Tag: nevin manimala

Curr Hypertens Rev. 2026 Mar 18. doi: 10.2174/0115734021421550260109060131. Online ahead of print.

ABSTRACT

INTRODUCTION: While medication non-compliance for hypertension (HTN) and type II diabetes mellitus (T2DM) patients drives poor outcomes globally, its specific clinical and financial impact in Jordan is poorly quantified. This study aimed to determine the prevalence of medication noncompliance, quantify its effect on hospitalization rates and costs, and assess the role of sociodemographic factors in a Jordanian patient cohort.

METHODS: A prospective cohort study was conducted at a major Jordanian hospital from 2022 to 2023. A final sample of 159 patients with HTN and/or T2DM was followed for one year. Participants were classified as compliant (n = 86) or non-compliant (n = 73) based on patient self-reports and pharmacy refill data. Hospitalization rates, intensive care unit admissions, and sociodemographic data were compared between groups.

RESULTS: The prevalence of poor compliance was 45.9% (n = 73). Poor compliance was strongly associated with hospitalization (p < 0.001). Non-compliant patients had significantly higher rates of floor admissions (82.6% vs. 16.4%) and intensive care unit admissions (37.2% vs. 0%) compared to the compliant group (n = 86). This resulted in substantially higher healthcare costs. After statistical adjustment, poor compliance was the most powerful independent predictor of hospital admission (Adjusted Odds Ratio 45.78), while baseline sociodemographic factors were not significantly associated with admission.

DISCUSSION: Our findings highlight that medication non-compliance is a major cause of hospitalizations and escalating healthcare costs in Jordan. The prevalence of non-adherence observed in our cohort (45.9%) aligns with trends reported in neighboring regional studies. Consequently, further research into the specific socio-behavioral barriers to adherence is essential.

CONCLUSION: Medication non-compliance is a prevalent and critical driver of preventable hospital admissions and high healthcare costs among Jordanian patients with HTN and T2DM. These findings underscore an urgent need for targeted interventions to improve compliance and reduce the associated healthcare burden.

PMID:41863125 | DOI:10.2174/0115734021421550260109060131

Clin Psychol Psychother. 2026 Mar-Apr;33(2):e70258. doi: 10.1002/cpp.70258.

ABSTRACT

This study examined the association between therapist-level flourishing and burnout with early client dropout. Participants included 141 therapists (M_age = 46.1; 82.8% White; 80.7% female) and 12,988 adult clients (M_age = 37.8; 41.9% White; 62.5% female) using a US-based digital mental health network. Early dropout was operationalised as attending fewer than three sessions. Therapists completed self-report measures of burnout and flourishing. Multilevel logistic regression examined therapist-level predictors of early dropout, accounting for nested client data. Approximately 27.8% of clients dropped out early. Therapists accounted for 9.4% of the variance in client dropout. Therapist flourishing was significantly associated with lower dropout rates (OR = 0.90, 95% CI [0.814, 0.998]), while therapist burnout was not (OR = 1.01, 95% CI [0.758, 1.353]). More years in practice (OR = 1.02, 95% CI [1.013, 1.031]) and larger weekly caseloads (OR = 1.02, 95% CI [1.003, 1.033]) were both significantly linked to higher early dropout rates. Dropout was significantly lower for White clients (OR = 0.827, 95% CI [0.736, 0.929]) and White therapists (OR = 0.711, 95% CI [0.539, 0.938]). Therapist flourishing may support early client retention, while higher caseload, more experience and racial/ethnic disparities are associated with increased dropout. Findings highlight the need for wellness promotion, structural support and culturally responsive practices in psychotherapy.

PMID:41863114 | DOI:10.1002/cpp.70258

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2026 Mar 21;47(1):85-91. doi: 10.2478/prilozi-2026-0009. Print 2026 Mar 1.

