Tag: nevin manimala

Cleft Palate Craniofac J. 2026 Mar 12:10556656261429897. doi: 10.1177/10556656261429897. Online ahead of print.

ABSTRACT

ObjectiveTo evaluate long-term effects of presurgical nasoalveolar molding (PNAM) on occlusal relationships and craniofacial development in children with unilateral cleft lip and palate (UCLP) using the 5-year-olds’ index and cone-beam computed tomography (CBCT).DesignRetrospective cohort study.SettingTertiary-level Class A specialized stomatological hospital.ParticipantsSixty-four patients with complete UCLP.InterventionsThirty patients underwent PNAM treatment, and 34 patients did not.Main Outcome MeasureCBCT scans were used to assess dental occlusion via the 5-year-old index and to measure craniofacial variables. Intergroup differences were analyzed using the Mann-Whitney U test and the chi-square test, while the correlation between occlusion and craniofacial variables was examined using the Pearson correlation coefficient. A P value of less than .05 was considered statistically significant.ResultsA comparison of 5-year-olds’ index scores in the two groups showed median scores of 3.0 (PNAM group) and 3.5 (non-PNAM group), respectively, with no significant difference found. For prognosis, no significant difference in orthognathic surgery need was found, but the PNAM group had a higher nonsurgery rate (60%) versus 50% in the non-PNAM group. In craniofacial development, the PNAM group had significantly longer maxillary length; favorable prognosis group showed smaller SNB angles, shorter mandibular body, larger ANB angles, and longer maxillary length. Correlation analysis showed 5-year-olds’ index positively correlated with SNB/mandibular body length, and negatively with ANB/maxillary length.ConclusionsEarly childhood evaluations showed that treatment with/without PNAM in the neonatal period was not a major factor influencing occlusal relationships or craniofacial development in patients with UCLP. Furthermore, correlation between 5-year-olds’ index and skeletal morphology in children with UCLP has been confirmed.

PMID:41816816 | DOI:10.1177/10556656261429897

J Cereb Blood Flow Metab. 2026 Mar 12:271678X261415784. doi: 10.1177/0271678X261415784. Online ahead of print.

ABSTRACT

We investigated dynamic changes in nicotinamide adenine dinucleotide (NAD⁺) metabolism in the human occipital lobe using ultra-high field ³¹P functional magnetic resonance spectroscopy (fMRS) at 7 T. Twenty-five healthy volunteers (mean age 24 ± 4 years, 10 females) performed a visual task alternating between fixation and flashing checkerboard stimuli. ³¹P MRS spectra were acquired from a visual cortex voxel functionally localized by prior functional magnetic resonance imaging (fMRI). Linear mixed-effects modeling revealed a significant reduction in NAD⁺ concentrations during the first stimulation block, while no significant change was observed during the second block. No significant changes were observed for other high-energy phosphate metabolites (ATP, phosphocreatine, and inorganic phosphate), indicating specificity in the NAD⁺ response. Exploratory analyses, dividing the blocks in two halves, suggested further reductions in NAD⁺ and tNAD in the second halves of both stimulation blocks, though these trends were not statistically significant. Our findings demonstrate the feasibility of using fMRS at 7 T to detect stimulus-induced dynamics in cerebral NAD⁺ metabolism in vivo, providing insights into the interplay between glycolysis and oxidative phosphorylation during neural activation.

PMID:41816808 | DOI:10.1177/0271678X261415784

Pan Afr Med J. 2025 Dec 8;52:147. doi: 10.11604/pamj.2025.52.147.43262. eCollection 2025.

ABSTRACT

INTRODUCTION: the COVID-19 pandemic had a devastating impact on society, with healthcare workers (HCWs) on the frontline bearing the brunt. As such, HCWs directly involved in the diagnosis, treatment, and care of patients with COVID-19 were at risk of developing psychological distress and other mental health symptoms. The overall aim of this study was to assess mental health symptoms among HCWs treating patients exposed to COVID-19 in Gauteng, South Africa. This research was critically important to determine the physiological burden on HCWs in response to the pandemic, so that mental health responses to the pandemic by HCWs, and psychosocial support structures in place for HCWs in South Africa can be considered.

METHODS: a cross-sectional study was conducted among frontline HCWs in the Inner City and Johannesburg South region (region F) of Gauteng, South Africa. Data was collected through both an online and an in-person approach. All participants completed a questionnaire enquiring about their socio-demographic characteristics and mental health symptoms. The presence and severity of symptoms of depression, anxiety, and insomnia of HCWs exposed to COVID-19 were assessed using the patient health questionnaire-9 (PHQ-9), the generalised anxiety disorder-7 (GAD-7), and the insomnia severity index-7 (ISI-7). Data analysis was performed using SPSS version 26.0 statistical software.

