Tag: nevin manimala

BMC Surg. 2025 Nov 3;25(1):518. doi: 10.1186/s12893-025-03272-2.

ABSTRACT

BACKGROUND: The aim of this study was to evaluate the clinical utility of the monocyte distribution width (MDW) as an early diagnostic biomarker for detecting postoperative complications in pancreatic surgery patients. Complications from pancreatic surgery, particularly pancreatic fistulas, significantly reduce patient survival rates. Compared with conventional markers, changes in the MDW may be detected earlier, facilitating timely intervention and potentially improving patient outcomes.

METHODS: The MDW, C-reactive protein (CRP) level, and white blood cell (WBC) count were measured preoperatively and on postoperative days 1, 3, and 7. Complications-including clinically relevant pancreatic fistulas (CR-POPF) and anastomotic leaks-were classified using standardized criteria. Statistical analysis involved ROC curves and multivariate modelling to assess diagnostic accuracy and independent predictors. This retrospective analysis of a prospectively collected cohort included 82 patients who underwent elective pancreaticoduodenectomy (PD) for cancer at a single centre between May 2021 and March 2024.

RESULTS: In this cohort of 82 patients with prospective data collection and retrospective analysis who underwent PD, the MDW emerged as a significant early predictor of postoperative complications. On postoperative day 3, the MDW was independently associated with CR-POPF (AUC 0.781; OR 1.31, p = 0.044) and anastomotic leaks (ΔMDW days 0-3: OR 1.30, p = 0.015). Compared with conventional markers, the MDW demonstrated superior diagnostic performance, with ROC AUC values ranging from 0.770 to 0.818 across different complications. A day 3 cut-off value of > 23.1 showed high sensitivity (84%) and yielded positive likelihood ratios of up to 3.7. Furthermore, the MDW on day 3 was moderately to strongly correlated with subsequent inflammatory markers, such as the CRP level, on day 7 (r = 0.468, p < 0.001). Multivariate models confirmed the independent prognostic value of the MDW for predicting overall complications, anastomotic leaks, and CR-POPF.

CONCLUSION: Compared with the CRP level and WBC count, the MDW demonstrated superior and earlier predictive ability for detecting postoperative complications. Its elevation by day 3 provided early warning, especially for CR-POPF and leaks. As a rapid, cost-effective marker available from routine blood counts, the MDW may enhance postoperative monitoring and guide timely intervention.

PMID:41184833 | DOI:10.1186/s12893-025-03272-2

BMC Pediatr. 2025 Nov 3;25(1):897. doi: 10.1186/s12887-025-06168-5.

ABSTRACT

BACKGROUND: This study aimed to evaluate the relationships among nutritional intake, malnutrition, and growth and development in children under 2 years of age with esophageal atresia.

METHODS: A survey was administered to the parents of healthy children and children with esophageal atresia who were followed up at Ankara City Hospital Pediatric Surgery Polyclinic. Nutrition education was provided, a follow-up visit was scheduled three months later, and the assessments were repeated.

RESULTS: The study included 20 children with esophageal atresia and 40 controls under 2 years of age. Height-for-age, weight-for-age and head circumference measurements were significantly lower in children with esophageal atresia than in the control group (p < 0.05). At the second interview, triceps skinfold thickness for age and mid-upper arm circumference for age were also significantly lower in children with esophageal atresia compared to control group (p < 0.05). Statistically significant differences were observed in dietary and food consistency preferences, eating status, and swallowing function (p < 0.05). In addition, according to the Pediatric Eating Assessment Tool-10 and Screening Tool for Risk of Impaired Nutritional Status and Growth, a high prevalence of swallowing disorders and a moderate risk of malnutrition were identified in children with esophageal atresia (p < 0.05). At the end of follow-up, significant increases in weight-for-age and height-for-age z scores were observed over time in children with esophageal atresia (p < 0.05). Furthermore, the percentages meeting daily requirements for protein, carbohydrates and dietary fiber increased over time (p < 0.05). Swallowing symptoms improved over time in children with esophageal atresia, and their current dietary patterns remained significantly different from those of the control group (p < 0.05).

CONCLUSIONS: Appropriate nutritional support delivered with a multidisciplinary approach and long-term follow-up can help children to achieve a growth rate appropriate for their peers.

