Tag: nevin manimala

Medicine (Baltimore). 2025 Mar 28;104(13):e41941. doi: 10.1097/MD.0000000000041941.

ABSTRACT

Vaccination against human papilloma virus (HPV) play a major role in preventing infection with HPV among heterosexual couples. The aim of this study was to assess public knowledge and attitude towards HPV vaccine in Saudi Arabia. This is an online cross-sectional survey study that was conducted between May and June 2023. This study utilized the convenience sampling technique to recruit the study participants. The study participants were invited to participate in this study through social media platforms (X, Facebook, and WhatsApp). Multiple logistic regression was performed to assess the factors associated with better knowledge level and the findings were presented as odds ratios (OR) with 95% confidence intervals (CI) and corresponding p-values. A total of 819 participants were included in the analysis. A total of 355 participants (43.3%) had a good knowledge score and 464 participants (56.7%) had poor knowledge. The total mean of knowledge score was (3.22 ± 2.44). As the table shown, single participants reported a significant higher knowledge score mean (3.59 ± 2.52) compared to married (2.84 ± 2.32) (P = .0001). Participants aged between 18 to 29 years reported a significant higher knowledge score mean (3.57 ± 2.52) compared to participants aged between 40 and 49 years (2.60 ± 2.21) (P = .0001). Participants who lived in Eastern area had significantly higher odds of knowledge compared to other areas (OR = 2.19, 95% CI = 1.45 – 3.33, P = .001). Participants who worked in medical field had significantly higher odds of having good knowledge compared to other jobs (OR = 3.65, 95% CI = 2.39-5.57, P = .0001). Participants who had 2 sexual partners have you had in the past 2 years had a significant higher odd of having good knowledge (OR = 2.05, 95% CI = 1.02-4.12, P = .04). This study identified that a considerable proportion of the study participants demonstrated poor level of knowledge of HPV vaccine. Participants who lived in Eastern area, those who worked in medical field, and those who had 2 sexual partners have you had in the past 2 years had a significant higher odd of having good knowledge. Future studies should be directed towards developing educational campaign to improve public awareness of HPV.

PMID:40153766 | DOI:10.1097/MD.0000000000041941

Medicine (Baltimore). 2025 Mar 28;104(13):e41950. doi: 10.1097/MD.0000000000041950.

ABSTRACT

Mandibular fractures are one of the most common maxillofacial bone fractures that can occur during many activities in daily life. The aim of this study was to provide data for practitioners and researchers about the variables and outcomes associated with mandibular fractures by examining the relationships between gender, age groups, trauma causes, side, type, and anatomic location of mandibular fractures and concomitant injuries. The demographic and clinical data of the patients were obtained from the hospital information management system of a university hospital. The hospital records for the 10-year period between 2014 and 2023 were examined retrospectively. The mandible fractures were classified according to type, side, and location and compared against gender, age group, and trauma cause. Evaluation was made of 142 patients with traumatic mandibular fracture, comprising 76.8% males and 23.2% females. Of these cases with mandible fracture, 82.4% were aged < 35 years, and 45.1% of the fractures occurred in road traffic accidents. The majority of mandibular fractures were caused by road traffic accidents in males and adults over the age of 18, whereas home, environmental, and leisure accidents were the major cause of mandibular fractures in females and persons under the age of 18. Compound fractures were determined in 59.2% of the cases, single fractures in 80.3%, and parasymphysis and symphysis fractures in 46.2%. The compound and parasymphysis/symphysis region fractures were more common in males, patients aged < 35 years, and those who had undergone any type of trauma. We consider the information obtained through this study could make significant contributions to the data bank for multicenter prospective in-depth epidemiological research in clinical and forensic sciences in the future.

PMID:40153762 | DOI:10.1097/MD.0000000000041950

Medicine (Baltimore). 2025 Mar 28;104(13):e41989. doi: 10.1097/MD.0000000000041989.

