Category: Nevin Manimala

Ital J Pediatr. 2025 May 23;51(1):154. doi: 10.1186/s13052-025-01947-3.

ABSTRACT

House dust mite (HDM) is the most common cause of perennial allergy worldwide, causing allergic rhinitis with or without conjunctivitis (AR/C). HDM-related clinical manifestations can be treated with allergy pharmacotherapy or allergen immunotherapy (AIT) in selected cases. AIT is acknowledged as the only therapeutic approach capable of modifying the course of allergic diseases. SQ HDM-SLIT tablets (Accarizax; Merck & Co, Kenilworth, NJ/ALK-Abellò, Hørsholm, Denmark) ensures a constant potency ratio of major HDM allergens of the Dermatophagoides pteronyssinus (DERM_PT) and Dermatophagoides farinae (DERM_FA) HDM species and has demonstrated beneficial effects on allergic rhinoconjunctivitis outcomes. In Italy, rhinoconjunctivitis affects up to as many as 40% of adolescents, but no studies on HDM AIT quality of life (QoL) regarding this exclusive cohort of patients have been specifically conducted. The aim of this study is to evaluate SQ HDM SLIT tablets’ performance in improving QoL in Italian adolescents. To assess the treatment at T0, T1, and T2, we employed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ(s)), a standardized self-administered questionnaire designed for Italian patients aged 12 and above. RQLQ(s) median values at T2 and T1 were significantly lower than those at T0 (p-values equal to 0.0018 and 0.0051 for T0 vs. T2 and T0 vs. T1, respectively). Our findings suggest that the QoL of SQ HDM SLIT tablet is highly promising, demonstrating substantial potential in alleviating signs and symptoms. Our data suggest that QoL significantly improved with SQ-HDM SLIT, highlighting the potential importance of introducing this therapy for selected cases.

PMID:40410848 | DOI:10.1186/s13052-025-01947-3

Trop Med Health. 2025 May 23;53(1):75. doi: 10.1186/s41182-025-00757-x.

ABSTRACT

BACKGROUND: Indonesia aspires to completely eliminate malaria by 2030. Malaria cases have fallen drastically due to the implementation of national strategic plans and policies, and the Ministry of Health has granted certification of elimination status to various areas, including Kalimantan. However, this low prevalence contrasts sharply with the continued high prevalence (18.9%, totalling 3290 cases) of Plasmodium knowlesi infections in Malaysian Borneo. Assessing the knowledge and preventive practices regarding malaria and attitudes towards zoonotic malaria within communities along the Kalimantan border is essential to understanding the low endemicity (API < 1) of malaria in this region.

METHODS: Between February and April 2021, a structured questionnaire was administered to respondents who lived in villages with recent malaria cases (P. vivax and P. falciparum infections) across the West, East, and North Kalimantan provinces bordering Malaysian Borneo. The questionnaire collected demographic information, knowledge, prevention practices, illness management, and attitudes towards contributing factors of zoonotic malaria. Data were analysed using descriptive statistic and the association between variables was determined using logistic regression. A P value less than 0.05 was considered statistically significant.

RESULTS: Of the 639 respondents, 47.6% had completed primary education, and 49.1% worked in the agricultural sector. More than half of the respondents had good knowledge (58.2%) and good practice (51%) regarding malaria’s cause, symptoms and prevention. A notable 58.9% could identify at least two classic symptoms of malaria (fever and shivering), and 78.6% associated the disease with mos quito bites. More than half of the respondents (53.7%) owned bed nets and stated using them every night on a regular basis (49.3%). However, more than half of these bed nets were not insecticide-treated. Indoor residual spraying by the health authority was uncommon. A common practice was that 84% of respondents sought treatment at health facilities when suspecting malaria (fever and shivering). Regarding the potential for acquiring zoonotic malaria, 36.2% of respondents lived near the forest, and 15.8% reported encountering monkeys within 500 m of their house. Multivariate analysis showed that an increase in education level significantly predicted good knowledge of malaria. Meanwhile, good malaria practices were significantly associated with women (aOR = 2.25; P < 0.001), age 25-64 (aOR = 2.64; P < 0.001), and age over 65 (aOR = 3.06; P = 0.004).