PMID:41184828 | DOI:10.1186/s12887-025-06168-5

BMC Pediatr. 2025 Nov 3;25(1):893. doi: 10.1186/s12887-025-06276-2.

ABSTRACT

BACKGROUND: Hip dislocation in children with cerebral palsy (CP) presents significant challenges, including pain, and severe contractures, which impair positioning, sitting, standing, and walking. This study investigated the prevalence and factors associated with hip displacement in a cohort of children with CP in a resource-limited setting lacking a dedicated hip surveillance program.

METHODS: A cross-sectional study was conducted from August 1, 2023, to January 30, 2024, at Tikur Anbesa Hospital, Ethiopia’s largest tertiary hospital. The study included 141 children with CP who met the inclusion criteria and underwent hip radiography. The hip migration percentage was assessed, with hip subluxation defined as a migration percentage between 30% and 80% and hip dislocation defined as a percentage greater than 80%. The migration percentages were analyzed in relation to sociodemographic and clinical data via statistical tests.

RESULTS: The study cohort predominantly consisted of children with spastic tetraplegic CP (56.7%), and 52.6% had GMFCS levels IV and V. A high comorbidity rate was observed, with 98% of the children having additional conditions, the most common being epilepsy (59%). The prevalence of hip displacement was 28%, with 88% of these cases classified as hip subluxation and nearly 11% as dislocation. Displacement was more common in the left hip (56.4%) than in the right hip or both hips. Osteopenia was present in 3.5% of the children. Factors associated with hip displacement included home rehabilitation, frequency of carrying by caregivers, GMFCS levels, and being aged 5-10 years.

CONCLUSIONS: This study highlights the significant prevalence of hip displacement among children with CP in a resource-limited setting, despite being managed at a tertiary hospital. The findings underscore the need for the implementation of hip surveillance programs and timely interventions to prevent or mitigate hip displacement, thereby enhancing the quality of life and functional outcomes of these children.

PMID:41184821 | DOI:10.1186/s12887-025-06276-2

BMC Cancer. 2025 Nov 3;25(1):1695. doi: 10.1186/s12885-025-15158-w.

ABSTRACT

BACKGROUND AND OBJECTIVES: Stomatitis is among the most debilitating complications of cancer treatment, particularly chemotherapy. The use of medicinal plants has been suggested as a potential therapeutic approach to mitigate this condition. This study aimed to evaluate the effect of Malva sylvestris (mallow) mouthwash on chemotherapy-induced stomatitis in cancer patients.

MATERIALS AND METHODS: This triple-blind randomized clinical trial was conducted in 2024 on 70 cancer patients with chemotherapy-induced stomatitis who attended medical centers in an urban area of Iran. Participants were randomly allocated to two groups using the minimization method. The intervention group received 15 ml of Malva sylvestris mouthwash three times daily for 14 days, while the control group received standard chlorhexidine mouthwash. The severity of stomatitis and associated pain were assessed at baseline and on days 3, 7, and 14 using the World Health Organization (WHO) Mucositis Scale and the Visual Analog Scale (VAS) for pain, respectively. Data were analyzed using SPSS version 22.

RESULTS: Before the intervention, no statistically significant differences were observed in mean stomatitis or pain scores between the two groups. By day 7, the intervention group demonstrated significantly lower mean scores for both stomatitis and pain compared with the control group (P < 0.001). Moreover, the reduction in stomatitis severity over time was greater in the intervention group than in the control group (P < 0.05). On day 14, although the intervention group maintained lower mean stomatitis scores, the difference between the two groups was not statistically significant (P = 0.08).

CONCLUSION: The findings suggest that Malva sylvestris mouthwash has a beneficial effect in reducing the severity of stomatitis and associated pain in patients undergoing chemotherapy. Therefore, its use may be recommended as a supportive intervention for patients, caregivers, and healthcare professionals involved in cancer care.

TRIAL REGISTRATION: Trial registration number: IRCT20150713023190N15. Date of registration: 2024/07/20.

PMID:41184820 | DOI:10.1186/s12885-025-15158-w

BMC Infect Dis. 2025 Nov 3;25(1):1484. doi: 10.1186/s12879-025-11966-4.

ABSTRACT

BACKGROUND: Measles remain a significant public health concern, especially in Botswana, where sporadic and silent epidemics continue to challenge existing control measures. This study aimed to determine the health system and caregivers related factors influencing measles vaccine uptake.