ABSTRACT

Chronic kidney disease (CKD) is a growing health concern worldwide. It is crucial to prevent CKD to mitigate its impact and enhance health results. Recognizing and managing the risk factors of chronic kidney disease at an early stage can aid in stopping its advancement. A cross-sectional study was carried out at a hospital from March 1 to April 30, 2023, involving 422 hypertensive patients. The participants were chosen using systematic random sampling. Data on socio-demographic and clinical factors, as well as knowledge and practices, were gathered through interviews, medical record reviews using structured questionnaires. Descriptive statistics were used to determine the frequency and percentage of variables. The data was entered into Epi-data version 4.6 and analyzed using SPSS version 23 (Chicago). Variables with P-values < .25 were considered for multivariable analysis, and those with P-values < .05 were deemed to be factors associated with knowledge and practices. The study found that 42.2% (178) of hypertensive patients had good knowledge about chronic kidney disease, and 43.6% (184) had good practices. Living in urban areas (with an adjusted odds ratio [AOR] of 3.94 at a 95% confidence interval [CI] of 2.42-6.42) and having a family history of kidney disease (AOR 5.59 at a 95% CI of 3.21-9.75) were factors associated with good knowledge. Being a government employee (AOR 7.29, at 95% CI 1.79-29.58) and maintaining a normal body mass index (AOR 8.03, at 95% CI 3.54-18.19) were linked to good practices. Less than half of the study participants had good knowledge and practices toward prevention of chronic kidney disease. Identifying factors that affect knowledge and practices towards the prevention of chronic kidney disease can offer healthcare providers, governmental and nongovernmental organizations (NGOs), and policymakers’ valuable insights for developing strategic interventions and education programs to promote better management of hypertension and CKD.

PMID:40153756 | DOI:10.1097/MD.0000000000041989

Medicine (Baltimore). 2025 Mar 28;104(13):e41970. doi: 10.1097/MD.0000000000041970.

ABSTRACT

This study aims to evaluate the prevalence and factors associated with high blood pressure in secondary school adolescents in the Bamenda municipality, the North West region of Cameroon. A community-based cross-sectional study was conducted over 5 months, involving 720 adolescents aged 10 to 19 years from 13 secondary schools, using a multi-stage sampling approach. Blood pressure was measured using both oscillometric and mercury sphygmomanometer devices. Weight, height, and body mass index (BMI) were also assessed. Participants with high blood pressure values at the first visit underwent repeat screening for over 3 weeks and hypertension defined according to American Academy of Pediatrics guidelines. Logistic regression analyzed factors associated with hypertension, considering P < .05 as statistically significant at 95% Confidence Interval. The prevalence of hypertension was 5% (4% for stage I and 1% for stage II) and that of elevated Blood Pressure was 4.3%. There was an increase in blood pressure with an increase in age. Systolic blood pressure and diastolic blood pressure were significantly positively correlated with BMI. There was a significant association between enrolled in private school (aOR = 0.32; P = .006) and obesity (aOR = 2.94; P = .017) with hypertension in these participants. This study provides valuable insights into the alarming prevalence of hypertension among secondary school adolescents in Bamenda, Cameroon. The identification of key risk factor, obesity, calls for comprehensive strategies to promote healthy lifestyle, regular screening and timely management of high blood pressure in this vulnerable population.

PMID:40153752 | DOI:10.1097/MD.0000000000041970

Medicine (Baltimore). 2025 Mar 28;104(13):e41974. doi: 10.1097/MD.0000000000041974.

ABSTRACT

This study explored connections between women’s reproductive factors and acute ST-segment elevation myocardial infarction (STEMI). A retrospective case-control study was conducted between 2016 and 2017. The study included 110 women diagnosed with STEMI and 110 control participants. Data on reproductive factors were collected through structured questionnaires and analyzed using statistical methods. Findings showed that increased STEMI risk was associated with longer lactation period, a higher number of parities, gravidity, and abortions. No significant relationships were observed for menopausal status, menopausal age, menarche age, reproductive duration, or oral contraceptive use. This study revealed that higher gravidity, parity, history of abortion, and longer breastfeeding duration were linked to an increased risk of STEMI. However, no significant differences were found between the case and control groups regarding menopausal status, age at menopause, age at menarche, reproductive duration, or oral contraceptive use.

PMID:40153750 | DOI:10.1097/MD.0000000000041974

Medicine (Baltimore). 2025 Mar 28;104(13):e41916. doi: 10.1097/MD.0000000000041916.

