Tag: nevin manimala

Hum Vaccin Immunother. 2025 Dec;21(1):2565927. doi: 10.1080/21645515.2025.2565927. Epub 2025 Oct 7.

ABSTRACT

The COVID-19 pandemic prompted strict measures and rapid vaccine deployment in Benin and Senegal. This longitudinal study uses Generalized Estimating Equations (GEE) to analyze the evolution of vaccination intent and its determinants, focusing on attitudes, risk perceptions, and social influence. This descriptive and analytical longitudinal study included 546 Beninese and 319 Senegalese individuals aged 18 and above, selected using marginal quotas. Data were collected via Random Digit Dialing (RDD) based on a questionnaire informed by the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM). Influential factors were assessed using GEE models. Vaccination intent increased more significantly in Senegal (+12.5 points, p = .000) than in Benin (+5.0 points, p = .089). There was a statistically significant increase in vaccine intent among women (+19.9 points) and individuals under 25 (+15.6 points) in Senegal, whereas in Benin, younger respondents showed a decrease (-11.5 points). In both countries, individuals surveyed in the second phase were significantly more likely to express vaccination intent (Benin: OR = 6.9; Senegal: OR = 5.0). Common positive determinants included perceived benefits, social influence, and favorable attitudes toward vaccination. Differences emerged: perceived efficacy and behavioral control were significant in Benin, while safety concerns were a major barrier in Senegal. This study highlights common and context-specific determinants of vaccination intent in Benin and Senegal. It emphasizes the need for tailored communication strategies and efforts to strengthen public trust to enhance vaccine uptake across West Africa.

PMID:41054838 | DOI:10.1080/21645515.2025.2565927

Int Health. 2025 Oct 7:ihaf112. doi: 10.1093/inthealth/ihaf112. Online ahead of print.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic was associated with unprecedented healthcare, economic and social disruptions that impacted persons with diabetes mellitus (PWDM). We aimed to establish how the quality of life (QoL) of persons with diabetes in rural Uganda was impacted by the COVID-19 pandemic, using the pre-pandemic, pandemic and post-pandemic self-reported QoL scores.

METHODS: We surveyed 410 PWDM ≥30 y of age from three rural districts in south-western Uganda. Median QoL scores were computed and variations across the three time periods were analysed using the Friedman analysis of variance and McNemar tests as appropriate. Logistic regression was used to identify factors associated with QoL. A p-value <0.05 indicated statistical significance.

RESULTS: The overall median QoL scores were 67.2 (pre-pandemic), 62.4 (pandemic) and 68.8 (post-pandemic) (p<0.001). There was a 75% increase in the proportion of participants with unsatisfactory QoL during the pandemic (p<0.001). Having diabetes complications (p<0.001), chronic comorbidity (p=0.012), no formal education (p<0.003) and travelling for healthcare using non-motorised transport (<0.001) were all independently associated with post-pandemic unsatisfactory QoL.

CONCLUSIONS: The COVID-19 pandemic caused significant deterioration in QoL among rural PWDM, raising the need for policies to prioritise the consideration of their evolving needs while designing measures for future similar widespread emergencies.

PMID:41054795 | DOI:10.1093/inthealth/ihaf112

Psychol Med. 2025 Oct 7;55:e300. doi: 10.1017/S0033291725101773.

ABSTRACT

BACKGROUND: The use of cannabis in adolescence and early adulthood, critical phases for brain development, is linked to psychotic-like experiences (PLEs). The underlying mechanisms, however, remain unclear. This research examined the relationship between recreational cannabis use and PLEs, emphasizing the connectivity of the salience network (SN), which plays a role in salience processing and psychosis. To determine whether this relationship reflects shared genetic or environmental contributions, twin modeling was used.

METHODS: We included 232 healthy adolescent Turkish twins who underwent diffusion MRI and psychometric assessment. SN connectivity was quantified using graph theory metrics. Linear mixed models were used to examine the associations among cannabis use, SN factors, and PLEs. Mediation analyses assessed whether SN parameters explained the cannabis-PLEs association. Twin models disentangle genetic and environmental contributions to these traits and their covariation.

RESULTS: Cannabis use was significantly associated with higher overall PLE frequency. A specific SN factor predicted both total and positive PLEs. However, SN connectivity did not mediate the cannabis-PLEs relationship. Twin modeling showed that cannabis use and PLEs were mainly influenced by unique environmental factors. No significant phenotypic covariations were found among cannabis use, PLEs, and SN parameters.

