Tag: nevin manimala

Turk Gogus Kalp Damar Cerrahisi Derg. 2026 Feb 17. doi: 10.4274/tjtcs.2026.28320. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to determine the relationship between near-infrared spectroscopy (NIRS) changes and shunt use, and the role of wakefulness in detecting early neurological events during carotid endarterectomy (CEA) surgeries performed under local anesthesia (LA) while the patient was awake.

METHODS: Patients who underwent CEA under LA were included in the study. All data were obtained retrospectively from patient files in our institution’s archives. Shunt use, decreases in NIRS values, internal carotid artery (ICA) closure technique, and clamping time were recorded during the procedure. Patients were divided into two groups: Those with and those without contralateral total occlusion (CTO). These groups were compared in terms of decrease rates in NIRS values and shunt use.

RESULTS: Present study included 635 patients (68% male, mean age: 66.7±5.6 years). One hundred thirty-four (21.1%) of the patients had bilateral ICA stenosis of 70% or greater. The patients were divided into two groups: With and without CTO. CTO was detected in 97 (15.3%) patients. In all groups, shunts were applied to patients with a 30% or more decrease in NIRS values. In the CTO group, percentage decreases in NIRS values were greater and statistically significant (p<0.001), except for decreases below 10% (p<0.001). Shunt usage in the CTO group was found to be statistically significant (p=0.042). However, shunt use was associated with a decrease in NIRS rather than the presence of CTO (r=0.747, p<0.001). The most common complications in the postoperative period were voice disorder and hoarseness at a rate of 20.8%.

CONCLUSION: With carotid surgery performed under LA, significant neurological deficits were detected early and necessary revisions were performed. We also found that a decrease in NIRS values is significant for shunt use, and a decrease of more than 30% in NIRS could be note worthy for shunt use.

PMID:41700460 | DOI:10.4274/tjtcs.2026.28320

Am J Hosp Palliat Care. 2026 Feb 17:10499091261427444. doi: 10.1177/10499091261427444. Online ahead of print.

ABSTRACT

BackgroundIn palliative care, drug delivery methods must be simple, rapid and acceptable especially in homecare settings to relatives as non-professional caregivers. This study compared intranasal (IN) and subcutaneous (SC) administration performed by medical laypersons under standardized conditions.Methods31 volunteers without medical training participated in a non-randomised crossover study. After receiving instructions, participants performed both SC and IN administration in a simulated environment using placebo medication. Primary endpoints were preparation and administration time. Secondary endpoints included perceived ease, comfort, safety and handling difficulties. Data were collected using structured questionnaires. Statistical analyses used paired t-tests and binomial testing.ResultsAll participants (27 female, median age range 50-60 years) completed both procedures. Mean administration time: 4:49 minutes (SD 1:20) for SC, 1:16 minutes (SD 0:20) for IN (p < .001, d = 2.97). >90% preferred IN and rated it as easier (30/31, 97%), more comfortable (30/31, 97%), faster (30/31, 97%) and safer (21/31, 68%). SC was consistently rated more complex (30/31, 97%) and cumbersome (30/31, 97%). Handling errors were more frequent with SC application. Nearly half of participants (15/31) had prior SC experience, while all had personal experience with nasal sprays, though not in administering them to another adult. Participants emphasized the importance of training for safe and accurate administration.ConclusionMedical laypersons strongly preferred IN over SC administration. IN was significantly faster, more acceptable and associated with fewer handling problems. These findings support IN administration as a practical and caregiver-friendly alternative in palliative care.Clinical Trial NumberNot applicable.Trial Identification173-02, protocol Version 02, 03.11.2022.

PMID:41700441 | DOI:10.1177/10499091261427444

Public Health Res (Southampt). 2026 Feb;14(2):1-22. doi: 10.3310/AKHD0407.

ABSTRACT

BACKGROUND: Childhood obesity is a major public health concern worldwide, yet the best way to prevent it remains unknown.

