Tag: nevin manimala

Public Health Nutr. 2025 Oct 14:1-30. doi: 10.1017/S1368980025101262. Online ahead of print.

ABSTRACT

OBJECTIVE: Restaurant marketing to children may be associated with consumption. We examined whether and to what extent reported frequency of restaurant advertisements exposure was associated with consumption and money spent at all types of restaurants among children living in Canada. We also describe what children and youth report as appealing restaurant marketing techniques.

DESIGN: This study reports findings from a cross-sectional, online survey. The survey covered reported exposure to restaurant marketing, restaurant product consumption, money spent at restaurants, and appealing features of restaurant advertisements. Descriptive statistics and adjusted and unadjusted linear and logistic regressions were constructed.

SETTING: Canadian provinces.

PARTICIPANTS: 1500 children and youth aged 9-17 years.

RESULTS: A third (32%) of participants reported restaurant advertisement exposure at least once per day. Overall, 43% of participants consumed restaurant products more than twice per week, 61% spent at least some money at a restaurant in the last seven days, and of those who spent money, the mean expenditure in the last week was $20.70. Frequency of advertisement exposure was significantly associated with all outcomes. Several significant differences in outcomes emerged by region, age, and race/ethnicity. Pictures were the most appealing marketing technique among both age groups, however, youth (aged 13-17) seemed to prioritize price and price promotions, while children (aged 9-12) prioritized toys, humour, and winning prizes.

CONCLUSIONS: A large proportion of Canadian children and youth consumed restaurant offerings more than twice a week. Reported restaurant advertising exposure was significantly positively associated with restaurant consumption frequency and money spent at restaurants.

PMID:41084742 | DOI:10.1017/S1368980025101262

Ther Adv Chronic Dis. 2025 Oct 9;16:20406223251381573. doi: 10.1177/20406223251381573. eCollection 2025.

ABSTRACT

BACKGROUND: Insulin pump therapy improves glycemic control in children with type 1 diabetes but is associated with technical and dermatological complications that can impact adherence. Research on these adverse effects in pediatric populations is limited.

OBJECTIVES: This study aimed to evaluate short- and long-term complications of insulin pump therapy in pediatric patients in Saudi Arabia, focusing on technical malfunctions, dermatological issues, and patient satisfaction.

DESIGN: A cross-sectional survey-based study conducted in multiple centers in Taif, Saudi Arabia.

METHODS: Fifty-nine parents of children with type 1 diabetes who used insulin pumps provided data for the study. Participants reported technical issues, skin-related complications, and overall satisfaction. IBM SPSS Statistics version 27.0.1 was used to conduct the statistical analysis.

RESULTS: Technical complications were frequent, with 64.4% experiencing tube blockages, 39.0% reporting needle dislodgment, and 39.0% observing air bubbles in the tubing. Dermatological issues included discomfort at the infusion site (54.2%), skin pigmentation (45.8%), and scarring (55.9%), with lipohypertrophy (22.0%) posing a concern for insulin absorption. Longer pump use was significantly associated with increased complications, particularly tube blockages and skin pigmentation. Despite these challenges, 84.7% of participants recommended insulin pumps over multiple daily injections.

CONCLUSION: Technical and dermatological complications were common, increasing with longer pump use. Proper infusion site rotation, infusion set management, and improved patient education are key to reducing adverse effects. To improve safety and efficacy, future studies should concentrate on infusion set change patterns, newer pump technologies, and standardized guidelines.

PMID:41084735 | PMC:PMC12515280 | DOI:10.1177/20406223251381573

Cureus. 2025 Oct 11;17(10):e94336. doi: 10.7759/cureus.94336. eCollection 2025 Oct.

