Nevin Manimala

Ther Adv Respir Dis. 2025 Jan-Dec;19:17534666251383662. doi: 10.1177/17534666251383662. Epub 2025 Oct 9.

ABSTRACT

BACKGROUND: Unplanned extubation (UE) in intensive care units (ICUs) is a significant patient safety concern, associated with increased morbidity and healthcare utilization; the reported rates of UE vary from 1% to 15%. There is sparse data on the effects of multiple performance improvement (PI) strategies to decrease the rate of UE, particularly in inner-city ICU populations. This study evaluates the impact of PI strategies on UE rates and associated patient outcomes in an adult ICU.

OBJECTIVES: To determine the impact of performance improvement (PI) strategies on rates of unplanned extubation (UE), reintubation, tracheostomy, mortality, and length of hospital stay in ICU patients.

DESIGN: Retrospective cohort studyMethods:This retrospective observational study included 6,397 mechanically ventilated patients admitted to a single tertiary ICU between 2015 and 2023. Three distinct time periods were compared: Period 1 (2015-2017, pre-PI), Period 2 (2018-2020, early-PI), and Period 3 (2021-2023, sustained-PI). Demographics, sedation practices, UE characteristics, and outcomes were analyzed using logistic regression.

RESULTS: UE incidence declined significantly from 3.79% in Period 1 to 2.17% in Period 3 (p = 0.002). Reintubation rates dropped from 45.2% to 26.7% (p = 0.011), and tracheostomy rates from 19.0% to 2.2% (p < 0.001). Multivariate analysis showed reduced odds of reintubation in Periods 2 (OR = 0.219, p = 0.001) and 3 (OR = 0.345, p = 0.021) and reduced odds of tracheostomy in Period 3 (OR = 0.011, p = 0.016). Risk factors for reintubation included the absence of prior intubation history and not undergoing spontaneous breathing trials. Older age (⩾71 years) and positive urine toxicology for opiates were strongly associated with tracheostomy.

CONCLUSION: Implementation of PI strategies significantly reduced rates of unplanned extubation, reintubation, and tracheostomy. These findings support continued quality improvement initiatives in ICU airway management.

PMID:41064905 | DOI:10.1177/17534666251383662

Acta Medica (Hradec Kralove). 2025;68(2):50-57. doi: 10.14712/18059694.2025.19.

ABSTRACT

OBJECTIVE: The objective of this study is to assess the expression levels of different immaturity CD markers in diverse subtypes of Acute Lymphoblastic Leukemia (ALL) among children and adults, and determine any statistically significant variations in marker expression between these two groups.

METHODS: This dataset included CD marker expressions (CD34, HLA-DR, TdT, and CD38) for 130 ALL patients (51 pediatric B-ALL, 16 pediatric T-ALL, 44 adult B-ALL, and 19 adult T-ALL patients). The Shapiro-Wilk test analysis was conducted to check for normality distribution in all data points before proceeding with the statistical analysis test. As a result for each marker within these subtypes, descriptive statistics were calculated. Independent samples t-tests were initially conducted to compare mean expression levels of CD markers between groups. Moreover, since non-normal distributions are likely to occur, Mann-Whitney U tests were used for Pediatric T-ALL and Adult T-ALL.

RESULTS: Descriptive analysis indicated variability in CD marker expression levels among the different subtypes of ALL. Both t-tests and Mann-Whitney U tests revealed statistically significant differences (p < 0.05) in the expression levels of CD markers between pediatric and adult groups, or between B-ALL and T-ALL groups.

CONCLUSION: Significant differences have been identified using different analysis methods across the studied groups. The investigation analyzes the expression levels of CD34, HLA-DR CD38, and TdT within pediatric B-ALL patients and pediatric T-ALL patients along with adult B-ALL patients and adult T-ALL patients. The patterns need appreciation because they might reveal biological differences at their base which influence disease development and both treatment results and patient survival outcomes.

PMID:41064890 | DOI:10.14712/18059694.2025.19

Acta Medica (Hradec Kralove). 2025;68(2):45-49. doi: 10.14712/18059694.2025.18.

