Tag: nevin manimala

Curr Med Res Opin. 2025 Jun 9:1-16. doi: 10.1080/03007995.2025.2516147. Online ahead of print.

ABSTRACT

Objective: Quantification of myasthenia gravis (MG) symptom severity and treatment satisfaction could differ whether reported by patients or physicians. The study objective was to explore concordance between assessments of symptom severity, symptom troublesomeness, and treatment satisfaction by patients with myasthenia gravis (MG) and their physicians.Methods: Data were from the Adelphi Real World MG Disease Specific Programme (DSP), a multinational (France, Germany, Italy, Spain, United Kingdom [UK], United States [US]), cross-sectional survey with retrospective chart review independently completed by physicians and their patients in 2020.Results: Across all patients and all symptoms, physician-patient concordance about symptom severity was moderate (Cohen’s Weighted Kappa [κ] statistic = 0.45). However, there was high variability, and when each of the 17 symptoms was examined individually, agreement was slight or fair (κ = 0.00-0.40). The proportion of physicians describing a given symptom as less severe than the patient ranged from 30.9-74.5%. There were many instances where a physician reported a symptom as absent, but the patient self-reported it as present (e.g. fatigue/tiredness: physician-reported absence in 42% of patients [of whom 11% self-reported mild, 17% moderate, 5% severe], muscle ache after activity: physician-reported absence in 58% of patients [of whom 12% self-reported mild, 10% moderate, 6% severe]. There was generally greater physician-patient concordance in recognizing patients’ most troublesome symptoms; agreement was poor (κ < 0) or slight/fair (κ = 0.00-0.40) for 6 symptoms and moderate/substantial (κ = 0.41-0.80) for 11. Physician-patient concordance regarding treatment satisfaction was fair (κ = 0.37), with physicians reporting higher satisfaction than patients in 36.6% of cases.Conclusions: Although some degree of physician-patient concordance was observed, there remained many patients reporting greater symptom severity and/or lower treatment satisfaction compared with physicians.

PMID:40485493 | DOI:10.1080/03007995.2025.2516147

Indian J Pathol Microbiol. 2025 Jun 7. doi: 10.4103/ijpm.ijpm_749_24. Online ahead of print.

ABSTRACT

BACKGROUND: Head-neck carcinoma, which includes oral squamous cell carcinoma (OSCC), is the eighth most common type of cancer. Secretarial for most head and neck cancers, this being one of the primary causes of morbidity and destruction worldwide. Included in OSCC are extranodal extension and depth of invasion and their relation with pTNM staging, which are essential to OSCC prognosis. These histopathological features can be incorporated into pathology data to provide further appropriate treatment for OSCC patients.

MATERIALS AND METHODS: Records of 65 patients were retrieved from the departmental archives and histopathological characteristics were studied. Statistical analysis was done and histopathologic parameters were correlated.

RESULTS: The Present study aimed to find a correlation between the extranodal extension of positive lymph nodes and depth of invasion histopathologically in tumors to rule out its impact on the survival and prognosis of patients. On correlating DOI with ENE, it showed that 27 patients had positive lymph nodes 15 patients having a DOI more than 10 mm showed extranodal extension and 9 patients showed negative ENE, suggesting a significant correlation between both parameters (p-0.008).

CONCLUSION: We hypothesized that there was a significant correlation between extracapsular spread and depth of invasion in OSCC and has an effect on the survival and prognosis of the patient.

PMID:40485490 | DOI:10.4103/ijpm.ijpm_749_24

Br J Psychiatry. 2025 Jun 9:1-5. doi: 10.1192/bjp.2025.118. Online ahead of print.

ABSTRACT

Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.

PMID:40485480 | DOI:10.1192/bjp.2025.118

Hypertension. 2025 Jun 9. doi: 10.1161/HYPERTENSIONAHA.125.24675. Online ahead of print.

