Nevin Manimala

Can J Infect Dis Med Microbiol. 2025 Mar 27;2025:4426596. doi: 10.1155/cjid/4426596. eCollection 2025.

ABSTRACT

Background: Antimicrobial-resistant Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter (ESKAPE) species pathogens pose a threat to global health by limiting available treatments, escalating the burden of disease, and raising mortality rates. This study investigated the prevalence of ESKAPE pathogens in different infections in a Nepalese hospital and studied their antibiotic resistance pattern. Methodology: The study was performed from September 2022 to February 2023 at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. ESKAPE pathogens were isolated in accordance with standard procedures and subjected to antimicrobial susceptibility testing (AST). Identification was done via biochemical testing. The rates of multidrug resistance (MDR), production of extended-spectrum beta-lactamase (ESBL), and methicillin resistance were studied and statistically compared in terms of the type of pathogen, infection, and hospital admission. Result: Altogether, 7429 different clinical samples were cultured and ESKAPE pathogens were isolated from 503/1564 (32.1%) positive samples. The prevalence of these pathogens was significantly higher in admitted patients (p < 0.001). Higher rates of isolation were from urine and sputum samples. Klebsiella pneumoniae was the most prevalent organism while Enterobacter was the least. A total of 52.3% and 7.4% of the isolates were MDR and ESBL producers, respectively. A significant proportion of MDR isolates were from patients admitted to the Intensive Care Unit (ICU). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 36.8%. AST revealed comparatively lower resistance of Gram-negative rods to tigecycline, polymyxin B, and colistin sulfate. Likewise, lower resistance rates to vancomycin and teicoplanin were observed in S. aureus. Conclusion: In various clinical samples, we discovered that ESKAPE pathogens were more prevalent. In order to escape the ESKAPE’s torment of antibiotic resistance, our findings urge the urgent implementation of sensible antibiotic use, training healthcare professionals in antibiotic stewardship, developing effective infection control strategies, and conducting effective surveillance.

PMID:40183111 | PMC:PMC11968158 | DOI:10.1155/cjid/4426596

PeerJ. 2025 Mar 31;13:e19202. doi: 10.7717/peerj.19202. eCollection 2025.

ABSTRACT

BACKGROUND: Radiation therapy (RT) is a primary postsurgical treatment for breast cancer; however, it can cause acute radiation dermatitis (ARD), which can severely impair quality of life. The aim of this study was to identify predictive factors associated with moderate to severe ARD.

MATERIALS AND METHODS: In this retrospective analysis, we utilized data from Chulabhorn Hospital’s Health Information System that was collected between January 2017 and December 2022. A radiation oncology specialist assessed ARD in a cohort of 635 patients using the Radiation Therapy Oncology Group (RTOG) ARD grading scale. The patients were classified into two groups based on the maximum grade recorded: mild (grade < 2) and moderate to severe (grade ≥ 2). Various factors were examined, including demographic characteristics (age, body mass index (BMI), comorbidities) and treatment-related variables (surgical history, adjuvant chemotherapy, hormone therapy, targeted therapy, fractionation, boost treatments, and bolus application). Logistic regression was used to perform the statistical analysis.

RESULTS: Among the 635 patients, the average age was 54.2 ± 10.9 years, and 32% were classified as having moderate to severe ARD. Multiple logistic regression analysis identified BMI ≥ 30 kg/m² (adjusted odds ratio (AOR) = 2.33; 95% confidence interval (CI) [1.36-3.98]; p-value = 0.002), localized boost treatments (AOR = 2.09; 95% CI [1.08-4.06]; p-value = 0.029), and bolus application (AOR = 2.08; 95% CI [1.02-4.24]; p-value = 0.044) as significant risk factors for moderate to severe ARD. Conversely, hypofractionated RT (AOR = 0.31; 95% CI [0.16-0.57]; p < 0.001) and hormonal therapy (AOR = 0.60; 95% CI [0.42-0.86]; p-value = 0.005) were associated with a decreased risk. However, radiation to both the primary site and regional lymph nodes (AOR = 0.81; 95% CI [0.41-1.59]; p-value = 0.538) and targeted therapy (AOR = 0.72; 95% CI [0.43-1.20]; p-value = 0.210) did not significantly affect the risk of moderate to severe ARD.

CONCLUSIONS: We have identified key risk factors for moderate to severe ARD, including obesity and treatment modalities such as localized boost treatments and bolus application. Hormone therapy and hypofractionated RT appear to reduce ARD severity. These findings have implications for the development of treatment plans and the mitigation of the risk of ARD in patients undergoing RT.