ABSTRACT

OBJECTIVE: To evaluate whether baseline serum creatinine is associated with survival outcomes in patients with advanced high-grade serous ovarian carcinoma undergoing neoadjuvant chemotherapy.

METHODS: We retrospectively analyzed 77 patients treated between 2009 and 2018. Patients were stratified by baseline serum creatinine levels (<84 vs. ≥84 µmol/L), and survival outcomes were assessed using Kaplan-Meier analysis.

RESULTS: No statistically significant differences in progression-free or overall survival were observed between groups. A trend toward shorter OS in the elevated creatinine group did not reach significance.

CONCLUSION: Baseline serum creatinine was not found to be a statistically significant prognostic marker in this cohort. These results highlight the need for adjusted analyses incorporating established prognostic factors in future research.

PMID:41064889 | DOI:10.14712/18059694.2025.18

Vet World. 2025 Aug;18(8):2450-2459. doi: 10.14202/vetworld.2025.2450-2459. Epub 2025 Aug 26.

ABSTRACT

BACKGROUND AND AIM: Antimicrobial resistance (AMR) presents a critical global health threat, compromising the efficacy of treatments across human, animal, and environmental health domains. While efforts have predominantly focused on livestock and human medicine, the role of pet owners remains underexplored, despite their direct involvement in antimicrobial administration and influence on veterinary decisions. This study aimed to assess perceptions, knowledge, and practices regarding antimicrobial use and resistance among pet owners in Chile, providing a baseline to inform future education and policy initiatives under a One Health framework.

MATERIALS AND METHODS: A cross-sectional survey targeting adult dog and cat owners was conducted from May 19 to 21, 2023, in Santiago, Chile, during a large public pet-focused event. Using a validated questionnaire, data were collected on demographics, pet characteristics, knowledge, attitudes, and practices related to antibiotics and AMR. A total of 378 valid responses were analyzed. Descriptive statistics and Chi-square tests were applied to examine associations, particularly between education level and reported practices.

RESULTS: Most respondents were female (74.4%) with professional degrees (64%) and aged between 21 and 50 years. Dogs were more commonly owned (73.8%) than cats (26.2%). While 86.2% reported their pet had received antibiotics, only 68.2% recalled veterinarians confirming proper administration understanding. A strong majority agreed that antibiotics should only be used for bacterial infections and opposed acquiring them without a prescription. Notably, 92.4% stated that they would stop treatment early if improvement was observed. Approximately 52% had used human antibiotics for pets, and 38% were open to substituting prescribed veterinary antibiotics with human ones. No significant association was found between education level and antibiotic use behaviors (p > 0.05).

CONCLUSION: Findings reveal important gaps in owner understanding and adherence to antimicrobial guidelines, particularly regarding treatment completion and human antibiotic use in pets. Strengthening veterinarian-owner communication, promoting species-specific antibiotic use, and enhancing awareness of AMR’s broader implications are essential. These insights support targeted educational efforts and integration of pet owner perspectives into national AMR strategies to advance One Health goals.

PMID:41064845 | PMC:PMC12501537 | DOI:10.14202/vetworld.2025.2450-2459

Vet World. 2025 Aug;18(8):2344-2356. doi: 10.14202/vetworld.2025.2344-2356. Epub 2025 Aug 18.

ABSTRACT

BACKGROUND AND AIM: Feline chronic gingivostomatitis (FCGS) is a debilitating inflammatory condition of the oral cavity in cats, associated with chronic pain, salivation, halitosis, and reduced quality of life. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have known anti-inflammatory properties and may offer a supportive treatment option. This study aimed to evaluate the safety and clinical efficacy of two marine-derived n-3 PUFA sources – krill oil and green-lipped mussel (GLM) oil – administered through lickable cat treats in cats with FCGS.

MATERIALS AND METHODS: Sixteen FCGS cats were randomized into three double-blinded treatment groups to receive daily lickable treats: Control (no n-3 PUFA), krill oil (100 mg), or GLM oil (100 mg) for 28 days. Clinical outcomes (stomatitis and pain scores, halitosis, and salivation) were assessed on days 0, 14, and 28 by veterinarians. Owner-reported outcomes and inflammatory cytokine levels (interleukin 6, interleukin 1 beta, and interferon-gamma) were also evaluated.

