Tag: nevin manimala

Eur J Neurol. 2026 Apr;33(4):e70598. doi: 10.1111/ene.70598.

ABSTRACT

BACKGROUND: The worsening of headaches or the occurrence of new headaches can occur after coil embolization. Although the frequency of headaches is reported to be greater when a stent is used, this phenomenon is poorly understood. Therefore, we aimed to evaluate the incidence and intensity of headache in patients treated with non-stent-assisted coil embolization (NSCE) versus stent-assisted coil embolization (SACE) for unruptured intracranial aneurysms (UIAs).

METHODS: In this prospective comparative cohort study, a total of 186 patients treated with coil embolization for UIAs between June 2018 and March 2022 were classified into NSCE or SACE groups. A Cox proportional hazards model was used to identify risk factors for occurrence of headache, and changes in headache intensity over time were assessed using a linear mixed-effects model.

RESULTS: Headaches occurred in 71.0% (132/186) of patients after coil embolization. During the 3-month follow-up, headaches after coil embolization were more common in patients who underwent SACE (adjusted hazard ratio, 1.57; p = 0.02). Female sex, cilostazol medication use, and pre-existing headache were also independently associated with the occurrence of headache after coil embolization. Changes in numeric rating scale (NRS) scores according to stent placement status and trends in NRS scores over time based on stent placement status were not statistically significant.

CONCLUSIONS: Patients treated with SACE were more likely to experience headache after coil embolization than those treated with NSCE were. However, changes in headache intensity over time were not significantly different between the groups.

PMID:41954024 | DOI:10.1111/ene.70598

Stroke. 2026 Apr 9. doi: 10.1161/STROKEAHA.125.054791. Online ahead of print.

ABSTRACT

BACKGROUND: Tenecteplase improves reperfusion and functional outcomes compared with alteplase in patients with large vessel occlusion. We assessed whether this superiority varies with thrombolysis-to-puncture time (TTP).

METHODS: This retrospective analysis of a prospective multicenter cohort included patients with large vessel occlusion who received bridging therapy with either tenecteplase or alteplase between January 2022 and September 2025. Patients were stratified by TTP (<60 versus ≥60 minutes). We subsequently assessed the association of TTP with efficacy and safety outcomes between the alteplase and tenecteplase groups using multivariable logistic regression adjusted for age, baseline National Institutes of Health Stroke Scale score, and time from stroke onset to arterial puncture. Functional independence was defined as a modified Rankin Scale score of 0 to 2 at 3 months.

RESULTS: Of 1106 patients who received bridging therapy, 1003 were included in the primary analysis (tenecteplase, 488; alteplase, 515). The median age was 68 (interquartile range, 58-75) years in both groups, with males comprising 64.3% and 66.0%, respectively. Tenecteplase was associated with superior 3-month functional independence compared with alteplase (53.6% versus 48.1%; adjusted odds ratio, 1.37 [95% CI, 1.03-1.82]). This benefit was concentrated in patients with a TTP <60 minutes, where tenecteplase yielded higher rates of both early recanalization (19.0% versus 9.1%; adjusted odds ratio, 2.36 [95% CI, 1.32-4.23]; P_interaction=0.047) and functional independence (61.0% versus 49.0%; adjusted odds ratio, 1.77 [95% CI, 1.13-2.77]; P_interaction=0.111). No between-agent differences were significant with TTP ≥60 minutes. Safety outcomes were comparable, but each 30-minute TTP increase independently elevated hemorrhagic risks for both agents.

CONCLUSIONS: The recanalization superiority of tenecteplase over alteplase is time-dependent, evident only within a TTP <60 minutes. Although the translation of this advantage into functional outcome was not statistically modified by time, optimizing workflow to achieve this rapid window maximizes the potential benefit of tenecteplase, which should be prioritized in capable settings.

PMID:41953987 | DOI:10.1161/STROKEAHA.125.054791

J Clin Periodontol. 2026 Apr 9. doi: 10.1111/jcpe.70127. Online ahead of print.

ABSTRACT

AIM: To assess how suture diameter, material composition and tissue characteristics influence the tension-to-tearing behaviour of oral soft tissues, with the objective of optimising atraumatic suturing.

