Tag: nevin manimala

JMIR Res Protoc. 2025 Apr 4;14:e66350. doi: 10.2196/66350.

ABSTRACT

BACKGROUND: Intestinal protozoal infections caused by Entamoeba histolytica, Giardia lamblia, and Cryptosporidium parvum are prevalent in Malaysia. They cause severe diarrheal diseases with symptoms such as bloody stools, abdominal pain, stomach discomfort, and bloating. These infection outbreaks have been reported in diverse socioeconomic backgrounds and geographical regions usually during the rainy season or in areas with poor sanitation. Despite the importance of these infections, data on its overall prevalence, risk factors, and diagnostic methods remain limited.

OBJECTIVE: The aim of this study is to systematically review and synthesize evidence on the risk factors, prevalence, and detection methods for intestinal protozoal infections in Malaysia, offering insights that are applicable to other tropical and low-income regions.

METHODS: Studies on intestinal protozoal infections among Malaysian patients published after January 2010 up to November 2024 will be eligible for inclusion. The eligibility criteria include studies investigating infections caused by E. histolytica, G. lamblia, and C. parvum using validated diagnostic methods such as microscopy, molecular techniques, or immunoassays. Case reports, reviews, and studies without original data will be excluded. Comprehensive database searches will be conducted in PubMed/MEDLINE, Scopus, ProQuest, Web of Science, Google Scholar, and the Cochrane Library. The reference lists of selected papers are also checked. A standardized data extraction form will be used to record study characteristics, outcomes, and associated variables. Risk of bias will be assessed using the Joanna Briggs Institute tools and Newcastle-Ottawa Scale approach. Data synthesis will utilize a random effects model to estimate pooled prevalence and identify risk factors associated with these infections. Subgroup analyses will examine variations by geographic region and diagnostic method. Statistical heterogeneity will be assessed using I² statistic and meta-regression. Publication bias will be assessed using Egger and Begg funnel plot test. The results are reported in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

RESULTS: This systematic review was funded in June 2024. Database searches were started in July 2024, and we identified 1652 papers as of December 2024 for screening. Completion of study screening is anticipated by May 2025, with data extraction and analysis expected to conclude by December 2025.

CONCLUSIONS: Our study will address critical knowledge gaps in the epidemiology and risk factors of intestinal protozoal infections in Malaysia. Study limitations include potential bias in study selection, heterogeneity in diagnostic methods, and differences in the reporting quality of the included studies. Our findings will provide valuable insights into the prevalence of these infections, the associated risk factors, and the diagnostic techniques employed, which should strengthen public health measures, improve diagnostic procedures, and guide future research to reduce the prevalence of intestinal protozoal infections in Malaysia.

TRIAL REGISTRATION: PROSPERO (International Prospective Registry of Systematic Reviews) registration CRD42023456199; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023456199.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66350.

PMID:40184188 | DOI:10.2196/66350

J Med Internet Res. 2025 Apr 4;27:e68199. doi: 10.2196/68199.

ABSTRACT

BACKGROUND: The COVID-19 pandemic disrupted behavior within populations, affecting physical activity (PA), heart rate (HR), and sleep characteristics in particular. Activity trackers provide unique insights into these changes, enabling large-scale, real-time monitoring.

OBJECTIVE: This study aims to analyze the associations between the features of the COVID-19 pandemic worldwide and PA, HR, and sleep parameters, using data collected from activity trackers over a 3-year period.

METHODS: We performed a retrospective analysis using anonymized data collected from the 208,818 users of Withings Steel HR activity trackers, spanning 34 countries, over a 3-year period from January 2019 to March 2022. Key metrics analyzed included daily step counts, average heart rate, and sleep duration. The statistical methods used included descriptive analyses, time-trend analysis, and mixed models to evaluate the impact of restriction measures, controlling for potential confounders such as sex, age, and seasonal variations.

