Tag: nevin manimala

Onderstepoort J Vet Res. 2026 Jun 18;93(1):e1-e4. doi: 10.4102/ojvr.v93i1.2262.

ABSTRACT

Pestivirus infection in camels has been insufficiently studied, particularly in Saudi Arabia. In the current work, the seroprevalence of pestivirus infection in camels’ sera (n = 180) in Rafha in northern Saudi Arabia was screened using Enzyme Linked Immuno-Sorbent Assay (ELISA). Data on age, sex and breed were analysed statistically. Pestivirus seroprevalence was 11.1. It was higher in adults (22.2%) than in young animals (10.5%), higher in females (33.3%) than in males (10.7%) and higher in the Mjahim breed (23.8%) compared to the Magater breed (9.4%). Chi-square analysis revealed a significant correlation between pestivirus infection and breed (p = 0.015), whereas no significant associations were noted with age (p = 0.123) or sex (p = 0.432). Wald statistics indicated that breed (p = 0.005) and sex (p = 0.048) were significant predictors of pestivirus infection.Contribution: To our knowledge, this is the first study to report the risk factors associated with pestivirus infection in camels in northern Saudi Arabia. The results can help explore epidemiological parameters and aid in control, while future research should include larger samples and molecular techniques to verify active infection.

PMID:42417001 | DOI:10.4102/ojvr.v93i1.2262

Breast J. 2026;2026(1):e1469203. doi: 10.1155/tbj/1469203.

ABSTRACT

BACKGROUND: Survivorship considerations have gained increasing importance in patients with early breast cancer. Every surgical procedure poses a risk of complications and a potential negative impact on patient-reported outcomes (PROs), thereby driving growing interest in de-escalation strategies in breast cancer surgery. In this context, we aimed to assess complication rates, the potential role of physiatric rehabilitation in managing these complications, and the impact of axillary surgery on PROs.

METHODS: This retrospective single-center cohort study included breast cancer patients who underwent surgery between January 2022 and March 2023 at the Breast Unit of Policlinico Umberto I, Rome. Among 164 patients operated on during the study period, 71 who underwent axillary surgery and received postoperative physiatric evaluation according to the institutional care pathway (PDTA) were included. The Disability of the Arm, Shoulder and Hand (DASH) questionnaire was administered to evaluate PROs.

RESULTS: Among the included patients (n = 71), SLNB was performed in 71.83% and ALND in 21.13%. A total of 34/71 patients (47.89%) developed complications requiring rehabilitative treatment and were classified as cases, while the remaining patients constituted the control group. Overall, shoulder painful mobility limitation (56.34%) (SPML), motor deficit (54.93%) (MD), and sensory deficit (46.48%) (SD) were the most frequent complications, whereas lymphedema (LE) and scapular winging (SW) occurred in 4.23% each. More extensive axillary procedures were associated with a higher number of lymph nodes removed (p < 0.0001). Cases had significantly more lymph nodes removed than controls (p = 0.0003). Patients requiring rehabilitation were younger on average than controls. Recovery time differed significantly between cases and controls (p < 0.0001), with most patients recovering within 3 months from the first physiatric visit. DASH scores were significantly worse in patients requiring rehabilitative treatment than in controls (p < 0.0001). The mean DASH score was 14%. Higher DASH values were associated with postoperative complications requiring rehabilitation and delayed or absent recovery, particularly SPML, DM, DS, and SW.

CONCLUSIONS: Functional impairment of the upper limb remained frequent and may affect patients’ daily activities. These findings support the importance of integrating surgical management with early physiatric evaluation and rehabilitation to optimize functional recovery. Systematic assessment using patient-reported outcome measures (PROMs), such as the DASH questionnaire, may help identify disability early and support patient follow-up.

PMID:42416988 | DOI:10.1155/tbj/1469203

Neurophotonics. 2026 Jul;13(3):035003. doi: 10.1117/1.NPh.13.3.035003. Epub 2026 Jul 7.

ABSTRACT

SIGNIFICANCE: Intraoperative cerebral ischemia is a critical complication that can arise during cerebral aneurysm clipping surgery. Although intraoperative neuromonitoring (IONM) can detect resulting functional deficits, these alerts may occur minutes after the initial ischemic event.

