Nevin Manimala

Eur J Med Res. 2024 Dec 30;29(1):635. doi: 10.1186/s40001-024-02251-2.

ABSTRACT

BACKGROUND: Ophthalmic procedures are increasingly being performed under regional anesthesia techniques such as peribulbar and incisionless sub-Tenon’s blocks. The aim is to compare peribulbar block with incisionless sub-Tenon’s block in terms of perioperative complications in patients who underwent cataract and vitreoretinal surgeries.

METHODS: The patients who underwent cataract or vitroretinal surgery under peribulbar block or incisionless sub-Tenon’s block were included in the study. Two groups were compared each other in terms of anesthesia-related complications.

RESULTS: A total of 125 patients [peribulbar block (N = 48) and incisionless sub-Tenon’s block (N = 77)] were included in the study. All basic characteristics and perioperative hemodynamic parameters were similar between the groups. One (0.8%) patient in the peribulbar block developed retrobulbar hemorrhage, whereas there was no major complication in the incisionless sub-Tenon’s group (P = 0.389). At 15th minutes after block and at the end of the operation, minor complications including chemosis and subconjunctival hemorrhage were observed significantly lower in the peribulbar block group in comparison to the incisionless sub-Tenon’s block group (P < 0.05).

CONCLUSIONS: Minor complications including subconjunctival haemorrhage and chemosis were more common in the incisionless sub-Tenon’s block; however, this difference was statistically balanced on the first postoperative day. One patient in the peribulbar block developed retrobulbar hemorrhage, whereas there was no major complication in the incisionless sub-Tenon’s block. According to those results, incisionless sub-Tenon’s block seems to be a safe and reliable alternative for ophthalmic procedures.

PMID:39734231 | DOI:10.1186/s40001-024-02251-2

BMC Pulm Med. 2024 Dec 29;24(1):635. doi: 10.1186/s12890-024-03432-9.

ABSTRACT

PURPOSE: To examine the outcome of palliative endoscopic treatment of malignant central airway obstruction (CAO) and identify predictors for Days Alive and Out of Hospital (DAOH), overall survival and treatment related complications.

METHODS: Consecutive adult patients treated endoscopically for malignant CAO at Aarhus University Hospital from 2012 to 2022 were included in the study. Statistical analyses were carried out to identify predictors for DAOH, survival and complications.

RESULTS: 127 consecutive patients met the inclusion criteria. The majority of patients were categorised with stage IV lung cancer, the majority being males, with a median age of 67 years. The endoscopic interventions were mainly tumour debulking combined with airway stent insertion or tumour debulking alone. The complication rate was 21.0% and the mortality rate was 3.9%. In total, 89.8% of the patients experienced symptom relief following surgery, and the majority (92.1%) were discharged from hospital within two days after intervention. Mean survival time following intervention was 144 days, mean DAOH₃₀ was 20.8 and mean DAOH₃₆₅ was 157. Survival was associated with comorbidity, type of intervention, preoperative respiratory support and postoperative oncologic treatment. A high preoperative ASA-score, preoperative respiratory support, urgency of intervention, female gender and insertion of airway stent were predictors for a poorer DAOH-outcome.

CONCLUSION: Endoscopic palliative treatment of malignant CAO is generally feasible and safe, offering symptom relief in most cases. The method is considered an effective measure for short to median term palliation of respiratory distress.

PMID:39734226 | DOI:10.1186/s12890-024-03432-9

Parasit Vectors. 2024 Dec 29;17(1):545. doi: 10.1186/s13071-024-06631-9.

ABSTRACT

BACKGROUND: Visceral leishmaniosis (VL) is the most severe form of human leishmaniosis, with an estimated 95% case fatality if left untreated. Dogs act as peridomestic reservoir hosts for the protozoan parasite Leishmania infantum, a causative agent for human leishmaniosis, endemic throughout the Mediterranean basin. To assure consistent and accurate surveillance of canine infection and prevent transmission to people, consistent diagnosis of canine L. infantum infection across this region is essential for protecting both human and animal health. Our goal was to compare the accuracy, sensitivity and specificity of enzyme-linked immunosorbent assays (ELISA) and immunofluorescence antibody tests (IFAT), performed at seven academic veterinary diagnostic centres across southern Europe and Israel.