OBJECTIVE(S): To determine what types of intervention strategy are most effective at preventing the development of obesity in children aged 5-18 years, as measured by change in body mass index, and to determine whether interventions work differentially in children with different characteristics associated with inequities.

DESIGN: Systematic reviews and statistical evidence syntheses.

ELIGIBILITY CRITERIA: Randomised controlled trials of dietary and/or activity interventions that aimed to prevent overweight or obesity in children and young people aged 5-18 years and reported outcomes at least 12 weeks after baseline. Non-randomised evidence was identified through an overview of systematic reviews. Sources of inequity of interest were those defined by the PROGRESS (place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, social capital) acronym: place, race/ethnicity, occupation (of parents), gender/sex, religion, education (of parents), socioeconomic status and social capital.

DATA SOURCES: Updating of an existing Cochrane Review, searching bibliographic databases up to February 2023, including MEDLINE, EMBASE, PsycInfo® (American Psychological Association, Washington, DC, USA) and Cochrane Central Register of Controlled Trials on the Cochrane Library, international trial registers and grey literature databases, and examining reference lists. Results subgrouped by inequity factors were sought directly from trialists.

REVIEW METHODS: Cochrane Reviews followed standard Cochrane procedures. The main statistical synthesis was informed by a novel analytic framework developed iteratively through discussions with children and young people, schoolteachers and public health professionals. Methodology was developed to analyse the data using multilevel metaregression. To examine the impact of inequity factors, we performed a two-stage meta-analysis of interactions, based on subgroup-level aggregate data collected directly from the trialists. We collected available information on intervention costs.

RESULTS: We included 172 trials in ages 5-11 and 74 in ages 12-18. In the main synthesis, of 204 trials from both reviews, we found interventions were effective on average (mean difference in standardised body mass index -0.037, 95% credible interval -0.053 to -0.022, which would correspond to a reduction in a proportion of 2.3% with obesity to a proportion of approximately 2.1%). Larger effects were associated with physical activity rather than dietary interventions, after 12 months of follow-up and in the older age group. The overview of non-randomised evidence included 24 systematic reviews, yielding mixed results. The investigation of inequity did not identify substantial differences in effectiveness according to place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, social capital characteristics, and there was very limited information about costs.

LIMITATIONS: We were able to examine only the interventions that had been evaluated in studies identified for inclusion in the systematic reviews, which does not cover all possible intervention approaches.

CONCLUSIONS: Interventions to prevent obesity in children aged 5-18 have a small beneficial effect on body mass index on average but with considerable variation. A novel re-analysis of existing randomised trials failed to identify general intervention characteristics driving this variation. No evidence was identified to suggest that interventions increase (or decrease) health inequities.

FUTURE WORK: Future studies of the effects of interventions to prevent childhood obesity should routinely collect baseline characteristics around potential inequities.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131572.

PMID:41700427 | DOI:10.3310/AKHD0407

Glob Health Action. 2026 Dec;19(1):2628362. doi: 10.1080/16549716.2026.2628362. Epub 2026 Feb 17.

ABSTRACT

BACKGROUND: Ragging is an initiation ritual in Sri Lankan universities where senior students harass newcomers. This practice leads to severe consequences such as depression, increased dropouts, and suicide, yet research on this issue remains scarce.

OBJECTIVE: This thesis aimed to explore ragging through the perspectives of students and university affiliates and to assess the prevalence of Major Depressive Disorder (MDD) among students.

METHODS: Study I was a cross-sectional survey (n = 623) among second- and third-year students from the Faculties of Medicine and Technology to determine the prevalence of ragging and its health consequences. Study II utilized focus group discussions (n = 17) with students to explore the social dynamics and motivations of ragging. Study III included focus group discussions (n = 7) and interviews (n = 11) with university staff to understand their attitudes towards ragging. Study IV surveyed second-year students (n = 637) from three faculties using the Patient Health Questionnaire to assess the prevalence of MDD.