RESULTS: a total of 234 out of 260 contacted individuals completed the survey. The majority of the participants were female (n=190, 81.2%), aged between 36 and 45 years (n=79, 33.8%), were unmarried (n=105,44.9%), and had a tertiary education (n=217, 92.7%). The majority of the participants worked in the public sector (151, 64.5%), while the minority (n=83, 35.5%) worked in the private sector. A considerable proportion of HCWs reported symptoms of depression (n=102, 43.6%), anxiety (n=105, 44.9%), and insomnia (n=70, 29.9%). It was found that there were no significant differences in symptoms of depression (X²=4.8, p>0.05), anxiety (X²=0.8, p>0.05), and insomnia (X²=2.1, p>0.05) between public and private sector HCWs. The results further showed that 49.1% of the participants indicated that psychological services did exist in their place of work, and 50.9% said they did not exist. Perceptions that psychological services existed were more common among HCWs in private healthcare facilities (66.3%) than among HCWs in public healthcare facilities (39.7%). Psychosocial support systems such as mental health counselling, support groups, psychological services, and employee assistance programmes were identified as some of the key services requested by HCWs.

CONCLUSION: the prevalence of depression, anxiety, and insomnia was shown in HCWs in Gauteng, South Africa, and there were differences in perceptions of the psychosocial support systems that exist in the region between private and public sector HCWs. The results indicate that a considerable proportion of HCWs have depression, anxiety, or insomnia, with only half indicating the presence of workplace psycho-social support structures. Psycho-social support structures for HCWs need to be strengthened and made more visible.

PMID:41816780 | PMC:PMC12973459 | DOI:10.11604/pamj.2025.52.147.43262

J Vasc Bras. 2026 Feb 6;24:e20240149. doi: 10.1590/1677-5449.202401492. eCollection 2025.

ABSTRACT

BACKGROUND: Injuries to the retrohepatic vena cava are associated with high mortality rates and vascular control must be obtained prior to exposure. Various treatment techniques have been described, including triple hepatic vascular exclusion, atriocaval shunt, and endovascular and hybrid strategies.

OBJECTIVES: To determine which of these is associated with the lowest mortality rate.

METHODS: A systematic literature review was conducted, guided by the Cochrane Handbook and PRISMA guidelines. The PUBMED, LILACS, Embase, Web of science, and Scopus databases were searched and Ryyan software was employed to manage the studies identified.

RESULTS: Sixteen studies were selected, reporting 96 cases, in 49 of which the patients were treated with triple hepatic exclusion, in 38 with an atriocaval shunt, and in 9 with endovascular or hybrid techniques, with the third of these groups being statistically less frequent (p < 0.0001). The mortality rate was 53.8%, with no statistically significant differences between any of the techniques studied (p = 0.9085).

CONCLUSIONS: Injuries to the retrohepatic vena cava had similar mortality rates regardless of the technique employed for treatment.

PMID:41816770 | PMC:PMC12974593 | DOI:10.1590/1677-5449.202401492

Turk J Med Sci. 2025 Dec 28;56(1):351-363. doi: 10.55730/1300-0144.6169. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: Spinal muscular atrophy (SMA) is a severe neuromuscular disorder with high treatment costs and significant psychosocial burden. In 2021, Türkiye launched a national premarital SMA carrier screening program integrated with in vitro fertilization (IVF) with preimplantation genetic testing (PGT) services for couples identified as carriers. This study aimed to compare the costs associated with the carrier screening and prevention program versus a no-screening (treatment-only) scenario.

MATERIALS AND METHODS: A cost comparison model was developed using data from the Turkish Statistical Institute, the Ministry of Health, and the Social Security Institution. The annual costs of SMA treatment (with nusinersen and risdiplam) and the costs associated with carrier screening, genetic counseling, and IVF with PGT were compared. Projections estimated 115 new SMA cases annually based on national birth rates and carrier frequencies.

RESULTS: The total annual cost of the premarital carrier screening and prevention program was estimated at TRY 112,801,201.6 (EUR 2,418,550.6). In contrast, the treatment of 115 new cases of SMA with nusinersen would cost TRY 1,091,623,700 in the first year alone, reaching a cumulative cost of TRY 2,183,247,377 over three years. The three-year cumulative cost for risdiplam treatment was calculated as TRY 1,196,414,795. The cost of preventing the birth of one SMA-affected child through the screening program was estimated as TRY 854,554.6, whereas treatment costs per child reached as high as TRY 18,984,759.6 with nusinersen.

CONCLUSION: The SMA premarital carrier screening and prevention program in Türkiye significantly reduces healthcare expenditures and disease burden. Primary prevention through carrier screening is associated with lower overall costs than long-term treatment, offering both economic and social advantages for public health policy.

