Nevin Manimala

Orthop Surg. 2025 Jun 2. doi: 10.1111/os.70056. Online ahead of print.

ABSTRACT

BACKGROUND: Antibiotic-loaded cement (ALC) is often used to reduce the risk of surgical site infections (SSIs) in hip hemiarthroplasty; however, controversy exists regarding the use of dual antibiotic-loaded cement (DALC) and single antibiotic-loaded cement (SALC).

OBJECTIVE: This systematic review and meta-analysis compare the efficacy of DALC and SALC for hip hemiarthroplasty.

METHODS: For this systematic review, a search was undertaken in the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and ClinicalTrials.gov. Grey literature such as ProQuest Dissertations and Theses Global (PQDT) was also explored. The inclusion criteria comprised randomized controlled trials (RCTs) or comparative observational studies, and patients undergoing hip hemiarthroplasty with DALC or SALC. Newcastle-Ottawa Scale (NOS) and RoB 2.0 tools were used for risk of bias assessment in observational and RCTs, respectively. Review Manager (RevMan, version 5.4.1; The Cochrane Collaboration, Copenhagen, Denmark) was used for statistical analysis. The primary outcome was the incidence of deep SSIs.

RESULTS: A total of five articles, including 28,418 participants, met the inclusion criteria. Three of the included studies were retrospective studies, one quasi-randomized study, and one RCT. The primary outcome revealed that DALC was associated with a statistically significant reduction in deep SSIs compared to SALC (RR, 0.47; 95% CI, 0.29-0.76; p = 0.002; I² = 27%). Subgroup analysis based on the study design did not show a significant difference for deep SSIs (p = 0.29). The majority of the secondary outcomes, such as superficial SSIs, mortality, participants with ≥ 1 complication, or antibiotic use, did not show any significant difference. However, DALC significantly lowered the risk of any infection (RR, 0.55; 95% CI, 0.38-0.79; p = 0.001; I² = 27%).

CONCLUSION: In conclusion, DALC can significantly reduce the risk of SSIs and the overall rate of any infection in hip hemiarthroplasty. A limitation of this study is that RCTs were pooled with observational studies, which decreased the power of analysis. Therefore, further research, including large RCTs, is needed to validate these findings.

PMID:40457409 | DOI:10.1111/os.70056

BMC Health Serv Res. 2025 Jun 2;25(1):784. doi: 10.1186/s12913-025-12951-y.

ABSTRACT

INTRODUCTION: Males have substantial sexual and reproductive health (SRH) needs, but there is low utilization of these SRH services. We compared the utilization and ascertained factors associated with the utilization of sexual and reproductive health services among males in urban and rural areas of Anambra State, Nigeria.

METHODS: A community-based cross-sectional study was conducted in Anambra State. Using multistage sampling, 1147 respondents were surveyed via interviewer-administered, structured questionnaires. Data was collected on socio-demographic characteristics, utilization of, and factors associated with the utilization of SRH services. We compared differences in the utilization of SRH services among males using Z test. Simple binary logistic regression analysis was performed to obtain odds ratios and 95% confidence intervals of the crude associations between each predisposing, enabling, and need factor and the utilization of male SRH services. Factors that had a p-value of ≤ 0.05 in the bivariable analysis were included in a multivariable logistic regression analysis to ascertain the independent association between each factor and the utilization of SRH services while controlling for the other factors. The level of statistical significance was set at < 0.05.

RESULTS: The mean age of the respondents was 28.00 ± 9.35 years. There was a low level of utilization, with males in rural areas (35.6%) having a higher level of utilization than males in urban areas (27.0%). Rural location, older age, higher educational level, communication with sexual partner, access to SRH information, exposure to SRH information on mass media, access to health insurance, being sexually active, feeling susceptible to SRH diseases, and having a diagnosis of SRH disease in the last 12 months were positively associated with the utilization of male sexual and reproductive health services. Marital and employment status, number of children, number of sexual partners and recent sexual intercourse were negatively associated with the utilization of male sexual and reproductive health services.