MATERIALS AND METHODS: This in vitro cadaver study evaluated 288 standardised porcine oral soft-tissue specimens (144 gingiva, 144 lining mucosa). Twelve different suture types including four distinct diameters (4-0, 5-0, 6-0, 7-0) and three different materials (polyvinylidene fluoride [PVF], polyamide [PA] and polyglycolic acid [PGA]) were tested using a calibrated Instron microtester. Maximum rupture force (N), failure mode and tissue thickness (mm) were recorded. Statistical analysis relied on three-way ANOVA, Tukey’s post hoc testing and Pearson’s correlation (α = 0.05).

RESULTS: The overall mean maximum rupture force was 5.03 ± 3.00 N. Rupture force increased with suture diameter (p = 0.0001) and differed between materials (p < 0.0001; PGA ≈ PVF > PA). Gingival specimens resisted higher loads than mucosal specimens (p = 0.003). Fine sutures (6-0, 7-0) failed mainly by thread rupture, while thicker sutures (4-0, 5-0) caused tissue tearing, supporting the concept of a mechanical safety buffer. PA (6-0) generally preserved tissue integrity, whereas PVF and PGA required 7-0 in delicate mucosa to ensure comparable tissue protection. Tissue thickness correlated positively with rupture force (r = 0.49, p < 0.001).

CONCLUSIONS: Finer sutures (6-0 and 7-0) function as protective mechanical fuses, safeguarding delicate tissues during manipulation. PA 6-0 provides reliable protection, while 7-0 PVF and PGA are recommended for fragile mucosa manipulation. These findings provide a biomechanical framework for evidence-based suture selection in periodontal plastic surgery.

PMID:41953941 | DOI:10.1111/jcpe.70127

J Oral Biol Craniofac Res. 2026 May-Jun;16(3):101444. doi: 10.1016/j.jobcr.2026.101444. Epub 2026 Mar 28.

ABSTRACT

BACKGROUND: Salivary glycoproteins contribute to enamel protection, lubrication, and microbial regulation, making them useful biochemical indicators of oral health.

OBJECTIVE: To evaluate the impact of Cocos nucifera oil (CNO) mouthwash on total salivary protein and selected salivary glycoproteins (MUC5B, albumin, globulin, and amylase) in adults with moderate caries over 28 days.

METHODS: In this double-blind, parallel-group randomized trial, 40 adults aged 18-40 years (DMFT >3) were assigned to use either CNO mouthwash (10 mL, 10 min daily) or amine fluoride (AF) mouthwash (15 mL, 1 min daily) for 28 days. Unstimulated saliva was collected at baseline and day 28 to assess total protein, MUC5B, albumin, globulin, and amylase. Salivary glycoproteins and total salivary protein may reflect different aspects of oral biochemical defence and should be interpreted independently. Statistical analysis was performed using IBM SPSS version 23.0. Within-group comparisons were conducted using the Wilcoxon signed-rank test, while between-group comparisons were performed using the Mann-Whitney U test. Statistical significance was set at p ≤ 0.05.

RESULTS: Both mouthwashes produced modest biochemical changes after 28 days. CNO resulted in a statistically significant increase in total salivary protein compared with amine fluoride (p = 0.035). No significant between-group differences were observed for MUC5B, albumin, globulin, or amylase.

CONCLUSION: CNO mouthwash produced a modest increase in total salivary protein; however, specific glycoproteins showed no significant changes. These results provide preliminary biochemical evidence only, and no clinical inferences regarding caries prevention or oral defense can be made. Larger trials with clinical endpoints are required.

PMID:41953932 | PMC:PMC13054032 | DOI:10.1016/j.jobcr.2026.101444

Contemp Clin Dent. 2026 Jan-Mar;17(1):39-47. doi: 10.4103/ccd.ccd_486_25. Epub 2026 Mar 26.

ABSTRACT

BACKGROUND: The microRNA-223 (miR-223)/FBXW7/FBXO8 molecular network governs ubiquitin-proteasome proteostasis, a cardinal process in cellular protein turnover. Dysregulation amplifies inflammatory cascades and expedites tissue degradation. This study elucidates stage-specific expression divergences of miRNAs-223 and its cognate F-box regulators in periodontitis.