AIM: We aimed to demonstrate the clinical utility of laser speckle contrast imaging (LSCI) for continuous, real-time monitoring of cerebral blood flow (CBF) during aneurysm surgery.

APPROACH: In this case study, a 67-year-old female underwent a craniotomy for a left-sided cerebral aneurysm. A microscope-integrated LSCI system was used to continuously monitor cortical perfusion. After surgery, LSCI data were correlated with IONM alerts, indocyanine green angiography (ICGA), and surgical events, including an ischemic period following clip placement. A paired t-test, mixed effects model, and changepoint analysis were used to compare mean perfusion between the pre-ischemic and ischemic periods across seven regions of interest (ROIs) on the cortical surface.

RESULTS: LSCI detected a widespread drop in cortical perfusion immediately following the application of an aneurysm clip. This perfusion deficit was detected by LSCI $\sim 8\min$ before the corresponding IONM alert. During the ischemic period, blood flow decreased across six of the seven ROIs, with reductions ranging from 7.9% to 28.0%. The overall decrease in perfusion from the pre-ischemic to the ischemic period was statistically significant ( $p<0.0001$ ).

CONCLUSIONS: LSCI can provide continuous imaging of tissue perfusion during surgery, enabling the detection of developing ischemia before functional deficits may be evident on IONM. The ability of LSCI to track tissue perfusion changes highlights its potential as a valuable complementary tool for enhancing surgical safety alongside IONM and ICGA.

PMID:42416970 | PMC:PMC13340444 | DOI:10.1117/1.NPh.13.3.035003

Cureus. 2026 Jun 7;18(6):e110381. doi: 10.7759/cureus.110381. eCollection 2026 Jun.

ABSTRACT

BACKGROUND: Acute exercise produces immediate changes in respiratory mechanics and airflow, but the pattern of spirometric response after a single bout of submaximal exercise is not uniform across studies. This study evaluated the immediate effect of a single bout of submaximal exercise on spirometric parameters in healthy young adult males.

METHODOLOGY: This prospective pre-post interventional study was conducted in the department of physiology over two years. A total of 200 healthy young adult males aged 18-30 years were included. Participants with a history of smoking, respiratory or cardiovascular disease, bronchial asthma, allergy, recent acute illness, alcoholism, athletic training, or musculoskeletal limitation were excluded. Baseline anthropometry was recorded. Spirometry was performed before exercise using a standard technique, with a minimum of three acceptable maneuvers obtained for each participant. Participants then underwent a single bout of submaximal exercise using the Harvard Step Test with a 16-inch step at a cadence of 40 steps per minute for six minutes. Spirometry was repeated immediately after exercise. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR), and FEV1/FVC ratio were analyzed. Pre- and post-exercise values were compared using the Wilcoxon signed-rank test; p < 0.05 was considered statistically significant.

RESULTS: The mean age of the participants was 22.12 ± 3.72 years. The mean FVC decreased significantly from 3.77 ± 0.82 L to 3.54 ± 0.74 L (p = 0.001). The mean FEV1 increased significantly from 3.26 ± 0.54 L to 3.41 ± 0.63 L (p = 0.020). PEFR also increased significantly from 7.26 ± 2.28 to 9.36 ± 1.70 (p < 0.001). The FEV1/FVC ratio changed from 0.84 ± 0.08 to 0.85 ± 0.08, which was not statistically significant (p = 0.337).

CONCLUSIONS: A single bout of submaximal exercise produced significant immediate changes in spirometric parameters in healthy young adult males. Expiratory flow indices improved after exercise, while FVC decreased, and the FEV1/FVC ratio remained stable.

PMID:42416965 | PMC:PMC13338812 | DOI:10.7759/cureus.110381

Cureus. 2026 Jun 6;18(6):e110377. doi: 10.7759/cureus.110377. eCollection 2026 Jun.

