Tag: nevin manimala

West Afr J Med. 2025 Feb 28;42(2):114-120.

ABSTRACT

BACKGROUND: Effective pain relief after caesarean section (CS) is desirable but pentazocine which has been a common component of multimodal analgesia may delay early mobilization and mother-child interaction due to its side effects.

OBJECTIVE: This study compared the efficacy of paracetamol-diclofenac with pentazocine-diclofenac for post- CS analgesia.

METHODS: A double-blind randomized controlled trial of three hundred and eighteen consenting parturients who had elective or emergency caesarean section were randomly assigned to two groups. A total of 159 participants were assigned to each group: one group received 750 mg of intravenous paracetamol, while the other received 30 mg of intravenous pentazocine. Both also had 100 mg of rectal suppository diclofenac as multimodal post-caesarean section analgesia in the first 24 hours after surgery. Post-operative pain was assessed by a visual analogue scale six hourly post-operatively. Data obtained was analysed using SPSS 26 and statistical significance was at p < 0.05. The study is registered with the Pan African Clinical Trials Registry with trial number PACTR202501703002153.

RESULTS: The median pain scores in both groups ranged from 2.5 to 4 across all periods of assessment. However, at the first assessment conducted at six hours post-operatively, the scores were higher-4.5 in the pentazocine-diclofenac arm and 5 in the paracetamol-diclofenac arm. Pain relief was slightly better in the pentazocine-diclofenac group, but this was not statistically significant. The pentazocine-diclofenac group experienced significantly more side effects, specifically nausea and drowsiness, compared to the paracetamol-diclofenac group (P < 0.001). Patient satisfaction with pain relief was not significantly different between both groups (p=0.101).

CONCLUSION: Pentazocine-Diclofenac provided better analgesia than Paracetamol-Diclofenac in the first 24 hours after caesarean section but was associated with more side effects.

PMID:40618387

West Afr J Med. 2025 Feb 28;42(2):90-96.

ABSTRACT

BACKGROUND AND OBJECTIVES: Work-related stress has been described as a global epidemic of the 21st century. University lecturers are observed to be exposed to various degrees of occupational stress which influence their multiple roles to impart knowledge and skills to students. This study assessed the prevalence of work-related stress and the factors influencing it among university lecturers in Lagos.

METHODS: A cross-sectional study design among 424 respondents using a multi-stage sampling technique was conducted. Work Stress Questionnaire (WSQ) tool, covering 4 main domains, (Influence at work, Indistinct organization and conflict, Individual demand and commitment, & Leisure time interference) was used to assess work-related stress among university lecturers in LASU, Ojo, Nigeria. Data was collected with KoboCollect app using an interviewer-administered questionnaire, and analyzed using SPSS software version 25 software. Data was presented using descriptive (percentages, summary measures) and inferential statistics (Chi-square test). Level of statistical significance set at p-value<0.05.

RESULTS: Mean age of respondents was 49.9+8.2SD years. Male respondents were twice as more than female respondents. Majority (93.4%) of respondents were married and average work experience was 16.7+8.6SD years. Overall prevalence of work-related stress was (80.5%). However, stress due to leisure time interference was (36.1%). There was a statistically significant association between work-related stress and family size(p<0.05), gender(p<0.05), marital status(p<0.05) and work experience(p<0.05).

CONCLUSION: The prevalence of work-related stress was high. High family size, male gender, being single and shorter work experience, were statistically significantly associated with work-related stress. Adequate awareness of work-life balance measures should be entrenched with enabling environment.

PMID:40618379

West Afr J Med. 2025 Feb 28;42(2):83-89.

ABSTRACT

INTRODUCTION AND OBJECTIVES: Erectile dysfunction (ED) is common among men over 40years and prevalence increases with age. ED occurs at an earlier age in the diabetic population and strongly associated with serum testosterone, age, hypertension and obesity. The aim of this study was to determine the predictors of ED among type 2 diabetic Nigerian men.

MATERIALS AND METHODS: A cross-sectional hospital-based study done among patients with ED and diabetes. ED was assessed using International Index of Erectile Function (IIEF) 5 questionnaire. Age, BMI serum testosterone, glycosylated haemoglobin and fasting lipid profile were measured in each group.

