Tag: nevin manimala

Med Oral Patol Oral Cir Bucal. 2026 Mar 7:28133. doi: 10.4317/medoral.28133. Online ahead of print.

ABSTRACT

BACKGROUND: To determine the causal efficacy of supportive periodontal care (SPC) frequency on inflammatory and anatomical periodontal outcomes using a propensity score-matched analysis.

MATERIAL AND METHODS: This retrospective cohort study utilized electronic health records from a multi-center dental data repository. Adult patients with periodontitis and at least one year of follow-up were classified into two maintenance cohorts based on their average recall interval: Frequent Maintenance (≤4.5 months) and Infrequent Maintenance (≥5.5 months). Propensity score matching (1:1) was performed to balance baseline covariates, including age, gender, diabetes, smoking status, and baseline disease severity (PPD and CAL), resulting in a matched sample of 1,500 patients. The primary outcomes were the annualized rates of change in PPD and Bleeding on Probing (BOP). Secondary outcomes included changes in clinical attachment level (CAL), furcation involvement, and tooth mobility.

RESULTS: Patients in the Frequent Maintenance group demonstrated significantly greater annual reductions in PPD (-0.19mm vs. -0.12mm; p<0.001) and BOP (-8.97% vs. -4.38%; p<0.001) compared to the Infrequent group. This represented a two-fold greater reduction in inflammatory burden for frequent attendees. However, no statistically significant differences were observed between groups regarding the improvement of acquired periodontal defects, including furcation involvement (p=0.15) and tooth mobility (p=0.57).

CONCLUSIONS: Frequent SPC provides a robust biological benefit by significantly reducing gingival inflammation and pocket depth but does not independently reverse acquired defects like furcation involvement or tooth mobility. These findings support a risk-based maintenance approach where visit frequency targets inflammation, while structural stability requires distinct therapeutic expectations or interventions.

PMID:41793731 | DOI:10.4317/medoral.28133

West Afr J Med. 2025 Aug 29;42(8):603-610.

ABSTRACT

BACKGROUND: Hyperglycemia in pregnancy (HIP) comes with both maternal and fetal complications; universal and selective screening have been used by various guidelines for its diagnosis. An appraisal of FIGO’s recommended universal screening is essential for domestication in low-resource settings.

OBJECTIVE: To compare universal and selective screening methods for the determination of hyperglycemia in pregnancy (HIP), including gestational diabetes mellitus (GDM) and diabetes in pregnancy (DIP) in a low-resource setting.

METHODS: A cross-sectional study of pregnant women in Enugu, southeast Nigeria. The eligible women in each group were consecutively recruited between 24-28 weeks gestational age and their fasting blood sugar (FBS) and 2 hours post prandial (2HPP) glucose levels were tested. Included were all consenting pregnant women between 24-28 weeks gestational age while excluded were those beyond 28 weeks and know diabetics already on treatment. The first group (universal group) was universally screened while in the second group (selective group) only participants with risk factors for HIP were screened. All data were analysed using statistical package for social sciences version 24 at 95% confidence level.

RESULTS: The overall prevalence of HIP, GDM and DIP were 7.1% (36/508), 5.6% (28/508) and 1.4% (7/508), respectively. There was no significant difference in the prevalence of HIP, GDM and DIP between the two groups (P > 0.05). However, 42.9% of cases of GDM and 66.7% of cases of DIP recorded in the universal group were from participants without any risk factor for HIP.

CONCLUSION: The detection of HIP, GDM and DIP is similar using the two screening methods. However, about half of the cases of HIP would be missed with selective screening. Obstetricians are therefore encouraged to adopt the universal screening method as selective screening is associated with missed diagnosis of HIP.

PMID:41793699

Asian Pac J Cancer Prev. 2026 Mar 1;27(3):1123-1133. doi: 10.31557/APJCP.2026.27.3.1123.

