Nevin Manimala

Reprod Health. 2024 Dec 24;21(1):197. doi: 10.1186/s12978-024-01931-w.

ABSTRACT

INTRODUCTION: Although the Government of Nepal has developed strategies to integrate contraceptive services with abortion care to better meet the contraceptive needs of women, data indicate that significant gaps in services remain. This paper assessed post-abortion contraceptive use, trends over 36 -months, and factors influencing usage.

METHODS: Data from this paper came from an ongoing cohort study of 1831 women who sought an abortion from one of the sampled 22 government-approved health facilities across Nepal. Women were interviewed eight times over 36 months between April 2019 to Dec 2023. Bivariate and multivariate analysis were used to analyze the data.

RESULTS: Results show that after abortion, 59% of women used modern contraception, with injection being the most prevalent method, followed by condoms, pills, implants, and IUD. The hazard model showed that discontinuation of modern contraception was significantly higher among women desiring additional children (aHR 0.62) and lower among literate (aHR – 0.15) and those with existing children (aHR – 0.30). Women’s age, ethnicity, cohabitation with husband, household’s income and autonomy were not associated with continuation.

CONCLUSION: After having an abortion, we found that just slightly more than half of women used modern methods of contraception; this percentage did not increase significantly over the course of three years.

PMID:39719611 | DOI:10.1186/s12978-024-01931-w

J Orthop Surg Res. 2024 Dec 24;19(1):872. doi: 10.1186/s13018-024-05372-w.

ABSTRACT

AIM: To evaluate the clinical efficacy and imaging outcomes of a domestically produced orthopedic surgical robot for total knee arthroplasty and to explore its applicability in patients with varying degrees of deformity.

METHODS: This study retrospectively included 120 patients who underwent TKA at our hospital between February 2023 and June 2024. The patients were divided into a control group (conventional TKA surgery) and an observation group (robot-assisted TKA surgery), with 60 patients in each group. Based on different lower extremity alignment angles, each group was further subdivided into mild deformities (Hip knee ankle angle (HKA angle)deviation < 10°) and significant deformities (HKA angle deviation ≥ 10°). Preoperative and postoperative HKA angles, range of motion (ROM), visual analog scale (VAS) pain scores, and Knee Society (AKS) scores were recorded for both groups. Postoperative measurements included the posterior tibial slope angle (PSA), femoral coronal component angle (FFC), tibial coronal component angle (FTC), and femoral sagittal component angle (LFC), as well as the incidence of abnormal values for each angle, which were analyzed statistically.

RESULTS: The operation time in the observation group was longer than that in the control group, but intraoperative blood loss was significantly lower in the observation group (P < 0.05). Postoperatively, the differences in the HKA and PSA angles and the incidence of abnormal values were significantly better in the robot-assisted group than in the control group (P < 0.05). The other indicators did not significantly differ between the two groups. (P > 0.05). For patients with mild preoperative deformities, those in the robot-assisted group had significantly better postoperative HKA angle deviations and rates of postoperative HKA angle outliers than those in the conventional group. For patients with significant deformities, the robot-assisted group presented greater postoperative HKA and PSA angle deviations than the control group; the postoperative HKA and PSA angle outlier rates were significantly lower in the robot-assisted group (P < 0.05).

CONCLUSION: The TINAVI robotic system demonstrated superior safety and efficacy in TKA surgery. Compared with conventional TKA, the robot-assisted system achieved significantly better outcomes regarding prosthesis implantation accuracy and lower extremity alignment, with a particular advantage in patients with severe limb alignment deformities.

PMID:39719605 | DOI:10.1186/s13018-024-05372-w

Acta Neuropathol Commun. 2024 Dec 24;12(1):202. doi: 10.1186/s40478-024-01898-6.

ABSTRACT

Alzheimer’s Disease (AD) is a debilitating neurodegenerative disease that affects 47.5 million people worldwide. AD is characterised by the formation of plaques containing extracellular amyloid-β (Aβ) and neurofibrillary tangles composed of hyper-phosphorylated tau proteins (pTau). Aβ gradually accumulates in the brain up to 20 years before the clinical onset of dementia, making it a compelling candidate for early detection of AD. It has been shown that there is increased deposition of Aβs in AD patients’ retinas. However, little is known about microglia’s ability to function and clear Aβ within the retina of AD and control eyes. We labelled microglia with ionised calcium-binding adaptor molecule 1 (IBA-1) in AD and age-matched control donor retinas. We then used interactive machine learning to segment individual microglia in 3D. In the temporal mid-peripheral region, we found that the number of microglia was significantly lower in AD retinas compared to controls. Unexpectedly, the size of the microglia was significantly larger in the AD retinas compared to controls. We also labelled retinal microglia for Cluster of Differentiation 68 (CD68), a transmembrane glycoprotein expressed by cells in the monocyte lineage and a marker of phagocytic activity and activated microglia. The size of CD68 + cells was statistically different between AD and control microglial, with CD68 + cells being larger in AD. In contrast, there was no difference in either size or shape for CD68- microglia between the two groups, suggesting an important difference in the active states of CD68 + microglia in AD retina. There was also significantly increased CD68 immunoreactivity in individual microglia within the AD group. Overall, this study reveals unique differences in the size and activity of the retinal microglia, which may relate to their potential chronic activation due to increased levels of Aβs in the AD retina.

