Category: Nevin Manimala

BMC Cardiovasc Disord. 2025 Mar 29;25(1):235. doi: 10.1186/s12872-025-04690-z.

ABSTRACT

BACKGROUND: The risk of hypertension varies based on ethnicity, environmental factors, and genetic predispositions. Studies have reported a higher risk of cardiovascular diseases (CVD) and hypertension among the Newar ethnic groups in Nepal. However, the genetic analysis for Methylenetetrahydrofolate reductase (MTHFR C677T) gene mutations, serum homocysteine, and high-sensitivity C-reactive protein (hs-CRP) levels across different ethnicities remains unexplored.

METHODS: Sociodemographic information and baseline data of 489 participants were obtained from the first phase of the Dhulikhel Heart Study. Preserved blood samples were analyzed for MTHFR C677T polymorphism using real-time polymerase chain reaction (TaqMan assay), and serum homocysteine was measured through immunoassay techniques. Descriptive analysis, the Hardy-Weinberg equilibrium test, and multinomial regression were performed.

RESULTS: The prevalence of homozygous mutation (TT) was 19.8% in the Newar group and 12.5% in the Brahmin/Chhetri ethnicity. The highest mean value of homocysteine (19.4 µmol/L) was observed in homozygous participants, followed by the heterozygous mutant group (17.4 µmol/L). A statistically significant association (P = < 0.001) was found between homocysteine levels and blood pressure.

CONCLUSIONS: The Dhulikhel Heart Study reveals a significant prevalence of the MTHFR C677T gene mutation among the Newar ethnicity compared to other groups. Elevated levels of homocysteine and high-sensitivity C-reactive protein (hs-CRP) were associated with increased blood pressure.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40158176 | DOI:10.1186/s12872-025-04690-z

BMC Pregnancy Childbirth. 2025 Mar 29;25(1):373. doi: 10.1186/s12884-025-07330-8.

ABSTRACT

BACKGROUND: There are no specific guidelines regarding the definition, diagnostic workup and treatment of recurrent pregnancy loss (RPL) in China at present. Whether the diagnostic workup should occur after two or three or more pregnancy losses in the Chinese population is not clear.

METHODS: This cross-sectional study collected data from January 2017 to December 2022 from the RPL Clinic at Shengjing Hospital, affiliated with China Medical University. The results of diagnostic tests for evidence-based and possible risk factors of RPL,which is defined as two or more failed clinical pregnancies, were collected. The data collected include parental chromosomal karyotypes, immune factors (anticardiolipin antibody, anti-β2-glycoprotein I antibody, lupus anticoagulants, and antinuclear antibodies), endocrine factors (polycystic ovary syndrome, thyroid dysfunction, hyperprolactinemia, obesity, and glucose abnormalities), anatomical factors (uterine malformations, endometrial polyps, intrauterine adhesions, uterine fibroids or adenomyosis), coagulation factors (thrombelastogram, antithrombin III, and homocysteine levels) and other factors (vitamin D levels, MTHFR polymorphisms and ultrasound indices of endometrial receptivity). All these data were compared between patients with two or three or more pregnancy losses.

RESULTS: Among all 785 patients with RPL, the rates of abnormal anatomical factors (40.96% versus 32.94%, P = 0.021, OR 1.41, (95% Cl 1.05-1.89)), endometrial polyps (6.21% versus 3.06%, P = 0.034, OR 2.10, (95% Cl 1.04-4.23)) and obesity (13.76% versus 5.59%, P < 0.0001, OR 2.69, (95% Cl 1.62-4.49)) were significantly higher in people with three or more pregnancy losses than in people with two pregnancy losses. The rates of other diagnostic tests were not statistically significant between the two groups.

CONCLUSION: Based on the high rate of abnormal test results in the Chinese RPL population, our findings may provide evidence for patients in our area begin routine etiological screening after two pregnancy losses.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03561766, 18/5/2018.

PMID:40158174 | DOI:10.1186/s12884-025-07330-8

BMC Gastroenterol. 2025 Mar 29;25(1):207. doi: 10.1186/s12876-025-03808-z.

