Tag: nevin manimala

Health Sci Rep. 2026 Feb 25;9(3):e71933. doi: 10.1002/hsr2.71933. eCollection 2026 Mar.

ABSTRACT

BACKGROUND AND AIMS: In Nepal, abortion was legalized in 2002; however, national-level evidence on the factors influencing abortion practices remains limited. This study explored the predictors of induced abortion among women of reproductive age in Nepal using data from the most recent nationally representative survey.

METHODS: We analyzed data from the 2022 Nepal Demographic and Health Survey (NDHS), which employed a nationally representative design. The analytic sample consisted of 14,845 women aged 15-49 years. Descriptive statistics were calculated, and associations were examined using the Rao-Scott chi-square test. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated through multivariable Poisson regression to identify determinants of abortion.

RESULTS: Overall, 19% of women reported having ever terminated a pregnancy. The prevalence of abortion was higher among women aged 45-49 years (aPR = 5.009, 95% CI: 3.437-7.302, p < 0.001), those with only basic education (aPR = 1.181, 95% CI: 1.075-1.298, p = 0.001), women with six or more children (aPR = 4.024, 95% CI: 2.950-5.490, p < 0.001), frequent internet users (aPR = 1.141, 95% CI: 1.026-1.270, p = 0.015), and women who listened to radio weekly (aPR = 1.115, 95% CI: 1.021-1.218, p = 0.015). In contrast, reduced prevalence was observed among women from poorer households (aPR = 0.838, 95% CI: 0.741-0.947, p = 0.005), those watching television once weekly (aPR = 0.874, 95% CI: 0.794-0.961, p = 0.006), and Buddhist women (aPR = 0.792, 95% CI: 0.679-0.924, p = 0.003).

CONCLUSIONS: Induced abortion remains relatively common in Nepal. Key determinants include maternal age, parity, education level, household wealth, religious affiliation, and media exposure. To reduce reliance on abortion and improve reproductive health outcomes, policies should expand access to modern contraceptives and comprehensive reproductive health services. Interventions must particularly prioritize older and multiparous women, those with limited education, and women from socioeconomically disadvantaged backgrounds who may face barriers to contraception and safe services, alongside populations highly exposed to internet and radio platforms.

PMID:41757345 | PMC:PMC12933135 | DOI:10.1002/hsr2.71933

Health Sci Rep. 2026 Feb 25;9(3):e71908. doi: 10.1002/hsr2.71908. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: Substance use, particularly cannabis and alcohol consumption, presents a growing public health challenge in Ghana, with significant implications for both mental and physical health. While the adverse psychological effects of these substances have been extensively studied, their biochemical impact remains inadequately explored, particularly in psychiatric settings. The rising prevalence of substance-use disorders among individuals receiving psychiatric care necessitates a comprehensive evaluation of the physiological consequences associated with cannabis and alcohol use. This study investigated these biochemical effects in patients at Accra Psychiatric Hospital.

AIM: The study sought to determine the impact of the use of cannabis and alcohol on hemoglobin level, lipid profile, and liver function analysis.

METHOD: This cross-sectional study at Accra Psychiatric Hospital assessed the impact of cannabis and alcohol use on hemoglobin levels, lipid profile, and liver enzymes among 184 participants. Using stratified purposive sampling, data collection involved structured interviews, and blood analysis. Hemoglobin concentration, lipid profile, and liver enzyme activity were measured using standard laboratory techniques. Statistical analysis was conducted with SPSS and GraphPad Prism, with significance set at p < 0.05.

RESULTS: The study compared 92 non-users with 92 substance users (alcohol-only, n = 21; cannabis-only, n = 50; dual users, n = 21). Hemoglobin levels were similar between non-users and single-substance users, but significantly higher in dual users compared with non-users (p = 0.017) and alcohol-only users (p = 0.027). Cannabis-only users had significantly lower total cholesterol than non-users (4.53 ± 0.98 vs. 5.30 ± 1.23 mmol/L, p < 0.001), while LDL-C was higher in non-users than in all substance user groups (p < 0.05). No group differences were found for HDL-C, triglycerides, and VLDL. Liver function analysis revealed significantly higher AST in all substance user groups, with dual users recording the highest levels (81.14 ± 72.26 U/L, p < 0.001 vs. non-users). GGT was markedly elevated in alcohol-only and dual users compared with non-users (p < 0.001). Both direct and indirect bilirubin were significantly higher in all substance user groups (p < 0.05), and albumin levels were significantly lower in non-users than in all substance user groups (p < 0.001).

