Tag: nevin manimala

Libyan J Med. 2025 Dec 31;20(1):2575709. doi: 10.1080/19932820.2025.2575709. Epub 2025 Nov 16.

ABSTRACT

Despite the wide availability of contraception, the abortion rate in Serbia remains high. Being in a steady relationship and perceiving low risk to catch sexually transmitted infections have been identified as the most common reason to not use condom, while around 11% of females used oral contraceptive pill. The study aim was to investigate the reasons of Serbian women to seek induced abortion as well as the factors that might impact the decision to terminate pregnancy. A cross-sectional study was conducted at the Clinic for Ob/Gyn, University Clinical Centre of Serbia in Belgrade, which is a referral public tertiary health care institution. Women who underwent induced abortions from 2022 to 2024 filled in a questionnaire on socio-demographic characteristics, life-style and habits, medical history and motives for an induced abortion. Multivariate regression models were used to identify factors associated with each reported abortion motive. The study analyzed 433 women aged 16 to 49 years (mean 32.0 years). The most common motives for abortion were already having enough children (44.3%) and financial difficulties for child upbringing (42.0%). In contrast, gaining weight and concerns about physical changes due to pregnancy was the least endorsed reason for seeking an abortion. The majority of women (52.9%) reported multiple motives for abortion. Motives were generally the same for women who the first and recurrent abortion. Most common factors influencing the decision to terminate pregnancy were not being in a relationship or marriage and vigorous physical activity at workplace. One-half of women had multiple motives for abortion and more than 50% of women sought abortion multiple times. The most important factors associated with voluntary abortion seeking is not having a steady partner and working in a physically demanding job. These findings should be considered in the public health policy agenda.

PMID:41241916 | DOI:10.1080/19932820.2025.2575709

Updates Surg. 2025 Nov 16. doi: 10.1007/s13304-025-02434-4. Online ahead of print.

ABSTRACT

Despite the growing popularity of single-incision laparoscopic surgery (SILS), no large-scale meta-analysis has compared the incidence of incisional hernia (IH) between SILS and traditional laparoscopic surgery (TLS).We make a meta-analysis of randomized controlled trials (RCTs) to compare the risk of IH between SILS and TLS. We searched studies in PubMed, Web of Science, and EMBASE databases for RCTs that compared SILS to TLS and reported IHs with a minimum follow-up period of 6 months. The risk of bias was assessed using the ROBINS-II tool. We used the R software to summarize and compare the incidence of IH between SILS and TLS. Additionally, we conducted subgroup analyses to explore the impact of surgical (including procedure type, incision length, incision approach, incision direction, fascia closure, and operation time) and patient factors (including BMI, age, and race) on the incidence of IH. 37 RCT studies were included in this meta-analysis. In the single-arm analysis, the incidence of IH in the SILS group was 0.7% (95% CI 0.2-1.5%), and 0.3% (95% CI 0.1-0.8%) in the TLS group. SILS does not confer an increased risk of IH, with an OR of 1.52 (95% CI 0.98-2.36) and P = 0. 57. Only variations in surgical procedures significantly influenced the incidence of IH when comparing SILS and TLS. Our study did not demonstrate a statistically significant difference in the incidence of IH between the SILS and TLS groups. Therefore, SILS is a viable alternative for patients who require minimally invasive surgical interventions. However, future RCTs with larger sample sizes and extended follow-up periods are warranted to further validate the safety profile.

PMID:41241886 | DOI:10.1007/s13304-025-02434-4

Orv Hetil. 2025 Nov 16;166(46):1818-1826. doi: 10.1556/650.2025.33410. Print 2025 Nov 16.

