Tag: nevin manimala

J Diabetes Investig. 2026 Aug 24. doi: 10.1111/jdi.70426. Online ahead of print.

ABSTRACT

AIMS/INTRODUCTION: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) delay gastric emptying and may impair bowel preparation for colonoscopy. However, evidence in Asian populations is limited, and the impact of dosing frequency remains unclear. We examined the association between GLP-1RA use and inadequate bowel preparation in Japanese patients with diabetes and compared weekly and daily formulations.

MATERIALS AND METHODS: This single-center retrospective observational study included Japanese patients with diabetes who underwent colonoscopy at Kameda Medical Center between October 2021 and September 2024. Bowel preparation quality was assessed using the Aronchick scale; fair, poor, and inadequate were classified as inadequate preparation. Propensity score matching was performed using age, sex, chronic kidney disease, HbA1c, and insulin use. Additional multivariable logistic regression and sensitivity analyses were performed.

RESULTS: Among 997 eligible patients, 90 propensity score-matched pairs were identified. Inadequate preparation was more frequent in GLP-1RA users than non-users after matching (32.2% vs 16.7%; relative risk 1.933, 95% CI 1.115-3.353; P = 0.024). Additional analyses showed similar directional associations, although statistical significance was attenuated. Weekly formulations were associated with a higher rate of inadequate preparation than daily formulations (44.2% vs 22.9%; relative risk 1.928, 95% CI 1.039-3.577; P = 0.044).

CONCLUSIONS: In Japanese patients with diabetes, GLP-1RA use was associated with a higher rate of inadequate bowel preparation in the propensity score-matched analysis, although additional adjusted analyses were not statistically significant. The finding for weekly formulations should be interpreted cautiously.

PMID:42635465 | DOI:10.1111/jdi.70426

Indian J Ophthalmol. 2026 Aug 24. doi: 10.4103/IJO.IJO_3062_25. Online ahead of print.

ABSTRACT

PURPOSE: To compare the effectiveness of femtosecond laser-assisted capsular marking and manual slit-lamp marking methods in correcting astigmatism during cataract surgery, for accurate positioning of toric intraocular lenses (IOLs).

METHODS: The medical records of 35 eyes that underwent preoperative manual marking with implantation of AcrySof IQ PanOptix (Alcon Laboratories, Fort Worth, TX) toric trifocal lens (Group 1), and 35 eyes that underwent the same toric trifocal lens implantation using femtosecond laser IntelliAxis software (Group 2), between 2019 and 2024, were retrospectively reviewed. Pre- and postoperative uncorrected and corrected visual acuity, preoperative corneal astigmatism, postoperative residual astigmatism, and slit-lamp and fundus examinations were evaluated.

RESULTS: In the manual-marking group, the mean preoperative corneal astigmatism was 2.11 ± 0.66 D, while the postoperative astigmatism was 0.51 ± 0.17 D. In the femtosecond laser marking group, the mean preoperative corneal astigmatism was 2.06 ± 0.61 D, and the postoperative astigmatism was 0.38 ± 0.13 D. Both groups demonstrated a statistically significant reduction in astigmatism values before and after surgery ( P < 0.05). Postoperative residual astigmatism was lower in the femtosecond group, and the difference between the two groups was statistically significant ( P < 0.05).

CONCLUSION: Both femtosecond laser-assisted and manual-marking methods are effective techniques for toric lens alignment. However, the femtosecond laser-assisted method was found to be statistically superior in correcting astigmatism. Additionally, femtosecond laser marking offers several advantages over manual marking. It is less surgeon-dependent, requires less experience, shortens the procedure time, and eliminates ink-related complications during surgery.

PMID:42635456 | DOI:10.4103/IJO.IJO_3062_25

Indian J Ophthalmol. 2026 Aug 24. doi: 10.4103/IJO.IJO_2192_25. Online ahead of print.

ABSTRACT

PURPOSE: To assess risk factors for local recurrence and metastasis in eyelid sebaceous carcinoma after complete excision in a Japanese population.

METHODS: In this retrospective study, we reviewed the medical records of 171 Japanese patients with histologically complete eyelid sebaceous carcinoma excision between December 2006 and August 2024. Patients who received adjuvant therapy other than surgery, did not have metastasis screening, or had metastasis detected prior to surgery were excluded. Sebaceous carcinomas were staged according to the American Joint Committee on Cancer staging system, 8 th edition. Kaplan-Meier analysis and the log-rank test were used to determine the risk factors for local recurrence and metastasis. The risk factors and the survival rate for local recurrence and metastasis were then assessed.