CONCLUSIONS: This study observed an exceptional level of malaria awareness among these communities. However, it is crucial to emphasise the importance of continuous malaria surveillance within this community for maintaining the current low malaria cases and achieving the goal of malaria-free status in the country by 2030.

PMID:40410846 | DOI:10.1186/s41182-025-00757-x

BMC Oral Health. 2025 May 23;25(1):774. doi: 10.1186/s12903-025-06168-y.

ABSTRACT

OBJECTIVES: In this review, we aimed to determine the effects of dental treatment under general anesthesia on the oral health-related quality of life and dental fear of preschool children.

MATERIALS AND METHODS: A comprehensive electronic search of PubMed, Embase, Scopus, and the Cochrane Library was conducted up to July 20, 2023 (updated on April 10, 2024). A manual search and evaluation of the gray literature were also performed. Clinical trials utilizing a before-and-after design to evaluate the effects of dental treatment under general anesthesia (DGA) on oral health-related quality of life (OHRQoL) and dental fear in preschool-aged children were included in this research. To assess study quality, tools specifically designed for “before-after studies without control groups” were employed to determine potential biases. Two independent investigators conducted separate evaluations of the studies’ quality assessment processes. A meta-analysis was conducted via the random effects model.

RESULTS: In the final analysis, 13 studies employing a pre-post design were included. The meta-analysis revealed a statistically significant difference in Early Childhood Oral Health Impact Scale (ECOHIS) scores between the pre-evaluation group (n = 1365) and the post-evaluation group (n = 1344) (mean difference [MD] = 9.61, 95% CI: 6.28-12.93; P < 0.00001). However, there was no significant difference in the mean Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) score between the pre-evaluation group (n = 536) and the post-evaluation group (n = 531) (MD = 5.53, 95% CI: -16.48-27.54; P = 0.62).

CONCLUSIONS: This study confirmed that children who received dental treatment with general anesthesia experienced improvements in their oral health-related quality of life. However, there is insufficient evidence to support the claim that dental treatment with general anesthesia can effectively alleviate dental fear in children.

CLINICAL RELEVANCE: Dental treatment with general anesthesia significantly improved the OHRQoL of children. However, methods to improve dental fear in children during this procedure remain to be explored.

PMID:40410840 | DOI:10.1186/s12903-025-06168-y

BMC Rheumatol. 2025 May 23;9(1):58. doi: 10.1186/s41927-025-00511-0.

ABSTRACT

BACKGROUND: Obesity is highly overrepresented in patients with psoriatic arthritis (PsA) and associated with increased disease activity and inferior treatment outcome. We have previously reported in 41 patients with PsA and body mass index (BMI) ≥ 33 kg/m² that weight loss treatment with Very Low Energy Diet (VLED) resulted in a median weight loss of 18,6% and concomitantly a significant improvement in C-reactive protein (CRP) and disease activity at six months (M6). This sub-study analyzes the effects on serum biomarkers associated with inflammation, bone and cartilage metabolism in the same PsA patients and matched controls.

METHODS: Patients and controls received VLED treatment (640 kcal/day) during 12-16 weeks depending on baseline (BL) BMI < 40 or ≥ 40 kg/m², followed by an energy restricted diet. Serum was collected at BL and M6, and biomarkers were measured with Magnetic Luminex^® Assays and enzyme-linked immunosorbent assay (ELISA). Nonparametric statistics and paired comparison tests were used.

RESULTS: In the PsA patients, the following proteins were significantly reduced at M6 as compared to BL: hepatocyte growth factor (HGF) (median (first-third quartile) 327.9 (250.3-413.6) pg/mL vs. 271.3 (206.9-331.0) pg/mL, p < 0.01), vascular endothelial growth factor (VEGF) (79.6 (55.9-113.5) pg/mL vs. 69.6 (53.1-105.3) pg/mL, p = 0.01), B-cell activating factor (BAFF) (794.4 (716.4-868.3) pg/mL vs. 674.6 (613.2-790.5) pg/mL, p = 0.01) and cartilage oligomeric matrix protein (COMP) (266.1 (209.9-366.0) ng/mL vs. 217.0 (156.0-272.0) ng/mL, p < 0.01), whereas carboxyterminal telopeptide of type-1 collagen (CTX-1) was significantly increased (268.0 (196.0-378.5) pg/mL vs. 508.0 (350.0-640.0) pg/mL, p < 0.01). Similar results were found in the control group.