METHODS: A cross-sectional study was conducted between September and October 2024 in Chadibe village. The facility registers served as the data source and the study analyzed information from 201 under-fives records with a follow up caregivers questionnaire used to capture information on sociodemographic variables and health system related factors. Statistical analysis involved frequencies, bivariate and multivariate logistic regression.

RESULTS: Our study revealed that 82.6% of children received first dose of measles vaccine, while 50.2% received the second dose. Both figures are lower than the WHO target. The key determinants related to two doses of measles vaccination include care giver characteristics and health system related. Caregivers aged 18-25 years (OR: 4.42; 95% C.I: 1.22-16.00, P = 0.023), 26-30 years (OR: 1.71; 95% C.I: 0.59-4.94) and 31-35 years of age (OR: 2.74; 95% C.I: 1.026-7.36) were more likely to get their children immunized. Care givers who walked to the health facility (OR: 2.28;95% CI:0.86-6.00), used public transport (OR:1.94; 95% CI 0.74-5.06) found vaccine to be always available (OR 12.8;95%CI: 2.24-73.92, P 0.004) sometimes available (OR 7.09;95% CI: 1.45-34.60, P0.01) were associated with the likelihood to have their children fully vaccinated. On multivariate analysis, caregivers who completed senior secondary education (AOR: 6.59; 95% CI: 1.02-7.36, P = 0.01), working full time (AOR = 1.77, 95% CI: 0.64-4.92) travelled less than 5 km to the health facility (AOR: 3.47;95% CI: 1.49-8.10, P = 0.004), received fairly good quality of service (AOR:2.20; 95% CI: 1.02-4.73, P = 0.043) had measles vaccine information (AOR = 3.97, CI = 1.455-10.85,P = 0.007) were also more likely to immunize their children.

CONCLUSION: The complete dose of measles vaccination rate in Chadibe is still low compared to the first dose of measles vaccination and global target. This study provides valuable insights into the epidemiology of the Measles vaccination. The low vaccination uptake highlights the urgency of raising awareness about vaccine importance and strengthening routine immunization programs.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41184818 | DOI:10.1186/s12879-025-11966-4

BMC Psychiatry. 2025 Nov 3;25(1):1048. doi: 10.1186/s12888-025-07505-9.

ABSTRACT

BACKGROUND: Physically active persons frequently change their dietary intakes to get the best results in their exercises. These changes in dietary intakes, which are not healthy in some cases, might influence the risk of psychological disorders in them. In the present study, we investigated the association between adherence to the MIND diet and the odds of depression, anxiety, and sleep disturbances among physically active adults.

METHODS: A total of 684 participants were included in this cross-sectional study. Dietary intakes of study participants were assessed using a validated 168-item semi-quantitative Food Frequency Questionnaire (FFQ). The MIND diet score was calculated based on participants’ dietary intakes obtained from FFQ. To assess depression, anxiety, and sleep quality, the Beck Depression Inventory II (BDI-II), the Beck Anxiety Inventory (BAI), and the Pittsburgh Sleep Quality Index (PSQI) were used, respectively. All statistical analyses were conducted using SPSS (SPSS Inc., version 18).

RESULTS: After adjusting for the potential confounding factors, participants at the top tertile of MIND diet score were 51% less likely to have depression compared with those at the bottom tertile (OR: 0.69, 95% CI: 0.18, 0.90). We found no significant association between the MIND diet score and odds of anxiety (OR: 1.17; 95% CI: 0.71, 1.95) and sleep disturbances (OR: 1.25; 95% CI: 0.86, 1.81).

CONCLUSION: Our findings showed that more adherence to the MIND diet might be negatively associated with the odds of depression in physically active adults. No such significant association was found for the odds of anxiety or sleep disturbances. More studies are warranted.

PMID:41184816 | DOI:10.1186/s12888-025-07505-9

BMC Pregnancy Childbirth. 2025 Nov 3;25(1):1156. doi: 10.1186/s12884-025-08088-9.

ABSTRACT

OBJECTIVE: Heterogenous results were reported in the effects of hypoglycemia in pregnancy. This study evaluated pregnancy outcomes in women with hypoglycemia during the antenatal 75-gram oral glucose tolerance test (OGTT).

