Tag: nevin manimala

J Spine Surg. 2025 Mar 24;11(1):88-95. doi: 10.21037/jss-24-99. Epub 2025 Mar 7.

ABSTRACT

BACKGROUND: Considering that implant backout is a recognized mode of failure, evaluating the pullout strength is critical for assessing anchoring efficacy. The Sacrix^® fully threaded screw (TS) was designed specifically for Less Exposure Spine Surgery (LESS) to reduce incision size, surgical time, and blood loss, using two implants for sacroiliac joint (SIJ) fixation. This study compares the Sacrix^® design with the SI-Bone iFuse non-threaded triangular titanium implant (TTI) design, which is widely regarded as the industry standard, and represents the first comparative biomechanical pullout strength study of these implant designs currently used in SIJ fusions.

METHODS: We conducted mechanical static axial pullout tests on three 7.0 mm × 45 mm iFuse non-threaded TTIs and six 8.0 mm × 40 mm Sacrix^® fully TS embedded in polyurethane foam blocks. An INSTRON 8874 Bi-Axial Tabletop Servohydraulic Dynamic Testing System was used to perform the tests by applying a 2.5 kN axial load.

RESULTS: The effective surface areas of the iFuse non-threaded TTI and Sacrix^® fully threaded TS were comparable, measuring 294.15 and 289.81 mm², respectively. The TS exhibited a significantly higher mean static axial pullout strength of 814.90 N [standard deviation (SD), ±99.428 N] compared to the TTI 200.14 N (SD, ±14.428 N). Statistical analyses, including Welch’s t-test and Mann-Whitney U test, revealed significant differences in pullout strength between the two implants (P<0.05). Variance analysis confirmed the differences in pullout strength variances between the implants (P=0.040), suggesting that the variability in pullout strength was distinct for each implant.

CONCLUSIONS: The Sacrix^® fully threaded TS demonstrated a threefold increase in pullout strength compared with the SI-Bone iFuse non-threaded TTI, suggesting that future SIJ fusion designs should favor threaded over non-threaded implants for improved anchoring capability.

PMID:40242812 | PMC:PMC11998034 | DOI:10.21037/jss-24-99

J Spine Surg. 2025 Mar 24;11(1):24-32. doi: 10.21037/jss-24-116. Epub 2025 Mar 17.

ABSTRACT

BACKGROUND: Endoscopic spine surgery (ESS) has evolved as a new minimally invasive surgical (MIS) approach to the lumbar spine. ESS allows smaller incisions, less paraspinal muscle splitting and surgical trauma compared to conventional open and MIS approaches. We present the first non-inferiority comparison of ESS and open approaches to treat lumbar radiculopathy in an Australian cohort. The aim of this study is to assess if ESS is non-inferior to open approaches for the treatment of lumbar radiculopathy in post operative outcomes of pain and disability scores, in order to address the paucity in data for outcomes of ESS in Australian patients.

METHODS: In this retrospective cohort study, routinely collected prospective data were collated from consecutive patients who had single level endoscopic discectomies for radiculopathy by two surgeons at a single institution between December 2020 and October 2022. Data collected included Visual Analogue Scores for Back (VAS-B) and leg (VAS-L) pain as well as Oswestry Disability Index (ODI) scores, length of stay (LOS) and complication rates. These were compared to data from consecutive patients who underwent open discectomies from August 2020 to September 2022 by the same surgeons at other private hospitals where the endoscope was unavailable, otherwise deemed suitable for either approach, allowing direct comparison of consecutive patients operated on for comparable pathologies differentiated only by equipment availability.

RESULTS: Analysis included 92 endoscopic and 97 open cases. Non-inferiority was established at 6-week with median VAS-L (1.0 vs. 1.8, between group difference -0.5, P<0.001), VAS-B (1.0 vs. 1.0, between group difference -0.3, P=0.002) and ODI (18 vs. 20, between group difference -0.5, P<0.001) and 6-month for ODI (14 vs. 20, between group difference -1.6, P<0.001). Six-month median VAS-L and VAS-B was identical between groups (1.0 and 2.0), however this was not statistically significant. LOS was lower in ESS (LOS <24 h 93% vs. 78%, P=0.005). Reoperation rates were similar (10% vs. 7%, P=0.73). There were fewer complications in the endoscopic cohort than in the open cohort (5% vs. 6%), however this was not statistically significant.