CONCLUSIONS: Weight loss was associated with reduced levels of serum biomarkers related to inflammation and cartilage degradation, and increased biomarkers for bone resorption. The study supports the strong relationship between obesity, inflammation, bone and cartilage metabolism, identifying BMI as a possible confounder for biomarker levels.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02917434, registered on September 21, 2016, retrospectively registered.

PMID:40410839 | DOI:10.1186/s41927-025-00511-0

J Transl Med. 2025 May 23;23(1):575. doi: 10.1186/s12967-025-06570-8.

ABSTRACT

BACKGROUND: Incorporation of gene expression when estimating polygenic risk scores (PRS) in atopic dermatitis (AD) may provide additional insights in disease pathogenesis and enhance predictive accuracy. In this study, we developed polygenic transcriptome risk scores (PTRSs) derived from AD-enriched tissues and evaluated their performance against traditional PRS models and a baseline risk model incorporating eosinophil and lymphocyte counts in the prediction of AD.

METHODS: We conducted transcriptome-wide association studies (TWAS) using the PrediXcan framework to construct tissue-specific PTRSs. Risk score performance was assessed in 256,888 Europeans (10,816 cases) and validated in an independent cohort of 64,152 Europeans (2669 cases) from the UK Biobank.

RESULTS: We observed a modest correlation between PRS and PTRS, exerting independent effects on AD risk. While PRS demonstrated superior predictive performance compared to single-tissue PTRSs, combining both models significantly enhanced prediction accuracy, yielding a c-statistic of 0.646 (95% confidence intervals: 0.634-0.656). Notably, tissue-specific PTRSs revealed stronger associations with baseline risk factors, where Eppstein-Bar virus (EBV)-transformed lymphocytes and unexposed skin PTRSs tissues reported positive associations with lymphocyte counts.

CONCLUSIONS: Our findings highlight the value of integrating transcriptome-based risk models to incorporating additional omics layer to refine risk prediction and enhance our understanding of genetic architecture of complex traits.

PMID:40410830 | DOI:10.1186/s12967-025-06570-8

Perioper Med (Lond). 2025 May 23;14(1):59. doi: 10.1186/s13741-025-00535-7.

ABSTRACT

BACKGROUND: Epidural block stands as the prevailing, secure, and efficient approach to labor analgesia. Inadequate maternal cooperation not only hampers anesthesia effectiveness but also may lead to severe consequences, including nerve damage due to positional changes.

METHODS: A randomized controlled clinical trial with 200 participants was conducted to compare painless delivery with epidural alone versus a combination of butorphanol nasal spray preceding epidural administration for painless delivery. The objective was to assess the combined approach’s efficacy in diminishing maternal pain and enhancing maternal compliance.

RESULTS: Within 8-min post-anesthesia, the combined analgesic group (EXP group) exhibited significantly lower maternal pain intensity scores, improved maternal cooperation, reduced visual analogue scale (VAS) pain, and McGill scores compared to the epidural alone group (CTRL group). No statistically significant differences emerged in 24-h postpartum blood loss, labor duration, or lactation period. Neonatal indicators, including umbilical artery blood PCO2, base excess of extracellular fluid (BE-ecf), weight, and Apgar score, showed no significant differences between the EXP and CTRL groups. However, the EXP group demonstrated a higher umbilical artery blood pH than the CTRL group. The EXP group exhibited significantly higher probabilities of pain intensity scores ≤ 6, maternal cooperation scores ≤ 3, VAS scores ≤ 3 at 6-, 8-, and 10-min post-anesthesia, and McGill scores of 0 compared to the CTRL group.

CONCLUSION: Butorphanol nasal spray emerges as an effective means to alleviate pain during epidural puncture in labor analgesia, markedly improving maternal anesthesia adherence. This combined analgesic method proves to be a safe and efficacious approach for maternal pain relief during labor.

