Tag: nevin manimala

Clin Endosc. 2025 Aug 26. doi: 10.5946/ce.2025.072. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is conventionally performed in the prone position (PP). Recent studies have shown that the supine position (SP) is an effective alternative, with comparable success rates. We conducted a meta-analysis to directly compare the safety and efficacy of the two ERCP positions.

METHODS: In line with Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was performed through a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library. Statistical analyses were performed using RevMan, with results considered significant at p<0.05 and reported as odds ratios (ORs) and mean differences (MDs).

RESULTS: Eleven studies (24,285 patients) were included in the final analysis. Procedural success was significantly higher in the PP (OR, 0.52; 95% confidence interval [CI], 0.36-0.75; p<0.0004) than the SP. However, no significant difference was observed in procedure times (MD, 0.22; 95% CI, -7.07 to 7.50; p=0.95), number of cardiopulmonary complications (OR, 1.08; 95% CI, 0.47-2.48; p=0.86), or post-ERCP pancreatitis (OR, 1.12; 95% CI, 0.52-2.42; p=0.31) between the two groups.

CONCLUSIONS: The PP demonstrates superior ERCP success compared to the SP, without prolonging procedure time or increasing the risk of adverse events. However, given the comparable procedure times, incidence of adverse events, and increased comfort for both patients and anesthesiologists, the SP may be a suitable alternative for a select group of patients in whom the PP is not feasible, such as those with morbid obesity or recent abdominal surgery.

PMID:40899240 | DOI:10.5946/ce.2025.072

Ann Geriatr Med Res. 2025 Aug 21. doi: 10.4235/agmr.25.0107. Online ahead of print.

ABSTRACT

AIM: This study aimed to reveal demographic data for care-dependent older adults receiving home medical care and to evaluate whether potentially inappropriate medication (PIM) prescriptions were associated with hospitalization and death.

METHODS: Data of health-care and long-term care insurance claims of older adults aged ≥65 years receiving home medical care of Kure City, Japan in April 2017 were obtained. They included age, sex, recorded diagnosis on medical claims, level of long-term care (LTC) needs, and medication profile. Hospital admissions and deaths were identified between April 2017 and April 2019. Factors associated with hospitalization/death and PIM (≥1 PIM) defined by STOPP-J were analyzed statistically.

RESULTS: A total of 2052 participants (mean age 86.5±7.4 years, female 71.7%) were included. The mean number of prescribed medications was 6.6±4.3. PIM increased as LTC level became severer (8.7% for support level 1 and 2, 22.6% for care level 1 and 2, 26.0% for care level 3 to 5). Among PIM, H2 receptor antagonists were the most common medication (29.0%), followed by antiplatelet agents (22.6%), magnesium oxide (19.4%), non-benzodiazepine sedatives (17.7%), and benzodiazepines (16.8%). On logistic regression analysis, the number of medications, PIM, and care level 1 and 2 were associated with higher likelihood of hospital admission. There was no significant correlation between each PIM and hospital admissions. Regarding death, while age was associated with higher likelihood, female gender and severer level of disability were associated with lower likelihood.

CONCLUSIONS: PIM was prevalent among homebound older adults, suggesting that careful medication review should be conducted especially in those with disability.

PMID:40899229 | DOI:10.4235/agmr.25.0107

Hua Xi Kou Qiang Yi Xue Za Zhi. 2025 Aug 1;43(4):592-602. doi: 10.7518/hxkq.2025.2024481.

ABSTRACT

OBJECTIVES: To evaluate the osteogenic efficacy of three-dimensional printing individualized titanium mesh (3D-PITM) as a scaffold material in guided bone regeneration (GBR).

METHODS: 1) Patients undergoing GBR for alveolar bone defects were enrolled as study subjects, and postoperative healing complications were recorded. 2) Postoperative cone beam computed tomography (CBCT) scans acquired at least 6 months post-surgery were used to calculate the percentage of actual bone formation volume. 3) Alveolar bone specimens were collected during the first-stage implant surgery for histomorphometric analysis. This analysis quantitatively measured the proportions of newly formed bone and newly formed unmineralized bone within the specimens. Specimens were categorized into three groups based on healing complications (good healing group, wound dehiscence group, 3D-PITM exposure group) to compare differences in the proportions of newly formed bone and newly formed unmineralized bone.

