Tag: nevin manimala

Front Surg. 2025 Dec 18;12:1719911. doi: 10.3389/fsurg.2025.1719911. eCollection 2025.

ABSTRACT

OBJECTIVE: To compare the clinical efficacy between unilateral biportal endoscopic lumbar interbody fusion (ULIF) and traditional posterior lumbar interbody fusion (PLIF) in the treatment of L4/5 lumbar disc herniation (LDH).

METHODS: A total of eighty-five patients with L4/5 LDH were enrolled and assigned into two groups: the ULIF group (n = 37) and the PLIF group (n = 48). Data regarding surgical conditions, hospital stay, perioperative Visual Analogue Scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, and serum inflammatory factor levels were recorded.

RESULTS: No statistically significant differences were observed in preoperative clinical characteristics (including age, disease duration, BMI, gender distribution, preoperative VAS scores, JOA scores, and serum inflammatory factor levels) between the two groups (all P > 0.05), indicating good comparability. Compared with the PLIF group, the ULIF group was associated with significantly less intraoperative blood loss, reduced postoperative drainage volume, and a shorter postoperative hospital stay (all P < 0.05). Additionally, the ULIF group exhibited lower serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) at 24 h postoperatively, as well as significantly lower VAS scores and higher JOA scores at 7 and 30 days postoperatively (all P < 0.05). However, the ULIF group was associated with a longer operative time and a higher number of intraoperative C-arm fluoroscopies compared with the PLIF group (both P < 0.05).

CONCLUSION: ULIF exhibits significant advantages in minimally invasive. Although it requires longer operative time and more intraoperative fluoroscopies, it is associated with reduced blood loss, attenuated inflammatory responses, shorter hospital stay, and superior early postoperative pain and functional recovery, facilitating patient rehabilitation.

PMID:41488888 | PMC:PMC12756358 | DOI:10.3389/fsurg.2025.1719911

Diabetes Metab Syndr Obes. 2025 Dec 30;18:4831-4842. doi: 10.2147/DMSO.S543826. eCollection 2025.

ABSTRACT

PURPOSE: Dumping syndrome (DS) is a postsurgical complication of bariatric procedures. It is classified into early and late dumping based on occurrence within different postprandial timeframes. This study measures the prevalence of DS among adult patients and its association with social determinants and nutrition knowledge.

PATIENTS AND METHODS: This cross-sectional study used a convenience sampling method via distributing an online validated questionnaires to patients who underwent sleeve gastrectomy or gastric bypass surgery in ≥3 months.

RESULTS: Out of 352 participants, 237 (67.3%) had a modified Sigstad weighted DS score of ≥3.26, indicating the presence of DS; 182 (76.8%) had early DS (symptoms within 1 hour postprandially) and 55 (23.2%) had late DS (symptoms 1-3 hours postprandially). Only gender and monthly income showed statistically significant differences between early and late DS patients. No statistically significant associations were found between the DS subtypes and sociodemographic characteristics, although participants’ age approached significance (p = 0.052). Type 1 diabetes was significantly associated with DS and affected patients were 6.7 times more likely to experience symptoms. The mean nutrition knowledge score among all the participants was 60.88 (SD = 14.76) suggesting moderate nutrition knowledge.

CONCLUSION: There is a high prevalence of DS (67.3%) among post-bariatric surgery patients in Saudi Arabia, and early DS is more common than late DS. The findings suggest a strong correlation between type 1 diabetes and DS. Nutrition knowledge was moderate but insufficient in key areas that affect postoperative outcomes. The study is novel in reporting a high prevalence of DS among post-bariatric patients in Saudi Arabia and uniquely explores the association of DS with social determinants, nutrition knowledge, and type 1 diabetes-areas less examined in previous research. It emphasizes the imperative need for comprehensive patient education and continuous dietary counseling to improve long-term management and outcomes for bariatric surgery patients.

PMID:41488871 | PMC:PMC12764344 | DOI:10.2147/DMSO.S543826

Diabetes Metab Syndr Obes. 2025 Dec 30;18:4803-4813. doi: 10.2147/DMSO.S555974. eCollection 2025.

ABSTRACT

OBJECTIVE: To identify risk factors for prognosis in diabetic foot patients undergoing digital subtraction angiography (DSA) intervention and analyze their correlation with ulcer severity.

METHODS: This retrospective study analyzed 135 diabetic foot patients who underwent DSA-guided intervention between August 2023 and January 2025. Patients were classified good and poor prognosis groups based on 6-month outcomes. We compared demographic data and clinical laboratory indexes between groups. Statistically significant variables were analyzed using Logistic regression to identify independent risk factors. The receiver operating characteristic (ROC) curves and Pearson correlation analysis were employed to assess the diagnostic value of these factors and correlation with ulcer severity.

