Tag: nevin manimala

Pediatr Surg Int. 2025 Sep 22;41(1):302. doi: 10.1007/s00383-025-06195-4.

ABSTRACT

PURPOSE: Pectus excavatum (PE) is the most common congenital chest wall deformity. While often perceived as a cosmetic issue, PE can impair cardiopulmonary function. Surgical correction has evolved from the Ravitch procedure to the minimally invasive Nuss technique, which offers reduced surgical risks and improved postoperative outcomes. However, diagnostic and therapeutic variability persists, highlighting the need for expert consensus.

METHODS: A 31-question web-based survey was distributed to CWIG members and PE specialists between November 2024 and January 2025. The survey explored five key domains: demographics, preoperative evaluation, surgical indications and timing, operative technique, and postoperative management. Responses from 100 international surgeons were analyzed.

RESULTS: The most common indications for surgery were severe deformity (88.9%), Haller index > 3.25 (78.8%), psychosocial distress (77.8%), and symptoms (77.8%). Technique selection was influenced by prior surgery (48%) and surgeon experience (45.9%). For complex cases, 90.8% preferred the double-bar technique. Most surgeons removed the bar within 2-3 years (86.6%). Postoperative pain was primarily managed with oral analgesics (64.6%) and IV pumps (47.5%). Early complications included pneumothorax (68.1%) and infections (62.8%); bar displacement (78%) was the most frequent late complication.

CONCLUSION: Despite widespread adoption of the Nuss procedure, significant variation remains in PE management. These findings emphasize the need for standardized, evidence-based guidelines to optimize patient outcomes.

PMID:40982104 | DOI:10.1007/s00383-025-06195-4

Ir J Med Sci. 2025 Sep 22. doi: 10.1007/s11845-025-04090-4. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to determine the prevalence of sarcopenia in postmenopausal women under the age of 60 and to evaluate the relationship between sarcopenia, bone mineral density (BMD), and clinical parameters.

MATERIALS AND METHODS: This cross-sectional study included 52 postmenopausal women under the age of 60, classified as osteoporotic or non-osteoporotic based on DXA results. Sarcopenia was assessed using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Muscle strength was measured using handgrip strength and the five-time sit-to-stand test (5STS), and muscle mass was assessed with the Tanita BC-418MA device. Skeletal muscle mass indices (SMMI) were calculated based on height², weight, and BMI.

RESULTS: Fat-free mass (FFM), skeletal muscle mass (SMM), and SMM/height² values were significantly lower in the osteoporotic group compared to the non-osteoporotic group (p < 0.05). No significant differences were found between the groups in handgrip strength or 5STS results. Sarcopenia prevalence varied depending on the muscle index used: 17.3% based on SMM/BMI (23.1% in the osteoporotic group, 11.5% in the non-osteoporotic group), 11.5% based on SMM/weight (3.8% vs. 19.2%), and 3.8% based on SMM/height² (equal in both groups). These differences were not statistically significant (p > 0.05). Femoral neck and lumbar BMD and T-scores showed positive correlations with FFM and SMM, but not with muscle strength tests.

CONCLUSION: In our study, sarcopenia prevalence did not significantly differ between osteoporotic and non-osteoporotic postmenopausal women under 60. However, the lower muscle mass observed in the osteoporotic group may indicate early structural changes associated with sarcopenia. The lack of difference in functional capacity suggests that these changes may not yet be clinically apparent.

PMID:40982103 | DOI:10.1007/s11845-025-04090-4

Spine Deform. 2025 Sep 22. doi: 10.1007/s43390-025-01188-8. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess whether using stable vertebra on push-prone traction radiographs for selecting the lowest instrumented vertebra (LIV) in adolescent idiopathic scoliosis (AIS) patients with Lenke types 3C and 6C undergoing posterior spinal surgery can preserve more lumbar motion segments while still achieving satisfactory surgical outcomes.

BACKGROUND: AIS patients requiring surgical treatment typically present with progressive curves exceeding 40° and are skeletally immature. This study specifically focuses on AIS patients exhibiting Lenke curve types 3C and 6C, which include structural thoracic as well as thoracolumbar and lumbar curves. The selection of the LIV remains a contentious issue due to concerns about distal adding-on and the potential for spinal imbalance postoperatively. Existing literature suggests that longer fusion constructs and positioning the LIV below L3 can lead to significant functional limitations and accelerated disc degeneration. While Lenke advocated for identifying the stable vertebra (SV) as the LIV, our recent study indicates that push-prone traction radiographs provide superior predictability for correcting postoperative spinal alignment. This study aims to evaluate the effectiveness of using the stable vertebra identified through push-prone traction radiographs as the LIV in preserving segmental motion during posterior spinal surgery for managing Lenke type 3C and 6C curves.