ABSTRACT

Objective: Neonatal sepsis is a leading cause of morbidity and mortality in newborns. Timely and accurate diagnosis remains a challenge due to the nonspecific clinical signs and the limited sensitivity and specificity of conventional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and white blood cell (WBC) count. Presepsin, a soluble CD14 subtype, has been proposed as a promising early marker of bacterial infection. This study aimed to assess the diagnostic value of serum presepsin in comparison with traditional inflammatory markers in neonates with suspected sepsis. Methods: In a prospective observational study conducted at a single tertiary care center, 18 neonates with clinical signs of sepsis were evaluated. The patients were divided into culture-proven (n=7) and culture-unproven (n=11) sepsis groups. Presepsin levels were measured using a chemiluminescent assay and compared to CRP, PCT, and WBC counts. Results: The median presepsin levels were higher in culture-proven cases (740 ng/L vs. 393 ng/L), but without statistical significance. Similar trends were observed for CRP and PCT, while WBC counts showed no diagnostic value. Conclusion: Although presepsin demonstrated potential as an early biomarker, its diagnostic performance in this small cohort was inconclusive. Combined use of presepsin with conventional markers and clinical evaluation may improve early sepsis diagnosis in neonates.

PMID:41863111 | DOI:10.2478/prilozi-2026-0009

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2026 Mar 21;47(1):25-45. doi: 10.2478/prilozi-2026-0003. Print 2026 Mar 1.

ABSTRACT

Background: Post-traumatic stress disorder (PTSD) is traditionally conceptualized as a disorder of fear learning and emotional dysregulation; however, accumulating evidence indicates that objective cognitive dysfunction, particularly memory impairment, represents a core and enduring feature of the disorder. Prior quantitative syntheses have been limited by heterogeneous control groups, pooling of disparate cognitive outcomes, and inadequate handling of statistical dependence across outcomes. Objective: This systematic review and meta-analysis is aimed at determining whether trauma-exposed adults diagnosed with PTSD exhibit objective impairments in memory performance compared with trauma-exposed adults without PTSD. Methods: A comprehensive search of PubMed/MEDLINE, Embase, PsycINFO, and Web of Science was conducted up to December 17, 2025. Eligible studies included trauma-exposed adults (≥18 years) with PTSD diagnosed using DSM or ICD criteria and a trauma-exposed non-PTSD comparator group. Objective neuropsychological measures of verbal episodic memory and working memory were extracted. Risk of bias was assessed using the Newcastle-Ottawa Scale. Standardized mean differences (Hedges’ g) were pooled using multilevel random-effects meta-analytic models to account for within-study dependence. Results: Ninety studies met the criteria for the systematic review, of which 88 contributed quantitative data to the meta-analysis. Across studies, individuals with PTSD demonstrated significantly poorer memory performance compared with trauma-exposed controls without PTSD. Impairments were most consistent for verbal episodic memory and working memory, with effects observed across diverse trauma types and assessment instruments. Considerable heterogeneity was present but did not negate the overall pattern of PTSD-specific cognitive impairment. Sensitivity analyses confirmed the robustness of findings. Although funnel plot asymmetry suggested possible publication bias, trim-and-fill-adjusted estimates remained statistically significant. Conclusions: Trauma-exposed adults with PTSD exhibit reliable and clinically meaningful impairments in objective memory performance beyond the effects of trauma exposure alone. These findings support conceptualizations of PTSD as a disorder involving maladaptive memory processing and underscore the importance of incorporating cognitive assessment and intervention into PTSD research and clinical care.

PMID:41863109 | DOI:10.2478/prilozi-2026-0003

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2026 Mar 21;47(1):15-24. doi: 10.2478/prilozi-2026-0002. Print 2026 Mar 1.

ABSTRACT

Background: Emotional intelligence has been identified as an important psychological factor influencing how individuals manage stress and regulate emotions. However, evidence regarding its differential association with adaptive and maladaptive coping styles in adolescents and young adults remains limited. Objective: This study aimed to examine the relationships between emotional intelligence and adaptive and maladaptive coping styles in a large sample of adolescents and young adults. Methods: A cross-sectional study was conducted among 700 participants aged 15-25 years. Emotional intelligence was assessed using the Wong and Law Emotional Intelligence Scale, while coping styles were measured using a 28-item COPE inventory aggregated into adaptive and maladaptive coping dimensions. Descriptive statistics, Pearson correlation analyses, and multiple linear regression models adjusted for age, gender, and education level were performed. Results: Emotional intelligence was positively associated with both adaptive coping (r = .16, p < .001) and maladaptive coping (r = .54, p < .001). Regression analyses indicated that emotional intelligence independently predicted both coping styles; however, the effect size was substantially larger for maladaptive coping. Age, gender, and education level were not significant predictors in either model. Conclusion: Emotional intelligence is differentially associated with coping styles in adolescents and young adults, with a particularly strong relationship observed for maladaptive coping. These findings underscore the importance of emotional intelligence in coping processes and suggest that interventions targeting emotional intelligence may help reduce maladaptive coping behaviors in youth.