CONCLUSIONS: Recreational cannabis use during adolescence and young adulthood is associated with heightened PLEs, although this association is not mediated by SN connectivity. The environment plays an important role during adolescence in shaping these traits independently. The findings underscore the need for longitudinal and genetically informed studies to clarify the mental health effects of adolescent cannabis use.

PMID:41054791 | DOI:10.1017/S0033291725101773

Surg Infect (Larchmt). 2025 Oct 7. doi: 10.1177/10962964251385387. Online ahead of print.

ABSTRACT

Background: Ventricular reservoir infections and cerebrospinal fluid (CSF) shunt infections are diagnosed when bacteria are recovered from microbiological cultures of CSF samples from these devices. We applied high throughput sequencing (HTS) to understand the course of changes in ventricular reservoir and shunt infection microbiota. Objectives: Evaluate the utility of monitoring microbiota in CSF (1) from ventricular reservoirs to detect development of an infection and (2) during treatment of CSF shunt infections to assess treatment response. Methods: Study populations included (1) neonates with temporizing ventricular reservoirs who developed reservoir infection and (2) children undergoing treatment for conventional culture-confirmed CSF shunt infection. The V4 region of the 16S ribosomal RNA gene was amplified and sequenced. Comparison of taxonomic results of HTS with standard microbiological culture results (when available) was described for each CSF sample. A robust HTS signal was defined by a microbial load of ≥1e5 microbial genome equivalents/mL. Results: In none of the five ventricular reservoir infection cases was there a robust HTS signal for the responsible bacteria immediately prior to infection. In six of the seven CSF shunt infection cases, there was a robust HTS signal for the genus of the responsible bacteria in the sample at the time of positive CSF culture. The proportion of sequences from the genus associated with the responsible bacteria decreased during infection treatment. Conclusions: These pilot data suggest limited utility in using HTS for surveillance for ventricular reservoir infections, as they emerge abruptly. In CSF shunt infection, HTS demonstrates a return to heterogeneous microbiota when bacterial cultures become negative.

PMID:41054788 | DOI:10.1177/10962964251385387

Indian J Orthop. 2025 Jun 27;59(9):1563-1574. doi: 10.1007/s43465-025-01440-3. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Ankle arthrodesis is still the gold standard for painful, dislocated ankles with insufficient response to conservative treatment. This study presents a new arthroscopic solution to treat varus ankles over 25 degrees.

METHODS: Sixty-four patients with varus ankle deformities (35 males, 29 females, 33 right ankles, 31 left ankles) underwent arthroscopic fusion between February 2019 and February 2022. Patients were categorized into Group A (34 patients, varus > 25 degrees) and Group B (30 patients, varus < 25 degrees). The conditions included post-traumatic osteoarthritis (50%), primary osteoarthritis (20.3%), rheumatoid arthritis (17.2%), talar osteonecrosis (7.8%), and talar dome osteochondral defects (4.7%). Outcome measures included ankle joint mobility, radiographic assessment, VAS score, Mazur score, range of motion, stiffness, swelling, union rate, and patient satisfaction at 6, 12, and 24 months postoperative. Statistics analyses were performed using Fisher’s Exact test and Mann-Whitney test.

RESULTS: All procedures were performed successfully and follow-up was 24.08 months on average. VAS and Mazur scores improved significantly in both groups. Group A had a better final outcome than Group B (14.47 weeks for union).

CONCLUSION: The proposed arthroscopic fusion technique can effectively improve the alignment of the tibiotalar joint in varus ankle deformities greater than 25° through medial deltoid release, with promising clinical and functional outcomes.

PMID:41054762 | PMC:PMC12496405 | DOI:10.1007/s43465-025-01440-3

Indian J Orthop. 2025 May 13;59(9):1537-1545. doi: 10.1007/s43465-025-01406-5. eCollection 2025 Sep.

ABSTRACT

OBJECTIVE: To explore the manifestations of extradural fat in patients with Redundant nerve roots (RNRs) via lumbar MRI.

