Tag: statistics

BMC Pregnancy Childbirth. 2026 Jan 12. doi: 10.1186/s12884-026-08640-1. Online ahead of print.

ABSTRACT

INTRODUCTION: This study investigated inflammation-related co-morbidities in women with gastroesophageal reflux (GER) and poor gestational outcomes.

METHODS: A retrospective cohort of 17 women with GER and 207 without GER who were admitted to a pre-conceptional counseling program was analyzed. All patients were evaluated for the presence of risk factors associated with obstetric complications and poor gestational outcomes, including hereditary thrombophilia, methylenetetrahydrofolate reductase (MTHFR) polymorphisms, type 2 diabetes mellitus, chronic inflammatory diseases, and autoimmune disorders.

RESULTS: GER was present in 7.59% (17/224) of women, and 35.3% (6/17) of GER-positive cases had gastritis and/or chronic peptic ulcer disease. Chronic inflammatory and autoimmune diseases were significantly more frequent in women with GER (p = 0.001 and p = 0.002, respectively). There was also a statistically significant difference in the distribution of MTHFR 677CC, -CT, and -TT genotypes in terms of the presence of GER (p = 0.036). A higher frequency of the MTHFR 677TT genotype was observed in women with GER.

CONCLUSIONS: Presence of GER may be indicative of inflammation-associated “placenta-related obstetric complications” and poor gestational outcomes in subsequent pregnancies.

PMID:41526858 | DOI:10.1186/s12884-026-08640-1

BMC Pregnancy Childbirth. 2026 Jan 13. doi: 10.1186/s12884-025-08594-w. Online ahead of print.

ABSTRACT

BACKGROUND: Vaginal Birth After Cesarean is a clinical measure that can reduce repeated cesarean deliveries, improve perinatal outcomes and shorten hospital stays. However, successful practice of Vaginal Birth After Cesarean remains restricted in the Middle East due to limited regional-specific guidelines. This study aimed to identify the predictors and maternal and neonatal outcomes of failed Vaginal Birth After Cesarean among a group of Middle Eastern women.

METHODS: A retrospective case-control design was conducted between January 2023 and February 2024 across three hospitals in Oman. The case group involved failed Vaginal Birth After Cesarean requiring repeat cesarean, while the control group comprised successful Vaginal Birth After Cesarean. Descriptive and inferential statistics were used. Additionally, logistic regression analysis was conducted to identify significant predictors of failed vaginal birth after cesarean.

RESULTS: Data of 364 participants were analyzed. The predictors of Vaginal Birth After Cesarean failure were high body mass index (32.66 ± 7.53; p < .001), low parity (median = 1; p < .001), low cervical dilation (2 cm vs. 4 cm; p < .001), obstetric complications (42.6% vs. 29.2%; p = .010), and meconium-stained amniotic fluid (16.3% vs. 6.9%; p = .006). Postpartum hemorrhage (21.6% vs. 4.6%; p < .001), scar tenderness (11.5% vs. 0.5%; p < .001), and low APGAR scores (p < .001) were more common in the case group.

CONCLUSIONS: The study findings advance the regional literature with critical information supporting the development of standardized Middle Eastern specific Vaginal Birth After Cesarean guidelines. Higher body mass index, lower parity, lower cervical dilation at admission, meconium-stained amniotic fluid, and obstetric complications are significant predictors of Vaginal Birth After Cesarean failure. A failed Vaginal Birth After Cesarean attempt may increase the risks of post-partum hemorrhage, scar tenderness, and lower APGAR scores. Future research may prioritize prospective multicenter studies across diverse regions of the Middle East to validate the Vaginal Birth After Cesarean predictive variables.

PMID:41526856 | DOI:10.1186/s12884-025-08594-w

BMC Geriatr. 2026 Jan 12. doi: 10.1186/s12877-025-06911-8. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to determine the amount of fluid consumed, factors influencing fluid intake, and the symptoms of thirst in elderly individuals living in the community, and to examine the relationship between thirst discomfort, hydration status, and ocular surface health.

METHODS: The study employed a quantitative, cross-sectional, descriptive design and was conducted between July 2023 and December 2024, in the Aydıntepe district of Bayburt Province. The study included 110 individuals aged 65 and older who were able to communicate and agreed to participate. Data were collected through face-to-face interviews. Participants’ demographic information was recorded using the Introductory Information Form. The level of thirst discomfort was assessed with the Thirst Discomfort Scale (TDS); ocular symptoms were measured with the Ocular Surface Disease Index (OSDI). Information about urine colour and daily fluid consumption was obtained from the participants. The results were analysed using SPSS version 26.0. Descriptive statistics, t-test for independent groups, ANOVA, and Pearson correlation analysis were used to analyse the data.