MATERIALS AND METHODS: This observational study enrolled 100 participants, categorized into five groups comprising periodontally healthy individuals and patients with Stage I-IV Grade B periodontitis. Gingival crevicular fluid (GCF) was collected using calibrated microcapillary pipettes. Total RNA was isolated from the GCF specimens, followed by complementary DNA (cDNA) conversion. Expression levels of miRNAs-223, FBXW7, and FBXO8 across all groups were assessed through the real-time quantitative PCR methodology. In silico target prediction analyses for miRNAs-223 and functional enrichment analyses were performed using the bioinformatic tools.

RESULTS: Expression analysis of GCF across Groups A (Healthy) to E (Stage IV) revealed statistically significant upregulation of miR-223 (25.38 ± 2.56; P = 0.001), accompanied by marked downregulation of FBXW7 (0.02 ± 2.05; P = 0.001) and FBXO8 (0.11 ± 2.04; P = 0.02). miR-223 levels positively correlated with clinical parameters, while FBXW7 and FBXO8 showed inverse correlations, strengthening with disease severity. Notably, miR-223 exhibited significant negative associations with both F-box proteins. Receiver operating characteristic analysis confirmed its diagnostic utility (AUC 0.919), highlighting miR-223 as a potential molecular signature for periodontal disease.

CONCLUSION: The pathophysiological derangement of the miR-223/FBXO8/FBXW7 signaling axis is entwined with aberrant proteolytic dynamics in periodontal pathology, accentuating the indispensable role of F-box-dependent ubiquitin-mediated degradation and positioning this molecular ensemble as a promising conduit for therapeutic stratagem.

PMID:41953918 | PMC:PMC13056218 | DOI:10.4103/ccd.ccd_486_25

Contemp Clin Dent. 2026 Jan-Mar;17(1):3-8. doi: 10.4103/ccd.ccd_566_25. Epub 2026 Mar 26.

ABSTRACT

BACKGROUND: During endodontic treatment, exposure of coronal dentin to various endodontic chemical substances (ECS) impacts its structural integrity, thereby affecting therapy’s success. This study employs preendodontic dentin hybridization (PEDH) to shield the coronal dentin from ECS.

AIM: This study evaluates the influence of chemicals used during endodontic therapy on coronal dentin microhardness and resin-dentin microshear bond strength (µSBS) and the protective effect of PEDH.

METHODOLOGY: Eighty square-shaped coronal dentin specimens were divided into four groups according to the time of chemical exposure: Control: No exposure to ECS. Late Dentin Hybridization (LDH): Exposed to ECS followed by dentin hybridization (DH); PEDH: DH followed by ECS; Ultrasonic LDH (ULDH): ECS followed by Ultrasonic repreparation then DH. Ten samples in each group were restored with composite and subjected to shear stresses under a Universal testing machine. The remaining 10 samples were tested for microhardness using a Vickers micro indenter.

STATISTICAL ANALYSIS: Data were analyzed with one-way analysis of variance and Tukey’s test.

RESULTS: LDH causes a significant reduction in bond strength compared to all groups. The PEDH group exhibits µSBS and microhardness values close to the control group. ULDH group showed increased bond strength values compared to the LDH group, but exhibited a significant reduction in microhardness values compared to all experimental groups.

CONCLUSION: Chemical exposure deteriorates properties of coronal dentin, thereby reducing µSBS and microhardness, whereas PEDH acts as a shield on coronal dentin, which effectively preserves its properties, producing outcomes close to untreated controls without the need for ultrasonic repreparation.

PMID:41953917 | PMC:PMC13056221 | DOI:10.4103/ccd.ccd_566_25

Health Sci Rep. 2026 Apr 6;9(4):e72280. doi: 10.1002/hsr2.72280. eCollection 2026 Apr.

ABSTRACT

BACKGROUND AND AIMS: Dengue fever is a rapidly expanding vector-borne disease that poses significant global epidemiological and public health challenges. Accurate and interpretable forecasting is essential for timely interventions, yet most models overlook spatiotemporal, sex-specific, and country-level heterogeneity in disease dynamics. This study aimed to develop a robust explainable AI (XAI) framework to predict dengue incidence globally and identify key environmental, health system, and socio-economic drivers.

