Tag: nevin manimala

BMC Surg. 2025 Oct 3;25(1):429. doi: 10.1186/s12893-025-03134-x.

ABSTRACT

BACKGROUND: Laparoscopic inguinal hernia repair is now widely performed worldwide. However, there is no consensus on the most appropriate surgical operation for inguinal hernia in adult males. This study aims to evaluate the clinical efficacy and applicability of laparoscopic free vas deferens separation with transabdominal preperitoneal (LFVD-TAPP) repair for inguinal hernia in adult males, in comparison to the conventional transabdominal preperitoneal prosthesis (TAPP) approach.

METHODS: A retrospective analysis was conducted on 189 adult male patients who underwent laparoscopic inguinal hernia repair at the First Affiliated Hospital of Soochow University between February 2020 and January 2023. Patients were divided into two groups that included the LFVD-TAPP (n = 95) and the conventional TAPP (n = 94). Observation targets included surgical and postoperative recovery, complication rates, recurrence and chronic pain. Data were analyzed using SPSS 27.0, with statistical significance defined as p < 0.05.

RESULTS: No significant differences were found in baseline characteristics between groups. The LFVD-TAPP group showed significantly shorter operative times for both unilateral and bilateral hernias compared to the TAPP group (0.97 ± 0.20 h vs. 1.60 ± 0.21 h; 1.21 ± 0.17 h vs. 2.01 ± 0.30 h; P < 0.001). No significant differences were observed in postoperative blood loss, length of hospital stay, or hospitalization costs (P > 0.05). However, the LFVD-TAPP group exhibited a higher incidence of temporary groin induration (11 vs. 4; P < 0.05),but significantly lower rates of scrotal hematoma (5 vs. 17; P < 0.05), and chronic pain (6 vs. 11; P < 0.05). No differences were observed in other complications or recurrence rates. Follow-up over 12-24 months revealed no cases of ischemic orchitis, testicular atrophy, or ejaculatory dysfunction in the LFVD-TAPP group.

CONCLUSIONS: LFVD-TAPP presents clinical advantages over conventional TAPP, including simplified intraoperative separation, reduced surgical difficulty, and lower rates of postoperative scrotal hematoma and chronic pain, without increasing the risk of recurrence. Therefore, the LFVD-TAPP provides better protection of the vas deferens, suggesting its potential for clinical application and broader promotion.

PMID:41044539 | DOI:10.1186/s12893-025-03134-x

BMC Public Health. 2025 Oct 3;25(1):3319. doi: 10.1186/s12889-025-24687-9.

ABSTRACT

INTRODUCTION: Tetanus is a public health concern in East Africa, impacting pregnant women and infants since vaccination rates are below acceptable levels. Despite several studies examining tetanus toxoid vaccine coverage in East Africa, the total pooled vaccination coverage rate remains unknown, and the results of these studies are related to these variables. The purpose of this meta-analysis is to estimate the pooled tetanus toxoid vaccination coverage rates among pregnant women in East Africa and identify contributing variables.

METHODS: We searched PubMed, Scopus, Embase, and Google Scholar for studies published between March 10, 2015, and March 10, 2025. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) criteria. The study quality was assessed using a modified version of the Newcastle-Ottawa quality assessment tool. The data were retrieved separately by two authors using Microsoft Excel and analyzed with Stata version 17. A random effects model was used to calculate the pooled vaccination coverage and related covariates. Publication bias is assessed using funnel plots and Egger’s test, while heterogeneity is evaluated through Cochran’s Q test and the I² statistic, helping to ensure the reliability of meta-analytic findings. The PROSPERO registration number for this evaluation was CRD420251008125.

RESULT: The meta-analysis included 25 articles and 70,592 participants. Pregnant women in East Africa had at least two doses of tetanus toxoid vaccination, with a pooled estimate of 47% (95% CI: 41%-54%). The meta-analysis revealed that maternal education (OR = 0.63), media exposure (OR = 1.14), ANC service follow-up (OR = 1.06), place of delivery (OR = 1.17), wealth index (OR = 1.25), family planning use (OR = 0.55), number of ANC visits (OR = 3.12), place of residence (OR = 0.88), and need for indexed birth status (OR = 1.36) were significant predictors of tetanus toxoid vaccination coverage.