ABSTRACT

The aim of this study was to examine the relationship between psychological flexibility levels, sociotropy-autonomy personality traits and decision-making styles of individuals with substance use disorder. The study was cross-sectional and correlational. The Data were obtained by face-to-face interviews with 106 patients who were hospitalized in a regional psychiatric hospital Alcohol and Substance Addiction Treatment Center between the dates of June and August 2023 and who agreed to participate in the study after obtaining ethics committee approval. Descriptive information form, sociotropy-autonomy personality traits scale, psychological flexibility scale and Melbourne decision making scale I-II (MDMQ) were used to collect the data. Descriptive statistics and correlation analysis were used to examine the relationship between variables. The patients who participated in the study consisted of 97.2% male and the mean age was 35.30 ± 10.53 years. 31.1% of the individuals stated that they started to use substances in the environment of friends and 65.1% of them stated that they had attempted to quit before. It was observed that the patients had a moderate level of psychological flexibility (116.36 ± 16.49), showed autonomy personality traits (79.77 ± 23.0) and used a Vigilance decision-making style (8.54 + 3.08). A statistically significant negative correlation was found between the mean scores of the psychological flexibility scale and the mean scores of the “buck-passing” subscale of the MDMQ (r=-.303 P = .002). In addition, a statistically significant positive correlation was found between the mean score of the “Sociotropy” subscale of the PES and the mean scores of the Vigilance Decision Making subscale and Hypervigilance Decision Making subscale of the MDMQ (r=.233 P = .016; r=.223 P = .022). There is a relationship between personality traits, psychological flexibility levels and decision-making styles of patients with substance use disorders. While those with low psychological flexibility levels show “buck-passing” decision-making tendencies, those with sociotropy personality traits show “vigilance” and “hypervigilance” decision-making tendencies.

PMID:40153749 | DOI:10.1097/MD.0000000000041916

Dent Med Probl. 2025 Mar 28. doi: 10.17219/dmp/167467. Online ahead of print.

ABSTRACT

BACKGROUND: Chitosan prepared with acetic acid is commonly used as an endodontic irrigant. However, the chitosan solution prepared with distilled water has not been evaluated for endodontic usage.

OBJECTIVES: The present study aimed to compare the effects of ethylenediaminetetraacetic acid (EDTA), fumaric acid, and the chitosan solutions prepared with distilled water (C-DW) and acetic acid (C-AA) on dentin microhardness and dentinal tubule penetration.

MATERIAL AND METHODS: Eighty maxillary central incisors were endodontically instrumented and randomly divided into 2 main groups (n = 40) for the evaluation of dentin microhardness and tubular penetration, with 4 subgroups in each main group (n = 10) according to the final irrigation solutions used (EDTA, fumaric acid, C-DW, and C-AA). The C-AA solution was prepared by diluting medium-molecularweight chitosan in acetic acid. The C-DW solution was prepared with distilled water and chitosan ammonium salts, which were synthesized using trichloroacetic acid and low-molecular-weight chitosan. After irrigation, the roots were sectioned horizontally 2 mm (the apical third) and 5 mm (the middle third) from the apex. The microhardness measurements were taken at depths of 500 μm and 1,000 μm from the canal lumen. The sections were examined for tubular penetration using confocal laser scanning microscopy. The data was analyzed using the analysis of variance (ANOVA), with a significance level set at p < 0.05.

RESULTS: The microhardness values were statistically similar at either depth for each third (p > 0.05), except for the 1,000-μm depth in the apical third, where the use of the C-AA solution resulted in lower microhardness as compared to fumaric acid (p < 0.05). No significant differences were observed in tubular penetration with regard to each third (p > 0.05).

CONCLUSIONS: All solutions showed a similar penetration ability in each third. At the 1,000-μm depth in the apical third, the fumaric acid solution provided a higher microhardness value than the C-AA solution.

PMID:40152894 | DOI:10.17219/dmp/167467

JAMA Health Forum. 2025 Mar 7;6(3):e250159. doi: 10.1001/jamahealthforum.2025.0159.

ABSTRACT

IMPORTANCE: Recently, there has been an emergence of veteran Medicare Advantage affinity plans (VMAPs) marketing to veterans, including those dually covered by the Veterans Health Administration (VHA). To date, limited evidence exists characterizing what benefits VMAPs offer and their veteran enrollees.

