Clinica Terapeutica最新文献

{"title":"Evaluating effect of Insulin therapy on Quality-of-life among Type 2 Diabetes Patients in Tertiary Care Hospitals: Observational Study from South Asian Region.","authors":"Arun Shirali, Lokireddy Venkata Sandeep, Sheetal Raj Moolambally, Mysore Srikantiah Rukmini, Ananya Bhat, Arun Shirali Priyanka","doi":"10.7417/CT.2026.2029","DOIUrl":"10.7417/CT.2026.2029","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with significant morbidity, mortality, and impaired quality of life (QOL). Insulin therapy is central to glycaemic control in advanced disease but poses psychosocial and practical challenges. This study evaluated QOL among insulin-treated T2DM patients in tertiary care hospitals.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in the outpatient and inpatient departments of hospitals affiliated with Medical College in south Asian city. Total 272 patients aged >30 years with T2DM on insulin therapy for ≥3 months were included. Patients with type 1 diabetes or on oral therapy alone were excluded. Data on demographics, comorbidities, HbA1c, and complications were collected. QOL was assessed using the Quality-of-Life Instrument in Indian Diabetic Patients (QOLID), and barriers to insulin therapy were measured with the BITQ questionnaire. Statistical analysis was performed using SPSS v25, with p<0.05 considered significant.</p><p><strong>Results: </strong>Of the 272 participants, 74% were aged >50 years and 61% were female. Neuropathy (18%) was the most common complication. Overall QOL score averaged 126.36 ± 21.69, with lowest scores in role limitation (19.40), physical endurance (19.25), and emotional health (15.58). Patients on combination therapy (insulin plus oral agents) reported better physical endurance and overall QOL compared to insulin-only users, though financial burden was greater. Complications and poor glycemic control (HbA1c) significantly worsened QOL across domains.</p><p><strong>Conclusion: </strong>Insulin-treated T2DM patients experience moderate impairment in QOL, influenced by complications, poor glycaemic control, and financial and psychological burdens. A holistic, patient-centred approach incorporating medical, psychosocial, and economic support is essential to improve outcomes.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"460-465"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthostatic Hypotension and Psychosocial Adversity Among Postpartum Women in Zambia: A Cross-Sectional Analysis.","authors":"Kartheek R Balapala, Suriyakala Perumal Chandran, Nelson Nyumbu Nyirenda, Clifford Tende, Garcia Katende, Suresh Babu Sayana, Visaka Kapalu","doi":"10.7417/CT.2026.2034","DOIUrl":"10.7417/CT.2026.2034","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic hypotension (OH) represents a link between haemodynamic instability and psychosocial adversity in low-resource settings.</p><p><strong>Objectives: </strong>To estimate the prevalence of OH among postpartum women in Ndola, Zambia, and examine associations with family scapegoating abuse (FSA) and symptoms of depression, anxiety, and stress.</p><p><strong>Methods: </strong>In a community-based cross-sectional study, postpartum women aged 20-30 years within one year of delivery (N = 666) underwent active-stand blood pressure testing. OH was defined as a ≥20 mmHg fall in systolic and/or ≥10 mmHg fall in diastolic pressure within 3 minutes of standing. FSA was measured using the FSA-25 and mental health symptoms using the DASS-21. Descriptive statistics, chi-square tests, logistic regression (including a stepwise sensitivity model), and structural equation modelling (SEM) evaluated direct, indirect, and moderated associations with OH.</p><p><strong>Results: </strong>OH was identified in 93 (13.9%) women. Any FSA was reported by 164 (24.6%) women, and moderate-to-severe scapegoating was present in 136 (20.4%). In SEM, depressive symptoms showed a positive direct association with OH, with indirect pathways involving anxiety and FSA, while stress related to OH primarily through FSA. In logistic regression, Stress_G(1) was associated with lower odds of OH (OR = 0.109, 95% CI: 0.042-0.280), whereas employment status was not independently associated with OH; interaction estimates with employment were unstable. In the stepwise model, Stress_G(1) was the only retained significant predictor of OH.