ABSTRACT

BACKGROUND: Preeclampsia remains one of the major causes of maternal and neonatal mortality and morbidity, and yet it is uncertain whether aspirin combined with calcium would reduce the burden of preeclampsia in Malawian women, as elsewhere. This study assessed the efficacy of early low-dose aspirin in preventing in women given calcium to prevent preeclampsia/eclampsia in Blantyre, Malawi.

METHODS: This was a pragmatic, double-blind, cluster randomized controlled trial conducted in 4 urban health centers and Queen Elizabeth Central Hospital in Blantyre. A total of 306 women at high risk of preeclampsia were assigned to low-dose aspirin (150 mg/day) or placebo from 12 to 16 weeks until 34 weeks of gestation in clusters. All women were given calcium 1 g/day. The intention-to-treat analysis and adherence analysis were conducted with the primary end point of preeclampsia.

RESULTS: A total of 39 women were lost to follow-up, and 1 withdrew consent. Data for 266 women were available for analysis. Overall, preeclampsia occurred in 15.8% (42/266) and eclampsia in 2.3% (6/266) of all women. There was no statistically significant difference in the rate of preeclampsia between the low-dose aspirin group 19.3% (26/135) and placebo group (12.2% 16/131; adjusted odds ratio, 1.16 [95% CI, 0.41-3.41]; P=0.781). No statistically significant difference was observed in the secondary maternal and neonatal outcomes. The overall adherence was 69%.

CONCLUSIONS: In high-risk women treated with calcium, additional low-dose aspirin resulted in no difference in the rate of preeclampsia, cesarean section rates, or important neonatal outcomes in Malawi.

PMID:40485444 | DOI:10.1161/HYPERTENSIONAHA.125.24675

Saudi J Gastroenterol. 2025 Jun 9. doi: 10.4103/sjg.sjg_133_25. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic kidney disease (CKD) has been associated with higher risk of gastrointestinal disorders, particularly Gastroesophageal reflux disease (GERD). However, the magnitude of this association and the underlying mechanisms remains unclear.

METHODS: A systematic search was conducted across major databases from inception to November 2024. We included cross-sectional and case-control studies evaluating the relationship between CKD and GERD. Data were extracted and analyzed using a random-effects model to calculate pooled odds ratios (ORs) and prevalence rates. Study quality was assessed using the Newcastle-Ottawa Scale, and heterogeneity was evaluated using the Cochran’s Q test and I² statistic.

RESULTS: Nine studies involving 4,650,709 participants were included. The pooled prevalence of GERD among CKD patients was 18% (95% CI: 0.10-0.26, I² =93.64%). The pooled crude OR for the association between CKD and GERD was 2.53 (95% CI: 1.30-4.92) and adjusted OR was 1.48 (95% CI: 1.05-2.08).

CONCLUSION: This meta-analysis reveals a marginally significant association between CKD and GERD, highlighting higher prevalence of GERD among individuals with CKD. Furthers studies are needed to elucidate the underlying pathophysiological mechanisms and potential clinical implications.

PMID:40485438 | DOI:10.4103/sjg.sjg_133_25

Soft Matter. 2025 Jun 9. doi: 10.1039/d5sm00138b. Online ahead of print.

ABSTRACT

Brain tissue accommodates non-linear deformations and exhibits time-dependent mechanical behaviour. The latter is one of the most pronounced features of brain tissue, manifesting itself primarily through viscoelastic effects such as stress relaxation. To investigate its viscoelastic behaviour, we performed ramp-and-hold relaxation tests in torsion on freshly slaughtered cylindrical ovine brain samples (25 mm diameter and ∼10 mm height). The tests were conducted using a commercial rheometer at varying twist rates of {40, 240, 400} rad m^-1 s^-1, with the twist remaining fixed at ∼88 rad m^-1, which generated two independent datasets for torque and normal force. The complete set of viscoelastic material parameters was estimated via a simultaneous fit to the analytical expressions for the torque and normal force predicted by the modified quasi-linear viscoelastic model. The model’s predictions were further validated through finite element simulations in FEniCS. Our results show that the modified quasi-linear viscoelastic model-recently reappraised and largely unexploited-accurately fits the experimental data. Moreover, the estimated material parameters are in line with those obtained in previous studies on brain samples under torsion. These material parameters could enhance our understanding of slow-progressing pathologies such as tumour growth or neurodegeneration and inform the development of improved in silico models for brain surgery planning and training. Our novel testing protocol also offers an efficient, robust and reliable method for determining the viscoelastic properties of brain tissue under much more rapid loading conditions, which are of crucial importance for modelling traumatic brain injury.

