Tag: nevin manimala

Diabetes Obes Metab. 2025 Jul 22. doi: 10.1111/dom.16588. Online ahead of print.

ABSTRACT

AIMS: Diabetes is increasingly reported as a cause of blindness and vision loss. However, the trends in the burden of blindness and vision loss attributed to diabetic retinopathy (DR) have yet to be fully elucidated.

MATERIALS AND METHODS: Utilizing the latest data from the Global Burden of Disease Study 2021, we extracted prevalence and years lived with disability (YLD) data for these conditions, including their respective age-standardized rate (ASR) indicators. The data were categorized by time, location, age and sociodemographic index (SDI). This study conducted comprehensive analyses over a span of 32 years (1990-2021) to identify trends in blindness and vision loss attributed to DR, employing advanced statistical methods such as estimated annual percentage change (EAPC), health inequity analysis (slope index and concentration index), decomposition analysis, frontier analysis, and predictive modelling using the Bayesian age-period-cohort method.

RESULTS: From 1990 to 2021, the global burden of blindness and vision loss attributed to DR (measured by prevalence and YLD) increased rapidly, and this trend was projected to remain stable until 2046. The age-standardized prevalence rates (ASPR) and age-standardized YLD rates (ADYR) in all five SDI regions exhibited an upward trend. Notably, the high and high-middle SDI regions surpassed global levels, with their EAPC and 95% CI values all greater than 0. In 2021, the prevalence cases, YLD cases, prevalence rates and YLD rates for females across all age groups were generally higher than those for males, and were approximately 1.4 times those of males. Health inequality analysis indicates that over the past 32 years, there have been significant disparities in the distribution of prevalence rates and YLD rates associated with the SDI across 204 countries and regions. Decomposition analysis on a global and cross-SDI regional scale indicated that ageing, population growth and epidemiological changes had all increased the burden of prevalence and YLD. The frontier analysis showed that high SDI regions had greater potential for improvement. In 2021, compared with the relatively stable trend of type 1 diabetes, the prevalence and YLD rates of blindness and vision loss attributable to type 2 diabetes rapidly increased with age.

CONCLUSIONS: Blindness and vision loss attributed to DR pose significant global health and economic challenges. It is imperative for health system managers to formulate strong strategies to address these growing issues effectively.

PMID:40693378 | DOI:10.1111/dom.16588

Int J Gynaecol Obstet. 2025 Jul 22. doi: 10.1002/ijgo.70403. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effectiveness of two dosages (12.5 and 25 μg) of 17β-estradiol vaginal gel for treating postmenopausal vaginal atrophy.

METHODS: A randomized non-inferiority trial was conducted in the Gynecologic Endocrinology and Menopause Clinic of a university hospital from June 2022 to February 2023. A total of 80 postmenopausal women were randomly assigned to receive a 12.5 μg (half-dose) or 25 μg (full-dose) 17β-estradiol vaginal gel daily for 14 days, followed by twice-weekly for 10 weeks. Efficacy outcomes were vaginal maturation value (VMV), vaginal health index (VHI), vaginal pH, most bothersome symptoms (MBSs), and female sexual function index (FSFI). Safety outcomes were endometrial thickness, serum estradiol level, and adverse events. All study outcomes were evaluated at three time points: baseline, week 4, and week 12.

RESULTS: At week 12, both the half-dose and full-dose groups displayed a significant improvement in the VMV, with median (25th-75th percentile) of 67.3 (59.1-72.9) and 71.8 (60.3-79.5), respectively. While the full-dose group exhibited slightly greater improvement in VMV, the difference was not statistically significant. The upper bound of the 95% confidence interval (CI) for the median difference in VMV was below the predefined non-inferiority margin of 15 (4.5, 95% CI: -0.5, 10.0; P = 0.082). Additionally, both groups demonstrated significant improvements from baseline in all efficacy outcomes without any safety concerns.

CONCLUSION: Both 12.5 and 25 μg doses of 17β-estradiol vaginal gel are safe and effectively improve vaginal atrophy in postmenopausal women. The non-inferiority of the half-dose to the full-dose suggests its potential as a cost-effective treatment option with comparable benefits.

PMID:40693355 | DOI:10.1002/ijgo.70403

J Diabetes. 2025 Jul;17(7):e70106. doi: 10.1111/1753-0407.70106.

