Tag: nevin manimala

Ultrasound Obstet Gynecol. 2025 Feb;65(2):198-205. doi: 10.1002/uog.29169.

ABSTRACT

OBJECTIVE: To investigate the correlation between the number, location and size of uterine fibroids and the incidence of late miscarriage during pregnancy.

METHODS: This was a retrospective, multicenter cohort study of singleton pregnancies, with a live fetus at the first-trimester ultrasound examination, without known genetic anomalies or major fetal defects, from January 2012 to December 2022. We assessed the impact of fibroids and their characteristics, identified on ultrasound imaging at 11 + 0 to 13 + 6 weeks, on the risk of late miscarriage occurring at 11 + 0 to 21 + 6 weeks. Fibroid number, location and size were investigated, and adjusted odds ratios (aORs) with 95% CIs were calculated using multiple logistic regression and propensity score analysis via inverse probability of treatment weighting (IPTW) to minimize confounding. Singleton pregnancies without uterine fibroids comprised the control group. We further calculated the adjusted absolute risk (aAR) for the control group and the adjusted risk differences (aRD) for the study groups.

RESULTS: In total, 31 355 singleton pregnancies were analyzed, of which 942 (3.0%) had uterine fibroids. Multiple logistic regression analysis showed that pregnancies with a single fibroid did not have higher odds for late miscarriage compared to those without fibroids (aOR, 1.2 (95% CI, 0.6-2.4)), but women with multiple fibroids did have higher odds of late miscarriage (aOR, 2.5 (95% CI, 1.0-6.2)). Similarly, multiple logistic regression analysis after IPTW did not find higher odds of late miscarriage in pregnancies with a single fibroid (aOR, 1.7 (95% CI, 0.9-3.0) and aRD, 0.7% (95% CI, -0.2 to 2.1%)) but revealed increased odds of late miscarriage in women with multiple fibroids (aOR, 2.9 (95% CI, 1.1-7.3) and aRD, 2.0% (95% CI, -0.6 to 9.7%)). Analysis of the location of single fibroids revealed that submucosal fibroids significantly increased the odds of late miscarriage by 4.7 times, while the presence of fibroids in other locations did not have a statistically significant association with late miscarriage. When we limited our study population to cases with submucosal and intramural fibroids, logistic regression showed no significant increase in the odds of miscarriage for a single fibroid (aOR, 1.8 (95% CI, 0.9-3.5) and aRD, 1.2% (95% CI, -0.1 to 3.1%)), but revealed significantly higher odds for multiple fibroids (aOR, 3.8 (95% CI, 1.4-10.6) and aRD, 5.1% (95% CI, 0.6-22.0%)) compared with controls. IPTW analysis found a 2.3-fold increase in the odds of late miscarriage for a single fibroid (aOR, 2.3 (95% CI, 1.2-4.2)) and an even larger increase in the odds of late miscarriage for multiple fibroids (aOR, 5.7 (95% CI, 2.2-15.1)).

CONCLUSION: Uterine fibroids are associated with increased odds of late miscarriage, particularly when they are multiple and submucosal. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.

PMID:39894923 | DOI:10.1002/uog.29169

Ultrasound Obstet Gynecol. 2025 Feb;65(2):226-234. doi: 10.1002/uog.29155.

ABSTRACT

OBJECTIVES: Ultrasound is the first-line imaging modality of the pelvis in the pediatric and adolescent gynecology (PAG) population. Ultrasound findings in pre- and postpubertal PAG patients differ from those in adults. Diagnostic models for adnexal pathology have not been validated in this cohort. The primary aim of this study was to evaluate normative findings and the incidence of pathology in this cohort. The secondary aim was to assess the performance of expert opinion alone, as well as using retrospective application of the International Ovarian Tumor Analysis (IOTA) simple rules (SRs) and benign descriptors (BDs) in those found to have an adnexal mass.