RESULTS: Study I found that 59% of students experienced ragging, 54% reported health consequences, and most sought help from friends and family. Ragging prevalence varied by faculty and year of study. Study II revealed that ragging was used to establish power and address social inequalities. Study III identified themes of normalization, fear of reprisal, and resistance among staff. Study IV showed that 31% of students experienced MDD. MDD prevalence was associated with students’ ethnicity.

CONCLUSION: Ragging is a pervasive issue with significant mental health consequences. Effective interventions require a multisectoral approach to create a safe and supportive university environment, enabling all students to thrive.

PMID:41700420 | DOI:10.1080/16549716.2026.2628362

Oral Dis. 2026 Feb 17. doi: 10.1111/odi.70252. Online ahead of print.

ABSTRACT

BACKGROUND: Oropharyngeal dysphagia is a common issue among community-dwelling older adults and is associated with adverse health outcomes. This study examined whether the number of remaining teeth mediates the association between age and oropharyngeal dysphagia (OD) risk.

METHODS: This cross-sectional study included 413 community-dwelling older adults (≥ 60 years) recruited from community health centers in Sulawesi, Indonesia. OD risk was assessed using a validated screening questionnaire. Oral examinations were conducted by trained nurses. Mediation analysis estimated the indirect, direct, and total effects of age on OD risk, adjusting for sex, educational level, hypertension, and diabetes mellitus.

RESULTS: Participants’ mean age was 69.9 years, with 15.3 remaining teeth. Mediation analysis revealed a significant indirect association between age and OD risk, mediated through the number of remaining teeth (adjusted β = 0.076, 95% CI: 0.034-0.114, p < 0.001). In contrast, the direct effect of age was not statistically significant. The total effect of age on OD risk remained significant.

CONCLUSION: The number of remaining teeth statistically mediated the association between age and OD risk. Although causal inference is limited by the cross-sectional design, these findings highlight oral health as a potentially modifiable factor for reducing OD risk among older adults.

PMID:41700387 | DOI:10.1111/odi.70252

Blood Coagul Fibrinolysis. 2026 Feb 17. doi: 10.1097/MBC.0000000000001418. Online ahead of print.

ABSTRACT

INTRODUCTION: The functional integrity of stored whole blood (WB) is critical for maintaining hemostatic potential during transfusion. While storage-related changes in coagulation components are known, comparative evaluation using viscoelastic and sonorheometric platforms remains limited. This in vitro study explores time-dependent changes in clotting dynamics during WB storage using rotational thromboelastometry (ROTEM) and sonic estimation of elasticity via resonance (SEER) sonorheometry (Quantra).

METHODS: WB from eight healthy donors was stored at 1-6 °C in citrate-phosphate-dextrose anticoagulant and sampled on Days 0, 1, 3, 7, 14, and 21. ROTEM parameters included INTEM/EXTEM/FIBTEM clotting time and amplitude; Quantra parameters included clotting time (CT), total clot stiffness (CS), platelet contribution (PCS), and fibrinogen contribution (FCS). Nonparametric statistics and effect sizes were used to assess temporal changes and agreement between platforms.

RESULTS: In this pilot in-vitro model (n = 8) we observed progressive prolongation of clotting time and reduction in clot stiffness were observed across both platforms, as early as 1-3 days into storage. PCS declined significantly, while FCS showed modest reductions. ROTEM and Quantra demonstrated strong correlations in matched parameters, with consistent fixed biases noted in Bland-Altman analysis and a proportional bias with fibrinogen between the two methods.

DISCUSSION: Our experimental in vitro study of stored WB exhibits steady, time-dependent hemostatic deterioration, particularly in platelet function and clot initiation. These in-vitro observations reveal early declines in platelet-driven clot stiffness in our model and are hypothesis-generating for further laboratory and clinical evaluation.

PMID:41700373 | DOI:10.1097/MBC.0000000000001418

Afr J Reprod Health. 2026 Feb 16;30(3):183-192. doi: 10.29063/ajrh2026/v30i3.15.