ABSTRACT

Bevezetés: A dohányzás lakáson belüli tiltása csökkenti a másodlagos dohányfüstnek való kitettséget, megelőzi a rászokást, és elősegíti a leszokást. Magyarországon kevés adat áll rendelkezésre a dohányfüstmentes háztartási szabályok időbeli változásáról és korrelátumairól. Célkitűzés: A hagyományos dohányzás lakáson belüli önkéntes tiltásának prevalenciáját, időbeli trendjét és szociodemográfiai korrelátumait feltáró vizsgálat. Módszer: Két 2009-ben és egy 2022-ben felvett kérdőíves kutatás adatainak másodelemzését végeztük el. Az elemzési egység a háztartás volt. Z-próbát, Cochran–Armitage-trendtesztet és binomiális logisztikus regressziót alkalmaztunk átlagos marginális hatásérték (AME) számításával. Eredmények: A dohányzás lakáson belüli teljes tiltásának aránya 2009 és 2022 között 60,6%-ról 75,1%-ra emelkedett (h = 0,3; p<0,01) Magyarországon. Ennek ellenére 2022-ben a 18 év alatti gyermekek 25,2%-a (95% CI 22,5–28,0%) továbbra is olyan háztartásban élt, ahol megengedett volt a beltéri dohányzás. A pénzügyi nehézségek (AME ≈ –0,09 – –0,01) és a legalább egy dohányzó háztartástag (AME ≈ –0,42 – –0,30) minden modellben negatív hatást mutatott. 18 éven aluli gyermek jelenléte a háztartásban enyhén növelte a teljes tiltás valószínűségét (AME ≈ 0,02–0,10). Megbeszélés: Bár a lakáson belüli tiltás terén javulás tapasztalható, a 18 éven aluliakat továbbra sem védi megfelelően a beltéri dohányfüsttől minden magyar háztartás. Következtetés: Eredményeink célzott egészségkommunikációs és intervenciós beavatkozások szükségességére hívják fel a figyelmet, különösen a hátrányos helyzetű és dohányzó taggal rendelkező gyermekes háztartások körében. Orv Hetil. 2025; 166(46): 1818–1826.

PMID:41241884 | DOI:10.1556/650.2025.33410

J Surg Oncol. 2025 Nov 16. doi: 10.1002/jso.70134. Online ahead of print.

ABSTRACT

INTRODUCTION: Procedural volume thresholds (VTs) for hospital quality reporting rely on expert consensus or analytic methods that may produce inconsistent VTs (e.g. restricted cubic splines (RCS), optimal cutpoints, classification and regression trees (CART), stratum specific likelihood ratios (SSLR)). The objective of this study was to compare variation in hospital-level VTs for pancreatectomy across multiple methodologies.

METHODS: Patients undergoing pancreatectomy from 2004 to 2021 were identified using the National Cancer Database. RCS, optimal cutpoints, CART, and SSLR were used to compute VTs based on 90-day mortality. From a single clinical data set, VTs were derived multiple times for each method by varying statistical parameters within each model.

RESULTS: Overall, 61,920 patients underwent pancreatectomy at 982 hospitals. VTs associated with reductions in 90-day mortality ranged from 9.2 to 26.1 cases/year (RCS), 15.7-33.8 cases/year (optimal cutpoints), and 11-18 cases/year (CART), all based on modifiable statistical parameters. SSLR analysis yielded a singular VT of 21 cases/year without variability due to lack of statistical input.

CONCLUSION: Among 4 common strategies for identifying VT that we studied, SSLR required the fewest assumptions. This may make it ideal for enhancing transparency and standardization in outcomes reporting.

PMID:41241876 | DOI:10.1002/jso.70134

J Manipulative Physiol Ther. 2025 Nov 15:S0161-4754(25)00055-7. doi: 10.1016/j.jmpt.2025.10.025. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to examine the effect of adding cervical stability training (CST) to a battery of treatment modalities on somatosensory evoked potential (SSEP) in patients with forward head (FHP) and chronic mechanical neck pain (CMNP).

METHODS: Sixty patients with FHP and CMNP were randomized into 2 groups: Group A (study group) was subjected to CST and a battery of treatment modalities, whereas Group B (traditional group) underwent a battery of treatment modalities alone. Treatment was applied 3 sessions per week for 8 successive weeks. The primary outcomes were SSEP and craniovertebral angle (CVA). The secondary outcomes were visual analog scale for pain intensity, Neck Disability Index Arabic version for functional disability, an endurance test for neck flexor and extensor muscles, craniocervical flexion test for deep cervical flexor muscles activation, lateral radiographs using the posterior tangent method for cervical lordotic curvatures, and a phone application clinometer for cervical range of motion.

RESULTS: The findings demonstrated short-term statistically significant differences (P < .05) at posttreatment between the study and traditional treatment groups in favor of the study group. The mean difference and 95% CI between both groups in SSEP and CVA = 1.83 (1.63, 2.03) and 7.37 (6.49, 8.25), respectively.

CONCLUSION: For patients with chronic neck pain, CST exercises plus a battery of treatment modalities exhibited a greater effect on primary and secondary outcomes than the battery of treatment modalities alone.