METHODS: We performed a known sample “ring” trial to compare L. infantum quantitative serological tests. Two hundred seventy-two (n = 272) canine serum samples of known serological status were chosen from these sites, representative of the region. In-house or commercial ELISA and IFAT were performed according to each laboratory’s specifications. Latent Class Analysis (LCA) was used to determine sensitivity and specificity of each test. True and false positives were calculated to determine the probability of identifying samples.

RESULTS: Sensitivity and specificity for ELISA ranged from 95 to 99% and 92% to 97%, respectively, with moderate variability from one site. Sensitivity and specificity for IFAT ranged from 89 to 99% and 83% to 94%, respectively, with increased variability compared to ELISA. Overall test agreement was 78% with a pair-wise agreement between 65 and 89%.

CONCLUSIONS: All sites demonstrated substantial comparative diagnostic accuracy, with good agreement based on known seropositive and seronegative samples. Studies and interventional trials that use these tests will remain valid because of high diagnostic agreement between sites.

PMID:39734221 | DOI:10.1186/s13071-024-06631-9

BMC Oral Health. 2024 Dec 30;24(1):1569. doi: 10.1186/s12903-024-05376-2.

ABSTRACT

BACKGROUND: Dens invaginatus is a developmental abnormality originating from tooth development, including coronal invaginatus and radicular invaginatus. The reported incidence varies greatly due to diagnostic techniques, classification criteria and race. The incidence of dens invaginatus in China was not clear, and the impact of dens invaginatus on periodontal support tissue were rarely reported. This study aims to clarify the incidence of maxillary lateral incisor dens invaginatus and its impact on periodontal supporting tissues.

METHODS: From the cone-beam computed tomography database, images of 212 maxillary lateral incisors from 106 Chinese patients were selected. Teeth that met the Oehlers classification criteria for coronal invaginatus were recorded as coronal invaginatus, and teeth with radicular cystoid invaginatus or radicular groove were classified as radicular dens invaginatus. The complexity of radicular groove was determined by Gu’s classification standard. Both of coronal invaginatus and radicular dens invaginatus were recorded as dens invaginatus. For 15 patients with unilateral radicular dens invaginatus, the periodontal ligament area of the affected teeth and the corresponding natural teeth in the same jaw were measured and compared.

RESULTS: The overall incidence of maxillary lateral incisor invaginatus in China is 25.0%. The incidence of coronal invaginatus is 12.3%, and the incidence of radicular dens invaginatus is 14.6%. No significant differences were observed between genders or sides. In this study, all radicular dens invaginatus exhibited as radicular groove, of which 87.1% were Gu type I, 9.7% were Gu type II, and 3.2% were Gu type III. Although the difference was not statistically significant, the average periodontal ligament area of the maxillary lateral incisor with radicular dens invaginatus was 148.93 ± 35.62mm², smaller than that of the control teeth (152.28 ± 40.22mm²).

CONCLUSIONS: The dens invaginatus of the maxillary lateral incisor is common. There is no significant difference in the incidence between genders or between sides. The main manifestation of the radicular dens invaginatus is the radicular groove (Gu’s type I). This anatomical abnormality may reduce the periodontal ligament area. The presence of the additional root of the maxillary lateral incisor is not rare and was supposed to be highly concerned by dentists.

PMID:39734211 | DOI:10.1186/s12903-024-05376-2

J Nanobiotechnology. 2024 Dec 29;22(1):802. doi: 10.1186/s12951-024-03045-8.