METHODS: This was a retrospective review of pelvic ultrasound examinations performed in patients < 18 years of age from January 2017 to July 2021 in one expert center in the UK. Analysis was performed on three age groups: neonatal (aged < 1 year), premenarchal (aged ≥ 1 year) and postmenarchal. The study was locally approved as an audit (GRM_082). Expert review of images of ovarian masses was performed using retrospective application of the IOTA-SRs and IOTA-BDs.

RESULTS: In total, data on 1429 pelvic ultrasound examinations were retrieved, of which 116 were excluded, resulting in the inclusion of 1313 ultrasound images (1145 patients). The median age at the first ultrasound scan was 2 days after birth in the neonatal group (n = 20), 8.8 years in the premenarchal group (n = 124) and 16.1 years in the postmenarchal group (n = 961). The status of menarche was unknown in a further 40 patients. Normative ultrasound findings were in keeping with those in the existing literature. Uterine anomalies were seen in 14 (1.2%) patients. Endometrial pathology was rare, with five cases of gestational trophoblastic disease. The most frequent indication for ultrasound scan for each group were a known medical condition in neonates (n = 11 (55.0%)), suspected precocious puberty in premenarchal girls (n = 38 (30.6%)) and abnormal vaginal bleeding in postmenarchal girls (n = 504 (52.4%)). Polycystic ovarian appearances were described in 150 (15.6%) postmenarchal girls. Adnexal pathology was identified in 102 (8.9%) participants on initial ultrasound: four neonates, three premenarchal and 95 postmenarchal patients. Benign cystadenomas and hemorrhagic cysts were the most common adnexal mass type in all groups. Final outcomes were available for 79/95 masses in the postmenarchal group, none of which were malignant. The IOTA-SRs, IOTA-BDs, expert opinion and standard ultrasound reporting could characterize as benign 96.2%, 87.3%, 98.7% and 77.2% of the masses, respectively, all with a specificity of 100%. Eleven patients underwent 12 surgeries overall (three oophorectomies, six cystectomies and three cyst aspirations), with 11 out of 12 masses classified as benign based on retrospective expert assessment.

CONCLUSIONS: Ultrasound is effective for assessment of the female pelvis in the PAG population. Adnexal masses are common, but few require surgical intervention and most resolve expectantly. The IOTA-BDs and IOTA-SRs maintain their performance in this population. Larger studies are required for the prospective validation of diagnostic models which may aid a fertility-sparing approach to care. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

PMID:39894922 | DOI:10.1002/uog.29155

Rural Remote Health. 2025 Feb;25(1):9170. doi: 10.22605/RRH9170. Epub 2025 Feb 2.

ABSTRACT

INTRODUCTION: The third objective of the UN Sustainable Development Goals (SDGs), ‘ensure healthy lives and promote well-being for all at all ages’, is manifest in Indonesia’s commitment to health. One of the SDG3 targets is to reduce under-five mortality and infant mortality. In rural areas of Indonesia, there is a lack of access to medical facilities (healthcare services, anthropometry tools) and health workers, so low birth weight (LBW, <2500 g) in rural areas remains high. This study aimed to determine the profile of and test the factors that cause LBW in Indonesia.

METHODS: This study used secondary data from the National Socio-Economic Survey/Survei Sosial Ekonomi Nasional (SUSENAS) 2021 with a national sample of 4 711 455 women (weighted), which is analyzed descriptively and inferentially. The analysis was conducted descriptively to determine the profile and distribution of LBW at the national and provincial levels, while inferential analysis was performed using logistic regression to determine the variables that most influence LBW.

RESULTS: The prevalence of LBW in Indonesia was found to be 11.7%. North Maluku was the province with the highest LBW rate (20.1%), and West Java had the highest number of LBW infants in Indonesia, with 104 585 infants. This study found that smoking, rural areas, poor nutrition, age of childbirth, age and birth spacing significantly affected the incidence of LBW in Indonesia. In rural Indonesia, women tend to give birth to LBW babies (adjusted odds ratio: 1.249; 95%CI: 1.241-1.256). The incidence of LBW babies in rural areas was higher than in urban areas (12.9% v 10.8%) in Indonesia.