CONCLUSION: The findings indicate that while single-substance use of alcohol or cannabis had limited impact on hemoglobin and lipid profiles, dual use was associated with elevated hemoglobin and marked liver enzyme abnormalities. Elevated AST, GGT, and bilirubin in substance users, particularly dual users, suggest potential hepatic stress, warranting targeted public health interventions and monitoring. It is recommended that routine liver function screening be incorporated into healthcare services for individuals with a history of alcohol and cannabis use to enable early detection and management of hepatic impairment.

PMID:41757343 | PMC:PMC12933133 | DOI:10.1002/hsr2.71908

Health Sci Rep. 2026 Feb 24;9(3):e71927. doi: 10.1002/hsr2.71927. eCollection 2026 Mar.

ABSTRACT

BACKGROUND AND AIMS: Vitamin A deficiency (VAD) is a pressing public health issue for young children in low- and middle-income countries like Somalia, significantly increasing risks of morbidity, mortality, and impaired development. High-dose Vitamin A supplementation (VAS) is a crucial preventative intervention, yet data on its coverage in Somalia’s complex humanitarian context are scarce. This study aims to assess the prevalence of VAS and identify its sociodemographic determinants among Somali children aged 6-59 months.

METHODS: This study utilized a quantitative, cross-sectional design, analyzing data from 15,456 children aged 6-59 months from the nationally representative Somalia Demographic and Health Survey (SDHS) 2020. The outcome was maternal report of a child receiving a Vitamin A supplement in the preceding 6 months. To ensure the results were nationally representative, weighted descriptive statistics and multivariate logistic regression were performed in Stata to account for the complex survey design.

RESULTS: The prevalence of VAS receipt was critically low at 11.2%. Multivariate analysis revealed significant and unexpected disparities. Contrary to expectations, compared to children of mothers with no education, those with primary (AOR = 0.453, p < 0.001), secondary (AOR = 0.302, p < 0.001), or higher education (AOR = 0.327, p < 0.001) had significantly lower odds of their child receiving VAS. Children in nomadic households had significantly lower odds than those in rural households (AOR = 0.626, 95% CI: 0.549-0.714, p < 0.001). Compared to mothers aged 15-19, older mothers (≥ 35 years) had significantly lower odds of their child receiving VAS. Children of divorced mothers also had lower odds than those of married mothers (AOR = 0.799, p = 0.028).

CONCLUSION: VAS coverage among young Somali children is alarmingly inadequate. The counterintuitive finding regarding maternal education suggests that conventional assumptions about health-seeking behaviors may not apply in this context. Targeted interventions and strengthened health system delivery are urgently needed to address these disparities.

PMID:41757342 | PMC:PMC12933129 | DOI:10.1002/hsr2.71927

Health Sci Rep. 2026 Feb 24;9(3):e71831. doi: 10.1002/hsr2.71831. eCollection 2026 Mar.

ABSTRACT

BACKGROUND AND AIMS: Breast cancer is the most commonly diagnosed cancer among women in Saudi Arabia, with early detection playing a critical role in improving survival outcomes. However, screening uptake remains suboptimal, particularly among younger women. To address this gap, this study aimed to evaluate the knowledge, attitudes, and practices (KAP) of young women in the Jazan region and identify key demographic and behavioral predictors influencing breast cancer screening uptake.

METHODS: A cross-sectional study (N = 480) was conducted between January and March 2024. A structured, validated questionnaire was used to collect data on demographic characteristics and KAP regarding breast cancer. The primary outcomes assessed were knowledge, attitude, and practice scores. Statistical analysis included descriptive and inferential statistics, Pearson’s correlation, and logistic regression to identify predictors of breast self-examination (BSE).