</p><p><strong>Conclusions: </strong>OH is a clinically relevant postpartum finding in this Zambian cohort and co-occurs with substantial family scapegoating and internalising symptoms. Integrating orthostatic blood pressure assessment with structured psychosocial screening may help identify women at heightened risk for dizziness, falls, and persistent mood and anxiety problems, supporting more holistic postpartum care in similar low-resource settings.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 3","pages":"496-501"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Recovery After Laparoscopic Ovarian Cystectomy: A Randomized Controlled Trial Comparing Opioid-Free Multimodal Analgesia Versus Opioid-Based Anesthesia.","authors":"Heba M Mohammed, Mai Mohammed Metwally, Omama Abdelrahman Taher Salama, Rasha Ezzat El-Sayed, Asmaa Elsaid Nabih, Alshaimaa Abdellah, Alshaimaa Rabie El Makawy, Mariam Salah Mohamed Emam, Naela Hamdy Abdelfattah, Shaimaa Ali Barakat, Doaa Helmy Abd Elkader Yousef, Salwa Hegazy Bassiony Alwakil, Ehsan Hamed Ali Abdelaal, Ateia Ahmad Ateia G, Attia Mohamed Attia G, Abdo Diab Awadallah G, Ali Mohamed Ali Esmail, Mahmoud Mohamed Mohamed Abdallah Selim, Taha Ahmed Abdeldayem Aly, Muhammad Mosleh Muhammad Muhammad Zabady, Mohamad Mohamad Abdelhamed Elghonimy, Waheed Mohamed Ali, Zainab Shehata Sayd, Fatma Mahmoud Ahmed, Mostafa R Bakry, Mahmoud Abubakr Negm, Diaa Abdslam M El-Menshawy, Maged El-Shourbagy","doi":"10.7417/CT.2026.2002","DOIUrl":"10.7417/CT.2026.2002","url":null,"abstract":"<p><strong>Background: </strong>Opioid-based anesthesia, though effective for pain control, is often associated with side effects such as nausea, vomiting, and delayed recovery. In the context of minimally invasive procedures like laparoscopic ovarian cystectomy, there is increasing interest in opioid-free anesthesia (OFA) to enhance postoperative outcomes.</p><p><strong>Objective: </strong>To compare the quality of recovery between opioid-free and opioid-based anesthesia using the QoR-15 score in patients undergoing laparoscopic ovarian cystectomy.</p><p><strong>Methods: </strong>This double-blind, randomized controlled trial included 80 ASA I-II female patients aged 18-65 undergoing elective laparoscopic ovarian cystectomy. Participants were randomized equally to receive either opioid-free multimodal anesthesia (dexmedetomidine, lidocaine, ketamine, paracetamol) or conventional opioid-based anesthesia. The primary outcome was QoR-15 score at 24 hours. Secondary outcomes included intraoperative anesthetic requirements, hemodynamic stability, postoperative pain, and adverse events.</p><p><strong>Results: </strong>Patients in the OFA group had significantly higher QoR-15 total scores (192 vs. 173; p = 0.029), especially in physical comfort (p = 0.014), independence (p = 0.035), and pain domains (p = 0.021). The OFA group also required a lower propofol maintenance dose (5.64 ± 1.21 vs. 6.32 ± 1.81 mg/kg/h; p = 0.012), had a longer time to first analgesic request (42.6 ± 7.52 vs. 33.6 ± 7.17 min; p = 0.003), and experienced fewer adverse effects such as nausea (15% vs. 45%; p < 0.001) and vomiting (10% vs. 30%; p < 0.001).</p><p><strong>Conclusions: </strong>Opioid-free multimodal anesthesia offers superior recovery quality, effective pain control, and fewer side effects compared to traditional opioid-based anesthesia in laparoscopic ovarian cystectomy. It is a viable alternative in enhanced recovery protocols.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"249-257"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interplay of iron regulatory proteins and inflammatory markers in benign and malignant ovarian cancer: A cross sectional study.","authors":"Manoj Haritha Padannapurath, K Sudha, Manjunath Pawar Neelam, Kollampare Sowndarya","doi":"10.7417/CT.2026.2004","DOIUrl":"10.7417/CT.2026.2004","url":null,"abstract":"<p><strong>Background: </strong>A wide array of alterations in the metabolism of iron makes it the most crucial micronutrient needed for cancer proliferation, mainly by generating oxygen derived free radicals, the key signalling molecules of inflammatory processes. Inflammation in turn induces iron sequestration by macrophages resulting in reduction of circulating iron for erythropoiesis. Iron may also facilitate metastasis by elevation of matrix metalloproteinases (MMP) responsible for remodelling of extracellular matrix through the ROS pathway. Hence, the aim of the study is to investigate alterations in the interplay of proteins that regulate iron homeostasis and inflammation in benign and malignant ovarian cancer (OC) patients.