OBJECTIVE: To examine plan-level differences between VMAPs and other Medicare Advantage (MA) plans and characteristics of their veteran enrollees.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study compared the plan benefit design, supplemental benefit offerings, and veteran enrollee characteristics of all VMAP and other MA plan enrollees in 2022 using standardized mean differences (SMDs). VMAPs were identified based on military-associated words in their plan name and further validated through a web-based search. Data were analyzed from April 2023 to August 2024.

EXPOSURE: VMAP designation.

MAIN OUTCOMES AND MEASURES: Plan-level characteristics, supplemental benefits, and veteran enrollee characteristics.

RESULTS: The sample included 188 VMAPs with 179 449 veteran enrollees and 3442 other MA plans with 954 581 veteran enrollees. A total of 1 088 938 (96.0%) were male, 3558 (0.3%) were American Indian or Alaska Native, 8845 (0.8%) were Asian or Pacific Islander, 162 934 (14.4%) were Black, 61 264 (5.4%) were Hispanic, and 876 234 (77.3%) were White; the mean (SD) age was 75.9 (8.6) years. Most VMAPs were administered by for-profit insurers (173 [92.0%]; SMD, 0.42), including Aetna (46 [24.9%]), Humana (36 [19.5%]), and United HealthCare (49 [26.5%]). Compared with veterans in other MA plans, veterans in VMAPs were slightly younger (mean [SD] age, 73.7 [8.0] years vs 76.3 [8.7] years; SMD, 0.31), more likely to be Black (34 837 [19.4%] vs 128 097 [13.4%]; SMD, 0.18), and more likely to have zero cost sharing for VHA services (ie, priority group 1) (62 056 [34.6%] vs 195 688 [20.5%]; SMD, 0.40). VMAPs were more likely than other MA plans to offer $0 plan premiums (186 [98.9%] vs 2064 [60.0%]; SMD, 1.10), and Medicare Part B premium reductions (140 [74.5%] vs 298 [8.7%]; SMD, 1.80), averaging $33 more in cash back benefits. Only 1 VMAP offered Medicare Part D coverage compared with most other MA plans (1 [0.5%] vs 3293 [95.7%]; SMD, 6.23). VMAPs were more likely than other MA plans to provide comprehensive dental coverage (179 [95.2%] vs 3006 [87.3%]; SMD, 0.28), hearing aids (184 [97.9%] vs 3012 [87.5%]; SMD, 0.40), eyewear (188 [100%] vs 3620 [94.7%]; SMD, 0.33), over-the-counter drug coverage (179 [95.2%] vs 2831 [82.2%]; SMD, 0.42), and meal benefits (151 [80.3%] vs 2348 [68.2%]; SMD, 0.28).

CONCLUSIONS AND RELEVANCE: This study found that MA insurers-specifically VMAPs-engaged in targeted marketing to veterans, offering $0 premiums, cash back benefits, and supplemental benefits. However, nearly all VMAPs excluded Medicare Part D, likely designed to attract veteran enrollees who use VHA care, making them low-cost enrollees to the plan. Since the VHA cannot bill plans for Medicare-covered services, VMAPs may be increasing wasteful federal spending.

PMID:40152874 | DOI:10.1001/jamahealthforum.2025.0159

JAMA Health Forum. 2025 Mar 7;6(3):e250273. doi: 10.1001/jamahealthforum.2025.0273.

ABSTRACT

IMPORTANCE: Acculturation among Hispanic/Latino populations, defined as adaptation to US lifestyle and culture, is often assumed to lead to adverse health outcomes that will reduce the immigrant health advantage.

OBJECTIVE: To evaluate the risks for incident diabetes and hypertension by levels of acculturation and educational attainment.

DESIGN, SETTING, AND PARTICIPANTS: This study used data from the Hispanic Community Health Study/Study of Latinos, a population-based cohort study of men and women aged 18 to 74 years who identified as Central American, Cuban, Dominican, Mexican, Puerto Rican, or South American living in 4 urban locales in the US. Visit 1 spanned March 2008 to June 2011; visit 2 spanned October 2014 to December 2017.

