Tag: nevin manimala

J Environ Radioact. 2025 May 4;287:107712. doi: 10.1016/j.jenvrad.2025.107712. Online ahead of print.

ABSTRACT

Radon is a by-product of decayed uranium and thorium isotopes, which are naturally occurring radionuclide with extremely long half-lives. It is rated as the second cause of lung cancer after tobacco cigarette smoking. This study assesses knowledge and awareness of health risks associated with radon among undergraduate students at Mkwawa University College of Education (MUCE) by using questionnaires. A structured questionnaire with 36 items was administered to 403 respondents at MUCE. Information was collected on the demographic variables of the respondents as well as knowledge and awareness of health risks associated with radon among undergraduates at MUCE. Data were analysed by using descriptive statistics. Respondents included 204 (50.6 %) females and 199 (49.4 %) males. Findings revealed that 257 (63.8 %) of the respondents had no knowledge of radon gas and had not even heard about it before this study, while only 146 (36.2 %) of the respondents had heard about radon gas. Moreover, 285 (70.7 %) of the respondents were not aware that radon gas can cause health effect, and only 118 (29.3 %) of the respondents were aware about health effect of radon gas. Likewise, only 145 (36 %) of the respondents were aware about the risks of radon gas, while 258 (64 %) of the respondents were not aware about the risk of radon as the second cause of lung cancer after tobacco smoking. This study suggests the need to increase public education and awareness campaigns on radon and its associated risks.

PMID:40324307 | DOI:10.1016/j.jenvrad.2025.107712

Medicine (Baltimore). 2025 May 2;104(18):e42300. doi: 10.1097/MD.0000000000042300.

ABSTRACT

The epidemic of HIV/AIDS, also known as human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), continues to be a major global public health concern with significant economic ramifications. East Africa is one of the severely hit regions. The East African economy suffers hugely due to the cost emanating from management of HIV infection. This review offers a thorough analysis of the financial burden of HIV/AIDS treatment, including direct medical costs, infrastructure costs for healthcare, social and indirect costs, and long-term sustainability difficulties. By examining epidemiological statistics, trends in healthcare spending, and socioeconomic factors, we clarify the complex financial environment surrounding HIV/AIDS. The paper also looks at ways to deal with these issues, highlighting the value of cooperation between governments, medical professionals, civil society organizations, and the global community. A thorough literature search that involved a wide range of credible sources, including academic databases (like PubMed, Google scholar, Science Direct, JSTOR), research repositories, government reports, and publications from nongovernmental organizations. It is possible to lessen the economic cost of HIV/AIDS and enhance results for impacted people and communities by making investments in prevention, treatment, and support services while addressing underlying structural concerns.

PMID:40324279 | DOI:10.1097/MD.0000000000042300

Medicine (Baltimore). 2025 May 2;104(18):e42261. doi: 10.1097/MD.0000000000042261.

ABSTRACT

Patients with metastatic malignant melanoma have a survival rate of less than one year. Nivolumab, a monoclonal antibody against programmed cell death 1 (PD-1) receptor, has improved survival in patients without BRAF mutations. The HALP score, calculated from hemoglobin, albumin, lymphocyte, and platelet levels, provides information about a patient immune and nutritional status. High HALP scores have been associated with a better prognosis in various cancers. This study aimed to investigate the effect of high HALP scores on response to nivolumab treatment in patients with metastatic malignant melanoma. A retrospective study was conducted on 44 patients with metastatic malignant melanoma treated with nivolumab at Adana City Training and Research Hospital between 2014 and 2021. Patients who received dabrafenib-trametinib before nivolumab treatment were excluded. The HALP scores were calculated using laboratory parameters before the first nivolumab treatment. Statistical analyses were performed using SPSS version 25.0. The study included 22 female and 22 male patients with a mean age of 61.4 ± 15.6 years. Of the patients, 10 (27.2%) had a positive BRAF mutation, whereas 34 (77.3%) did not. The HALP score cutoff value was determined as 30.1. Patients with high HALP scores had significantly longer progression-free survival (PFS) and overall survival (OS) compared to those with low HALP scores (PFS: median 5.8 vs 3.1 months, P = .041; OS: median 54.9 vs 14.4 months, P = .005). In this study, we found that high HALP scores were significantly associated with longer PFS and OS in metastatic malignant melanoma patients receiving nivolumab treatment. HALP score was associated with both PFS and OS in patients with metastatic malignant melanoma treated with nivolumab. This immuno-nutritional parameter may be useful in various cancers; however, further prospective studies with larger patient cohorts are needed for clinical application.