CONCLUSION: There is suboptimal utilization of SRH services in Anambra State, Nigeria. Interventions targeting these identified factors could increase the utilization of male sexual and reproductive health services in such settings.

PMID:40457399 | DOI:10.1186/s12913-025-12951-y

Thyroid Res. 2025 Jun 3;18(1):23. doi: 10.1186/s13044-025-00239-6.

ABSTRACT

Micronutrients play a crucial role in several metabolic processes including thyroid hormone metabolism and functions. The current study aimed to assess the associations between thyroid hormone levels and micronutrient status in a cohort of adolescents Afghan refugees residing in a refugee camp in Pakistan. A randomised, community based, cross-sectional study design was employed to recruit 206 adolescent (both male and female) Afghan refugees aged 10-19 years. Sociodemographic data, anthropometric assessments and blood samples were collected using standard methods. Serum vitamins, minerals and thyroid hormones levels were assessed using ELISA, electrochemiluminescence and inductively coupled plasma mass spectrometry (ICP-MS) respectively. Overall results showed the median levels of T3 and TSH were significantly higher (p < 0.05) in younger adolescents (10-14 years) compared to 15-18 year olds while T4 was significantly higher in boys compared to girls. Correlational analysis between serum micronutrients status (vitamin D, vitamin B12, ferritin, folate, zinc, copper, selenium) and thyroid hormones revealed significant relationships in different age groups. Overall, vitamin D exhibited a statistically significant positive correlation with T4 (r = 0.279) in the combined, younger (r = 0.277) and older (r = 0.319) age groups. In contrast, a statistically significant but negative correlation was observed when zinc levels were compared with T3 (r=-0.288) in the older age group and with T4 (r=-0.195) in the younger age group. In conclusion, micronutrients status, especially vitamin D and zinc, have important implications for thyroid health and thereby require close monitoring in any thyroid deficiency related disorders in vulnerable population such as refugees.Clinical trial number: Not applicable.

PMID:40457391 | DOI:10.1186/s13044-025-00239-6

J Orthop Surg Res. 2025 Jun 3;20(1):559. doi: 10.1186/s13018-025-05972-0.

ABSTRACT

BACKGROUND: Femoral neck system (FNS) and cannulated screws combined with medial plate (CS with medial plate) both are commonly used internal fixation for femoral neck fractures in recent years. There is a debate that which is the better choice for young and middle-aged patients with femoral neck fractures. The objective of the study is to compare clinical effects of FNS and CS with medial plate on young and middle-aged patients with femoral neck fractures by a prospective multicenter randomized controlled trial for the first time.

METHODS: Patients between 18 and 65 years old with femoral neck fractures were allocated to FNS fixation and CS with medial plate fixation with 2 years follow-up. The primary outcomes included fracture bone union rate and Harris hip score. The secondary outcomes included Garden’s alignment index, surgical data, Barthel index, visual analogue scale (VAS), gait analysis and complications during follow-up. Statistical analysis was performed by multiple linear regression and logistics regression.

RESULTS: 165 patients in FNS group and 166 patients in CS with medial plate group were analyzed finally. There was no statistical difference in bone union rate, Garden’s alignment index, Barthel index, gait analysis between two groups. The FNS group had a higher Harris hip score at 3 months after operation (P < 0.05), lower surgical data including operation time, intraoperative blood loss and fluoroscopy frequency (P < 0.001) and lower VAS at 1 month after operation (P < 0.05) than that of CS with medial plate group, but no significant difference at 3, 6, 12, and 24 months. There was no statistical difference in the incidence of complications between groups, except the incidence of coxa vara, which is higher in FNS group (P < 0.05).

CONCLUSIONS: For young and middle-aged patients with femoral neck fractures, both FNS and CS combined with a medial plate are effective.

TRIAL REGISTRATION: ChiCTR2100042960, registered 1 February 2021, http://www.chictr.org.cn .