RESULTS: The study found that the mean total TDS score was 20.61 ± 6.43, indicating moderate levels of thirst discomfort among elderly individuals. According to the OSDI results, individuals with severe ocular symptoms exhibited significantly higher discomfort related to thirst (F = 3.936, p = 0.010). A trend toward significance was observed between hydrated, moderately dehydrated, and dehydrated individuals regarding thirst discomfort levels; dehydrated individuals tended to have higher scores (F = 3.019, p = 0.053).

CONCLUSIONS: In elderly individuals, thirst discomfort was moderate, and ocular symptoms influenced the perception of thirst. The findings emphasise the importance of individualised approaches to thirst management and regular monitoring of hydration status in older adults.

CLINICAL RELEVANCE: Dehydration is a significant issue that can impact the quality of life for elderly individuals. Health professionals should regularly assess individuals’ hydration status and develop individualised strategies to improve fluid intake. Given the relationship between ocular surface disease symptoms and fluid intake, interventions should be planned using a multidisciplinary approach.

TRIAL REGISTRATION: Not applicable.

PMID:41526836 | DOI:10.1186/s12877-025-06911-8

J Headache Pain. 2026 Jan 13. doi: 10.1186/s10194-026-02271-9. Online ahead of print.

ABSTRACT

BACKGROUND: Trigeminal neuralgia, classified as a painful disorder of the trigeminal nerve (PDTN), is characterized by brief, electric shock-like or stabbing pain localized mainly to the maxillary and mandibular regions. The severity of these paroxysmal attacks severely impairs quality of life and, in extreme cases, may lead to suicidal ideation. We hypothesized that PDTN shares a common neuroanatomical signature with other chronic pain disorders, while also exhibiting disorder-specific alterations.

METHODS: High-resolution T1-weighted structural MRI scans from 85 individuals diagnosed with painful disorders of the trigeminal nerve (PDTN) and 49,280 control participants from the UK Biobank were analyzed. A non-parametric permutation test (10,000 iterations) randomly reassigned group labels between 85 PDTN cases and 85 individuals reporting no chronic pain or pain-related conditions to generate a null distribution for statistical inference. A second analysis compared the same PDTN group with 85 matched participants reporting chronic pain (excluding orofacial pain), using five covariates and nearest-neighbor matching (1:1 ratio).

RESULTS: Compared to individuals reporting no chronic pain, PDTN patients exhibited significant volumetric reductions in eight amygdala and nineteen thalamic nuclei, as well as eighteen hippocampal subfields. When compared to the chronic pain group, significant differences were restricted to six thalamic nuclei and seven hippocampal subfields.

CONCLUSIONS: These findings underscore that PDTN is associated with a distinct neuroanatomical signature, particularly involving subcortical structures such as the thalamus and hippocampus.

PMID:41526814 | DOI:10.1186/s10194-026-02271-9

Int J Radiat Biol. 2026 Jan 12:1-14. doi: 10.1080/09553002.2025.2606998. Online ahead of print.

ABSTRACT

BACKGROUND: When the same energy is delivered to a cellular target, DNA damage and the resulting cellular response may vary depending on the density and distribution pattern of the energy delivered to the critical volume of each cell. DNA damage can be quantitated based on the pattern of dose distribution over the sub-micrometer volumes in nucleus. DNA double-strand breaks (DSBs) are considered the most critical events for cellular effects. Local effect model (LEM), DNA damage model (DDM), and Giant LOop Binary LEsion (GLOBLE) model have been used to predict cell survival under radiation exposure.

PURPOSE: This study aims to implement computational modeling for prediction of cell survival under radiation exposure, by quantitating radiation events on cellular targets, such as local energy deposition and DSB production, in a unified frame. The conceptual bases of LEM, DDM, and GLOBLE model were adopted to derive parameters for radiation events.

METHODS: The physics models of Geant4-DNA were used to simulate the interactions of X-rays and alpha particles with bio-matter. Cell nucleus was modeled to be a collection of ${(540\text{nm})}^3$ sub-volumes. Statistical variation of energy deposition to individual sub-volumes was analyzed to count DSB production and DSB multiplicity. Cell surviving fractions (SFs) were calculated by LEM based on the distribution of local doses to sub-volumes and by DDM and GLOBLE model based on the DSB production and their potential interactions in sub-volumes. Model parameters were derived by fitting the models to experimental data for rat diencephalon (RD) cells and rat gliosarcoma (RG) cells.