CONCLUSION: The findings indicate that receiving at least two doses of tetanus toxoid immunization coverage among pregnant women in East Africa was low. Furthermore, various factors were significantly associated.

PMID:41044529 | DOI:10.1186/s12889-025-24687-9

BMC Public Health. 2025 Oct 3;25(1):3326. doi: 10.1186/s12889-025-24701-0.

ABSTRACT

BACKGROUND: Masturbation is a common practice across various demographics worldwide. However, its prevalence among the general population in Nigeria remains unknown. This study investigates the prevalence of self- and mutual masturbation and their associated factors among sexually active Nigerians.

METHODS: Data were obtained from the Sexual Behaviour and HPV Infection in Nigerians in Ibadan cross-sectional study, including males and females aged 18-45 years. After obtaining consent, participants were asked during face-to-face interviews whether they had ever touched their genitals or inserted fingers into the vagina or anus for sexual pleasure (self-masturbation) or whether they and their sexual partners had ever touched each other’s genitals by hand for sexual pleasure (mutual masturbation). The prevalence of self- and mutual masturbation was reported using percentages, while their associations with participants’ demographic, lifestyle, and biological characteristics were examined using chi-square tests. Poisson regression with robust variance was performed to identify associated factors. Statistical significance was set at p < 0.05.

RESULTS: Mutual masturbation (83.7%) was more common than self-masturbation (64.9%) among participants. The prevalence of self-masturbation was significantly higher among males than females (69.9% vs. 62.4%, p = 0.022), while mutual masturbation was significantly higher among females than males (86.6% vs. 78.1%, p = 0.001). Occupation, smartphone ownership, and alcohol consumption were significantly associated with self-masturbation, while ethnicity, location, number of penile-vaginal sex partners, and receiving oral sex were associated with mutual masturbation.

CONCLUSION: Self- and mutual masturbation are highly prevalent among sexually active Nigerians, with distinct factors influencing each behaviour.

PMID:41044527 | DOI:10.1186/s12889-025-24701-0

BMC Public Health. 2025 Oct 3;25(1):3335. doi: 10.1186/s12889-025-24746-1.

ABSTRACT

OBJECTIVES: Although previous research has established a strong link between sarcopenia and fall risk in middle-aged and older adults, the effects of sarcopenic obesity and possible sarcopenic obesity on fall risk remain underexplored in large-scale studies. This longitudinal analysis aimed to examine these associations using nationally representative cohort data.

METHODS: We analyzed data from the China Health and Retirement Longitudinal Study (CHARLS), including 9,996 participants aged 45 and older with available body composition measurements. Participants were categorized into four groups based on Asian Working Group for Sarcopenia (AWGS) criteria and median waist circumference (WC): (1) normal WC without sarcopenia (control group), (2) normal WC with sarcopenia, (3) obesity without sarcopenia, and (4) obesity with sarcopenia. Cox proportional hazards model was used to estimate adjusted hazard ratios (HRs), 95% confidence intervals (CIs), and P-values, with the control group as the reference. The model was sequentially adjusted for demographic (age, sex, residence), socioeconomic (education), and behavioral (smoking, alcohol) variables.

RESULTS: Compared to participants with normal WC and no sarcopenia (reference group), those with sarcopenic obesity had a significantly higher risk of falls (HR = 1.25; 95% CI: 1.00-1.56; P = 0.048), even after adjusting for demographic, socioeconomic, and behavioral factors. Similarly, possible sarcopenic obesity was linked to a modest but statistically significant increase in fall risk (HR = 1.12; 95% CI: 1.02-1.24; P = 0.021). Subgroup analyses revealed that the fourth quartile showed a trend toward higher fall risk across all subgroups, especially among individuals aged ≥ 60 years and males. However, in most Subgroups, the 95% CIs cross 1, suggesting limited statistical significance in some strata.

CONCLUSIONS: Both sarcopenic obesity and possible sarcopenic obesity are associated with an elevated risk of falls. Middle-aged and older adults should adopt preventive strategies, such as maintaining regular physical activity, to preserve muscle mass and reduce the risk of falls.

PMID:41044525 | DOI:10.1186/s12889-025-24746-1

BMC Pulm Med. 2025 Oct 3;25(1):448. doi: 10.1186/s12890-025-03756-0.