RESULTS: A total of 147 cases were included. Female sex ( P = 0.024) and pagetoid spread ( P = 0.006) were significantly associated with local recurrence. T stage ≥T1c ( P = 0.041), lower eyelid tumor site ( P = 0.021), and pagetoid spread ( P = 0.011) were significantly associated with metastasis. At 5 years postoperatively, the local recurrence-free survival rate was 93.5% (95% CI: 86.9-96.9) and the metastasis-free survival rate was 89.6% (95% CI: 82.0-94.2).

CONCLUSION: Excision margins, and follow-up and surveillance protocols for sebaceous carcinoma may need to reflect the significantly greater risk of local recurrence and metastasis with pagetoid spread, female sex, T stage (worse than T1b), and tumor location on the lower eyelid.

PMID:42635455 | DOI:10.4103/IJO.IJO_2192_25

Indian J Ophthalmol. 2026 Aug 24. doi: 10.4103/IJO.IJO_2876_25. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effects of postoperative eye patching on the sclerostomy wound architecture in 25-gauge sutureless pars plana vitrectomy (PPV).

DESIGN: Single-blind prospective randomized controlled trial.

METHODS: Twenty-eight subjects who underwent 25-gauge sutureless PPV were randomly assigned to either the intervention group (n = 14) or the control group (n = 14). The intervention group received postoperative eye patching for approximately 24 hours, whereas the control group received an eye shield. The sclerostomy wound architecture was examined postoperatively at day 1, week 1, and month 1 using anterior segment optical coherence tomography.

RESULTS: The outer diameter of the sclerotomy wound in the intervention group was generally smaller than in the control group: day 1 (194.0 [IQR: 51] μm vs 107.5 [IQR: 44] μm, P = 0.285), week 1 (69.1 ± 18.4 μm vs 72.8 ± 26.1 μm, P = 0.667), and month 1 (44.2 ± 12.0 μm vs 52.9 ± 13.6 μm, P = 0.086). A similar difference was also observed in the inner diameter: day 1 (78.5 [IQR: 45] μm vs 85.0 [IQR: 121] μm, P = 0.946), week 1 (71.0 [IQR: 32] μm vs 63.0 [IQR: 42] μm, P = 0.874), and month 1 (44.2 ± 12.0 μm vs 53.0 ± 13.6 μm, P = 0.086). However, the result was not statistically significant.

CONCLUSION: Postoperative eye patching facilitates scleral healing and has a role in protecting the scleral wound during the vulnerable immediate postoperative period. It demonstrated better healing characteristics of the wound compared to the control group.

PMID:42635453 | DOI:10.4103/IJO.IJO_2876_25

Indian J Ophthalmol. 2026 Aug 24. doi: 10.4103/IJO.IJO_1908_25. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate whether factors observed at initial clinical examination are predictors of the ability to achieve motor alignment with single vision spectacles in hypermetropic children with esotropia.

METHODS: Prospective case series. Thirty-eight children with esotropia from 6 months to 13 years of age were analyzed, out of the 46 recruited. Successful outcome was considered when the angle of deviation for distance was less than 10 prism diopters with the prescribed spectacles.

RESULTS: Among the factors analyzed, intermittent esotropia ( P = 0.028) and higher refractive error ( P = 0.029) were significantly associated with achievement of motor alignment. Logistic regression showed intermittent deviation had a 5.5 times greater chance of successful outcome with spectacles alone ( P = 0.039, regression coefficient, 1.717; 95% CI, 1.089 to 28.450).

CONCLUSION: The presence of intermittent deviation had a statistically significant chance of successful motor outcome with spectacles alone in children with hypermetropia and esotropia.

PMID:42635451 | DOI:10.4103/IJO.IJO_1908_25

Indian J Ophthalmol. 2026 Aug 24. doi: 10.4103/IJO.IJO_2363_25. Online ahead of print.

ABSTRACT

PURPOSE: To compare the efficacy of subconjunctival triamcinolone versus topical prednisolone in controlling postoperative inflammation after phacoemulsification.