PMID:41863106 | DOI:10.2478/prilozi-2026-0002

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2026 Mar 21;47(1):63-74. doi: 10.2478/prilozi-2026-0006. Print 2026 Mar 1.

ABSTRACT

Aim: To clinically evaluate the efficacy of Dexamethasone depending on the method of administration in the treatment of postoperative complications following odontectomy of lower impacted third molars. Materials and Methods: At the Clinic for Oral Surgery at USKC “St. Panteleimon” in Skopje, North Macedonia, 45 patients, 20 to 40 years, indicated for odontectomy of lower impacted third molars, were included. 15 patients were treated with DXP (Dexamethasone), ampule of 4mg/1ml, applied submucosally (SM). Another 15 patients were treated with DXP administered intramuscularly (IM) into the deltoid muscle. No DXP was applied to the control group (CG). Edema was monitored by measuring three facial lines: tragus to labial commissure (Tr-Co), tragus to gnathion (Tr-Gn), and lateral eye canthus to angulus mandibulae (Cn-Am). The clinical effects in the three study groups were monitored at 24 hours (T1), 48 hours (T2), and 7 days (T3) post-op. Results: Cn-Am direction in T1, showed significantly larger edema in the CG vs the examined groups. In all time points there were no statistically significant differences between the examined groups (p>0.05). In T1 and T2, in the Tr-Co direction, the results showed the biggest reduction of the edema with a statistically significant difference (p=0.012) in IM vs SM application at T2. T3 showed least edema in the SM group. Tr-Gn direction, at T1, a significant difference in edema dimensions was found between the IM and CG (p=0.015), indicating a significantly smaller measured edema in the IM group. Identical findings were seen at T2. T3 showed better results in edema control in the SM vs. other groups. Conclusion: The intramuscular application technique of DXP was more effective than the submucosal technique across all measurement lines and time points in managing postoperative edema following surgical extraction of lower impacted third molars.

PMID:41863105 | DOI:10.2478/prilozi-2026-0006

Clin Implant Dent Relat Res. 2026 Apr;28(2):e70137. doi: 10.1111/cid.70137.

ABSTRACT

OBJECTIVES: To investigate the potential benefits of Xanthan-based chlorhexidine gel application in addition to professional mechanical plaque removal (PMPR) in the treatment of peri-implant mucositis (PM).

MATERIAL AND METHODS: Subjects diagnosed with PM were consecutively included in this randomized split-mouth study. All participants received a single session of PMPR using titanium curettes, followed by the application of an air-polishing glycine powder device. Implants allocated to the Test group were additionally treated with local delivery of Xanthan-based chlorhexidine gel. Clinical evaluation was performed at T0 (i.e., baseline), at 30 (T1), 90 (T2) and 180 days (T3) after treatment, while treatment success was evaluated at T2 and T3. Change in bleeding on probing (BoP) was considered as primary outcome measure. A logistic multivariate regression model was developed to explore the predictive role of implant and patient-level variables on primary outcome measure.

RESULTS: Fifty-nine patients (mean age: 65.4 ± 8.7 years; 54.2% male; 88.1% non-smokers) and 182 implants completed the study. At T1, only the Test group displayed a significant reduction in BoP (p < 0.001), PPD (p = 0.021) and PI (p = 0.021) compared to T0, while at T2 and T3 clinical improvements were recorded within both groups without any statistically significant difference between groups (p > 0.05). T2 Treatment success as well as the frequency distribution of complete (BoP = 0) and partial (BoP ≤ 1, ≤ 2, ≤ 3) disease resolution did not significantly differ between groups (p > 0.05). Multiple regression model revealed that smoking (p = 0.008), and implant position (i.e., premolar p = 0.009) did significantly affect the primary outcome measure.

CONCLUSION: The adjunctive use of XanCHX gel did not result in any statistically significant clinical benefit compared to PMPR alone in the treatment of PM up to 6 months, despite the reported clinical positive effects within the first month after treatment.

PMID:41863097 | DOI:10.1111/cid.70137

J Paediatr Child Health. 2026 Mar 21. doi: 10.1111/jpc.70365. Online ahead of print.

ABSTRACT

AIMS: This study describes the location, mode of death, palliative care and advance care planning (ACP) use amongst children who died at KK Women’s and Children’s Hospital (KKH), Singapore, between 2011 and 2020.