PMID:39719599 | DOI:10.1186/s40478-024-01898-6

BMC Genomics. 2024 Dec 24;25(1):1242. doi: 10.1186/s12864-024-11159-4.

ABSTRACT

BACKGROUND: Fat traits in cattle are considered important due to their contribution to beef eating quality and carcass economic value. Discovering the genes controlling fat traits in cattle will enable better selection of these traits, but identifying these genes in individual experiments has proven difficult. Compared to individual experiments, meta-analyses allow greater statistical power for detecting quantitative trait loci and identifying genes that influence single and multiple economically important fat traits.

RESULTS: This meta-analysis study focussed on fat traits related to the major adipose depots in cattle (namely, carcass fat, intramuscular fat, internal fat, intermuscular fat, and subcutaneous fat) and was conducted using data from the Animal Quantitative Trait Loci (QTL) database. There were more Meta-QTL regions for intramuscular fat and subcutaneous fat (n = 158 and n = 55 regions, respectively) and far fewer for carcass fat and internal fat (n = 2 regions each). There were no Meta-QTL regions found for intermuscular fat. Of these 216 Meta-QTL regions, only 16 regions overlapped and affected two or more fat depots. The number of genes found for the fat depots was reflected in the size and number of the Meta-QTL regions (n = 20, 84, 1336 and 3853 genes for the carcass, internal, subcutaneous and intramuscular fat, respectively). The identification of these QTL allowed a more refined search for candidate genes. For example, the 232 genes in the Meta-QTL regions for carcass fat on BTA2, for intramuscular fat on BTA12, and the overlapping Meta-QTL regions on BTA2, BTA5, and BTA6 were readily screened, and 26 candidate genes were nominated based on their physiological roles using the GeneCards and DAVID databases.

CONCLUSIONS: The number of Meta-QTL regions for the various fat depots was relative to the number of associations in the database. However, the scarcity of overlapping Meta-QTL regions suggests that pleiotropic gene variants, which control multiple fat depots in cattle, are rare. The identification of candidate genes in the Meta-QTL regions will improve our knowledge of the genes with regulatory functions in adipose metabolism affecting meat quality and carcass economic value.

PMID:39719593 | DOI:10.1186/s12864-024-11159-4

BMC Pregnancy Childbirth. 2024 Dec 24;24(1):859. doi: 10.1186/s12884-024-07092-9.

ABSTRACT

BACKGROUND: This study aims to determine the impact of a childbirth educational intervention, based on empowerment theory, on childbirth experience and empowerment in women with fetal occiput posterior and occiput transverse malpositions.

METHODS: A randomized controlled trial was conducted from February 2022 to December 2022 involving pregnant women with fetal occiput posterior and occiput transverse malpositions. Eligible women were randomly assigned to either the control or study group. The control group received routine care during childbirth, while the study group received routine care and a childbirth-empowering educational intervention delivered by midwives. Primary outcomes assessed were childbirth experience and patient perceptions of patient-empowering nurse behaviors in pregnant women. Secondary outcomes included pregnancy outcomes, delivery support and control, maternal coping behavior during delivery, maternal participation in delivery decisions, and perception of empowerment.

RESULTS: A total of 137 pregnant women were enrolled, with 69 and 68 in the control and study groups, respectively. The study group showed significantly higher levels of childbirth experience and reported better patient perceptions of patient-empowering nurse behaviors than the control group. Additionally, the study group demonstrated higher levels of delivery support and control, maternal coping behavior, and specific aspects of perceived participation and patient perception of empowerment compared to the control group. There were no statistically significant differences in pregnancy outcomes between the two groups.

CONCLUSION: The childbirth empowering educational intervention effectively improved the childbirth experience and empowerment of women with fetal occiput posterior and occiput transverse malpositions. However, further studies are required to investigate its impact on pregnancy outcomes.