PMID:41241867 | DOI:10.1016/j.jmpt.2025.10.025

J Med Econ. 2025 Dec;28(1):1979-1988. doi: 10.1080/13696998.2025.2584888. Epub 2025 Nov 16.

ABSTRACT

AIMS: Obstructive hypertrophic cardiomyopathy (oHCM) is associated with substantial disease burden, healthcare resource utilization (HCRU), and healthcare costs. This study assessed HCRU and healthcare costs among patients with oHCM treated in real-world settings over 5 years of follow-up.

METHODS: This retrospective cohort study used the Optum database (January 2013-December 2021) and included patients aged ≥18 years with ≥2 claims for oHCM and continuous health plan enrollment for ≥6 months pre-initial and post-initial oHCM claim (index date). Patients with ≥5 years of follow-up data were analyzed. All-cause and HCM-related HCRU (ambulatory visits [physician office visits and outpatient visits], emergency room [ER] visits, hospital admissions, length of stay [LOS], and pharmacy use) and healthcare costs were assessed in US dollars.

RESULTS: In total, 5,129 patients with oHCM were identified: 5,056 (98.6%) had an all-cause ambulatory visit and 4,669 (91.0%) had an HCM-related visit. 4,079 (79.5%) had an all-cause ER visit, and 1,499 (29.2%) an HCM-related ER visit. 2,949 (57.5%) reported an all-cause admission, and 2,232 (43.5%) an HCM-related admission. The mean (SD) per-person count of all-cause ambulatory visits was 101.0 (90.7) and 15.3 (18.7) for HCM-related ambulatory visits. Mean (SD) all-cause admissions per patient were 1.8 (3.8), and 0.9 (1.6) were HCM related. Mean (SD) all-cause LOS was 18.0 (54.7) days, and HCM-related LOS was 10.0 (39.6) days. Mean (SD) all-cause healthcare cost per patient was $181,968 (241,608), of which $67,531 (114,705) was HCM related. Hospital admissions were the largest proportion of medical costs: all-cause admissions cost $71,001 (149,533) during follow-up, of which $44,781 (99,431) was HCM-related.

LIMITATIONS: Analyses were unadjusted for covariates or confounding factors.

CONCLUSION: Patients with oHCM experience substantial HCRU and costs over 5 years of follow-up. These results indicate a need for new treatment options which could decrease HCRU and improve patient outcomes.

PMID:41241831 | DOI:10.1080/13696998.2025.2584888

Pak J Pharm Sci. 2025 Nov-Dec;38(6):2292-2302. doi: 10.36721/PJPS.2025.38.6.REG.14034.1.

ABSTRACT

To compare synthetic and natural-source pulmonary surfactants (PS) for treating neonatal respiratory distress syndrome (NRDS) in very low-birth-weight neonates. A total of 113 neonates with NRDS were retrospectively divided into the natural-source PS group (NSPS, 63 cases) and the synthetic PS group (SPS, 50 cases). Oxygenation, ventilation, complications, efficacy and mortality were compared. Binary logistic regression analysis was performed using Statistical Package for the Social Sciences (SPSS) 23.0 to analyze the impact of PS type on the treatment of NRDS in very low birth weight neonates (VLBWIs). Additionally, the receiver operating characteristic curve (ROC) and the area under the curve (AUC) were calculated and evaluated to assess the association and closeness between PS type and the treatment of NRDS in VLBWIs. After treatment, NSPS group had higher arterial partial pressure of oxygen (PaO₂), lower arterial partial pressure of carbon dioxide (PaCO₂) and oxygenation index (OI). It also had shorter ventilation and hospital stay, lower pneumothorax, total-complication and mortality rates and higher effective rate. PS type correlated with complications and efficacy; the closeness (AUC) order was: clinical efficacy > complications. Natural-source PS in treating NRDS in very low-birth-weight neonates improves efficacy, optimizes blood gas, shortens treatment and reduces complications and mortality.

PMID:41241798 | DOI:10.36721/PJPS.2025.38.6.REG.14034.1

Pak J Pharm Sci. 2025 Nov-Dec;38(6):2271-2278. doi: 10.36721/PJPS.2025.38.6.REG.14594.1.