RESULTS: 1) Twelve patients were included. Guided bone regeneration failed in one patient, and 3D-PITM exposure occurred in three patients (exposure rate: 25%). 2) The mean percentage of actual bone formation volume in the 11 successful guided bone regeneration cases was 95.23%±28.85%. 3) Histomorphometric analysis revealed that newly formed bone constituted 40.35% of the alveolar bone specimens, with newly formed unmineralized bone accounting for 13.84% of the newly formed bone. Intergroup comparisons showed no statistically significant differences (P>0.05) in the proportions of newly formed bone or newly formed unmineralized bone between the good healing group and the wound dehiscence group or the 3D-PITM exposure group.

CONCLUSIONS: 3D-PITM enables effective bone augmentation. Radiographic assessment demonstrated favorable bone formation volume, while histological analysis confirmed substantial formation of newly formed mineralized bone within the surgical site.

PMID:40899215 | DOI:10.7518/hxkq.2025.2024481

Curr Eye Res. 2025 Sep 2:1-7. doi: 10.1080/02713683.2025.2549289. Online ahead of print.

ABSTRACT

PURPOSE: Sex hormone changes, often occurring during menopause, are implicated in meibomian gland dysfunction (MGD) and evaporative dry eye disease (DED). This study aimed to evaluate whether menopausal status affects the treatment outcomes of perfluorohexyloctane eye drops.

METHODS: This post hoc analysis used data from a phase 3 trial (NCT05515471) of perfluorohexyloctane eye drops in patients with DED associated with MGD. The efficacy and safety of perfluorohexyloctane compared with 0.6% saline were evaluated within each menopausal status subgroup (premenopausal or postmenopausal), and the interaction between treatment and menopausal status was assessed.

RESULTS: In total, 245 women (94 postmenopausal and 151 premenopausal) were included. In the postmenopausal subgroup, the propensity score weighted least-squares mean differences (LSMD) in changes from baseline to day 57 in total corneal fluorescein staining (tCFS) score and eye dryness score (EDS) between perfluorohexyloctane and saline were -1.0 (95% CI, -2.0, 0.0) and -7.9 (95% CI, -15.6, -0.2), respectively. In the premenopausal subgroup, the propensity score weighted LSMD in changes from baseline to day 57 in tCFS score and EDS were -1.4 (95% CI, -2.3, -0.5) and -14.0 (95% CI, -20.3, -7.8), respectively. Both subgroups showed improvements in some DED symptoms. No statistically significant interaction was observed between menopausal status and treatment across all measured outcomes. Perfluorohexyloctane was well tolerable in both subgroups.

CONCLUSIONS: Perfluorohexyloctane eye drops improved signs and symptoms of DED associated with MGD and were safe in both postmenopausal and premenopausal women. Further studies are needed to confirm the influence of menopausal status on perfluorohexyloctane efficacy.

TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT05515471.

PMID:40898391 | DOI:10.1080/02713683.2025.2549289

Transplantation. 2025 Sep 3. doi: 10.1097/TP.0000000000005510. Online ahead of print.

ABSTRACT

BACKGROUND: Acceptance of pediatric liver transplantation (PLT) in this part of the world has been slow because of a number of considerations, including those of cost, infections, and the nonavailability of expertise. Despite several obstacles, PLT has seen impressive growth in the recent years. Against a backdrop of this changing landscape of PLT in India, we present our experience of performing 700 PLT over a period of 13 y.

METHODS: All 700 children (<18 y old) who underwent PLT from January 2011 to February 2024 were included in the study. Children were grouped in to group 1 (<5 kg), group 2 (5-10 kg) and group 3 (>10 kg) and survival analysis was performed. The outcomes of PLT performed over the first 7 y were compared with those of the next 6 y, with the aim to present any learning curve/teething troubles that could have presented while setting up the unit.

RESULTS: The overall 90-d, 1-, 5-, and 10-y survivals were 94.2%, 90.4%, 86%, and 85.4%, respectively. The median (interquartile range) follow-up of the entire cohort was 65 mo (16-96 mo). There was no statistically significant difference in survival between the 3 weight-based groups or between the 2 eras.

CONCLUSIONS: We present the first report of long-term survival of the largest series of PLT from an emerging nation. Remarkably, with increasing numbers of liver transplantation being performed in the region over the past decade, the focus of care has now shifted from achieving early survival after liver transplantation to long-term follow-up.

PMID:40898390 | DOI:10.1097/TP.0000000000005510

J Health Popul Nutr. 2025 Sep 2;44(1):322. doi: 10.1186/s41043-025-01062-3.