RESULTS: Both krill and GLM oil treatments were well-tolerated, with no adverse changes in body weight, hematological, or biochemical parameters. Mean stomatitis and pain scores showed a non-significant downward trend in all groups. Halitosis and salivation improved in seven cats, particularly in the GLM and control groups. Owner-reported improvement was observed in 10 of 16 cats, with the highest in the krill oil group (75%). Cytokine levels demonstrated high variability and no statistically significant changes. No significant differences were observed between the n-3 PUFA sources.

CONCLUSION: Daily administration of n-3 PUFA-enriched cat treats is safe and may provide mild clinical benefit in cats with FCGS, particularly in alleviating oral discomfort. While no significant differences were found between krill and GLM oils, both formulations were palatable and suitable as adjunctive therapy. Further research with larger cohorts, extended durations, and sensitive scoring systems is warranted to optimize treatment protocols.

PMID:41064844 | PMC:PMC12501575 | DOI:10.14202/vetworld.2025.2344-2356

Vet World. 2025 Aug;18(8):2206-2221. doi: 10.14202/vetworld.2025.2206-2221. Epub 2025 Aug 2.

ABSTRACT

BACKGROUND AND AIM: The small intestinal microbiota plays a pivotal role in poultry digestion and immune function. Rearing systems can influence their composition, thereby affecting the overall health and performance of the birds. This study aimed to investigate how rearing systems (intensive [IN] vs. free-range [FR]) and immune status, reflected by leukocyte profiles, influence the small intestinal microbiome of IPB-D3 chickens, a genetically improved Indonesian local breed.

MATERIALS AND METHODS: Ninety IPB-D3 chickens were reared for 12 weeks under either IN or FR systems. Hematological profiling was conducted to assess health status, with leukocyte counts used to stratify birds. Microbiota samples from the small intestine were analyzed using full-length 16S ribosomal RNA (V1-V9) sequencing on the Oxford Nanopore platform. Taxonomic identification was performed using the SILVA database. Statistical comparisons were made using t-tests, and microbial diversity was assessed through alpha and beta diversity metrics.

RESULTS: While most hematological parameters did not differ significantly between rearing systems, total leukocyte counts were higher in intensively reared chickens (p = 0.002). FR chickens exhibited significantly greater microbial diversity (p < 0.05) across multiple alpha diversity indices. A total of 1,294 unique species were identified in FR birds versus 720 in the IN group, with 1,761 shared species. Leukocyte level further influenced microbial profiles; chickens with high leukocyte (HL) counts were dominated by Ligilactobacillus aviarius, whereas low-leukocyte chickens had a higher abundance of Bacteroides caecigallinarum. Gallibacterium anatis, a potential pathogen, dominated in IN systems with elevated leukocytes.

CONCLUSION: This study demonstrates that both the rearing environment and immune status substantially influence small intestinal microbial composition in IPB-D3 chickens. FR systems promoted richer, more beneficial microbial communities, while IN systems, especially with HL levels, were associated with opportunistic pathogens. Leukocyte profiling may serve as a non-invasive biomarker for gut health, supporting future development of precision poultry management strategies and immune-responsive probiotics.

PMID:41064842 | PMC:PMC12501567 | DOI:10.14202/vetworld.2025.2206-2221

Vet World. 2025 Aug;18(8):2553-2562. doi: 10.14202/vetworld.2025.2553-2562. Epub 2025 Aug 30.

ABSTRACT

BACKGROUND AND AIM: Suture ligation is the standard technique for feline orchiectomy, but it requires surgical expertise and is time-consuming. Silicone rubber bands (SRBs), previously used in human procedures, offer a potential alternative. This study aimed to (1) evaluate the effects of common veterinary sterilization methods on the mechanical integrity of SRBs and (2) compare the surgical outcomes of SRB versus suture ligation in feline orchiectomy.