METHODS: AIS patients with Lenke type 3C and 6C who underwent posterior spinal surgery between 2021 and 2024 were enrolled in the study. Preoperative 36-inch whole spine radiographs, including push-prone traction view, were obtained for curve flexibility assessment. The lowest instrumented vertebra (LIV) was determined by identifying the stable vertebra (SV) on push-prone traction radiographs. Demographic data, including sex, age, BMI, Lenke’s curve type, and pre- and postoperative major coronal Cobb angle, thoracic kyphosis, lumbar lordosis, and C7 to central sacral vertical line (C7-CSVL), were collected. Statistical analysis was conducted to assess the differences in curve magnitudes between pre- and postoperative measurements.

RESULTS: Thirty-six AIS patients (33 female and 3 male) with a mean age of 13.9 ± 2.2 years were included in this study, with a mean follow-up period of 28.4 months. Preoperatively, the cohort presented with Lenke type 3C (24 out of 36) and Lenke type 6C (12 out of 36). The preoperative thoracic curve was corrected to an average of 5.7°, demonstrating an average correction rate of 89%. Similarly, the preoperative lumbar curve was corrected to an average of 5° with a correction rate of 90%.

CONCLUSION: Push-prone traction radiographs may serve as an alternative method for determining the optimal LIV level in patients with Lenke type 3C and 6C. Identifying stable vertebra on push-prone traction radiographs as LIV can potentially preserve more lumbar motion segments while achieving favorable surgical outcomes.

PMID:40982098 | DOI:10.1007/s43390-025-01188-8

Ann Bot. 2025 Sep 22:mcaf231. doi: 10.1093/aob/mcaf231. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Antibiotics are natural compounds produced by microorganisms that have long existed in ecosystems. However, the widespread clinical and agricultural use of antibiotics has intensified selective pressures on bacteria, leading to the proliferation of antibiotic resistance genes (ARGs). The increasing prevalence of these genetic elements in clinical and environmental settings now poses a major global health threat. While ARGs are well documented in anthropogenically influenced environments, their distribution and origins in remote ecosystems, such as the boreal forests, remain poorly understood. Here, we investigate the occurrence, diversity, and potential origins of ARGs in the boreal lichen Cladonia stellaris.

METHODS: We conducted the first targeted assessment of ARGs in lichens by analyzing 42 C. stellaris samples from northern and southern lichen woodlands (LWs) in eastern Canada. Using high-throughput quantitative PCR, we screened for 33 ARGs and three mobile genetic elements (MGEs), quantifying their relative abundance. Bacterial community composition was characterized via 16S rRNA gene sequencing. Statistical analyses evaluated geographical patterns, co-occurrence between ARGs and bacterial taxa, and the influence of latitude on ARG distribution.

KEY RESULTS: Ten ARGs conferring resistance to four antibiotic classes (aminoglycosides, beta-lactams, quinolones and sulfonamides), along with one MGE, were detected. The ARGs blaCTX-M-1, qnrB, and qepA were highly prevalent, with qepA often surpassing 16S rRNA gene abundance. Only qnrB showed significantly higher abundance in southern samples. Latitude significantly influenced ARG profiles, whereas bacterial community composition did not.

CONCLUSIONS: Our findings demonstrate that C. stellaris harbors diverse ARGs in remote boreal ecosystems with limited anthropogenic influence. Proposed explanations for ARG presence include long-distance dispersal via bioaerosols and endogenous development within lichen microbiomes, yet these remain speculative. Future work incorporating bacterial isolation, whole-genome sequencing, metatranscriptomics, air sampling, and metabolomic profiling is necessary to unravel the ecology and evolution of ARGs in natural habitats.

PMID:40977499 | DOI:10.1093/aob/mcaf231

J Cardiovasc Med (Hagerstown). 2025 Sep 1;26(9):511-518. doi: 10.2459/JCM.0000000000001762. Epub 2025 Sep 12.

ABSTRACT

BACKGROUND: Differences in prevalence of cardiovascular risk factors, prevention of cardiovascular disease and cardiovascular outcomes in migrants are well established when compared with host populations. Less is known, however, with respect to acute coronary syndrome (ACS), its occurrence and possible differences in management and outcome in immigrant populations. We therefore aimed in this study to assess in a comparative analysis possible differences in the occurrence and outcome of ACS between immigrants and the host population in a real-world setting.

METHODS: Patients urgently admitted to the acute cardiac care unit (ACCU) for ACS were included in the study: in-hospital survival outcome was analyzed and immigrants were compared with the resident population.

