Nevin Manimala

JMIR Form Res. 2025 Jan 9;9:e63948. doi: 10.2196/63948.

ABSTRACT

BACKGROUND: Hypnotherapy has been shown to be a safe, nonhormonal intervention effective for treating menopausal hot flashes. However, women experiencing hot flashes may face accessibility barriers to in-person hypnotherapy. To solve this issue, a smartphone app has been created to deliver hypnotherapy. The Evia app delivers audio-recorded hypnotherapy and has the potential to help individuals experiencing hot flashes.

OBJECTIVE: This study aims to determine user outcomes in hot flash frequency and severity for users of the Evia app.

METHODS: This study is a retrospective analysis of a dataset of Evia app users. Participants were divided into 2 groups for analysis. The first group reported daytime hot flashes and night sweats, while the second group was asked to report only daytime hot flashes. The participants in the first group (daytime hot flashes and night sweats) were 139 women with ≥3 daily hot flashes who downloaded the Evia app between November 6, 2021, and June 9, 2022, with a baseline mean of 8.330 (SD 3.977) daily hot flashes. The participants in the second group (daytime hot flashes) were 271 women with ≥3 daily hot flashes who downloaded the Evia app between June 10, 2022, and February 5, 2024, with a baseline mean of 6.040 (SD 3.282) daily hot flashes. The Evia program included a 5-week program for all participants with daily tasks such as educational readings, hypnotic inductions, and daily hot-flash tracking. The app uses audio-recorded hypnosis and mental imagery for coolness, such as imagery for a cool breeze, snow, or calmness.

RESULTS: A clinically significant reduction, defined as a 50% reduction, in daily hot flashes was experienced by 76.3% (106/139) of the women with hot flashes and night sweats and 56.8% (154/271) of the women with daily hot flashes from baseline to their last logged Evia app survey. On average, the women with hot flashes and night sweats experienced a reduction of 61.4% (SD 33.185%) in their hot flashes experienced at day and night while using the Evia app, and the women with daily hot flashes experienced a reduction of 45.2% (SD 42.567%) in their daytime hot flashes. In both groups, there was a large, statistically significant difference in the average number of daily hot flashes from baseline to end point (women with hot flashes and night sweats: Cohen d=1.28; t₁₃₈=15.055; P<.001; women with daily hot flashes: Cohen d=0.82; t₂₇₀=13.555; P<.001).

CONCLUSIONS: Hypnotherapy is an efficacious intervention for hot flashes, with the potential to improve women’s lives by reducing hot flashes without hormonal or pharmacological intervention. This study takes the first step in evaluating the efficacy of an app-delivered hypnosis intervention for menopausal hot flashes, demonstrating the Evia app provides a promising app delivery of hypnotherapy with potential to increase accessibility to hypnotherapy.

PMID:39787588 | DOI:10.2196/63948

Noise Health. 2024 Oct-Dec 01;26(123):577-583. doi: 10.4103/nah.nah_111_24. Epub 2024 Dec 30.

ABSTRACT

OBJECTIVE: Evaluate the effect of white noise intervention on sleep quality and immunological indicators of patients with breast cancer undergoing neoadjuvant chemotherapy (NAC).

METHODS: From January 2020 to December 2022, 104 newly diagnosed female patients (the number of people who met the inclusion criteria) with breast cancer who were confirmed to be preoperative NAC by puncture pathology were selected for a randomised single-blind trial. The patients were randomly divided into an observation group and a control group, with 52 cases in each group. The control group of patients received routine NAC treatment. The observation group played white noise at regular intervals every night on the basis of routine NAC, covering the entire treatment cycle. We evaluated the clinical efficacy, safety, sleep quality and immunological indicators of the two groups.

RESULTS: We found no statistically significant difference in the objective response rate between the two groups (P > 0.05). There was no statistically significant difference in the incidence of safety events between the two groups (P > 0.05). The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (P < 0.05). After intervention, the sleep latency, subjective sleep quality, sleep duration, daytime function and sleep disorder scores of both groups decreased, and the observation group had significantly lower scores than the control group (P < 0.05). After intervention, both groups showed changes in immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM), C-reactive protein and serum interleukin-6, but the differences between the groups were not statistically significant (P > 0.05).

CONCLUSION: White noise intervention can improve the sleep quality of the NAC population with breast cancer and reduce the incidence of adverse reactions. In addition, it has no effect on the treatment efficacy, safety and immune indicators of patients.

PMID:39787561 | DOI:10.4103/nah.nah_111_24

Noise Health. 2024 Oct-Dec 01;26(123):535-542. doi: 10.4103/nah.nah_39_23. Epub 2024 Dec 30.

