Tag: nevin manimala

Int Ophthalmol. 2025 Aug 25;45(1):351. doi: 10.1007/s10792-025-03715-y.

ABSTRACT

BACKGROUND/OBJECTIVES: To determine the proportion of eyes with optical coherence tomography (OCT) features of polypoidal choroidal vasculopathy (PCV) among patients diagnosed as neovascular age-related macular degeneration (nAMD) based on Asia-Pacific Ocular Imaging Society (APOIS) Diagnostic Criteria.

METHODS: This study was a retrospective cross-sectional review of OCT images. Medical records of treatment-naïve nAMD patients between January 2018 and June 2023 were reviewed. Clinical and demographic profile at presentation was collected. OCT scans were reviewed for presence of APOIS Diagnostic Criteria. Eyes were classified as having PCV features (PCV) based on the presence of ≥ 2 major OCT APOIS diagnostic criteria and then compared with eyes not having these features (non-PCV).

RESULTS: OCT scans of 45 eyes of 38 patients diagnosed with nAMD were analyzed. Mean age was 69.4 years old (range 53-83), 71.1% of patients were female, and 81.6% had unilateral disease. There was no statistically significant difference among clinical and demographic characteristics between PCV and non-PCV groups. Twenty-four eyes (53.3%) had ≥ 2 major APOIS criteria for PCV. Among PCV eyes, sub-RPE ring-like lesion and double-layer sign were the most common major (87.5%) and minor OCT criteria (100%), respectively. Sharp-peaked PED (p < 0.001), sub-RPE ring-like lesion (p < 0.001), en face OCT complex RPE elevation (p = 0.005) and double-layer sign criteria (p = 0.007) were more frequent in the PCV than in the non-PCV group.

CONCLUSION: More than half of Filipino eyes diagnosed with nAMD fulfill the OCT criteria for PCV. The APOIS PCV Workgroup Criteria helps identify patients who will benefit from additional confirmatory and treatment options.

PMID:40853572 | DOI:10.1007/s10792-025-03715-y

Urolithiasis. 2025 Aug 25;53(1):163. doi: 10.1007/s00240-025-01831-z.

ABSTRACT

Infections are common postoperative complications associated with the use of medical implants such as ureteric double-J stents. However, bacterial resistance to antibiotics poses serious risks to human health. These complications highlight the need for novel antibacterial agents. This study aimed to synthesize ionic liquids (ILs) with antibacterial potential, namely, 1-benzyl-3-(2-nitrobenzoyl)-1 H-imidazol-3-ium chloride (OM-1) and 4-(dimethyl amino)-1-(4-nitrobenzoyl) pyridin-1-ium chloride (OM-2), for use as biocompatible coating materials on double-J stents. The chemical structures of the synthesized ILs were confirmed by Nuclear Magnetic Resonance (NMR) and Fourier Transform Infrared (FTIR) spectroscopy. The antibacterial properties were evaluated using the Kirby-Bauer Disk Diffusion method on Klebsiella pneumoniae and Escherichia coli. Cytotoxicity was evaluated in a human skin fibroblast cell line (HFF-1) using a 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2 H tetrazolium (MTS) assay. Molecular docking and ADMETox analyses were also performed to calculate binding affinities and pharmacokinetic properties. At 50 µg/mL, OM-1 and OM-2 exhibited significant activity against Klebsiella pneumoniae (p = 0.04), with OM-1 differing significantly from Gentamicin (p = 0.017). In Escherichia coli, both ILs exhibited significant differences compared to piperacillin/tazobactam (p < 0.001 and p = 0.002, respectively). At 100 µg/mL, both ILs demonstrated statistically significant differences compared to Ceftazidime and Piperacillin/Tazobactam. The IC₅₀ values for OM-1 and OM-2 in HFF-1 cells were calculated as 260.90 µg/mL and 216.35 µg/mL, respectively. Docking studies performed on OM-1 revealed stronger binding affinity as antifungal and antioxidant, while OM-2 was a stronger candidate for antibacterial applications due to its ADMETox profile. These findings, supported by both experimental and computational studies, confirm the biocoating potential of OM-1 and OM-2 for double-J stents.