ABSTRACT

BACKGROUND AND HYPOTHESIS: Sarcoidosis (SAR) and lymph-node tuberculosis (LNTB) are granulomatous diseases that present diagnostic challenges, especially in TB-endemic regions. We hypothesized that serum-metabolic profiles would help in differentiating SARs from LNTBs.

OBJECTIVE: This study aimed to identify serum metabolic biomarkers to distinguish SAR from LNTB using NMR-based metabolomics analysis.

METHODS: Serum samples were collected from 26 SAR and 22 LNTB patients. The serum metabolic profiles were measured using 800 MHz NMR spectroscopy and quantified using the commercial software CHENOMX. The serum metabolic profiles were compared using multivariate partial least squares discriminant analysis (PLS-DA), and potential discriminatory metabolites were identified using variable importance in projection (VIP) scores and subsequently evaluated for statistical significance using a volcano plot. The diagnostic potential of the discriminatory metabolites was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS: PLS-DA demonstrated significant metabolic disparity between the SAR and LNTB groups. The key metabolic features identified included elevated levels of glutamate, pyroglutamate, acetate, and leucine and a decreased glutamate-to-glutamine ratio (EQR) and decreased levels of glutamine, pyruvate, and myo-inositol in TB patients. These metabolic changes suggest that TB-infection involves activated glutaminolysis and elevated host lipid metabolism. ROC curve analysis revealed several metabolites with high diagnostic potential (AUC > 0.8), including glutamate, pyroglutamate, and glutamine (AUC > 0.98).

CONCLUSION: In conclusion, this study underscores the potential of serum metabolic profiling as a noninvasive tool for distinguishing SARs from LNTBs. However, further studies are imperative to validate these findings on independent patient cohorts and to facilitate their integration into routine clinical practice.

PMID:41044523 | DOI:10.1186/s12890-025-03756-0

BMC Surg. 2025 Oct 3;25(1):435. doi: 10.1186/s12893-025-03176-1.

ABSTRACT

BACKGROUND: Appendicitis, as a prevalent acute abdominal condition in general surgery, has established a comprehensive diagnostic and therapeutic framework. However, significant academic debate persists regarding the optimal treatment strategy. With advancements in minimally invasive techniques, endoscopic retrograde appendicitis therapy (ERAT) has emerged as an innovative therapeutic approach, providing new options for clinical decision-making. This study employed network meta-analysis to systematically evaluate and compare the clinical efficacy and safety profiles of three treatment modalities: conventional appendectomy, the ERAT, and pharmacological conservative therapy.

METHODS: We systematically reviewed randomized controlled trials (RCTs) published through 2024 that evaluated the three treatment strategies for acute uncomplicated appendicitis. Databases searched included PubMed, Web of Science, Embase, CNKI, Cochrane Central Register of Controlled Trials, and Wanfang. The surface under the cumulative ranking curve (SUCRA) was used to rank the comparative effectiveness of each intervention.

RESULTS: A total of 23 RCTs were included. Regarding complications, the ERAT group (SUCRA, 99.7%) demonstrated significantly lower rates than antibiotics (SUCRA, 37.8%; OR, 0.20; 95% CI, 0.06-0.67), while appendectomy (SUCRA, 12.5%) showed significantly higher rates versus the ERAT (OR, 6.33; 95% CI, 2.35-17.03), with no significant difference between appendectomy and antibiotics. For recurrence, appendectomy (SUCRA, 99.9%) exhibited lower rates than both antibiotics (SUCRA, 2.2%; OR, 0.06; 95% CI, 0.03-0.11) and the ERAT (SUCRA, 53.2%; OR, 0.27; 95% CI, 0.12-0.64), while the ERAT showed significantly lower recurrence than antibiotics (OR, 0.22; 95% CI, 0.08-0.57). Treatment failure analysis revealed appendectomy (SUCRA, 94.6%) had significantly lower rates than antibiotics (SUCRA, 2.2%; OR, 0.05; 95% CI, 0.02-0.15), with no other significant intergroup differences. Hospital stay showed no statistical differences. Cochrane RoB 2.0 assessment indicated overall sound methodological quality. Network meta-analysis demonstrated good consistency (P > 0.05) with low heterogeneity (τ² low-to-moderate; I² < 50%), and adult subgroup analysis yielded similar trends.