METHODS: Medical records of all children who died in the general ward, high dependency unit and paediatric intensive care unit (PICU) were reviewed. Data collected included: demographics, diagnosis, cause, location, mode of death, palliative care and ACP use. Trends were analysed using the Mann-Kendall test and compared using logistic regression. A p-value of < 0.05 was considered statistically significant.

RESULTS: Amongst 326 372 hospital admissions, 412 children (0.13%) died, of whom 270 (65.5%) had at least one complex chronic condition (CCC). Most deaths occurred in the PICU (319/412, 77.4%), and 188 children (45.6%) died following non-escalation of care. Palliative care consultations were provided in 119 cases (28.9%), and ACP was documented in 25 cases (6.1%). From 2011 to 2020, palliative care consultations increased from 20.4% to 39.3% (p = 0.06) and ACP use increased from 0% to 15.2% (p < 0.05). Over the same period, deaths after withdrawal of life-sustaining measures (WLSM) increased from 14.3% to 30.3% (p = 0.09), whilst deaths in the general ward decreased from 12.2% to 6.1% (p = 0.36).

CONCLUSIONS: Most hospitalised children died in the PICU following non-escalation of care without palliative care or ACP use. Future research is needed to identify the barriers and facilitators to their use.

PMID:41863091 | DOI:10.1111/jpc.70365

Sociol Health Illn. 2026 Mar;48(3):e70173. doi: 10.1111/1467-9566.70173.

ABSTRACT

Persistent adolescent smoking in China presents a paradox within the context of advancing nicotine control. Moving beyond social-environmental explanations, this study employs Mills’ sociological imagination to conceptualise this persistence as an agentive response to constrained realities and futures, enacted through peer-curated lay epidemiology. Its core argument is that adolescents cultivate a folk sociological imagination-a vernacular system of sense-making-to manufacture agency and reframe smoking risk. Qualitative data from 21 adolescent smokers in Shenzhen, including 208 health diaries and 17 interviews, reveal how this is achieved through three practices: the selective valorisation of healthy smoker exemplars; folk attribution of causality to external or individual factors; and prevalence-as-safety normalisation. This folk process reconfigured the public issue of smoking risk into a series of manageable private troubles, transforming statistical harm into a matter of individual circumstance. Findings highlight three gaps in current efforts: an epistemic gap in policy, which dismisses peer-validated evidence; an intervention gap in health education, which fails to engage with lay reasoning and a structural hope gap, which generates a form of cruel optimism that overlooks the need for alternative avenues for agency and belonging.

PMID:41863090 | DOI:10.1111/1467-9566.70173

Hepatol Res. 2026 Mar 21. doi: 10.1111/hepr.70152. Online ahead of print.

ABSTRACT

AIM: We aimed to determine the associations between the pretreatment Advanced Lung Cancer Inflammation Index (ALI) and survival outcomes in patients with unresectable hepatocellular carcinoma (u-HCC) who received atezolizumab plus bevacizumab (Atez/Bev).

METHODS: This retrospective study analyzed 563 patients with u-HCC who were treated with Atez/Bev (Sept 2020-Dec 2024). The ALI was calculated according to Body Mass Index × serum albumin level/neutrophil-to-lymphocyte ratio. Associations between ALI and overall survival (OS) and progression-free survival (PFS) were evaluated by Cox proportional hazards regression analysis.

RESULTS: An ALI cutoff value of 27.04, determined by receiver operating characteristic curve analysis, was used to classify patients into low- and high-ALI groups. High-ALI patients had longer median OS (26.1 vs. 13.7 months, p < 0.001) and PFS (9.3 vs. 5.2 months, p < 0.001), and a higher disease control rate (82.5% vs. 69.1%, p < 0.001) compared to low-ALI patients. Multivariate Cox regression analysis confirmed that a high ALI value was a significant prognostic marker for OS (hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.54-0.88, p = 0.003) and PFS (HR: 0.75, 95% CI: 0.61-0.92, p = 0.006). Subgroup analyses showed that the trend toward improved outcomes was consistent for high ALI values in all clinically relevant subgroups.

CONCLUSIONS: A high pretreatment ALI value was associated with improved survival and disease control in u-HCC patients receiving Atez/Bev, underscoring its potential utility as a prognostic marker for clinical management and further studies.

PMID:41863089 | DOI:10.1111/hepr.70152