METHODS: In this randomized control study, a total of 100 eyes were enrolled. Patients with age-related cataract undergoing phacoemulsification under peribulbar anesthesia were randomly allocated into two groups using a computer-generated random table. Group A received single-dose subconjunctival triamcinolone acetonide (20 mg/0.5 ml) at the end of surgery; Group B received topical prednisolone 1% eyedrops in tapering doses for 1.5 months. Patients were followed up on postoperative days 1, 7, 21, and 42 for anterior chamber (AC) cells, flare, intraocular pressure (IOP), subconjunctival hemorrhage, and cystoid macular edema using optical coherence tomography (OCT). SPSS version 20.0, Chi-square, and t-tests were applied for statistical analysis. A P value < 0.05 was considered statistically significant.

RESULTS: There was no significant difference in AC cells, flare, and mean IOP between both groups on any postoperative day. Three patients had extensive AC inflammation for 5-7 days. Pressure spikes >25 mmHg were noted in four patients in Group A and three patients in Group B ( P value = 0.69). Subconjunctival hemorrhage was significantly more in Group A (P 0.001) on days 1 and 7, which resolved in all patients by 21 days. There was no significant difference in central subfoveal thickness on OCT in both groups on day 42. All the patients had good postoperative gain in visual acuity. A few patients complained of mild cosmetic blemish from steroid deposit.

CONCLUSION: Subconjunctival triamcinolone is noninferior to topical steroids in controlling post-phacoemulsification intraocular inflammation.

PMID:42635450 | DOI:10.4103/IJO.IJO_2363_25

Phys Occup Ther Pediatr. 2026 Aug 24:1-18. doi: 10.1080/01942638.2026.2718158. Online ahead of print.

ABSTRACT

AIMS: To compare the limit of stability (LoS) in a group of children and adolescents with autism spectrum disorder (ASDG) and with typical development (TDG), under different sensory conditions.

METHODS: Fifty-nine participants (ASDG = 28; TDG = 31) performed LoS test under four sensory conditions: eyes_open/stable; eyes_closed/stable; eyes_open/unstable; eyes_closed/unstable. Maximum CoP displacements and velocities were tracked in the anterior/posterior and medial/lateral directions. Statistical analysis included a repeated-measures ANOVA (p < 0.05).

RESULTS: The groups showed similar CoP displacement in the anterior and mediolateral directions. The ASDG showed greater CoP velocities in anterior-posterior and mediolateral directions. The groups showed greater anterior and mediolateral CoP displacement and faster oscillation with an unstable base of support than with a stable one, regardless of the visual manipulation. The absence of visual information associated with an unstable base of support increased CoP velocity and reduced the anterior displacement. Under stable conditions, the absence of visual information reduced CoP during anterior displacement.

CONCLUSION: The ASDG exhibited reduced postural control during the test, as evidenced by greater AP and ML CoP velocities. Both groups were similarly affected when visual and somatosensory information was manipulated. Regardless of the visual information, the unstable surface resulted in increased displacement and velocity of CoP.

PMID:42635441 | DOI:10.1080/01942638.2026.2718158

Oper Neurosurg. 2026 Aug 24. doi: 10.1227/ons.0000000000002159. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Intradural extramedullary spinal tumors (IDEMs) are ideally managed with gross total resection (GTR) for optimal local disease control in the absence of established adjuvant regimens. In this retrospective cohort study, we investigated the utility of morphology-based analysis of optimal IDEM resection quality compared with current linear measurement benchmarks.

METHODS: Tumors were manually segmented from preoperative contrast-enhanced MRI. Morphological features of sphericity, elongation, and volume were extracted from masks, along with manual anteroposterior, craniocaudal, and transverse linear measurements. Optimal resection was defined as Simpson Grade 1 or 2 for meningiomas or en bloc GTR for myxopapillary ependymomas (MPEs) and was predicted for dorsal and ventral spinal meningiomas plus conus and nonconus MPEs.