RESULTS AND CONCLUSIONS: The overkill effect was reflected in the models based on LEM and DDM by employing threshold local dose and threshold number of DSBs in sub-volumes, respectively. Results suggest that the number of sub-volumes impacted with DSBs rather than the DSB multiplicity within individual sub-volumes would be better parameter to predict cell killing effect, which complies with the GLOBLE model.

PMID:41525142 | DOI:10.1080/09553002.2025.2606998

Clin Ter. 2026 Jan-Feb;177(1):146-152. doi: 10.7417/CT.2026.1986.

ABSTRACT

AIMS: Acute abdomen is a common indication to surgery in paediatric emergency departments. Appendicitis is the most frequent diagnosis, followed by bowel obstruction and female genital conditions. Some rare aetiologies may lead to challenges in surgical management. Aim of this study is to analyse the distribution of rare causes of acute abdomen in patients undergoing emergency surgery in the past five years at our centre.

METHODS: Records of patients undergone urgent abdominal surgery were retrospectively reviewed from 2015 to 2019. Information relative to age, sex, underlying pathology, and surgery was recorded. The inclusion criteria were age <18 years and undergoing abdominal surgery. Neonates were excluded.

RESULTS: The study population consisted of 957 patients. Median age was 9.7 years. Surgical procedure was laparoscopic in 22%, open in 78%. Common diagnoses were appendicitis in 815 patients, bowel obstruction in 72, adnexal and gynaecological pathology in 43, trauma in 9, complicated Meckel’s diverticulum in 8. Rare findings included omental pathology (2), endometriosis (2), ectopic pregnancy (1), intestinal duplication (1), internal hernia (1), Amyand’s hernia (1), epiploic appendix torsion (1), accessory spleen torsion (1).

CONCLUSIONS: The aetiologies of acute abdomen in children vary depending on the age. Appendicitis is the most common surgical cause of acute abdomen, followed by other causes. Differential diagnosis, including rare pathologies, is required to predict the right surgical approach and to apply the proper treatment. Imaging techniques sometimes still result too invasive or insufficient, whereas the widespread use of laparoscopy may render surgical exploration acceptable in selected cases.

PMID:41525125 | DOI:10.7417/CT.2026.1986

Clin Ter. 2026 Jan-Feb;177(1):130-138. doi: 10.7417/CT.2026.1984.

ABSTRACT

BACKGROUND: Osteoarthritis (OA) is a pathological condition widely prevalent throughout the world. The inability to perform some physical functions was the main symptom of OA and it impacted the quality of life (QOL) of patients. Therefore, TKR surgery was necessary to improve their QOL. However, to our knowledge, no study addressed the assessment of physical health and improvement in QOL before and after TKA in Saudi Arabia.

OBJECTIVE: To assess the QOL of patients before and after TKA.

METHODS: A cross-sectional study included 139 TKR patients with a mean age of 63.8±6.2 years. Data on sociodemographic characteristics, date of TKR surgery, and body mass index (BMI) were recorded. QOL was assessed (before TKR surgery and from 6 months to 3 years after surgery). The WOMAC, SF-12, and SF-36 physical health and QOL assessment scale questionnaires were sent to the participants and the results were obtained. Data and relationships were analyzed with SPSS, t-test, and ANOVA.

RESULTS: The mean WOMAC and SF-12 total scores after TKR surgery showed significant improvement compared to before surgery (14.3±5.7 vs. 61±6.1, p=0.001) and (56±4.8 vs. 38.5±7.4, p= 0.02) respectively. There was statistical significance for mean gender, educational level, date of surgery, and BMI with QOL scales.

CONCLUSIONS: Our results suggest that patients who had undergone TKR surgery at least six months prior reported improvements in physical health status and QOL according to the study scales WOMAC, SF-12, and SF-36, which are considered the most appropriate scales to evaluate the QOL of TKR patients.

PMID:41525123 | DOI:10.7417/CT.2026.1984

Clin Ter. 2026 Jan-Feb;177(1):123-129. doi: 10.7417/CT.2026.1983.

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder with both reproductive and metabolic manifestations. Subclinical hypothyroidism (SCH), is defined by elevated thyroid-stimulating hormone (TSH) with normal free thyroxine levels, is increasingly recognized in women with PCOS, yet its clinical impact remains debated. This study intended to explore the prevalence of SCH in PCOS and examine its influence on metabolic, hormonal, and anthropometric profiles in an Indian population.

