International Journal of Scientific Reports

Biochemical predictors of ovarian hyperstimulation syndrome in women undergoing in vitro fertilization: a retrospective cohort study from a tertiary fertility center in Pakistan

2026-10-01T06:46:08+0530

Background: Ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of controlled ovarian stimulation during assisted reproductive technology. This study identified biochemical predictors and described outcomes of OHSS among women undergoing in vitro fertilization (IVF) at a tertiary fertility center in Khyber-Pakhtunkhwa, Pakistan.

Methods: Records of 316 infertile women treated at the Center for Reproductive Medicine, Peshawar General Hospital, from December 2023 to December 2024 were reviewed. Patient characteristics, infertility diagnosis, treatment parameters, anti-Müllerian hormone (AMH), peak serum estradiol (E2), antral follicular count (AFC), and total oocytes retrieved were assessed. All patients received HCG Alpha 250 µg for final oocyte maturation. OHSS was classified using Golan and Weissman (2009) criteria. Analysis was performed using IBM SPSS Statistics v26.

Results: The mean age was 32.21±4.85 years and BMI 27.42±1.71 kg/m²; 69.6% had PCOS. Sixteen patients (5.06%) developed OHSS, all with PCOS as a contributing risk factor. 25.0% had moderate, 62.5% severe, and 12.5% had critical OHSS. Compared with non-OHSS patients, mean AFC (24 versus 13), AMH (6.5 versus 3.4 ng/ml), peak E2 (35 versus 18 ng/ml), and oocytes retrieved (15 versus 9) were higher. Nine (56.25%) achieved live birth, all after frozen embryo transfer.

Conclusions: AFC, AMH, peak serum estradiol, and total oocytes retrieved are the principal biochemical markers associated with OHSS in this Pakistani IVF cohort. The universal use of standard hCG triggering in a PCOS-predominant population represents the most modifiable contributor to the high severity distribution observed from low - and -middle income country centers.

Factors associated with nutritional status of children under-five in Pipara rural municipality, Mahottari district

2026-10-01T06:46:24+0530

Background: Poor nutritional status among children under five remains a pressing problem in Nepal and is particularly prevalent in Madhesh Province. Poor educational status and culturally influenced community affect the nutritional intake and poses serious problems in under-five children. The objective of this study was to determine the prevalence of stunting, underweight and wasting along with the factors associated with it in Pipara rural municipality, Mahottari district.

Methods: An analytical cross sectional study design was employed among children aged 6 to 59 months with the sample size of 300. All seven wards of Pipara Rural Municipality were included in the study, and eligible participants were selected using systematic random sampling within each ward. Face to face interview and anthropometric measurement technique was used by using semi-structured questionnaire, dietary diversity questionnaire, weighing machine and stadiometer. Data was collected using kobo toolbox and analyzed using World Health Organization (WHO) Anthro Survey Analyzer, Microsoft Excel and statistical package for the social sciences (SPSS) v23.

Results: The prevalence of stunting, underweight and wasting was found 39.7%, 24.7%, and 12.3% respectively. Minimum dietary diversity was found 59%. However, stunting and wasting had significant association with ethnicity and parental education.

Conclusions: Under-five children nutritional status was still found as the issue needs to be addressed, higher stunting and underweight rate shows about the collective outcome of combination of several socio-demographic, socio-economic and childhood-feeding related determinants. Therefore, it reflects about the essence of having closer scrutiny on the policies or implementation gaps.

Inula racemosa ameliorates acute lung injury through integrated modulation of innate immune signalling, inflammation activation and redox homeostasis

2026-10-01T06:45:43+0530

Background: Chronic respiratory diseases are associated with persistent inflammation and dysregulated immune responses. Although corticosteroids are widely used, prolonged therapy may cause immunosuppression and increase susceptibility to secondary infections. Inula racemosa (IR) Hook. F. (Pushkarmool), an Ayurvedic medicinal plant traditionally used for respiratory and inflammatory disorders, contains bioactive sesquiterpene lactones, particularly alantolactone and isoalantolactone, with reported anti-inflammatory and immunomodulatory activities.

Methods: The study employed human lung epithelial NCI-H460 cells and an lipopolysaccharide (LPS) induced pulmonary inflammation model in BALB/c mice. Cytotoxicity and inflammatory responses were evaluated following treatment with IR extract. Gene expression of key inflammatory and signalling markers was analysed by RT-qPCR, while protein levels of inflammatory cytokines were quantified using ELISA. Cytokine profiling, BALF cellular analysis, and lung histopathological examination were performed to assess the anti-inflammatory effects of the extract. The expression of genes associated with the TLR4/MyD88/NF-κB, MAPK, NLRP3 inflammasome, and Nrf2/HO-1 pathways was investigated to elucidate the potential molecular mechanisms underlying observed effects.