ABSTRACT

BACKGROUND: Tinnitus refers to a common disorder affecting older adults frequently. This condition can disturb mental health and psychological well-being and contribute to cognitive decline. Despite recent advances in research, its pathophysiology remains incompletely understood. Therefore, this study aimed to investigate the sensation of tinnitus, its consequences on the quality of life of older adults, and its correlation with cytokine levels.

METHODS AND MATERIAL: This cross-sectional study included a sample of 103 independent older adults. Information regarding clinical history, tinnitus, and hearing loss was obtained through interviews. Assessment of tinnitus intensity and resulting impairments was conducted using Visual Analogue Scale (VAS) and Tinnitus Handicap Index (THI), respectively. Subjects underwent audiological evaluation and were measured for inflammatory markers. Statistical analyses included chi-square, Mann-Whitney, and Kruskal-Wallis tests and calculation of the effect size (Φ).

RESULTS: The condition of older adults with tinnitus (51.5%) was associated with hearing loss and previous noise exposure. No differences were observed in the cytokines between groups with and without tinnitus (P > 0.05), whereas a difference was found in the interleukin-10 (IL-10) of the male group (P = 0.016; r = 0.69). In those with tinnitus, VAS had a median and (interquartile range) of 5 (2-7), and the values were 21 (10-38) for THI. In addition, VAS and minimum masking level exhibited a significant correlation with IL-6 (P = 0.018; rs = 0.335) and IL-2 (P = 0.035; rs = 0.299), respectively. Furthermore, the groups with intense and mild VAS presented different levels of tumour necrosis factor alpha (TNF-α) (P = 0.041; E2R = 0.12).

CONCLUSION: The results reveal an association between tinnitus and hearing loss and previous noise exposure. Moreover, increased sound-masking levels and VAS correlated with IL-2 and IL-6, respectively. TNF-α levels varied between the mild and intense VAS groups.

PMID:39787555 | DOI:10.4103/nah.nah_39_23

Noise Health. 2024 Oct-Dec 01;26(123):523-534. doi: 10.4103/nah.nah_10_24. Epub 2024 Dec 30.

ABSTRACT

OBJECTIVE: Besides psychosocial stressors, teachers are exposed to disturbing noise at work, such as students’ irrelevant speech. Few studies have focused on this issue and its health consequences. We explored occupational noise exposure among teachers within the French workforce and analyzed how noise and work-related stress are related to their health.

MATERIALS AND METHODS: The prevalence of perceived noise exposure, evaluated through the question “Do you work in an environment where you sometimes have to raise your voice to talk to people 2 to 3 m away?” was compared between teachers (n = 13,843) and various occupational groups (n = 34,338) using inclusion data (2012-2020) from the ongoing French population-based CONSTANCES cohort (>217,000 participants). Additionally, the relationships between perceived noise and two health dimensions, perceived health (poor vs. good) and depressive symptoms (Centre for Epidemiologic Studies-Depression Scale, high vs. low/moderate), among teachers were alternately investigated using logistic regressions. Moreover, how perceived noise may interact with work-related stress (effort-reward imbalance/strained relationships) was explored.

RESULTS: Thirty-two percent of teachers reported working in a noisy environment, compared with 14% of noneducation employees (P < 0.001). Primary school teachers were the most likely to report noise exposure (43%). Independent of stress, teachers exposed to noise had poorer perceived health and higher odds of depressive symptoms than nonexposed teachers, with odds ratios (95% confidence interval) of 1.21 (1.07; 1.37) and 1.14 (1.01; 1.28), respectively. Evidence of an interaction between perceived noise and strained relationships was observed on perceived health (P = 0.05).

CONCLUSION: French teachers commonly reported disturbing noise at work, and those exposed showed poorer health indicators, particularly when facing strained relationships. The findings call for further studies on noise in schools, especially longitudinal studies, to ascertain its long-term effect on teachers’ health and its potential interaction with the psychosocial environment.

PMID:39787554 | DOI:10.4103/nah.nah_10_24

Noise Health. 2024 Oct-Dec 01;26(123):495-500. doi: 10.4103/nah.nah_78_24. Epub 2024 Dec 30.

ABSTRACT

PURPOSE: Noise levels may have an impact on the level of fear and anxiety in hospitalized children, which, in turn, may affect the effectiveness of treatment. This retrospective study aimed to investigate the impact of noise levels on medical anxiety in hospitalized children with pneumonia.

METHODS: Children hospitalized for pneumonia in our hospital from January 2020 to December 2023 were consecutively enrolled in this study. They were divided into high- and low-noise groups according to the environmental noise level, using 60 dB as a threshold value. Demographic, clinical, and psychological data were collected from medical records and patient assessments. Statistical analyses, including post-hoc analysis, were performed to conduct relevant research.