PMID:40457366 | DOI:10.1186/s13018-025-05972-0

BMC Public Health. 2025 Jun 2;25(1):2029. doi: 10.1186/s12889-025-23191-4.

ABSTRACT

BACKGROUND: Exposure to political violence, which pervades many parts of the Middle East and Northern African (MENA) region, is a key potential factor behind the rising rates of risky behaviors among youth, such as drug use, alcohol use, and sexual activity. Theory and empirical work on youth elsewhere suggests that individual characteristics, mental health, and youths’ future orientation play a role in such behaviors. It is possible that political violence impacts behavior in part through its effects on these factors, in particular mental health. However, very little is known about the determinants of youth risk behavior in the region. Understanding the determinants will help MENA countries to deal with emerging public health threats as well as risks to youth health and well-being resulting from engagement in risky behavior. We examined determinants of risky behavior among Palestinian youth in the West Bank and East Jerusalem.

METHODS: We employed structural equation modeling using a 2014 nationally representative data from the Palestinian Youth Health Risk Study to examine the factors associated with engagement of youth ages 18-24 (N = 1449) in risky behaviors.

RESULTS: Personal experience of political violence was the strongest direct predictor of engagement in interpersonal violence (β = 0.21, p = 0.00) and substance use (β = 0.21, p = 0.00). With respect to indirect effects, global distress mediates the impact of witnessing and vicariously experiencing violence on the three outcomes. However, no association was found between personally experiencing political violence and global distress. The study also identified several individual characteristics, such as religiosity, that may be protective against risky behavior. Females are less likely to engage in risky behavior than males, despite experiencing higher levels of global distress.

CONCLUSIONS: The study is the first to use population-based data to test the effects of exposure to political violence on key risky health behaviors of Palestinian youth, a population facing protracted conflict and hardship for which solutions remain elusive. The findings suggest the need for customized interventions to target male and female Palestinians at an early age to develop their coping skills in dealing with violence and distress.

TRIAL REGISTRATION: Not applicable.

PMID:40457364 | DOI:10.1186/s12889-025-23191-4

BMC Infect Dis. 2025 Jun 2;25(1):784. doi: 10.1186/s12879-025-11009-y.

ABSTRACT

BACKGROUND: Antiretroviral therapy (ART) and ART adherence are crucial for preventing HIV transmission and prolonging the lifespan of people living with HIV (PLWH). Serostatus disclosure is a significant factor influencing both ART initiation and ART adherence. However, studies evaluating the impact of disclosure on ART initiation and ART adherence in mainland China have yielded inconsistent findings. This systematic review and meta-analysis aim to examine the associations between disclosure and both ART initiation and adherence.

METHODS: We systematically reviewed English databases (MEDLINE, Embase, Web of Science and the Cochrane Library) and Chinese databases (CNKI, WanFang, CQVIP, and SinoMed) to identify literature on factors that influence ART initiation and ART adherence from inception to Sep 24, 2024. Microsoft Excel 2019 sheet was used for data extraction. The data extraction sheet included information on the author’s names, publication year of the study, study design, study population, sample size, definition of adherence to ART, and study quality score. The Joanna Briggs Institute (JBI) critical appraisal checklist for prevalence studies was employed to assess the quality of the selected articles. Data were analyzed using STATA 17.0, and a random effects model was utilized to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Sensitivity analyses were conducted through the sequential exclusion of studies. Publication bias was assessed using Begg’s test and Egger’s test.

RESULTS: Our search yielded 517 results, of which 21 were eligible and included in the final meta-analysis. The analysis found that PLWH who disclosed their HIV serostatus were 2.59 times more likely to initiate ART compared to those who did not disclose (OR = 2.59, 95%CI: 1.92-3.49). However, we found no statistically significant association between HIV serostatus disclosure and ART adherence (OR = 1.21, 95%CI: 0.89-1.65). Additionally, no significant associations were identified between HIV serostatus disclosure and ART adherence in any subgroup analyses based on the subjects of disclosure, participants, or adjusted effect estimates for confounding factors.