RESULTS: A total of 102 participants were recruited; 51 participants in each study group. Majority, were >55 years in the diabetic and non-diabetic groups respectively (p = 0.456). The BMI and the waist circumference of the two groups showed statistically significant difference (0.006 and 0.007 respectively). The weight, hip circumference and waist/hip ratio of the two groups showed no statistical significance. The median value of serum testosterone for the non-diabetic group (622.2ng/ml) was significantly higher than the diabetic group (288ng/ml) (p=0.001). Multivariate logistic regression analysis showed increased risk of ED in diabetic patients aged > 60years ( OR 4.9), serum testosterone <270ng/ml (OR 3.8), hypertension (OR 2.93), fasting blood glucose (FBS) >125mg/dl (OR 2.6), low density lipoprotein (LDL) > 160mg/dl (OR 6.3) and triglyceride >150mg/dl (OR 2.9).

CONCLUSION: The study showed that age, serum testosterone, hypertension, elevated FBS and dyslipidaemia are independent predictors of ED among type 2 diabetic men.

PMID:40618378

Trop Biomed. 2025 Jun 1;42(2):85-89. doi: 10.47665/tb.42.2.001.

ABSTRACT

Soil-transmitted helminths (STH) are among the most common parasitic infections associated with neglected tropical diseases (NTDs), particularly in regions with poor sanitation and hygiene. The prevalence of STH is disproportionately high in middle- to low-income countries due to inadequate infrastructure and hygiene practices. This study aimed to identify risk factors associated with STH infections among native communities in the rural Simalungun District, North Sumatra, Indonesia. A cross-sectional study was conducted among 592 native Simalungun Bataknese individuals living and working in 14 villages across the district. Participants were interviewed regarding sanitation, hygiene practices, and demographic factors, while fecal samples were collected for parasitological examination using the direct smear and Kato-Katz methods. All laboratory analyses were conducted at the Parasitology Laboratory, Faculty of Medicine, Universitas Sumatera Utara, and interpreted by a parasitologist. Statistical analysis was performed using chi-square tests and multivariate logistic regression to identify significant risk factors for STH infection. The overall STH prevalence was 14.5% (86/592 participants), with identified species including Trichuris trichiura (33.7%), hookworm (31.4%), Ascaris lumbricoides (11.6%), and mixed infections (23.3%). Multivariate analysis revealed two significant risk factors for STH infection: consumption of uncooked drinking water (AOR 2.05, 95% CI 1.10-3.81, p=0.000) and not using a toilet with a septic tank (AOR 2.38, 95% CI 1.46-3.87). These findings highlight the critical role of sanitation and water safety in reducing STH transmission. Improving access to safe drinking water and proper sanitation facilities is essential for controlling STH infections in rural communities.

PMID:40618354 | DOI:10.47665/tb.42.2.001

J Robot Surg. 2025 Jul 6;19(1):353. doi: 10.1007/s11701-025-02528-6.

ABSTRACT

To compare the therapeutic efficacy of conventional laparoscopic pyeloplasty (LP) and robot-assisted single-port laparoscopic pyeloplasty (RSLP) for ureteropelvic junction obstruction (UPJO) in infants and to summarize the preliminary experience and advantage of RSLP. The clinical data of UPJO infants (≤ 12 months) who received LP and RSLP in our center from October 2018 to October 2024 were analyzed retrospectively. A total of 51 patients with UPJO were included, with 11 cases receiving RSLP (8 with left UPJO; 3 with right UPJO) and 40 receiving LP (29 with left UPJO; 11 with right UPJO). In the RSLP group, the median age was 3 months (range: 1-9 months). In the LP group, the median age was 2.5 months (range: 1-11 months). The mean operative time was 217.45 ± 20.77 min for the RSLP group and 258.57 ± 52.56 min for the LP group. The mean time of ureteropelvic anastomosis in the RSLP group was shorter than that in the LP group (79.36 ± 17.74 vs. 99.35 ± 21.03). The mean hospital stay was 6.27 ± 2.53 days for the RSLP group and 6.32 ± 2.71 days for the LP group. The mean postoperative hospital stay was 1.9 ± 0.94 days for the RSLP group and 2.67 ± 2.37 days for the LP group. The mean hospital costs were 57,950.63 ± 1,165.68 yuan for the RSLP group and 30,396.30 ± 5214.06 yuan for the LP group. Significant improvements in the hydronephrosis grading, anterior-posterior renal pelvic diameters, and renal parenchymal thickness were observed in both groups after surgery. RSLP is a safe and effective method for the treatment of UPJO in infants. Compared with LP, RSLP has the advantages of precise suturing, short anastomosis time, and short operation duration, making it an attractive and safe option. However, it faces the disadvantages of higher cost of hospitalization.

PMID:40618311 | DOI:10.1007/s11701-025-02528-6

Calcif Tissue Int. 2025 Jul 6;116(1):94. doi: 10.1007/s00223-025-01404-7.