PMID:40485423 | DOI:10.1039/d5sm00138b

Indian J Pathol Microbiol. 2025 Jun 7. doi: 10.4103/ijpm.ijpm_174_24. Online ahead of print.

ABSTRACT

BACKGROUND: Oral cancer is the common reason for the poor prognosis in head and neck carcinomas and the increase in morbidity and mortality rates. The biological behavior of cancer is a complex process. About 50-60% of solid tumors exhibit hypoxic areas within the tumor stroma, which was influenced by the transcriptional activity of hypoxia inducible factor (HIF). HIF promotes stemness and the proliferation of vessel-like structures in tumors, which leads to invasion and metastasis.

AIM: To evaluate and correlate the expression of HIF- 1α, MCT1, NESTIN, and SALL2 in the tumor proper and tumor periphery of non- metastatic, metastatic, and recurrent OSCC.

MATERIALS AND METHODS: A Total of 60 proven OSCC cases with proper tumor center and periphery were collected. Among them, 25 were nonmetastatic, 25 were metastatic, and 10 were recurrent cases of OSCC. Immunohistochemical analysis of HIF- 1α, MCT1 NESTIN, SALL2, and CD31/PAS double staining was done.

RESULTS: Depending on the extent of stained tumor cells, the intensity of staining, and the index score, the expressions of both MCT1, SALL2, and NESTIN were highly significant in the periphery of OSCC with a P value of 0.001. The total number of vessels expressed in non-metastatic, metastatic, and recurrent OSCC were not significant, but overall expression of CD31/PAS was statistically significant in the periphery of the tumor with P value -0.024.

CONCLUSION: Based on the above results, it is observed that the role of hypoxia helped in cancer stem cell (CSC) maintenance with the formation of vessel-like structures by tumor cells at an early stage of cancer promotes its development and recurrence.

PMID:40485407 | DOI:10.4103/ijpm.ijpm_174_24

Am J Hum Biol. 2025 Jun;37(6):e70075. doi: 10.1002/ajhb.70075.

ABSTRACT

OBJECTIVE: The relationship between cesarean delivery and infant growth is controversial. Therefore, the aim of this study was to evaluate the association between the type of delivery and the growth trajectory of Brazilian infants in the first year of life.

MATERIALS AND METHODS: This was a prospective cohort study conducted between 2016 and 2021 as part of the Araraquara Cohort Study that assessed quarterly anthropometry of 719 and 667 infants to evaluate, respectively, the effects of type of delivery on weight gain velocity (WGV) and length gain velocity (LGV) using generalized estimating equations.

RESULTS: The type of delivery was not associated with WGV or LGV in the first year of life. Higher mean WGV was observed among infants born to mothers with higher education, male infants, formula-fed infants, and those with the lowest birth weight, while infants with diarrhea had lower mean WGV. Higher mean LGV was found among formula-fed infants and infants born to taller mothers, while infants with the highest length at birth had lower LGV.

CONCLUSION: The factors that explain WGV and LGV in this population are more closely related to maternal characteristics such as height and educational attainment, birth characteristics, feeding behavior, and morbidity than to the type of delivery.

PMID:40485396 | DOI:10.1002/ajhb.70075

J Integr Complement Med. 2025 Jun 9. doi: 10.1089/jicm.2024.0744. Online ahead of print.

