Category: Nevin Manimala

BMC Pediatr. 2026 Jan 31. doi: 10.1186/s12887-026-06526-x. Online ahead of print.

ABSTRACT

BACKGROUND: Child malnutrition is a critical public health issue in Bangladesh, significantly affecting child development and health. This study analyzes the prevalence and determinants of malnutrition among children under five years old using data from the Bangladesh Demographic and Health Survey (BDHS) 2017-18.

METHODS: The study employed Generalized Linear Mixed Models (GLMM) and Generalized Estimating Equations (GEE) to examine socio-economic, demographic, and health-related factors associated with stunting, wasting, and underweight conditions among children.

RESULTS: The study found that 31% of children were stunted, 22% were underweight, and 8% were wasted in Bangladesh in 2017-18, with overlaps likely among these forms of malnutrition. Higher parental education levels and wealthier household status were significantly (p < 0.05) associated with a lower prevalence of malnutrition. Children from Sylhet had 1.3 times higher odds of being stunted (AOR = 1.3, 95% C.I. = 1.05-1.65) and 1.46 times higher odds of being underweight (AOR = 1.46, 95% C.I. = 1.14-1.88) compared to children from Barisal. Mothers with normal BMI were significantly less likely to have stunted (AOR = 0.67, 95% C.I. = 0.56-0.79), wasted (AOR = 0.49, 95% C.I. = 0.37-0.66), and underweight (AOR = 0.63, 95% C.I. = 0.53-0.75) children compared to mothers with underweight BMI. Both GLMM and GEE models identified the same associated factors for stunting, wasting, and underweight, with close estimates. However, GLMM was found to have better predictive power for all three models, as indicated by higher area under the curve (AUC) values.

CONCLUSION: The findings emphasize the association of poor parental education, economic conditions, and maternal health with child malnutrition in Bangladesh. The GLMM demonstrated better predictive power based on AUC values across all three outcomes, making it a more reliable choice for this type of analysis. Policymakers should prioritize enhancing maternal education, household economic status, and access to healthcare services.

PMID:41620673 | DOI:10.1186/s12887-026-06526-x

BMC Cardiovasc Disord. 2026 Jan 31. doi: 10.1186/s12872-026-05582-6. Online ahead of print.

ABSTRACT

BACKGROUND: This study employed four-dimensional automated left atrial quantitative analysis (4D Auto LAQ) technology to assess left atrial structure and function in patients with H-type hypertension and to investigate the impact of serum homocysteine (Hcy) level on the left atrium in patients with primary hypertension.

METHODS: A total of 173 patients with primary hypertension newly diagnosed between December 2023 and December 2024 were enrolled and divided into two groups: H-type hypertension (n = 85) and non-H-type hypertension (n = 88). Additionally, 60 healthy volunteers were recruited as the control group.

RESULTS: The results showed that compared with the non-H-type hypertension group and the control group, the H-type hypertension group exhibited statistically significant differences in Hcy, total cholesterol, triglycerides, estimated glomerular filtration rate (eGFR), and uric acid (p < 0.05). Additionally, there was a decrease (p < 0.05) in left atrial reservoir systolic longitudinal strain (LASr), left atrial systolic longitudinal strain (LASct), left atrial reservoir systolic circumferential strain (LASr-c), and left atrial systolic circumferential strain (LASct-c). Multiple linear regression analysis identified plasma Hcy levels as an independent associated factor for decreased left atrial strain parameters, including LASr (β=-0.246, p < 0.001), LASct (β=-0.279, p < 0.001), LASr-c (β=-0.333, p < 0.001), and LASct-c (β=-0.303, p < 0.001).

CONCLUSIONS: In conclusion, patients with H-type hypertension have decreased left atrial strain parameters, and when serum Hcy levels rise, the degree of strain dysfunction gradually gets worse. This suggests that these parameters could be used as an early indicator of left atrial myocardial injury in patients with H-type hypertension.

PMID:41620662 | DOI:10.1186/s12872-026-05582-6

BMC Infect Dis. 2026 Jan 31. doi: 10.1186/s12879-026-12664-5. Online ahead of print.

NO ABSTRACT

PMID:41620659 | DOI:10.1186/s12879-026-12664-5

BMC Med Educ. 2026 Jan 31. doi: 10.1186/s12909-026-08642-9. Online ahead of print.