METHODS: OGTT results of the mothers of all live-born delivered in a tertiary obstetrics centre were evaluated between Jan 2021 and June 2022. All patients had OGTT at 26-30th weeks of gestation. Hypoglycemia was defined as any low plasma glucose ≤ 3.5mmol/L on OGTT. Maternal and neonatal outcomes were compared among the four groups; normal results (group 1), hypoglycemia in OGTT (group 2), gestational diabetes mellitus (GDM) (group 3) and pregestational diabetes mellitus (DM) (group 4).

RESULTS: There were 3715 women delivered within the study period and 3164 (85.2%) had normal results. 65 (1.7%) women had hypoglycemia, 464 (12.5%) women had GDM and 22 (0.6%) women had pregestational DM. None of the Group 2 patients were symptomatic. Maternal demographics were comparable. Patients with hypoglycemia during OGTT were not at an increased risk of preterm delivery (1.5% vs. 2.8%, p = 0.86). There was no statistical difference in the incidence of Caesarean Sect. (32.3% vs. 34.4%, p = 0.54), postpartum haemorrhage (10.8% vs. 14.7% p = 0.28). Women with hypoglycemia during OGTT were not at risk of adverse outcome in terms of neonatal intensive care unit admission (16.9% vs. 8.5%, p = 0.28) and Apgar score at 5th minute of life (9.8 vs. 9.8, p = 0.17).

CONCLUSION: Hypoglycemia in antenatal OGTT is not associated with adverse neonatal or maternal outcomes. It is likely to resolve after delivery.

PMID:41184800 | DOI:10.1186/s12884-025-08088-9

BMC Cancer. 2025 Nov 3;25(1):1687. doi: 10.1186/s12885-025-15140-6.

ABSTRACT

BACKGROUND: The clinical heterogeneity observed in chronic lymphocytic leukemia (CLL) is largely attributed to diverse underlying genomic alterations. Fluorescence in situ hybridization (FISH) remains the standard cytogenetic technique but is limited to predefined loci. As a genome-wide approach, optical genome mapping (OGM) facilitates the identification of structural variants (SVs), such as copy number variations (CNVs), offering a broader genomic perspective. This study was designed to compare the findings of FISH and OGM in a cohort of CLL patients. By integrating these two cytogenetic approaches, we sought to evaluate the potential of OGM in detecting additional or cryptic genomic alterations that may impact prognosis and therapeutic decision-making.

METHODS: Twenty newly diagnosed or treatment-naive CLL patients were analyzed using both FISH and OGM. SVs, CNVs, and chromosomal abnormalities were compared across methods. Concordance and discordance were evaluated, and OGM-specific alterations were examined for clinical relevance. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0. Given the limited sample size (n=20), only descriptive statistics were applied. Frequencies and percentages were used to summarize categorical variables, while continuous variables were expressed as median and range.

RESULTS: The cohort had a median age of 61.5 years (range: 44-83), with 60% male. No abnormalities were detected by either method in 2 patients. Among the remaining 18 patients OGM revealed 22 SVs, 32 CNVs, and 8 aneuploidies. In 3 patients, FISH results were negative, whereas OGM identified various abnormalities.

CONCLUSIONS: According to our results OGM identified additional chromosomal abnormalities not covered by the FISH panel in three of our patient cohort out of the five patients in whom FISH analysis had not detected any abnormalities, highlighting the potential to reshape prognostic algorithms in CLL. Our data emphasize the utility of OGM as a valuable adjunct to standard cytogenetic assessment.

PMID:41184797 | DOI:10.1186/s12885-025-15140-6

BMC Infect Dis. 2025 Nov 3;25(1):1486. doi: 10.1186/s12879-025-11834-1.

ABSTRACT

BACKGROUND: Interferon-gamma release assays (IGRAs) are widely used for detecting latent tuberculosis infection (LTBI). However, these tests can yield indeterminate results, posing challenges for clinical management. The management of these indeterminate outcomes varies, creating uncertainty in clinical practice. This study systematically evaluates the effectiveness of repeat IGRA testing versus additional tuberculin skin testing (TST) in resolving indeterminate IGRA results during LTBI screening.

METHODS: We conducted a systematic review and meta-analysis, searching PubMed, Embase, Web of Science, and the Cochrane Library databases on May 18, 2024, without start date or language restrictions. Studies were included if they screened for LTBI in healthy or high-risk populations using IGRA, reported indeterminate results, and managed these results with repeat IGRA testing and/or additional TST. A random-effects model was used to calculate pooled results.