</p><p><strong>Materials and methods: </strong>Plasma ceruloplasmin, total iron binding capacity (TIBC), erythropoietin and iron were analysed by spectrophotometric methods in 33 cystadenoma and 50 adenocarcinoma OC patients. Plasma TNFα and MMP9 the proinflammatory molecules were estimated by ELISA.</p><p><strong>Results: </strong>Plasma iron levels were markedly reduced, whereas erythropoietin and TIBC were elevated in both benign and malignant cancer patients compared to normal reference intervals, indicating severe anemia irrespective of tumor type. The rise in erythropoietin was significantly greater in benign cases than malignant (p=0.012). TIBC increased progressively from normal mean value of 80µg/ dl to 102 in benign and 113 in malignant cancer. Plasma ceruloplasmin, a powerful antioxidant and a ferroxidase was significantly higher in malignant OC patients compared to benign group (p=0.001). While there was a substantial increase in MMP9 in OC patients, strikingly higher values were seen in the benign group (p=0.005) compared to the malignant group. Although there was a conspicuous increase in TNFα in both the groups, the increase in malignant OC was highly significant (p= 0.05), which points to the ongoing inflammatory reactions in the tumor microenvironment.</p><p><strong>Conclusion: </strong>We conclude that a higher magnitude of dysregulation of iron homeostasis observed in malignant OC patients compared to benign cases may be one of the major factors that prompt persistent ROS generation and foster inflammatory processes in the tumor microenvironment that promote subsequent cancer progression and metastasis.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"268-271"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of coexisting myocardial bridging and hypertrophic cardiomyopathy.","authors":"Aybüke Şimşek, Fatih Furkan Bedir, Abdullah Doğan, Cemalettin Akman, Ahmet Güner","doi":"10.7417/CT.2026.1993","DOIUrl":"https://doi.org/10.7417/CT.2026.1993","url":null,"abstract":"","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"187-188"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrient levels in the cord blood of term neonates and its association with oxidative stress and neonatal anthropometry: a cross sectional study.","authors":"S U Kameshwara, S S Rao, P Manjrekar, B S Baliga","doi":"10.7417/CT.2026.2006","DOIUrl":"10.7417/CT.2026.2006","url":null,"abstract":"<p><strong>Introduction: </strong>The key roles of micronutrients are centered on their catalytic functions in chemical reactions and their structural support for significant molecules, such as enzymes and hormones. Micronutrient deficiencies and oxidative stress have been linked to low birth weight. We aimed to study the relationships of cord blood zinc, magnesium, copper and iron and the oxidative stress marker malondialdehyde (MDA) with neonatal anthropometry.</p><p><strong>Methods: </strong>We enrolled sixty-four term neonates born via vaginal delivery. Micronutrients and MDA levels were estimated from the cord blood. Birth weight, length and head circumference were recorded. The chi-square test and the Pearson correlation coefficient were applied.</p><p><strong>Results: </strong>Thirteen (20.3%) neonates were small for gestational age. Among the subjects, 6.3% were zinc deficient, 48.4% were magnesium deficient, and 46.9% were iron deficient. The mean MDA level was 23.8 (±3.8) nmol/ml. There was no correlation between neonatal anthropometry and cord blood MDA. Iron was positively correlated with birth weight (r= 0.42, p= 0.001). Zinc (r= 0.39 p 0.001) and copper (r = 0.43 p <0.001) showed linear correlation with the MDA level, and magnesium was negatively correlated (r= 0.53 p <0.001).</p><p><strong>Conclusion: </strong>Cord blood iron levels inversely correlated with birth weight and head circumference, whereas other zinc, copper and magnesium did not show any correlation. Additionally, oxidative stress, measured by cord blood MDA levels, showed negative correlation with cord blood magnesium and positive correlation with zinc and copper.