ABSTRACT

Background: Evidence regarding the optimal dosage of forest therapy is limited. The aim of this study was to compare the effects of two dosages of standardized forest therapy sessions on participant-reported outcomes in the general population. This study also explored whether these effects depended on a specific forest location. Methods: In this randomized controlled multisite trial taking place in three different German forests, participants of the general population were assigned to either a two-session group (2SG) of forest therapy of 2 h each with a break-day in between or three consecutive sessions (3SG) of forest therapy of 2 h each. The primary outcome was the between-group difference of 2SG versus 3SG of forest therapy on Total Mood Disturbance (TMD) using the Profile of Mood States (POMS) at day 3, immediately postintervention. Secondary outcomes were vitality (SVS-G), self-efficacy (GSE), physical/mental health (PH/MH), anxiety (STAI), physical symptoms (BLR/BLR’), perceived stress (PSQ), and perceived benefits of nature (PBNQ). A subset of questionnaires was used before and after each session (POMS, STAI, SVS-G, and PSQ). Pre- and postintervention differences were computed for comparisons within each group and between them using t test statistics, while analysis of variance (ANOVA) tested for differences between forests. Results: One hundred and seventy-one participants (91 in 2SG and 80 in 3SG; 56.1 ± 14.5 years) were included in the intention-to-treat analysis. No significant group differences were found for the TMD (p = 0.99), although there was an overall improvement in both groups (TMD: within-group p < 0.001 for both, 2SG: d = 0.95, 3SG: d = 0.81). No significant group differences were found for any secondary outcomes, although significant improvements were seen within groups for most outcomes. The ANOVA revealed neither statistically significant interactions between the three forests nor statistically significant interactions between the factors “group” and “location” for TMD. Conclusions: Participation in two versus three sessions of standardized forest therapy sessions with 2 h each may have similar beneficial effects on physical/mental health parameters in the general population. A low-dose approach may already achieve beneficial effects on mental health. These findings can provide evidence for the possible implementation of forest therapy as a therapy form in Germany.

PMID:40485383 | DOI:10.1089/jicm.2024.0744

Indian J Pathol Microbiol. 2025 Jun 7. doi: 10.4103/ijpm.ijpm_383_24. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal carcinoma (CRC) is a heterogeneous disease caused by multiple genetic and environmental alterations. One of these molecular alterations is microsatellite instability (MSI) caused by mutation of MMR proteins (MLH1, PMS2, MSH2, and MSH6). This study aimed to evaluate immunohistochemical (IHC) expression of MMR proteins in CRC and its correlation with clinicopathological findings in a sample of Iraqi patients.

MATERIALS AND METHODS: A retrospective study included 35 patients with CRC from January 2023 to January 2024. Sections from formalin-fixed paraffin-embedded tissue were used and stained immunohistochemically using (MLH1, PMS2, MSH2, and MSH6) markers.

RESULTS: The mean age of CRC was 59.7 ± 9.9 years, 45.7% of cases were located in the rectosigmoid. Most cases (88.6%) were adenocarcinoma and (97.1%) were moderately differentiated, 54.3% had T3 stage, and 65.7% had no lymphovascular invasion. Six cases (17.12%) had MSI (8.6% had loss of MSH6 and 8.6% had combined loss of MLH1 and MSH2), all were under 50 years of age, four (66.6%) cases were females, three (50%) cases located in the descending colon, four cases (66.6%) had mucinous carcinoma, three (50%) cases had T3 stage, three (50%) had nodal metastasis, and four cases (66.6%) had lymphovascular invasion.

CONCLUSION: This study shows that MSI has a highly significant association with young age and mucinous carcinoma. The combined loss of MLH1 and MSH2 was statistically and highly significant than other combinations. IHC is a simple process to detect MSI status and guide oncologists in determining treatment options such as conventional chemotherapy or immunotherapy.

PMID:40485379 | DOI:10.4103/ijpm.ijpm_383_24