CONCLUSIONS: We found evidence that serostatus disclosure is likely to positively associated with ART initiation, but not with ART adherence. Encouraging serostatus disclosure among PLWH, while simultaneously increasing public awareness about HIV and fostering a supportive environment for disclosure, may enhance ART adherence.

PMID:40457351 | DOI:10.1186/s12879-025-11009-y

BMC Public Health. 2025 Jun 2;25(1):2032. doi: 10.1186/s12889-025-23036-0.

ABSTRACT

OBJECTIVE: To analyze the epidemiological profile of women who experienced physical violence before and during the coronavirus disease (COVID-19) pandemic from reports of corpus delicti performed at the Forensic Medical Institute, Curitiba, Paraná, Brazil.

MATERIALS AND METHODS: This study used a retrospective cross-sectional design and secondary data analysis of cases of injuries caused by physical violence against women between 2019 and 2021 contained in Forensic Medical Institute reports. Only records of physical violence examinations performed on women were eligible for inclusion. Reports that did not allow for the identification of the victim’s gender, as well as those referring to other physical violence that did not involve aggression, were excluded. Data were collected electronically. The variables analyzed were age, ethnicity, marital status, sex, and relationship with the aggressor. A bivariate analysis using Pearson’s chi-square test was conducted to assess associations between the outcome (year) and independent variables. For significant associations, pairwise comparisons of proportions were made using the Z-test, with Bonferroni correction applied to control for Type I errors. Variables with p-values ≤ 0.05 were considered significant. Statistical analyses were performed using SPSS version 25.0.

RESULTS: In total, 5033 reports of physical violence against women were included in the study. In 2020, a greater proportion of personal injury examinations were observed in white women than in 2019 and 2021 (p < 0.001). Single women are the most vulnerable to physical violence in 2020 and 2021 (p < 0.001). During the same years, assaults by men, partners, former partners, and family members were more prevalent than in 2019 (p < 0.001). The Women’s Police Station was the sought-after place for reporting cases.

CONCLUSION: Over the two pandemic years analyzed, a significant reduction in the number of physical violence examinations conducted at the Forensic Medical Institute was observed. Nevertheless, single women, particularly those subjected to male-perpetrated violence, including by partners, ex-partners, and relatives, sought forensic services with greater frequency compared to the pre-pandemic period. Furthermore, the Women’s Police Station was the most frequently utilized facility for reporting such incidents.

PMID:40457344 | DOI:10.1186/s12889-025-23036-0

BMC Public Health. 2025 Jun 2;25(1):2035. doi: 10.1186/s12889-025-23100-9.

ABSTRACT

BACKGROUND: Medical and non-medical expenses could be incurred during antenatal care, however, few studies about it in Beijing were found. Hence, this study assesses the cost of antenatal care in Beijing and explores it’s influencing factors, aiming to inform targeted strategies.

METHODS: A cross-sectional study was conducted in Beijing from October 14 to December 16, 2024. A cluster sampling technique was used to select subjects. Data were collected through an in-person questionnaire. The cost of antenatal care includes direct costs and indirect costs. The demographic characteristics were statistically described. Univariate analysis and quantile regression model were applied.

RESULTS: A total of 253 pregnant women in Beijing were recruited in this study, and the cost of antenatal care was USD 2,198. The results of the univariate analysis showed statistically significant differences between antenatal cost and pregnant women’s age, family size, gravidity, parity, pregnancy complication, whether or not to hire caregivers, whether the caregiver missed work or not and outpatient visits times (P < 0.05). The results of the quantile regression modeling showed that age, pregnancy complications, whether or not to hire caregivers, whether the caregiver missed work or not, and outpatient visits times can affect the cost of antenatal care at one or more quantiles (P < 0.05).

CONCLUSION: There are high proportion of direct medical costs. It is suggested that reducing the lost wages of pregnant women and caregivers by increasing leaves for them, and controlling complications to alleviate the financial burden of pregnancy.