RESULTS: A total of 106 patients, including 66 patients with low noise and 40 patients with high noise, were included. Results revealed that children in the high-noise group exhibited significantly higher scores on the Brief Illness Perception Questionnaire compared to those in the low-noise group (32.56 ± 7.14 vs. 29.18 ± 6.25, t = 2.557, P = 0.012), as well as higher scores on the Face, Legs, Activity, Cry, Consolability (FLACC) behavioral pain scale (2.34 ± 0.96 vs. 2.01 ± 0.67, t = 2.081, P = 0.040), indicating higher levels of medical anxiety and pain perception in the high-noise group.

CONCLUSION: This study demonstrates that noise levels in the hospital environment have a substantial impact on the fears and perceptions of hospitalized children with pneumonia. High-noise levels were associated with increased medical anxiety and pain perception in pediatric patients.

PMID:39787550 | DOI:10.4103/nah.nah_78_24

Noise Health. 2024 Oct-Dec 01;26(123):489-494. doi: 10.4103/nah.nah_83_24. Epub 2024 Dec 30.

ABSTRACT

PURPOSE: This study aimed to assess the levels and sources of noise in the emergency intensive care unit (EICU) of an emergency department and investigate their effects on the sleep quality of conscious patients.

METHODS: A study was conducted on patients admitted to the EICU from December 2020 to December 2023. They were categorised according to their sleep quality with the Pittsburgh Sleep Quality Index. Environmental noise levels were measured using precision sound level metres and environmental noise automatic monitoring instruments. Data analysis was performed using SPSS version 25.0, and Chi-square test, Fisher’s exact probability and t-tests were conducted when applicable. The significance threshold was set at P < 0.05. Regression analysis was carried out for indicators with significant differences.

RESULTS: A total of 200 patients were included in the study. Of them 96 in the ideal sleep group and 104 in the non-ideal sleep group. Patients with non-ideal sleep experienced significantly higher noise levels across various measures (P < 0.05). Additionally, patients with non-ideal sleep reported significantly higher occurrences of noise-related awakening, difficulty in falling asleep, nightmares or vivid dreams and sleepwalking episodes (P < 0.05). Significant differences in staff activities, including staff conversations, equipment noise exposure, cleaning activities, patient interventions and overhead pages, were observed between the groups (P < 0.05). Multivariate logistic regression analysis indicating that the average noise level, conversational speech, equipment alarms, ambient noise, peak noise levels, staff conversations, cleaning activities, patient interventions and overhead pages were significant contributors to poor sleep.

CONCLUSION: The study suggested that high noise levels and staff-related activities affected the sleep quality of conscious patients in the EICU. Targeted measures could improve the prognoses of patients.

PMID:39787549 | DOI:10.4103/nah.nah_83_24

Noise Health. 2024 Oct-Dec 01;26(123):474-482. doi: 10.4103/nah.nah_98_24. Epub 2024 Dec 30.

ABSTRACT

BACKGROUND: The effect of background noise on auscultation accuracy for different lung sound classes under standardised conditions, especially at lower to medium levels, remains largely unexplored. This article aims to evaluate the impact of three levels of Gaussian white noise (GWN) on the ability to identify three classes of lung sounds.

METHODS AND MATERIALS: A pre-post pilot study assessing the impact of GWN on a group of students’ ability to identify lung sounds was conducted. The three intensities were applied to the three classes of lung sounds: no GWN, signal-to-noise ratio (SNR), SNR-40 (medium level) and SNR-20 (high). This resulted with three exams, each containing nine questions. Fifty-two participants underwent a 4-day training programme and were tested on their identification of lung sound classes under the three levels of GWN, but seven subjects were excluded for not completing all three assessments. Statistical analysis was performed on 45 subjects, using non-parametric tests to analyse the data. A P-value of 0.05 was considered statistically significant.

RESULTS: The GWN did not impact the overall lung sound identification capacity of medical students, with consistent scores of 66.7% across the three noise levels for all three lung sound classes combined. However, when considering sound classes separately, GWN affected the identification of normal (NAS) and discontinuous (DAS), but not continuous (CAS) types. Exam scores for NAS varied significantly across the three noise levels, with respective scores of 66.7%, 100% and 66.7%. Scores for DAS also varied, revealing 66.7%, 33.3% and 66.7%.

CONCLUSION: This study introduces a standardised simulation-based approach to investigate the effect of GWN on the accuracy of auscultation amongst medical students. Findings indicate that whilst CAS sounds are robust to background noise, the identification of NAS and DAS sounds can be compromised. The medium noise levels (SNR-40) of noise pollution had the greatest effect on the DAS lung sounds.

PMID:39787547 | DOI:10.4103/nah.nah_98_24

Appl Physiol Nutr Metab. 2025 Jan 9. doi: 10.1139/apnm-2024-0392. Online ahead of print.