CONCLUSION: This study concluded that smoking behavior is the main variable that influences the incidence of LBW in Indonesia. Therefore, there should be assistance to families by prioritizing significant factors for LBW (living in a village/rural area, low education, smoking behavior, not or rarely consuming nutritious food, maternal age at first birth 35 years and birth spacing <33 months). Especially for rural areas, governments need to improve access to healthcare facilities including availability of anthropometry tools, health workers, and healthcare services.

PMID:39894906 | DOI:10.22605/RRH9170

Lasers Med Sci. 2025 Feb 3;40(1):60. doi: 10.1007/s10103-025-04326-w.

ABSTRACT

Verrucous venous malformation (VVM) is a rare vascular malformation with hyperkeratosis. Concomitant laser and surgery are first line treatments, but evidence establishing efficacy is limited. We assess the efficacy of laser alone for VVM. Retrospective analysis of patients receiving laser treatment for VVM between 1994-2023. Of 83 patients, 29 were excluded due to missing data, 7 due to concomitant surgical excision and 47 were evaluated. Pulse dye laser (PDL) and combined dual PDL-neodymium-doped yttrium aluminium garnet (PDL-Nd:YAG) lasers were used. Outcomes were difference in percentage surface area (SA) reduction and colour improvement after laser treatment. Two blinded healthcare professionals independently graded the VVMs. Tools used included a numerically graded colour chart, and a 10 × 10 surface area grid to assess pre/post photos printed to the same scale. Mean Joules delivered with PDL; 9.29 and PDL-Nd:YAG; 9.16. Spot size (mm) for PDL; 8.58 and PDL-Nd:YAG; 9.63. Mean number of treatments was 5.27 and 3.68 in red and purple lesions respectively. Mean SA reduction for red and purple lesions; PDL; 71.11% and 6.67%, and PDL-Nd:YAG; 54.30% and 32.35%. Mean colour improvement in red and purple; PDL; 53.13% and 8.59%, and PDL-Nd:YAG; 46.88% and 40.81%. Red responded better than purple (p = 0.0014 and p = 0.024), for SA and colour respectively. There was no statistical significance in better outcomes; age at first treatment or number of treatments. Laser alone is an effective non-invasive method for improvement of colour and SA. Red lesions responded better to laser. PDL-Nd:YAG laser is preferred in purple lesions.

PMID:39894904 | DOI:10.1007/s10103-025-04326-w

J Cancer Educ. 2025 Feb 3. doi: 10.1007/s13187-025-02570-w. Online ahead of print.

ABSTRACT

This study aims to explore disparities in cancer treatment decision-making and the factors associated with the decision to pursue treatment. We used Behavioral Risk Factor Surveillance System (BRFSS) data collected between 2017 and 2022. We employed the PRECEDE-PROCEED model to guide our analysis of factors associated with treatment decisions. Descriptive statistics and multivariable logistic regression analysis were conducted to assess the association between treatment decision-making and the predisposing, enabling, and reinforcing factors (following the PRECEDE-PROCEED model). All analyses were weighted and adjusted for the demographic characteristics of the participants. Our sample included N = 19,388 cancer patients, 20.98% of whom refused treatment. American Indians, younger adults, and breast cancer patients were more likely to decide to go for treatment. Patients who had private insurance (OR = 1.25, P = .037) and those who did not have problems affording care (OR = 1.22, P = .02) were more likely to decide to get treatment. The more patients had regular doctors, the more they decided to continue to pursue treatment for cancer (Only one doctor: OR = 1.20, P = .042; More than one: OR = 1.28, P = .007). Finally, the more days patients experienced a bad health situation, the more they decided to have cancer treatment (for 14 + days with bad health: OR = 1.20, P < .001). The results suggest the need for enhanced patient education to improve cancer treatment adherence and informed decision-making. It highlights the importance of culturally tailored educational programs, age-related concerns, addressing financial barriers, and emphasizing the importance of regular healthcare visits for cancer patients.