RESULTS: Most participants were young, single Saudi students residing in urban areas. The mean scores were: knowledge (3.66 ± 0.66), attitude (4.09 ± 0.58), and practice (3.81 ± 0.73). Moderate-to-strong positive correlations were observed between knowledge and attitude (r = 0.569, p < 0.001) and between knowledge and practice (r = 0.567, p < 0.001), indicating meaningful associations among the three domains. Age differences were evident, with both the youngest (< 25 years) and oldest (> 45 years) groups demonstrating comparatively higher knowledge scores. Participants in health-related specializations also showed higher knowledge levels (mean = 3.78 ± 0.66), suggesting a notable effect of academic background. Logistic regression demonstrated that age (26-35 years) substantially increased the likelihood of performing BSE (adjusted OR = 12.422; 95% CI: 1.12-137.95), while having two to three children markedly reduced the odds (adjusted ORs = 0.051-0.065). Additionally, non-Saudi participants had lower odds of practicing BSE (crude OR = 0.212; 95% CI: 0.06-0.72), highlighting demographic disparities in screening behaviors.

CONCLUSION: Age, education, specialization, and family responsibilities significantly influence women’s breast cancer knowledge, attitudes, and preventive behaviors, including BSE and screening uptake. Targeted, population-specific awareness strategies are essential to enhance early detection practices and reduce the breast cancer burden in the KSA.

PMID:41757341 | PMC:PMC12933140 | DOI:10.1002/hsr2.71831

Health Sci Rep. 2026 Feb 25;9(3):e71923. doi: 10.1002/hsr2.71923. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: Tuberculosis (TB) remains a significant public health challenge, necessitating accurate forecasting methodologies to support effective control and prevention strategies. This paper explores the application and comparative performance of single and hybrid time-series models for forecasting TB incidence trends specifically in Somalia.

METHODS: Annual TB incidence data from 2000 to 2022 were sourced from the World Bank to train and evaluate a comprehensive suite of 14 time-series models. This included five single models-ARIMA, ETS, TBATS, Theta, and NNAR-and nine hybrid model combinations (e.g., ARIMA-ETS, ARIMA-TBATS, ARIMA-ETS-TBATS). Model performance was assessed using Theil’s U statistic, Mean Absolute Percentage Error (MAPE), Symmetric Mean Absolute Percentage Error (SMAPE), and Root Mean Square Error (RMSE).

RESULTS: Among the single time-series models, the TBATS model demonstrated the best fit. However, the comparative analysis revealed that the hybrid ARIMA-ETS-TBATS model outperformed other hybrid configurations. The study highlights that hybrid modeling offers enhanced forecasting accuracy compared to single models.

CONCLUSION: The resulting forecasts provide valuable insights into future TB incidence trends in Somalia. These findings underscore the importance of hybrid modeling in generating accurate data to aid informed public health decision-making and the development of targeted intervention strategies for TB control.

PMID:41757340 | PMC:PMC12933138 | DOI:10.1002/hsr2.71923

Facial Plast Surg Aesthet Med. 2026 Feb 26:26893614261422044. doi: 10.1177/26893614261422044. Online ahead of print.

ABSTRACT

BACKGROUND: Literature regarding the longevity of deep plane facelifts is limited.

OBJECTIVE: To measure the time duration between initial deep plane facelifts and revision facelifts among patients treated in a single-surgeons practice over a 30-year period.

METHODS: Chart review from a surgeon’s 30-year experience performing revision facelifts. Patient demographics and motivation, timing for primary/revision facelifts, and adjunctive procedures were collected. Patients were stratified into groups ≤53 and >53 based on statistical assessment. t-Tests were used.