ABSTRACT

BACKGROUND: Limited research has been conducted on the effects of dietary fiber (DF) intake on gallstones. We aimed to investigate the actual DF intake in a nationally representative sample in the United States (US) and explore its association with gallstones.

METHODS: We used data from the National Health and Nutrition Examination Survey database, including the 2017-2020 and 2021-2023 cycles. Using participants’ gallstone histories and their average 2-day DF intake, we investigated the actual DF intake among US adults. After adjusting for traditional confounders, we used weighted multivariable logistic regression models, trend tests, spline curve fitting, subgroup analyses, and interaction tests to explore the independent association between DF intake and gallstones.

RESULTS: A total of 8,782 participants were included. The weighted analysis showed the prevalence of gallstones is 10.03%. The average DF intake among adult men and women is 18 ± 10 g/day and 15 ± 7.8 g/day, respectively, which is well below the recommended levels. Multivariable regression analysis revealed a statistically significant negative linear association between DF intake and gallstone prevalence. For every 10 g/day increase in DF intake, the risk of gallstones significantly decreases by 21% (OR = 0.79, 95% CI: 0.63-1.00, P = 0.047). Curve fitting showed a negative linear relationship between these two variables (P = 0.003, P for non-linearity = 0.134).

CONCLUSION: A negative linear relationship between DF intake and gallstones among adults in the US was observed, and the current DF intake in the US is far below recommended levels.

PMID:40898378 | DOI:10.1186/s41043-025-01062-3

Antimicrob Resist Infect Control. 2025 Sep 2;14(1):103. doi: 10.1186/s13756-025-01584-9.

ABSTRACT

BACKGROUND: Improving healthcare-associated infections, fighting antibiotic resistance, and controlling outbreaks are all made possible by infection prevention and control, a significant global public health concern, particularly in Africa. To pinpoint areas that needed improvement, this study aimed to assess Infection Prevention and Control in Somali Healthcare Facilities using the WHO Infection Prevention and Control Assessment Framework.

METHODS: 307 healthcare facilities in Somalia, or 30% of the 1,023 facilities listed by the Federal Ministry of Health, had their IPC practices evaluated by cross-sectional research in October and November 2022. Descriptive statistics were used in the study to examine data categorized by facility type, ownership, and location. The facilities were divided into four IPC levels-inadequate, basic, intermediate, and advanced using the World Health Organization’s Infection Prevention and Control Assessment Framework (IPCAF).

RESULTS: The mean overall IPCAF score was 136/800, which indicates inadequate IPC practices. 85% of the institutions were public hospitals, while the majority (68.83%) were primary healthcare centers. CC1 (IPC Program) and CC 5 (Multi-modal Strategies) got the lowest values out of the eight IPC core components, suggesting major improvement. while CC 7 (Workload, Staffing, and Bed Occupancy) and CC 8 (Environments, Materials, and Equipment) had the greatest results. Inadequate IPCAFs were found in all States. The results highlight the urgent need for national and regional policies to give IPC programs and infrastructure funding the Highest priority, mainly in low-performing areas and primary healthcare settings. Regional differences highlight the need for specialized approaches to increase IPC capacity in every state.

CONCLUSIONS: The initial IPCAF assessment of Somali healthcare facilities reveals inadequate IPC levels, highlighting the need for urgent intervention to improve practices, ensure patient safety, and support the development of a national IPC policy in Somalia.

PMID:40898374 | DOI:10.1186/s13756-025-01584-9

BMC Glob Public Health. 2025 Sep 3;3(1):78. doi: 10.1186/s44263-025-00190-6.

ABSTRACT

BACKGROUND: Health limitations, defined as problems in life that limit an individual from activities of daily living, have been associated with human flourishing, globally. However, how health problems leading to functional limitations vary across multiple demographic characteristics and how these vary across countries requires additional exploration.

METHODS: The Global Flourishing Study is a 5-year longitudinal study of human flourishing among 202,898 individuals across 22 countries. The purpose of this analysis was to assess the regional and demographic variation of health limitations in life associated with health problems in wave 1 of the Global Flourishing Study. The study explored the distributions and descriptive statistics of key demographic features (age, gender, marital status, employment, religious service attendance, education, immigration status) across and within countries. The following hypotheses were tested: (1) the distributions and descriptive statistics of key demographic factors will reveal diverse patterns across the international sample, (2) the proportions of health limitations will vary meaningfully across different countries, and (3) health limitations will exhibit variations across different demographic categories such as age, gender, marital status, employment, religious service attendance, education, and immigration status. These differences across demographic categories will vary by country.