METHODS: A total of 492 patients with RNRs were enrolled and divided into two groups: Group A (n = 459) with known potential causes of RNRs, such as lumbar spondylolisthesis, scoliosis, disc herniation, and ligamentum flavum hypertrophy; Group B (n = 33) without the aforementioned causes; and control Group C (n = 33) with age- and sex-matched RNRs-negative patients. MRI was used to assess the morphology of extradural fat and the appearance of the cauda equina and to measure the subcutaneous fat thickness in the lumbar-sacral region (LSFTT). Statistical analysis was performed via t tests, chi-square tests, and Wilcoxon signed-rank tests, with p < 0.05 considered statistically significant.

RESULTS: In Group A, there was no statistically significant difference in the LSFTT among the different grades of extradural fat. In Group B, the incidence rates of Grade 2 and Grade 3 extradural fat were 66.7% and 24.2%, respectively, which were significantly greater than the 27.3% and 0% reported in Group C, with a statistically significant difference between Groups B and C (p < 0.001). The correlation coefficient between increased extradural fat and RNRs was 0.669 (p < 0.001). There were no statistically significant differences in the morphology or relative length of the RNRs among the different grades of extradural fat in Group B.

CONCLUSION: MRI is an important tool for assessing extradural fat and RNRs, providing crucial information for clinical decision-making and improving patients’ prognoses. Increased extradural fat may contribute to the development of RNRs and should be a concern for clinicians.

PMID:41054757 | PMC:PMC12496402 | DOI:10.1007/s43465-025-01406-5

Indian J Orthop. 2025 Jun 11;59(9):1413-1419. doi: 10.1007/s43465-025-01430-5. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: On-the-go (OTG) reference is defined as the reference that clinicians make on the go in a narrow time frame during patient care, which tends to play a significant role in decision-making. The common sources of these references over the years, have been changing from hard copies of textbooks and journals to online platforms. With the introduction of artificial intelligence (AI) based large language model (LLM) platforms, they are now being relied upon for these OTG references to provide clinicians with the necessary facts to make good clinical decisions by analyzing the maximum available resources. This study aims to compare the answers given by various LLM platforms with the answers obtained by clinicians using conventional referencing and also grade the relevance of the answers provided by these platforms.

METHODS: Three commonly used AI-based LLM chat platforms: ChatGPT Version 4(GPT 4), Microsoft Bing chat and Google Bard were selected for the study. 250 OTG clinical queries were collated from orthopaedic practitioners along with their answers and references used. The queries were given to the LLMs and their answers were compared and graded with the human answers for relevance and level of evidence (LOE) of the reference cited to support their answers.

RESULTS: We did not find any significant difference between the AI-LLM models tested regarding the relevance of generated answers to the clinical queries raised (p = 0.110). ChatGPT answers were significantly better to queries that necessitated numerical answers (p = 0.006) while Bard (p = 0.503) and Bing (p = 0.545) did not differ in their performance based on query types. We noted a statistically significant difference concerning the LOE of answers obtained (p < 0.001). Upon ranking the three LLMs with the LOE of human references, human references ranked the best followed by Bing, ChatGPT, and Bard.

CONCLUSION: Of the three compared tools, Bing Chat used relatively better LOE in answering OTG questions. All three compared AI-LLM tools show promising results concerning OTG referencing. We propose that customization to the medical domain and regulatory policies are needed before their recommended use.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43465-025-01430-5.

PMID:41054750 | PMC:PMC12496309 | DOI:10.1007/s43465-025-01430-5

Indian J Orthop. 2025 May 13;59(9):1440-1446. doi: 10.1007/s43465-025-01386-6. eCollection 2025 Sep.

ABSTRACT

AIM: To identify the frequency of developmental dysplasia of the hip (DDH) in infants subjected to traditional swaddling for awareness purpose and early intervention, in addition to detect the accuracy of clinical and radiological techniques in the diagnosis of cases.

METHODS: This prospective observational study was conducted by a multidisciplinary team at Azadi Teaching Hospital and Maternity Hospital in Duhok City from October 2022 to October 2024. This study included a total of 110 newborns whose parents continued to practice traditional swaddling despite receiving immediate postnatal warnings against its use. however, newborns who were not exposed to this method of swaddling were excluded. Clinical and radiological assessments were conducted at birth till 6 months of age. Statistical analyses were performed using SPSS version 27 to evaluate the relationship between traditional swaddling and DDH.

RESULTS: Among the 110 neonates, 6.4% were diagnosed with DDH by the age of six months. Significant associations were found with female sex, breech presentation, first-born status, and a positive family history. Left-sided hip involvement was predominant. Early ultrasound by about 8 weeks detected dysplasia in 10% of patients, with 54% progressing to DDH. By six months, X-rays imaging confirmed a 6.4% prevalence of DDH.