ABSTRACT

The present study aimed to determine the influence of different degrees of energy restriction (ER) on the bones in young female rats. Forty female Sprague-Dawley rats (n = 40; age, 6 weeks) were randomly divided into the following five experimental groups after a 1-week acclimatization period: 0% ER, 10% ER, 20% ER, 30% ER, and 40% ER groups. The experimental period was 10.5 weeks. Statistical analysis was conducted using one-way analysis of variance, Tukey’s post hoc comparison tests, and simple linear regression analysis. The body weight and fat weight showed significantly lower values above 20% ER. The bone mineral content and bone mineral density of the tibia in the 30% ER group were significantly lower than those in the 10% and 20% ER groups, and those in the 40% ER group was significantly lower than those in the 0%, 10%, and 20% ER groups. The trabecular thickness, cortical bone volume, and cortical total volume in the 40% ER group were significantly lower than those in the 0% ER group. The serum levels of parathyroid hormone, bone-specific alkaline phosphatase, and tartrate-resistant acid phosphatase significantly increased with increasing degree of ER. However, the serum levels of leptin, carboxylated osteocalcin, and carboxylated osteocalcin / uncarboxylated osteocalcin significantly decreased with increasing degree of ER. Our findings showed that 30% or 40% ER resulted in lower bone mass and 40% ER impaired bone microstructure in young female rats. However, 10% or 20% ER did not affect these parameters.

PMID:40618303 | DOI:10.1007/s00223-025-01404-7

Dig Dis Sci. 2025 Jul 6. doi: 10.1007/s10620-025-09181-x. Online ahead of print.

ABSTRACT

PURPOSE: Intestinal ultrasound (IUS) is increasingly being used to evaluate induction efficacy in both clinical practice and clinical trials. We aimed to quantify the rates of induction IUS transmural (TM) remission and response across advanced therapies (AT) in Crohn’s disease (CD).

METHODS: Single-center retrospective review of patients with CD initiating AT with IUS pre- and post-induction. Primary outcome was induction TM segmental response (> 25% decrease in bowel wall thickness (BWT), absolute BWT decrease > 2 mm, or absolute BWT decrease > 1 mm with ≥ 1-point improvement in Modified Limberg Score (MLS) for bowel wall hyperemia of 0-3). Secondary outcomes were segmental and complete (all segments) TM remission (BWT ≤ 3.0 mm and MLS 0). Descriptive statistics summarized data (median [IQR]): univariate and multivariate tested associations.

RESULTS: 101 patients (53% female, age 17.4 years [15.0-21.1]); disease duration 0.80 years [0.17-3.96]. IUS performed 78 [56-102] days on AT (44% anti-TNF, 53% AT naïve). Segmental TM induction response and remission across all AT were 63% and 36%, respectively. Complete TM remission was 35% and was independently associated with infliximab (aOR 12.9 [2.1-79.8]), upadacitinib (aOR 10.4[1.4-75.4]), as well baseline MLS 3 (aOR 0.20[0.049-0.79]) and loss of bowel wall stratification on baseline IUS (aOR 0.21[0.056-0.77]).

CONCLUSIONS: Transmural induction outcomes are achievable across multiple advanced therapies, with 2/3 of patients achieving a response and 1/3 of patients achieving complete remission. These data, combined with the high correlation between IUS and endoscopy, suggest that IUS response could be considered as a clinical trial endpoint.

PMID:40618289 | DOI:10.1007/s10620-025-09181-x

Clin Cardiol. 2025 Jul;48(7):e70173. doi: 10.1002/clc.70173.

ABSTRACT

BACKGROUND: Educational attainment and economic status are important socioeconomic characteristics and are associated with metabolic diseases and premature death risk. However, their relative importance and contributions to premature death remain unclear.

METHODS: Data were collected from ten survey waves of the National Health and Nutrition Examination Survey from 1999 to 2018. Deaths before age 75 from all-cause and cause-specific mortality were ascertained from linkage to the National Death Index with follow-up through 2019. Weighted Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CI) for death by educational attainment and income level. Population-attributable fractions (PAFs) were calculated to quantify the proportional contributions of low income and low educational attainment to mortality.

RESULTS: Over an average of 10.1 years of follow-up, 4310 premature deaths were confirmed from 43 637 participants. Low income and low educational attainment were associated with increased risks of all-cause and cause-specific mortality, respectively. The associations between low educational attainment and mortality risk disappeared after mutual adjusting for income and education. However, among those with high school education or above, the adjusted HRs of middle income and low income were 1.81 (95% CI, 1.48-2.21) and 2.88 (95% CI, 2.31-3.59) for all-cause mortality. The PAF showed that low educational attainment did not contribute to mortality, while 33.0% of premature deaths were attributable to low income.