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"279-284"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid Machine Learning Method and Standard Data Analysis Approaches for Predicting Treatment Outcomes of Cardiovascular Diseases: A Randomized Controlled Trial.","authors":"Anna Berestova, Yulia Klyueva, Elena Gorozhanina, Mariya Timoshina","doi":"10.7417/CT.2026.1997","DOIUrl":"10.7417/CT.2026.1997","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the effectiveness of data analysis using a hybrid method in predicting and diagnosing cardiovascular diseases compared to standard methods. Methods. The study involved 200 patients diagnosed with cardiovascular diseases (arterial hypertension, ischemic heart disease, heart failure) in Moscow, Russia. Patients were randomly assigned to two equal groups. Group A underwent analysis of clinical data using random forest, support vector machines, and linear regression methods. Group B was subjected to hybrid method analysis. For Group B, patient survival was higher by 5%, and complication frequency was lower by 3%. The hybrid method demonstrated superior forecasting and treatment efficacy (p < 0.001) compared to similar indicators in Group A.</p><p><strong>Results: </strong>PCA analysis revealed that principal components explained over 70% of the variability among clinical parameters. Kaplan-Meier survival curves showed a statistically significant influence of cholesterol levels on survival and complication frequency (p < 0.05). Correlation analysis identified an inverse relationship between cholesterol levels and survival (p < 0.05). A hybrid data analysis method proves more effective than standard methods in predicting cardiovascular treatment outcomes and improving patient survival. The use of a hybrid method demonstrates the success of new data processing techniques in clinical practice, enabling the optimization of therapies and improving the quality of care for patients with cardiovascular disease.</p><p><strong>Conclusion: </strong>The use of a hybrid method demonstrates the success of new data processing techniques in clinical practice, enabling the optimization of therapies and improving the quality of care for patients with cardiovascular disease.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"209-217"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Compassion as a Buffer of Stress and Predictor of Emotion Regulation Among Indian Postgraduate Medical Trainees: A Cross-Sectional Study.","authors":"Alluri Swetha Reddy, H Arjun, C Pradeep, B Lakshmi Dorai, P Periasamy, Choudhary Arbind Kumar","doi":"10.7417/CT.2026.2008","DOIUrl":"10.7417/CT.2026.2008","url":null,"abstract":"<p><strong>Abstract: </strong>Postgraduate medical training is characterized by high stress and emotional demands, often leading to burnout and difficulties in regulating emotions. Identifying protective psychological factors that can mitigate these effects is critical for trainee well-being. This cross-sectional study examined the role of self-compassion in relation to stress and emotion regulation among 80 postgraduate medical trainees at a teaching hospital in Tamil Nadu, India. Participants completed a sociodemographic proforma, the Self-Compassion Scale (SCS), the Difficulties in Emotion Regulation Scale (DERS), and the Perceived Stress Questionnaire (PSQ). Reliability analysis showed excellent internal consistency for both SCS (α=0.89) and DERS (α=0.91). Correlation analysis revealed that self-kindness and mindfulness were significantly negatively associated with emotion dysregulation, while self-judgement and over-identification showed positive associations. In multivariable regression, self-kindness (β=-0.24, p=0.012) and mindfulness (β=-0.22, p=0.019) independently predicted lower dysregulation, whereas self-judgement (β=+0.27, p=0.006) predicted higher dysregulation, after adjusting for age, gender, marital status, and substance use. Mediation analysis using bootstrapping demonstrated that self-compassion partially mediated the association between stress and dysregulation, accounting for approximately 32% of the total effect. These findings highlight self-compassion as a robust psychological resource that not only predicts emotion regulation but also buffers the impact of stress in medical trainees. Incorporating compassion-based training into postgraduate curricula may therefore represent a feasible strategy to promote resilience, reduce burnout, and support sustainable professional development.