ABSTRACT

BACKGROUD: Gallstones are a common disease that imposes a significant burden on public health resources. Sarcopenia is an age-related condition characterized by a decline in muscle mass, strength, and function. However, its relationship with gallstones remains unclear.

METHODS: This cross-sectional study included 2,167 US adults from the National Health and Nutrition Examination Survey. We used the multivariable logistic regression models and restricted cubic spline regression to to assess the relationship between sarcopenia and gallstones. Additionally, subgroup analyses and propensity score matching (PSM) were conducted to account for potential confounding factors.

RESULTS: We found a significant negative association between the sarcopenia index and the prevalence of gallstones (OR: 0.253, 95% CI: 0.132-0.471, P < 0.001). In Model 4, which integrated all covariates, sarcopenia was associated with approximately a 100% increased prevalence of gallstones compared to non-sarcopenia patients (OR: 1.995, 95% CI: 1.340-2.948, P < 0.001). The results of PSM also confirmed the association between sarcopenia and gallstones (OR: 1.982, 95% CI: 1.217-3.285, P = 0.007). Notably, this association was more pronounced in subgroups including females, non-Hispanic whites, married individuals, and higher education level.

CONCLUSION: In summary, our findings suggest a positive association between sarcopenia and the prevalence of gallstones in US adults. This suggests that we should increase the emphasis on gallstone disease screening in sarcopenia patients. However, this finding needs to be validated through further large-scale prospective studies.

PMID:40158173 | DOI:10.1186/s12876-025-03808-z

BMC Nurs. 2025 Mar 29;24(1):338. doi: 10.1186/s12912-025-03028-6.

ABSTRACT

INTRODUCTION: Innovative approaches are essential in nursing education to ensure the continuity of skill acquisition, particularly in situations where traditional face-to-face teaching methods are not feasible.

OBJECTIVE: This study aimed to evaluate the effectiveness of remote learning in enabling student nurses to acquire psychomotor skills, with a focus on ‘blood pressure measurement’-a noninvasive procedure that can be practiced safely at home.

METHODS: Using an experimental design with group randomization and a mixed-method approach, 44 first-year nursing students participated, with 22 in the experimental group and 22 in the control group. After a theoretical course on blood pressure measurement, the control group followed a licensed video program, while the experimental group practiced with a simulated patient under an educator’s guidance in an remote environment. The research was conducted between March 2021 and October 2021, encompassing all phases of the study. These phases included preliminary information, remote training, and feedback sessions in March 2021, the first assessment in April 2021, and the second assessment in October 2021. The ‘Descriptive Characteristics Form,’ ‘Blood Pressure Measurement Skill Checklist,’ and ‘We Practice Remote Clinical Skills Together Online Comments Form’ were used for data collection. Descriptive statistics (means, standard deviations, frequencies, percentages) and the Mann-Whitney U test were applied for quantitative data analysis, while qualitative data were analyzed inductively based on student opinions from both groups.

RESULTS: The first performance assessment showed no significant difference between the control and experimental groups’ mean scores (p = 0.440). However, the second assessment revealed a significant difference favoring the experimental group (p = 0.001). The qualitative data were categorised into three main themes: emotions, learning and confidence, with a total of 34 codes. Emotions accounted for 50% of the codes, including happiness, stress, comfort and anxiety. Learning accounted for 41% and included awareness, interaction-communication, skill acquisition and information retention. Finally, self-confidence, represented by skill practice in the laboratory, accounted for 9% of the codes.

CONCLUSION: This study demonstrates that educator-guided remote skill training can positively impact students’ psychomotor skill acquisition. It highlights the potential for effectively teaching specific nursing skills in remote environments when guided by an educator.

PMID:40158171 | DOI:10.1186/s12912-025-03028-6

BMC Public Health. 2025 Mar 29;25(1):1199. doi: 10.1186/s12889-025-22385-0.