ABSTRACT

Objective Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease associated with a rate of mortality during hospitalization. On the other hand, SLE can be associated with other autoimmune diseases with different morbidity and mortality, so a combination of SLE and other autoimmune diseases, as overlap diseases, may increase the risk of morbidity and mortality. The aim of this study was to determine the survival rate of hospitalized SLE patients who also had other autoimmune diseases. Method We used a retrospective data collection from the inpatient files collected over the past 10 years in the Shariati Hospital, Rheumatology Department, Tehran University of Medical Sciences. Results We identified 219 patients with SLE who overlapped with other autoimmune diseases. Nearly 90% (n=197) were female patients. The mean age of patients was 37.9 years. The most common overlap autoimmune disease alongside SLE was anti-phospholipid syndrome (APS; n=99; 45.4%), followed by rheumatoid arthritis (RA) and scleroderma (n=29; 13.3% each). We had eight (3.7%) deaths in the hospitalized patients, of which six (75.0%) were female patients. The SLE patients who had overlap with APS, scleroderma, and RA died during hospitalization. The general survival rate of SLE patients with at least one autoimmune disease was around 75% (n=164), and the female patients had a better survival rate than the male patients (n=152; 77.0% and n=12; 75.0%, respectively). Infection was the main cause of mortality. Conclusion The general survival rate of SLE patients with at least one autoimmune disease was around 75%. Presence of overlap with APS, scleroderma and RA, and male gender worsened the survival rate.

PMID:41084726 | PMC:PMC12515529 | DOI:10.7759/cureus.94336

Cureus. 2025 Oct 10;17(10):e94309. doi: 10.7759/cureus.94309. eCollection 2025 Oct.

ABSTRACT

Background Healthcare-related infections initially meant those infections that developed during a stay in an extended-care hospital, but currently are used to describe the infections that develop in the continuum of healthcare settings where individuals receive care. Aim The aim of this study is to explore the relationship between causative agents of healthcare-associated infections (HAIs) and predisposing factors contributing to extended hospital stays. It seeks to generate insights that improve patient care, optimize outcomes, and reduce infection-related burdens. Method This retrospective cohort study was conducted at Dr. Hassan Ghazzawi Hospital, Jeddah, Saudi Arabia, using data from the medical records department. All patients who received an HAI diagnosis while in the hospital between January 2024 and December 2024 made up the research population. In line with this background, this study investigated the distribution of causative agents of infection in hospitalized patients (n = 60) with respect to gender and length of hospital stay. The study design and reporting followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results Data were collected on 10 major pathogens, including Klebsiella pneumoniae, Acinetobacter baumannii, and methicillin-resistant Staphylococcus aureus (MRSA), among others. The Kruskal-Wallis test was applied to assess differences in mean hospital stay, while the Chi-square test was utilized to assess the relation between gender and hospital-born causative agents. Result shows that gender differences were not statistically significant for any of the infections (all p > 0.05). An independent t-test of the total pathogen counts in males and females revealed no significant difference (t-test p = 0.594). The F-test, which compares variance, also revealed no discernible variation in group variability (F = 0.964, p = 0.521). Although certain infections, such as Klebsiella pneumoniae and Acinetobacter baumannii, were more frequent, the overall distribution did not differ significantly by gender. The Kruskal-Wallis test was conducted to determine whether hospital stay differed significantly across patients with different causative agents of HCAIs. Statistical analysis did not demonstrate a significant difference in hospital stay between the different causative agents. One-way analysis of variance (ANOVA) yielded F = 1.65 and p = 0.126, and the nonparametric Kruskal-Wallis H test also confirmed nonsignificance (H = 7.96, p = 0.538). This indicates that the type of causative agent was associated with variations in the length of hospital stay, meaning variation in hospital stay appears to be more patient-specific rather than strongly dependent on the causative agent of infection. Conclusion These findings suggest that factors other than pathogen type and gender such as severity of illness, underlying comorbidities, host immune status, treatment strategies, timeliness of intervention, antimicrobial resistance (AMR) patterns, hospital hygiene regulation, adequacy of infection control practices, staffing ratios, availability of critical care resources, and overall quality of the hospital care system may have a greater influence on patient outcomes.

PMID:41084725 | PMC:PMC12515517 | DOI:10.7759/cureus.94309

Cureus. 2025 Sep 12;17(9):e92158. doi: 10.7759/cureus.92158. eCollection 2025 Sep.