METHODS: A cross-sectional study was conducted between January 2023 and January 2025 at a tertiary care center in South India. A total of 368 women with PCOS, diagnosed according to Rotterdam criteria, were enrolled and classified as either euthyroid (n = 316) or having SCH (n = 52). Comprehensive evaluations included anthropometry, blood pressure, glycemic indices, lipid profile, insulin resistance via HOMA-IR, and reproductive hormone levels. Statistical analyses included t-tests and Spearman correlation.

RESULTS: The prevalence of SCH among women (with PCOS) was 14.13%. Compared with the euthyroid group, SCH-PCOS patients exhibited significantly higher BMI, fasting blood glucose, HbA1c, serum insulin, HOMA-IR, and adverse lipid profiles (p < 0.05). No significant diffe-rences were observed in LH, FSH, or testosterone levels. TSH demonstrated positive correlations with BMI, Glycemic markers, and HOMA-IR, underscoring its association with metabolic risk.

CONCLUSION: SCH is a common and metabolically relevant comorbidity in women with PCOS, aggravating insulin resistance and dyslipi-demia without significantly affecting reproductive hormones. These findings highlight the need for routine thyroid function screening in PCOS management, especially among those with metabolic syndrome features. Further longitudinal studies are warranted to evaluate the benefits of targeted thyroid intervention in this subgroup.

PMID:41525122 | DOI:10.7417/CT.2026.1983

Clin Ter. 2026 Jan-Feb;177(1):100-103. doi: 10.7417/CT.2026.1980.

ABSTRACT

BACKGROUND: Hypertension is a major risk factor for cardiovascular disease. Despite pharmacologic interventions, a substantial proportion of patients exhibit poor blood pressure (BP) control. High sodium intake is a modifiable contributor to uncontrolled hypertension. This study eva-luates 24-hour urinary sodium excretion as an objective biomarker for sodium intake in controlled versus uncontrolled hypertensive patients.

OBJECTIVES: To compare 24-hour urinary sodium excretion between hypertensive patients with controlled and uncontrolled BP, and to assess its association with treatment response.

METHODS: This cross-sectional study was conducted at VMKV Medical College and Hospital, Salem, over 15 months. A total of 100 hypertensive patients aged 45-65 years were recruited and grouped into controlled (n=50) and uncontrolled (n=50) based on JNC VIII BP criteria. Data on demographics, clinical history, and 24-hour urine collections were analyzed. Sodium, potassium, and albumin levels were measured. Independent t-tests and Chi-square tests were used for statistical comparisons.

RESULTS: Mean 24-hour urinary sodium was significantly higher in the uncontrolled group (174.5 ± 32.1 mmol/day) compared to the controlled group (142.7 ± 28.3 mmol/day; p < 0.001). No significant differences were noted in urinary potassium levels (p = 0.42) or microalbuminuria prevalence (p = 0.31) between the groups.

CONCLUSION: Higher urinary sodium excretion is significantly associated with poor BP control, underscoring the importance of dietary sodium reduction even in patients under antihypertensive therapy. 24-hour urine sodium measurement can serve as a reliable biomarker in clinical management.

PMID:41525119 | DOI:10.7417/CT.2026.1980

Clin Ter. 2026 Jan-Feb;177(1):93-99. doi: 10.7417/CT.2026.1979.

ABSTRACT

INTRODUCTION: Women are vulnerable to depression, with evidence of MAO-A and HTTP gene variations’ impact. We studied depression in women at a UAE hospital to analyze hormonal changes, psychological symptoms severity, and gene variations related to MAO and HTTP promoter region polymorphism.

METHODS: This prospective analytical study included 100 participants (50 depressed, 50 non-depressed women aged 18-60 years). Women with thyroid diseases, abnormal mammograms, organic causes, cardiovascular diseases, or atherosclerotic conditions were excluded. Depression severity was assessed using Beck Depression Inventory. Cortisol, serotonin, and leptin levels were measured using ELISA kits. Saliva samples were collected for DNA polymorphism detection using PCR and gel electrophoresis. Statistical analysis used SPSS software.

RESULTS: Participants showed simple depression (20%), moderate (13%), severe (10%), and very severe (7%). HTTP cases were L/L (41%), L/S (39%), and S/S (20%). MSP distributions were SA/SG (32%), SA/SA (29%), LA/SA (25%), and SA/LG(14%); MAO were 3/4 (57%), 3/3 (32%), and 4/4 (11%).

CONCLUSION: This UAE study demonstrates hormones and gene variations’ influence. HTTP genotyping revealed three groups: S/S, S/L, and L/L alleles. MAO variants were 3/4, 3/3 and 4/4. Genetic factors can guide treatment planning for severe depression.

PMID:41525118 | DOI:10.7417/CT.2026.1979