RESULTS: A total of 59 studies were included in this analysis. Among these, 40 studies assessed the use of additional TST in individuals with indeterminate IGRA results, yielding a pooled confirmation rate of 98.6% (95% CI: 96.2-99.8%). Additionally, 27 studies examined repeat IGRA testing, which resulted in a pooled confirmation rate of 68.9% (95% CI: 57.0-79.6%). Furthermore, eight studies evaluated both TST and repeat IGRA testing, with the pooled confirmation rate for the TST being 93.7% (95% CI: 78.7-99.9%), higher than the pooled confirmation rate for repeat testing at 76.5% (95% CI: 44.6-97.1%). However, there was no statistically significant difference in the confirmation rates between the two testing methods (OR = 2.13, 95% CI: 0.47-9.76).

CONCLUSIONS: In managing indeterminate IGRA results during LTBI screening, head-to-head studies show no significant difference in confirmation rates between additional TST and repeat IGRA. Across nearly 60 studies, additional TST tends to have a slightly higher confirmation rate, though the difference is not statistically significant. Clinically, for patients with an initial indeterminate IGRA who are immunocompetent, with convenient sample collection or a need for rapid results, additional TST may help achieve more reliable outcomes. Selection of follow-up testing should consider the cause of indeterminate results, feasibility, and risk of patient loss to follow-up.

PMID:41184792 | DOI:10.1186/s12879-025-11834-1

BMC Musculoskelet Disord. 2025 Nov 3;26(1):1022. doi: 10.1186/s12891-025-09227-1.

ABSTRACT

PURPOSE: Artificial intelligence (AI) has become incredibly popular over the past several years, with large language models (LLMs) offering the possibility of revolutionizing the way healthcare information is shared with patients. However, to prevent the spread of misinformation, analyzing the accuracy of answers from these LLMs is essential. This study will aim to assess the accuracy of five freely accessible chatbots by specifically evaluating their responses to questions about patellofemoral instability (PFI). The secondary objective will be to compare the different chatbots, to distinguish which LLM offers the most accurate set of responses.

METHODS: Ten questions were selected from a previously published international Delphi Consensus study pertaining to patellar instability, and posed to ChatGPT4o, Perplexity AI, Bing CoPilot, Claude2, and Google Gemini. Responses were assessed for accuracy using the validated Mika score by eight Orthopedic surgeons who have completed fellowship training in sports-medicine. Median responses amongst the eight reviewers for each question were compared using the Kruskal-Wallis and Dunn’s post-hoc tests. Percentages of each Mika score distribution were compared using Pearson’s chi-square test. P-values less than or equal to 0.05 were considered significant. The Gwet’s AC2 coefficient was calculated to assess for inter-rater agreement, corrected for chance and employing quadratic weights.

RESULTS: ChatGPT4o and Claude2 had the highest percentage of reviews (38/80, 47.5%) considered to be an “excellent response not requiring classification”, or a Mika score of 1. Google Gemini had the highest percentage of reviews (17/80, 21.3%) considered to be “unsatisfactory requiring substantial clarification”, or a Mika score of 4 (p < 0.001). The median ± interquartile range (IQR) Mika scores was 2 (1) for ChatGPT4o and Perplexity AI, 2 (2) for Bing CoPilot and Claude2, and 3 (2) for Google Gemini. Median responses were not significantly different between ChatGPT4o, Perplexity AI, Bing CoPilot, and Claude2, however all four statistically outperformed Google Gemini (p < 0.05). Inter-rater agreement was classified as moderate (0.40 > AC2 ≥ 0.60) for ChatGPT, Perplexity AI, Bing CoPilot, and Claude2, while there was no agreement for Google Gemini (AC2 < 0).

CONCLUSION: Current free access LLMs (ChatGPT4o, Perplexity AI, Bing CoPilot, and Claude2) predominantly provide satisfactory responses requiring minimal clarification to standardized questions relating to patellar instability. Google Gemini statistically underperformed in accuracy relative to the other four LLMs, with most answers requiring moderate clarification. Furthermore, inter-rater agreement was moderate for all LLMs apart from Google Gemini, which had no agreement. These findings advocate for the utility of existing LLMs in serving as an adjunct to physicians and surgeons in providing patients information pertaining to patellar instability.

LEVEL OF EVIDENCE: V.

PMID:41184787 | DOI:10.1186/s12891-025-09227-1