBJECTIVE: Signaling was introduced to the otolaryngology match in 2021, with 5 signals allotted to applicants in 2021, 4 in 2022, 7 in 2023, and 25 in 2024. This study investigated the modifying effect of signaling volume on the relationship between away rotations and matching in otolaryngology from 2018 to 2024.

STUDY DESIGN: Cross-sectional.

SETTING: National survey of US medical students.

METHODS: We used the Texas Seeking Transparency in Application to Residency (STAR) survey responses of otolaryngology applicants from 2018 to 2024. Using multivariate logistic regression, we determined the odds of matching where away rotations were performed and how these odds varied across the pre-volume (2018-2020), low-volume (2021-2023), and high-volume (2024) signaling eras.

RESULTS: In total, 28.3% (n = 855) of otolaryngology applicants from 2018 to 2024 completed the Texas STAR survey. Using multivariate logistic regression, adjusting for applicant characteristics, and including an interaction term between performing away rotations and signaling time period, applicants in the high-volume signaling era were found to be significantly less likely to match at programs where away rotations were performed (odds ratio [OR]: 0.56, 95% CI: 0.33-0.95; P < .05) compared to the pre-signaling era. The same trend was seen in the low-volume signaling era, though not statistically significant (OR: 0.76, 95% CI: 0.47-1.22, P = .24). The most impactful factor on matching across all study years was performing an away rotation (OR: 12.1, 95% CI: 9.0-16.5, P < .001).

CONCLUSION: The introduction of signaling and the recent increase in signal number are associated with decreased likelihood of matching at a program where an away rotation was performed compared to the pre-signaling era.

LEVEL OF EVIDENCE: V.

PMID:41523886 | PMC:PMC12780956 | DOI:10.1002/oto2.70190

Glob Health Epidemiol Genom. 2025 Dec 11;2025:2867843. doi: 10.1155/ghe3/2867843. eCollection 2025.

ABSTRACT

INTRODUCTION: With growing recognition of the prolonged effects of COVID-19, there is an urgent need to understand its extended clinical and public health implications across diverse settings. Long-term consequences following SARS-CoV-2 infection remain insufficiently studied in Middle Eastern populations. This study aimed to assess the prevalence of persistent COVID-19 symptoms among Palestinian adults and to evaluate their associations with hospitalization and recovery duration.

METHODS: This cross-sectional study was conducted on a randomized sample of 407 adult COVID-19 patients confirmed by the Palestinian Ministry of Health between November 25 and December 15, 2020. We used a standardized Arabic questionnaire to cover demographics, medical history, symptoms, complications, and physical activity. Data were gathered by phone interviews in October 2021. All data came from self-reports. With significance defined at p < 0.05, associations between the symptom duration, hospitalization, and recovery time were examined using descriptive statistics and chi-square tests.

RESULTS: The study population had a mean age of 40 years; 54% were female, and 70.3% had no previous medical history. Common complaints were fatigue (64.9%), anosmia (61.9%), joint pain (52.6%), and headache (51.8%). Hospitalization was necessary in 7.6% of patients, while 5.9% required oxygen or intubation. Most patients (92.6%) recovered in 4 months. The persistence of chest pain (χ ², 16.225), shortness of breath (χ ², 13.257), and lethargy (χ ², 8.194) was significantly associated with hospitalization (p < 0.001). The persistence of the previously mentioned symptoms was significantly associated with the duration of recovery.

CONCLUSION: This study offers valuable insights into the long-term symptoms experienced by individuals recovering from COVID-19 in the West Bank. The findings carry implications for clinicians, public health authorities, and affected individuals, highlighting the importance of integrated care strategies and sustained support throughout the postacute phase of the disease.

PMID:41523874 | PMC:PMC12782249 | DOI:10.1155/ghe3/2867843

Pan Afr Med J. 2025 Oct 31;52:89. doi: 10.11604/pamj.2025.52.89.48467. eCollection 2025.

ABSTRACT

INTRODUCTION: unmet family planning needs remain a significant health challenge. In Kenya, 14% of women have an unmet need. In Siaya County unmet need is 21% among the women, and this is high. This study seeks to determine the intervening role of community health education on the reduction of unmet needs among women of reproductive age in Siaya County.