ABSTRACT

Introduction Invasive mammary carcinoma with medullary features represents an uncommon subtype of breast cancer. Despite their high-grade histological appearances, they have a favourable prognosis. This study aims to correlate its radiologic and histopathologic characteristics. A comprehensive understanding of the radiopathologic profile is essential for enhancing the diagnosis precision and guiding patient treatment, particularly because of its typically benign imaging findings, which may result in misinterpretation and underdiagnosis. Materials and methods A retrospective observational study was conducted by reviewing cases of histologically confirmed invasive mammary carcinoma with medullary features and triple-negative basal-like carcinoma that met the WHO criteria over five years (2020-2025) at the Sri Ramachandra Institute of Higher Education and Research, Chennai, India. We reviewed preoperative mammographic and ultrasound features and compared them with histopathological findings. Descriptive statistics summarise the prevalence of each feature. Results We included a total of 45 patients (age range: 25-76 years) with a confirmed diagnosis of medullary carcinoma. On mammograms, 30 (90.9%) had a detectable mass, of which 16 (53.3%) presented as an irregular shape with circumscribed margins and equal density. Rarely were calcifications identified, and they were present only in three (10%) cases. Sonographic examination revealed 29 (83%) cases as hypoechoic; 26 (74%) irregular masses, with microlobulated margins in 18 (51.4%) cases; and posterior acoustic enhancement in 32 (91%) cases. Eighteen (51%) of the masses showed minimal internal vascularity. Histopathology confirmed that 42 (93%) of the cases showed a syncytial growth pattern, with 39 (86%) having a high nuclear grade and 44 (97.8%) showing no glandular or tubular elements. There were prominent lymphoplasmacytic infiltrates in 100% of cases, and they were all triple-negative immunophenotypes. Conclusion Medullary carcinoma can present similarly to benign lesions in imaging studies, exhibiting characteristics like circumscribed morphology and posterior acoustic enhancement. Despite these similarities, imaging techniques cannot definitively differentiate medullary carcinoma from other types of breast lesions, making it essential to conduct a biopsy and obtain histopathological confirmation for a conclusive, timely, and accurate diagnosis.

PMID:41084718 | PMC:PMC12515487 | DOI:10.7759/cureus.92158

Cureus. 2025 Sep 12;17(9):e92118. doi: 10.7759/cureus.92118. eCollection 2025 Sep.

ABSTRACT

Background Caries-affected dentin is a partially demineralized substrate that retains its collagen matrix and has the potential to be remineralized. Recent biomimetic materials have shown potential in enhancing remineralization and improving composite bonding. The study aimed to compare the shear bond strength of composite resin to demineralized dentin after remineralization with three agents: silver diamine fluoride (SDF), nanohydroxyapatite (nHAp), and self-assembling peptide P11-4 (SAP P11-4). Materials and methods An in vitro, non-randomized, experimental study was conducted using sixty premolars with a single root, collected post-extraction, and equally divided into four groups: control, SDF, nHAp, and SAP. Remineralizing agents were applied to exposed dentin surfaces, followed by the placement of composite resin. After surface treatment with remineralizing agents, the resin-based composite was applied, and a universal testing machine was utilized to determine the shear bond strength. The modes of failure were examined using a stereomicroscope. One-way ANOVA and Tukey’s post hoc test were used (p < 0.001). Results The SAP P11-4 group showed the highest mean bond strength (28.13 N), followed by the SDF groups and nHAP groups, while the control group demonstrated the lowest values. All remineralized groups exhibited significantly higher bond strength compared to the control (p < 0.001). Intergroup comparisons revealed statistically significant differences among all test groups, with SAP P11-4 significantly outperforming SDF and nHAP. Failure mode analysis revealed that SAP P11-4 predominantly resulted in cohesive failure, whereas SDF and nHAP primarily exhibited adhesive failure. Conclusions Among the three remineralizing agents tested, SAP P11-4 demonstrated the highest shear bond strength to demineralized dentin. Its superior performance highlights its potential to enhance the longevity and durability of resin-based restorations in minimally invasive dentistry. The predominance of cohesive failure further supports its effectiveness in creating a strong, integrated bond between the composite resin and dentin substrate.