PMID:40324274 | DOI:10.1097/MD.0000000000042261

Medicine (Baltimore). 2025 May 2;104(18):e42292. doi: 10.1097/MD.0000000000042292.

ABSTRACT

BACKGROUND: Early enteral nutrition (EEN) is the preferred nutritional strategy for critically ill patients in the intensive care unit (ICU). However, its implementation is often accompanied by various complications that can hinder the achievement of nutritional goals, thereby adversely impacting patient outcomes. To address these challenges, this study proposes an EEN protocol grounded in the principles of Enhanced Recovery After Surgery (ERAS), aiming to optimize nutritional support while minimizing enteral nutrition-related complications.

METHODS: A randomized controlled trial was conducted to develop an ERAS-based EEN protocol for intensive care patients. Using a quasi-experimental design and convenience sampling, 100 patients were randomized to either a control group receiving standard nutritional support or an intervention group receiving the ERAS-based protocol. Within 7 days of the intervention, outcomes – including calorie and protein intake, hemoglobin and albumin levels, gastrointestinal tolerance and ICU length of stay – were assessed and compared between groups.

RESULTS: After the intervention, the intervention group demonstrated significantly higher calorie intake [(1042.00 ± 232.58) kJ/d] and protein intake [(103.96 ± 13.52) g/d] than the control group [(876.30 ± 190.46) kJ/d and (97.00 ± 11.17) g/d] (P<.05). Initially, hemoglobin and albumin levels did not differ significantly between the 2 groups (P > .05). Post-intervention, the intervention group had higher hemoglobin [(117.16 ± 6.69) g/L] and albumin [(45.58 ± 3.23) g/L] levels compared to the control group [(106.98 ± 6.56) g/L and (41.78 ± 3.70) g/L] (P < .05). The intervention group had lower incidence rates of gastric retention (20.0%), diarrhea (12.0%), abdominal distension (14.0%), and gastrointestinal bleeding (6.0%) than the control group (38.0%, 22.0%, 32.0%, 12.0%). Gastric retention and abdominal distension incidence differences were statistically significant (P < .05). The intervention group’s ICU length of stay [(9.16 ± 3.48) d] was shorter than the control group’s [(11.86 ± 4.09) d] (P < .05).

CONCLUSION: The ERAS-based EEN protocol for ICU patients effectively improves nutritional status, improves gastrointestinal tolerance, reduces ICU length of stay, and contributes to better clinical outcomes in critically ill patients. These results provide a valuable reference for the implementation of EEN by ICU nurses.

PMID:40324272 | DOI:10.1097/MD.0000000000042292

Medicine (Baltimore). 2025 May 2;104(18):e42274. doi: 10.1097/MD.0000000000042274.

ABSTRACT

This study investigates the impact of complications associated with chronic obstructive pulmonary disease (COPD) on pulmonary function and inpatient medical expenditures in the Zhongshan region. A retrospective analysis of data from January 2012 to December 2021 was conducted, focusing on lung function and hospitalization expenses for COPD patients (n = 272). The included cases were initially categorized into a simple group (without comorbidities, n = 99) and a nonsimple group (with comorbidities, n = 173). Changes in lung function within each subgroup over a decade were evaluated, along with the average annual hospitalization rate, average duration of hospital stay, and mean hospitalization cost for COPD patients. A comparison between the simple group and the nonsimple group of COPD patient’s uncovered statistically significant distinctions (P < .05) in age, extent of lung function alteration, average annual hospitalization frequency, and average hospitalization cost. Moreover, multivariable logistic regression analysis showed that, after adjusted for age, sex, smoking, and hospitalizations, patients with comorbidities (nonsimple group) were independently associated with lung function changes (β = 4.048, 95% CI: 1.435-6.659, P = .003) compared to those without comorbidities (simple group). Comorbidities have a substantial impact on the lung function of COPD patients. Furthermore, they are associated with increased hospitalization frequency, elevated hospitalization costs, and a higher economic burden of hospitalization for COPD patients.