ABSTRACT

BACKGROUND: Intimate partner violence (IPV) is a prevalent public health problem and a significant contributor to morbidity and mortality among women and girls. IPV significantly interferes with individual’s quality of life (QoL). This study examined and compared the relationship between experience of IPV and QoL of young women in urban slums and non-slums communities of Ibadan, Nigeria.

METHODS: The study was conducted in the five Local Government Areas (LGAs) of Ibadan municipal, Oyo State, and employed a cross-sectional design. The study population were 1,050 young women aged between 18 and 24 years, who had ever been or currently was in a relationship. Data were collected using semi-structured and close-ended 97-items questionnaire, adapted from standardized instruments of the WHO VAW study (WHO, 2013) and WHOQOL BREF. Data were analysed using STATA 16. hierarchical multiple regression model was used to describe relationship between the outcome and independent variables.

RESULTS: The age (21.0 ± 2.1 years) of respondents was the same in both communities. Prevalence of physical (31.4%, 13.4%), psychological (58.6%, 31.5%) and sexual IPV (37.1%, 18.3%) were (p < 0.05) higher in the slums than non-slums, respectively. Overall QoL score was lower among IPV victims than non-victims in both non-slum (67.3 ± 23.4; 72.2 ± 19.8) and slum communities (67.3 ± 23.1 versus 72.4 ± 21.1). Physical and psychological QoL scores were lower (p < 0.05) among IPV victims in both settings. The predictors of overall QoL were experience of any IPV, perceived social support, partner’s age, while experience of sexual IPV and partner’s age were predictors of psychological QoL. Lastly, the predictors of physical QoL were experience at sexual debut and perceived social support.

CONCLUSION: Experience of IPV was common in both communities, with a consequential reduction in the QoL of young women. Measures to improve the QoL of young women need to target reduction of IPV and available social support in both settings.

PMID:40158170 | DOI:10.1186/s12889-025-22385-0

World J Surg Oncol. 2025 Mar 29;23(1):107. doi: 10.1186/s12957-025-03717-1.

ABSTRACT

BACKGROUND: Neuropilin and tolloid-like 2 (NETO2) facilitates the progression of various cancers, but its role in hepatocellular carcinoma (HCC) is not known. This study aimed to assess the potential of targeting NETO2 in HCC and its relationship with the STAT3/C-MYC pathway.

METHODS: HCC cells (Huh7 and MHCC-97 H) were cultured and transfected with control siRNA (siCtrl), NETO2 siRNA (siNETO2), control overexpression (oeCtrl), or NETO2 overexpression (oeNETO2), with non-transfected cells used as blank controls.

RESULTS: NETO2 mRNA and protein expressions were reduced in both Huh7 and MHCC-97 H cells. EdU and CCK-8 assays indicated that cell proliferation was decreased after siNETO2 transfection in Huh7 and MHCC-97 H cells. TUNEL assay found revealed that the cell apoptosis rate was greater after siNETO2 transfection in MHCC-97 H cells, and tended to be greater in Huh7 cells (but the difference was not statistically significant). Transwell invasion assay revealed that the number of invasive Huh7 and MHCC-97 H cells decreased after siNETO2 transfection. Cell scratch assay revealed that the cell migration rate was reduced after siNETO2 transfection in Huh7 cells but was not significantly different in MHCC-97 H cells. Western blotting revealed that p-STAT3 and C-MYC expressions were decreased after siNETO2 transfection in Huh7 and MHCC-97 H cells. Overexpression experiments revealed that cell proliferation and invasion were promoted but that the cell apoptosis rate was reduced after oeNETO2 transfection in Huh7 and MHCC-97 H cells.

CONCLUSION: NETO2 knockdown suppresses HCC cell proliferation, invasion, and migration and inactivates the STAT3/C-MYC pathway, suggesting that NETO2 is a potential target for HCC treatment.

PMID:40158169 | DOI:10.1186/s12957-025-03717-1

Cardiovasc Diabetol. 2025 Mar 29;24(1):147. doi: 10.1186/s12933-025-02692-x.