CONCLUSIONS: ESS is non-inferior to open decompression for the management of lumbar radiculopathy up to 6 months. LOS was also found to be lower in ESS. There were fewer complications with ESS however this was not statistically significant.

PMID:40242811 | PMC:PMC11998043 | DOI:10.21037/jss-24-116

J Spine Surg. 2025 Mar 24;11(1):24-32. doi: 10.21037/jss-24-116. Epub 2025 Mar 17.

ABSTRACT

BACKGROUND: Endoscopic spine surgery (ESS) has evolved as a new minimally invasive surgical (MIS) approach to the lumbar spine. ESS allows smaller incisions, less paraspinal muscle splitting and surgical trauma compared to conventional open and MIS approaches. We present the first non-inferiority comparison of ESS and open approaches to treat lumbar radiculopathy in an Australian cohort. The aim of this study is to assess if ESS is non-inferior to open approaches for the treatment of lumbar radiculopathy in post operative outcomes of pain and disability scores, in order to address the paucity in data for outcomes of ESS in Australian patients.

METHODS: In this retrospective cohort study, routinely collected prospective data were collated from consecutive patients who had single level endoscopic discectomies for radiculopathy by two surgeons at a single institution between December 2020 and October 2022. Data collected included Visual Analogue Scores for Back (VAS-B) and leg (VAS-L) pain as well as Oswestry Disability Index (ODI) scores, length of stay (LOS) and complication rates. These were compared to data from consecutive patients who underwent open discectomies from August 2020 to September 2022 by the same surgeons at other private hospitals where the endoscope was unavailable, otherwise deemed suitable for either approach, allowing direct comparison of consecutive patients operated on for comparable pathologies differentiated only by equipment availability.

RESULTS: Analysis included 92 endoscopic and 97 open cases. Non-inferiority was established at 6-week with median VAS-L (1.0 vs. 1.8, between group difference -0.5, P<0.001), VAS-B (1.0 vs. 1.0, between group difference -0.3, P=0.002) and ODI (18 vs. 20, between group difference -0.5, P<0.001) and 6-month for ODI (14 vs. 20, between group difference -1.6, P<0.001). Six-month median VAS-L and VAS-B was identical between groups (1.0 and 2.0), however this was not statistically significant. LOS was lower in ESS (LOS <24 h 93% vs. 78%, P=0.005). Reoperation rates were similar (10% vs. 7%, P=0.73). There were fewer complications in the endoscopic cohort than in the open cohort (5% vs. 6%), however this was not statistically significant.

CONCLUSIONS: ESS is non-inferior to open decompression for the management of lumbar radiculopathy up to 6 months. LOS was also found to be lower in ESS. There were fewer complications with ESS however this was not statistically significant.

PMID:40242811 | PMC:PMC11998043 | DOI:10.21037/jss-24-116

Phys Imaging Radiat Oncol. 2025 Mar 31;34:100759. doi: 10.1016/j.phro.2025.100759. eCollection 2025 Apr.

ABSTRACT

BACKGROUND AND PURPOSE: Locoregional recurrence (LRR) is the primary pattern of failure in head and neck cancer (HNC) following radiation treatment (RT). Predicting an individual patient’s LRR risk is crucial for pre-treatment risk stratification and treatment adaptation during RT. This study aimed to evaluate the feasibility of integrating pre-treatment and mid-treatment diffusion-weighted (DW)-MRI radiomic parameters into multivariable prognostic models for HNC.

MATERIALS AND METHODS: A total of 178 oropharyngeal cancer (OPC) patients undergoing (chemo)radiotherapy (CRT) were analyzed on DW-MRI scans. 105 radiomic features were extracted from ADC maps. Cox regression models incorporating clinical and radiomic parameters were developed for pre-treatment and mid-treatment phases. The models’ discriminative ability was assessed with the Harrel C-index after 5-fold cross-validation.