PMID:40183060 | PMC:PMC11967412 | DOI:10.7717/peerj.19202

PeerJ. 2025 Mar 31;13:e19145. doi: 10.7717/peerj.19145. eCollection 2025.

ABSTRACT

OBJECTIVES: To develop a model incorporating computed tomography (CT) radiomic features and clinical parameters for predicting bronchiolitis obliterans (BO) with adenovirus pneumonia in children.

METHODS: A total of 165 children with adenovirus pneumonia between October 2013 and February 2020 were enrolled retrospectively. Among them, BO occurred in 70 patients, and the remaining 95 patients did not have BO. These children were stratified into training and testing groups at a ratio of 7:3. Manual segmentation of lesions in baseline CT images during acute pneumonia was performed to extract radiomic features. Multiple statistical methods were used to determine the best radiomic features. Combined models based on radiomic and clinical features were established via logistic regression (LR), random forest (RF), and support vector machine (SVM) algorithms. Model performance was evaluated via the area under the receiver operating characteristic curve (AUC).

RESULTS: A total of 2,264 radiomic features were extracted from the lesions, from which 10 optimal radiomic features were ultimately selected. The length of hospitalization, number of pneumonia lobes, and optimal radiomic features were incorporated into the combined models. In the training group, the AUCs of the combined LR, RF and SVM models were 0.946, 0.977, and 0.971, respectively; while in the testing group, they yielded AUCs of 0.890, 0.859, and 0.885, respectively. The predictive performance of these combined models surpassed that of the radiomic and clinical models.

CONCLUSION: Combining CT-based radiomic features with clinical parameters can offer an effective noninvasive model to predict BO in children with adenovirus pneumonia.

PMID:40183053 | PMC:PMC11967419 | DOI:10.7717/peerj.19145

Int J Womens Health. 2025 Mar 30;17:937-945. doi: 10.2147/IJWH.S518312. eCollection 2025.

ABSTRACT

BACKGROUND: Threatened preterm labor is a common reason for hospital admission, and DHA supplementation may lower the risk of preterm labor.

OBJECTIVE: To compare the rates of premature birth between individuals with threatened preterm labor who received DHA and those who did not.

METHODS: In this multi-center randomized controlled trial, the sample size was calculated to be 60 participants. Pregnant individuals who experienced threatened preterm labor at 24 to 34 weeks gestation were given either 1000 milligrams of DHA daily or no DHA supplement. The criteria for inclusion consisted of singleton pregnancies that had been diagnosed with threatened preterm labor, with no cervical change present. DHA supplementation was initiated when threatened preterm labor was diagnosed and continued until 37 weeks of gestation or until delivery, whichever occurred first. The main outcome was to compare the rates of premature births between the two groups. Moreover, we intended to evaluate the side effects of the DHA supplement along with the outcomes for neonates.

RESULTS: Sixty-one pregnant individuals were enrolled and randomly assigned to two groups. Group 1 consisted of 30 participants, each receiving a daily intake of 1,000 milligrams of DHA supplement. Group 2, comprising 31 individuals, did not receive any supplemental DHA. The rate of preterm birth was 23.33% (7/30) and 25.81% (8/31) for the participant group receiving DHA and not receiving DHA, respectively, with a p-value of 0.82. The rate of low-birth-weight neonates was 13.33% (4/30) and 19.35% (6/31) for the participant group receiving DHA and not receiving DHA, respectively, with a p-value of 0.73. The overall results did not show any statistically significant differences. In addition, the rates of cesarean sections, peripartum infections, early postpartum hemorrhage, and NICU admissions did not show significant differences between the two groups.

CONCLUSION: Taking DHA supplements after a diagnosis of threatened preterm pregnancy does not decrease the actual rates of early or late preterm births. To reduce the risk of premature birth, DHA should be taken from the beginning of pregnancy, with a recommendation to start in the first trimester. This should ideally start in the second trimester, no later than around 20 weeks of gestation, and should continue until childbirth or approximately 37 weeks of gestation.

CLINICAL TRIAL REGISTRATION: https://register.clinicaltrials.gov/.

CLINICAL TRIALS: gov; ID: NCT06302023.

PMID:40183030 | PMC:PMC11967355 | DOI:10.2147/IJWH.S518312

Health SA. 2025 Mar 21;30:2752. doi: 10.4102/hsag.v30i0.2752. eCollection 2025.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has been associated with stress because of its disruption to normal lifestyle. While the resilience of people was challenged, some coping strategies were adopted to maintain balance in the face of the pandemic.

AIM: To assess psychological distress and coping strategies among the academic staff.

SETTING: Afe Babalola University located in the Southwest, Nigeria.