ABSTRACT

Glucose-lowering medication expenditures per user by different payers among patients with diabetes.

PMID:40693336 | DOI:10.1111/1753-0407.70106

Catheter Cardiovasc Interv. 2025 Jul 22. doi: 10.1002/ccd.70040. Online ahead of print.

ABSTRACT

AIMS: We aimed to externally validate the PRECISE-DAPT cancer score which showed better accuracy in predicting bleeding events in patients with cancer than the original PRECISE-DAPT score.

METHODS: We used data from the BleeMACS (Bleeding complications in a Multicenter registry of patients discharged after an Acute Coronary Syndrome) project. We compared the performance and clinical usefulness of the original score and the cancer score by calculating the C-statistic, the net reclassification index (NRI), and decision curve analysis.

RESULTS: A total of 13,932 patients were included, of which 864 patients had a diagnosis of cancer at the time of presentation with an AMI. According to the original PRECISE DAPT score, 63.3% of patients with cancer were classified as HBR, whereas 94.9% of patients with cancer were classified as HBR according to the cancer score. Cox-regression models showed that patients classified as HBR by the updated cancer score have higher odds of bleeding (HR 2.6, 95% CI 2.1-3.1) events than patients classified as HBR by the original score (HR 2.2, 95% CI 1.8-2.7). The cancer score showed higher discrimination ability (C-statistic 0.66) than the original score (C-statistic 0.64). The overall NRI of the cancer score was 2.7%. The decision curves analysis showed that the cancer score use is roughly identical to the original score in patients without cancer but superior to the original score in patients with cancer.

CONCLUSION: The PRECISE-DAPT cancer score is a valid and useful tool for the prediction of bleeding risk in patients with cancer and presenting with AMI.

PMID:40693319 | DOI:10.1002/ccd.70040

BJOG. 2025 Jul 22. doi: 10.1111/1471-0528.18319. Online ahead of print.

ABSTRACT

B. Haydardedeoglu, F. Gjemalaj, P.C. Aytac, and E.B. Killicdag, “Direct Aspiration Versus Follicular Flushing in Poor Responders Undergoing Intracytoplasmic Sperm Injection: A Randomised Controlled Trial,” BJOG: An International Journal of Obstetrics & Gynaecology 124, no. 8 (2017): 1190-1196, https://doi.org/10.1111/1471-0528.14629. The above article, published online on 09 March 2017 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Aris Papageorghiou; and John Wiley & Sons Ltd. UK. Concerns were raised by a third party regarding the randomized control trial and the successful implementation of randomization. The third party was unable to recalculate the statistical results presented in Table 1, raising concerns that the statistical reports were also flawed. The authors provided their raw dataset to the journal so it could be evaluated by an independent expert. This expert confirmed that many of the statistical results were not reproducible using the reported methods. They also found several inconsistencies and errors within the article, including the duplication of two participants in the dataset. As a result, the data and conclusions are considered unreliable and the article must be retracted.

PMID:40693313 | DOI:10.1111/1471-0528.18319

BJOG. 2025 Jul 22. doi: 10.1111/1471-0528.18318. Online ahead of print.

ABSTRACT

M. El-Sedeek, E.E. Awad, S.M. Elsebaey, “Evaluation of Postpartum Blood Loss After Misoprostol-Induced Labour,” BJOG: An International Journal of Obstetrics and Gynaecology, 116, 3 (2009): 431-435, https://doi.org/10.1111/j.1471-0528.2008.02054.x. The above article, published online on 21 January 2009 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Aris Papageorghiou; and John Wiley & Sons Ltd. UK. Concerns were raised by a third party regarding the statistical data reported in the article. The third party noted the p-values reported in Table 1 were not compatible with the article’s summary data, and the distribution data featured in the scatterplots of Figures 3 and 4 was unusual. An independent expert evaluated the summary data reported in the article and confirmed that many of the statistical results were not reproducible using reported methods. The expert noted that there were several instances of data anomalies within the article, including the distribution of postpartum bleeding within Group 1, where the scores reported feature a pattern that is unusual. The authors did not respond when asked for their original data and clarification. As a result, the data and conclusions are considered unreliable, and the article must be retracted.

PMID:40693309 | DOI:10.1111/1471-0528.18318

BJOG. 2025 Jul 22. doi: 10.1111/1471-0528.18317. Online ahead of print.