RESULTS: We detected a significant decrease in PA, with a 12.3% reduction in daily step count (from 5802 to 5082 steps/d) over the 3 years. The proportion of sedentary individuals increased from 38% (n=14,177) in 2019 to 52% (n=19,510) in 2020 and remained elevated at 51% (n=18,972) in 2022, while the proportion of active individuals dropped from 8% (n=2857) to 6% (n=2352) in 2020 before returning to 8% (n=2877) in 2022. In 2022, the global population had not returned to prepandemic PA levels, with a noticeable persistence of inactivity. During lockdowns, HR decreased by 1.5%, which was associated with lower activity levels. Sleep duration increased during restrictions, particularly in the countries with the most severe lockdowns (eg, an increase of 15 min in countries with stringent measures compared to 5 min in less restricted regions).

CONCLUSIONS: The sustained decrease in PA and its physiological consequences highlight the need for public health strategies to mitigate the long-term effects of the measures taken during the pandemic. Despite the gradual lifting of restrictions, PA levels have not fully recovered, with lasting implications for global health. If similar circumstances arise in the future, priority should be given to measures for effectively increasing PA to counter the increase in sedentary behavior, mitigate health risks, and prevent the rise of chronic diseases.

PMID:40184182 | DOI:10.2196/68199

Epileptic Disord. 2025 Apr 4. doi: 10.1002/epd2.70019. Online ahead of print.

ABSTRACT

OBJECTIVE: The current study aimed to clarify the representation of early postoperative seizures (EPSs) in different glioma subtypes under the 2021 WHO classification, explore the risk factors for EPSs in glioma patients, and investigate the clinical impact of EPSs on seizure and survival outcomes.

METHODS: Data from 78 patients were analyzed. The differences in clinical-pathological features between patients with EPSs and those without were compared using appropriate statistical methods. Multivariate binary logistic regression analysis was subsequently conducted to explore potential risk factors for EPSs. Finally, the Kaplan-Meier method was applied to analyze the correlation of EPSs with progression-free survival and overall survival.

RESULTS: Early postoperative seizures occurred in 17 patients (21.8%). The incidence of EPSs was highest in patients with oligodendroglioma, IDH-mutant, and 1p/19q-codeleted (25.7%), followed by astrocytoma, IDH-mutant (20.8%), and glioblastoma, IDH-wildtype (12.5%). An extent of resection (EOR) of less than 92.24% was identified as the only independent predictor for EPSs (Odds ratio 8.490, 95% confidence interval 1.873-38.488, p = .006) through multivariate regression analysis. In addition, EPSs showed no significant impact on late postoperative seizure occurrence and survival outcome.

SIGNIFICANCE: In glioma patients, EPSs are considered neurological disorders induced by surgery-related factors rather than a tumor-related mechanism. EPSs are more prone to occur in patients with an EOR of less than 92.24%, which can contribute to improving individualized glioma management.

PMID:40184162 | DOI:10.1002/epd2.70019

Vet Med Sci. 2025 May;11(3):e70334. doi: 10.1002/vms3.70334.

ABSTRACT

BACKGROUND: Caseins are the major proteins found in cow’s milk. There are four known casein fractions: α_S1-casein, α_S2-casein, β-casein and κ-casein, encoded by the CSN1S1, CSN1S2, CSN2 and CSN3 genes located on the sixth chromosome of cattle. These genes are considered candidate genes in marker-assisted selection. Therefore, it is essential to determine the relationship between these genes and quantitative characters.

OBJECTIVES: This study aimed to identify genotypes of CSN1S1, CSN1S2, CSN2 and CSN3 genes and investigate their effect on milk components with the PCR-RFLP method in Holstein cattle.

METHODS: The material of the study consisted of 519 Holstein cows that managed under intensive systems in Konya (n:189), Manisa (n:195) and Diyarbakır (n:135) provinces in Türkiye. Blood and milk samples from these cows were used in the study. The genetic structures of bovine CSN1S1, CSN1S2, CSN2 and CSN3 genes were examined by PCR-RFLP in three Holstein cattle populations. A general linear model (GLM) was applied to analyse the effect of genotypic variants on phenotypic characters.

