Tag: nevin manimala

Ecancermedicalscience. 2026 May 26;20:2129. doi: 10.3332/ecancer.2026.2129. eCollection 2026.

ABSTRACT

BACKGROUND: In resource-limited settings like Ghana, the growing burden of oncology care demands robust pharmaceutical quality improvement (QI) strategies to ensure safe and effective systemic cancer treatment. However, limited evidence exists on the implementation and impact of such strategies within pharmacy departments of tertiary healthcare facilities.

AIM: The study assessed the effectiveness, impact and challenges associated with QI strategies and practices in the pharmacy departments of four major tertiary healthcare facilities in Ghana.

METHODS: A multi-centre cross-sectional study was conducted to assess QI practices in oncology care. A structured questionnaire and an observational checklist were used to collect data from 91 pharmacy staff who were recruited via stratified random sampling. Quantitative analysis was performed using STATA version 19 with descriptive and inferential statistics applied to evaluate the implementation and perceived effectiveness of QI strategies.

RESULTS: The mean age was 37.5 ± 9.9 years. Various QI strategies were widely implemented, including the use of technology (100%), standard operating procedures (92.3%) and staff training (83.5%). Key focus areas were inventory management, patient safety and reduction of medication error. While overall perceptions of QI effectiveness were high (mean = 4.92), training adequacy and resource allocation scored lower. Major challenges included theft, preferential treatment of patients and inventory issues. Regression analysis identified staff training (p = 0.026), patient-centered focus (p = 0.013) and responsiveness (p = 0.011) as significant predictors of perceived performance, underscoring the importance of these factors in enhancing pharmacy service quality.

CONCLUSION: The study highlights the widespread adoption of QI strategies in Ghanaian tertiary hospital pharmacy departments and their perceived positive impact on oncology care delivery. Despite notable strengths in technology use and service orientation, gaps in staff training and resource allocation remain. Addressing these challenges through targeted investments and continuous professional development is essential to strengthen pharmaceutical services and ensure safer, more efficient cancer care in resource-limited settings.

PMID:42428818 | PMC:PMC13346692 | DOI:10.3332/ecancer.2026.2129

Ecancermedicalscience. 2026 May 7;20:2122. doi: 10.3332/ecancer.2026.2122. eCollection 2026.

ABSTRACT

BACKGROUND: Breast cancer (BC) represents a major public health issue in Morocco. This study aims to describe the epidemiological, clinical and histopathological profile of women with BC diagnosed at the Taza Reproductive Health Reference Center in eastern Morocco between November 2016 and December 2024.

METHODS: This was a descriptive, retrospective, cross-sectional study of 412 confirmed cases of BC. Data were collected from archived medical records and analysed using IBM SPSS Statistics software.

RESULTS: 412 new cases were identified, with an increasing trend over the years, from 15.1 per 100,000 in 2017 to 29.2 per 100,000 in 2024. The mean age at diagnosis was 51.5 ± 11.8 years. The majority of patients (59%) were aged between 40 and 59, 70.9% were married and 52.6% lived in rural areas. Most were housewives (97.3%). Regarding health coverage, 73.5% were insured, including 40.3% affiliated with RAMED’s health insurance regime. Clinically, the left breast was affected in 54.1% of cases and the predominant tumour localisation was the superolateral quadrant (57.8%). The most frequent histological type was invasive ductal carcinoma (95%). According to Scarff-Bloom-Richardson (SBR) histoprognostic grade, 68% of tumours were grade II, 28% grade III and 4% grade I.

CONCLUSION: This study highlights a progressive increase in the incidence of SBR in the Taza region, as well as a socio-economic profile marked by precariousness and rurality. Intermediate-grade infiltrating ductal carcinoma is the dominant histological form. These results underline the importance of early detection and improved access to care, particularly in rural areas.

PMID:42428817 | PMC:PMC13346689 | DOI:10.3332/ecancer.2026.2122

Orthop J Sports Med. 2026 Jul 8;14(7):23259671261440196. doi: 10.1177/23259671261440196. eCollection 2026 Jul.

ABSTRACT

BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) is frequently followed by significant quadriceps atrophy and strength loss due to postoperative pain and the necessity for low-load rehabilitation. Blood flow restriction (BFR) training is an emerging modality that may facilitate muscle strength and hypertrophy under low-load conditions, but its efficacy for improving functional outcomes after ACLR remains to be conclusively determined.

PURPOSE: To systematically evaluate the effects of BFR training on lower limb function, quadriceps strength, and knee pain in patients following ACLR.

STUDY DESIGN: Systematic review; Level of evidence, 3.