RESULTS: Gray Level Co-occurrence Matrix (GLCM)-correlation emerged as a significant pre-treatment radiomic predictor of locoregional control (LRC) with a C-index (95 % CI) of 0.66 (0.57-0.75). Significant clinical predictors included HPV status, stage, and alcohol use, yielding a C-index of 0.70 (0.62-0.78). Combining clinical and radiomic data resulted in a C-index of 0.72 (0.65-0.80), with GLCM-correlation, disease stage and alcohol use as significant predictors. The mid-treatment model, which included delta (Δ) mean ADC, stage, and additional chemotherapy, achieved a C-index of 0.74 (0.65-0.82). Internal cross-validation yielded C-indices of 0.60 (0.51-0.69), 0.56 (0.44-0.66), and 0.63 (0.54-0.73) for the clinical, combined, and mid-treatment models, respectively.

CONCLUSION: The addition of Δ ADC improves the clinical model, highlighting the potential complementary value of radiomic features in prognostic modeling.

PMID:40242809 | PMC:PMC12002943 | DOI:10.1016/j.phro.2025.100759

Front Immunol. 2025 Apr 2;16:1572821. doi: 10.3389/fimmu.2025.1572821. eCollection 2025.

ABSTRACT

The intricate interaction between skeletal muscle biomechanics, the tumor microenvironment, and immunotherapy constitutes a pivotal research focus oncology. This work provides a comprehensive review of methodologies for evaluating skeletal muscle biomechanics, including handheld dynamometry, advanced imaging techniques, electrical impedance myography, elastography, and single-fiber experiments to assess muscle quality and performance. Furthermore, it elucidates the mechanisms, applications, and limitations of various immunotherapy modalities, including immune checkpoint inhibitors, adoptive cell therapy, cancer vaccines, and combined chemoimmunotherapy, while examining their effects on skeletal muscle function and systemic immune responses. Key findings indicate that although immunotherapy is effective in augmenting antitumor immunity, it frequently induces muscle-related adverse effects such as weakness, fatigue, or damage, primarily mediated by cytokine release and immune activation. This work underscores the significance of immune niches within the tumor microenvironment in influencing treatment outcomes and proposes strategies to optimize therapy through personalized regimens and combinatorial approaches. This review highlights the need for further research on the formation of immune niches and interactions muscle-tumor. Our work is crucial for advancing the efficacy of immunotherapy, reducing adverse effects, and ultimately improving survival rates and quality of life of patients with cancer.

PMID:40242775 | PMC:PMC12000078 | DOI:10.3389/fimmu.2025.1572821

Front Immunol. 2025 Apr 2;16:1457758. doi: 10.3389/fimmu.2025.1457758. eCollection 2025.

ABSTRACT

PURPOSE: The metabolic pattern in autoimmune encephalitis (AE) has been frequently reported. Through this semi-quantitative analysis, we aim to explore a practical diagnostic model based on positron emission tomography (PET) for timely diagnosis of pediatric AE with high accuracy. Moreover, we aim to identify factors that affect the prognosis of pediatric AE and explore the utility of PET as a prognostic biomarker.

METHOD: Data were collected from 93 AE patients and 67 non-AE patients (age range: 1-18 years old). Semi-quantitative parameters of ¹⁸F-FDG PET imaging were evaluated, including the score of cortical lesion extent and the ratios of lesion-to-basal ganglia and thalamus. The Clinical Assessment Scale in Autoimmune Encephalitis (CASE) was used to rate the disease severity and long-term outcome. Multivariate statistical analysis was used to establish a diagnostic model and analyze predictors.

RESULTS: The diagnostic model includes three PET parameters. The sensitivity, specificity, and accuracy of the model are 91.4%, 85.1%, and 88.8%, respectively. Participants were followed up for a median of 34 months. Logistic regression analysis indicated that male, initial CASE score >4.5,memory dysfunction, and the ratio of the maximum SUV of the lesion to thalamus (SUVRmax_L/T) < 0.577 are independent factors associated with poor prognosis in AE. We established a prognostic model through these predictors.

CONCLUSION: ¹⁸F-FDG PET plays a vital role in the diagnosis and prognosis of AE. The PET-based diagnostic model has higher specificity and accuracy than visual analysis. The prognostic model is a useful predictive tool for the long-term prognosis of children with AE.

PMID:40242763 | PMC:PMC12000777 | DOI:10.3389/fimmu.2025.1457758

Front Psychol. 2025 Apr 2;16:1568284. doi: 10.3389/fpsyg.2025.1568284. eCollection 2025.