RESULTS: Results indicated that milk solids-non-fat (SNF) (p < 0.01), protein (p < 0.05) and lactose (p < 0.01) percentages were significantly affected by the genetic variants of the CSN2 gene of cow in general population. CSN2 A2A2 genotype led to a significant increase in SNF, protein and lactose percentages by 0.14, 0.05 and 0.08 in comparison to other genotypes, respectively. Moreover, significant effect of the CSN1S1 BC (p < 0.05) and CSN3 AA (p < 0.01) genotypes on fat percentage were found in Konya province. Furthermore, a statistically significant genotype-by-environment interaction was identified in both the CSN1S1 (p < 0.05) and CSN3 (p < 0.01) genes in relation to milk fat content.

CONCLUSIONS: As a result, after increasing the number of studies that investigated the relationship between casein genes and milk traits and determined the genetic variation of CSN1S1, CSN2 and CSN3 genes of the Holstein cattle, these genes can be a strong genetic marker as marker-assisted selection programme in early selection.

PMID:40184159 | DOI:10.1002/vms3.70334

Medicine (Baltimore). 2025 Jan 3;104(1):e40981. doi: 10.1097/MD.0000000000040981.

ABSTRACT

The need for home healthcare (HHC) is increasing among people living with dementia (PLWD) to achieve their desire to age. This study aimed to investigate the determinants of hospitalization among PLWD receiving HHC. This retrospective cohort study used data from the National Health Insurance Research Database of Taiwan from 2007 to 2017. The primary outcome was subsequent hospitalization after HHC for PLWD. Using multivariate Poisson regression, baseline and follow-up HHC-related characteristics were examined as covariates and influencing factors. A total of 95,831 PLWD received HHC (mean age: 80.2 years), and 81.7% had at least one subsequent hospitalization during the follow-up period. Regarding baseline characteristics, prior admission was the strongest determinant of subsequent hospitalization, especially being admitted three to six months before HHC use (aRR = 1.47, 95% confidence interval [CI] 1.39-1.56, P < .001), followed by dementia duration from diagnosis to index date more than 3.5 years (aRR = 1.22, 95% CI 1.19-1.24). Among HHC-related characteristics, a higher frequency of HHC visits (more than 2 counts/month) (aRR = 4.81, 95% CI 4.63-5.00) and visits by both physicians and nurses (aRR = 2.03, 95% CI 1.98-2.07) were associated with a higher risk of hospitalization. Our findings suggest that prior admission, longer dementia duration from diagnosis to the index date, and frequency of HHC were positively associated with increased hospitalization. Future interventions and strategies can focus on these factors to decrease hospitalization among PLWD receiving HHC.

PMID:40184148 | DOI:10.1097/MD.0000000000040981

Medicine (Baltimore). 2025 Jan 3;104(1):e41104. doi: 10.1097/MD.0000000000041104.

ABSTRACT

BACKGROUND: The incidence of cesarean section (c-section) has been increasing after the introduction of national health coverage. There is potential evidence that unnecessary c-sections can be reduced through an effective financial strategy, which would make it possible to increase health equity in the future. Consistent with global trends, the rate of c-section in Indonesia increased from 1.6% in 1991 to 17.6% in 2017, while the World Health Organization standard rate is 10% to 15%. This study aims to explore and analyze strategies to reduce c-section rates and to report evidence-based research on an effective financial strategy model for reducing these rates.

METHODS: We used a systematic review framework involving electronic databases including PubMed, ProQuest, and ScienceDirect. The following literature search terms were used: “cost-benefit analysis,” “universal health care,” “cost controls,” “health expenditures,” “out-of-pocket expenses,” “c-section,” and “abdominal delivery.” The Joanna Briggs Institute critical appraisal checklist was used to independently assess the methodological quality. The findings were compiled using a meta-aggregation approach to summarize quantitative analysis results potentially based on different methodologies.

RESULTS: Among 883 database records, 26 studies were retained for full-text review. C-section risk factors, the role of financial system evaluation, and the application of the clinical audit cycles with assessments using Robson classification were discussed in the included papers. Several studies highlighted the crucial function of evaluating reward reimbursement schemes, suggesting that decreased c-section rates and other maternal-neonatal outcomes should be used as indicators.