RESULTS: The stratified diabetic foot ulcer risk score (SINBAD) was significantly higher in patients with poor prognosis (7.15±2.76) compared to those with good prognosis (3.24±1.81); Serum levels of procalcitonin (PCT), galactoagglutinin-3 protein (Gal-3), noncoding RNA molecule with circular structure (Hsa_circ_0057362), interleukin-6 (IL-6), and serum C-reactive protein (CRP) was significantly elevated in the poor prognosis group (P < 0.05). Pearson correlation analysis revealed positive corrections between these biomarkers and ulcer severity (r=0.283, 0.240,0.434, 0.370, 0.443, respectively; all P < 0.05); Logistic regression analysis identified PCT, Gal-3, Hsa_circ_0057362, IL-6, and CRP as independent influencing factors for poor prognosis in diabetic foot. Furthermore, ROC curve analysis demonstrated that each of these indicators possessed a certain degree of predictive value for poor prognosis following diabetic foot surgery.

CONCLUSION: A plethora of risk factors, including PCT, Gal-3, Hsa_circ_0057362, IL-6 and CRP, influence poor prognosis in diabetic foot patients undergoing DSA-guided intervention. These biomarkers demonstrate significant correlations with ulcer severity and hold substantial clinical utility in the predicting postoperative outcomes. Early identification of patients at risk for poor prognosis enables the implementation of targeted interventions, thereby effectively improving patient outcomes.

PMID:41488869 | PMC:PMC12764337 | DOI:10.2147/DMSO.S555974

Ann Gastroenterol Surg. 2025 Aug 31;10(1):241-250. doi: 10.1002/ags3.70087. eCollection 2026 Jan.

ABSTRACT

BACKGROUND: The survival benefit of adjuvant chemotherapy (AC) in intrahepatic cholangiocarcinoma (ICC) remains uncertain, particularly in advanced-stage disease.

METHODS: We retrospectively analyzed 480 patients who underwent curative-intent hepatic resection for ICC at eight institutions between 2006 and 2023. Patients were stratified by receipt of AC, and survival outcomes were compared across LCSGJ stages. Multivariable Cox regression was used to identify prognostic factors.

RESULTS: Among 480 patients, 206 received AC. While AC did not significantly improve survival in stage I-III disease, it was associated with significantly longer overall survival (median 25.5 vs. 17.1 months, p = 0.008) and recurrence-free survival (median 10.3 vs. 6.0 months, p = 0.010) in stage IV patients. Multivariable analysis in stage IV revealed that AC independently reduced the risk of death (HR 0.540, p = 0.020), while poor liver function, severe postoperative complications, tumor size, and lymph node metastasis were adverse prognostic factors. Among AC regimens, S-1 demonstrated significantly longer OS (69.3 vs. 17.1 months, p = 0.001) and RFS (9.6 vs. 6.0 months, p = 0.015) compared with no AC, whereas other regimens did not show statistically significant benefits.

CONCLUSIONS: Adjuvant chemotherapy was associated with improved survival in patients with resected stage IV ICC. Among available regimens, S-1 appeared to contribute to this benefit. These findings support the use of AC in advanced ICC and suggest that S-1 may play a potential role, warranting further prospective validation. Stage-specific treatment planning may be essential to optimize outcomes.

PMID:41488852 | PMC:PMC12757147 | DOI:10.1002/ags3.70087

Ann Gastroenterol Surg. 2025 Jul 16;10(1):67-76. doi: 10.1002/ags3.70067. eCollection 2026 Jan.

ABSTRACT

BACKGROUND: Radical gastrectomy with lymph node dissection is the primary treatment for gastric cancer. However, the overall complication rate remains approximately 10%-20%, with a postoperative mortality rate of 2.3%. Therefore, preoperative stratification of patients based on their expected surgical risks is important. This study aimed to develop a deep learning prediction model using big data from the National Clinical Database (NCD) to predict operative mortality after total gastrectomy.

METHODS: Patients aged 18 years or older who underwent total gastrectomy for gastric cancer and were registered in the NCD between January 2018 and December 2019 were included. A total of 62 variables, including age, sex, past medical history, preoperative blood test results, and tumor characteristics, were used as covariates, with operative mortality as the outcome variable. Deep learning models were developed using Python, TensorFlow and Keras. Hyperparameters were adjusted using the k-fold method with the training data. The model was evaluated using validation data.

RESULTS: Of the 14 980 eligible cases, 11 980 were used for training and 3000 for validation. The event rate was 1.2%. A four-layer, 5217-variable model was developed. The final C-statistic was 0.79 (95% confidence intervals: 0.74-0.83) for the training data and 0.74 (95% confidence intervals: 0.62-0.85) for the validation data.

CONCLUSION: We developed a deep learning model to predict operative mortality using big data from the NCD. To improve the accuracy, it is necessary to introduce new variables related to postoperative complications or factors that cannot be analyzed using conventional methods.