ABSTRACT

BACKGROUND: It is known that stress occurring through/against a phenomenon will have physiological and psychological effects on the human organism. Therefore, this research aimed to determine the physiological and psychological effects of weight loss-induced stress before a competition in senior wrestlers.

METHODS: This cross-sectional study used a purposeful sampling method to select participants. Two hundred and forty-three wrestlers participated in the study voluntarily. The perceived stress scale and athlete weight loss methodology and effects scale were used to determine the physiological and psychological effects of weight loss-induced stress. Independent samples t-test, One-way ANOVA, Pearson correlation analysis, and linear regression analysis were used to analyze normally distributed data.

RESULTS: There was no statistical difference in the wrestlers’ body weight loss percentages, stress levels, and weight loss methods and effects sub-dimensions according to their gender and wrestling styles (p > 0.05). Despite this, there was a statistical difference in wrestlers’ stress levels, ergogenic aids sub-dimension from weight loss methods, and psychological effect levels according to body weight loss percentages (p < 0.05). Additionally, there was a positive relationship between the body weight loss percentages of wrestlers with their stress levels (r: 0.461) and psychological effects (r: 0.240). Furthermore, there was a positive relationship between the stress levels of wrestlers with the average physiological (r: 0.298) and psychological (r: 0.508) effects. According to these results, it was determined that as the body weight loss percentages of wrestlers increased, their stress levels and the psychological effects they were exposed to would increase. It was also determined that as the stress level of wrestlers increased, the physiological and psychological effects they were exposed to would increase the weight loss-induced stress levels of wrestlers positively predicted their exposure to physiological and psychological effects at 8.5% (Adj. R ² = 0.085) and 25.8% (Adj. R ² = 0.258), respectively.

CONCLUSION: It was determined that as the percentage of body weight loss increases in wrestlers, the stress level will also increase and the stress level increases, the physiological and psychological effects will also increase. It is thought that weight loss-induced stress has both physiological and psychological effects on wrestlers and may reduce their athletic performance.

PMID:40242746 | PMC:PMC11999944 | DOI:10.3389/fpsyg.2025.1568284

Cureus. 2025 Mar 17;17(3):e80715. doi: 10.7759/cureus.80715. eCollection 2025 Mar.

ABSTRACT

Background Self-harm includes suicide attempts and non-suicidal self-injury (NSSI), both of which are linked to psychiatric disorders and psychosocial stressors. While suicide attempts involve an intent to die, NSSI often serves as a maladaptive coping mechanism. In India, stigma and limited mental health resources hinder early intervention. This study analyzes self-harm patterns, psychiatric comorbidities, and risk factors in patients presenting to a tertiary care hospital. Methodology This retrospective study reviewed the medical records of 165 patients with suicide attempts or NSSI between January and June 2024. Data on demographics, psychiatric diagnoses, self-harm methods, and substance use were analyzed using descriptive and inferential statistics. Results Of the 165 cases, 69 involved suicide attempts, and 96 involved NSSI. Suicide attempts were more common among individuals aged 31-40, whereas NSSI was predominant in the 18-30 age group. Depressive disorder was the most frequent diagnosis among those attempting suicide, affecting 55 (68.7%) individuals, while substance use disorder was more prevalent in NSSI cases, with 51 (67.1%) individuals affected. Self-poisoning emerged as the most common method, possibly influenced by weak pesticide regulations in India. A significant association was found between suicide intent and a history of past suicide attempts. Conclusion Early screening, access control to harmful substances, identifying at-risk populations, and structured post-discharge care are essential in reducing self-harm and suicide risk. Targeted interventions can improve mental health outcomes in at-risk populations.

PMID:40242716 | PMC:PMC12002096 | DOI:10.7759/cureus.80715

Cureus. 2025 Mar 16;17(3):e80690. doi: 10.7759/cureus.80690. eCollection 2025 Mar.