TRIAL REGISTRATION: The study protocol was approved by the hospital ethics committee (approval number:2020140A01) and registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2300070915; date of first registration: 26/04/2023).

PMID:39719592 | DOI:10.1186/s12884-024-07092-9

BMC Gastroenterol. 2024 Dec 24;24(1):475. doi: 10.1186/s12876-024-03458-7.

ABSTRACT

BACKGROUND: This study aimed to investigate the association between Metabolic-dysfunction-associated steatotic liver disease(MASLD)and C-reactive protein/lymphocyte ratio (CLR).

METHODS: MASLD was defined as a Controlled Attenuation Parameter (CAP ≥ 274dB/m) and CLR = C-reactive protein/lymphocyte. A multifactor linear regression model was used to test the relationship between MASLD and CLR. Smoothed curves and threshold effects analyses were fitted to describe nonlinear relationships. Subgroup analyses and interaction tests were then performed according to gender, prevalence of diabetes, ethnicity, and smoking status.

RESULTS: A total of 1846 participants from the NHANES database were included in this study. In the unadjusted model and model 1 (adjusted for age, sex, and race), CLR was positively associated with MASLD pathogenicity. Unadjusted model (OR = 1.04, 95% CI: 1.02-1.07, P = 0.0017), model 1 (OR = 1.04, 95% CI: 1.01-1.07, P = 0.0056). The results of the fitted smoothed curves showed that CLR and the risk of developing MASLD were nonlinear. Interaction tests and subgroup analyses confirmed that there were no significant interactions between CLR and MASLD causation with gender, race, prevalence of diabetes mellitus, and smoking status(P interaction>0.05).

CONCLUSIONS: This study shows that CLR is positively associated with the risk of developing MASLD Targeting CLR levels may be a new approach to treating MASLD.

PMID:39719591 | DOI:10.1186/s12876-024-03458-7

BMC Oral Health. 2024 Dec 24;24(1):1549. doi: 10.1186/s12903-024-05288-1.

ABSTRACT

BACKGROUND: Dental anxiety has become a major concern for both dental practitioners and patients and prevents a significant proportion of people from attending dental clinics. The present study aimed to determine dental anxiety and associated factors among adult patients attending a public outpatient dental clinic in a base hospital, in the Eastern Province of Sri Lanka.

METHODS: A descriptive cross-sectional study was conducted among 400 adults aged 18 to 75 years awaiting dental treatment. A validated and pretested interviewer-administered questionnaire was utilised, and it included demographic information, past dental treatment, and the Modified Dental Anxiety Scale (MDAS) which was used to assess dental anxiety. Anxiety scores ranged from 5 to 25, with scores of 5-9 classified as less anxious, 10-18 as moderately anxious, and scores above 18 as extremely anxious. Statistical analysis was done using SPSS version 28. Descriptive analysis, correlation test, chi-square test and multiple logistic regression were applied for statistical analysis. The significance level was set at p < 0.05.

RESULTS: The majority of participants in this sample experienced dental anxiety, with 19% classified as extremely anxious, 70% as moderately anxious, and 11% as less anxious. The mean MDAS score was 14.5 (SD = 4.4). Bivariate analysis revealed that dental anxiety is significantly associated with age group, sex, marital status, employment status, monthly family income, past dental visits, sex of treatment provider and previous dental experiences. Multiple logistic regression analysis indicated that age, sex and postponing dental treatment appointments were significant predictor variables of dental anxiety.

CONCLUSION: The findings reveal that the majority of participants in this study experience moderate to high levels of dental anxiety. Notably, younger individuals (under 35 years), females, and those who tend to postpone dental appointments were identified as significant predictors of heightened dental anxiety.

PMID:39719588 | DOI:10.1186/s12903-024-05288-1

BMC Med Educ. 2024 Dec 24;24(1):1526. doi: 10.1186/s12909-024-06559-9.

ABSTRACT

BACKGROUND: For health science students, publishing in scientific journals is a significant milestone that can positively impact their professional careers, providing recognition and credibility within the academic and professional community. However, despite the apparent increase in scientific production among undergraduate dental students in Latin America and the Caribbean, it remains low compared to other regions. The study aimed to determine the frequency of publication in scientific journals of the documents to obtain the professional title of dental surgeon by undergraduate dental students at a private Peruvian university over seven years.