PMID:40853571 | DOI:10.1007/s00240-025-01831-z

JAMA. 2025 Aug 25. doi: 10.1001/jama.2025.13074. Online ahead of print.

ABSTRACT

IMPORTANCE: Melanoma, the fifth most common cancer in the US, has increased from 8.8 per 100 000 in 1975 to 28.42 per 100 000 in 2022. Cutaneous melanoma comprises 94% of cases, with 104 960 US cases projected for 2025.

OBSERVATIONS: Cutaneous melanoma presents as a new, changing, or irregularly pigmented skin lesion. Cutaneous melanoma subtypes include superficial spreading (≈70%), lentigo maligna (≈15%), nodular (≈5%), desmoplastic (≈4%), amelanotic (2%-8%), spitzoid (<2%), and acral (≈1%). Risk factors for cutaneous melanoma include UV radiation exposure, skin type (eg, skin that always burns, never tans), presence of benign and atypical nevi, and personal or family history of melanoma. Primary prevention consists of avoiding direct sunlight and indoor tanning, and photoprotection (sunscreen and sun-protective clothing). Based on United States Cancer Statistics data from 1999 to 2021, 77% of patients with cutaneous melanoma had localized disease (involving only the primary site), 9.5% had regional (nodal) disease, 4.7% had distant metastasis, and 8.8% were unstaged. Melanoma staging, which includes tumor thickness and ulceration and presence of lymph node or distant metastasis, ranges from stage 0 (melanoma in situ) to stage IV (distant metastasis). Localized melanoma (stage IA-IIA) is surgically excised, with margins of 0.5 cm to 2 cm based on depth of invasion. Sentinel lymph node biopsy is recommended for cutaneous melanoma that is ulcerated or 0.8 mm or more thick. Following surgery, patients with stage IIB-C melanoma have improved recurrence-free survival with adjuvant anti-PD-1 immunotherapy compared with placebo (hazard ratio [HR] for recurrence or death, 0.62 [95% CI, 0.49-0.79] for pembrolizumab and 0.42 [95% CI, 0.30-0.59] for nivolumab). For stage III disease, recurrence risk is decreased with nivolumab (HR, 0.72 [95% CI, 0.60-0.86]), pembrolizumab (HR, 0.61 [95% CI, 0.51-0.72]), or BRAF + MEK inhibitor therapy (dabrafenib + trametinib) (HR, 0.52 [95% CI, 0.43-0.63]). First-line treatment for distant metastatic or unresectable melanoma is dual checkpoint blockade with ipilimumab (anti-CTLA-4) and nivolumab. In 2017, 10-year melanoma-specific survival rates were 98% to 94% for stage IA-B, 88% to 75% for stage IIA-C, 88% for stage IIIA, 77% to 60% for stage IIIB-C, and 24% for stage IIID. In 2024, patients with distant metastatic or unresectable melanoma treated with ipilimumab and nivolumab had a 10-year overall survival rate of 43%.

CONCLUSIONS AND RELEVANCE: Melanoma is a common cancer in the US. Treatment for stage IA-IIA melanoma is surgical resection. Anti-PD-1 immunotherapy after surgical excision improves recurrence-free survival in stages IIB-C melanoma. For stage III melanoma, anti-PD-1 immunotherapy or BRAF + MEK inhibitor therapy decreases risk of melanoma recurrence. First-line therapy for metastatic melanoma is dual checkpoint blockade with ipilimumab and nivolumab.

PMID:40853557 | DOI:10.1001/jama.2025.13074

J Ultrasound. 2025 Aug 25. doi: 10.1007/s40477-025-01069-w. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the inter- and intra-assessor reliability of ultrasonographic assessment of swallowing-related muscle indices in healthy young adults.

