Tag: nevin manimala

Med Glas (Zenica). 2025 Aug 25;22(2):212-217. doi: 10.17392/1949-22-02.

ABSTRACT

OBJECTIVE: This study aims to analyze the effects of Pulmonary Rehabilitation (PR) and short-wave Diathermy (SWD) on the Blood Urea Nitrogen (BUN)/Albumin ratio, Pneumonia Severity Index (PSI), IL-8 levels, and length of stay (LOS) in hospitalized pneumonia patients.

MATERIAL AND METHOD: This is a randomized experimental study with a pre-post control group structure. The study included 24 pneumonia patients who were treated at Dr. Saiful Anwar General Hospital and Lawang General Hospital between 2022 and 2023. For 5 days, subjects were separated into three groups: control, intervention (PR only), and intervention (PR and SWD). The data were examined by comparing the deltas of each group. PSI and CURB-65 were used to calculate severity indices and blood samples were obtained before and after the intervention to determine the BUN/Albumin ratio and IL-8 levels.

RESULTS: There was a significant decrease in the BUN/Albumin ratio after the intervention (p=0.03). IL-8 levels and LOS showed a decreasing trend, although not statistically significant (p=0.208; p=0.249). There was a substantial correlation between PSI and IL-8 and the BUN/Albumin ratio (p=0.015; p=0.002; p=0.001).

CONCLUSION: This study highlights reduced IL-8 levels, the BUN/Albumin ratio, and a shorter LOS in pneumonia patients receiving PR and SWD therapy for 5 days. This study reinforces the evidence that PR and SWD can serve as adjunctive therapies for patients with pneumonia.

PMID:41082741 | DOI:10.17392/1949-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):201-206. doi: 10.17392/1972-22-02.

ABSTRACT

Aim This study compared the extent of coronary artery calcification in patients with and without type 2 diabetes mellitus (T2DM) using Coronary Computed Tomography Angiography (CCTA). Methods This retrospective, observational cohort study included 107 patients who underwent CCTA at the Clinical Centre of the University of Sarajevo between July and December 2024. Patients were divided into two groups: those with T2DM (n=51) and those without T2DM (n=56). Laboratory parameters, demographic data, and calcium scores were analysed. The calcium score was categorised into six groups based on cardiovascular risk and the comparison was made using appropriate statistical analysis. Results Patients with T2DM had significantly higher calcium scores than non-diabetic patients (p=0.0001). In the T2DM group, 35.3% of patients had a calcium score >400, indicating high cardiovascular risk. Patients without diabetes were more frequently classified into lower-risk categories (p=0.0001). A significant correlation was found between calcium score and age (r=0.442, p=0.001) and gender (r=-0.218, p=0.024), with men having higher calcium scores. Additionally, total cholesterol, LDL, and uric acid levels were significantly higher in diabetic patients (p=0.005; p=0.025; p=0.03, respectively). Conclusion This study confirms a strong association between T2DM and increased coronary artery calcification. Age and male gender are significant predictors of higher calcium scores. Further research is needed to explore these relationships, particularly within the Bosnian population. Keywords Coronary angiography, coronary artery calcification, coronary disease, diabetes mellitus type 2.

PMID:41082739 | DOI:10.17392/1972-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):185-190. doi: 10.17392/1915-22-02.

ABSTRACT

AIM: This study aimed to assess recipient characteristics and blood product usage patterns at the Transfusion Medicine Institute of Federation of Bosnia and Herzegovina(FB&H) in 2023, focusing on clinic-specific blood requests.

METHODS: The study was conducted from 1st January to 29th December 2023. Data were collected from the Renovatio information system of the Transfusion Medicine Institute of FB&H. Information about patient age, gender, the clinics requesting blood, and the number and composition of issued blood products were gathered.

RESULTS: A total of 27,927 units of blood products were issued for 3,341 patients. The average age of transfused patients was 57.25 years, with a nearly equal distribution of male1.662 (49.75%) and females 1.679 (50.25%). Blood requests came from 28 clinics/hospital department, with the following distribution of blood products: 12,267 units of red blood cells, 6,982 units of platelet products, 8,661 units of fresh frozen plasma, and 17 units of cryoprecipitate. The number of doses issued per patient ranged from 1 to 356.

CONCLUSION: Our findings highlight the importance of assessing transfusion practices and recipient outcomes. It is essential to incorporate clinical parameters, such as hemoglobin levels, to optimize transfusion strategies. Multidisciplinary patient blood management approaches are necessary for ensuring safe and effective transfusions, aimed at achieving appropriate clinical outcomes.

PMID:41082736 | DOI:10.17392/1915-22-02

Med Glas (Zenica). 2025 Aug 25;22(2):179-184. doi: 10.17392/2014-22-02.