PMID:39894898 | DOI:10.1007/s13187-025-02570-w

BMC Public Health. 2025 Feb 2;25(1):422. doi: 10.1186/s12889-025-21535-8.

ABSTRACT

BACKGROUND: Type 2 diabetes (T2D) disproportionately affects individuals of South Asian descent. Additionally, diabetes distress (DD) may lead to complications with diabetes management. This study examines the prevalence of DD among foreign-born individuals of South Asian descent in New York City (NYC) and its association with sociodemographic and clinical factors.

METHODS: Baseline data was collected from the Diabetes Research, Education, and Action for Minorities (DREAM) Initiative, an intervention designed to reduce hemoglobin A1c (HbA1c) among South Asian individuals with uncontrolled T2D at primary care practices in NYC. The Diabetes Distress Scale (DDS) measured DD, and Core Healthy Days Measures assessed physical and mental healthy days. Sociodemographic variables were analyzed using descriptive statistics, Chi-square tests assessed categorical variables, and Wilcoxon Rank Sum tests evaluated continuous variables (Type I error rate = 0.05). Logistic regression models examined associations between HbA1c, mental health, and other covariates with dichotomized DD subscales.

RESULTS: Overall, 414 participants completed the DDS at baseline (median age = 55.2 years; SD = 9.8). All were born outside of the US; the majority were born in Bangladesh (69.8%) followed by India, Pakistan, and Nepal (24.7%) and Guyana and Trinidad and Tobago (5.5%). High emotional burden, regimen-related distress and physician-related distress were reported by 25.9%, 21.9%, and 6.2% of participants, respectively. In adjusted analyses, individuals with ≥ 1 day of poor mental health had higher odds of overall distress (OR:3.8, p = 0.013), emotional burden (OR:4.5, p < 0.001), and physician-related distress (OR:4.6, p = 0.007) compared to individuals with no days of poor mental health. Higher HbA1c (OR:1.45, p = < 0.001) was associated with regimen-related distress; and lower emotional support was associated with overall distress (OR:0.92, p < 0.001) and regimen-related distress (OR:0.95, p = 0.012). Individuals born in Bangladesh had significantly lower odds of overall distress, emotional burden, and regimen-related distress compared to individuals born in Guyana and Trinidad and Tobago.

CONCLUSIONS: Findings highlight the rate and risk factors of DD among individuals of South Asian descent living in NYC. Screening for DD in patients with prediabetes or diabetes should be integrated to address mental and physical health needs. Future research can benefit from a longitudinal analysis of the impact of DD on diabetes self-management and health outcomes.

TRIAL REGISTRATION: This study uses baseline data from “Diabetes Management Intervention for South Asians” (NCT03333044), which was registered with clinicaltrials.gov on 6/11/2017.

PMID:39894868 | DOI:10.1186/s12889-025-21535-8

Sci Rep. 2025 Feb 2;15(1):4026. doi: 10.1038/s41598-025-88651-8.