METHODS: Three examiners conducted ultrasonographic evaluations on healthy young adults (n = 34, age: ≥ 20 years) examining the thickness and area of the geniohyoid muscle, anterior belly of the digastric muscle, tongue, and the mylohyoid, masseter, and depressor anguli oris muscles. To assess inter-rater reliability, each examiner evaluated each assessment item for one subject three times on the same day. Intra-rater reliability was assessed by rater No. 3 re-evaluating the participants 4-7 days after the initial measurement, using the retest method. Image analysis was conducted by a single examiner utilizing an ultrasonography measurement tool. Statistical analysis was performed using intraclass correlation coefficients (ICCs) for intra- and inter-rater reliability.

RESULTS: The study included 34 participants (male: 17, female: 17; age: 25 ± 2 years, body mass index: 20.3 ± 1.7 kg/m²). For intra-rater reliability for thickness of the geniohyoid muscle, ICC = 0.94 [95% CI (0.89, 0.97)], and ICC = 0.90 [95% CI (0.81, 0.93)] for the area of the anterior belly of the digastric muscle. For inter-rater reliability, ICC = 0.93 [95% CI (0.88, 0.96)] and 0.86 [95% CI (0.77, 0.92)] for the thickness of the geniohyoid muscle, and area of the anterior belly of the digastric muscle, respectively.

CONCLUSIONS: The inter- and intra-assessor reliability of ultrasound assessments of swallowing-related indices in young healthy subjects was good, exhibiting particularly high accuracy for the geniohyoid muscle and the anterior belly of the digastric muscle.

PMID:40853540 | DOI:10.1007/s40477-025-01069-w

Neurol Sci. 2025 Aug 25. doi: 10.1007/s10072-025-08443-w. Online ahead of print.

ABSTRACT

Amyotrophic lateral sclerosis (ALS) is a fatal disease characterized by slowly progressive degeneration of upper motor neurons (UMNs) and lower motor neurons (LMNs). Although the pathogenesis of sporadic form of ALS has not been fully elucidated, the initial damage mostly leads to hyperexcitability of the central and peripheral motor neuron. The results of our study aimed to confirm the changes in the excitability of the peripheral motor axon and contribute to the emergence of these measurements as potential biomarkers for disease progression. A total of 56 ALS patients [24 women (43%), median age 62.5 (interquartile range: 53.75-70.25) years] were finally included in the study. Twenty-four healthy controls that were age- and sex-matched to the cases [12 women (50%), mean age 58.46 ± 8.84] were recruited. The first main finding of our study is the fact that abnormalities of the voltage gated K⁺ ion channels were constantly present in ALS patients than in the controls. The multivariate analysis revealed that Superexcitability 7ms lower than – 21.06%, related to shorter survival. Additionally using receiver operating characteristic (ROC) curves, the c-statistic showed Superexcitability 7ms moderate predictive ability. The clinical significance of our results is that Superexcitability 7ms can be used as a biomarker not only for survival but also for disease progression.

PMID:40853517 | DOI:10.1007/s10072-025-08443-w

Pediatr Cardiol. 2025 Aug 25. doi: 10.1007/s00246-025-03925-2. Online ahead of print.

ABSTRACT

Cardiac remodeling has been reported in HIV-exposed but uninfected (HEU) infants. Inflammatory biomarkers have also been observed to be associated with cardiac remodeling in older HEU children but have not been widely studied in infants. We identified left ventricular (LV) cardiac changes in HEU infants exposed to current ARV therapy in utero and determined their association with the inflammatory biomarkers, C-reactive protein (CRP), and cardiac troponin. This comparative cross-sectional study included 196 HEU infants and 198 matched HIV-unexposed controls. We evaluated LV structure and function using echocardiography and tested blood samples using highly sensitive CRP (hsCRP) and cardiac troponin I (cTnI-plus) measurements. Data were analyzed using the R statistical software package; p values of < 0.05 were considered statistically significant. The HEU infants had thicker LV posterior walls and interventricular septa in diastole (median difference 0.55 and 0.30, 95% CI 0.22-0.89 and 0.13-0.54, respectively, p < 0.001), higher left ventricular mass index (median difference 3.8, 95% CI 1.2-6.9, p < 0.001), and left ventricular wall thickness-to-diameter ratio (median difference 0.02, 95% CI 0.01-0.03, p < 0.001) compared with controls. The interventricular septa Z score was significantly thicker in HEU infants with elevated hsCRP levels (AOR 2.3, 95% CI 1.22-3.36, p = 0.006). Cardiac remodeling is present in HEU infants exposed to current ARV regimens in utero. Longitudinal studies are required to identify infants who may require cardiac evaluation and further explore biomarkers associated with cardiac remodeling in HEU infants.