METHODS: A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, Web of Science, PEDro, EBSCO and CNKI for randomized controlled trials (RCTs) published between January 2015 and August 2025. A total of 606 records were identified through database searching, and 9 RCTs were included after screening. Data on functional scores (Lysholm, International Knee Documentation Committee [IKDC]), quadriceps peak torque (PT), pain (visual analog scale [VAS]), and range of motion (ROM) were extracted and analyzed using RevMan 5.4, and risk of bias was assessed using the Cochrane tool. Meta-analyses were performed using weighted mean differences (WMDs) with fixed- or random-effects models as appropriate, and heterogeneity was assessed using the I ² statistic.

RESULTS: Nine RCTs involving 372 participants were included. Meta-analysis revealed that BFR training significantly improved Lysholm scores (WMD, 5.75; 95% CI, 0.60-10.90; P = .03) and quadriceps PT (WMD, 8.34; 95% CI, 7.47-9.22; P < .00001), and increased total work output (P = .006). However, no significant differences were observed in IKDC scores, VAS pain scores, or ROM (P > .05). Sensitivity analyses confirmed the robustness of the primary findings.

CONCLUSION: Our study demonstrated that BFR training may promote early recovery of quadriceps strength and selected aspects of knee function after ACLR under low-load conditions. BFR appears feasible and generally well tolerated in the included trials; however, safety conclusions are limited by inconsistent adverse-event reporting. Its effects on pain relief, joint mobility, and long-term functional recovery require further investigation.

PMID:42428806 | PMC:PMC13346806 | DOI:10.1177/23259671261440196

NPJ Clim Atmos Sci. 2026;9(1):151. doi: 10.1038/s41612-026-01424-6. Epub 2026 May 4.

ABSTRACT

Statistical downscaling translates coarse-resolution climate model output into locally relevant information for climate services and impact assessment. Recent advances in artificial intelligence (AI) enable high-resolution, probabilistic, and computationally efficient approaches. This paper provides a perspective on the evolution from classical to AI-driven and hybrid downscaling approaches, assesses key challenges related to interpretability, uncertainty, data availability, and computational requirements, and outlines physically constrained and generative frameworks that support decision-making across sectors.

PMID:42428801 | PMC:PMC13345914 | DOI:10.1038/s41612-026-01424-6

Crohns Colitis 360. 2026 Jun 3;8(3):otag048. doi: 10.1093/crocol/otag048. eCollection 2026 Jul.

ABSTRACT

BACKGROUND: Pregnant women with inflammatory bowel disease (IBD) and an ileal pouch-anal anastomosis (IPAA) often receive conflicting medical advice regarding mode of delivery, and healthcare providers may have diverging opinions. Cesarean delivery is commonly performed out of concern of injuring the anal sphincter during vaginal delivery, causing poorer long-term pouch function. This study aims to describe rates of vaginal and cesarean delivery, complication rates and assess the impact of pregnancy and delivery on pouch function for patients with IBD and an IPAA.

METHODS: This retrospective single center chart review study included patients with IBD, an IPAA, and a completed pregnancy between January 1, 2002 and February 1, 2021. Patient demographics, IBD diagnosis, IPAA procedure details, mode of delivery and complications, and pouch function surrounding pregnancy were compared using descriptive statistics.

RESULTS: Sixty-two patients completed 85 pregnancies. Eighty-one percent of pregnancies had a cesarean delivery (69/85); of these, 51 (73.9%) were planned elective cesareans while 18 (26.1%) were urgent. Among the planned elective cesareans, 51.6% were indicated to prevent injury to the anal sphincter and preserve pelvic pouch function. Immediate risks of cesarean and vaginal delivery were similar to the general population. Rates of delivery intervention with episiotomy were high (50% of vaginal deliveries). All vaginal deliveries took place in the later 10 years of the study period. Pouch function postpartum was infrequently documented.

CONCLUSIONS: Pregnant patients with IBD and an IPAA frequently had a cesarean delivery, often to avoid anal sphincter injury from vaginal delivery and preserve pelvic pouch function. Delivery practices shifted in the past 10 years to include vaginal delivery, likely reflecting an increased perceived safety of this delivery mode.

PMID:42428799 | PMC:PMC13348844 | DOI:10.1093/crocol/otag048

Front Surg. 2026 Jun 25;13:1871497. doi: 10.3389/fsurg.2026.1871497. eCollection 2026.

ABSTRACT

BACKGROUND: Routine circumcision using penile circumcision and suturing devices (PCSD) is widely performed in outpatient settings. However, the conventional technique usually requires two operators, which increases manpower demand and limits procedural efficiency in high-volume clinical practice.

OBJECTIVES: To evaluate the feasibility and short-term perioperative outcomes of a single-operator circumcision technique using a penile circumcision and suturing device, compared with the traditional dual-operator method.