ABSTRACT

Background and aims The outcome of a diabetic foot ulcer (DFU) may be affected by many factors, including the clinical anatomy of the ulcer, metabolic control, the presence of complications, and infections. This study evaluates the effect of metabolic factors, the clinical anatomy of the ulcer at presentation, and antibiotic appropriateness on treatment outcomes in terms of amputation in patients with diabetic foot (DF). Materials and methods This is a cross-sectional observational study involving data collected from patients with IPD diagnosed with type 2 diabetes mellitus and DFU at a tertiary care DF specialty hospital in Maharashtra, India. Results Data from a total of 106 patients were included for analysis. Fifty-two patients healed without amputation while 54 underwent either minor or major amputation. Patients who did not require amputation had a statistically significant higher incidence of cellulitis, ulcers at the heel and lateral malleolus, and ulcers classified as Wagner grade 1 or 2. In contrast, factors significantly associated with amputation included lower weight and BMI, multiple ulcers at presentation, ulcers involving the second, third, fourth, or fifth toe, midfoot, or medial malleolus, ulcers graded 3, 4, or 5, and additional surgery performed during the same hospital admission. The most commonly collected specimen was pus, followed by tissue and bone. The most frequently isolated microorganisms were Escherichia (E.) coli and Klebsiella. All microorganisms were sensitive to Piperacillin-Tazobactam and matched the initially prescribed antibiotic, which was chosen as per the hospital antibiogram. Angiotensin-converting enzyme inhibitors (ACE-I)/angiotensin receptor blockers (ARBs) were prescribed more frequently in the non-amputation group while insulin use was higher in the amputation group, although there was no significant difference in the use of metabolic drugs between the two groups. Conclusion The anatomical location of the wound, advanced grade, number of ulcers, additional procedures, nutritional status, and the presence of Coagulase-negative Staphylococcus aureus in tissue are significant predictors of amputation.

PMID:40242699 | PMC:PMC12000793 | DOI:10.7759/cureus.80690

Cureus. 2025 Mar 16;17(3):e80685. doi: 10.7759/cureus.80685. eCollection 2025 Mar.

ABSTRACT

BACKGROUND: Dandruff is a widespread scalp issue that affects many people worldwide, often causing itching and discomfort. It is linked to the presence of certain microorganisms on the scalp, especially Malassezia yeast, which interacts with skin cells to trigger dandruff. This condition can lead patients to experience health concerns and social or emotional distress. Common treatments include antifungal shampoos. Neem leaves have been selected for their natural ability to fight germs, reduce inflammation, and support immune health. They contain beneficial compounds that help treat infections, aid healing, and have long been used in traditional medicine as a natural remedy. This study aims to evaluate the effectiveness of neem leaf paste in treating scalp dandruff among female students.

MATERIALS AND METHODS: A quasi-experimental pre-test post-test control group study was conducted on female students aged 18-24 with minimal, moderate, and severe dandruff levels. The modified Van Abbe’s scale was used to assess the dandruff level. A total of 100 female students were selected using non-probability purposive sampling with no history of allergy to neem leaf formulations. The primary objective was to reduce the dandruff score. The dandruff levels were assessed before and after the application of neem leaf paste at baseline, Week 1, and Week 2. Statistical analysis was performed using frequency and percentage for demographic variables, and a t-test was used to compare dandruff levels between the control and experimental groups. A p-value of 0.05 was considered statistically significant.

RESULTS: The study included 50 female students in the experimental group and 50 in the control group. Before applying neem leaf paste, 66% (n=33) in the experimental group and 60% (n=30) in the control group had a moderate level of dandruff, while 10% (n=5) and 14% (n=7) in the respective groups had severe dandruff. After the intervention, 44% (n=22) in the experimental group had no dandruff, compared to just 4% (n=2) in the control group. Additionally, 42% (n=21) in the experimental group had a minimal level of dandruff, whereas 28% (14 participants) in the control group had the same. Only 14% (n=7) in the experimental group still had moderate dandruff, compared to 60% (n=30) in the control group. The control group also had 8% (n=4) with severe dandruff, while none remained at this level in the experimental group. After one week, the mean dandruff score significantly dropped to 0.7 in the experimental group, compared to 1.72 in the control group (p-value = 0.00001), indicating a statistically significant reduction in dandruff severity due to neem leaf paste application.

CONCLUSION: The application of neem leaf paste was effective in managing dandruff among the participants. Neem leaf paste, known for its antimicrobial and anti-inflammatory properties, offers a cost-effective and natural alternative for managing dandruff. Its effectiveness in reducing dandruff levels among study participants highlights its potential as a safe and accessible treatment option.

PMID:40242687 | PMC:PMC11999905 | DOI:10.7759/cureus.80685