METHODS: A Convolutional Long Short-Term Memory (ConvLSTM) network was applied to predict dengue incidence across 118 countries from 2000 to 2021. The data set included total, male, and female dengue incodence alongside 20 climatic, environmental, health system, and socio-economic predictors. The model was trained using data from 2000 to 2018 and tested on 2019-2021. Model performance was evaluated using RMSE, MAE, R², and adjusted R². Feature contributions were assessed through multiple XAI approaches: SHAP values, permutation importance, ±50% perturbation sensitivity perturbations, integrated gradients (IG), and layer-wise relevance propagation (LRP).

RESULTS: ConvLSTM achieved the best predictive performance (R² = 0.7731), demonstrating suitability for national-level public health planning. Sex-specific analysis revealed that annual freshwater withdrawals (SHAP: 44.37%; IG: 0.41; LRP: 0.38) dominated male dengue incidence, whereas hospital bed density had a greater influence for females (SHAP: 31.86%; IG: 0.34; LRP: 0.32). Temperature anomalies contributed consistently to both sexes (SHAP: 11.51%; IG: 0.18; LRP: 0.17). Country-level contributions highlighted electricity access (India: 97.35%; Bangladesh: 89.62%) and UHC coverage (Bangladesh: 8.33%) as key socio-economic determinants, with environmental and healthcare factors such as community health resources (Afghanistan: 35.42%; Brazil: 9.00%) further shaping sex-specific patterns. Sensitivity analysis indicated dengue incidence varied from -65% to +91% under ±50% predictor perturbations, underscoring model responsiveness and targeted intervention potential.

CONCLUSION: By integrating SHAP, IG, and LRP, the ConvLSTM-XAI framework provides transparent, sex-aware, and country-specific dengue forecasts. The results support targeted, climate-resilient, and equitable dengue control strategies.

PMID:41953901 | PMC:PMC13053675 | DOI:10.1002/hsr2.72280

Health Sci Rep. 2026 Apr 6;9(4):e72286. doi: 10.1002/hsr2.72286. eCollection 2026 Apr.

ABSTRACT

BACKGROUND AND AIMS: Helicobacter pylori (H. pylori)-induced gastric ulcer is a public health challenge in Pakistan. The current study examined the knowledge, attitudes, and practices regarding H. pylori-induced gastric ulcers among the general Pakistani population.

METHODS: A cross-sectional study was conducted in Lahore, Pakistan’s second-largest city, involving 385 participants from the general population selected through convenience sampling. Data were collected via interview-administered questionnaires. Statistical analyses, including descriptive statistics, χ ² tests, and binary logistic regression, were performed using SPSS version 25.

RESULTS: Among the participants, 51.4% were male and 48.6% female, primarily 54.1% were aged 18-24 with 57.4% holding bachelor’s degrees. In general Pakistani population majority have moderate knowledge of H. pylori-induced gastric ulcers, with 49.1% having heard of the condition and many were unsure about its symptoms and transmission. Regarding attitude, 86.8% recognized it as a serious health issue, and only 40.0% believed they could be infected. Preventive practices such as regular hand washing (52.2%) and proper food hygiene (43.8%) were common, but lifestyle factors like smoking and diet affected knowledge and attitudes significantly. Regression analysis highlighted that individuals aged 18-24 (odds ratio (OR) = 2.592, p = 0.014) and students (adjusted odds ratio (ORa) = 20.849, p < 0.001) showed higher knowledge, while low education (ORa = 0.151, p = 0.004), low income (ORa = 0.230, p = 0.001), and smoking (ORa = 0.379, p = 0.026) were associated with poorer attitudes. Students (ORa = 0.130, p = 0.005), and unemployment (ORa = 0.173, p = 0.013) were linked to poorer practices.

CONCLUSION: The results of the current study highlight significant knowledge, attitude, and practice gaps regarding H. pylori-induced gastric ulcers in the general Pakistani population. Targeted educational interventions are important to address misconceptions, promote healthy behaviors, and improve management strategies for H. pylori-induced gastric ulcers in Pakistan.