RESULTS: A total of 93 revision facelifts on patients who underwent deep plane lifts were included. Seventy-seven patients had a second facelift, 14 had a third, and 2 had a fourth. Sex (female 73/77, 94.8%; male 4/77, 5.2%), age at time of first facelift (mean = 53.5 ± 6.85), second facelift (mean = 64.5 ± 6.5). Adjunctive procedures: Upper/lower blepharoplasty (18.18%, 7.8%), brow lift (15.5%), and rhinoplasty (7.8%) (Table 1). The mean interval between the primary deep plane facelift and the secondary lift was 10.9 years ± 5.1 Patients who underwent primary facelift surgery at ≤53 years of age returned for revision facelift after 12.4 years ± 5.6; patients >53 returned 9.3 years later ± 3.9 (p = 0.004).

CONCLUSION: Patients returning for revision surgery following deep plane facelifts do so after an average of 10.9 years. Patients who are younger at the time of their initial facelift may have greater longevity.

PMID:41749415 | DOI:10.1177/26893614261422044

J Biomed Mater Res B Appl Biomater. 2026 Mar;114(3):e70047. doi: 10.1002/jbm.b.70047.

ABSTRACT

Placental-derived biomaterials are rising in popularity for use in treating severe skin injuries due to their abundant pro-healing factors which result in improved healing outcomes. Clinical use of human-derived placental products, however, is limited by high costs, donor availability, and high variability (due to age, health, and genetic factors). Porcine-derived placental biomaterials have structure and pro-healing factors similar to human placental materials, and can be mass produced on a larger scale, with reduced variability and cost. In this study, porcine-derived placental biomaterials were compared to human-derived placental biomaterials in a full-thickness skin defect rat model. Porcine-derived placental powder (PP), porcine-derived placental membrane (PM), and human-derived amniotic membrane (HM) were tested and compared to no treatment in 36 rats. At 3, 7, and 14 days, rats were euthanized, and defects were excised for H&E and picrosirius red staining. Analyses included wound area measurement, gross inflammation and histological inflammation scoring, qualitative assessments via H&E staining, and quantification of collagen in defects via picrosirius staining over the 14-day healing process. No statistical differences were found between treatment groups at each timepoint for percent difference to adjacent control defect measurements including wound area, histological inflammation scoring, and collagen quantification analyses. PP treated defects had lower gross inflammation scores compared to HM at Day 3 (p = 0.048). Trends observed in wound area measurements, gross and histological inflammation scores, and collagen quantification suggested that PP treated defects induced greater healing efficacy at earlier timepoints. Additionally, PP defects had more rapid and robust crust formation which may have contributed to improved healing outcomes based on reduced inflammation, improved hair follicle growth, re-epithelialization, collagen formation, and protection during wound dressing changes.

PMID:41749412 | DOI:10.1002/jbm.b.70047

Cancer Imaging. 2026 Feb 26. doi: 10.1186/s40644-026-01012-0. Online ahead of print.

ABSTRACT

PURPOSE: Response assessment in the treatment of metastatic sarcoma primarily depends on imaging, as no established clinical or serological biomarkers reliably predict survival outcomes. This study evaluates the utility of Response Evaluation Criteria in Solid Tumors (RECIST v1.1) in predicting overall survival (OS) in sarcoma patients with pulmonary metastases.

METHODS: We selected consecutive study subjects from a prospective registry based on the following criteria: (1) available CT imaging at first diagnosis of pulmonary metastases from sarcoma, (2) available follow-up CT imaging within 16 weeks of systemic therapy initiation, (3) documentation of OS. Volumetric segmentation of up to 5 lung metastases was performed over time. Progressive disease (PD) was defined as increase of the unidimensional sum of lesions ≥ 20% or appearance of new metastases according to RECIST v1.1. Kaplan-Meier survival analyses were performed. P values < 0.05 were considered statistically significant.

RESULTS: Ninety-two patients were included (median age: 58 years; 50% female). Average time of follow-up CT was 67 days after baseline imaging. Patients with PD on first follow-up imaging (n = 24; 26%) showed significantly shorter OS (13.9 months vs. 29.3 months; p = 0.014). The unidimensional growth threshold of 20% proposed by RECIST did not stratify OS (14.6 months vs. 26.8 months, p = 0.221). The appearance of new metastases (n = 16; 17%) indicated significantly shorter OS (7.8 months vs. 27.0 months; p < 0.001) and was frequently observed even in patients with decreasing size of existing metastases (n = 7; 8%).