METHODS: This cross-sectional study considered all records of theses required for the professional title of dental surgeon from the Faculty of Dentistry at a private Peruvian university, as published in its institutional repository between 2017 and 2023. The main variable of the study was publication in scientific journals. In contrast, the year of formal submission of the document to obtain the professional title of dental surgeon, the type of document, the modality of obtaining the professional title, the area of dental specialty according to the American Dental Association, the year of publication, international indexing, impact factor (IF), and journal’s quartile ranking were considered as covariates. Descriptive analysis was conducted to obtain absolute and relative frequencies.

RESULTS: Between 2017 and 2023, 246 documents for the professional title of dental surgeon were published in the institutional repository of a Peruvian university, of which 23 were subsequently published in scientific journals. Of these, 20 (86.96%) were published in internationally indexed scientific journals, 1 (5.00%) was published in journals with an IF ≥ 2, and 2 (10.00%) were published in Q2 category journals.

CONCLUSIONS: The seven-year analysis reveals significant challenges in converting undergraduate dental research at a Peruvian university into published scientific literature, with low rates of research documents achieving publication in scientific journals.

PMID:39719580 | DOI:10.1186/s12909-024-06559-9

BMC Med Educ. 2024 Dec 24;24(1):1525. doi: 10.1186/s12909-024-06557-x.

ABSTRACT

BACKGROUND: New Zealand guidelines stipulate that patient consent is obtained for medical student involvement in clinical care, however, patients’ preferences regarding consent for medical student teaching have not been widely explored. This study examined patient preferences for consent for medical student teaching with the aim to increase patient empowerment, to optimise care and to reflect societal expectations more accurately.

METHOD: Observational, semi-qualitative, cross-sectional study of in-patients. Each participant was presented with a series of nine hypothetical clinical scenarios and were allowed a limited number of responses. For each scenario the participants completed a short questionnaire about their preferences for consent. These included their preferred mode of consent (implicit, verbal or written), timing of consent, and who should take their consent. The analysis used descriptive statistics and ordinal logistic regression mixed models to investigate associations between patient characteristics and chosen mode of consent.

RESULTS: There were 123 participants (50% male), median age was 64 years. Patients were admitted to either medical (69%), surgical (22%) or women’s health (9%). Increasing age was statistically significantly associated with a preference for verbal and implicit rather than written consent with the exception of ‘breaking bad news’ and ‘bedside teaching’. The majority of patients preferred verbal consent across all nine clinical scenarios (57-82%), including two surgical scenarios where verbal consent was preferred by 59%. Most patients preferred the supervising doctor to take consent, with no clear preference about the timing.

CONCLUSIONS: This study identifies the patient voice in the consent process for the involvement of medical students in clinical care. Although the patients’ views generally align with an existing national consensus statement, there is variability in the expectations of the patients suggesting flexibility in the consent process is still needed. The preference for older patients for verbal or implicit consent compared with younger patients for more invasive scenarios highlights the need for consideration of inter-generational differences. Most patients in this study were willing to contribute to student learning in all scenarios.

PMID:39719579 | DOI:10.1186/s12909-024-06557-x

BMC Public Health. 2024 Dec 24;24(1):3578. doi: 10.1186/s12889-024-21001-x.

ABSTRACT

Although many studies have reported the relationship between female hormone intake and cardiovascular disease (CVD) development, their association has not been fully elucidated and defined, based on data from the Third National Health and Nutrition Examination Survey intending to assess the health and nutritional status of non-institutionalized children and adults in the United States. This study examined the relationship between female hormone intake and coronary artery disease (CVD) development in 38,745 women, averaging 38.10 ± 12.59 years in age. We explored the association between hormone intake and CVD incidence, considering various social determinants of health (SDOH) with statistical methods like Chi-square tests, logistic regression, and stratified Chi-square analysis. Our findings reveal a complex relationship between female hormone intake and CVD development. Hormones appear to reduce CVD risk in women over 60 years old. However, hormone intake correlates with increased CVD risk in highly educated women. Socioeconomic status also influences this relationship; while hormones pose a risk factor for heart failure and stroke in impoverished or wealthy women, they serve as a protective factor against CVD for middle-income women. Additionally, hormonal intake seems beneficial for women who experienced menarche between 13 and 15 years old, menopause between 30 and 49, and had 7-9 pregnancies, especially when coupled with a diet low in sugar, fat, cholesterol, and adequate folic acid intake. These results indicate that while hormones can prevent CVD under specific conditions, their impact can be detrimental in different SDOH contexts. In conclusion, while appropriate hormone intake can prevent CVD, its effects vary across different demographic and health backgrounds. This underscores the necessity for meticulous screening of SDOH factors in clinical settings to maximize the protective benefits of hormones against CVD.

PMID:39719571 | DOI:10.1186/s12889-024-21001-x