METHODS: A descriptive-cross-sectional design was used on the population of 512 academics where a sample size of 248 was drawn using Taro Yamane with a 10% non-response rate. The instruments used were a modified Kessler Psychological Distress Scale (K10) and an adapted COPE inventory for coping strategies. The scale reliability of K10 was 0.866 while that of coping strategy was 0.610. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 28. The results were presented in simple percentages, means and standard deviations.

RESULTS: Most respondents had severe psychological distress (185, 98.9%) with the most rated report ‘Feel worthless’ 4.8 ± 0.59. The most rated coping strategy was ‘I try to lose myself for a while by drinking alcohol or taking drugs’3.8 ± 0.60 with overall coping scale mean, 2.3 ± 1.02.

CONCLUSION: There was severe distress and substance used among academics. The study recommends teaching on effective coping styles and institution probable preparation for future pandemic.

CONTRIBUTION: The study provides insight into the psychological state of the academic staff during the COVID-19 pandemic and unveils the adaptive strategies used. The results of the study are useful for the development of appropriate coping skills for the staff.

PMID:40183029 | PMC:PMC11966654 | DOI:10.4102/hsag.v30i0.2752

F1000Res. 2025 Jan 13;13:1022. doi: 10.12688/f1000research.152775.2. eCollection 2024.

ABSTRACT

BACKGROUND: Age-related central auditory processing disorder and mild cognitive impairment (MCI) can be concomitant in older adults, making it difficult to communicate, especially in challenging listening conditions. This preliminary study investigated the efficacy of auditory-based cognitive training on the auditory processing abilities and cognitive functions of older adults with MCI.

METHODS: In this randomized controlled trial twenty-two older adults with mild cognitive impairment (MCI) were randomly assigned to either an experimental (n=11) or a control group (n=11). The experimental group received 15 cognitive training sessions through tasks involving the auditory domain. The outcome measures of this study included auditory resolution (Temporal gap detection, frequency discrimination, and modulation detection) and cognitive measures (Trail making tests and digit recall), which were administered at three-time points (before training, post-training, and follow-up). The linear mixed model computed the effects of training on the outcome measures.

RESULTS: A significant improvement was observed in the modulation detection threshold between baseline and follow-up and between post-training and follow-up sessions. However, GDT and FD thresholds did not reveal any statistically significant difference. In the trail making test, Part B showed consistent significance across the time points, whereas Part A and the delayed recall task showed no significant difference.

CONCLUSION: Auditory-based cognitive training may improve auditory processing and executive function in older adults with mild cognitive impairment (MCI).

TRIAL REGISTRATION: CTRI/2019/01/017073, registered on 14.01.2019.

PMID:40183007 | PMC:PMC11966092 | DOI:10.12688/f1000research.152775.2

F1000Res. 2024 Aug 30;13:183. doi: 10.12688/f1000research.142871.2. eCollection 2024.

ABSTRACT

BACKGROUND: Motorcycle accidents can be particularly hazardous, as riders are exposed to various risk factors, such as high speeds, lack of protective enclosures, and limited safety features.

AIM OF THE STUDY: To describe the ocular injuries associated with motorcycled accidents presented to tertiary hospitals and forensic centers in Iraq.

PATIENTS AND METHODS: The study was conducted in three Teaching hospitals and forensic centers in Baghdad and Al-Qadisiyah in Iraq. Information regarding ocular injuries, recorded and classified according to the International Ocular Trauma Classification, was gathered from motorcycle crash injuries that were presented to the emergency departments of these facilities from June 1, 2019, to June 1, 2023.

RESULTS: The study involved 335 ophthalmological accidents; the mean age of the patients was 27.84± 9.6 years, most of them were males (96.7%), and there were only 11 females as passengers, 39 (11.6%) had injuries in both eyes. Lesions involving the periorbita, lids, and conjunctiva comprised most of the findings. There were 60.9% of patients with lid lacerations with or without sub-conjunctival bleeding, 22.1% with corneoscleral injury, and 17.9% with commotio retinae. It was the leading cause of decreased visual acuity, with 9% having lens capsule damage with or without iris prolapse and 8.1% having a ruptured capsule, 55.82% of patients had a mild injury, 27.16% had a moderate injury, and 17.01% had a severe injury.

CONCLUSION: Eye injury associated with motorcycle accidents mainly affects males in their youth age and has serious outcomes, sometimes ending with blindness.

PMID:40183006 | PMC:PMC11966094 | DOI:10.12688/f1000research.142871.2

F1000Res. 2025 Jan 27;13:1060. doi: 10.12688/f1000research.155286.2. eCollection 2024.

