Tag: nevin manimala

Sci Rep. 2025 Oct 13;15(1):35641. doi: 10.1038/s41598-025-19464-y.

ABSTRACT

Portal hypertension (PHT) is pivotal in managing decompensated cirrhosis. In clinical practice, hepatic venous collaterals are frequently present, often leading to failure or reduced accuracy of hepatic venous pressure gradient (HVPG) measurements, thereby making HVPG an imperfect surrogate for the portal pressure gradient (PPG). Artificial neural networks (ANNs) have shown potential in integrating multidimensional clinical variables and predicting complex disease states; however, their value in the assessment of PHT remains insufficiently validated. The study compared ANN-predicted PPG with measured PPG and HVPG in two cohorts: Group A (all patients), reflecting routine clinical practice, and Group B (excluding cases with coefficient of variation (CV) > 30%, most with venous collaterals), approximating optimized conditions. Subgroup analyses in Group B further assessed differences by etiology and Child-Pugh class. We retrospectively included 164 patients with decompensated cirrhosis who underwent TIPS between June 2014 and July 2024, with intra-procedural HVPG and PPG measurements. An ANN model predicted PPG based on INR, WBC, and portal vein diameter. Group A included all patients (n = 164), reflecting real-world conditions where HVPG may be affected by collaterals. Group B represented a strict quality-control cohort (n = 101), in which cases with a measurement CV > 30% were excluded; retrospective review indicated that most of these excluded patients exhibited hepatic venous collaterals thereby approximating an “ideal condition” without the influence of collaterals. Statistical analyses included paired t tests, Pearson correlations, Steiger’s Z-tests, and Bland-Altman analysis. Subgroup analyses were conducted by etiology and Child-Pugh class. In the overall cohort (Group A, n = 164), HVPG showed negligible correlation with PPG (r = 0.014), whereas ANN-predicted PPG demonstrated moderate correlation (r = 0.437, P < 0.001) with significantly narrower LoA. In the quality-controlled cohort (Group B, n = 101), both HVPG and ANN-predicted PPG correlated moderately with PPG (r = 0.457 vs. 0.476) with comparable agreement. Subgroup analyses indicated that ANN outperformed HVPG in hepatitis B and Child-Pugh C patients, while HVPG was slightly better in alcohol-related cirrhosis; both methods performed poorly in autoimmune liver disease. HVPG remains the gold standard for assessing portal pressure but is limited by hepatic venous collaterals, advanced liver dysfunction, and the need for invasive measurement. ANN-predicted PPG showed favorable correlation and agreement with measured PPG, providing a noninvasive, simple, and reproducible complement to HVPG for clinical assessment and follow-up.

PMID:41083502 | DOI:10.1038/s41598-025-19464-y

Med Glas (Zenica). 2025 Aug 25;22(2):339-343. doi: 10.17392/1922-22-02.

ABSTRACT

PURPOSE: &nbsp; The objective of this study was to assess the benefits of utilizing a silicone ring tourniquet in relation to traditional pneumatic cuff tourniquets and scenarios without any tourniquet intervention. The tested hypothesis was that the clinical results could be increased after use of the silicone ring tourniquet.

METHODS: &nbsp;The study was monocentric and retrospective evaluation of collected data. Inclusion criterion was open reduction and internal fixation of a displaced distal radius fracture in pediatric population (6-12 years). The pneumatic tourniquet (PT) group involved 18 patients, the no tourniquet (NT) 19 patients and the silicon ring (SR) group 19 patients. All patients were followed for 6 months. Primary criterion was the VAS score at 1 day and 7 days postop. &nbsp;Secondary criteria were delay of discharge, time of surgery and occurrence of complications.

RESULTS: &nbsp;The VAS score in the first and seven day postop was respectively 3.8 &plusmn;1 and 2.0 &plusmn; 0.5 for the PT group, 3.5 &plusmn; 0.5 and 1.8 &plusmn; 0.2 for the NT group and 3.2 &plusmn; 0.8 and 1.8 &plusmn; 0.4 for the SR group without statistically significant differences (p&gt;0.1). There was a non-significant higher rate of complication PT group, especially for skin complications and a higher time of surgery in the NT group.