ABSTRACT

Background Benign breast diseases represent a heterogeneous group of non-neoplastic disorders frequently encountered in surgical practice. Despite their non-malignant nature, these lesions often produce significant concern among women because of their resemblance to breast carcinoma. Certain proliferative lesions are additionally associated with an increased future risk of malignancy, thereby highlighting the importance of accurate evaluation and timely diagnosis. Aim To evaluate the clinical, radiological, and pathological profile of benign breast diseases among women presenting to a tertiary care center and to describe the role of triple assessment in routine diagnostic evaluation. Methodology A prospective observational study was conducted in the Department of General Surgery at All India Institute of Medical Sciences, Rajkot, over a six‑month period. Female patients aged 20-60 years presenting with breast‑related complaints were enrolled consecutively after obtaining informed consent. Detailed clinical examination, radiological assessment using ultrasonography and/or mammography, and pathological evaluation by fine‑needle aspiration cytology, core needle biopsy, or excision biopsy were performed wherever indicated. Demographic characteristics, clinical presentation, radiological findings, pathological diagnoses, laterality, and quadrant distribution were analyzed using descriptive statistical methods. Results Eighty‑nine female patients were included in the study. The mean age at presentation was 34.4 years, with the majority of patients belonging to the reproductive age group. Mastalgia was the most frequent presenting complaint, either isolated (38.2%) or associated with a palpable lump (27.0%). Fibroadenoma was the most common pathological diagnosis, accounting for 31.46% of cases, followed by fibrocystic disease in 25.84% of patients. Left‑sided involvement was more frequent than right‑sided disease, while the upper outer quadrant represented the predominant site of localization among focal lesions. Conclusion Benign breast diseases constitute a major proportion of breast‑related morbidity in women of reproductive age. Triple assessment remains a dependable and effective diagnostic approach for accurate characterization of breast lesions and formulation of individualized treatment strategies. Early diagnosis and selective pathological confirmation are essential for reducing patient anxiety and preventing unnecessary surgical intervention.

PMID:42416960 | PMC:PMC13338488 | DOI:10.7759/cureus.110377

Cureus. 2026 Jun 7;18(6):e110407. doi: 10.7759/cureus.110407. eCollection 2026 Jun.

ABSTRACT

Background and objectives: Stenotrophomonas maltophilia (S. maltophilia) is an emerging pathogen causing hospital-acquired infections, particularly in critically ill and immunocompromised patients. Limited therapeutic options are available due to its multidrug resistance (MDR) nature. Despite the availability of advanced automated diagnostic methods in Eastern India, data describing its prevalence and antibiotic susceptibility patterns are limited. The present study was conducted to evaluate the prevalence, antimicrobial susceptibility patterns, and resistance trends of S. maltophilia over five years in a tertiary care hospital in Eastern India. Materials and methods: A retrospective laboratory-based observational study was conducted in the Department of Microbiology at Kalinga Institute of Medical Sciences (KIMS), a tertiary care hospital in Eastern India. Records of patients with positive culture reports for S. maltophilia isolates between January 2021 and December 2025 were analyzed after Institutional Ethics Committee approval (KIIT/KIMS/IEC/2616/2026). Clinically significant S. maltophilia isolates from various clinical specimens of hospitalized patients aged >18 years were included in the study. Samples were processed using standard microbiological procedures. Isolate identification was performed by VITEK 2 compact automated system (bioMérieux, Marcy-l’Étoile, France) and/or MALDI-TOF MS (VITEK MS PRIME system -bioMérieux, Marcy-l’Étoile, France). Antimicrobial susceptibility testing for trimethoprim-sulfamethoxazole, levofloxacin, and minocycline was performed by automated systems and interpreted according to CLSI M100, 34th edition (2024). Demographic, clinical, and laboratory data were retrieved from the laboratory information system and analyzed using R software Version 4.4.3 (R Foundation for Statistical Computing, Vienna, Austria). Categorical data were described with frequencies and percentages. A p-value of <0.05 was considered statistically significant. Results: During the five-year period, a total of 415 clinically significant S. maltophilia isolates were identified from 88,315 culture-positive samples, with an overall prevalence of S. maltophilia infection of 0.5%. The annual prevalence of isolates increased considerably from 38/10,239 (0.37%) in 2021 to 131/20,529 (0.6%) in 2025. The majority of the isolates were from ICUs (272/415; 65.5%), and males were 281/415 (67.7%), with a median age of 54 years. Blood was the most common specimen source (138/415; 33.3%), followed by pus/tissue/wound swabs (113/415; 27.2%). During the five years, minocycline had the highest susceptibility (73.7-83.2%), followed by trimethoprim-sulfamethoxazole (66.7-74.0 %) and levofloxacin (60.5-71.4%). Most isolates remained susceptible, while resistance phenotypes persisted, especially to levofloxacin and trimethoprim-sulfamethoxazole. Conclusions: The rising isolation rate of S. maltophilia from clinical specimens, particularly from bloodstream infections, is an emerging epidemiological and clinical concern. There was an observed stable but notable resistance pattern to the antibiotics, such as fluoroquinolones and trimethoprim-sulfamethoxazole, highlighting the need for continuous surveillance and prudent antibiotic use, while minocycline remained the most effective antimicrobial during the study period.