PMID:41084714 | PMC:PMC12515371 | DOI:10.7759/cureus.92118

Cureus. 2025 Sep 10;17(9):e91972. doi: 10.7759/cureus.91972. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: Heart failure (HF) is one of the causes of morbidity and mortality. High-intensity interval training (HIIT) has been suggested as a positive intervention that can be practiced to help optimize heart function and overall health. However, the effect of HIIT in the long-term on heart functioning, the level of symptoms shown by patients with HF, and the survival of the affected people are poorly understood. This study explores the effects of a long-term HIIT intervention on individuals who have HF.

METHODS: This was a longitudinal observational study conducted in the cardiac department of Pakistan Institute of Medical Sciences (PIMS) in Islamabad, Pakistan, from July 2024 to January 2025. Purposive non-probability sampling was used to recruit all HF patients, with 158 patients aged 30 years and older participating. The demographic information and research instruments used at baseline, three months, and six months include the Kansas City Cardiomyopathy Questionnaire (KCCQ-12), Duke Activity Status Index (DASI) questionnaires, and New York Heart Association (NYHA) classification. IBM SPSS version 26 (IBM Corp., Armonk, NY, US) was used to conduct statistical tests, including repeated-measures ANOVA, Pearson correlation, and multiple linear regression.

RESULTS: The sample size consisted of 158 participants (N = 113, 71.0% men; N = 45, 29.0% women), with a mean age of 56.3 ± 12.4 years. There was a significant improvement in both KCCQ-12 and DASI (p < 0.01), whereas the NYHA classification worsened (p < 0.001). Increased levels of HIIT were associated with improved functional capacity and quality of life (r = 0.392, p < 0.01 for DASI; r = 0.215, p < 0.01 for KCCQ-12) and reduced symptom severity (r = -0.265, p < 0.01 for NYHA). The main predictors of these outcomes identified through regression analysis included HIIT, age, gender, and comorbidities. Gender differences were demonstrated by women reporting better outcomes and men exhibiting worse indicators concerning symptoms.

CONCLUSION: Long-term HIIT is highly effective in improving cardiac performance, decreasing the severity of HF symptoms, and improving the quality of life among HF patients. These findings demonstrate the promising potential of HIIT as an effective adjunctive treatment in managing HF, as it can bring significant benefits to patients of diverse ages and backgrounds. Early HIIT, tailored to the individual needs of each patient, has the potential to improve clinical outcomes and increase survival rates in HF populations.

PMID:41084708 | PMC:PMC12515264 | DOI:10.7759/cureus.91972

Cureus. 2025 Sep 10;17(9):e92014. doi: 10.7759/cureus.92014. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Multidisciplinary cancer conferences (MCCs) are essential forums for collaborative oncology decision-making. However, existing literature has primarily examined the role of attending specialists and has rarely differentiated effects by specialty. The contributions of trainees, particularly in nuclear medicine, have been largely overlooked, leaving a gap in understanding how their participation influences both educational outcomes and patient management. This study addresses this gap by systematically evaluating the perceived impact of nuclear medicine trainees in MCCs.

METHODS: A cross-sectional survey was distributed to 73 healthcare professionals at a tertiary medical center, including nuclear medicine specialists, trainees, and clinicians from surgery, oncology, and radiology. The survey included Likert-scale and multiple-choice questions to assess perceptions of trainee contributions to interprofessional collaboration, clinical decision-making, and patient outcomes. Descriptive statistics were calculated, and analysis of variance (ANOVA) and chi-square tests were applied to analyze Likert-scale responses and compare responses between nuclear medicine and non-nuclear medicine specialists. P-values < 0.05 were considered statistically significant.

RESULTS: Of the 73 respondents, 57 (78.1%) indicated that nuclear medicine trainees enhanced interprofessional collaboration, while 56 (76.7%) reported a positive influence on patient care. Additionally, 60 (82.2%) perceived an educational benefit through enriched clinical knowledge. Chi-square analysis revealed no significant differences in perceptions across professional groups (p = 0.568). Reported barriers included inconsistent attendance, limited clinical experience, and time constraints.