CONCLUSIONS: &nbsp;The proposed hypothesis was not validated, as there were no notable changes observed in the clinical outcomes. Additionally, the analysis of complications revealed no evidence of bias. However, the reduced incidence of skin complications may indicate a beneficial effect associated with the silicone ring tourniquet.

PMID:41082764 | DOI:10.17392/1922-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):315-319. doi: 10.17392/1998-22-02.

ABSTRACT

Aim To assess Qualitiy of life (QoL) in adults by comparing two groups, the one with diagnosed hearing loss (HL) and the other without hearing complaints. Methods This cross-sectional study included 110 consecutive voluntary adult&nbsp; patients divided in two groups: patients with hearing loss and control group. All participants , after examination , answered to a questionnaires on sociodemographic, clinical data and the World health Organization Quality of Life- Short version (WHOQOL-BREF). Results: Among 110 adults&nbsp; participants, 59 &nbsp;were with hearing loss (hearing loss group &ndash; HLG) and 19 &nbsp;in hearing loss&nbsp; with hearing aid group (HLHAG) and 51 in control group.&nbsp; Consistently&nbsp; higher score&nbsp; in the domains of physical health (p=0.036) and psychological health (p=0.024) in control group was found; other domains did not reach statistical significance Significant differences between the HLHAG and control group in physical health (mean difference = -11.3; p=0.036) and psychological health (mean difference = -11.3; p=0.029) was confirmed. Conculsion Hearing loss could decrease QoL. Therefore, it is very important to recognize hearing impairment in a timely manner and to take a serious approach to treatment.

PMID:41082760 | DOI:10.17392/1998-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):304-310. doi: 10.17392/1906-22-02.

ABSTRACT

Introduction Children receiving regular kidney replacement therapy frequently encounter a state of heightened inflammation, which is evident through symptoms like loss of appetite and elevated levels of &beta;-2 microglobulin (B2M) in their bloodstream. This loss of appetite leads to a reduction in muscle mass, which, on a biochemical level, can result in diminished cardiac function in these patients.

AIM: This research aimed to assess the reduction of inflammation by examining ferritin and B2M serum levels in children with ESKD who are receiving a combination of hemodialysis and hemoperfusion (HDHP).

METHODS: This research was a retrospective cohort study that utilized data from medical records, focusing on children with CKD who received hemodialysis between January 2020 and December 2022. Pediatric patients undergoing hemodialysis routinely have their nutritional status and appetite assessed. If a patient exhibits reduced food intake and appetite, a B2M serum test is warranted. An elevated B2M level in patients indicates the need for hemodialysis-hemoperfusion (HDHP). Prior to each procedure, including HDHP and blood sampling, informed consent was obtained from both the patients and their legal guardians.

RESULTS: HDHP significantly reduces urea, ferritin, and B2M levels in children with ESKD, their decrease are statistically significant with p-value &lt; 0.001. There was a weak positive correlation between ferritin and B2M levels, with a correlation coefficient of 0.195 (95% confidence interval [CI]: 0.003&ndash;1.000) and p = 0.043. This finding suggests that increased ferritin levels are associated with significantly increased B2M levels.

CONCLUSION: HDHP leads to a significant reduction in urea, ferritin, and B2M levels in children with ESKD, with these decreases being statistically significant, as indicated by a p-value of less than 0.001. A weak positive correlation was observed between ferritin and B2M levels, with a correlation coefficient of 0.195 (95% confidence interval [CI]: 0.003&ndash;1.000) and a p-value of 0.043. This result implies that higher ferritin levels are linked to a notable increase in B2M levels.

PMID:41082758 | DOI:10.17392/1906-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):278-282. doi: 10.17392/1996-22-02.