ABSTRACT

Duchenne muscular dystrophy (DMD) is a severe neuromuscular disease due to loss of dystrophin, leading to progressive muscle wasting and physical inactivity. In this pilot study, we studied the effect of daily supplementation of the anabolic substrate beta-hydroxy-beta-methylbutyrate (HMB) on whole body protein and amino acid kinetics using novel isotope methods and daily activity in a canine model of DMD. Six DMD dogs were administered 3 g daily of HMB or placebo for 28 days according to a randomized, placebo-controlled, double-blinded crossover design. We measured pre- and post-intervention daily activity, biochemistry markers, and whole-body amino acid kinetics. We tracked daily activity with an activity monitoring device and measured plasma creatine kinase and standard clinical biochemistry panels to monitor muscle and organ function. To calculate whole body and intracellular amino acid production, we administered in the postabsorptive state an IV stable isotope solution containing 20 amino acid tracers. We collected blood before and six times after until two hours post tracer pulse administration and measured amino acid enrichments and concentrations by LC-MS/MS, subsequently followed by (non) compartmental modeling of the decay enrichment curves. Results were expressed as mean with 95% CI. Whole body production, plasma concentrations, and intra-/extracellular compartmental analyses of various amino acids were attenuated in HMB-dosed DMD dogs. Specifically, the plasma concentration of hydroxyproline (marker of collagen breakdown) was significantly higher in the placebo group compared to the HMB group. The intra- and extracellular pool sizes and flux between the two compartments of hydroxyproline was reduced in HMB treated dogs. DMD dogs treated with HMB as compared to placebo had a respective 40% increase in exertional (play) (951 [827, 1075] versus 569 [491, 647]; p < 0.0001) and 10.5% increase in non-exertional (active) activity (15,366 [14742, 15990] versus 13,806 [13148,14466]; p = 0.0016). In addition, a 6% reduction was found in rest time after HMB supplementation compared to placebo (23,857 [23,130, 24,584], versus 25,363 [24500, 26225]; p = 0.0122). Creatine kinase was not statistically different between groups. We did not observe any adverse clinical or biochemical-related effects of HMB dosing. Daily HMB supplementation in DMD dogs can safely and positively influence protein and amino acid metabolism and improve overall daily activity.

PMID:39894866 | DOI:10.1038/s41598-025-88651-8

Breast Cancer Res Treat. 2025 Feb 2. doi: 10.1007/s10549-025-07624-7. Online ahead of print.

ABSTRACT

PURPOSE: This study explored changes in employment and financial hardship following breast cancer diagnosis.

METHODS: We used data from a single-institution, longitudinal study of women with newly diagnosed breast cancer who received curative intent chemotherapy. The primary outcomes of interest in this analysis were breaks in active employment, defined as being out of work for the four weeks prior, and patient-reported acute financial burden during chemotherapy and up to 24 months following chemotherapy completion. Mixed-effects logistic regression models were used to identify factors associated with breaks in employment and financial burden.

RESULTS: The cohort consisted of 104 women who were employed at time of breast cancer diagnosis. The mean age was 49.6 years and 86% were non-Hispanic White, 11% African American or Black, and 4% another race or ethnicity. In multivariable models, African-American women were 168% more likely to report a break from active employment than their non-Hispanic white counterparts (adjusted odds ration [aOR] 2.68; p = 0.026). A break from active employment was not statistically associated with greater self-reported acute financial burden, but patients from the lowest socioeconomic status tertile were 173% more likely to report financial burden than those in the highest tertile (aOR 2.73; p = 0.022).

CONCLUSION: African-American breast cancer survivors were more likely to report breaks from active employment than their White peers, even after adjusting for type of work and socioeconomic status.

IMPLICATION FOR CANCER SURVIVORS: African-American and Black breast cancer survivors may face greater challenges returning to work.

PMID:39894861 | DOI:10.1007/s10549-025-07624-7

BMC Oral Health. 2025 Feb 2;25(1):179. doi: 10.1186/s12903-025-05448-x.

ABSTRACT

PURPOSE: This study compares the effect of conventional cigarette smoke versus heated tobacco on the discoloration, surface roughness, and bacterial colonization of different oral prosthesis materials.