ABSTRACT

INTRODUCTION: Zero-dose children (ZDC) are defined as those that have never been reached by routine immunization services. In Latin America, almost 2.7 million infants younger than 1 year of age, have incomplete vaccination schedules, and vaccine preventable diseases such as measles or polio have increase worldwide. ZDC are reported to reside in high risk and fragile settings, including remote-rural areas, urban slums, and conflict-affected areas. Identifying the problem and settings in each country is mandatory to propose possible solutions to the immunization coverage situation.

AREAS COVERED: In November 2023, a group of experts of the Latin America Society of Pediatric Infectious Diseases (SLIPE) analyzed the global and regional reality of ZDC, and present in this document an updated reality of the Latin American region and the weight of the possible interventions to overcome this problem.

EXPERT COMMENTARY: Communication is a key element to improve vaccination coverage, as it is quality and use of vaccination data. Campaigns that deliver targeted and effective messages to communities and families, provide education about vaccination, avoid missed vaccination opportunities, and coordinate efforts across different sectors and communities, among other strategies, could improve the current immunization situation.

PMID:40183005 | PMC:PMC11966093 | DOI:10.12688/f1000research.155286.2

Saudi J Ophthalmol. 2024 Mar 26;39(1):77-83. doi: 10.4103/sjopt.sjopt_226_23. eCollection 2025 Jan-Mar.

ABSTRACT

PURPOSE: The purpose is to assess the corneal endothelial changes after phacoemulsification surgery in diabetic patients and compare with those of nondiabetic subjects.

METHODS: The study compared the corneal endothelial changes in diabetics and nondiabetics after phacoemulsification surgery. The study population included 40 patients with diabetes mellitus with good glycemic control and 40 nondiabetic patients who underwent uneventful phacoemulsification surgery. Central corneal endothelial cell density (ECD), central corneal thickness (CCT), and percentage of hexagonality percentage coefficient of variation (%CV) were measured preoperatively and postoperatively (at 4 and 12 weeks) using a specular microscope.

RESULTS: Mean ECD loss (%) was measured as 9.85% and 8.41% at 4 weeks and 12 weeks postoperatively in the diabetic group while ECD loss percentage was 7.09% and 5.74% in the control group at the same time intervals, respectively. Furthermore, a significant difference was noted on comparing mean ECD measurements between the two groups at the postsurgical visits (4 weeks and 12 weeks). While the CCT was found to be similar in both diabetic and nondiabetic patients, increase was observed in the values of (%CV in both the groups at postoperative 4 weeks’ and 12 weeks’ follow-up. The values of both %CV and percentage hexagonality showed statistically significant differences between the diabetic and nondiabetic group before surgery and at 4 weeks’ and 12 weeks’ postoperative examinations.

CONCLUSION: The patients with diabetes suffered greater endothelial damage despite good glycemic control as compared to nondiabetic patients which indicates the necessity of far more care to protect cornea endothelium in patients with diabetes.

PMID:40182979 | PMC:PMC11964349 | DOI:10.4103/sjopt.sjopt_226_23

Saudi J Ophthalmol. 2024 Aug 8;39(1):71-76. doi: 10.4103/sjopt.sjopt_214_23. eCollection 2025 Jan-Mar.

ABSTRACT

PURPOSE: Dry eye symptoms can substantially affect the quality of life and visual outcome. There are several studies on ocular surface changes reported in diabetic patients. There is limited literature defining the relationship between dry eye with diabetic retinopathy (DR). The study aimed to find out the correlation of dry eye with the severity of DR.

METHODS: In a cross-sectional observational study, we recorded the grading of dry eye in patients with DR on Schirmer’s, tear film breakup time (TBUT), and impression cytology. We correlated the severity of dry eye with the severity of retinopathy using Spearman’s correlation and Kruskal-Wallis test. We also found a significant correlation between glycemic control and the severity of dry eye. P < 0.05 was considered statistically significant.

RESULTS: One hundred and eighty-four eyes of 96 patients with DR were assessed. One hundred and fifty-eight eyes with nonproliferative DR and thirty-four eyes with proliferative DR were included in the study. Mean Schirmer’s and TBUT values were 15.4 ± 5.8 mm and 10.1 ± 2.8 s, respectively. Average impression cytology grade on Modified Nelson’s grading was found to be Grade 3. A positive correlation was found between the severity of dry eye with the severity of DR on Schirmer’s, TBUT, and impression cytology.

CONCLUSION: Diabetics with severe grades of retinopathy had poor tear function along with compared to those with milder grades of DR. Hence, routine screening of the ocular surface should become a part of diabetic eye evaluation.

PMID:40182977 | PMC:PMC11964339 | DOI:10.4103/sjopt.sjopt_214_23