ABSTRACT

M. El-Sedeek, A.A. Korish, and M.M. Deef, “Plasma Orexin-A Levels in Postmenopausal Women: Possible Interaction With Estrogen And Correlation With Cardiovascular Risk Status,” BJOG: An International Journal of Obstetrics and Gynaecology 117, no. 4 (2010): 488-492, https://doi.org/10.1111/j.1471-0528.2009.02474.x. The above article, published online on 08 February 2010 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Aris Papageorghiou; and John Wiley & Sons Ltd. UK. Concerns were raised by a third party regarding the reported calculations and statistical results. The third party was unable to recalculate the mean BMI using the reported weight and height metrics and also noted that the F values in Tables 1 and 2 were unusually large and the p-values reported in these tables do not appear compatible with the reported summary data. An independent expert evaluated the summary data reported in the article and confirmed the incompatibility of the statistical results and found that both the reported and recalculated F values are implausibly large. The authors did not respond when asked for their original data and clarification. As a result, the data and conclusions are considered unreliable, and the article must be retracted.

PMID:40693303 | DOI:10.1111/1471-0528.18317

Clin Ophthalmol. 2025 Jul 17;19:2373-2381. doi: 10.2147/OPTH.S519777. eCollection 2025.

ABSTRACT

PURPOSE: To compare the efficacy, safety and outcomes of micropulse cyclophotocoagulation (MP-CPC) to ultrasound cycloplasty (UCP) in patients referred to a tertiary eye care center in Riyadh, Saudi Arabia.

PATIENTS AND METHODS: A retrospective study evaluated data from patients who had undergone MP-CPC or UCP from January 2017 to October 2023. Patients who lost to follow up and patients with incomplete medical reports were excluded from the study. Data was collected for day 1, 2nd week, 1 month and 3, 6, and 12 months postoperatively. At each visit, data was collected on intraocular pressure (IOP), corrected distance visual acuity (CDVA), medications and possible complications. Data was compared between groups. P<0.05 was considered statistically significant.

RESULTS: Out of 139 eyes, 65 underwent UCP, and 74 underwent MP-CPC. IOP in the UCP group decreased from 29.67±9.82 mmHg preoperatively to 21.00±6.78 mmHg at one year postoperatively and in the MP-CPC group, IOP decreased from 28.44±9.46 mmHg to 20.41±8.77 mmHg respectively. In the UCP group, at the 1-year follow-up, vision remained unchanged from the preoperative levels in 6 eyes (27.3%), while 2 eyes (9.1%) lost 1 line of vision, and 8 eyes (36.4%) experienced a loss of ≥2 lines. In the MP-CPC group, at the 1-year follow-up, vision remained unchanged in 24 eyes (43.6%), 2 eyes (3.6%) lost 1 line, and 20 eyes (36.4%) had a loss of ≥2 lines. The number of antiglaucoma medications at 1 year postoperatively did not differ between groups. The qualified success rate at 1 year was similar between groups.

CONCLUSION: Both UCP and MP-CPC are safe and effective for reducing IOP in refractory glaucoma, with similar reductions observed between the two techniques. Visual outcomes and qualified success rates were comparable between UCP and MP-CPC.

PMID:40693283 | PMC:PMC12278948 | DOI:10.2147/OPTH.S519777

Environmetrics. 2024 Jun;35(4):e2843. doi: 10.1002/env.2843. Epub 2024 Feb 1.

ABSTRACT

Maternal exposure to air pollution during pregnancy has a substantial public health impact. Epidemiological evidence supports an association between maternal exposure to air pollution and low birth weight. A popular method to estimate this association while identifying windows of susceptibility is a distributed lag model (DLM), which regresses an outcome onto exposure history observed at multiple time points. However, the standard DLM framework does not allow for modification of the association between repeated measures of exposure and the outcome. We propose a distributed lag interaction model that allows modification of the exposure-time-response associations across individuals by including an interaction between a continuous modifying variable and the exposure history. Our model framework is an extension of a standard DLM that uses a cross-basis, or bi-dimensional function space, to simultaneously describe both the modification of the exposure-response relationship and the temporal structure of the exposure data. Through simulations, we showed that our model with penalization out-performs a standard DLM when the true exposure-time-response associations vary by a continuous variable. Using a Colorado, USA birth cohort, we estimated the association between birth weight and ambient fine particulate matter air pollution modified by an area-level metric of health and social adversities from Colorado EnviroScreen.