MATERIALS AND METHODS: A total of one hundred and twenty disc-shaped samples made of four different denture base materials were prepared to represent different denture bases to assess the surface roughness and biofilm formation; group (CA): conventional heat-cured acrylic resin (Acrostone, Egypt), group (FA): flexible acrylic resin (Valplast International Corp, USA), group (TA): heat-cured acrylic resin reinforced with titanium nanoparticles (TA nanoparticles, Nanogate, Egypt), and group (PA): 3D printed acrylic resin (Nexdent, The Netherlands). Another sixty samples of artificial and 3D printed teeth were used to assess the color change: conventional ready-made acrylic resin teeth (Acrostone, Egypt) and 3D-printed acrylic resin teeth (Nexdent, The Netherlands). Each group was further divided according to the smoking method into three subgroups (n = 10): the no-smoking exposure group (C), the conventional smoking exposure group (CS), and the heated tobacco exposure group (HT). A custom-made smoking device was used to perform the experiment. Six hundred cigarettes/heets representing 30 days of medium smoking behavior (20 cigarettes/day) were used. The surface roughness of the disc-shaped samples was measured before and after the experiment using the JITAI8101 surface roughness tester (Beijing Jitai Tech Detection Device Co., Ltd, China), and the color parameters were assessed before and after the experiment using VITA Easyshade Advance 4.01 (VITA shade, VITA made, VITA).

RESULTS: The results showed that both conventional cigarette smoking and heated tobacco increased the surface roughness of the denture base disc samples. This change was statistically significant in all sample groups. Bacterial accumulation was also increased in all four denture base sample groups, with the heated tobacco causing greater bacterial accumulation than conventional cigarette smoke. Regarding the color change, conventional smoking caused a more significant color change than heated tobacco for both types of teeth used.

CONCLUSION: Both conventional smoke and heated tobacco affect dental materials adversely. Conventional cigarette smoking caused greater surface roughness and discoloration of the samples, while heated tobacco resulted in greater bacterial accumulation of study materials.

CLINICAL IMPLICATIONS: Increase dentists’ and patients’ awareness of the effects of different types of smoke.

PMID:39894835 | DOI:10.1186/s12903-025-05448-x

BMC Public Health. 2025 Feb 2;25(1):417. doi: 10.1186/s12889-025-21531-y.

ABSTRACT

BACKGROUND: Childhood adversity places individuals in a vulnerable position, resulting in potentially enduring disadvantage across life domains like health and work. Studying the manifestation of this disadvantage is crucial for understanding which resources society can provide to mitigate or prevent it, which makes this subject a fundamental public health concern. This study investigated whether disadvantage patterns after childhood adversity differ by gender and educational level, using out-of-home care as proxy for early adversity.

METHODS: We used register data from a 1953 Swedish birth cohort. Distinct profiles of socioeconomic and health disadvantage in individuals with out-of-home care experience were identified using group-based multi-trajectory modelling. Multinomial logistic regression was then used to determine whether gender and education, individually or in interaction with each other, predict group membership.

RESULTS: In the population without history of out-of-home care, adulthood disadvantage was highly gendered, with women being more likely to experience disadvantage related to unemployment and poor health, while criminality and substance misuse was more common among men. History of out-of-home care was associated with a general increase in adulthood disadvantage, but the gender differences were largely absent. Women in this group were however less likely than men to experience disadvantage across multiple life domains (complex disadvantage OR = 0.56, p = 0.046; unemployment-related disadvantage OR = 0.51, p = 0.005). Higher level of education was associated with reduced likelihood of membership in the group marked by disabling health disadvantage (OR = 0.55, p = 0.002) and complex disadvantage (OR = 0.37, p = 0.001). An interaction term between gender and education was not significant.

CONCLUSIONS: Adulthood disadvantage was more common in the group with history of out-of-home care. The gender differences in disadvantage present in the full cohort were largely attenuated among individuals with out-of-home care history. We showed that using administrative data on outcomes across multiple life domains can provide rich descriptions of adult experiences after childhood adversity. Future research could examine gender differences in mechanisms translating into resilient or vulnerable trajectories, including the protective potential of education in relation to specific disadvantage patterns.

PMID:39894834 | DOI:10.1186/s12889-025-21531-y