CONCLUSION: Each treatment modality demonstrates unique value in specific clinical scenarios. Conventional appendectomy remains the most reliable definitive treatment approach at present. As a minimally invasive alternative, the ERAT shows promising potential in select patient populations, though broader clinical implementation requires further evidentiary support. While antibiotic therapy avoids surgical intervention, it carries significantly higher risks of recurrence and treatment failure. Additional rigorously designed multicenter randomized controlled trials are needed to optimize current therapeutic decision-making frameworks.

TRIAL REGISTRATION: The network meta-analysis and systematic review were registered in PROSPERO on December 2, 2024. (CRD42024616515).

PMID:41044518 | DOI:10.1186/s12893-025-03176-1

BMC Health Serv Res. 2025 Oct 3;25(1):1293. doi: 10.1186/s12913-025-13294-4.

ABSTRACT

BACKGROUND: The achievement of an emergency caesarean response time of ≤ 30 min in Indonesia is still far below the target. This can impact the patient experience. This study aims to explore the factors causing delays in emergency caesarean response time and quality improvement strategies to address this issue.

METHOD: This qualitative study was conducted in five hospitals in the city of Makassar, Indonesia, from November 2024 to January 2025. The phenomenological approach, along with in-depth interviews, was employed in this research. Data were collected through semi-structured interviews. A total of 14 healthcare workers were interviewed using purposive sampling, consisting of obstetricians, general practitioners, midwives, and nurses, and the data were analyzed using thematic analysis. The inclusion criteria for selecting informants are healthcare professionals who possess knowledge and expertise in the field of emergency cesarean sections, as well as having at least two years of work experience handling patients with such cases in hospitals.

RESULTS: This study identifies four main factors that can impact the patient experience in achieving emergency caesarean response time, namely: system factors, patient and family factors, staff factors, and internal hospital policy factors. This study also produces quality improvement strategies to achieve emergency caesarean response times across various health professions, such as the importance of patient and family education, emotional support, the need for comprehensive hospital facilities to ensure the smooth operation of emergency caesarean procedures, the need for periodic performance evaluations of healthcare workers regarding response time achievements and most importantly the availability of documented, socialized, and actively used standard operating procedures by all healthcare workers.

CONCLUSION: This study provides a comprehensive understanding of the factors that cause delays in achieving emergency cesarean response times. This can have both positive and negative impacts on the patient experience. Therefore, policy support and commitment from various health professions are essential for the successful implementation of achieving emergency cesarean response times in Indonesia.

PMID:41044517 | DOI:10.1186/s12913-025-13294-4

BMC Pediatr. 2025 Oct 3;25(1):753. doi: 10.1186/s12887-025-06161-y.

ABSTRACT

BACKGROUND: This study aimed to evaluate the efficacy of different treatment modalities in children with cystic fibrosis (CF) and determine the superiority of specific treatment modalities.

METHODS: A comprehensive literature search was conducted using different search strings across multiple databases, including PubMed, Cochrane Library, EMBASE, WOS, Scopus, CINAHL, PsycINFO, and Google Scholar, up to October 2024. Randomized controlled trials (RCTs), case-control studies and cohort studies were included.

RESULTS: The triple therapy indicated a significant reduction in CF-related complications, with an OR of 0.29 and an RR of 0.54, accompanied by low heterogeneity (I² = 0% for both). Physiotherapy and pulmonary exercises also yielded a beneficial effect, with an OR of 0.24 and an RR of 0.49, without heterogeneity. In contrast, nutritional interventions revealed non-significant outcomes (OR = 6.91 and RR = 2.63), suggesting the need to re-evaluate these strategies. Ivacaftor alone did not achieve statistical significance (OR = 0.34 and RR = 0.58), and the confidence intervals were broad, indicating uncertainty in the effect estimates. Azithromycin exhibited a positive effect on CF management, with an OR of 2.37 and an RR of 1.54. The overall pooled OR across all treatments was 0.71, with an RR not computed due to substantial heterogeneity (I²=93%).

CONCLUSION: The study underscores the effectiveness of certain treatments, such as triple therapy and physiotherapy exercises, for CF while highlighting the considerable variability in treatment outcomes. Notably, nutritional interventions need to be carefully reassessed. The findings emphasize integrating physiotherapy and targeted pharmacological interventions into standard CF management tailored to individual needs.