Results: IR extract attenuated LPS-induced inflammatory responses in NCI-H460 cells, with reduced production of TNF-α, IL-6, IL-1β, IL-8, IL-18, IL-4, and CCL2. In LPS-challenged BALB/c mice, treatment reduced inflammatory cell infiltration, including neutrophils, in BAL fluid and improved inflammation-associated histopathological alterations in lung tissue.

Conclusions: The findings demonstrate that whole IR extract possesses significant anti-inflammatory activity in cellular and experimental pulmonary inflammation models. Its effects may involve modulation of multiple inflammatory and antioxidant signalling pathways. These findings provide experimental support for the traditional use of IR in respiratory inflammatory conditions and warrant further mechanistic and translational investigations.

Efficacy of music therapy on pain reduction during arterial blood gas analysis: an open-label randomized controlled trial

2026-10-01T06:46:07+0530

Background: Arterial blood gas (ABG) sampling is commonly associated with procedural pain and anxiety. Nonpharmacological approaches such as music therapy may attenuate pain without impacting workflow or safety. Objectives were to evaluate whether music therapy reduces pain during ABG sampling compared with standard care, and to assess effects on number of puncture attempts and procedure duration.

Methods: Open-label, parallel-group randomized controlled trial. General medicine wards of a tertiary-care teaching hospital in Eastern India (3-month enrollment). Adults (≥18 years) requiring ABG sampling who were alert or verbally responsive (AVPU A/V). Participants were randomized (SNOSE) to music therapy via headphones during ABG (intervention) or standard care (control). Primary outcome was post-procedure pain using 0-10 numerical rating scale (NRS). Secondary outcomes were number of puncture attempts and procedure duration. Analyses used independent t-test and chi-square as appropriate (α=0.05).

Results: Among 186 participants (n=92 music; n=94 control), mean NRS pain was lower with music (4.07±2.08) versus control (5.11±2.59); mean difference -1.04 (95% CI -1.72 to -0.36), p=0.003. First-attempt success was similar (77.2% vs 73.4%; p=0.280). Procedure duration distribution (<30s/ 30-60s />60s) did not differ between groups (p=0.890).

Conclusions: Music therapy significantly reduced procedural pain during ABG without affecting success or duration. This feasible, low-cost intervention can be incorporated into routine nursing practice for procedural comfort. Nurses can lead implementation of music therapy during brief invasive procedures to improve patient experience without disrupting workflow.

Time to recovery from asphyxia and its predictors among newborns admitted to neonatal intensive care units at public hospitals in North Shoa, Amhara region, Ethiopia

2026-10-01T06:45:43+0530

Background: Birth asphyxia is a cause of early neonatal mortality worldwide. Similarly, the burden of birth asphyxia in Ethiopia remains high. Thus, studies on the time to recovery of asphyxiated neonates and their predictors are critical. Therefore, the current study aimed to determine the time to recovery of asphyxiated neonates and its predictors among newborns admitted to the neonatal intensive care unit of public hospitals in North Shewa, Amhara region, Ethiopia.

Methods: A retrospective cohort study was conducted on 523 asphyxiated neonates in North Shoa, using a simple random sampling method. Data was collected using Kobo and STATA, and survival times were estimated using Kaplan-Meier survival curves. Bivariate and multivariate cox proportional hazards regression analyses were performed.

Results: A total of 523 admitted asphyxiated newborns were monitored for 3682 neonatal days, ranging from a minimum of 1 day to a maximum of 28 days. The overall survival rate was 79.1%. The median recovery time was seven days (95% CI: 6.60-7.39). A depressed Moro reflex (AHR: 0.52, 95% CI: 0.38-0.87), stage I hypoxemic ischemic encephalopathy (AHR: 2.5, 95% CI: 1.65-5.87), not receiving calcium gluconate (AHR: 1.40, 95% CI: 1.02-1.68), and receiving 2/3 intravenous fluids during their stay (AHR: 0.68, 95% CI: 0.53-0.99) were predictors of the time to recovery of asphyxiated newborns.

Conclusions: Compared with other research findings, the overall proportion of recovery is lower. To increase the recovery time from asphyxia, standardized care protocols, including fluid and electrolyte monitoring, could be established.