PMID:40853460 | DOI:10.1007/s00246-025-03925-2

J Pak Med Assoc. 2025 Aug;75(8):1320-1326. doi: 10.47391/JPMA.21001.

ABSTRACT

OBJECTIVE: To assess the frequency of anxiety and its coping mechanism among medical and engineering students.

METHODS: The comparative cross-sectional study was conducted from April to September 2023 in Faisalabad, Pakistan, and comprised students from two medical and two engineering education institutions. Within the two subsets, one was a public-sector institution and the other was in the private sector. Data was collected using Generalised Anxiety Disorder-7 and Brief Cope Inventory. Data was Analysed using SPSS 27.

RESULTS: Study subjects ranged between 17-26 years of age and 144(36%) of them were females. Of the 400 subjects, 200(50%) were medical students and the rest were engineering students uniformly representing all years of education. Also, 200(50%) responses were from private-sector institutions and the rest were from public-sector institutions. Mild anxiety was present in 220(55%) subjects, more in engineering students. Moderate anxiety was found in 98(24.5%) students, most in public-sector medical institutions. Minimal and severe anxiety were noted in 56(14%) and 26(6.50%) subjects, respectively. Medical and engineering students showed the same patterns of coping mechanisms, with planning (2.55±0.69) being the most adopted, and substance abuse (1.78±0.68) the least.

CONCLUSIONS: Except for mild anxiety, all other groups of anxiety levels were found to be higher among medical students. In terms of coping behaviour, there was no difference between medical and engineering students.

PMID:40851158 | DOI:10.47391/JPMA.21001

J Pak Med Assoc. 2025 Aug;75(8):1267-1270. doi: 10.47391/JPMA.20788.

ABSTRACT

The retrospective, observational study was planned to present the clinical manifestations of obstructive nephropathy secondary to urolithiasis, and its effect on long-term renal function. The sample comprised patients diagnosed with obstructive nephropathy secondary to stones admitted to the Department of Urology and Renal Transplant, Lahore General Hospital, Lahore, Pakistan, between January 1, 2018, and December 31, 2021. Data was analysed using SPSS 20. Of the 76 patients with a mean age of 50.06±13.42 years, 56(73.7%) were males and 20(26.3%) were females. The most frequent clinical cause was bilateral ureteric obstruction in 39 (51.3%) patients. The most common emergency procedure performed was unilateral percutaneous nephrostomy. It took an average of 10.8±2.3 days for patients to have a nadir value of creatinine. On follow-up, diabetes, presence of lower urinary tract symptoms and a higher value of creatinine at admission were significantly related to poorer outcomes (p<0.05).

PMID:40851138 | DOI:10.47391/JPMA.20788

J Pak Med Assoc. 2025 Aug;75(8):1218-1223. doi: 10.47391/JPMA.20611.

ABSTRACT

OBJECTIVES: To analyse prescribing patterns of cyclooxygenase-2 inhibitor for low-back pain patients with cardiovascular comorbidities in American outpatient settings.