ABSTRACT

INTRODUCTION: The Medical Education Society (MedED) at Imperial College School of Medicine (ICSM) offers near-peer educational opportunities across all years of medical school. Near-peer education has demonstrated significant benefits in medical education. However, studies have yet to explore the value of establishing a peer-to-peer teaching community.

METHODS: Medical students who participated in MedED as student-attendees or student-teachers during the academic year 2022-23 were invited to participate in a survey and follow-up interview, exploring their experiences within the Society. Survey data was collected anonymously through Qualtrics, and interviews were held on Microsoft Teams. Quantitative survey data was analysed using descriptive statistics, while interview transcripts and free-text survey responses underwent inductive thematic analysis.

RESULTS: A total of 66 students completed the survey, with 19 (28.8%) from years 1-2 and 47 (71.2%) from years 3-6. Early-year students had higher lecture attendance rates (79%) compared to later-year students (34%), and both groups preferred online rather than in-person lectures (both > 50%). For student-attendees, benefits of participating in MedED included improving knowledge, motivation and sense of community. Among student-teachers, main motivations for teaching included helping others and developing transferrable skills. A total of 13 participants were interviewed, including 5 who were both student-attendees and student-teachers. Three themes emerged: academic value, highlighting knowledge and skills gained through MedED; career prospects, focusing on long-term professional benefits; and sense of community and wellbeing, emphasising the positive social interactions and support networks fostered through MedED.

CONCLUSION: MedED provides student-led teaching initiatives that supplement the formal curriculum, enhancing student confidence and inclusivity, and fostering a sustainable community of peer-education. Beyond immediate academic values, this community has also created longer-term, personal and professional impacts on students, including broadening career aspirations. This work highlights opportunities for further development through student-staff collaborations and the role of peer communities in supporting student wellbeing.

PMID:41620657 | DOI:10.1186/s12909-026-08642-9

BMC Gastroenterol. 2026 Jan 31. doi: 10.1186/s12876-026-04654-3. Online ahead of print.

ABSTRACT

BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common brain-gut interaction disorders, characterized by chronic abdominal pain, altered bowel habits, and heightened stress responses that significantly affect patients’ psychological functioning and quality of life. Given that chronic stress plays a central role in the onset and maintenance of IBS symptoms, identifying psychological resources that promote adaptation and well-being is crucial. The present study aimed to examine the mediating role of resilience in the relationship between cognitive flexibility and psychological well-being among patients with IBS.

METHOD: This descriptive-correlational study employed a structural equation modeling approach. The statistical population included all IBS patients who referred to the Gastrointestinal Health Center at Al-Zahra Hospital in Isfahan in 2024. A sample of 300 patients was selected using convenience sampling. Data were collected using the Psychological Well-Being Scale, Cognitive Flexibility Inventory, and Connor-Davidson Resilience Scale, and analyzed using SPSS and AMOS version 28.

FINDINGS: Results showed that cognitive flexibility and resilience significantly predicted psychological well-being, and that resilience mediated the relationship between cognitive flexibility and psychological well-being. These findings highlight the importance of resilience and cognitive flexibility as protective psychological resources that help patients manage stress and improve well-being in the context of IBS.

PMID:41620640 | DOI:10.1186/s12876-026-04654-3

BMC Musculoskelet Disord. 2026 Jan 31. doi: 10.1186/s12891-026-09567-6. Online ahead of print.

ABSTRACT

BACKGROUND: Anterior glenohumeral instability is a common issue, particularly among young and active individuals. Arthroscopic Bankart repair is an effective surgical method for achieving long-term shoulder stability. However, despite favorable biomechanical outcomes, return to sport rates vary widely. Psychological factors, especially kinesiophobia, may play a decisive role in this variability.

PURPOSE: The aim of this study was to evaluate the impact of postoperative kinesiophobia on clinical outcomes, functional scores, and return to sport following arthroscopic Bankart repair.

METHODS: A retrospective review was conducted on 73 patients who underwent arthroscopic Bankart repair between December 2019 and June 2024. All patients had a minimum follow-up of 12 months. The Tampa Scale for Kinesiophobia (TSK), Western Ontario Shoulder Instability Index (WOSI), and American Shoulder and Elbow Surgeons Shoulder Score (ASES) were utilized for assessments. Patients were stratified based on their TSK scores, and the relationships between kinesiophobia levels, functional outcomes, and return-to-sport rates were analyzed statistically.