MATERIALS AND METHODS: Twenty-eight: SRBs were randomly assigned to four sterilization groups: No sterilization (control), 2% chlorhexidine gluconate, autoclaving, and hydrogen peroxide gas plasma. Bands were tested for ultimate tensile strength (UTS), elongation at break, and elastic modulus using a universal testing machine. Separately, 20 healthy male cats were randomly assigned to undergo orchiectomy using either SRB ligation (n = 10) or traditional suture ligation (n = 10). Surgical time, intraoperative/post-operative complications, Glasgow composite measure pain scale scores, wound healing, and gastrointestinal (GI) symptoms were monitored for 10 days.

RESULTS: Hydrogen peroxide gas plasma sterilization preserved SRB elasticity without significantly affecting UTS, while autoclaving and chlorhexidine treatment increased stiffness and reduced elongation at break (p < 0.05). SRB ligation significantly reduced surgical time (3.06 ± 0.32 min) compared to suture ligation (4.48 ± 0.62 min; p < 0.01). There were no significant differences in post-operative pain scores, wound healing characteristics, or complication rates between groups (p > 0.05). Mild GI symptoms were observed in both groups but were not statistically different.

CONCLUSION: SRB ligation is a viable, time-efficient, and clinically comparable alternative to traditional suture ligation in feline orchiectomy. Hydrogen peroxide gas plasma is recommended for SRB sterilization due to its minimal impact on material integrity. This technique may be especially beneficial in high-volume or resource-limited settings, offering a safe, efficient approach to feline population control. Future research should evaluate the long-term biocompatibility and broader surgical applications of SRBs in veterinary practice.

PMID:41064836 | PMC:PMC12501543 | DOI:10.14202/vetworld.2025.2553-2562

Vet World. 2025 Aug;18(8):2487-2498. doi: 10.14202/vetworld.2025.2487-2498. Epub 2025 Aug 30.

ABSTRACT

BACKGROUND AND AIM: Biofilms formed by foodborne pathogens represent a significant threat to public health by enhancing microbial survival and facilitating antimicrobial resistance (AMR). In Iraq, data on the biofilm-producing potential of key meat-borne pathogens remain scarce, particularly for fastidious organisms such as Campylobacter, Arcobacter, and Salmonella serovars. This study investigated the prevalence and intensity of biofilm formation in selected meat-borne bacterial isolates and examined their correlation with phenotypic AMR, focusing on moderate to strong biofilm producers.

MATERIALS AND METHODS: A total of 44 bacterial isolates – including Staphylococcus aureus (methicillin-resistant S. aureus [MRSA]), Arcobacter butzleri, Arcobacter cryaerophilus, Campylobacter jejuni, Campylobacter coli, Salmonella enterica serovars Enteritidis, and Salmonella Typhimurium – were recovered from retail meat samples collected between 2018 and 2023 in Wasit, Iraq. Biofilm-forming ability was quantified using microtiter plate assays and interpreted per Stepanovic’s criteria. Antimicrobial susceptibility was assessed through the Kirby-Bauer disk diffusion method, with resistance patterns statistically analyzed for associations with biofilm strength.

RESULTS: Among all isolates, 25% were strong and 40.91% moderate biofilm producers. Salmonella serotypes showed the highest biofilm strength (100%), followed by C. jejuni (75%) and MRSA (57.14%). A significant correlation (p ≤ 0.05) was observed between biofilm production and resistance to vancomycin, ofloxacin, gentamicin, enrofloxacin, and cefoxitin. Gram-negative isolates with strong to moderate biofilm capacity exhibited resistance rates ranging from 61.90% to 95.24%, while Gram-positive MRSA showed higher resistance to fluoroquinolones and aminoglycosides.

CONCLUSION: Biofilm production significantly contributes to increase AMR among meat-borne pathogens, compromising food safety and treatment efficacy. Enhanced surveillance, targeted biofilm control strategies, and molecular studies are crucial to mitigate the rising threat of biofilm-associated AMR in the food chain.

PMID:41064834 | PMC:PMC12501576 | DOI:10.14202/vetworld.2025.2487-2498

Vet World. 2025 Aug;18(8):2158-2168. doi: 10.14202/vetworld.2025.2158-2168. Epub 2025 Aug 2.