PMID:40410829 | DOI:10.1186/s13741-025-00535-7

BMC Chem. 2025 May 23;19(1):141. doi: 10.1186/s13065-025-01507-0.

ABSTRACT

An ecofriendly, sensitive, selective, precise, and accurate HPLC method with fluorescence detection (FD) has been developed and validated for simultaneous determination of two hypertensive drugs, felodipine and metoprolol in their pure samples, combined pharmaceutical dosage form and in spiked human plasma. Separation was carried out on Inertsil C₁₈ column (150 mm × 4.6 ID; Particle size 5 µm) and a mobile phase composed of ethanol and 30mM potassium dihydrogen phosphate buffer, adjusted to pH 2.5 using ortho-phosphoric acid (40:60, v/v) was used. A constant flow rate of 1.0 mL/min at an ambient temperature was adopted. Method validation was performed according to the ICH Q2 R2 and bioanalytical method validation was done according to FDA guidelines for determination of both drugs simultaneously in biological matrices. The method demonstrated excellent linearity over the concentration range of 0.01-1.00 µg/mL and 0.003-1.00 µg/mL that were selected with accordance to the C_max of both drugs with a correlation coefficient (r²) of 0.9998 and 0.9999 for felodipine and metoprolol, respectively in human plasma. The intra-day and inter-day precision were ≤ 2% in their pure forms and in spiked human plasma, and the accuracy was within ± 2% of the nominal concentration for both drugs in their pure forms and within ± 10% of the nominal concentration in human plasma. A statistical comparison was conducted between the proposed method and the reported method; it showed no significant difference between both methods regarding both accuracy and precision. The proposed method proved to be eco-friendly with three green assessment tools (AGREE calculator, MoGAPI, RGBfast study).

PMID:40410825 | DOI:10.1186/s13065-025-01507-0

BMC Res Notes. 2025 May 23;18(1):229. doi: 10.1186/s13104-025-07291-3.

ABSTRACT

OBJECTIVE: Vaccine Hesitancy (VH) challenges previously perceived attitudes of a simple dichotomy of “accept” or “reject”. This is not just due to people being uninformed or misinformed but rather due to multiple forms of distrust. It is criticized as a vague notion with an uncertain hypothetical background. Therefore, this study aimed to assess the baseline knowledge and immunization practices of postnatal mothers and their hesitancy after intervention with the health education tool ‘SuBaDRa’ and compare it with those of the control group.

RESULT: This hospital-based, single-blinded randomized control study was performed for 2 years with 272 (136 per group) postnatal mothers (booked cases with immunization cards and access to a smartphone) in Karnataka, India. ‘SuBaDRa’, a tailored health education tool, was used to counsel the intervention group: Presenting Sustainable initiatives by the government; assessing mothers’ Baseline immunization knowledge and postintervention revaluations via the ‘WHO SAGE questionnaire’, Dissipating knowledge via health education and Reinforcement with social media applications. The control group was counseled about essential newborn care. The vaccine delay of infants at birth and at 6, 10, and 14 weeks and 9 months of age was assessed. The secondary outcome measures mothers’ attitudes toward immunization postintervention. The vaccine was considered delayed if it was received later than 2 weeks after the recommended age. The characteristics of the study subjects, i.e., postnatal mothers with eligible newborns, were analyzed via descriptive statistics. These characteristics were compared between the intervention and control groups via the Chi-square (χ²) test and Fischer’s exact test. The results revealed that the intervention group vaccine delays at 6, 10, 14 weeks and 9 months were 5.9%, 3%, 0.7% and 11.9%, respectively, and the control group vaccine delays were 20%, 28.9%, 55.6% and 48.1%, respectively, with p values of 0.001 at 6 weeks and 0 for the rest, all of which were highly significant. Trial registration The study was registered on Clinical Trials Registry – India (CTRI) with the registration number (CTRI/2021/08/035749), registered on (18/08/2021).

PMID:40410821 | DOI:10.1186/s13104-025-07291-3

Part Fibre Toxicol. 2025 May 23;22(1):14. doi: 10.1186/s12989-025-00628-7.

ABSTRACT

BACKGROUND: Multiple effects of ultrafine particles (UFP) on human subjects are known but there is less knowledge of how relative exposure levels between ultrafine and fine particles as typically encountered in large cities affect lung function and cardiovascular parameters.