RESULTS: The mean patient age was 28 years (range, 15-47 years), with a mean follow-up period of 22 months (range, 12-50 months). Patients with high TSK scores demonstrated significantly worse WOSI and ASES outcomes (p < 0.001), indicating poorer shoulder-related quality of life and diminished shoulder function. Elevated levels of kinesiophobia were also associated with reduced rates of high-level return to sport. A strong positive correlation was observed between preoperative and postoperative TSK scores (r = 0.611), suggesting persistence of kinesiophobia over time. Despite achieving surgical stability, fear of reinjury emerged as a significant barrier to returning to sport.

CONCLUSION: Kinesiophobia is a critical psychological factor that adversely affects functional recovery and return to sport following arthroscopic Bankart repair. Patients with high levels of kinesiophobia demonstrated poorer shoulder function, reduced shoulder-related quality of life, and lower rates of return to high-level sport, despite achieving surgical stability. These findings highlight the importance of incorporating psychological assessment and targeted interventions into postoperative rehabilitation protocols to optimize functional outcomes and facilitate a successful return to sport.

PMID:41620625 | DOI:10.1186/s12891-026-09567-6

Angiology. 2026 Jan 31:33197261416660. doi: 10.1177/00033197261416660. Online ahead of print.

ABSTRACT

Acute myocardial infarction is a major cause of mortality in individuals with obstructive airway disease. The impact of inpatient care quality following non-ST elevation myocardial infarction (NSTEMI) on long-term mortality among those with chronic obstructive pulmonary disease (COPD) and asthma remains poorly understood. We analysed 499 318 adults with NSTEMI from the Myocardial Ischaemia National Audit Project registry between 2005 and 2019, linked with Hospital Episode Statistics for airway disease diagnosis and Office for National Statistics data for mortality outcomes. Inpatient care quality was measured using the opportunity-based quality-indicator (OBQI) score. Long-term outcomes were evaluated using multivariable Cox regression and Kaplan-Meier analyses. Individuals with COPD and asthma received lower quality of care (OBQI score: no airways disease: 83.5 vs COPD: 78.1, asthma: 80.8, P < .001). Percutaneous coronary intervention was less frequent in COPD patients (22%) than in those without airway disease (30%) or with asthma (31%), P < .001. COPD was associated with higher 10-year mortality (hazard ratio [HR]: 1.58, 95% CI 1.56-1.60), whereas those with asthma had lower risk (HR: 0.97, 95% CI 0.95-0.98). COPD was associated with increased adjusted cardiovascular mortality (sub-distribution HR: 1.89, 95% CI 1.84-1.95). Individuals with COPD received lower-quality inpatient care and fewer coronary interventions, which was associated with higher long-term mortality.

PMID:41619185 | DOI:10.1177/00033197261416660

Int J Clin Oncol. 2026 Jan 31. doi: 10.1007/s10147-026-02977-5. Online ahead of print.

ABSTRACT

BACKGROUND: In the EMBRACE study, eribulin (ERI) monotherapy improved the overall survival (OS) of patients with HER2-negative advanced breast cancer (HER2-negative ABC). A post hoc analysis identified the baseline absolute lymphocyte count (ALC) as a predictive marker in the ERI arm; nevertheless, factors affecting post-ERI had not been well explored.

PATIENTS AND METHODS: We retrospectively analyzed clinical data of 370 patients receiving ERI for HER2-negative ABC between July 2011 and June 2024 across 3 institutions. Clinical data, including ALC, were extracted. Statistical analyses included the log-rank test and Cox hazard model. The OS was defined as survival from ERI initiation (OS1) and from ERI termination (OS2).

RESULTS: Identical to the previous report, the OS1 was significantly improved in patients with ALC ≥ 1000/μL at ERI initiation and with ER-positive. Regarding the OS2, we identified independent factors which significantly improve the OS2 as follows: ALC ≥ 1000/μL at the termination of ERI, ≥ 120 days time-to-treatment-discontinuation of ERI, and first-line use of ERI. Furthermore, ALC was maintained during ERI therapy, whereas it significantly decreased in other regimens (P < 0.001).

CONCLUSION: An ALC ≥ 1000/μL at ERI completion was associated with an improved post-ERI OS (OS2). It is suggested that not only the factors at the initiation of ERI, but also the immunological status at the end of ERI, may have prognostic value after ERI.

PMID:41619158 | DOI:10.1007/s10147-026-02977-5

Clin Rheumatol. 2026 Jan 31. doi: 10.1007/s10067-025-07754-9. Online ahead of print.