PMID:40324270 | DOI:10.1097/MD.0000000000042274

Medicine (Baltimore). 2025 May 2;104(18):e41939. doi: 10.1097/MD.0000000000041939.

ABSTRACT

BACKGROUND: Osteoporosis (OP) is the second most detrimental chronic disease, and thus novel diagnostic and therapeutic approaches are needed. In recent years, there has been an increased emphasis on the utilization of gut microbiota (GM) in the context of OP. However, a comprehensive bibliometric analysis on this subject is currently lacking. Furthermore, a deeper exploration of the role of GM in bone health is imperative, and there is a pressing need to foster international and inter-agency exchange and experience in this field. Accordingly, this study aimed to provide an overview of the research trends in this field and propose suggestions for related scientific and technological research and development.

METHODS: The Web of Science database was searched for articles related to both GM and OP. Statistical analyses and data visualization were performed using the EXCEL and CiteSpace software.

RESULTS: China exhibited the highest number of publications, followed by the United States. NUTRIENTS and Sichuan University were identified as the journal and institution, respectively, with the highest number of articles. Notably, the keywords “gut microbiota” and “bone loss” have been increasingly used in publications.

CONCLUSION: In conclusion, this study fills the existing gap in the literature and contributes valuable insights to the understanding of the relationship between GM and OP.

PMID:40324264 | DOI:10.1097/MD.0000000000041939

Medicine (Baltimore). 2025 May 2;104(18):e42264. doi: 10.1097/MD.0000000000042264.

ABSTRACT

This study investigated the efficacy of the nurse-assisted modified Valsalva maneuver compared to the traditional Valsalva maneuver in the treatment of paroxysmal supraventricular tachycardia (PSVT) in patients with limited lower limb mobility following orthopedic surgery. Sixty patients with PSVT were randomly divided into 2 groups: the traditional Valsalva maneuver group and the modified Valsalva maneuver group. The patients’ sinus rhythm conversion effect and adverse reactions were observed. Compared to the traditional Valsalva maneuver, the modified Valsalva maneuver significantly increased the sinus conversion rate for PSVT treatment, with a statistically significant difference. There were no serious complications associated with the modified Valsalva maneuver compared to the traditional method, and the difference was not statistically significant. Additionally, the modified Valsalva maneuver reduced hospital stay duration and costs significantly. The modified Valsalva maneuver effectively increased the sinus conversion rate for PSVT in patients with restricted lower limb activities post-orthopedic surgery. It is a simple, safe, and cost-effective method, suitable for patients with limited lower limb mobility.

PMID:40324261 | DOI:10.1097/MD.0000000000042264

Medicine (Baltimore). 2025 May 2;104(18):e42331. doi: 10.1097/MD.0000000000042331.

ABSTRACT

A plethora of research has identified a comorbid association between smoke and an elevated risk of knee pain. Despite these findings, the causal link between genetically influenced smoke and the risk of knee pain remains to be elucidated. Considering this knowledge gap, we undertook a Mendelian randomization (MR) study to delineate the potential causal relationship. The instrumental variables were derived from genome-wide association studies (GWAS). We procured summary statistics for ever smoked from a GWAS dataset (280,508 cases and 180,558 controls, dataset: ukb-b-20261) to represent the exposure. The outcome was determined by GWAS data for knee pain for 3+ months, encompassing 76,910 cases and 20,979 controls (dataset: ukb-b-8906). The primary MR method employed was the inverse-variance weighted approach. Assessments for pleiotropy and heterogeneity were conducted utilizing the MR pleiotropy residual sum and outlier test, the MR-Egger intercept test, the leave-one-out analysis, and the Cochran Q test. There was a statistically significant genetic causal effect of smoke on the increased risk of knee pain (odds ratio = 1.08, 95% confidence interval = 1.01-1.16, P = .014]. Cochran Q statistic showed no heterogeneity (Q P = .66). The leave-one-out analysis chart, the global test P value in MR-pleiotropy residual sum, and outlier revealed no significant pleiotropy (global test P = 0.53). The intercept P value in MR-Egger revealed no significant pleiotropy (intercept P = 0.66). Our MR study showed no pleiotropy or heterogeneity. The findings from our study point toward an association between genetic predisposition to smoke and the incidence of knee pain. This genetic association underscores the clinical relevance of our findings, indicating that interventions aimed at smoking cessation could be particularly beneficial for those individuals who are predisposed to smoking or are at risk of developing knee pain.