METHODS: Four sites with high/low levels of ultrafine particles and/or fine particles were selected in the city of Munich, Germany: control area (woodland), urban environment, heavy traffic site, biomass combustion (beech wood). In a randomized cross-over design, 26 young, healthy individuals were exposed at each site over 75 min to atmospheric pollutants, which were monitored continuously, while performing intermittent (5 min per 15 min) light exercise. Parameters assessed pre and post exposure comprised symptoms, spirometry, lung diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO), alveolar volume (AV), the fractional concentration of exhaled nitric oxide (FeNO), reactive hyperemia index (RHI), blood pressure, and heart rate. Outcomes were expressed as percent changes of parameters and analyses performed by either comparing the four sites or by multiple linear regression analyses using the measured pollutant levels.

RESULTS: The sites showed the planned pattern of exposure levels but with large overlap. Outcomes showed no statistically significant differences between sites, except for symptoms which were elevated with heavy traffic site exposure and biomass combustion. In regression analyses, AV decreased by 0.92 (95% confidence interval (CI): 0.28 to 1.57) % per 10,000/cm³ UFP; similarly, for LDSA (lung-deposited surface area), which was highly correlated with UFP. Overall, FeNO slightly increased after exposure, but this increase was attenuated by 5.4 (95% CI: 1.8 to 9.2) % per 10 ppb ambient NO₂. Heart rate decreased after exposures overall; this decrease was enhanced by 2.1 (95% CI: 0.3 to 4.0) % per 10,000/cm³ UFP.

CONCLUSIONS: Short-term exposures to UFP elicited a reduction in the lung volume (AV) accessible to gas transport by diffusion and convection. FeNO was slightly elevated after all exposures, but this increase was significantly smaller at higher ambient NO₂ concentrations. While these effects were too small to be clinically relevant, they demonstrated that typical levels of urban air pollution had measurable acute effects in young, healthy individuals.

PMID:40410818 | DOI:10.1186/s12989-025-00628-7

Scand J Trauma Resusc Emerg Med. 2025 May 23;33(1):95. doi: 10.1186/s13049-025-01416-0.

ABSTRACT

BACKGROUND: Prehospital physician-staffed services in the Nordic countries vary in crew structure, medical specialisation of crew and preparedness for major emergency surgical procedures. Performing emergency surgical procedures in prehospital settings requires equipment, training and clinical ability. This study aimed to explore the organisation of Nordic prehospital physician-staffed services and their preparedness for resuscitative thoracotomy, perimortem caesarean section and prehospital amputation.

METHODS: A cross-sectional survey was conducted among Nordic prehospital physician-staffed services. A web-based questionnaire was distributed to medical directors. The questions included local organisation, equipment, training, and the ability of the service to perform major emergency surgical procedures. The responses were analysed using descriptive statistics.

RESULTS: Out of 61 prehospital physician-staffed services, 54 responded (89% response rate). The various organisations showed variability in geographical coverage, staffing, and transportation options. Resuscitative thoracotomy had been carried out by 41% of the services, 85% had equipment for the procedure, and 48% had established local guidelines. Perimortem caesarean section had been performed by 7% of the services, 80% had equipment for the procedure, and 31% had established local guidelines. Prehospital amputations had been carried out by 35% of the services, 81% had equipment for the procedure, and 22% had established guidelines. Preparation for the procedures varied. 61% of the services carried out special training for resuscitative thoracotomy, 22% for perimortem caesarean section, and 39% for prehospital amputation.

CONCLUSIONS: Prehospital physician-staffed units need to be prepared and have a strategy and guidelines for the treatment of unusual but life-threatening conditions. To perform major surgical procedures outside a hospital, guidelines, training, equipment, and experience are required. The study has demonstrated significant differences between Nordic countries and regions in how major surgical procedures outside the hospital are addressed. Many services lack standardised procedures and training. Addressing these gaps by implementing protocols and training programs may improve patient care. However, the potential benefits for a small number of patients should be weighed against the investment to have the ability to perform major surgical procedures outside the hospital.

PMID:40410815 | DOI:10.1186/s13049-025-01416-0