MATERIALS AND METHODS: This prospective pilot observational study consecutively enrolled patients undergoing circumcision at a single center. Patients were divided into two groups: Group 1 (dual-operator circumcision, n = 82) and Group 2 (single-operator circumcision, n = 113). All patients received the same anesthesia protocol consisting of 2% lidocaine for dorsal penile nerve block (DPNB). Operative time, intraoperative blood loss, and adverse surgical events were compared between the two groups.

RESULTS: The mean operative time was 6.18 ± 0.22 min in the single-operator group and 6.14 ± 0.25 min in the dual-operator group, with no statistically significant difference (P = 0.295). The mean difference was 0.04 min (95% confidence interval, -0.03-0.11). The mean intraoperative blood loss was 4.95 ± 2.41 cm² in the single-operator group and 5.01 ± 2.90 cm² in the dual-operator group, with no statistically significant difference (P = 0.864). The mean difference was -0.06 cm² (95% confidence interval, -0.78-0.66). No adverse surgical events occurred in either group.

CONCLUSION: This pilot comparative study suggests that single-operator circumcision using a penile circumcision and suturing device is feasible and associated with comparable short-term perioperative outcomes. However, the present study was not designed as a formal equivalence or non-inferiority trial, and the absence of statistically significant differences should not be interpreted as proof of equivalence. Further studies are required to confirm safety, long-term outcomes, and potential resource implications.

PMID:42428781 | PMC:PMC13346218 | DOI:10.3389/fsurg.2026.1871497

J Public Health Res. 2026 Jul 8;15(3):22799036261461038. doi: 10.1177/22799036261461038. eCollection 2026 Apr.

ABSTRACT

OBJECTIVES: Health literacy (HL) is an important determinant of health behaviors, including diet. In military populations, optimal nutrition is critical for physical performance, readiness, and long-term health. In Norway, first-time military service provides a unique opportunity to influence young conscripts’ health habits. This study investigates the relationship between HL and dietary patterns, body mass index (BMI), and meal adherence among Norwegian conscripts, with an emphasis on potential sex differences.

STUDY DESIGN: A cross-sectional study.

METHODS: This cross-sectional study included Norwegian conscripts completing first-time military service. HL was measured using the validated HLS-Q12 instrument. Dietary behaviors, meal patterns, and BMI were assessed using self-reported questionnaire data. A digital questionnaire was sent to Norwegian conscripts completing their first-time military service in 2022 (n=9,991). A total of 2,225 conscripts consented to participate in the study. The survey assessed dietary habits across different military settings, self-reported diet quality, and HL using the HLS-Q12 tool. BMI was calculated from self-reported height and weight. Statistical analyses included chi-square tests and Pearson correlation to explore associations between HL, diet, and BMI.

RESULTS: Significant associations were observed between HL and several dietary variables; however, most associations were weak in magnitude. Higher HL was associated with more regular meal patterns and better self-reported diet quality. Additionally, differences between sexes were observed, but effect sizes were generally small. More than half of conscripts had an adequate HL, with males scoring significantly higher than females. Conscripts with adequate HL were more likely to rate their diet as good, follow meal recommendations, and maintain a normal BMI. However, no significant association between HL and BMI was found in the total population; differences appeared in sex-stratified analyses, among female conscripts. Independently of HL, unhealthy snacking and high-sugar drink consumption were more common during field training, whereas conscripts with inadequate HL (iHL) reporting higher sugary snack intake at home. Adequate HL was weakly but significantly correlated with higher self-reported diet quality, more frequent adherence to regular meals, and lower sugary snack consumption. This could mean that HL was associated with self-reported dietary intentions but not outcomes like BMI.

CONCLUSIONS: HL may be associated with dietary behaviors among conscripts. However, given the weak associations and study limitations, the findings should be interpreted with caution. Although more than half of the conscripts had adequate HL, iHL was prevalent among Norwegian conscripts. Poorer self-reported diet quality and lower adherence to regular meal patterns is associated with iHL, particularly during field training. No significant associations was found between HL and BMI. The findings suggest a need for tailored education to improve HL and behavior change, to promote healthier dietary habits during military service.

PMID:42428758 | PMC:PMC13346719 | DOI:10.1177/22799036261461038

Drug Chem Toxicol. 2026 Jul 9:1-10. doi: 10.1080/01480545.2026.2638309. Online ahead of print.

ABSTRACT

Gestational diabetes mellitus (GDM) is a growing health problem causing a higher risk of delivering large infants and experiencing maternal and neonatal mortality. Studies have found a link between increased levels of mercury (Hg) and lead (Pb) in the blood and a higher risk of developing GDM. However, there are other reports contradicting the aforementioned findings. In this meta-analysis, we investigated the association between exposure to Hg and Pb and the elevated risk of being diagnosed with GDM. To that end, a systematic search was performed through Google Scholar, Web of Science, PubMed, and Scopus, from inception to May 01, 2024, to gather relevant studies. The association between maternal Hg and Pb exposure and the potential risks of GDM was evaluated through the use of pooled odds ratios (OR) and the corresponding 95% confidence intervals (CI). To make the calculations, the fixed-effects or random-effects models were also applied. Overall, 8 eligible studies met the inclusion criteria and were included in our meta-analysis. The results of our meta-analysis revealed that maternal Hg exposure increases the risk of GDM 1.27 times, which is statistically significant (OR = 1.27, 95% CI =1.10-1.46). Conversely, no significant association was observed between Pb levels and GDM. In conclusion, results showed that Hg exposure, unlike Pb, markedly gave rise to higher risks of GDM.