ABSTRACT

Diabetes mellitus (DM) prevalence is rising worldwide. Current therapies comprising subcutaneous insulin injections can cause adverse effects such as lipodystrophy, local reactions like redness and swelling, fluid retention, and allergic reactions. Nanoparticle carriers for oral insulin are groundbreaking compared to existing methods because they are non-invasive treatments, showing operational convenience, controlled release profile, and ability to simulate the physiological delivery route into the bloodstream. These systems improve patient adherence and have demonstrated the potential to lower blood glucose levels in DM. We present a systematic review and meta-analysis aimed at compiling relevant data to pave the way for developing innovative nano- and microparticles for the oral delivery of insulin. Our analysis of 85 articles revealed that the diminution of glucose levels is not proportional to the administered insulin dosage, which ranged from 1 to 120 International Units (IU). The meta-analysis data indicated that 25 IU of encapsulated porcine insulin did not produce a statistically significant outcome (p = 0.93). In contrast, a dosage of 30 IU was efficacious in eliciting an optimal hypoglycemic effect compared to excipient controls. Parameters such as a high degree of encapsulation (~ 90%), particle size (200-400 nm), and polydispersity index (0.086-0.3) are all associated with lower blood glucose levels. These parameters were also significant in the linear regression analysis. Among the excipients employed, chitosan emerged as a prevalent excipient in formulations due to its biocompatible and biodegradable properties and its ability to establish stable polymeric matrices. Even though oral insulin administration is a promising therapeutic method, it cannot guarantee preclinical safety and therapeutic efficacy yet in regulating glucose levels in diabetic conditions.

PMID:39734205 | DOI:10.1186/s12951-024-03045-8

BMC Cardiovasc Disord. 2024 Dec 30;24(1):754. doi: 10.1186/s12872-024-04450-5.

ABSTRACT

BACKGROUND: Ischemic stroke is a major contributor to global morbidity and mortality, particularly in critically ill patients in intensive care units (ICUs). While advances in stroke management have improved outcomes, predicting mortality remains challenging due to the involvement of complex metabolic and cardiovascular factors. The triglyceride-glucose (TyG) index, a marker for insulin resistance, has gained attention for its potential to predict adverse outcomes in stroke patients. Furthermore, the TyG-BMI index, which combines TyG with body mass index (BMI), may offer a more comprehensive measure by accounting for obesity-related metabolic burden. However, the comparative impact of these indices on short- and long-term mortality among critically ill ischemic stroke patients remains unclear.

METHODS: This retrospective cohort study analyzed data from the Medical Information Mart for Intensive Care IV (MIMIC-IV 3.0) database, including 1,334 critically ill ischemic stroke patients. The patients were divided into four groups based on TyG and TyG-BMI quartiles, respectively. Cox proportional hazards models were employed to assess the association of these indices with 30-day, 90-day, 180-day, and 1-year all-cause mortality (ACM). Kaplan-Meier survival analysis was used to compare survival rates across different index levels. We utilized restricted cubic splines (RCS) to examine the association between the TyG, TyG-BMI index and the specified outcomes. Furthermore, TyG and TyG-BMI index were utilized to establish logistic regression models for mortality across different time periods, and corresponding Receiver Operating Characteristic (ROC) curves were generated.

RESULTS: Kaplan-Meier survival analysis show that Higher TyG levels were associated with significantly increased mortality risk at all time points, with patients in the highest TyG quartile exhibiting the greatest risk. Conversely, patients having a lower TyG-BMI level faced a heightened risk of long-term ACM. The RCS analysis results demonstrated that the TyG index did not exhibit a statistically significant nonlinear relationship with mortality across all time points. However, a significant nonlinear relationship was observed between the TyG index and long-term mortality. From the ROC curve, it can be observed that TyG performs better in predicting short-term mortality. Conversely, TyG-BMI demonstrates superior performance in predicting long-term mortality. The analysis revealed that while the TyG index alone is a strong predictor of mortality, the TyG-BMI index enhances the ability to predict long-term outcomes.

CONCLUSION: This finding suggests both the TyG and TyG-BMI indices serve as valuable predictors of mortality in critically ill ischemic stroke patients. However, significant differences were observed across the various follow-up periods. Based on the distinct characteristics of these two indicators, future research should focus on the selective integration of TyG and TyG-BMI indices into clinical risk assessment models, tailored to the metabolic profiles of ischemic stroke patients in the ICU. This approach could enhance the precision of mortality risk stratification and optimize patient management strategies.

PMID:39734194 | DOI:10.1186/s12872-024-04450-5

BMC Plant Biol. 2024 Dec 30;24(1):1275. doi: 10.1186/s12870-024-06012-5.