CONCLUSION: Nuclear medicine trainees play a valuable role in MCCs by enriching clinical discussions, supporting patient care, and contributing to professional development. To maximize their impact, structured learning opportunities, increased mentorship, and improved logistical support are recommended. These findings emphasize the importance of formally integrating trainees into MCC workflows to enhance both educational and clinical outcomes.

PMID:41084706 | PMC:PMC12515522 | DOI:10.7759/cureus.92014

Cureus. 2025 Sep 11;17(9):e92105. doi: 10.7759/cureus.92105. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: Knee osteoarthritis (KOA) is a chronic degenerative condition characterized by joint space narrowing (JSN), pain, and functional limitations, affecting a significant portion of the population in India. Radiographic evaluation (standing anteroposterior (AP) view – standard technique) is crucial for diagnosing and grading KOA. The aim of this study was to evaluate the efficacy of the Rosenberg posteroanterior (PA) view compared to the standard anteroposterior (AP) view in grading KOA and to estimate the correlation between joint space width (JSW), radiographic grading, and the Oxford knee score (OKS).

MATERIALS AND METHODS: A total of 384 knees (192 patients) aged 40 years and above, presenting with knee pain, were included in this cross-sectional study. Radiographs of the standing AP and Rosenberg views were taken, and the medial and lateral tibiofemoral JSW were measured digitally on calibrated images. KOA was graded using the International Knee Documentation Committee (IKDC) classification. Statistical analysis included Spearman’s rho correlation coefficient, with significance set at p<0.05.

RESULTS: The mean medial JSW was 3.91±0.89 mm in the AP view and 3.52±1.02 mm in the Rosenberg view, with a strong correlation (p<0.0001). The mean lateral JSW was similar between views (5.88±0.47 mm in AP and 5.89±0.43 mm in Rosenberg), showing moderate correlation (p<0.0001). The Rosenberg view identified more severe KOA grades, with 41.9% of patients classified as IKDC Grade 3 or higher, compared to 27.6% in the AP view. Additionally, 18.2% of patients were reclassified to a more severe grade in the Rosenberg view, indicating its superior sensitivity in detecting early disease progression.

CONCLUSION: The Rosenberg view is more effective in detecting early and severe KOA, providing a more accurate assessment of disease severity for improved management.

PMID:41084705 | PMC:PMC12515347 | DOI:10.7759/cureus.92105

Cureus. 2025 Sep 12;17(9):e92153. doi: 10.7759/cureus.92153. eCollection 2025 Sep.

ABSTRACT

Background Type 2 diabetes mellitus (T2DM) is often associated with overweight and obesity, contributing to poor glycemic control and increased risk of complications. Lifestyle modification is a cornerstone in the management of T2DM, but its real-world impact on anthropometric measures like weight and body mass index (BMI) requires further evaluation. Objective The objective of the study was to assess the effectiveness of lifestyle modification counseling on weight and BMI reduction among people with T2DM over a six-month period. Methods This randomized controlled trial included 110 participants with T2DM, equally divided into intervention (n=55) and control (n=55) groups. The intervention group received structured lifestyle counseling, including dietary advice, physical activity recommendations, and behavioral strategies, while the control group received routine clinical care. Anthropometric parameters (weight and BMI) were recorded at baseline and at the six-month follow-up. Statistical analysis was performed using paired and unpaired t-tests with significance set at p<0.05. Results At baseline, there were no significant differences between groups in weight, BMI, or waist-hip ratio (p>0.05), confirming comparability. At six months, the intervention group showed a significant mean weight reduction of 2.04 ± 2.30 kg (p<0.001) and BMI reduction of 0.792 ± 1.009 kg/m² (p<0.001). The control group showed non-significant changes in both parameters. Between-group comparisons revealed a significantly greater weight reduction in the intervention group (p=0.001), although the BMI difference was not statistically significant (p=0.924). Conclusion Structured lifestyle modification counseling significantly improved weight and BMI in people with T2DM over six months, highlighting its role as an effective, non-pharmacological strategy for obesity management in diabetes care.

PMID:41084691 | PMC:PMC12515480 | DOI:10.7759/cureus.92153