RESULTS: A total of 1199 consecutive patients were enrolled in the 2.5 years of the study: 40 (3.3%) were immigrants, mortality rate was 2.6%, mean hospital stay 7.7 ± 6 days. Hospitalized immigrants for ACS were in 65% of cases Eastern Europeans, 20% North-Africans-Middle-Easterns. Annual incidence of hospitalization in the ACCU for ACS was 0.18% in immigrants vs. 0.30% in residents (P = 0.0010); in-hospital death rates were comparable (2.5% vs. 2.6%, P = n.s.). When split for background world region, mortality rates were highest in the Eastern-Europe an women (10%, P = n.s.).

CONCLUSIONS: In an observational study on ACCU hospitalized ACS patients, ACS occurrence was lower in immigrants when compared with residents, while clinical outcomes were comparable. Among immigrants, worse prognosis and higher female prevalence were observed in the Eastern-European group; less ACS was found among women from Africa and the Middle East.

PMID:40977472 | DOI:10.2459/JCM.0000000000001762

J Cardiovasc Med (Hagerstown). 2025 Sep 1;26(9):490-498. doi: 10.2459/JCM.0000000000001766. Epub 2025 Aug 20.

ABSTRACT

AIM: Percutaneous pericardiocentesis represents the sole curative intervention for significant pericardial effusion, especially in cardiac tamponade. While the subxiphoid route is traditionally the most utilized, alternative approaches – such as the apical access – have also been adopted. To date, no studies have directly compared the performance, risk profile, and clinical implications of these techniques. This study aims to evaluate and compare the effectiveness, complication rates, and short- to medium-term outcomes of apical versus subxiphoid pericardiocentesis.

MATERIALS AND METHODS: We performed a retrospective analysis of pericardiocentesis procedures carried out at the Cardiac Intensive Care Unit of the IRCCS San Gerardo dei Tintori Foundation in Monza, Italy, between January 2011 and December 2024. Patients were categorized based on the access site: apical or subxiphoid.

RESULTS: Among 199 procedures, 85 (42.7%) were performed via the subxiphoid route and 114 (57.3%) through apical access. Most interventions addressed acute tamponade or pretamponade states. Imaging guidance was employed in 89.6% of cases. Baseline demographics, comorbidities, and echocardiographic features were comparable between the two groups. The overall success rate was 98.5%, with no significant differences between approaches. Major complications were rare (0.5%), and minor complications occurred in 11.1% of cases, without notable variance between techniques. Patient outcomes – including overall survival, in-hospital survival, and pericardiocentesis-free survival – showed no statistically significant differences (median follow-up: 17.2 months; interquartile range: 3.8-69.2 months).

CONCLUSIONS: Apical access for percutaneous pericardiocentesis demonstrates similar efficacy and safety to the subxiphoid approach, representing a valid alternative in appropriate clinical contexts.

PMID:40977469 | DOI:10.2459/JCM.0000000000001766

Ann Afr Med. 2025 Sep 17. doi: 10.4103/aam.aam_219_25. Online ahead of print.

ABSTRACT

BACKGROUND: Irisin is an adipo-myokine that is released by proteolytic cleavage of the membrane protein, fibronectin type III domain-containing protein 5. Irisin is responsible for the process of browning of white adipose tissue and is known to impact thermogenesis. Owing to the similarities in action between irisin and thyroid hormones, identifying these mutual influences in the body seems to be imperative.

AIM: This study aimed at investigating the association between serum irisin levels and thyroid dysfunction.

METHODOLOGY: This cross-sectional study was conducted in the Department of Endocrinology, Ramaiah Medical College and Hospital, Bengaluru, India, from January 1, 2025, to May 1, 2025, among individuals greater than 18 years old with new-onset hypothyroidism or hyperthyroidism and euthyroid age- and sex-matched control population who consented to the study. Serum irisin levels were assayed and compared between groups (hypothyroid, hyperthyroid, and control). Statistical analysis was performed using SPSS version 22 and Microsoft Excel (2016). An independent t-test was used as a significant test to identify the mean difference between two quantitative variables. Categorical data were represented in frequencies and proportions. Continuous data were expressed as mean and standard deviation. Correlations were performed with the Pearson Correlation coefficient. P <0.05 was considered statistically significant.

RESULTS: The study included 23 euthyroid controls and 48 individuals with thyroid dysfunction (28 hyperthyroid; 20 hypothyroid). A significant difference was noted in serum irisin levels between controls and individuals with thyroid dysfunction (P = 0.03). Further analysis depicted hypothyroid individuals showing a strong positive correlation between irisin and thyroid-stimulating hormone levels (r = 0.382, P = 0.04).

CONCLUSION: This study highlights the positive correlation of irisin levels in hypothyroid individuals, speculating on the possibility of irisin’s role in physiological adaptations in individuals with hypothyroidism.