PMID:40324260 | DOI:10.1097/MD.0000000000042331

Medicine (Baltimore). 2025 May 2;104(18):e42334. doi: 10.1097/MD.0000000000042334.

ABSTRACT

Previous studies have suggested a potential connection between schizophrenia (SCZ) and sleep and eating disorders. However, these studies have not sufficiently accounted for potential confounding factors, leaving the true causal relationship unclear. Understanding this causal link is essential for developing effective prevention and treatment strategies. To address this gap, we aim to investigate the causal effect of SCZ on sleep and eating disorders using Mendelian randomization (MR) analysis. This method offers a more robust approach by leveraging genetic variants as instrumental variables to rigorously examine the relationship between SCZ and its comorbidities. We conducted bidirectional MR analyses using genome-wide association study summary statistics of SCZ, sleep disorders, and eating disorders. These analyses were conducted after confirming adherence to the 3 core MR assumptions, removing instrumental variables with confounding effects, and directionally harmonizing all data. Then we used Cochran Q test, MR-Egger intercept analysis, and leave-one-out method to conduct the sensitivity analysis of this study to test its heterogeneity and pleiotropy. The results of the inverse-variance weighted (IVW) approach suggest that SCZ increases the risk of sleep disorders (IVW: odds ratio [OR] = 1.041, 95% confidence interval [CI]: 1.012-1.070, P < .01), whereas studies in the opposite direction have not found an effect of sleep disorders on SCZ. The results of IVW suggest that SCZ increases the risk of eating disorders (IVW: OR = 1.228, 95% CI: 1.090-1.384, P < .001), and the weighted median (WM) method similarly provided evidence that SCZ increases the risk of eating disorders (WM: OR = 1.200, 95% CI: 1.019-1.407, P < .05). This study concluded that SCZ is causally associated with sleep and eating disorders. In clinical practice, psychiatrists should pay attention to the daily sleep and eating status of patients with SCZ, and take appropriate measures and countermeasures as early as possible if there is any abnormality.

PMID:40324258 | DOI:10.1097/MD.0000000000042334

Medicine (Baltimore). 2025 May 2;104(18):e42271. doi: 10.1097/MD.0000000000042271.

ABSTRACT

Transcription factor EB (TFEB) is an endogenous protective factor. Here, we sought to discern the possibility of serum TFEB as a prognostic biomarker of moderate-severe traumatic brain injury (msTBI). Serum TFEB levels of 141 patients with msTBI and 70 controls were quantified in this prospective cohort study. Rotterdam computed tomography (CT) classification and Glasgow coma scale (GCS) were considered as the severity metrics. Glasgow outcome scale (GOS) scores of 1 to 3 at 6 months after trauma meant a poor prognosis. The results were analyzed using multivariate analysis. Patients versus controls had a notable reduction of serum TFEB levels. Serum TFEB levels of independent correlation with Rotterdam CT scores and GCS scores were independently relevant to continuous GOS scores and ordinal GOS scores. Serum TFEB levels of linear relation to risk of poor prognosis under restricted cubic spline were independently predictive of poor prognosis. Using receiver operating characteristic curve analysis, serum TFEB levels displayed analogous prognostic predictive ability to Rotterdam CT scores and GCS scores. The constructed model by merging the 3 prognostic independent predictors, that is serum TFEB, Rotterdam CT scores and GCS scores, was pictorially exhibited via the nomogram, and was demonstrated to perform well by adopting several statistical approaches. An obvious decline of serum TFEB levels subsequent to msTBI are firmly related to trauma severity and poor neurological outcomes of patients, reinforcing the clinical meaningfulness of serum TFEB as a prognostic biochemical indicator of msTBI.

PMID:40324256 | DOI:10.1097/MD.0000000000042271