METHODS: The data of this retrospective, cross-sectional study were from the 2007-2019 National Ambulatory Medical Care Survey except 2017 for which data were not available. Data related to low-back pain patients of either gender aged ≥20 years. Those having cardiovascular comorbidities were placed in group A, while those without such comorbidities were placed in group B. Descriptive statistics were employed to evaluate visit characteristics, stratified by cyclooxygenase-2 inhibitor use. Multivariable logistic regression analysis was utilised to assess factors associated with cyclooxygenase-2 inhibitor prescriptions. Data was analysed using R 4.1.2.

RESULTS: Of the 242.65 million patients with 107.19(44.2%) females, 76.83 million (31.7%) were in group A and 165.82 million (68.3%) in group B. Compared to group B patients, those in group A were older (62.0±14.1years vs 49.7±16.1 years, p<0.01) and had a higher prevalence of cyclooxygenase-2 inhibitor use (p=0.01). Overall, 5.2 million (2.14%) patients were prescribed cyclooxygenase-2 inhibitors. Those using cyclooxygenase-2 inhibitor exhibited a higher prevalence of cardiovascular comorbidities (p=0.01), especially hypertension (p=0.01), and were older in age (p<0.01). Older age (odds ratio = 1.019, 95% confidence interval: 1.003-1.035; p<0.05) and higher prevalence of cardiovascular comorbidities (odds ratio = 1.638, 95% CI: 1.017-2.637; p<0.05) were associated with increased likelihood of receiving cyclooxygenase-2 inhibitor prescriptions.

CONCLUSIONS: Cyclooxygenase-2 inhibitor use was positively correlated with age and cardiovascular comorbidities among low-back pain patients in American ambulatory care, suggesting potential contradiction to current medication guidelines and heightened risk of adverse cardiovascular events.

PMID:40851131 | DOI:10.47391/JPMA.20611

Sci Rep. 2025 Aug 24;15(1):31108. doi: 10.1038/s41598-025-17083-1.

ABSTRACT

Our study aimed to evaluate the survival impact of adjuvant radiotherapy (RT) following breast-conserving surgery (BCS) in elderly male patients with early-stage, low-risk breast cancer (node-negative, HR+), and to identify RT-benefiting subgroups using machine learning and causal inference approaches. We conducted a retrospective cohort study using Surveillance, Epidemiology, and End Results (SEER) database (2000-2021), including 360 patients after propensity score matching (PSM). Patients were grouped by RT and non-RT (NRT) status, and a 1:3 nearest neighbor PSM was applied. Overall survival (OS), relative survival (RS), standardized mortality ratio (SMR), and transformed Cox regression were used to estimate RT benefit. Additionally, machine learning models, including random forest, support vector machines and causal forest model, were applied for survival prediction and validation. In early-stage, low-risk male breast cancer (MBC) patients treated with BCS, adjuvant RT did not demonstrate a significant survival advantage over NRT. After PSM, 15-year OS, RS, and SMR were 31.8%, 15.2%, and 2.14 for RT versus 34.1%, 21.5%, and 2.25 for NRT (p = 0.36, 0.68, and 0.81, respectively). The cumulative incidence of breast cancer-related death (BCRD) and non-BCRD also showed no statistically significant differences between groups (p = 0.06 and 0.75). Machine learning models (Cox, GBM, and XGBoost) confirmed the limited contribution of RT to survival prediction, with the Cox model demonstrating the best discrimination (C-index = 0.713). While RT was associated with a lower risk of death within the first 10 years, its benefit diminished over time. Causal forest analysis revealed notable heterogeneity in treatment effects across subgroups. Patients who were younger, diagnosed earlier, or had stage I disease showed relatively higher estimated benefit from RT, while older patients or those with more recent diagnoses demonstrated attenuated benefit. In elderly, low-risk MBC patients treated with BCS, adjuvant RT was not associated with improved long-term survival. While our findings suggest that RT may be safely omitted in selected individuals, this decision should be made cautiously in the absence of recurrence data. Model-based analyses underscore the importance of tailoring treatment to patient-specific risk profiles. Prospective studies dedicated to MBC are needed to support individualized de-escalation strategies.

PMID:40851101 | DOI:10.1038/s41598-025-17083-1