MAIN OUTCOMES AND MEASURES: Multivariable logistic regression was used to evaluate the association between language acculturation level defined by the Short Acculturation Scale for Hispanics (SASH) and educational attainment (less than high school graduate vs more than high school) and incident diabetes and hypertension by heritage group.

RESULTS: Of 11 623 adult participants, 1207 (10.4%) were of Central American heritage, 1645 (14.2%) of Cuban heritage, 1021 (8.8%) of Dominican heritage, 11 623 (41.3%) of Mexican heritage, 1801 (15.5%) of Puerto Rican heritage, and 795 (6.8%) of South American heritage. The mean (SE) age of all participants was 43.1 (0.3) years, and 7345 (56.3%) were female. A total of 8697 (71.4%) were born outside the US, 4358 (32.5%) had less than a high school education, and 7475 (58.3%) were less acculturated (SASH score less than 2). Incident rates of diabetes (total cohort, 14.6% [95% CI, 13.6%-15.6%]) and hypertension (total cohort, 20.4% [95% CI, 19.0%-21.9%]) varied across heritages; Mexican individuals (17.2% [95% CI, 15.5%-19.0%]) had the highest diabetes incidence and Dominican individuals the highest hypertension incidence (27.1% [95% CI, 22.7%-31.4%]). Persons with more educational attainment were at lower risk for diabetes and hypertension independent of acculturation, and more acculturated participants had a lower risk for incident diabetes. Less acculturated with lower socioeconomic status (SES) were more likely to have incident diabetes (weighted predicted probability [WPP], 0.17 [95% CI, 0.14-0.19]), and more acculturated with lower SES had the highest predicted probability of hypertension (WPP, 0.19 [95% CI, 0.15-0.23]). More acculturated with higher SES were at lower risk of diabetes (WPP, 0.11 [95% CI, 0.09-0.13]) and had a lower predicted probability of hypertension (WPP, 0.10 [95% CI, 0.08-0.12]).

CONCLUSIONS AND RELEVANCE: In this cohort study, the association of acculturation with health outcomes is not unidirectional and interacts with educational attainment in determining incident diabetes and hypertension. The Hispanic and Latino paradox, in which immigrants have a health advantage, is influenced by more factors than acculturation and may persist with higher educational attainment. These observations may inform prevention and treatment strategies associated with cardiometabolic health in Hispanic/Latino populations.

PMID:40152873 | DOI:10.1001/jamahealthforum.2025.0273

J Laparoendosc Adv Surg Tech A. 2025 Mar 28. doi: 10.1089/lap.2025.0003. Online ahead of print.

ABSTRACT

Purpose: Minimally invasive surgery is the standard approach for colorectal cancers and requires an abdominal incision for specimen removal. Natural orifice specimen extraction (NOSE) may improve outcomes, reducing trauma, and speeding postoperative recovery. This study compares both techniques regarding postoperative complications, operative outcomes, and recurrence. Methods: We searched PubMed, Scopus, and Cochrane Central Register of Clinical Trials for studies published up to November 2024. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using a random-effects model, and heterogeneity was assessed with I² statistics. Statistical analyses were conducted using R Software version 4.4.1 (R Foundation for Statistical Computing). Results: Four randomized controlled trials involving 439 patients with colorectal cancer were included, with 212 (48.2%) undergoing NOSE and 227 (51.7%) undergoing conventional laparoscopic specimen extraction. NOSE significantly reduced postoperative pain (visual analog scale score: mean difference [MD] -1.8; 95% confidence interval [CI] -2.5 to -1.1; P = .01), time to pass flatus (MD -0.8; 95% CI -1.1 to -0.6; P < .01), and surgical site infection rates (OR 0.15; 95% CI 0.03-0.69; P = .015) but was associated with a longer operative time (MD 11.1 minutes; 95% CI 1.5-20.6; P = .02). No significant differences were observed between the groups in bowel leaks, lymph nodes harvested, intraoperative blood loss, hospital stay duration, or local recurrence rates. Conclusion: NOSE was associated with reduced postoperative pain, faster time to pass flatus, and lower infection rates but required longer operative time than conventional laparoscopic specimen extraction. Other outcomes, including complications, operative characteristics, and recurrence, showed no significant differences between the techniques.

PMID:40152871 | DOI:10.1089/lap.2025.0003