ABSTRACT

A caesarean section (CS) is an obstetric surgical intervention and mode of delivery which aims to finish the pregnancy surgically. CS are one of the most important surgical interventions in modern obstetrics and have lead to a significant reduction of fetal and maternal mortality. However, it is important to take into consideration that CS can have risks and lead to unwanted short-term and long-term consequences. One of the main questions of modern obstetric is the ideal CS rate, including ways to reduce an undesirably high CS rate. The ideal CS rate ranging between 10 to 20% according to various research, but some countries have reached rates exceeding 50%, while in other, less developed countries, the issue of accessibility for CS still exists and consequently leads to a high mortality rate. Significant inequality exists in CS accessibility between developed and less developed areas of countries, and countries themselves. In some cases it is even desirable to increase CS rates in order to reduce negative patient outcome.

PMID:41082735 | DOI:10.17392/2014-22-02

Health Lit Res Pract. 2025 Oct;9(4):e105-e116. doi: 10.3928/24748307-20250612-03. Epub 2025 Oct 15.

ABSTRACT

BACKGROUND: Despite the significance of health literacy, studies show the inadequacy of health literacy in the health system of Iran. Inadequate health literacy is considered a warning for service providers. It needs to be integrated into educational programs that are administered within health and medical centers.

OBJECTIVE: Therefore, the present study was conducted to explore the barriers to health literacy in Iran’s health system.

METHODS: The present qualitative study was conducted in 2023 using a conventional content analysis. To this aim, 18 participants were selected among urban health center staff, 21 from rural health centers, 10 health volunteers, and 8 trainees (people participating in training classes) for interviews and group discussions. After the first interview, continuous data analysis began and continued to saturation level. The data were collected through semi-structured interviews and focus group discussions and were simultaneously analysed using a conventional qualitative analysis.

KEY RESULTS: Two main categories of internal and external barriers were detected. The data analysis led to the extraction of four main subcategories: (1) personal barriers (trainee’s inadequate competence, lack of physical or mental health, low motivation and commitment of health staff, beliefs, contextual barriers); (2) interpersonal barriers (health care providers’ misunderstanding of correct training, malcommunication or miscommunication in training sessions, the trainer’s limited skill, underestimated role of education in behavior change); (3) organizational barriers (high workload of health care staff, inadequate human resources, poor management and distrust in the health system, low organizational motivation); and (4) social barriers (uninterest in learning about health issues, issues related to the internet and cyberspace, lack of interpectoral cooperation).

CONCLUSION: Considering the multidimensional nature of barriers to health literacy, it is recommended to make and implement a comprehensive plan to integrate efforts by health authorities and institutions, mass media, experts, decision-makers, policymakers, and service providers to remove barriers.

PMID:41082729 | DOI:10.3928/24748307-20250612-03

J Glob Health. 2025 Oct 14;15:04312. doi: 10.7189/jogh.15.04312.

ABSTRACT

BACKGROUND: Current recommendations for neonatal bed requirements are largely assumption-based rather than data-driven. We aimed to estimate the number of beds per 1000 live births needed for the care of small and sick newborns.

METHODS: We first extracted data from studies published between 2018 and May 2023. Then, due to considerable heterogeneity in the data, we performed a meta-analysis using a random effects model to estimate the number of neonatal admissions and the length of stay. We divided the total patient days (admission rate multiplied by the length of stay) by 365 to estimate the annual number of beds per 1000 live births.

RESULTS: We include 54 included studies, of which 46 provided data on the incidence of neonatal admissions and 20 on length of stay. The pooled analysis indicated that the number of neonates requiring admission ranged from 126 to 143 per 1000 live births. Admission rates were higher in the African region (160.5; 95% confidence interval (CI) = 122.2-198.7), in low-income countries (175.3; 95% CI = 102.8 to 247.8), in tertiary care settings (147.5; 95% CI = 115.9-179.1), and in settings with a high neonatal mortality rate (149.4; 95% CI = 90.5-218.2). The pooled length of stay was estimated to be 6.4 days (95% CI = 5.7-7.1). The overall estimated number of beds needed for the care of small and sick newborns was 2.4 (95% CI = 2.0-2.8) per 1000 live births, with regional variations.

CONCLUSIONS: This method estimates the required neonatal care beds using admission rates and hospital stay data, aiding healthcare planning. Refinements and local adaptations are needed for effective policy decisions.

REGISTRATION: PROSPERO: CRD42023417847.

PMID:41082719 | DOI:10.7189/jogh.15.04312

J Clin Oncol. 2025 Oct 13:JCO2500036. doi: 10.1200/JCO-25-00036. Online ahead of print.

ABSTRACT

PURPOSE: Immunotherapy targeting PD-L1 improves outcomes in patients with unresectable stage III non-small cell lung cancer (NSCLC) and no progression after definitive, concurrent chemoradiotherapy (cCRT). Earlier administration of immunotherapy, simultaneously with cCRT, may improve outcomes further.

METHODS: Eligible patients were randomly assigned (2:1) to receive either durvalumab or placebo administered from the start of cCRT. Patients without progression after completing cCRT received consolidation durvalumab or placebo (per initial random assignment) until progression. The primary end point was progression-free survival (PFS) by blinded independent central review. Key secondary end points included objective response rate (ORR), overall survival (OS), the proportion of patients alive at 24 months (OS24), and safety.