ABSTRACT

Fasting during Ramadan involves abstaining from food and drink from dawn to dusk for 29 to 30 days, annually. Dietitians, experts in food and nutrition, play a vital role in fostering the well-being of Canadians. Given that 1 in 20 Canadians are Muslim, access to culturally safe care is essential for their health. The consumption of adequate nutrients during the non-fasting hours is important for Muslims well-being. It is unknown whether dietitians in Canada feel comfortable and knowledgeable providing safe care during Ramadan. An online survey, was developed using the World Health Organization’s Knowledge Attitude and Practice Protocol, and then reviewed for content validity by 6 dietitians. From March 5, 2023 to April 1, 2023, 159 Canadian dietitians, from a variety of practice areas including acute care, community health, and private practice, completed the online survey. Descriptive statistics, cross tabulations, and chi-square tests, enhanced by post hoc analyses with Bonferroni correction, were employed to determine any relationship between categorical variables and identify significant associations or differences. While most participants demonstrated an adequate understanding of Ramadan fasting practices, including its duration and restrictions, 91% reported not receiving information on how to provide culturally safe care during their university degree. Many dietitians expressed discomfort providing care (43.7%, 69/158) and lacked adequate resources (51.3%, 81/158). Among the 37% of dietitians who did offer care to Muslims (58/157), the majority felt comfortable (72.1%, 44/58). This study reveals a gap in capacity to provide culturally safe care, highlighting the need for training interventions for nutrition professionals, and curriculum for dietetics programs.

PMID:39787537 | DOI:10.1139/apnm-2024-0392

J Perinat Neonatal Nurs. 2024 Oct 10. doi: 10.1097/JPN.0000000000000856. Online ahead of print.

ABSTRACT

BACKGROUND: Noninvasive mechanical ventilation (NIMV), when in synchronized intermittent mandatory ventilation, continuous positive airway pressure, or patient-triggered ventilation modes, is known to be a cause of facial, nasal, head, and skin pressure injuries in preterm infants.

OBJECTIVE: The objective of this study is to examine the efficacy of using a checklist with preterm infants under nasal NIMV in preventing facial, nasal, and head pressure injuries.

METHOD: The study was conducted quasi-experimentally on preterm infants under NIMV. The sampling comprised a total of 104 infants, an intervention group of n = 52 and a control group of n = 52. All procedural steps of NIMV of the infants in the intervention group were performed in accordance with a checklist. The checklist covered: (1) preparation of the ventilation device and cannula placement; (2) care; and (3) monitoring and assessment.

RESULT: There was a statistically significant difference in nasal tip, septal, intranasal, upper lip, and right-left cheek pressure injury scores between the intervention and control groups (P < .05).

CONCLUSION: Performing all procedural steps of nasal NIMV in accordance with a checklist is effective in preventing pressure injuries on the face, nose, and head of preterm infants, reducing the severity of pressure injuries.

IMPLICATIONS FOR PRACTICE: It is recommended to use a checklist covering the ventilation device preparation, cannula placement, care, observation, and assessment steps to prevent any pressure injuries in the face, nose, and head, as well as to reduce the severity of pressure injuries and improve the skin condition of preterm infants under nasal NIMV support.

PMID:39787536 | DOI:10.1097/JPN.0000000000000856

Cir Cir. 2025 Jan 9. doi: 10.24875/CIRU.23000380. Online ahead of print.

ABSTRACT

OBJECTIVE: To report the statistics of complications in gender reassignment surgery (vaginoplasty) observed in the first surgical center in Mexico for public transgender surgery.

METHOD: We conducted a descriptive, observational study of patients treated and postoperatively underwent vaginoplasty surgery in the period 2019 to 2022. Intraoperative, immediate and late complications were evaluated. Intraoperative complications were taken as: rectal perforation and bleeding. Immediate complications: wound dehiscence, hematoma, and necrosis of the vaginal segment. Late complications: urethrovaginal fistula, rectovaginal fistula, and stenosis of the vaginal introitus.

RESULTS: Twenty-two patients who underwent vaginoplasty with inversion of the foreskin were evaluated. Regarding immediate complications, the most frequent were alterations in scarring and tissue integration, being necrosis of the vaginal segment the most frequent. As for late complications, only vaginal prolapse and urethral stricture were found.

CONCLUSION: Foreskin inversion vaginoplasty is the most widely used and safest technique worldwide, above colovaginoplasty and peritoneal vaginoplasty techniques, and fortunately serious complications are rare. In our report, tissue alterations were the common ones and that is secondary alteration of vascular integration and devascularization factors during the dissection.

PMID:39787535 | DOI:10.24875/CIRU.23000380