RESULTS: We identified 103 tumors, including 71 meningiomas and 32 MPEs. Linear measurement did not reliably predict optimal resection across anatomic subtypes of meningiomas or MPEs (all P > .05). Instead, optimal resection was determined by higher sphericity across meningiomas and, specifically, dorsal meningiomas (optimal resection median 0.80 (IQR: 0.77-0.82) vs suboptimal 0.76 (0.72-0.77), P = .027). Shape features were not predictive in ventral meningiomas. En bloc GTR was limited to nonconus MPEs, in which sphericity again emerged as a predictor (0.74 (0.69-0.77) for en bloc vs 0.68 (0.64-0.72) for piecemeal, P = .047), likely reflecting resectability for encapsulated tumors. After excluding patients with <1 year of surveillance to determine nonrecurrence, 62 patients without genetic syndromes remained for recurrence analysis with a median follow-up of 36.1 months. Optimal resection was associated with significantly lower recurrence (optimal 8.6% vs suboptimal 29.6%, P = .045). This protective effect remained, although statistically insignificant after adjusting for adjuvant radiation and tumor grade (recurrence odds ratio = 0.22, 95% CI: 0.04-1.07, P = .077).

CONCLUSION: IDEM tumor morphology is predictive of optimal resection for dorsal meningiomas and nonconus MPEs, whereas linear measurements offer less consistent predictive value. Morphological assessment is feasible with standard MRI and may be further automated.

PMID:42635412 | DOI:10.1227/ons.0000000000002159

Expert Opin Pharmacother. 2026 Aug 24. doi: 10.1080/14656566.2026.2723581. Online ahead of print.

ABSTRACT

BACKGROUND: Perioperative corticosteroids suppress pro-inflammatory pathways that drive postoperative coagulation, suggesting a potential anti-thrombotic effect. No prior systematic review has examined this relationship.

METHODS: We systematically reviewed studies reporting DVT or PE in patients receiving perioperative corticosteroids versus controls (MEDLINE, Embase, CENTRAL; inception-January 2026), performing exploratory pooled analysis using a random-effects model with GRADE certainty assessment. Risk of bias was assessed using RoB 2 (RCT) and the Newcastle-Ottawa Scale (observational studies).

RESULTS: Four studies (78,282 patients) were included. Pooled DVT analysis showed a statistically significant reduction favoring corticosteroids (RR 0.85, 95% CI 0.75-0.96; P = 0.008; I² = 0%); however, one observational study contributed 96.7% of patient-level weight, rendering the estimate functionally a single-study restatement. Excluding it reversed the effect direction. The only RCT trended toward DVT harm (RR 1.20). The PE estimate was non-significant (RR 0.55, 95% CI 0.23-1.31; P = 0.18; I² = 47%). GRADE certainty was very low for all outcomes.

CONCLUSIONS: The apparent DVT benefit reflects healthy-user confounding in a dominant observational study and is unsupported by randomized evidence. A dedicated, adequately powered RCT with pre-specified VTE endpoints is urgently needed.

PROTOCOL REGISTRATION: http://www.crd.york.ac.uk/prospero; identifier is CRD420261325249.

PMID:42635397 | DOI:10.1080/14656566.2026.2723581

J Endourol. 2026 Aug 24:8927790261480580. doi: 10.1177/08927790261480580. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the efficacy and safety of the flexible and navigable suction ureteral access sheath (FANS-UAS) against the conventional ureteral access sheath (CUAS) in retrograde intrarenal surgery (RIRS).

MATERIALS AND METHODS: A total of 161 patients who underwent RIRS at seven centers using similar surgical methods (thulium fiber laser and 7.5 F disposable flexible ureterorenoscope) were prospectively enrolled in the study between May 2024 and September 2025. The patients were randomized into two groups based on the use of UAS (Group 1: CUAS; Group 2: FANS-UAS). Demographic and clinical data of the patients, stone characteristics, surgical data, perioperative and postoperative complications, duration of hospitalization, and stone-free rates (SFRs) were analyzed for comparison.

RESULTS: Of the 161 patients included in the study, 79 received a CUAS and 82 received a FANS-UAS. The groups were demographically similar (p > 0.05). The postoperative SFR at 1 month was statistically significantly higher in the FANS-UAS group (79.3% vs 63.3%, p = 0.041), and the operative time was shorter in the CUAS group (p = 0.011). The perioperative bleeding rate was higher in the FANS-UAS group (p = 0.034), although there was no significant difference in postoperative hemoglobin decrease. No significant difference was observed between the two groups in terms of postoperative complications (p = 0.162).

CONCLUSION: The FANS-UAS is an effective method that increases SFR compared to the CUAS. Although the FANS-UAS prolongs operation time and increases perioperative bleeding, both FANS-UAS and the CUAS are similarly safe in terms of postoperative complications.

PMID:42635373 | DOI:10.1177/08927790261480580