DISCUSSION: This study identified an evidence base that suggests using Robson classification in clinical audit cycles to reduce c-section rates and avoid unnecessary c-sections. The other proposals for decreasing the rate were mainly focused on financial and nonfinancial strategies applied nationally and locally in hospital settings.

PMID:40184147 | DOI:10.1097/MD.0000000000041104

Medicine (Baltimore). 2025 Jan 3;104(1):e41091. doi: 10.1097/MD.0000000000041091.

ABSTRACT

We collected data on imported dengue cases between 2011 and 2020 from Taiwan’s Centers for Disease Control to determine changes in the case number and importation rate of dengue. We used open data provided by Taiwan’s Centers for Disease Control to extract the number of confirmed imported cases of dengue between 2011 and 2020. From 2011 to 2020, 2883 imported cases of dengue were reported in Taiwan. The importation rate was 25.8 to 46.4 per 100,000 inbound travelers from 2011 to 2020, peaking in 2020. Disease incidence varied between sexes, age groups, seasons (P < .001), and residence from 2011 to 2020. Numerous dengue cases were imported from Indonesia (548 cases), Vietnam (516 cases), and the Philippines (500). For travelers from Taiwan, the risk ratio of becoming infected by dengue was 31,712 for traveling to the Maldives, 3153 to Cambodia, and 996 to Myanmar. In this study, more serotype 1 and 2 strains were reported by Vietnam, and more serotype 3 and 4 strains were reported by Indonesia. Our data indicate that the rate of imported cases of dengue significantly increased annually from 2011 to 2020 in Taiwan, especially during the COVID-19 pandemic (46.4 per 100,000 inbound travelers).

PMID:40184127 | DOI:10.1097/MD.0000000000041091

Medicine (Baltimore). 2025 Jan 3;104(1):e41116. doi: 10.1097/MD.0000000000041116.

ABSTRACT

The study aims to compare the efficacy of flexible ureteroscopy (FURS) with holmium laser lithotripsy (HLL, herein collectively referred to as FURS-HLL) and percutaneous nephrolithotomy (PCNL) in the treatment of complex upper urinary tract calculi in elderly patients, highlighting the advantages of FURS-HLL. A total of 40 elderly patients (aged ≥ 60) with complex upper urinary tract calculi admitted to the Department of Urology, Fuyong People’s Hospital from October 2020 to October 2023 were randomly divided into 2 groups on the basis of the treatment they received: the FURS-HLL group (preset ureteral stent) and the PCNL group. The operation time, intraoperative blood loss, hospital stay, stone-free rate, and postoperative complications (fever, hematuria, infection, and severe urinary tract injury) were compared and analyzed between the 2 groups. There were no statistically significant differences in the average age, sex, stone diameter, stone type, and underlying diseases between the 2 groups (P > .05). The FURS-HLL group had significantly less intraoperative blood loss, shorter hospital stays, and longer operation time than the PCNL group (P < .05). The postoperative infection rate and the 1-week stone-free rate were lower in the FURS-HLL group than in the PCNL group (P < .05). However, there were no statistically significant between-group differences in postoperative fever, hematuria, urinary tract injury, 1-month stone-free rate, and the rate of secondary surgery (P > .05). FURS-HLL can significantly improve the stone-free rate and reduce postoperative complications, making it an ideal surgical approach for elderly patients with complex upper urinary tract calculi.

PMID:40184126 | DOI:10.1097/MD.0000000000041116

Medicine (Baltimore). 2025 Jan 3;104(1):e41204. doi: 10.1097/MD.0000000000041204.

ABSTRACT

RATIONALE: Conservative treatment has shown limited effectiveness in managing thoracolumbar tuberculosis (TB) that extends to the intervertebral space, as antibiotics are unable to penetrate avascular intervertebral discs, while conventional surgery is known for its extensive trauma and slow healing process.