PMID:41816748 | PMC:PMC12974293 | DOI:10.55730/1300-0144.6169

Turk J Med Sci. 2025 Oct 8;56(1):344-350. doi: 10.55730/1300-0144.6168. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: The protein kinase RNA-like endoplasmic reticulum kinase (PERK) pathway plays a critical role in preventing the accumulation of misfolded or unfolded proteins within the endoplasmic reticulum. In this study, the role of the PERK signaling pathway was evaluated in newly diagnosed, treatment-naïve patients with acute myeloid leukemia (AML).

MATERIALS AND METHODS: Plasma levels of eukaryotic translation initiation factor 2-alpha kinase 3 (eIF2AK3), glucose-regulated protein 78 (GRP78), activating transcription factor 6 (ATF6), CCAAT/enhancer-binding protein homologous protein (CHOP), hypoxia-inducible factor-1 alpha (HIF-1α), and caspase 3 were measured by enzyme-linked immunosorbent assay in peripheral blood samples obtained from AML patients and healthy controls.

RESULTS: A total of 40 individuals were included, comprising 19 (47%) AML patients and 21 (53%) healthy controls. HIF-1α, eIF2AK3, GRP78, ATF6, CHOP, and caspase 3 levels were significantly higher in the AML group than in the control group (p = 0.019, 0.005, <0.001, 0.006, <0.001, and <0.001, respectively). No significant differences were observed in HIF-1α, GRP78, ATF6, CHOP, and caspase 3 levels between diagnosis and the 30th day of remission-induction therapy in the AML group, whereas a significant decrease was observed in eIF2AK3 levels (p = 0.049). At diagnosis, a strong positive correlation was found between GRP78 and CHOP levels (r = 0.740, p < 0.001), and a moderate positive correlation was detected between CHOP and caspase 3 levels (r = 0.514, p = 0.024) in the AML group. In the Cox regression analysis of the AML cohort, no statistically significant association was identified between overall survival and age, risk category, or biomarker levels (HIF-1α, eIF2AK3, GRP78, ATF6, CHOP, and caspase 3).

CONCLUSION: PERK and ATF6 signaling pathways were activated in patients with AML. Targeting the unfolded protein response pathway may represent a promising therapeutic strategy for patients with AML.

PMID:41816747 | PMC:PMC12974292 | DOI:10.55730/1300-0144.6168

Turk J Med Sci. 2025 Nov 17;56(1):144-151. doi: 10.55730/1300-0144.6147. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: This study aimed to evaluate the impact of diabetic foot ulcers (DFUs) on retinal microvascular changes, specifically the radial peripapillary capillary (RPC) vessel density and retinal nerve fiber layer (RNFL) thickness in patients with mild-to-moderate nonproliferative diabetic retinopathy (NPDR).

MATERIALS AND METHODS: Ninety participants were enrolled and divided into three groups: 30 patients with DFUs and mild-to-moderate NPDR, 30 patients with NPDR but without DFUs, and 30 healthy controls. RPC density and RNFL thickness were evaluated using optical coherence tomography angiography (OCTA), a noninvasive imaging method. Comparisons between groups were made with statistical adjustments, including optic disc area.

RESULTS: Patients with DFUs exhibited significantly lower RPC vascular density across multiple quadrants than those without DFUs and healthy controls (p < 0.001). Furthermore, RNFL thickness was significantly increased in the DFU group, particularly in the inferior-hemi (p < 0.001) and temporal-inferior (p < 0.001) quadrants. The optic disc area was significantly larger in the DFU group (p = 0.017), which may have influenced the RNFL measurements.

CONCLUSION: The study underscores notable alterations in RPC density and RNFL thickness among patients with DFUs and mild-to-moderate NPDR. These alterations may reflect systemic microvascular impairment, potentially exacerbated by systemic inflammation, or changes suggestive of reactive gliosis, though further validation is needed. These findings underscore the need for early ophthalmological evaluation and a comprehensive approach to managing both peripheral and ocular diabetic complications. Future studies incorporating systemic inflammatory biomarkers and functional visual assessments are needed to explore the mechanisms underlying these retinal changes.

PMID:41816743 | PMC:PMC12974285 | DOI:10.55730/1300-0144.6147

Turk J Med Sci. 2025 Dec 21;56(1):23-31. doi: 10.55730/1300-0144.6134. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: Gout, the most prevalent form of inflammatory arthritis, has shown a global increase in prevalence; however, data from Türkiye remain scarce, inconsistent, and largely confined to western regions. This study aimed to estimate the prevalence of gout among adults in the Sincan district of Ankara, Türkiye, and to provide updated data from a previously understudied region.