RESULTS: The proportion of health limitations was greater among older age individuals and those with fewer years of education. Being widowed and retired showed higher proportions of having a health limitation compared to those married and working, respectively. The Philippines (0.34), United Kingdom (0.31), and Germany (0.30) had the highest proportions of health problems, while Israel (0.14), Turkey (0.14), and Poland (0.13) had the lowest.

CONCLUSIONS: Understanding key demographic associations of such health problems and daily functioning could help inform policy, programs, and practices aimed at addressing the well-being of individuals who experience health limitations.

PMID:40898369 | DOI:10.1186/s44263-025-00190-6

Inj Epidemiol. 2025 Sep 2;12(1):54. doi: 10.1186/s40621-025-00603-y.

ABSTRACT

BACKGROUND: Although health inequalities associated with ethnic disadvantage are of increasing concern to policymakers in the United Kingdom (UK), evidence on ethnicity and childhood unintentional injuries is unclear. Given that people from some minority ethnic communities face disproportionate disadvantage such as unemployment, poverty, and insecure and low-quality housing, children from these families might be expected to have higher risks of unintentional injuries compared to their White counterparts.

AIMS: To determine whether the likelihood of unintentional childhood injuries vary among children from minority ethnic backgrounds and whether this variation can be explained by maternal migration status and variables relating to household composition, parenting attitudes and behaviours.

METHODS: We used logistic regression to analyse data from 12,717 children using sweeps two (2003-2004) and three (2005-2006) of the Millennium Cohort Study. Unintentional childhood injuries were measured in the third sweep of data collection when the children were aged five. Exposure variables included socioeconomic information, ethnicity, housing, household composition, maternal migration status and variables relating to parenting, values, and behaviours.

RESULTS: Children from some minority ethnic backgrounds (Pakistani, Bangladeshi, Black African, and ‘other’) were less likely to be injured than White children. Having a mother who was born outside the UK explained the relationship in Pakistani and Bangladeshi children. We observed differences in variables such as parenting style, values, household composition, and smoking and alcohol use among minority ethnic and migrant groups, but these variables did not statistically explain the differences in childhood injury.

CONCLUSIONS: Children from minority ethnic families in the UK are less likely to sustain unintentional injuries compared to their White peers, with this protective effect primarily evident among children whose mothers were born outside the UK. While cultural and behavioural differences were observed between ethnic groups, these did not statistically explain the injury variation. The findings emphasise the importance of disaggregating ethnicity and migrant status in injury prevention research and investigating the mechanisms underlying lower injury rates among first-generation migrant families.

PMID:40898367 | DOI:10.1186/s40621-025-00603-y

Inj Epidemiol. 2025 Sep 2;12(1):55. doi: 10.1186/s40621-025-00610-z.

ABSTRACT

BACKGROUND: The purpose of this study was to describe the injury and illness epidemiology in Team Korea athletes during 2024 Paris Summer Olympic Games. Incidence rates in pre-Olympic training camp and the Olympic Village were calculated and compared.

METHODS: Medical records of Team Korea athletes who competed for 2024 Paris Summer Olympic Games were analyzed. This study was conducted in accordance with the International Olympic Committee Consensus Statement 2020. Incidence rates (case per 1000 athlete-days) were calculated and incidence rate ratios were used for comparisons.

RESULTS: Team Korea athletes (n = 122, 57 males and 65 females) were analyzed. A total of 43 injuries (pre-Olympic training camp, n = 6, 8.3 injuries per 1000 athlete-days; Olympic Village, n = 37, 22.9 injuries per 1000 athlete-days) and 53 illnesses (pre-Olympic training camp, n = 16, 22.1 illnesses per 1000 athlete-days; Olympic Village, n = 37, 22.9 illnesses per 1000 athlete-days) newly occurred. The Olympic Village had a greater risk of injury than the pre-Olympic training camp (incidence rate ratio = 2.8, 95% CI: 1.2 to 6.6, p-value = 0.016). However, there was no significant difference in the risk of illness (incidence rate ratio = 1.04, 95% CI: 0.58 to 1.87, p-value = 0.900).

CONCLUSIONS: Team Korea athletes participating in the 2024 Paris Summer Olympic Games exhibited higher incidences of injury and illness than previous Olympic Games statistics. This single-delegation epidemiological research will contribute to our understanding of the true incidence of health problems in Olympians.

PMID:40898365 | DOI:10.1186/s40621-025-00610-z