ABSTRACT

AimAcute respiratory infections caused by viral pathogens are the most common reason for hospitalization of children. Annually, 150 million infants worldwide are diagnosed with bronchiolitis, and 2-3% of them are hospitalized. This study aimed to compare bronchiolitis severity before and after the COVID-19 pandemic. MethodsThis retrospective study was conducted at the Department of Pulmonology, Paediatric Clinic, Clinical Centre University of Tuzla, covering the period from November 1st, 2018, to April th 30, 2019 (pre-COVID period) and November 1st, 2023, to April 30th, 2024 (post-COVID period). A total 129 children under the age of 2 years were involved. Results No significant differences in the age, body mass, comorbidities, duration of hospitalization, use of oxygen therapy, and mechanical ventilation was found. There was a significant reduction in antibiotic in the post-COVID group (p=0.0173), and a significant increase in the use of aminophylline and inhalation therapy drugs in the post-COVID group. There was a significantly higher number of isolated respiratory syncytial virus (RSV) cases in the post-COVID group, 32 (42.7%). prevalence of fully vaccinated children was significantly higher in the pre-COVID period compared to the post-COVID period, &nbsp;34 (74.4%?) and &nbsp;29 (45.3%), respectively. Conclusion This study reveals a significant increase in the severity of bronchiolitis and an increase in RSV cases after the COVID-19 pandemic. Keywords: anti-bacterial agents,coinfection, oxygen inhalation therapy,respiratory syncytial virus infections, vaccination.

PMID:41082753 | DOI:10.17392/1996-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):268-272. doi: 10.17392/1941-22-02.

ABSTRACT

Aim To determine whether Ki67 can be predicted through its correlation with the estrogen receptor (ER) and progesterone receptor (PR), to identify breast cancer subtypes and evaluate cell proliferation level and prognosis. Methods Patient clinical data were collected from medical records and pathology laboratory reports at Teaching Hospital, Faculty of Medicine, Universitas Sumatera Utara. Ki67 expression, as a proliferation marker, was measured and detected using immunohistochemistry (IHC). Ki67 data were categorized into two groups: &lt;20% (low proliferation) and &gt;20% (high proliferation). Statistical analysis was conducted by calculating the frequency distribution and percentage of receptor status and using the &chi;2 test. Results The study revealed an inverse relationship between ER/PR status and Ki67 (&lt;0.001). Low Ki67 levels were generally associated with positive ER/PR status, while high Ki67 levels showed increased frequency in ER/PR- negative cases. Conclusion: Ki67 expression can be determined based on the frequency of ER/PR status; however, these markers have distinct roles in the management of breast cancer patients.

PMID:41082751 | DOI:10.17392/1941-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):263-267. doi: 10.17392/1942-22-02.

ABSTRACT

Aim To examine and evaluate the clinicopathological characteristics of young-onset breast cancer across molecular subtypes in patients from Southeast Asia, with a specific focus on those treated at H. Adam Malik Hospital, Indonesia. Methods A descriptive observational study with a cross-sectional design was conducted on medical records of breast cancer patients aged &lt;40 years treated at H. Adam Malik Hospital from January 2017 to December 2022. Data included demographic, clinical, histopathological, and immunohistochemical findings. Statistical analyses were performed descriptively. Results Among the 104 patients analyzed, 71 (69.2%) had T4 tumors, and 49 (47.1%) had NST-type tumors. Most cases lacked ER (72, 69.2%) and PR (71, 68.3%) expression. A total of 41 patients had poorly differentiated tumors, with the majority at stage IV. The HER-2 positive subtype was most common (39, 37.5%), followed by Luminal B (31, 29.8%) and TNBC (22, 21.2%). Conclusion Young-onset breast cancer at H. Adam Malik Hospital predominantly features advanced stages, aggressive histopathological grades, and a high prevalence of HER2-positive and Luminal B subtypes. These findings highlight the importance of early detection and personalized treatment approaches.

PMID:41082750 | DOI:10.17392/1942-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):258-262. doi: 10.17392/1968-22-02.