PMID:41488848 | PMC:PMC12757171 | DOI:10.1002/ags3.70067

Ann Gastroenterol Surg. 2025 Sep 11;10(1):167-177. doi: 10.1002/ags3.70091. eCollection 2026 Jan.

ABSTRACT

AIM: This study used Bayesian model averaging to develop an online dynamic nomogram for predicting colon cancer survival, showcasing its value in integrating key prognostic factors for clinical use.

METHODS: This retrospective study analysed surgical colon cancer cases from the Cabrini Monash colorectal neoplasia database using Bayesian model averaging to identify survival risk factors. Model performance was validated with data from Alfred Hospital, and dynamic online nomograms were developed using the DynNom R package.

RESULTS: The study analysed 2475 colon cancer patients (2010-2021), reporting an overall mortality rate of 6.4 per 100 (95% CI: 5.9-7.1) and post-relapse mortality of 7.0 per 100 (95% CI: 6.4-7.6), with 5-year overall and relapse-free survival probabilities of 0.75 and 0.74, respectively. Bayesian model averaging identified key predictors with posterior inclusion probabilities greater than 0.3, including age, ASA score, stage, chemotherapy, lymph node ratio and cancer side. The model showed strong performance (C-index: 0.84 training, 0.80 validation; AUCs: 0.88-0.91 training, 0.84-0.88 validation), good calibration and clinical utility across thresholds. A dynamic nomogram incorporating these factors was developed using the entire dataset as an accessible online tool to support personalised survival prediction in clinical practice.

CONCLUSION: This study showcases the robust capabilities of Bayesian model averaging in uncovering key prognostic factors for colon cancer survival. By integrating these predictors into a dynamic online nomogram, it delivers a powerful, clinician-friendly tool that significantly enhances prognostic accuracy and enables personalised, data-driven decision-making in oncology care.

PMID:41488843 | PMC:PMC12757156 | DOI:10.1002/ags3.70091

Front Glob Womens Health. 2025 Dec 18;6:1669950. doi: 10.3389/fgwh.2025.1669950. eCollection 2025.

ABSTRACT

BACKGROUND: Human papillomavirus (HPV) is the most common sexually transmitted infection in women worldwide. Due to the high prevalence, communities need to know that the risk of HPV infection can be prevented by HPV vaccination.

AIM: This study aims to assess the knowledge and attitudes of female nursing students at Umm Al-Qura University regarding HPV infection and HPV vaccination.

MATERIALS AND METHODS: A descriptive cross-sectional quantitative study was conducted among 261 female nursing students using a self-administered online questionnaire. Data were collected through the validated 28-item Knowledge and Attitudes Toward HPV and Its Vaccination for University Students Scale, which was adapted and culturally modified to align with the Saudi context. The instrument comprised three parts: demographic information, general knowledge, and attitudes toward HPV vaccination. A non-probability purposive sampling technique was used. Data were analyzed using descriptive statistics and one-way ANOVA to explore differences across demographic variables.

RESULTS: Of the 261 participants, 49.4% demonstrated poor knowledge, 47.1% moderate knowledge, and 3.4% high knowledge. The mean attitude score was 2.79 ± 0.87, indicating a moderate level of acceptance toward HPV vaccination. Although most participants recognized its preventive importance, barriers remained, primarily related to parental consent and communication. One-way ANOVA results showed no significant differences in knowledge based on academic year or parental education, whereas living arrangement demonstrated a significant effect (F = 2.826, p = 0.025, η ² = 0.042).

CONCLUSION: Nursing students had low to moderate knowledge of HPV and held a moderate level of acceptance toward the HPV vaccine highlighted the needs for targeted interventions and educational initiatives to enhance HPV vaccination uptake and promote overall well-being in the community.

PMID:41488811 | PMC:PMC12756078 | DOI:10.3389/fgwh.2025.1669950

Infect Chemother. 2025 Dec;57(4):596-601. doi: 10.3947/ic.2025.0056.

ABSTRACT

The association between varicella-zoster virus (VZV) reactivation and coronary artery disease (CAD) remains uncertain. We enrolled 107 patients (mean age 66.5±10.8 years; 72% male) who underwent coronary angiography due to suspected CAD and assessed subclinical VZV reactivation via salivary VZV PCR. Patients were divided into three groups: acute coronary syndrome, chronic coronary syndrome, and insignificant CAD. VZV DNA was detected in three patients (3%) -one in the acute group and two in the chronic group (P=0.469). Although not statistically significant, these findings warrant further investigation into the potential link between VZV reactivation and CAD.