ABSTRACT

OBJECTIVES: This study aims to investigate the clinicopathological significance and prognostic impact of SLFN11 expression and tumor-infiltrating lymphocytes (TILs) in high-grade and low-grade ovarian serous carcinoma.

METHODS: A total of 70 patients diagnosed with high-grade and low-grade serous carcinoma were retrospectively analyzed. Clinical data, including age, Karnofsky Performance Status (KPS), CA125 levels, treatment details, and survival outcomes, were collected. Immunohistochemistry was used to assess SLFN11 expression in tumor cells and TILs. Statistical correlations were performed with chemotherapy response, recurrence, progression-free survival (PFS), and overall survival (OS).

RESULTS: High SLFN11 expression was significantly associated with better response to neoadjuvant chemotherapy (p = 0.003), higher histopathologic chemotherapy response score (p = 0.026), lower recurrence rate (p = 0.037), and improved survival outcomes (p < 0.001). High SLFN11 expression had significantly longer PFS (median= 33.05 months) and OS (median= 66.91 months), compared to those with low SLFN11 expression (median PFS =7.60 and median OS = 31.50, p<0.001). Similarly, high TILs count was associated with improved response to neoadjuvant chemotherapy (p = 0.008) and higher response score (p = 0.007). TILs-high patients had longer median PFS (25.52 months) and median OS (68.24 months) than TILs-low patients (median PFS = 10.30 and median OS = 30.63 months, p<0.001).

CONCLUSION: Our findings highlight that immunohistochemical expression of SLFN11 and the density of TILs may serve as predictive biomarkers for chemotherapy response and survival in ovarian serous carcinoma, with potential implications for personalized treatment strategies.

PMID:41793692 | DOI:10.31557/APJCP.2026.27.3.1123

Asian Pac J Cancer Prev. 2026 Mar 1;27(3):1099-1107. doi: 10.31557/APJCP.2026.27.3.1099.

ABSTRACT

BACKGROUND: Next-generation sequencing (NGS) has improved genomic analysis depth in precision oncology. This study analyzed genomic biomarker testing in stage IV NSCLC, focusing on brain metastasis and clinicopathological correlations.

OBJECTIVE: To study molecular markers and clinicopathological correlations in stage IV NSCLC patients, with and without brain metastasis.

METHODS: A total of 169 stage IV NSCLC patients were studied from April 2023 to May 2025. Demographic data, clinical presentations, and mutation analyses were assessed using NGS on tissue blocks or liquid biopsies.

RESULTS: Among 169 patients, 41.42% (n = 70) had brain metastasis (NSCLC-BM), while 58.58% (n = 99) had no brain metastasis (mNSCLC). Median ages were 51.5 and 56 years, respectively. Adenocarcinoma comprised 95.27% (n = 161) of cases. The cerebral hemisphere was the most common intracranial metastatic site, while skeletal involvement was the most common extracranial site. Headache was the predominant neurological symptom. EGFR mutations were the most common overall. EGFR > TP53 > ALK > other mutations were observed in NSCLC-BM, while EGFR > TP53 > KRAS > other mutations were seen in mNSCLC. Mutation analysis stratified by smoking history (χ²(1) = 1.347, p = 0.245) and sex (χ²(1) = 0.0302, p = 0.862) was not statistically significant. The benefit of gefitinib plus chemotherapy in EGFR exon 19 and exon 21 L858R mutations was greater in mNSCLC (log-rank χ²(1) = 10.813, p = 0.001) than in NSCLC-BM (log-rank χ²(1) = 3.100, p = 0.078). Median survival was 11 months (95% CI: 7.506-14.494) for NSCLC-BM versus 21 months (95% CI: 8.365-33.635) for mNSCLC, with a statistically significant difference (log-rank χ²(1) = 8.639, p = 0.003).

CONCLUSION: NSCLC-BM showed higher genomic biomarker enrichment (80% vs. 68.68%) but poorer outcomes than mNSCLC. EGFR was the most common targetable mutation, followed by ALK in NSCLC-BM and KRAS in mNSCLC.