ABSTRACT

The study investigated the relationship between household income, malnutrition, and mortality in China based on longitudinal data collected at five-year intervals from 1995 to 2020. Accordingly, trends in adult female, adult male, and infant mortality were examined together with changes in household income and undernourishment prevalence. The results show a steady decline in mortality in every group, whereas malnutrition fell precipitously, especially after 2010. Household income was rather volatile but generally increased in later years, matching the decline in mortality. Graphical evidence suggests that there are inverse relationships between mortality and income, as well as between mortality and malnutrition. This is reflected in the correlation matrix, with all co-movements strong because of common downward trends over time. Overall, improved household welfare, enhanced nutritional status, and health system strengthening all seemed to contribute to the better health status of the population in China. Based on these results, the study recommends continued investment in nutrition programs, expanded social welfare measures to support household income, and further strengthening of maternal and child healthcare services to sustain progress in reducing mortality.

PMID:41700359 | DOI:10.29063/ajrh2026/v30i3.15

Afr J Reprod Health. 2026 Feb 16;30(3):170-182. doi: 10.29063/ajrh2026/v30i3.14.

ABSTRACT

Fertility patterns in Nigeria are strongly influenced by socioeconomic and cultural factors. This study examined the effects of income, educational attainment, occupational status, contraceptive use, and cultural beliefs on fertility behaviour among households in Enugu State. A descriptive cross-sectional design was employed, involving 422 adults selected through a multistage sampling technique from six purposively chosen communities. Data were collected using structured questionnaires and in-depth interviews. Quantitative data were analysed using descriptive statistics and chi-square tests in SPSS version 25, while qualitative data underwent thematic analysis.Findings revealed significant associations between low income and higher fertility (χ² = 54.87, p < 0.001), higher education and lower fertility (χ² = 41.32, p < 0.001), formal-sector employment and reduced fertility (χ² = 36.19, p < 0.001), and contraceptive use and smaller family size (χ² = 29.45, p < 0.001). Traditional sociocultural norms including male-child preference, perception of children as economic assets, and religious opposition to contraception were also significantly associated with higher fertility (χ² = 38.76, p < 0.001).These findings underscore the complex interplay of structural and cultural factors in shaping reproductive behaviour. Addressing fertility disparities in Enugu State requires integrated interventions that enhance economic opportunities, expand female education, and provide culturally sensitive reproductive health services.

PMID:41700358 | DOI:10.29063/ajrh2026/v30i3.14

Int J Adolesc Med Health. 2026 Feb 16. doi: 10.1515/ijamh-2025-0202. Online ahead of print.

ABSTRACT

OBJECTIVES: Suicide remains a significant public health concern among adolescents in Ghana, yet limited research exists on how young people conceptualize suicide within their cultural context. This study aimed to examine how Ghanian high school students conceptualize suicide in relation to religious, cultural, and legal frameworks that shape their understanding.

METHODS: This descriptive qualitative study was conducted as part of the 2024 Ghana Youth Mental Health Survey. Twenty junior high school students were purposively selected from rural, peri-urban, and urban schools across four major regions to ensure diverse representation. In-depth, semi-structured cognitive interviews were conducted in English. Data was analyzed using Braun and Clarke’s approach, with multiple coders contributing to thematic development and refinement.

RESULTS: Participants described suicide through four overlapping constructs: as a sin, taboo, mental health issue, and crime. Religious framings emphasized divine ownership of life, biblical teachings, and spiritual consequences. Cultural perspectives focused on shame, communal identity, and ancestral values. Others associated suicide with criminality and police involvement. Across interviews, students expressed coexisting views, drawing from diverse belief systems to explain suicide occurrence and treatment.

CONCLUSIONS: Ghanaian adolescents do not conceptualize suicide in singular terms. Their understandings are shaped by the interplay of religious, cultural, psychological, and institutional narratives. Suicide prevention must be grounded in these lived meanings and avoid one-size-fits-all approach. Preventive strategies should engage religious leaders, affirm community values, reduce mental health stigma, and provide safe spaces for adolescents to alleviate distress. Addressing the nuanced logics adolescents draw upon is essential to designing interventions that resonate with their realities.

PMID:41700340 | DOI:10.1515/ijamh-2025-0202