CONCLUSION: Imaging progression patterns of pulmonary metastatic sarcoma demonstrate distinct associations with OS, highlighting the need for sarcoma-specific adaptations to established response criteria.

PMID:41749400 | DOI:10.1186/s40644-026-01012-0

Eur J Med Res. 2026 Feb 26. doi: 10.1186/s40001-026-04081-w. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the relationships between inflammatory markers obtained from complete blood count (CBC) and the prevalence of myocardial infarction (MI).

METHODS: A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2020. A total of 46,697 US adults were enrolled, including 1824 with self-reported physician-diagnosed MI history. Systemic inflammatory response index (SIRI) and five other CBC-derived inflammatory indices were included. Logistic regression models, restricted cubic spline analysis, and subgroup analysis were applied to examine the association between these indices and MI prevalence with adjustments for potential confounding variables. Interaction analysis was used to verify the sex-specific effect modification and mediation analysis was performed to explore the mediating role of metabolic diseases including hypertension, diabetes and dyslipidemia.

RESULTS: After full adjustment for confounding factors, elevated SIRI, NLR, MLR, and NMLR were significantly positively associated with MI prevalence (all P < 0.001). Restricted cubic spline analysis revealed nonlinear dose-response relationships between SIRI, MLR, SII, and MI prevalence (all P for non-linearity < 0.05). Significant sex-specific heterogeneity was observed. SIRI, NLR, NMLR, and SII had markedly stronger positive correlations with MI in females than males (all P for interaction < 0.05). Mediation analysis indicated metabolic diseases mediated approximately one-quarter to one-third of the SIRI-MI history association.

CONCLUSION: This study revealed a significant link between CBC-derived inflammation markers and MI prevalence, with sex acting as a key modifier. Further longitudinal research is crucial to assess the utility of these accessible, low-cost indicators in routine cardiovascular risk assessment and to clarify causal pathways.

PMID:41749357 | DOI:10.1186/s40001-026-04081-w

Syst Rev. 2026 Feb 26. doi: 10.1186/s13643-026-03123-y. Online ahead of print.

ABSTRACT

BACKGROUND: Preventive care – asking, advising or referring patients for help with smoking, nutrition, alcohol, physical activity, and weight (SNAP-W) – is not consistently provided in routine outpatient care due to barriers such as time, other priorities, and forgetfulness. Digital health interventions (DHIs) integrated into routine care offer a promising solution and are acceptable to clinicians and patients. A systematic review is needed to synthesise existing evidence on the effectiveness of DHIs that engage patients, alongside routine care, to provide preventive care targeting SNAP-W in outpatient settings.

METHODS: We will include randomised and non-randomised studies that compare a DHI supporting the provision of preventive care for SNAP-W health behaviours with usual care. The DHI must integrate with routine clinician-provided care. Participants will be adult patients/clients of any outpatient healthcare service. The primary outcomes will be provision/receipt of preventive care elements addressing the SNAP-W health behaviours. Secondary outcomes will include SNAP-W behaviour change outcomes. Eligible studies will be identified via MEDLINE, EMBASE, PsycINFO, Scopus, and CINAHL. Two reviewers will independently conduct study selection, data extraction, and risk of bias assessment, with a third resolving disagreements. Risk of bias will be assessed using Cochrane RoB-2 for randomised and ROBINS-I for non-randomised trials. If feasible, a meta-analysis will be conducted to estimate the pooled effect of DHIs by health behaviour. Exploratory sub-group (e.g., type of clinical setting, preventive care element) analyses will be conducted to determine possible causes of statistical heterogeneity. If a meta-analysis is not feasible, results will be summarised using direction of effect per the Synthesis Without Meta-analysis guidelines.

DISCUSSION: This review will identify whether DHIs that engage patients as part of outpatient health care are effective at improving delivery of SNAP-W preventive care for adults attending these services. These findings will be of interest to service providers, policy makers and implementation researchers seeking to improve health outcomes through routine preventive care provision.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD420251067831.

PMID:41749355 | DOI:10.1186/s13643-026-03123-y