METHODS: the study employed a quasi-experimental design with non-randomized, geographically distinct clusters. Assignment to the intervention and control arms was based on geographic allocation to avoid contamination into an intervention group that received structured health education for six months, and a control group, which did not. Data were collected at two time points (baseline and end line). The design enabled a difference-in-differences analysis to determine changes in outcomes between the groups over time. The FANTA formula by Robert Magnani determined the sample size of 1,448 respondents for the study. The WHO 30 by 30 two-stage cluster sampling method was used to sample the number of women of reproductive age. Data analysis was done using IBM SPSS version 28.0, with both bivariate and multivariate analyses conducted. Unmet needs for family planning were modeled using a generalized linear mixed-effects model (GLMM).

RESULTS: one thousand four hundred and forty-seven (1447) women of reproductive age (WRA) were interviewed at baseline and end line. There was a 17.1% increase in high family planning (FP) knowledge and a 12% rise in positive attitudes in the intervention, and a decline in the control group. Despite an increase in unmet need for FP in both study arms, the rise was lower in the intervention (6.7%) compared to the counterfactual (20.8%). The intervention had a protective effect against worsening of unmet need (aOR=0.31, 95% CI=0.10-1.00; p=0.051). This effect had borderline statistical significance (p=0.051). Family planning (FP) uptake decreased in the control group by 11.3% but increased in the intervention group by 6.6%, with aOR=2.42, 95% CI=0.92-6.40, p=0.075 indicating marginal statistical significance (p=0.075).

CONCLUSION: the intervention improves knowledge and attitudes, mitigates worsening of unmet FP needs, and promotes FP uptake.

PMID:41523867 | PMC:PMC12790397 | DOI:10.11604/pamj.2025.52.89.48467

Health Sci Rep. 2026 Jan 8;9(1):e71739. doi: 10.1002/hsr2.71739. eCollection 2026 Jan.

ABSTRACT

BACKGROUND AND AIMS: This systematic review and meta-analysis aimed to compare the clinical outcomes of antihypertensive medication administration at bedtime versus morning, focusing on major adverse cardiovascular events (MACE), mortality, and secondary cardiovascular outcomes in hypertensive patients.

METHODS: We conducted a systematic search across multiple databases to identify randomized controlled trials (RCTs) comparing bedtime versus morning antihypertensive dosing. Studies were included if they evaluated MACE, all-cause mortality, or cardiovascular mortality. Myocardial infarction, stroke, and heart failure were considered secondary outcomes. Data were extracted, and statistical analysis was performed using hazard ratios and mean differences with 95% confidence intervals. A random-effects model with Hartung-Knapp correction was used to account for between-study heterogeneity. Sensitivity analyses were conducted to assess the robustness of the results.

RESULTS: Five studies with 36,477 patients (42.30% male) were included. No significant differences were found between bedtime and morning dosing for MACE (HR: 0.71, 95% CI: 0.43-1.15, p = 0.11) and mortality outcomes (all-cause HR: 0.76, 95% CI: 0.50-1.16, p = 0.14; cardiovascular HR: 0.54, 95% CI: 0.08-3.86, p = 0.31). These findings, which showed substantial heterogeneity (I² > 90%), were consistent in sensitivity analyses. Also, for secondary outcomes, there were no significant differences observed in myocardial infarction (HR: 0.79, 95% CI: 0.49-1.29, p = 0.26), stroke (HR: 0.61, 95% CI: 0.32-1.17, p = 0.10), or heart failure (HR: 0.64, 95% CI: 0.37-1.08, p = 0.07).

CONCLUSION: This meta-analysis found no significant difference in cardiovascular outcomes between bedtime and morning antihypertensive dosing. Within the limitations of the available evidence, a universal chronotherapy strategy does not appear to provide additional cardiovascular benefit. Once-daily antihypertensive medications can be taken at a time that aligns with the patient’s lifestyle, with adherence being the most critical factor in ensuring treatment effectiveness.

PMID:41523855 | PMC:PMC12783704 | DOI:10.1002/hsr2.71739