ABSTRACT

BACKGROUND: The Cardiovascular-Kidney-Metabolic (CKM) syndrome underscores the complex interactions among metabolic disorders, kidney disease, and cardiovascular conditions. Insulin resistance (IR) and inflammation are crucial in CKM syndrome development, but their combined effect in stages 0-3 remains unclear.

METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES), we included 18,295 participants with CKM syndrome stages 0-3 from 10 cycles between 1999 and 2018. IR was assessed using the estimated glucose disposal rate (eGDR), and systemic inflammation was evaluated using the Systemic Inflammation Response Index (SIRI). The primary endpoint was all-cause mortality, and the secondary endpoint was cardiovascular disease (CVD) mortality.

RESULTS: Over an average follow-up period of 121 months, we recorded 1,998 all-cause deaths and 539 CVD deaths. Both eGDR and SIRI were independent risk factors for mortality. The hazard ratios (HR) for eGDR were 0.90 (0.86, 0.94) for all-cause mortality and 0.85 (0.78, 0.93) for CVD mortality, per unit increase in eGDR. For SIRI, the HRs were 1.16 (1.11, 1.21) for all-cause mortality and 1.33 (1.19, 1.46) for CVD mortality, per unit increase in SIRI. Compared to individuals with high eGDR and low SIRI levels, those with low eGDR and high SIRI levels exhibited significantly higher mortality risks, with HRs of 1.97 (1.58, 2.44) for all-cause mortality and 2.35 (1.48, 3.73) for CVD mortality. Subgroup analysis revealed that the combined impact of eGDR and SIRI was particularly significant in patients under 60 years old.

CONCLUSION: In CKM syndrome stages 0-3, eGDR and SIRI have joint effect on mortality. Combining these markers can help identify high-risk individuals early, enabling timely monitoring and intervention to improve outcomes.

PMID:40158167 | DOI:10.1186/s12933-025-02692-x

BMC Palliat Care. 2025 Mar 29;24(1):86. doi: 10.1186/s12904-025-01726-1.

ABSTRACT

BACKGROUND: Death anxiety in physicians is considered to be a possible factor affecting the quality of palliative care. As the reserve force of future medical careers, the level of death anxiety among clinical medical freshmen and its impact mechanism deserves attention. Previous studies have indicated that personality traits and self-efficacy may be factors influencing death anxiety. However, there is limited research on the current state of death anxiety among clinical medical freshmen, and the impact of health personality, death coping self-efficacy on death anxiety. The objectives of this study were to investigate the death anxiety levels of clinical medical freshmen, explore whether death anxiety is affected by health personality and death coping self-efficacy, and examine whether death coping self-efficacy mediates the association between health personality and death anxiety among clinical freshmen.

METHODS: A cross-sectional survey among 378 clinical medical freshmen was conducted at a university in Wuhan, Hubei Province, China between June and July 2023. Demographic questionnaire, the Chinese versions of the Health Personality Assessment (HPA), Death Coping Self-efficacy Scale (DCSS) and Death Anxiety Scale (DCS) were used. SPSS 25.0 statistical software was used for descriptive analysis, independent sample t-tests, one-way ANOVA, and Pearson correlation analysis. The mediating effect analysis was performed with PROCESS version 4.1 Model.

RESULTS: A total of 360 valid questionnaires were collected. Clinical medical freshmen exhibited high levels of death anxiety was (45.55 ± 7.57). Health neuroticism has a significant positive impact on death anxiety (β = 0.407, t = 2.323, P < 0.05). In contrast, death anxiety was significantly impacted negatively by death coping self-efficacy (β=-0.105, t=-3.441, P < 0.05). The association between health neuroticism and death anxiety was partially mediated by death coping self-efficacy; the mediating impact accounted for 18.44% of the total effect, with a 0.092 coefficient.

CONCLUSIONS: This study revealed that clinical medical freshmen had high levels of death anxiety. Health neuroticism and death coping self-efficacy directly affected clinical medical freshmen’ death anxiety. Death coping self-efficacy mediated the relationship between health neuroticism and death anxiety among clinical medical freshmen. Interventions by medical educators that focus on both individuals’ health personality and death coping self-efficacy may be most effective in reducing death anxiety among clinical medical freshmen.