PMID:40457342 | DOI:10.1186/s12889-025-23100-9

BMC Oral Health. 2025 Jun 2;25(1):881. doi: 10.1186/s12903-025-06243-4.

ABSTRACT

BACKGROUND: Chronic temporomandibular disorder (TMD) pain with pain catastrophizing (PC) is associated with altered brain morphology; however, its neuroanatomical underpinnings remain unclear. This study aimed to investigate gray matter volume (GMV) in the brain regions of chronic TMD pain patients with PC using voxel-based morphometry.

METHODS: A case-control study was conducted with 28 participants, including 14 chronic TMD pain patients with high PC and 14 age- and sex-matched healthy controls. T1-weighted magnetic resonance imaging (MRI) data were acquired using a 3-Tesla scanner and analyzed with Statistical Parametric Mapping 12 (SPM12). Whole-brain and Region-of-Interest (ROI) analyses were performed to assess GMV differences and associations between GMV with clinical variables.

RESULTS: Whole-brain analysis revealed no significant GMV differences between groups. However, ROIs analyses showed significantly smaller GMV in the bilateral hippocampus, left parahippocampal gyrus, and right putamen in the patient group. Additionally, GMV in the orbital part of the inferior frontal gyrus was negatively associated with pain duration.

CONCLUSION: This study suggests that central nervous system alterations are linked to chronic TMD pain condition with pain catastrophizing. These findings contribute to understanding the neurobiological basis of chronic musculoskeletal pain and highlight the need for further research into the role of cognitive-emotional factors in pain-related neural adaptations.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40457334 | DOI:10.1186/s12903-025-06243-4

BMC Nurs. 2025 Jun 2;24(1):627. doi: 10.1186/s12912-025-03252-0.

ABSTRACT

BACKGROUND: Self-management and empowerment are critical components in the treatment of diabetes, a chronic condition that has become an increasingly significant global health issue. While standard diabetes education is essential for effective disease management, personalized interventions aligned with the patient’s preferences are also necessary. One promising solution is the integration of coaching approaches into chronic disease management.

METHODS: This study was designed as a randomized controlled trial with a pretest-posttest design and three parallel arms: a Holistic Nurse Coaching group (n = 34), a Diabetes Education (n = 34) group, and a control group (n = 34). Data were collected through a Sociodemographic Data Collection Form, a Diabetes Data Collection Form, the Type 2 Diabetes Mellitus Self-Management Scale and the Diabetes Empowerment scale. The aim was to evaluate the effect of Holistic Nurse Coaching on glycemic control, diabetes self-management, and empowerment in individuals with type 2 diabetes. The Holistic Nurse Coaching group received nine individualized holistic nurse coaching sessions over a three-month period. The Diabetes Education group participated in nine group-based diabetes education sessions over the same period. The control group received no intervention. Mean comparison tests, correlation tests and multiple regression analysis techniques were employed in the statistical analysis. A 5% margin of error (p < 0.05) was adopted to determine statistical significance.

RESULTS: Following the holistic nurse coaching intervention, statistically significant improvements were observed in participants’ diabetes self-management, empowerment, and HbA1c levels (d = 3.752, d = 3.104, and d = 1.147, respectively; p < 0.001). A strong, positive, and statistically significant correlation was identified between posttest diabetes self-management and empowerment scores. Furthermore, the diabetes empowerment scores accounted for approximately 68.5% of the variance in diabetes self-management scores (p < 0.05).

CONCLUSIONS: Holistic nurse coaching was found to significantly enhance diabetes self-management and empowerment. These findings suggest that holistic nurse coaching may serve as an effective, person-centered intervention to support individuals with type 2 diabetes in managing their condition.

TRIAL REGISTRATION: The study was registered in ClinicalTrials NCT05545722. Retrospectively registered. 16/09/2022.

PMID:40457333 | DOI:10.1186/s12912-025-03252-0