All Articles in october, 2025

Purpose: To determine trends in breast imaging services utilization among privately and government-insured patients at a national radiology practice.Method: Monthly breast imaging volume data from January 2019 to September 2022 were analyzed across five insurance types: three commercial carriers (Com1-Com3), Medicaid, and Medicare. Primary analysis involved calculating quarterly volumes and standard errors of the mean, followed by a joinpoint regression to identify trend inflection points and quarterly percentage changes (QPC). In the secondary analysis, the entire period trend was obtained and measured as the average quarterly percentage change (AQPC).Results: Between 2019 Q1 and 2022 Q3, a total of 4,640,619 breast imaging services were accessed, including 2,034,833 2D screening mammograms, 1,640,689 screening digital breast tomosynthesis, 497,592 diagnostic mammograms, 452,549 breast ultrasounds, and 14,956 breast MRIs. AQPC values for imaging modalities varied across insurance types. Medicare and Medicaid patients showed the highest rates of utilization increases, particularly for modalities other than screening breast tomosynthesis, where private insurers dominated. Variations were observed between different commercial payors.Conclusion: Breast imaging utilization increased among patients insured by Medicare and Medicaid from 2019 to 2022, outpacing that of those with private insurance. These findings contrast previous research suggesting better access and utilization among privately insured individuals, highlighting increased access for government-insured patients in this study.

Depression, trauma, and anxiety disorders continue to be predominant causes of global disability, with typical therapies proving to be only marginally successful. Heart Rate Variability Biofeedback (HRVB) offers patients a self-regulation method that improves the flexibility of the autonomic nerve system via resonance breathing. Clinical research shows that training can significantly lower symptoms of sadness and PTSD, with improvements shown after 4 to 8 weeks. HRVB is inexpensive, non-invasive, and scalable, making it a promising supplementary therapy in psychiatry. Subsequent study ought to inform its incorporation into clinical protocols.

Sagittal split osteotomy (SSO) of the mandible is still an important part of orthognathic surgery, but “bad split” fractures that happen during the surgery are still a big problem. This report describes a rare case of bilateral bad split associated with highly compact mandibular bone (D1–D2 type) in a 53-year-old male undergoing mandibular advancement. The bone was too hard for the piezoelectric and rotary tools to work, and there was very little bleeding. This caused fractures in the cortex and lingual. Postoperative computed tomography confirmed the presence of highly dense bone, correlated with delayed healing and recurrence. Consistent pre-surgical CT scanning for an assessment of the density of the mandibular bone can provide essential information about the potential risk of the osteotomy procedure in the patient. Performing a careful bone quality and density examination pre-operatively will allow the surgeons to select the most appropriate instruments and surgical techniques that will fit the patient’s individual anatomy. Such a point escalates to being very significant when dealing with the geriatric population, as bone density increase can not only alter the fracture behavior but also the recovery process during and after surgery. The inclusion of regular CT-based bone density evaluations into the preoperative routine not only facilitates the anticipation of surgical difficulties but also results in safer and more efficient osteotomies.

Aims: The study was conducted from January to June 2023 to observe the prevalence of repeat breeding syndrome in cows, to isolate and identify the bacteria with their molecular confirmation, and antibiotic sensitivity in Bangladesh. Study design & Place and duration of study: The study was conducted under the supervision of the Department of Medicine, Surgery, and Obstetrics, Hajee Mohammad Danesh Science and Technology University, Dinajpur-5200. Some laboratory work was performed at the Microbiology Department of Pathology and Parasitology laboratory, HSTU, from January to June 2023.Methodology: A questionnaire was used to identify repeat breeding syndrome. Bacteria were isolated and identified from the cervical mucus of affected cows. For confirmation of the detected bacteria, PCR was used. The agar disc diffusion method was utilized to investigate the antibiotic sensitivity of the detected isolates against widely used antibiotics in vitro. Results: The prevalence of Repeat Breeding (RB) was 41.33%. The prevalence of E. coli was 40%, Staphylococcus aureus 40% and Klebsiella spp. 10%. Molecular detection of E. coli and Staphylococcus aureus was confirmed by using Eco 223 (F), Eco 455 (R), Sau 234(F), and Sau 1501(R) primers. The target genes were 16S and 23S rRNA, and the size of the product amplified at 232 bp and 1267 bp, respectively. According to the antibiogram profile, E. coli was resistant to ciprofloxacin, penicillin, tetracycline, amoxicillin, and erythromycin, but sensitive to ceftriaxone and gentamicin. While Staphylococcus aureus was resistant to ampicillin and erythromycin, it was sensitive to ciprofloxacin, ceftriaxone, and levofloxacin. It was also intermediately resistant to vancomycin and amoxicillin. Klebsiella spp. Showed resistance to ceftriaxone, penicillin, and amoxicillin, while remaining sensitive to ciprofloxacin, tetracycline, and intermediate resistance to erythromycin and gentamicin. Conclusion: This study concluded that E. coli, Staphylococcus aureus, and Klebsiella spp. are the most common bacteria causing repeat breeding syndrome in cows.