PMID:42426582 | DOI:10.1080/01480545.2026.2638309

J Chem Inf Model. 2026 Jul 9. doi: 10.1021/acs.jcim.6c00143. Online ahead of print.

ABSTRACT

The elastic properties of biological membranes can be described by mechanical constants like the bending modulus at flexure (k_c) and the area compressibility modulus (K_A), which quantify the energy cost associated with bending, compression, and stretching of the membrane area. These properties provide a means to describe phenomena such as the shape variation of a vesicle in response to pressure or the strain energy of a membrane influenced by lipid composition, interactions with ions, small molecules, or biomolecules. The determination of elastic moduli provides a quantitative basis for describing deformation-related processes in cellular systems at the molecular and mesoscopic levels. However, measurements of elastic constants, such as the bending modulus, exhibit a wide dispersion of reported values, ranging from approximately 10 k_BT (4 × 10^-20 J) to 100 k_BT (4 × 10^-19 J) for liquid disordered phospholipid membranes. Computational protocols for estimating elastic constants of lipid membranes commonly rely on Fourier analysis of the membrane surface, where the upper integration limit is determined by lipid molecular dimensions, making results sensitive to lipid composition and complicating cross-system comparisons. We have implemented the s_comp tool in the SuAVE software to estimate area compressibility from the direct integration of membrane surface areas, circumventing the dependence on wavevector integration limits that arises when elastic constants are extracted from Fourier mode amplitude spectra. The calculation does not require prior knowledge of lipid molecular dimensions and is therefore applicable to membranes of arbitrary composition and morphology. The calculated elastic constants are in reasonable agreement with values reported in the literature, falling within the variability observed across computational protocols and experimental techniques. As with any fluctuation-derived property, fully converged trajectories and appropriate statistical sampling are prerequisites for reliable estimates. The SuAVE software is freely available from https://github.com/SuAVE-Software.

PMID:42426567 | DOI:10.1021/acs.jcim.6c00143

Diabetes Obes Metab. 2026 Jul 9. doi: 10.1111/dom.71094. Online ahead of print.

ABSTRACT

BACKGROUND: The effects of individual sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) and glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) on ventricular arrhythmias (VAs) remain uncertain. This study aimed to comprehensively compare their effects on VAs and cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM) and/or heart failure (HF).

METHODS: Four databases were systematically searched from inception through May 16, 2026, to identify randomised controlled trials. Nine outcomes were evaluated, including VAs, cardiovascular mortality, all-cause mortality and hospitalization for heart failure (HHF).

RESULTS: Thirty-seven publications, corresponding to 32 independent RCTs and 140 156 participants, were included. Most SGLT2 inhibitors and GLP-1 receptor agonists did not significantly increase VA risk; empagliflozin showed a statistically significant but exploratory signal for lower VA risk in the T2DM network (OR 0.31, 95% CI 0.11-0.86). Dapagliflozin in the HF network and empagliflozin and liraglutide in the T2DM network, were associated with lower cardiovascular and all-cause mortality. SGLT2 inhibitors consistently reduced HHF across both networks. Dapagliflozin was associated with lower AKI risk, while albiglutide and liraglutide were associated with lower hypoglycemia risk; however, these safety findings should be interpreted cautiously because adverse-event reporting was not uniform across trials. Several safety outcomes were based on sparse events and non-uniform adverse-event reporting; no statistically significant increase in diabetic ketoacidosis risk was detected for empagliflozin and the semaglutide fracture signal should be interpreted cautiously. Because the evidence networks were largely placebo-centered and lacked closed loops, treatment rankings and between-drug comparisons depend heavily on the transitivity assumption. These rankings, including P-score rankings, should be regarded as exploratory and should not be interpreted as head-to-head comparative evidence.

CONCLUSIONS: SGLT2 inhibitors consistently reduced HHF risk across the HF and T2DM networks and selected agents showed mortality benefits in clinically relevant populations. Empagliflozin showed an exploratory signal for lower VA risk in the T2DM network; however, this finding requires confirmation in trials with prespecified and adjudicated arrhythmia endpoints. Safety signals, including DKA and fracture, should be interpreted cautiously because adverse-event ascertainment was not uniform across trials.

PMID:42426564 | DOI:10.1111/dom.71094