ABSTRACT

BACKGROUND: Subtropical forest plant diversity, characterized by a wide range of species adapted to seasonal variations, is vital for sustaining ecological balance, supporting diverse wildlife, and providing critical ecosystem services such as carbon sequestration and soil stabilization. The Changa Manga Forest, an ecologically rich area with varied vegetation, was analyzed to understand the intricate relationship between plant diversity and environmental factors. This study investigates the diversity patterns, vegetation structure, and environmental influences on forest biodiversity.

METHODS: A comprehensive survey was conducted across 127 stands within the Changa Manga Forest to document plant species and classify vegetation communities. Soil samples were collected and analyzed for key physicochemical parameters, while multivariate statistical methods, including hierarchical clustering and ordination, were applied to examine the relationships between vegetation structure and environmental factors. Diversity indices and beta diversity components were calculated to assess variations across plant communities.

RESULTS: The species were classified into six distinct vegetation communities: Neltuma-Ziziphus-Malvestrum (NZM), Broussonetia-Lantana-Morus (BLM), Dalbergia-Lantana-Solanum (DLS), Morus-Abutilon-Ricinus (MAR), Eucalyptus-Vachellia-Sorghum (EVS), and Bombax-Leucaena-Croton (BLC). Analyses using hierarchical clustering and ordination methods revealed significant differences in species composition among these communities, with NZM and DLS exhibiting the highest dissimilarity. Canonical Correspondence Analysis (CCA) indicated that environmental factors such as soil pH, available phosphorus (AP), and organic matter percentage (OM%) are crucial in shaping plant distribution, though the total explained variation remained relatively low. Diversity indices varied significantly among communities, with the NZM community showing the highest Shannon and Simpson diversity, while EVS exhibited the lowest. The beta diversity analysis revealed a high species turnover between certain communities, indicating complex ecological interactions. Our results indicate significant variability in plant community composition and diversity patterns, influenced by edaphic factors and environmental gradients. We anticipate that future environmental changes, such as shifts in soil properties, precipitation patterns, and increased human activity, may exacerbate declines in local plant species richness and disrupt community structures. To preserve the invaluable biodiversity of the study area for future generations, it is essential to implement timely and effective conservation and management strategies.

PMID:39734183 | DOI:10.1186/s12870-024-06012-5

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):71-76. doi: 10.13201/j.issn.2096-7993.2025.01.015.

ABSTRACT

Objective:This study aims to investigate the differences in hemostatic efficacy and patient comfort between an innovative domestically produced biodegradable nasal packing sponge and a traditional absorbent sponge following endoscopic nasal surgery. Methods:A prospective, randomized controlled trial design was utilized, including 30 patients who were divided into two groups according to random allocation, each receiving one of the two types of nasal packing. The study assessed the hemostatic efficacy, comfort, and safety of the materials by comparing the rates of no bleeding within 24 hours after packing, re-bleeding rates after 48 hours, pain ratings in the head and nasal areas, scores on a visual analog scale for nasal ocular symptoms, and safety indicators between the two groups. Results:The rates of no bleeding within 24 hours post-packing were 73.33% for both the experimental and control groups, with a no-bleeding rate of 100% after 48 hours in both groups. The pain rating in the head and nasal areas at various times post-packing was Grade Ⅰ（100%） in both groups, with no statistically significant difference（P=1.000）. The experimental groups sneezing score on the day of packing was（0.73±1.03）, lower than the control groups（2.27±1.67）, （P=0.007）; after 48 hours, the experimental groups sneezing score was（0.67±0.98）, also lower than the control groups（1.67±1.18）, （P=0.019）. There was no significant difference between the two groups in the Lund-Kennedy scoring during endoscopic examinations at the screening period, 7 days, 1 month, and 3 months post-packing（P>0.05）. Laboratory tests for other examination indicators were normal in both groups. Conclusion:The innovative domestically produced biodegradable nasal packing sponge not only provides hemostatic efficacy comparable to imported materials but also significantly improves patient comfort after surgery. It represents an economical and effective choice for nasal packing materials.