RESULTS: In total, 328 patients were randomly assigned to receive durvalumab (n = 219) or placebo (n = 109). There was no statistically significant difference with durvalumab versus placebo in PFS (hazard ratio [HR], 0.85 [95% CI, 0.65 to 1.12]; P = .247) or OS (HR, 1.03 [95% CI, 0.78 to 1.39]; P = .823); OS24 was 58.4% versus 59.5%, respectively. Confirmed ORR was 60.7% with durvalumab versus 60.6% with placebo (difference, 0.2% [95% CI, -15.2 to 16.3%]; P = .976). With durvalumab versus placebo, respectively, maximum grade 3 or 4 adverse events (AEs) occurred in 53.4% versus 59.3% of patients, pneumonitis or radiation pneumonitis (group term) in 28.8% (grade ≥3: 4.6%) versus 28.7% (grade ≥3: 5.6%), AEs leading to discontinuation of durvalumab or placebo in 25.6% versus 12.0%, and fatal AEs in 13.7% versus 10.2%.

CONCLUSION: Among patients with unresectable stage III NSCLC, durvalumab administered from the start of cCRT failed to demonstrate additional benefit compared with cCRT plus placebo. Consolidation durvalumab following definitive cCRT remains the standard of care in this setting.

PMID:41082707 | DOI:10.1200/JCO-25-00036

Neurology. 2025 Nov 11;105(9):e214309. doi: 10.1212/WNL.0000000000214309. Epub 2025 Oct 13.

NO ABSTRACT

PMID:41082698 | DOI:10.1212/WNL.0000000000214309

Neurology. 2025 Nov 11;105(9):e214250. doi: 10.1212/WNL.0000000000214250. Epub 2025 Oct 13.

ABSTRACT

BACKGROUND AND OBJECTIVES: Preclinical-to-clinical translational failure is common in neurologic research. Reasons for translational failure are complex and multifaceted, but it is increasingly recognized that translational decision making may be influenced by preclinical work that is overly optimistic, due to a lack of scientific rigor. Previous research has demonstrated that statistical errors are common in preclinical research, yet results of preclinical null hypothesis significance testing contribute to the body of evidence used to evaluate whether a new intervention is a candidate for translation. However, no empirical investigations exist yet that compare positive and negative clinical trials on the statistical soundness of contributing studies. The aim of this study was to explore, for 3 neurologic indications (multiple sclerosis, Parkinson disease, epilepsy), whether negative clinical trials show a higher prevalence of statistical misapplication in preceding animal experiments, compared with positive human trials.

METHODS: A modified meta-research, case-control design with multistep systematic search was used. Phase 2 clinical trials (completed January 1, 2010-October 31, 2020) were identified on ClinicalTrials.gov. Best practice methods were used to systematically search MEDLINE and Embase for animal experiments preceding the start of each human trial, for each intervention and disease. Statistical reporting and decision-making data were gathered from animal articles by collectors blinded to human trial outcome. Rates of statistical mistakes were compared between animal articles preceding positive vs negative human trials using weighted percentages and CIs.

RESULTS: The final sample included 24 trials (8 negative) and 70 associated rodent studies. Animal studies preceding negative human trials had higher rates of misapplication of solely cross-sectional statistical tests to longitudinal data (93% [95% CI 83-100] vs 66% [95% CI 47-82]) and of the use of plots that concealed continuous data distributions (98% [95% CI 95-100] vs 71% [95% CI 51-91]), indicating possible mishandling of continuous data.

DISCUSSION: Statistical practice in animal studies was generally poor or not well reported, with rates of some statistical mistakes occurring more frequently before negative trials than positive trials. This was an exploratory study with a highly selected sample, yet it suggests that translational decision making should include evaluation of the quality of preclinical statistical practice.

PMID:41082697 | DOI:10.1212/WNL.0000000000214250

Ecol Lett. 2025 Oct;28(10):e70219. doi: 10.1111/ele.70219.

ABSTRACT

The phenotypes of individuals within a population create a dynamic social environment that influences phenotypic selection and population growth. Fluctuations in the frequencies of these phenotypes can influence population mean fitness and the relative fitness of phenotypes, and thus impact both population dynamics and phenotypic evolution. Various theoretical frameworks have been used to study the impact of frequency dependence on ecological and evolutionary dynamics. However, their diversity and mathematical complexity have obscured the relationship between theoretical models and empirical work. To bridge this gap, we discuss the effects of frequency dependence on phenotypic selection and population growth from a statistical perspective. We classify frequency-dependent effects on fitness according to their additive, relative or multiplicative effects, and explore how their interaction with population density can affect the eco-evolutionary dynamics of continuous traits. We show how these different effects can be mapped onto the parameters of simple linear regression models and derive how their magnitude is expected to affect the population carrying capacity and equilibrium mean phenotype. We then use individual-based simulations to complement our analytical results and demonstrate that quantifying frequency-dependent effects on fitness is key for understanding how populations will respond to environmental change.

PMID:41082684 | DOI:10.1111/ele.70219