PMID:40693281 | PMC:PMC12278763 | DOI:10.1002/env.2843

Digit Health. 2025 Jul 20;11:20552076251357657. doi: 10.1177/20552076251357657. eCollection 2025 Jan-Dec.

ABSTRACT

OBJECTIVE: This study investigates the effects of developing and implementing an integrated service model for antepartum, intrapartum, and postpartum care in maternal and child specialty hospitals under the deep integration of Internet technology. The goal is to provide practical references for addressing declining birth rate challenges and promoting the sustainable development of maternal and child specialty hospitals.

METHODS: Using a convenience sampling method, 100 pregnant and postpartum women from a tertiary maternal and child health hospital in Chengdu, China, were selected as the participants for this study. A random number table was used to assign the participants into the control group and the intervention group, with 50 participants in each group. The control group received conventional nursing care, while the intervention group was provided with an integrated service model for antepartum, intrapartum, and postpartum care, fully implemented with Internet technology. A comprehensive comparative analysis was conducted between the two groups across several key dimensions, including the number of return visits within 42 days postpartum: The actual number of return visits for checkups, treatments, or consultations due to various health issues during this period was recorded and compared; Postpartum complications within 42 days: The occurrence rates of common complications, such as postpartum infections, hemorrhage, and milk stasis, were meticulously documented and analyzed for both groups. Service satisfaction: A nursing satisfaction questionnaire was used to objectively and comprehensively assess the satisfaction levels of participants in both groups with the care they received. Willingness for postpartum follow-up visits: Differences in participants’ subjective willingness and proactive attitudes toward arranging subsequent postpartum visits were thoroughly examined. Psychological indicators: Using psychological assessment scales, the psychological status of the two groups was evaluated from the establishment of personal health records to postpartum follow-up, analyzing the psychological differences between the two groups.

RESULTS: Through systematic data collection, organization, and rigorous statistical analysis, the results revealed that the average number of return visits within 42 days postpartum was significantly lower in the intervention group (0.16 ± 0.42) compared to the control group (1.44 ± 1.11) (t = -7.630, P < .001). For service satisfaction, 84.00% (42/50) of participants in the intervention group were very satisfied, significantly higher than 52.00% (26/50) in the control group (χ² = 3.170, P = .001). The incidence of mastitis within 42 days postpartum was 2.00% (1/50) in the intervention group, markedly lower than 28.00% (14/50) in the control group (χ² = 2.670, P < .001). For willingness to seek follow-up visit, 96.00% (48/50) of participants in the intervention group stated they would return to the hospital if they had health issues, compared to 82.00% (41/50) in the control group (χ² = 5.010, P = .025). 92.00% (46/50) of participants in the intervention group were willing to choose our hospital for the newborn’s health checkup, significantly higher than 76.00% (38/50) in the control group (χ² = 61.060, P < .001). The 28 weeks GAD-7 scored lower in the intervention group (4.14 ± 0.73) than in the control group (5.27 ± 1.00) (t = -6.430, P < .001) and also lower in the intervention group than in the control group at admission (5.58 ± 1.40 vs. 7.29 ± 1.61; t = -5.630, P < .001). There was no significant difference in 28 weeks EPDS scores between two groups (9.02 ± 0.68 vs. 9.18 ± 0.78; t = -1.110, P = .270). The intervention group showed significantly lower EPDS scores at 42 days postpartum (7.84 ± 0.71 vs. 9.61 ± 1.84; t = -6.310, P < .001).

CONCLUSION: The integrated service model for antepartum, intrapartum, and postpartum care in maternal and child specialty hospitals, based on the “Internet+” concept, effectively integrates Internet technology with critical processes in nursing services. This model precisely and efficiently addresses pregnant and postpartum women’s unique maternal and childcare needs at different physiological stages. It demonstrates significant advantages in optimizing medical resource allocation, improving the quality and efficiency of nursing services, and enhancing patients’ healthcare experiences and trust. The findings of this empirical study provide robust evidence for the model’s effectiveness in nursing care. The successful implementation of this innovative service model offers new perspectives and directions for transforming and upgrading maternal and child specialty hospitals in the face of declining birth rates and the associated challenges and opportunities. It holds significant value for broader application and promotion, with promising prospects for further development.

PMID:40693253 | PMC:PMC12277550 | DOI:10.1177/20552076251357657