PMID:39734177 | DOI:10.13201/j.issn.2096-7993.2025.01.015

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):66-70;76. doi: 10.13201/j.issn.2096-7993.2025.01.014.

ABSTRACT

Objective: To explore the efficacy of vonoprazan fumarate in the treatment of laryngopharyngeal reflux disease（LPRD） evaluated by the Chinese version of the RSS-12 scale. Methods:A total of 100 LPRD patients treated in the otolaryngology-head and neck surgery outpatient clinic of our hospital were randomly divided into two groups（50 cases each）. The observation group was treated with vonoprazan fumarate（20 mg, once daily）, and the control group was treated with esomeprazole enteric-coated capsules（20 mg, twice daily） for 12 weeks. The selected observation indicators in this study included RSI, the Chinese version of RSS-12, and RFS scores before and after treatment. Results:Prior to treatment, there was no statistically significant difference in the Chinese version of RSS-12, RSI, and RFS between the two groups（P>0.05）. After 8 and 12 weeks of antacid treatment, both the Chinese version of RSS-12 and RSI significantly decreased in both group （P<0.05）. The changes in symptoms were particularly noticeable between 0-8 weeks of treatment according to the Chinese version of RSS-12 and RSI. After 12 weeks of treatment, the RFS scores significantly decreased compared to pretreatment levels （P<0.05）. After 12 weeks of antacid treatment, according to the Chinese version of RSS-12, 80% of patients in the observation group showed a good therapeutic response, compared to 64% in the control group; according to RSI, 90% of patients in the observation group showed a good therapeutic response, compared to 84% in the control group. There was no statistically significant difference in the treatment effect between the two groups after 12 weeks of treatment（P>0.05）. Conclusion:Vonoprazan fumarate can significantly improve the symptoms and signs of laryngopharyngeal reflux, and their treatment effect is not inferior to proton pump inhibitors. Compared with RSI, the Chinese version of RSS-12 can serve as a new screening tool for clinical diagnosis of LPRD in China.

PMID:39734176 | DOI:10.13201/j.issn.2096-7993.2025.01.014

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):61-65. doi: 10.13201/j.issn.2096-7993.2025.01.013.

ABSTRACT

Objective:To investigate optimal treatment strategy for pT3N0 laryngeal squamous cell carcinoma（SCC）. Methods:A retrospective study of 150 patients with pT3N0 laryngeal SCC treated in the First Affiliated Hospital of Chongqing Medical University was performed. The efficacies of partial laryngectomy and total laryngectomy, as well as surgery alone and postoperative radiotherapy were evaluated. The overall survival（OS）, disease specific survival（DSS） and disease-free survival（DFS） were analyzed with statistical package from SPSS. Results:Among the 108 patients with glottic laryngeal SCC, there were no significant differences in OS, DSS and DFS between the partial laryngectomy group and the total laryngectomy group（Log-rank=0.184, 0.010 and 0.051, P>0.05）. Similarly, there were no significant differences in OS, DSS and DFS between the surgery-alone group and postoperative radiotherapy group（Log-rank=0.214, 0.251 and 0.003, P>0.05）. Among the 38 patients with supraglottic laryngeal SCC, the OS in the total laryngectomy group was significantly higher than that in the partial laryngectomy group（Log-rank=7.338, P=0.007）. The DSS and DFS in the total laryngectomy group were higher than in the partial laryngectomy group, but the differences were not statistically significant（Log-rank=0.895 and 1.792; P>0.05）. The DFS in the postoperative radiotherapy group was significantly higher than in the surgery-alone group（Log-rank=7.172, P=0.007）, but there were no significant differences in OS and DSS between these two groups（Log-rank=0.010 and 0.876, P>0.05）. Conclusion:For pT3N0 glottic laryngeal cancer patients, the efficacy of partial laryngectomy is comparable to total laryngectomy, same as surgery alone and postoperative radiotherapy. For pT3N0 supraglottic laryngeal cancer patients, total laryngectomy could improve the overall survival, and postoperative radiotherapy could reduce the recurrence. Prospectively randomized study with large samples is still needed.

PMID:39734175 | DOI:10.13201/j.issn.2096-7993.2025.01.013