MATERIALS AND METHODS: This cross-sectional, community-based study employed a multistage design. Adults aged ≥18 years who presented to selected family health centers in Sincan between February and June 2023 were screened using a structured questionnaire. Individuals with suspected gout underwent comprehensive clinical evaluation, including medical history, physical examination, and relevant laboratory testing, conducted by rheumatologists. Gout was classified according to the 2015 ACR/EULAR criteria, with a score of ≥8 required for classification.

RESULTS: Of the 517 individuals approached, 515 provided consent, and data from 513 participants were included in the final analysis. Screening identified 26 individuals with suspected gout, of whom 24 completed evaluation, resulting in the confirmation of seven gout cases (five men and two women). The overall estimated prevalence of gout was 1.36% (95% CI: 0.55%-2.81%). Prevalence was higher in men (2.18%; 95% CI: 0.71%-5.01%) than in women (0.70%; 95% CI: 0.09%-2.52%) although this difference was not statistically significant due to the small sample size, and prevalence increased with age.

CONCLUSION: These findings provide updated epidemiological data, indicating a higher prevalence than previously reported in western Türkiye, while remaining within the lower range of global estimates. These data underscore the need to enhance gout awareness and to develop effective management strategies within the Turkish population.

PMID:41816741 | PMC:PMC12974274 | DOI:10.55730/1300-0144.6134

Turk J Med Sci. 2026 Jan 19;56(1):218-228. doi: 10.55730/1300-0144.6155. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: Effective postoperative pain management after cesarean section is essential for maternal recovery. Poor pain control can lead to complications, including postpartum depression. This study aimed to compare the postoperative analgesic efficacy of erector spinae plane (ESP) and transversus abdominis plane (TAP) blocks following cesarean section, with a particular focus on their potential impact on postpartum depression.

MATERIALS AND METHODS: Sixty patients were randomly assigned to receive either an ESP block (Group E, n = 30) or a TAP block (Group T, n = 30) after cesarean section. Pain severity was assessed using a visual analog scale (VAS), and the need for rescue analgesics and patient satisfaction were recorded. Postpartum depression was evaluated using the Edinburgh Postpartum Depression Scale (EPDS) at 4-6 weeks postpartum.

RESULTS: There was no significant difference between the groups in analgesic duration (Group E: 15 h, Group T: 14 h, p = 0.314). Group E showed a significantly lower need for rescue analgesics (0 vs. 1, p = 0.049). The VAS score at the first hour was lower in Group E (2 vs. 3, p = 0.032), but no differences were observed at subsequent time points. Postpartum depression rates were not statistically significant.

CONCLUSION: With the ESP block, no significant difference was observed compared to the TAP block in terms of total analgesic duration, opioid consumption, postpartum depression, or patient satisfaction, except for the postoperative 1-h VAS pain score. This suggests that the ESP block does not provide clear superiority over the TAP block.

PMID:41816738 | PMC:PMC12974309 | DOI:10.55730/1300-0144.6155

Turk J Med Sci. 2025 Nov 17;56(1):32-37. doi: 10.55730/1300-0144.6135. eCollection 2026.

ABSTRACT

BACKGROUND/AIM: To evaluate the association between the preoperative pan-immune inflammation value (PIV) and prognostic factors, including stage, lymph node involvement, and metastasis, in patients who underwent radical orchiectomy for germ cell testicular tumors.

MATERIALS AND METHODS: Data from 178 patients who underwent radical orchiectomy for testicular tumors between January 2014 and January 2024 were retrospectively reviewed. Preoperative serum tumor markers, hematologic parameters, and histopathological findings were recorded. Tumor staging was determined based on radiological imaging and serum tumor markers. The PIV was calculated using the formula: (monocyte count × neutrophil count × platelet count) / lymphocyte count. Optimal cut-off values for PIV were determined using ROC curve analysis. The association between the PIV score and clinicopathological variables was analyzed.

RESULTS: The mean age of the patients was 32.34 ± 9.62 years. The mean PIV score in patients with metastasis and retroperitoneal lymph node invasion (RPLNI) was significantly higher than in those without metastasis or RPLNI (p = 0.01 and p = 0.04, respectively). The PIV score increased progressively with higher tumor T, N, and M stages. Additionally, a statistically significant increase in PIV scores was observed among patients classified into higher International Germ Cell Cancer Collaborative Group risk groups (p = 0.01).

CONCLUSION: Higher PIV scores are significantly associated with tumor stage, lymph node involvement, and metastasis in patients with germ cell testicular tumors. The PIV score appears to be a useful and cost-effective preoperative marker for predicting advanced disease in testicular tumors at the time of diagnosis.

PMID:41816726 | PMC:PMC12974310 | DOI:10.55730/1300-0144.6135