ABSTRACT

BACKGROUND AND AIM: In The Gambia, malaria transmission persists due to insecticide resistance and residual vector behavior, despite extensive use of indoor residual spraying and insecticide-treated nets. Community-led larval source management using Bacillus thuringiensis var. israelensis (Bti) offers a sustainable vector control alternative. This study aimed to assess the effectiveness and feasibility of community-led Bti application for reducing Anopheles mosquito populations, compared to expert-supervised application and non-intervention control arms.

MATERIALS AND METHODS: A non-randomized controlled trial was conducted across malaria-endemic regions in The Gambia from 2023 to 2024. Intervention arms included: (1) community-led Bti application, (2) expert-supervised Bti application, and (3) untreated control. Trained volunteers and entomologists applied Bti to breeding sites at weekly or biweekly intervals. Entomological surveys were conducted biweekly to monitor larval, pupal, and adult mosquito densities. Data were analyzed using generalized linear mixed models and negative binomial regression, adjusting for environmental covariates.

RESULTS: By round 10, community-led and expert-supervised interventions achieved 96.8% and 98.6% reductions in larval density, 97.4% and 99.1% reductions in pupal emergence, and 96.2% and 98.8% reductions in adult mosquito populations, respectively. Statistically significant declines in mosquito densities were observed by 2024 (p < 0.001). Community participation enabled high coverage and operational sustainability, with over 85% of participants reporting visible mosquito reduction.

CONCLUSIONS: Seasonal Bti application, especially when led by trained community members, significantly suppresses Anopheles populations. Although expert-supervised methods yielded slightly higher efficacy, community-led biolarviciding offers a scalable, sustainable, and environmentally safe vector control strategy, supporting The Gambia’s malaria elimination goals.

PMID:41064829 | PMC:PMC12501536 | DOI:10.14202/vetworld.2025.2158-2168

Vet World. 2025 Aug;18(8):2357-2366. doi: 10.14202/vetworld.2025.2357-2366. Epub 2025 Aug 18.

ABSTRACT

BACKGROUND AND AIM: The reproductive efficiency of livestock, especially indigenous breeds such as Donggala bulls, is pivotal to successful breeding programs. While conventional semen parameters are widely used, molecular markers, such as sperm protein profiles and DNA integrity, are emerging as reliable indicators of fertility. This study aimed to characterize the sperm protein profiles of Donggala bulls and examine their correlation with sperm DNA integrity and protamine deficiency.

MATERIALS AND METHODS: Frozen semen samples were collected from six Donggala bulls (aged 5-7 years). Pre-freezing evaluations included progressive motility (via computer-assisted sperm analysis), sperm morphology (using Diff-Quik staining), DNA integrity (assessed by the acridine orange assay), and protamine deficiency (assessed by the chromomycin A3 assay). Protein concentrations were determined using the bicinchoninic acid assay, and protein profiling was performed using 1D sodium dodecyl sulfate polyacrylamide gel electrophoresis. Band intensities and distributions were analyzed using ImageJ. Statistical correlations were analyzed using a one-way analysis of variance and Pearson’s correlation coefficients.

RESULTS: Significant individual variation was observed in semen quality among bulls. Progressive motility ranged from 38.3% to 46.1%, DNA integrity from 79.5% to 96.8%, and protamine deficiency from 96.0% to 98.7%. The number of protein bands per sample varied between 8 and 11, with molecular weights ranging from 5 to 175 kilodaltons (kDa). Protein concentration ranged from 8.32 to 20.70 μg/mL. A 35 kDa protein band was notably absent in one bull, which may be linked to lower motility. Strong correlations were observed between sperm motility and DNA fragmentation (r = 0.628), protamine deficiency (r = 0.539), protein concentration (r = 0.658), and protein band expression (r = 0.788).

CONCLUSION: Sperm protein profiles in Donggala bulls are significantly correlated with DNA integrity and protamine deficiency, indicating their potential as molecular biomarkers for fertility prediction. These findings provide a foundation for integrating protein profiling into breeding soundness evaluations, suggesting that targeted proteomic analysis may enhance reproductive management strategies.

PMID:41064824 | PMC:PMC12501601 | DOI:10.14202/vetworld.2025.2357-2366