PMID:40158159 | DOI:10.1186/s12904-025-01726-1

BMC Psychiatry. 2025 Mar 29;25(1):301. doi: 10.1186/s12888-025-06754-y.

ABSTRACT

BACKGROUND: The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7) are widely used symptom-based instruments for screening depression and anxiety. However, their validation in Chinese children and adolescents remains insufficient. We aim to investigate the performance and optimal cut-offs of PHQ-9 and GAD-7 in Chinese children and adolescents in screening clinical depression and anxiety, and to discuss the influencing factors of the cut-offs.

METHODS: The study subjects were chosen from 3 sites of the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a total of 2,237 participants who had been screened positive by self-administered questionnaire and further diagnosed by using the gold standard were included in the final analysis. The Receiver Operating Characteristic (ROC) curves were used to determine the discriminative ability of the two instruments, measured by using the area under curve (AUC). The optimal cut-offs of the two instruments were determined by the maximum Youden’s index. A series of stratified analyses were performed to discover the best cut-offs for children and adolescents of different characteristics. Logistic regression models were adopted to evaluate the influence of self-harm (SH) on identified optimal cut-offs.

RESULTS: We found the performance was generally poor for both the PHQ-9 and GAD-7 in screening clinical depression and anxiety in our study sample, with the AUCs ranged only between 0.622-0.712. When using the two instruments for diagnosis purpose, 11 was the optimal cut-off for both clinical depression and anxiety (AUC for PHQ-9: 0.664, AUC for GAD-7: 0.669). For study subjects of different age, gender, race, and left-behind status, discordant cut-offs were identified. SH also showed conspicuous influence on the optimal cut-offs of PHQ-9 and GAD-7, and the combination of SH information can increase screening accuracy of PHQ-9 in some subgroups.

CONCLUSIONS: Both the PHQ-9 and GAD-7 showed poor performance in screening clinical depression and anxiety in our study sample. This crucial finding suggests that, despite the wide use of the two scales, they might be fundamentally inadequate for depression and anxiety screening in Chinese children and adolescents. Other screening tools of higher accuracy should be developed and used in this age group.

PMID:40158158 | DOI:10.1186/s12888-025-06754-y

BMC Public Health. 2025 Mar 29;25(1):1195. doi: 10.1186/s12889-025-22335-w.

ABSTRACT

BACKGROUND: The under-five child stunting has remained a public health problem in the world. In Rwanda, child stunting rates have fluctuated significantly and remained higher than the targets despite a continuing decline of the national average rate. The key drivers of the persistently high child stunting rates and their geographical variation in Rwanda are currently not well known. This study examined the spatial and temporal variation of the under-five child stunting rates and associated factors in Rwanda between 2010 and 2020.

METHODS: This study analysed data from the 2010 Rwanda Demographic and Health Survey (RDHS) (n = 4075), the 2014/15 RDHS (n = 3538), and the 2019/20 RDHS (n = 3809). A series of geo-additive binary logistic regression analyses were used to identify the key risk factors for child stunting and their variation in Rwanda between 2010 and 2020.

RESULTS: The results show significant variation in the key risk factors over the studied period. The child’s gender, birth order, age, and birth weight, mother’s height and marital status, number of antenatal care visits, household economic status, and altitude were consistently significant factors of child stunting in Rwanda. The influence of place of residence, mother’s education, water source, and type of toilet facility varied. The district-level spatial effects significantly attenuated in the Eastern province while they intensified in the Western and Northern provinces.

CONCLUSIONS: The key risk factors for the under-five child stunting and their importance varied considerably over time in Rwanda. The findings suggest the need to improve the household-level welfare by strengthening targeted and district-tailored intervention programs from a multi-sectorial perspective, and sustain the programs outcomes beyond the intervention period.

PMID:40158157 | DOI:10.1186/s12889-025-22335-w