CONCLUSION: Traditional swaddling practices were linked with an increased risk of DDH, particularly in infants with other risk factors. Ultrasound within the first 3 months and follow-up X-ray at 6 months are reliable diagnostic tools for identifying DDH. Early screening and safe swaddling education are critical for DDH prevention.

PMID:41054749 | PMC:PMC12496375 | DOI:10.1007/s43465-025-01386-6

Indian J Orthop. 2025 Jun 28;59(9):1455-1461. doi: 10.1007/s43465-025-01452-z. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Tourniquets are used in knee arthroplasty surgeries for a bloodless field and effective bone-cement integration. However, their use is associated with known complications and of late surgeons have proposed limiting their use. The present randomized study was carried out to analyze the effectiveness of limited tourniquet usage in knee arthroplasty.

METHODOLOGY: 60 patients were randomized into two groups, full tourniquet time (FTT) group and the limited tourniquet time (LTT) group. Demographic parameters, preoperative haemoglobin and haematocrit, operative time, duration of tourniquet use, and measured blood losses were recorded. Drain outputs, post-operative Hb, hematocrit, transfusion requirements, total blood loss by day 5 were recorded and calculated. Hidden blood loss was calculated based on the above-derived data.

RESULTS: The demographic and the pre-operative variables of the two groups were similar. On intra-group analysis, all the parameters were statistically significant except the VAS scores. On comparison between the two groups the tourniquet time, day 1 Hb in the FTT group and pain experienced by the FTT group on day 5 was significantly higher whereas the operative time LTT group was significantly higher. There was no significant difference in the rest of the parameters.

CONCLUSION: Tourniquet usage is associated with known complications. There is no significant advantage in blood loss while using tourniquet throughout the surgery. However, limiting the tourniquet use is associated with significantly lower pain scores on 5th post-op day. Hence, it is recommended that the use should be reduced to mitigate the complications of tourniquet usage.

PMID:41054748 | PMC:PMC12496396 | DOI:10.1007/s43465-025-01452-z

Indian J Orthop. 2025 Jun 29;59(9):1462-1468. doi: 10.1007/s43465-025-01464-9. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: Conventionally, radiographs have been used to assess the severity of knee osteoarthritis (OA), but they fail to measure soft tissue changes responsible for generating symptoms. In recent literature, there is discordance between clinical symptoms and X-ray findings in knee OA. Therefore, we used MRI in our study to assess the correlation between patient-reported outcome measures as assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and MRI findings as assessed by the Whole-Organ Magnetic Resonance Imaging Score (WORMS) score in knee OA. The study was done after approval from The Institutional Human Ethics Committee.

METHODS: The sample size was calculated as 34. Eight women and 26 men who fulfilled the inclusion and exclusion criteria were included in the study. The knee with a higher Kellgren and Lawrence (KL) grade underwent MRI. The WOMAC score was used to assess pain, morning stiffness and physical function and the MRI findings were evaluated using the WORMS score. Spearman’s rank correlation coefficient was used for correlation analysis.

RESULTS: The mean age was 53.5 ± 8.08 years, BMI 29.35 ± 4.51 kg/m², disease duration 2.57 ± 1.91 years, VAS score 5.08 ± 1.50, total WOMAC score 41.50 ± 10.80, and total WORMS score 64.78 ± 26.49. Statistical analysis revealed a positive correlation between WOMAC score and WORMS score (Spearman’s rho value-0.645, p-value- < 0.05, Confidence Interval- 95%), and between WORMS score and KL grade (Spearman’s rho value-0.637, p-value- < 0.05, Confidence Interval- 95%). There was no correlation between the WOMAC score and KL grade, highlighting the limitation of radiographs in reflecting symptom severity.

CONCLUSION: Conventional radiography is a good screening tool for knee osteoarthritis but cannot detect structural changes causing symptoms, leading to symptom-radiograph discordance. MRI better identifies these changes, as our study shows, and is useful when symptoms and radiographs misalign or conservative treatment fails. Future research should identify WORMS subgroups that better correlate with symptoms for improved diagnosis and management.

PMID:41054741 | PMC:PMC12496301 | DOI:10.1007/s43465-025-01464-9