ABSTRACT

Aim to investigate the prevalence of cervical cytology abnormalities over five years and to correlate it with patient&rsquo;s age and presence/absence of HPV infection. Methods Pap findings of 614 women with documented cervical abnormalities and Pap findings of HPV-positive women (regardless of whether the Pap test showed an intraepithelial abnormality) were included in this study. Results The majority of women included in the study (36.5%) were aged 30-39 years. The most common abnormalities included atypical squamous cells-ASC (47.4%) and low-grade intraepithelial lesions (LSIL)-15.1%. Out of 614 women, 270 (43.9%) were positive for HPV. HR HPV positivity was found in 256 (41.7%). The proportion of HPV infection positivity decreases with age, especially in the two oldest age groups (women older than 60), p=0.03. The analysis showed a higher ratio of Pap smear abnormalities in groups of patients older than 40 years of age (p=0.02). The youngest age group (patients younger than 20 years of age) showed no other lesions than ASC, while women younger than 40 had no SCC on Pap smear. (p&lt;0.01). Out of 256 HR HPV- positive women 42.2% (n=108) showed Pap abnormalities. HR HPV-positive women more commonly had HSIL lesions, but without statistical significance (p&gt;0.05). Conclusion The results obtained contribute to the knowledge about HPV prevalence and the incidence of squamous cell abnormalities and confirm the necessity for further implementation of HPV vaccination and organized cervical cancer screening program on national level. Keywords: cervical dysplasia, Pap smear, screening.

PMID:41082749 | DOI:10.17392/1968-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):248-252. doi: 10.17392/1978-22-02.

ABSTRACT

AIM: This study aimed to reveal the prevalence of the insulin resistance (IR) identified by triglyceride glucose index (TyG index) among students of University of Sarajevo. The impact of visceral fat level and waist to hip ratio measures on TyG value in students has been investigated.

PATIENTS AND METHODS: Study included 160 apparently healthy students, both genders, aged from 19-27 years. Two groups were formed: Group1, TyG &lt;4,49 and Group 2, TyG&sup3;4,49. A short interview, questionnaire, anthropometric measures, visceral fat level (VFL), blood pressure and biochemical parameters were applied. The statistical level of significance was P&lt;0,05.

RESULTS: Forty-five students (28, 1%) were insulin resistant. There was a significant difference in TyG value (P&lt;0,001), [group 1- 4,19 (3,93-4,34 vs. group 2 – 4,59 (4,55-4,74)]. Fasting blood glucose (FBG) and lipid parameters-total cholesterol, triglycerides and very low-density lipoprotein cholesterol (TC, TG and VLDL-C) were significantly higher in group TyG &sup3;4,49 compared to TyG &lt;4,49 group, with exception of HDL-C of LDL-C (P&gt;0.05). Stepwise linear regression analysis showed significant impact of waist to hip ratio on TyG value (P=0,001).

CONCLUSION: The prevalence of IR measured by TyG in university students was 28,1%. The impact of waist to hip ratio on value of TyG index points on possible application of both parameters in visceral obesity and insulin resistance assessment in apparently healthy individuals.

PMID:41082747 | DOI:10.17392/1978-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):218-224. doi: 10.17392/1918-22-02.

ABSTRACT

AIM: &nbsp; This study examines the effects of implementing a modified Re-Engineered Discharge (RED) intervention on Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) and readmission rates 30 days after Coronary Artery Bypass Graft (CABG) surgery. Methods A randomized clinical trial was conducted with 104 participants who underwent elective CABG surgery. Participants were randomly assigned to either an intervention group or a control group. The intervention group received discharge training through the modified re-engineered discharge program, while the control group followed the standard discharge protocol used at the center. Data on major adverse events and readmission rates were collected 30 days after discharge.

RESULTS: The results indicated no statistically significant differences between the intervention and control groups regarding major adverse events and readmission rates post-discharge. Both groups showed similar outcomes after the implementation of the modified re-engineered discharge program. Conclusion This study contributes to the growing body of research on discharge interventions by providing insights into the challenges of integrating structured programs into routine care. It highlights the importance of comprehensive planning, resource allocation, and extended follow-up to enhance patient outcomes in cardiac surgery.

PMID:41082742 | DOI:10.17392/1918-22-02