Nevin Manimala

J Cannabis Res. 2025 Jun 18;7(1):36. doi: 10.1186/s42238-025-00297-5.

ABSTRACT

BACKGROUND: Medical cannabis (MC) is approved for the treatment of opioid use disorder (OUD) in Pennsylvania, but little is known about how MC impacts illicit opioid use or the clinical and psychosocial factors including pain severity levels that can precede illicit opioid use. This observational study examined the extent to which changes in rates of illicit opioid use and in pain and psychosocial functioning were observed following the first three months of MC treatment.

METHODS: A referred sample of 47 adults taking buprenorphine/naloxone for OUD with a minimum pain severity rating of 5/10 enrolled from March 2022-April 2023. Participants were recruited from an outpatient MC physician recommender’s office and were offered a discounted MC 1:1 tetrahydrocannabinol:cannabidiol 5 mg:5 mg daily oral capsule. The primary study outcomes were pain severity, self-efficacy and interference, and the rates of illicit substance use as assessed via urine drug screening (UDS).

RESULTS: Participants (64% male, 49% Black, average age = 44 years) reported significant decreases in pain severity from baseline (M = 5.18, SD = 2.09) to Month 3 (M = 4.39, SD = 2.28), P < 0.01, Cohen’s d = 0.54, and pain interference from baseline (M = 5.21, SD = 2.79) to Month 3 (M = 4.32, SD = 2.86), P < 0.01, Cohen’s d = 0.47, and increases in pain-related self-efficacy from baseline (M = 6.55, SD = 3.57) to Month 3 (M = 8.05, SD = 3.30), P < 0.01, Cohen’s d = 0.44. Rates of opioid use (X²[1] = 4.00, P = 0.13) did not differ significantly from baseline (16%) to Month 3 (5%). Cravings for opioids were mildly higher at baseline (M = 2.15, SD = 2.88) than at 3-months (M = 1.78, SD = 2.95) but this difference was not statistically significant, P = 0.49, d = 0.1. Sleep quality scores improved significantly from baseline (M = 12.38, SD = 4.40) to Month 3 (M = 10.95, SD = 4.95), P < 0.05, d = 0.33. Quality of life significantly improved in seven of eight domains (P < 0.05).

CONCLUSION: MC treatment initiation was associated with reductions in pain severity and interference and improvements in quality of life and sleep quality, but not in illicit opioid use or cravings in adults with chronic pain receiving buprenorphine/naloxone for OUD.

PMID:40533856 | DOI:10.1186/s42238-025-00297-5

J Health Popul Nutr. 2025 Jun 18;44(1):205. doi: 10.1186/s41043-025-00944-w.

ABSTRACT

AIM: Depression is a prevalent mental health disorder in patients with cardiovascular disease worldwide. The purpose of this observational study was to determine the association between nutrients intake, food insecurity, and diet quality with depression in patients with coronary artery diseases (CAD).

MATERIALS AND METHODS: This cross-sectional study was conducted on 225 coronary artery patients. Nutrients intake, diet quality (by calculating Framingham Nutrition Risk Score (FNRS)), food insecurity and depression status of patients were obtained by using standard validated questionnaires. Relevant statistical analyses including logistic regression were used to analyze all data. P-value ≤ 0.05 was considered significant.

RESULTS: The multivariate-adjusted regression model showed that a higher intake of total fat (P = 0.02, OR = 1.031) increases the odds of depression. However, a higher intake of PUFA and Vitamin B12 was associated with its lower odds. (P = 0.005, OR = 0.87 and P = 0.005, OR = 0.73, respectively). It also indicated food insecurity was associated with depression in CAD patients (P < 0.001, OR = 6.92). FNRS could not show any significant association.

CONCLUSION: This study indicated that the dietary intake of PUFA and vitamin B12 were negatively associated with depression, while the intake of total fat from diet was directly associated with depression and might be considered as a risk factor in CAD patients. Furthermore, food insecurity was strongly and positively associated with depression in these patients. However, diet quality based on FNRS was not associated with depression among patients with CAD.