PMID:42416956 | PMC:PMC13340860 | DOI:10.7759/cureus.110407

Cureus. 2026 Jun 6;18(6):e110338. doi: 10.7759/cureus.110338. eCollection 2026 Jun.

ABSTRACT

Objective This study aimed to evaluate the effectiveness of the Renal Angina Index (RAI) in predicting acute kidney injury (AKI) among pediatric ICU (PICU) patients. Methods This prospective observational study, conducted at Gandhi Medical College, Bhopal, from September 2022 to February 2024, included 300 PICU patients aged one month to 13 years. RAI was calculated 24 hours post-admission, and its correlation with the development of AKI after 24 hours of admission was analyzed using SPSS Statistics version 25 (IBM Corp., Armonk, NY). Results The mean patient age was 36.16 months (standard deviation (SD): 15.08); 50.7% were male. AKI occurred in 5% of patients. Mortality increased significantly across RAI categories: 0% (low-risk), 7.5% (moderate-risk), and 68.8% (high-risk) (p < 0.001). RAI at 24 hours demonstrated excellent discriminatory ability with an area under the curve (AUC) of 0.87; 95% confidence interval (CI): 0.80-0.94. At a threshold ≥ 8, RAI showed 81.8% sensitivity and 97.2% specificity, with a 75.0% positive predictive value (PPV). Strong associations existed between RAI and vasopressor support, PRISM (Pediatric Risk of Mortality) scores, and KDIGO (Kidney Disease: Improving Global Outcomes)-documented AKI (all p < 0.001). Conclusions RAI can predict AKI in critically ill pediatric patients, enabling early intervention. The 24-hour assessment provides valuable prognostic information for patient risk stratification.

PMID:42416932 | PMC:PMC13341005 | DOI:10.7759/cureus.110338

Cureus. 2026 Jun 6;18(6):e110373. doi: 10.7759/cureus.110373. eCollection 2026 Jun.

ABSTRACT

BACKGROUND: Breath-holding spells (BHS) are benign, self-limiting episodes in children that often cause parental anxiety. Adult awareness is crucial to mitigate undue panic and prevent inappropriate medical interventions, yet public understanding of BHS is limited, particularly in Saudi Arabia.

AIM: To evaluate and quantify the levels of knowledge, awareness, and attitudes toward BHS among adults in Riyadh, and to identify specific socio-demographic factors significantly associated with good knowledge scores using a structured cross-sectional design.

METHODS: A descriptive cross-sectional study was conducted among 444 Saudi adults in Riyadh, Saudi Arabia. Data were collected using an expert-reviewed, pilot-tested online questionnaire. Knowledge scores were calculated based on correct responses (≥60%=good knowledge). Data were analyzed using IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York, United States), and associations were tested using the chi-square test.

RESULTS: Most participants were female (n=367, 82.7%) and married (n=287, 64.6%), with a bachelor’s degree (n=258, 58.1%). Only 44.4% (n=197) had heard of BHS, and 24.3% (n=108) demonstrated good knowledge. The main sources of information perceived as helpful were the internet (n=207, 46.6%), family/friends (n=195, 43.9%), and healthcare providers (n=192, 43.2%), although only 9.5% (n=42) had actually received direct BHS information from a provider previously. Younger adults (18-25 years) and single participants had significantly higher knowledge (p<0.05), while gender, education, income, and parental status showed no significant association. Most participants reported high anxiety regarding episodes (n=339, 76.4%) and indicated they would seek medical advice for recurrent spells (n=278, 62.6%) regardless of knowledge level.