CONCLUSIONS: Income had a greater impact on mortality risk than education. The disparities in mortality risk could be reduced by narrowing the income differentials.

PMID:40618234 | DOI:10.1002/clc.70173

Womens Health (Lond). 2025 Jan-Dec;21:17455057251351410. doi: 10.1177/17455057251351410. Epub 2025 Jul 6.

ABSTRACT

BACKGROUND: Intimate partner violence (IPV) is the most prevalent form of violence against women globally and is linked to depressive symptoms and other mental health disorders. Socioeconomic status is associated with both IPV and depressive symptoms, yet few studies have explored household wealth as a potential modifier of this relationship.

OBJECTIVES: To analyze the association between IPV and depressive symptoms according to household wealth levels among Peruvian women in 2023.

DESIGN: Cross-sectional study.

METHODS: A secondary analysis of the 2023 Demographic and Family Health Survey (ENDES) in Peru was conducted, including 10,161 women of reproductive age in the final analysis. The exposure variable was IPV, and the outcome variable was depressive symptoms. Household wealth levels were classified into quintiles ranging from Q1 (poorest) to Q5 (wealthiest). A multivariate regression analysis was performed.

RESULTS: The association between IPV and depressive symptoms decreased as household wealth increased: poorest (adjusted prevalence ratio (aPR): 2.42, 95% confidence interval (CI): 2.07-2.83), poor (aPR: 2.02, 95% CI: 1.64-2.5), and middle-income (aPR: 1.89, 95% CI: 1.47-2.43); however, no associations were found in wealthy households (aPR: 1.37, 95% CI: 0.96-1.94). In the wealthiest households, the association between IPV and depressive symptoms was significant again (aPR: 2.71, 95% CI: 1.69-4.34). Emotional and physical violence showed similar trends in relation to household wealth levels. In wealthy households, no type of IPV (emotional, sexual, or physical) was associated with depressive symptoms.

CONCLUSION: We found that the association between IPV and depressive symptoms is unequal and not present at all household wealth levels in Peru. A moderate level of wealth may weaken the association between IPV and depressive symptoms among Peruvian women of reproductive age. Moreover, in the wealthiest households, the association is even stronger than in poorer households, which has implications for the implementation of universal and inclusive public policies that address women and families across all socioeconomic sectors.

PMID:40618231 | DOI:10.1177/17455057251351410

Ann Pharmacother. 2025 Jul 6:10600280251355619. doi: 10.1177/10600280251355619. Online ahead of print.

ABSTRACT

BACKGROUND: In patients with septic shock, intravenous (IV) hydrocortisone is recommended when there is an ongoing vasopressor requirement. Guidelines recommend IV hydrocortisone 200 mg/day administered as a continuous infusion or 50 mg every 6 hours. To prevent waste during a hydrocortisone shortage and reduce cost, our institution implemented a dosing regimen of 100 mg every 12 hours.

OBJECTIVES: The primary objective of this study was to compare the impact of hydrocortisone 100 mg IV every 12 hours vs 50 mg IV every 6 hours on clinical outcomes in patients with septic shock.

METHODS: This was a retrospective, multicenter study that evaluated patients admitted from April 2022 to September 2023 to a Greater Charlotte Atrium Health facility. Adult patients diagnosed via the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) codes with sepsis, severe sepsis, or septic shock receiving ≥15 mcg/min of norepinephrine equivalents requiring ≥ 24 hours of hydrocortisone were included. The primary outcome was time to shock reversal. Secondary outcomes included in-hospital mortality, hospital and intensive care unit (ICU) length of stay, and hyperglycemia.

RESULTS: Of 446 screened patients, 111 were included. Median Sequential Organ Failure Assessment scores and Charlson Comorbidity Index were similar among groups. The median time to shock reversal was 56 [34-81] hours in the every 12 hours group compared to 65 [39-101] hours in the every 6 hours group (P = 0.21). In-hospital mortality was comparable between the every 6 hours group and the every 12 hours group (51.9% vs 45.6%, P = 0.51). There was no difference in hospital or ICU length of stay nor in incidence of hyperglycemic episodes between groups.

CONCLUSION AND RELEVANCE: There was no difference in the primary outcome of time to shock reversal or any secondary outcome between hydrocortisone groups. This alternative hydrocortisone dosing strategy may warrant further evaluation in large, prospective studies.

PMID:40618220 | DOI:10.1177/10600280251355619