PMID:41793689 | DOI:10.31557/APJCP.2026.27.3.1099

Asian Pac J Cancer Prev. 2026 Mar 1;27(3):1081-1090. doi: 10.31557/APJCP.2026.27.3.1081.

ABSTRACT

OBJECTIVE: Consumption of fermented freshwater fish is common in Northeast Thailand but increases the risk of Opisthorchis viverrini (OV) infection, nitrosamine exposure, and cholangiocarcinoma (CCA). This study evaluated a 3Es-based safety program designed to enhance knowledge, attitudes, behaviors, and to reduce ergonomic risks among informal fish processors.

METHODS: A quasi-experimental study was conducted with 100 participants from two fishing communities in Ubon Ratchathani Province. The experimental group (n = 50) received a 13-week safety program based on engineering, education, and enforcement (3Es), while the comparison group (n = 50) received routine health services. Data were collected through a structured questionnaire and an ergonomic assessment using the Rapid Upper Limb Assessment (RULA). Statistical analyses included t-tests and effect size estimation with Cohen’s d.

RESULTS: Post-intervention, the experimental group demonstrated significantly greater improvements than the comparison group in knowledge (mean difference = 2.09, p < 0.001, d = 2.69, very large effect), attitudes (mean difference = 0.39, p < 0.001, d = 3.88, very large effect), and behaviors (mean difference = 0.25, p < 0.001, d = 1.06, large effect). RULA scores also improved markedly, with fish sorting, drying, and packaging risk levels reduced from high to low, and cleaning and gutting reduced from very high to medium risk.

CONCLUSION: The 3Es-based program significantly improved safety-related knowledge, attitudes, behaviors, and reduced ergonomic risks. Large effect sizes confirm that these gains are both statistically and practically meaningful, supporting integration into community health services and local policies for sustainable OV and CCA prevention.

PMID:41793687 | DOI:10.31557/APJCP.2026.27.3.1081

Asian Pac J Cancer Prev. 2026 Mar 1;27(3):1053-1059. doi: 10.31557/APJCP.2026.27.3.1053.

ABSTRACT

BACKGROUND: Genetic variations in estrogen receptor genes are implicated in the development of breast cancer (BC). Among these, the ESR1 PvuII and XbaI polymorphisms have been frequently evaluated, but findings remain inconsistent. This study aimed to examine the association of the PvuII and XbaI polymorphisms with breast cancer risk in an Iranian female population.

MATERIALS AND METHODS: A case-control study was conducted on 100 breast cancer (BC) patients and 100 healthy, age-matched controls. Genotyping of the ESR1 PvuII (rs2234693 T>C) and XbaI (rs9340799 A>G) polymorphisms was performed using PCR-RFLP, with results validated by direct DNA sequencing. Associations between genotypes, clinicopathological features, and disease risk were analyzed.

RESULTS: Nominal differences in genotype distributions were observed. After applying multiple-testing correction across the pre-specified models, several associations remained statistically significant; however, marked deviations from Hardy-Weinberg equilibrium (HWE) in controls warrant cautious interpretation.

CONCLUSION: Given the hospital-based design, small sample size, and significant deviations from HWE in controls, the observed ESR1 associations should be considered hypothesis-generating rather than confirmatory. Replication in larger, population-based Iranian cohorts with orthogonal genotyping approaches is required before any clinical implications are drawn.

PMID:41793684 | DOI:10.31557/APJCP.2026.27.3.1053

Asian Pac J Cancer Prev. 2026 Mar 1;27(3):999-1005. doi: 10.31557/APJCP.2026.27.3.999.