PATIENT CONCERNS: Infection of the thoracic and lumbar vertebrae with tuberculosis can lead to difficulties in treatment due to involvement of the intervertebral space.

DIAGNOSIS: The diagnosis of TB was confirmed through clinical manifestations, impact studies, and T-spot experiments.

INTERVENTIONS: A retrospective analysis was conducted on the clinical data of 8 patients with thoracolumbar spinal TB who underwent postural drainage focusing on the intervertebral space as a treatment from June 2012 to August 2019. The average duration of treatment was 7.75 ± 10.19 months. Among the patients, there were 2 cases of thoracolumbar and 6 cases of lumbar spine involvement, with 6 cases affecting a single segment and 2 cases involving 2 segments. The total number of affected vertebrae included 4 thoracic, 12 lumbar, and 2 sacral vertebrae. All patients received standardized quadruple antituberculosis treatment (HRZE scheme). Specific postural drainage paths and catheter placement locations were determined based on clinical imaging results, and percutaneous catheter placement was performed with the assistance of foraminoscopy. Erythrocyte sedimentation rate, C-reactive protein, Visual Analogue Scale score, American Spinal Cord Injury Association score, and Oswestry function index were statistically analyzed before, after postural drainage, and at the final follow-up.

OUTCOMES: The average operation time was 44.38 ± 10.50 minutes, with a blood loss of 6.88 ± 2.59 mL. The average catheter drainage time was 13.25 ± 4.95 days, and the follow-up period ranged from 36 to 122 months. The average total drainage volume was 281.25 ± 167.69 mL. Significant improvements were observed in erythrocyte sedimentation rate, C-reactive protein, Visual Analogue Scale score, American Spinal Cord Injury Association score, and Oswestry functional index at 7 days after postural drainage and at the last follow-up compared to before postural drainage (P < .05). At the last follow-up, there were 8 cases with no recurrence reported among the patients.

LESSONS: The utilization of positional drainage in the intervertebral space, coupled with chemotherapy, has demonstrated encouraging clinical results and may be deemed appropriate for treatment.

PMID:40184121 | DOI:10.1097/MD.0000000000041204

Medicine (Baltimore). 2025 Jan 3;104(1):e41185. doi: 10.1097/MD.0000000000041185.

ABSTRACT

Medical students represent the future of the healthcare workforce. However, the demanding nature of medical education places them at an increased risk of mental health issues. Ensuring their mental well-being is crucial for maintaining a competent and compassionate healthcare system. This study aims to determine the prevalence of depression, anxiety, and stress, along with barriers to accessing mental health services among medical students. A cross-sectional self-administered online survey conducted among medical students of Jazan University, Saudi Arabia, from September 2023 to March 2024. Descriptive and inferential statistical analyses were conducted using International Business Machines Corporation Statistical Package for the Social Sciences version 27.0.1 (Chicago). The study included 390 participants. Median scores for depression, anxiety, and stress were 14.00, 12.00, and 16.00, respectively, with interquartile ranges of 4.00 to 22.00, 4.00 to 20.00, and 6.00 to 24.00. Depression severity categories showed that 38.2% were normal, while 11.5%, 31.8%, 13.6%, and 4.9% experienced mild, moderate, severe, and extremely severe symptoms, respectively. Anxiety severity classifications revealed 37.4% as normal, with 6.2%, 17.4%, 10.0%, and 29.0% falling into mild, moderate, severe, and extremely severe categories, respectively. For stress, 49.2% were normal, while 11.0%, 16.7%, 14.1%, and 9.0% experienced mild, moderate, severe, and extremely severe levels, respectively. Barriers to accessing mental health care included a preference for self-management, confidentiality concerns, societal judgment, and fears of career-related repercussions. This study highlights a high prevalence of depression, anxiety, and stress among medical students at Jazan University, with notable gender differences and symptom severity. Addressing barriers to mental health care, such as confidentiality concerns and societal stigma, is essential to improving service utilization and student well-being.

PMID:40184119 | DOI:10.1097/MD.0000000000041185