PMID:41044511 | DOI:10.1186/s12887-025-06161-y

BMC Public Health. 2025 Oct 3;25(1):3325. doi: 10.1186/s12889-025-23867-x.

ABSTRACT

BACKGROUND: Studies have indicated that the risk of death on the first day of life (day 0) was higher than risk of death during other periods (days 1 to 6 and 7 to 27). However, little is known about whether the pattern of mortality trends on day 0 differs from those on days 1 to 6 and 7 to 27. We aimed in this study to examine NMRs trends by age at death in Japan, Korea, and Taiwan.

METHODS: In this cross-sectional study, we calculated NMRs (deaths per 1000 live births) by age at death from 2005 to 2021 in Japan, 2005 to 2022 in Korea, and 2005 to 2023 in Taiwan. Joinpoint regression model was used to estimate the annual percent change (APC) for each segment of the trend in NMRs to examine whether the trend changed significantly.

RESULTS: A slowdown of decreasing trend on days 0 to 27 was observed from 2015 to 2021 with APC of – 4.3% to – 1.5% in Japan and from 2008 to 2018 with APC of – 8.5% to – 1.4% in Korea. In contrast, an initial decline followed by an increase pattern of trend was noted in Taiwan with APC of – 2.5% from 2005 to 2014 to 2.1% from 2014 to 2023. In Japan, the slowdown was mainly due to the levelling-off in the decline in NMRs for days 1 to 6. In Korea, the slowdown was mainly attributed to the levelling-off in the decline in NMRs for days 7 to 27. In Taiwan, the prominent change was primarily due to the changes in day 0 NMRs.

CONCLUSIONS: Further analyses are needed to explore potential factors associated with the particular pattern of trends of NMRs at specific age-at-death group. Neonatal mortality on the first day of life is not an appropriate indicator of neonatal care quality, as it may be influenced by artifacts related to birth certification practices.

PMID:41044502 | DOI:10.1186/s12889-025-23867-x

BMC Pediatr. 2025 Oct 3;25(1):756. doi: 10.1186/s12887-025-06175-6.

ABSTRACT

BACKGROUND: Nocturnal Enuresis (NE) is a prevalent childhood condition with a multifactorial pathogenesis comprising genetic, neurological, and connective tissue factors. Recent evidence points toward a possible link between joint hypermobility and NE, but the underlying mechanisms remain unclear, and existing data are limited. The objective of this study is to determine the prevalence of joint hypermobility in patients with primary nocturnal enuresis (PNE) relative to healthy controls and investigate potential correlations between these conditions.

METHODS: This cross-sectional study was conducted in 2024 at Imam Reza Clinic, the largest pediatric outpatient clinic affiliated with Shiraz University of Medical Sciences in Shiraz, Iran. A total of 180 children aged 6-13 years were recruited, including 90 children with primary nocturnal enuresis (study group) and 90 healthy children without nocturnal enuresis (control group). Participants were assessed for generalized joint hypermobility (GJH) using the Beighton score (≥ 6 indicating hypermobility). Demographic and clinical information was gathered on structured checklists. Statistical tests, such as chi-square tests, t-tests, and logistic regression, were carried out using SPSS (version 25) at a significance level of p < 0.05.

RESULTS: The prevalence of joint hypermobility was significantly higher in children with NE (87.8%) than in controls (28.9%) (p < 0.0001). Conversely, NE was present in 75.2% of hypermobile children compared with 14.7% of non-hypermobile children (p < 0.0001). Logistic regression analysis revealed that children with nocturnal enuresis were 19.87 times more likely to have joint hypermobility compared to non-enuretic children following the adjustment for age, gender, and BMI (p < 0.05). Gender-specific analysis indicated that hypermobile girls with nocturnal enuresis at a greater likelihood of suffering from urinary incontinence and frequent urinary tract infections (UTIs), whereas hypermobile boys with nocturnal enuresis had increased rates of constipation and urinary symptoms during the day.

CONCLUSION: This study shows a strong association between GJH and PNE. Further research is needed to determine causal direction and underlying mechanisms.

PMID:41044501 | DOI:10.1186/s12887-025-06175-6