PMID:41486444 | DOI:10.3947/ic.2025.0056

Eur J Nucl Med Mol Imaging. 2026 Jan 5. doi: 10.1007/s00259-025-07721-1. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the clinical impact of ¹⁸F-FDG PET/CT versus ⁶⁸Ga-FAPI-46 PET/CT in patients with advanced epithelial ovarian cancer (EOC), this study aims to investigate preoperative scoring criteria and establish a basis for the formulation of treatment plans tailored to this patient population.

METHODS: A total of forty-one treatment-naive patients with advanced epithelial ovarian cancer were recruited for this study between July 2022 and February 2024. Each participant underwent both ¹⁸F-FDG and ⁶⁸Ga-FAPI-46 PET/CT imaging. The study compared the diagnostic accuracy, PET/CT parameters, tumor staging, and the guidance provided for clinical treatment decisions by these two imaging modalities. Additionally, the tumor burden as assessed by both imaging techniques was evaluated to predict the likelihood of achieving R0 resection in subsequent surgical procedures.

RESULTS: In the context of peritoneal metastasis, various PET/CT parameters were analyzed, including Gross Tumor Volume (GTV), SUVmax, Total Lesion Glycolysis (TLG(FDG)), and Total Lesion-FAPI (TL-FAPI). The comparative analysis of the two imaging modalities revealed statistically significant differences (P < 0.001). ⁶⁸Ga-FAPI-46 PET/CT showed a higher PCI score and better sensitivity than ¹⁸F-FDG PET/CT (P = 0.03). Notably, the diagnostic accuracy of ⁶⁸Ga-FAPI-46 PET/CT for detecting pelvic, para-aortic, and extra-abdominal lymph nodes was superior to that of ¹⁸F-FDG PET/CT, demonstrating enhanced sensitivity, specificity, and overall accuracy. Following the application of ⁶⁸Ga-FAPI-46 PET/CT, tumor stages were upgraded in 22% (9 out of 41) of patients, while 39% (16 out of 41) exhibited alterations in their PET/CT scores relative to ¹⁸F-FDG PET/CT. Furthermore, the implementation of ⁶⁸Ga-FAPI-46 PET/CT influenced treatment decisions in 17.1% (7 out of 41) of cases. For patients undergoing primary debulking surgery (PDS), receiver operating characteristic (ROC) curve analysis indicated that the GTV derived from both ¹⁸F-FDG PET/CT (AUC = 0.784, P = 0.018) and ⁶⁸Ga-FAPI-46 PET/CT (AUC = 0.809, P = 0.010), along with TL-FAPI (AUC = 0.809, P = 0.010), demonstrated predictive value for incomplete resection during EOC debulking surgery.

CONCLUSION: In comparison to ¹⁸F-FDG, ⁶⁸Ga-FAPI-46 PET/CT presents significant advantages in the detection of peritoneal and lymph node metastases, thereby providing a more accurate reference for the clinical staging of patients with advanced epithelial ovarian cancer. Importantly, ⁶⁸Ga-FAPI-46 PET/CT has the potential to modify treatment decisions in nearly 20% of patients, facilitating the selection of more appropriate therapeutic strategies.

PMID:41486388 | DOI:10.1007/s00259-025-07721-1

Eur J Med Res. 2026 Jan 4. doi: 10.1186/s40001-025-03761-3. Online ahead of print.

ABSTRACT

BACKGROUND: Prophylaxis of norepinephrine (NE) at a constant rate has been demonstrated to be as efficacious as prophylaxis of phenylephrine (PE) at equivalent doses for the prevention of maternal hypotension during cesarean section. Nevertheless, the impact of prophylactic infusion of NE or PE at a constant rate on pregnant women on fetal outcomes remains to be elucidated.

METHODS: 90 women scheduled for caesarean section under spinal or combined spinal-epidural anesthesia were randomly assigned to either the NE or PE group. The “study drug” (NE or PE) was administered intravenously at a rate of 15 mL/h from the time of injection of subarachnoid solution until the time of delivery of the fetus. Fetal umbilical artery (UA) blood was collected for blood gas analysis. The primary outcome of the study was base excess, and the incidence of fetal acidosis (Defined as base excess < 6 mmol/l) and blood glucose levels were also assessed.

RESULTS: The UA base excess mean (standard deviation) was not different from the NE group, – 1.6 (2.6) versus – 2.4 (2.9) in the PE group (P = 0.223). The incidence of fetal acidosis was 4.7% (NE) versus 14.3% (PE), with no statistically significant difference (P = 0.308). However, fetal blood glucose levels were significantly lower in the NE group, 3.16 (0.43) versus 3.43 (0.60) in the PE group (P = 0.019).

CONCLUSIONS: Prophylactic infusion of equivalent doses of NE at a constant rate resulted in fetal base excess values and an incidence of acidosis comparable to that of PE. However, a lower fetal UA blood glucose value was observed in the NE group, a finding that warrants further investigation.

PMID:41486377 | DOI:10.1186/s40001-025-03761-3