ABSTRACT

Tuberculosis, being an infectious disease, is unchecked and still hard to wipe out in the underdeveloped countries. Despite ongoing efforts, no new TB vaccine has been successfully developed in the past century beyond BCG, although DNA-based vaccines have shown promise over the last two decades. In this study, five Mycobacterium tuberculosis-specific genes- Rv1908c/KatG, Rv3418c/GroES, Rv0934/PhoS1/PstS, Rv0440/GroEL2 and Rv0350/DnaK-were cloned into the pVAX1 expression vector to construct DNA vaccines. These constructs were evaluated in rats using naked DNA and BCG prime-boost strategies. Forty-five Wistar albino rats were divided into three major groups: DNA vaccine group, BCG prime-boost group and no vaccine control. Post-immunization responses were evaluated through cytokine ELISA for TNF-α, IFN-γ and IL-6. Among DNA vaccines, DnaK-pVAX1 and GroES-pVAX1 elicited the strongest cytokine responses, followed by GroEL2-pVAX1 and PstS-pVAX1. The prime-boost groups (especially BCG + DnaK-pVAX1, BCG + GroES-pVAX1 and BCG + cocktail) showed further enhanced responses. Statistical analysis confirmed significant cytokine elevation in vaccinated groups compared to controls (p < 0.05). DNA vaccines, whether used alone or in combination with BCG, show strong potential as immunogenic and therapeutic tools for TB and may help reduce treatment duration in the future.

PMID:41241795 | DOI:10.36721/PJPS.2025.38.6.REG.14594.1

Pak J Pharm Sci. 2025 Nov-Dec;38(6):2264-2270. doi: 10.36721/PJPS.2025.38.6.REG.14009.1.

ABSTRACT

The therapeutic approach of combining doxycycline (DOX) with azithromycin (AZM) has emerged as an effective strategy for managing pediatric Mycoplasmal pneumonia (MP), with its clinical efficacy well-established. It is worth noting that both DOX and AZM are antibiotics and require an interval of 24-72 hours when used in combination, but there are few studies on the optimal interval between the two drugs. This study aimed to elucidate the differential outcomes of two treatment regimens. The short-term group received DOX in combination with AZM within 24-72 hours after AZM administration for MP treatment, while the long-term group initiated DOX therapy more than 72 hours after AZM treatment. Our findings indicated that there were no statistically significant differences in clinical efficacy and the impact on pediatric pulmonary function between the two groups (P>0.05). However, the time for symptom improvement in the short-term group was significantly shortened (P<0.05), while the long-term group exhibited lower inflammatory responses, stress responses and a reduced incidence of complications (P<0.05). In conclusion, initiating DOX within 72 hours after AZM treatment can expedite the treatment course of MP, while using DOX more than 72 hours after AZM treatment confers enhanced safety.

PMID:41241794 | DOI:10.36721/PJPS.2025.38.6.REG.14009.1

Cancer. 2025 Nov 15;131(22):e70174. doi: 10.1002/cncr.70174.

ABSTRACT

IMPORTANCE: Although Black women have higher absolute quantitative breast density, they are often assigned lower subjectively determined Breast Imaging and Reporting Data System (BI-RADS) density scores than White women. Background parenchymal enhancement (BPE) on breast magnetic resonance imaging is independently linked to breast cancer risk and may improve risk stratification for Black and White women.

OBJECTIVE: To evaluate differences in quantitative BPE between Black and White women and determine whether breast cancer risk factors mediate these differences.

DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study of 1202 women (200 Black, 1002 White; aged 40-74 years) with negative mammograms and no breast cancer history who underwent breast magnetic resonance imaging between 2016 and 2023 at an academic medical center.

EXPOSURES: Self-reported race (Black vs. White).

MAIN OUTCOMES AND MEASURES: The primary outcome was automated, quantitative BPE (median BPE and BPE ratio). Covariates included BI-RADS density, fibroglandular tissue volume, qualitative BPE, age, body mass index, and menopausal status.

RESULTS: Fewer Black women were classified as having extremely dense breasts (10% vs. 21%; p < .01), yet similar proportions had high qualitative BPE (35% vs. 29%; p = .29). Quantitative BPE was significantly higher in Black women (median difference, 1.51; standard deviation, 9; 95% CI, 0.13-2.90), independent of covariates. No risk factors mediated this difference.

CONCLUSIONS AND RELEVANCE: Despite lower BI-RADS density in Black women, as suggested by prior literature, higher quantitative BPE was found, suggesting that BPE captures aspects of breast tissue composition not reflected by density. Future studies can incorporate BPE into risk models, which can improve performance and reduce disparities in risk prediction.

PMID:41241787 | DOI:10.1002/cncr.70174