CONCLUSIONS: Knowledge and awareness of BHS in Riyadh are suboptimal despite high concern and willingness to seek care. Age and marital status were the only significant predictors of knowledge. These findings highlight the need for primary care-based education to improve public understanding of BHS, reduce anxiety, and minimize unnecessary healthcare utilization.

PMID:42416931 | PMC:PMC13337343 | DOI:10.7759/cureus.110373

Cureus. 2026 Jun 7;18(6):e110395. doi: 10.7759/cureus.110395. eCollection 2026 Jun.

ABSTRACT

Background Healthcare workers (HCWs) faced substantial psychological pressure during the COVID-19 pandemic. Evidence from Indian tertiary care settings during the acute phase of the outbreak remains limited. This study examined the prevalence of anxiety, depression, and stress among doctors and nurses at a New Delhi tertiary care hospital during the early pandemic period. Methods An anonymous, cross-sectional online survey was conducted among 100 HCWs (84 doctors, 16 nurses) at Moolchand Hospital, New Delhi. The Depression, Anxiety and Stress Scale-21 (DASS-21) was used to quantify psychological morbidity. Sociodemographic and occupational data, including infection-control training adequacy, trust in personal protective equipment (PPE) supply, and perceived social support, were collected via a structured questionnaire. Descriptive statistics were used to characterise the cohort and the prevalence of psychological symptoms. Results The cohort comprised 53 (53.0%) male and 47 (47.0%) female participants; the majority (40, 40.0%) were aged 31-40 years. Anxiety was the most prevalent psychological outcome (65, 65.0%), followed by depression (20, 20.0%) and stress (15, 15.0%). Insomnia was the most frequently reported individual symptom (43, 43.0%). Participants commonly reported inadequate infection control training, limited trust in PPE adequacy, and self-imposed isolation from family members to reduce transmission risk. Fear of infecting family members and perceived stigma were recurrent qualitative themes. Conclusions Psychological morbidity, particularly anxiety, was highly prevalent among doctors and nurses at a New Delhi tertiary hospital during the acute phase of the COVID-19 pandemic. Modifiable factors such as infection control training, PPE provision, and social support emerged as important considerations for institutional response. These findings contribute to the evidence base informing mental health preparedness frameworks for future infectious disease outbreaks, particularly in lower-middle-income country settings.

PMID:42416930 | PMC:PMC13340416 | DOI:10.7759/cureus.110395

Cureus. 2026 Jun 7;18(6):e110379. doi: 10.7759/cureus.110379. eCollection 2026 Jun.

ABSTRACT

Objectives To compare the short- and mid-term surgical outcomes in patients undergoing mini-thoracotomy (MT) and conventional open thoracotomy (COT) as anterior approaches to the thoracic spine. Methods Data were collected for adults who underwent thoracic spine procedures via an anterior surgical approach for various indications at the Department of Neurosurgery, Queen Elizabeth Hospital Birmingham (QEHB), between 2016 and 2021. Electronic medical records and clinical imaging of the patients enrolled on the study were reviewed. Primary outcomes measured were complications and post-operative pain levels. Secondary outcomes included the lengths of hospitalisation and intensive care unit (ICU) stays, estimated blood loss (EBL), duration and output of the post-operative chest drain, operation time, and radiation exposure. These outcomes were then compared between the MT and COT cohorts. The software, IBM SPSS Statistics, version 28 (IBM Corp., Armonk, NY, USA), alongside parametric and non-parametric tests, was used, with a p-value set at <0.05. Results A total of 31 patients (18 females and 13 males) with an average age of 53±15 were included. Fourteen underwent MT, while 17 had COT. There were no significant demographic differences between the cohorts. MT resulted in fewer complications, but the difference was not statistically significant. Pain levels were lower at 48 hours post-operation but higher on discharge in MT. Secondary outcome results yielded that the MT group had a statistically significant 80% shorter post-operative ICU stay than the COT group (p=0.034). Duration of the procedure and EBL were comparable in both groups. The differences between duration and output of the chest drain and post-operative opioid use favoured MT, but were not statistically significant. Conclusion Based on our study, MT is non-inferior to COT. MT seemed related to shorter post-operative ICU stay and is potentially positively associated with the other outcomes. However, studies involving larger patient cohorts are required to verify the statistical significance and clinical relevance of these observations.

PMID:42416929 | PMC:PMC13338813 | DOI:10.7759/cureus.110379