ABSTRACT

INTRODUCTION/OBJECTIVES: Psychological stress impacts rheumatoid arthritis (RA) disease activity, and California’s response to the COVID-19 pandemic created historically significant stressors for patients. This study examined factors associated with changes in RA flares during the pandemic.

METHODS: In this cross-sectional COVID-19 RA study, patients with RA ICD-9/10 codes were emailed a questionnaire in July/November of 2020 containing questions on RA disease activity, Routine Assessment of Patient Index Data 3 (RAPID3), flare number and frequency, RA Flare Questionnaire (RA-FQ), Perceived Stress Scale 4 (PSS-4), stressors, and demographics. Age, anti-cyclic citrullinated antibody, and rheumatoid factor were extracted from medical records. Analyses examined associations between current flare status, number of flares, and changes in flare frequency with PSS-4 and stressors.

RESULTS: Of 1138 respondents (22.6% response rate), 69.3% reported at least one RA flare, 43% multiple flares, and 36.3% currently experiencing a flare. Compared to pre-pandemic levels, 36.3% noted more frequent flares, while 9.2% reported fewer. Increased stress was noted across all flare groups. Regression analyses revealed significant associations between current flare and PSS-4 scores, financial stress, and sleep quality (all p < 0.03). A higher number of flares were significantly associated with PSS-4, financial stress, and home stress (p < 0.03). Increased flare frequency was associated with PSS-4, apprehension, panic, financial stress, and sleep quality (all p < 0.05). Asian race was negatively associated with the number of flares and flare frequency (both p < 0.05).

CONCLUSIONS: This study reports a link between stress and RA flares during the pandemic, underscoring the need for targeted strategies to manage RA patients at risk of flare during heightened stress. Key Points • During the COVID-19 pandemic, patient-reported RA flares increased significantly compared to pre-pandemic levels, signifying there may be value in reevaluating RA management strategies during periods of heightened stress. • Financial stress, home stress, and poor sleep were major pandemic stressors linked to current and increased frequency of RA flares. • RA patients not in remission may be more susceptible to disease exacerbations while under stress, as those experiencing flares during the pandemic were less likely to have been in remission beforehand. • Asian race was associated with fewer RA flares and reduced flare frequency, suggesting racial and ethnic differences may influence flare patterns.

PMID:41619155 | DOI:10.1007/s10067-025-07754-9

Clin Rheumatol. 2026 Jan 31. doi: 10.1007/s10067-025-07755-8. Online ahead of print.

ABSTRACT

BACKGROUND: A well-known global public health issue, osteoarthritis (OA) primarily affects the elderly. Although the etiology of OA remains unknown, immune and inflammatory factors are considered nonnegligible risk factors. This study investigated the association between the systemic immune-inflammatory index (SII) and the risk of OA.

METHODS: Based on data from the National Health and Nutrition Examination Survey (NHANES), laboratory testing, basic information, and questionnaires were collected for cross-sectional analysis from a total of 15,317 adults during 2013-2018. In this study, the exposure variable was systemic inflammatory status as defined by SII, and the outcome was OA. Due to the complex survey design and sample weighting, we employed multiple logistic regression models and stratified analyses to evaluate the association between SII and OA. In addition, using an interaction test, we examined the relationship between SII, OA, and other variables.

RESULTS: This study included a total of 15,317 participants, of whom 2207 were diagnosed with OA. Compared with the non-OA group, participants in the OA group had a significantly higher SII level. After adjusting for all covariates, log SII was positively associated with OA prevalence (OR = 1.27, 95% CI: 1.02, 1.59, P = 0.0353). Participants in the fourth SII quartile had a significantly higher OA prevalence than those in the first quartile (OR = 1.18, 95% CI: 1.00, 1.39, P = 0.0454). Subgroup analyses further confirmed the robustness of this positive association.

CONCLUSION: Our study demonstrated that SII was associated with the risk of OA, suggesting a complex correlation between immunity and inflammation in OA. SII may serve as a useful predictor of OA and offer new insights into the diagnosis and management of the condition. Key Points • Elevated systemic immune-inflammatory index (SII) is significantly associated with a higher prevalence of osteoarthritis in a large, representative US adult population. • This positive association persists after comprehensive adjustment for potential confounders and across diverse population subgroups. • SII, as a novel and integrated biomarker, may offer valuable insights for the prediction and management of osteoarthritis.

PMID:41619154 | DOI:10.1007/s10067-025-07755-8