ABSTRACT

OBJECTIVE: Significant gaps exist between hospital-incurred medical costs and national health insurance reimbursement rates, challenging the sustainability and equity of breast cancer care in Indonesia. Fixed tariffs often fail to capture the complexities and financial burdens associated with chemotherapy. This study compares hospital-incurred medical costs with both INA-CBG and non-INA-CBG reimbursement rates for breast cancer chemotherapy, identifies the key cost components, and evaluates the appropriateness of current tariffs under the National Health Insurance (JKN) scheme.

METHODS: A retrospective cross-sectional study was conducted at a tertiary hospital in Surabaya, Indonesia, using data from breast cancer patients who underwent chemotherapy in 2021. Clinical and cost data were obtained from hospital billing records, electronic medical records, and BPJS Kesehatan claims. The Wilcoxon signed-rank test was used to compare hospital-incurred medical costs with reimbursement rates. Subgroup analyses by INA-CBG code and chemotherapy regimen were performed to assess variability in coverage.

RESULTS: A total of 80 patients were included, predominantly female (97.5%) and diagnosed with stage IV disease (64.1%). Most were categorized under INA-CBG code C-3-13-0 (93.75%). Overall, the median hospital-incurred medical costs significantly exceeded reimbursement rates: IDR 3,657,290 vs. IDR 1,161,000 for C-3-13-0 (p < 0.001) and IDR 3,964,189 vs. IDR 2,151,900 for C-4-13-I (p = 0.031). Key cost drivers were chemotherapy administration (57.93%), nursing care (14.04%), and handling of cytotoxic drugs (7.88%). Specific regimens, such as vinorelbine, showed significantly higher costs that were not adequately reimbursed.

CONCLUSION: JKN tariffs for breast cancer chemotherapy substantially underestimate actual treatment costs. To improve financial sustainability and access, periodic tariff adjustments, adoption of activity-based costing, and consideration of hybrid payment models should be implemented to ensure equitable financing of oncology care in Indonesia.

PMID:41793678 | DOI:10.31557/APJCP.2026.27.3.999

Asian Pac J Cancer Prev. 2026 Mar 1;27(3):989-997. doi: 10.31557/APJCP.2026.27.3.989.

ABSTRACT

BACKGROUND: The Enhanced Recovery After Surgery (ERAS) protocol aims to achieve early recovery. However, its effects on the quality of recovery (QoR), as measured by patient-reported outcomes, still require further evaluation. This study aims to assess the QoR in patients undergoing lobectomy under ERAS protocol and identify the factors influencing QoR.

METHODS: A cross-sectional study was conducted using the QoR-15 score to measure QoR. The implementation of its twenty-seven components measured ERAS protocol adherence. Descriptive statistics were applied to describe the characteristics of QoR. Correlation and multivariable regression analyses assessed associations between ERAS adherence and QoR-15. Structural equation modeling (SEM) was used to evaluate whether potential factors mediated the ERAS adherence and QoR relationship via the average causal mediation effect (ACME).

RESULTS: This study included 98 patients. Their median QoR-15 score was 133, with an interquartile range of 130 to 134. QoR was excellent in 9.2%, good in 85.7%, and moderate in 5.1% of patients. The QoR-15 score moderately correlated with pain severity within the first 24 hours postoperatively (at POD0; ρ=-0.43, p<0.001) and ERAS adherence levels (ρ=0.31, p=0.002). Multivariable linear regression showed that pain at POD0 independently affected QoR-15 scores (β=-0.296, 95% confidence interval [CI] -0.407 to -0.184, p<0.001), while overall ERAS adherence did not (β=0.288, 95% CI -0.293 to 0.868, p=0.327). SEM analysis confirmed that higher ERAS adherence significantly reduced pain severity at POD0 (β = -0.47 per additional factor adhered to, p < 0.001), which in turn improved QoR-15 scores via a significant indirect effect (ACME = 0.381, p = 0.016).

CONCLUSIONS: Patients undergoing lobectomy under the ERAS protocol generally report positive QoR experiences. Adherence to the ERAS protocol may indirectly enhance QoR by reducing early postoperative pain. The study shows favorable QoR outcomes with ERAS implementation and highlights the importance of protocol adherence.