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"295-304"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, Predictors and Prognosis of Pacemaker Implantation after Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Prospective Cohort Study.","authors":"Abdulaziz Aboshahba, Mostafa El Sayed, Islam Ahmed, Zia Sabah, Amer Albarznjy, Mohamed Shaban, Ahmed Elmedany, Abdelhamid Abu Rahhal, Ibrahim Said, A M Galal, Mohamed A Mansour, Ehab Ahmed, Hend O El Gharib, Saleh Alshehri, Ahmed Sanad, Abdelaal Alkhouly, Ahmed Faheem Abdo, Hani A Khalaf, Bassam Mokhaimar, Essam Khalil, Karim Mashhour, Mahmoud Khalifa, Mohamed Elghanam, Ahmed Mohamed, Khaled Elsayed, Abdallah Mahmoud, A ElsebaeyShousha, Ibrahim K Gamil, Mohamed M Elbably, Hanan Abd ElRazek, Manal Khaled, Asmaa Shahien, Abdulmabod Omar, Wael Tawfik","doi":"10.7417/CT.2026.2003","DOIUrl":"10.7417/CT.2026.2003","url":null,"abstract":"<p><strong>Background: </strong>Cardiac conduction disturbances remain a frequent complication after aortic valve replacement, particularly following transcatheter aortic valve implantation. These disturbances may necessitate permanent pacemaker implantation and can influence post procedural outcomes, yet comparative prospective data integrating anatomical predictors remain limited.</p><p><strong>Aim: </strong>To compare the incidence and prognosis of cardiac conduction disturbances and permanent pacemaker implantation after transcatheter versus surgical aortic valve replacement, and to identify independent clinical and radiological predictors of pacemaker requirement.</p><p><strong>Method: </strong>This prospective cohort study included 60 elderly patients with severe aortic stenosis who underwent either surgical aortic valve replacement or transcatheter aortic valve implantation. Clinical, electrocardiographic, echocardiographic, and computed tomography based radiological data were collected. Patients were followed for six months to assess new onset conduction disturbances, pacemaker implantation, and clinical outcomes. Multivariable regression analysis was used to identify independent predictors of permanent pacemaker implantation.</p><p><strong>Results: </strong>Among 60 patients, 20 underwent SAVR and 40 underwent TAVI. New onset conduction disturbances were more frequent after TAVI than SAVR (45% vs 15%). Permanent pacemaker implantation occurred in 35% of TAVI patients compared with 10% after SAVR. Within TAVI, pacemaker implantation was higher with self-expandable valves than balloon expandable valves (50% vs 20%). Greater implantation depth and higher LVOT calcification were independent predictors of pacemaker implantation.</p><p><strong>Conclusion: </strong>Transcatheter aortic valve implantation is associated with a higher risk of conduction disturbances and permanent pacemaker implantation than surgical replacement, driven largely by procedural and anatomical factors. Integration of detailed pre procedural imaging may improve risk stratification and procedural planning.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"258-267"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consequence of malaria and dengue on reproductive vigor. A scoping review.","authors":"Pratik Kumar Chatterjee, Poulomi Chatterjee, Babi Dutta, N Anupama, Mythri R, Swati Dhar, Rashmi Ks, Shilpa N Bijoor, Akash Tomar, Aparna Tripathy","doi":"10.7417/CT.2026.2016","DOIUrl":"10.7417/CT.2026.2016","url":null,"abstract":"<p><strong>Backgroundv: </strong>Malaria is associated with decreased semen quality, oligozoospermia, necrozoo-spermia/azoospermia. Antimalarial-drugs have adverse-effects on re¬productive functions. (40-90) % of male infertility is due to scarce sperm production of obscure source. This review was undertaken to understand the effects of malaria/dengue and antimalarial drugs on reproductive health.</p><p><strong>Methodology: </strong>A broad systematic exploration was steered, using electronic databases, limiting to articles (English) using words- \"Infertility\", \"Malaria\", \"Preterm birth\", \"Dengue\" etc., (2013-2024), to identify relevant studies.</p><p><strong>Results: </strong>Malaria causes decreased semen quality in men; higher rates of miscarriage, intrauterine demise, premature delivery, LBW, neonatal deaths, anemia and maternal deaths in pregnancy. Antimalarial-drugs (chloroquine, quinine, quinacrine, pyrimethamine) cause male infertility. Acute dengue infection leads to temporary alterations in sperm but not long-term infertility; during pregnancy it causes an increased risk of premature delivery, fetal death, and hemorrhagic complications.</p><p><strong>Conclusion: </strong>Malaria/dengue affect reproductive health in humans, indirect effect being infertility due to antimalarial-drugs.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 2","pages":"358-372"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}