PMID:41953899 | PMC:PMC13053671 | DOI:10.1002/hsr2.72286

Int J Nanomedicine. 2026 Apr 3;21:583269. doi: 10.2147/IJN.S583269. eCollection 2026.

ABSTRACT

PURPOSE: Aerobic and facultative anaerobic bacteria are most commonly found in failed root canal cases. Among those, Enterococcus faecalis (E. faecalis) is the most resistant intracanal microbe. Hence, the antibacterial effectiveness of various intracanal medicaments (ICMs) is primarily tested against E. faecalis. To eliminate such resistant bacteria from the entire root canal system, various contemporary intracanal medicaments (ICMs) with an effective antibacterial action are evaluated. The purpose of the study is to compare the antimicrobial efficacy of intracanal medications, Phytosphingosine nano-emulsion (PHSN), Chitosan nano-emulsion (CHN), and Triple Antibiotic Paste (TAP) against E. faecalis in endodontics.

PATIENTS AND METHODS: Assuming the Minimum Inhibitory Concentration (MIC) of 15.93 and SD 1.53 with estimated error of 1, 80% power, and 5% alpha error, the sample size was calculated as 9. All three ICMs were prepared following the standard protocols. These ICMs were categorised into 3 groups as follows: Group I: PHSN; Group II: CHN; Group III: TAP. The antibacterial property of these ICMs was evaluated using MIC and disk diffusion methods. ANOVA and post hoc Tukey’s tests.

RESULTS: The minimum inhibitory concentration (MIC) was found to be 1 μg/mL for PHSN, 32 μg/mL for CHN, and 4.0 μL/mL for TAP against E. faecalis. PHSN showed the largest zone of inhibition (38.3 ± 1.48), followed by CHN (8.16 ± 0.966), and TAP (6.30 ± 1.71). Thus, PHSN showed significantly higher antimicrobial efficiency compared to CHN and TAP (p < 0.05). Although CHN showed a higher zone of inhibition than the TAP, the difference between them was statistically nonsignificant.

CONCLUSION: Phytosphingosine nano-emulsion (PHSN) has maximum efficacy against E. faecalis, and it can hinder its growth with a minimum inhibitory concentration of 1μg/mL. Chitosan nano-emulsion (CHN) shows slightly more efficacy than Triple Antibiotic Paste (TAP), but without any statistical significance.

PMID:41953859 | PMC:PMC13055908 | DOI:10.2147/IJN.S583269

Indian J Palliat Care. 2026 Jan-Mar;32(1):45-50. doi: 10.25259/IJPC_29_2025. Epub 2025 Jul 31.

ABSTRACT

OBJECTIVES: Anxiety is a common concern among breast cancer patients undergoing chemotherapy. This study aimed to explore the impact of relaxation therapy combined with natural expressions of gratitude, either towards God or in a non-religious context, on anxiety levels in these patients.

MATERIALS AND METHODS: A quasi-experimental study was conducted with 46 breast cancer patients aged 18-65 years at Ngoerah Hospital One Day Care Chemotherapy Clinic from March to December 2023. Participants underwent a 15-minute relaxation therapy. Following the session, they were naturally assigned to one of two groups based on their response: 26 participants expressed gratitude towards God, and 20 participants expressed plain gratitude. Anxiety levels were measured using the Beck Anxiety Inventory (BAI) before and after the intervention. Data were analysed statistically.

RESULTS: The gratitude to God group showed a greater reduction in BAI scores (mean difference = 10.93, standard deviation [SD] = 5.73) compared to the plain gratitude group (mean difference = 5.56, SD = 3.43). Paired t-tests indicated significant reductions in anxiety for both groups (P < 0.001 for both). The independent t-test revealed a significant difference in anxiety reduction between the two groups (t[44] = 3.24, P < 0.01, 95% confidence interval = 0.89-8.27), with the gratitude to God group experiencing a larger decrease in anxiety levels.

CONCLUSION: The findings suggest that relaxation therapy, particularly when accompanied by a natural expression of gratitude directed towards a higher power, may be more effective in reducing anxiety among breast cancer patients undergoing chemotherapy.

PMID:41953835 | PMC:PMC13054332 | DOI:10.25259/IJPC_29_2025