PMID:41793677 | DOI:10.31557/APJCP.2026.27.3.989

Asian Pac J Cancer Prev. 2026 Mar 1;27(3):941-946. doi: 10.31557/APJCP.2026.27.3.941.

ABSTRACT

OBJECTIVE: Assessment of treatment efficacy in neuro-oncology is measured by radiographic criteria. This can be misleading, as imaging findings may not translate into clinical benefit. The NANO scale, constructed by multidisciplinary experts, is an objective and measurable metric of neurological function that can be evaluated during routine examinations in brain tumor patients, so that patients receive an overall assessment of progression, along with radiological findings. This study aims to determine the validity and reliability of the Indonesian version of the NANO scale (NANO-Ina).

METHODS: The study was performed at Cipto Mangunkusumo National Referral Hospital, Jakarta. The validity and reliability process incorporated forward and backward translation to ensure cross-cultural equivalence, and an initial trial was conducted with 10 physicians to identify potential issues and refine item clarity. Subsequently, the 9 domains of the NANO-INA version were tested on 30 pathologically confirmed brain tumor patients by 2 distinct physicians separately. Inter-rater reliability was analyzed using the Kappa statistics.

RESULT: A total of 30 subjects were enrolled from January to August 2023, which included subjects mostly diagnosed with brain metastasis (30%), and the rest were equally distributed among meningioma, glioblastoma, and other primary brain tumors (23.3%). Among these, the majority had not received any treatment (77%), and the remaining were on chemoradiation (10%), chemotherapy (10%), and radiation (3.3%). Our inter-observer variability study demonstrated that the NANO-INA scale exhibits substantial to almost perfect agreement (kappa statistic ranging from 0.629-0.935) for all domains (p<0.05), with the highest agreement observed in strength, facial strength, and language.

CONCLUSION: The NANO-INA scale shows a high level of inter-observer agreement and serves as a reliable tool for assessing neurological function in patients with brain tumors in clinical settings in Indonesia.

PMID:41793672 | DOI:10.31557/APJCP.2026.27.3.941

Asian Pac J Cancer Prev. 2026 Mar 1;27(3):921-929. doi: 10.31557/APJCP.2026.27.3.921.

ABSTRACT

PURPOSE: Acute Myeloid Leukemia (AML) is a heterogeneous hematologic malignancy characterized by a wide range of cytogenetic abnormalities that have critical diagnostic and prognostic implications. South Indian populations are underrepresented in global AML research, warranting region-specific cytogenetic profiling.

METHODS: We performed a cytogenetic analysis of 400 newly diagnosed adult AML patients at a tertiary care center in South India. Conventional karyotyping and fluorescence in situ hybridization (FISH) were performed, and findings were correlated with clinical parameters according to the 2016 WHO and FAB classifications.

RESULTS: Abnormal karyotypes were observed in 49.5% of cases, while 50.5% showed normal karyotypes. The most frequent abnormalities were t(15;17) (16.2%), t(8;21) (6.7%), and inv(16) (3.7%). Other notable findings included trisomy 8 (1.7%), trisomy 21 (1%), and complex karyotypes (6.5%). AML-M4 (33.5%) was the most common FAB subtype. Significant associations were noted between cytogenetic risk groups and variables such as age, gender, and white blood cell count. The distribution of cytogenetic aberrations revealed both similarities and distinct differences when compared with global data, reflecting ethnic and geographical influences.

CONCLUSION: This study highlights the cytogenetic diversity of AML in a South Indian cohort and confirms the importance of cytogenetic analysis in disease classification, risk stratification, and therapeutic decision-making. The findings underscore the need for regional data to refine AML diagnosis and optimize management strategies across different populations.

PMID:41793670 | DOI:10.31557/APJCP.2026.27.3.921