PMID:40977446 | DOI:10.4103/aam.aam_219_25

Indian J Ophthalmol. 2025 Sep 19. doi: 10.4103/IJO.IJO_926_25. Online ahead of print.

ABSTRACT

PURPOSE: To present results from the Vitreo Retina Society-India (VRSI) 2024 Preference and Trends (PAT) survey focusing on retinal detachment (RD) and myopia management practices among Indian vitreoretinal surgeons.

METHODS: A 62-item questionnaire was distributed to all VRSI members over email. Responses were collected over 6 weeks by google forms. Data were analyzed using descriptive statistics.

RESULTS: A total of 289 members participated in the survey. Prophylactic barrage prerefractive surgery was preferred by 55.21% of the respondents. For phakic retinal detachments, scleral buckling was preferred in the absence of posterior vitreous detachment (PVD) (69.45% single hole, 52% multiple holes), while in pseudophakic, the trend was toward vitrectomy, with an encirclage for inferior breaks (54.38% with no PVD, 52.75% with PVD). For RD with superior breaks with < Grade B PVR, respondents preferred laser to break alone intraoperatively during vitrectomy (65.44%) compared to 360-degree laser and gas tamponade (67.52%), while silicon oil was more preferred tamponade for RD with inferior breaks with > Grade B PVR (99%). Respondents preferred imaging myopic choroidal neovascular membranes with optical coherence tomography and optical coherence tomography angiography (45.42%), initiate treatment with ranibizumab (41.2%), and follow pro-re-nata regimen (61.62%). For myopic macular schisis, vitrectomy was the preferred management for Stage 2C (70%) and Stages 4A and 4C (80%).

CONCLUSIONS: The VRSI-PAT survey highlights current diverse preferences among Indian vitreoretinal surgeons. These survey results will guide fellow practitioners to understand current real-world practice with relation to established literature.

PMID:40977429 | DOI:10.4103/IJO.IJO_926_25

Mov Disord Clin Pract. 2025 Sep 22. doi: 10.1002/mdc3.70370. Online ahead of print.

ABSTRACT

BACKGROUND: Anticholinergic medications and botulinum neurotoxin injections are established treatments for dystonia, yet they carry potential side effects and practical challenges. Deep brain stimulation (DBS) is offered in case of poor response to these approaches.

OBJECTIVES: To assess the need for anticholinergic medications and botulinum neurotoxin injections in adult and pediatric patients at two specialized Canadian centers before and after DBS over the past 10 years.

METHODS: 58 patients were included analyzing data before, 6 and 12 months after DBS. Clinical assessment included the Toronto Western Spasmodic Torticollis Rating Scale and Fahn-Marsden Dystonia Rating Scale. Anticholinergic burden was determined by the Anticholinergic Drug Scale (ADS).

RESULTS: Severity of cervical dystonia and ADS scores reduction were statistically significant after DBS. Anticholinergic medication and Botulinum Neurotoxin injections were discontinued a year after surgery in 28.8% and 72.4% of the patients, respectively.

CONCLUSION: Simplification of anti-dystonia treatments is another added benefit of DBS.

PMID:40977423 | DOI:10.1002/mdc3.70370

Indian J Public Health. 2025 Sep 20. doi: 10.4103/ijph.ijph_935_24. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer is the most common cancer among Yemeni women. In this study, we aimed to determine the socioeconomic and lifestyle factors of breast cancer risk and survival among Yemeni women in Thamar.

OBJECTIVES: We assessed the association between socioeconomic status, lifestyle factors, and the risk of developing breast cancer; and compared disease-free survival (DFS) and overall survival between urban and rural breast cancer patients.

MATERIALS AND METHODS: We performed a retrospective, case-control study using data from the Thamar cancer registry and household survey. Cases were women with histologically confirmed breast cancer diagnosed from January 1, 2019 to December 31, 2023, and frequency-matched controls included women without breast cancer. Risk determinants were determined using multivariate logistic regression models and survival outcomes were analyzed using Cox regression.

RESULTS: A total of 115 cases and 119 controls were included in the study. Significant breast cancer-associated factors were illiteracy (adjusted odds ratio [aOR] =5.46, P < 0.001), wood fuel for cooking (aOR =15.8, P < 0.001), low monthly income below 200 USD (aOR =12.1, P < 0.001), and postmenopausal status (aOR =2.54, P = 0.035). The comparison of DFS between urban and rural residents showed no statistically significant difference.

CONCLUSIONS: The study identified illiteracy, wood fuel for cooking, postmenopausal status, and low monthly income as key associated factor for breast cancer among the cases and controls examined. No significant difference in DFS was observed between urban and rural residents.

PMID:40977414 | DOI:10.4103/ijph.ijph_935_24