PMID:40533855 | DOI:10.1186/s41043-025-00944-w

J Health Popul Nutr. 2025 Jun 18;44(1):206. doi: 10.1186/s41043-025-00976-2.

ABSTRACT

The rising prevalence of hypertension underscores the urgent need for effective management strategies. While niacin-based medications and supplements have shown promise in improving outcomes among patients with hypertension, the impact of dietary niacin intake on prognosis remains an area requiring further investigation. Using data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2016, this study examined the association between dietary niacin intake and mortality risk among 13,237 individuals with hypertension. During a median follow-up of 103 months, 3,151 participants (23.80%) died from all causes, and 864 (7.89%) died from cardiovascular diseases. In multivariable-adjusted Cox proportional hazards models, dietary niacin intake was independently associated with a lower risk of both all-cause mortality (HR = 0.993, 95% CI: 0.986-1.000, p = 0.036) and cardiovascular mortality (HR = 0.984, 95% CI: 0.971-0.997, p = 0.017). Niacin intake was categorized into quartiles: Q1 (< 15.5 mg/day), Q2 (15.5-21.1 mg/day), Q3 (21.1-28.2 mg/day), and Q4 (> 28.2 mg/day). Cox regression analysis indicated that participants in the Q3 group had a significantly lower risk of all-cause mortality compared to those in Q1 (HR = 0.788, 95% CI: 0.657-0.944, p = 0.010). Moreover, restricted cubic spline (RCS) analysis revealed a U-shaped association between dietary niacin intake and all-cause mortality (P for nonlinearity = 0.016). These findings highlight the potential benefits of dietary niacin in reducing mortality risk among hypertensive individuals and suggest that moderate increases in dietary niacin intake may represent a feasible strategy for reducing mortality risk in this population.

PMID:40533845 | DOI:10.1186/s41043-025-00976-2

J Health Popul Nutr. 2025 Jun 18;44(1):208. doi: 10.1186/s41043-025-00915-1.

ABSTRACT

BACKGROUND: Uterine cancer poses a growing global health threat, with rising incidence among women aged ≥ 50 years. This study aimed to evaluate its disease burden across regions and nations.

METHODS: Using Global Burden of Disease 2021 data, we analyzed the incidence, mortality, disability-adjusted life years (DALYs), and trends via estimated annual percentage change (EAPC), decomposition, inequality analyses, and Bayesian Age-Period-Cohort modeling for 2022-2040 projections.

RESULTS: In 2021, global uterine cancer cases among women ≥ 50 years reached 414,754 (95% UI: 370,388-453,502), causing 90,509 deaths (95% UI: 78,633-101,441) and 2,189,261 DALYs (95% UI: 1,920,396-2,446,737). Age-standardized incidence rate (ASIR) rose (EAPC = 0.56, 1990-2021), while mortality and DALYs declined. High-income North America had the highest ASIR (128/100,000), with the United States, China and Russia leading new cases. High Socio-demographic index (SDI) regions exhibited widening disparities, evidenced by a 21% increase in the slope index of inequality (SII) for incidence (47 in 1990 to 57 in 2021) and concentration indices (CI) rising from 0.33 (95% CI: 0.28, 0.37) in 1990 to 0.35 (95% CI: 0.29, 0.4) in 2021. Population growth drove 132.55% of DALY changes, outweighing epidemiological (-32.95%) and aging (0.4%) factors. Projections suggest declining ASIR, the age-standardized mortality rate (ASMR), and DALY rates by 2040, yet absolute cases will rise to 617,571 new cases, 131,961 deaths, and 2,851,768 DALYs.

CONCLUSIONS: Despite declining mortality and DALY rates, uterine cancer incidence continued to increase globally, driven by population growth. High-income regions faced disproportionate burdens, with persistent health inequities. Projected absolute case growth demands urgent prioritization of equity-oriented screening, prevention, and resource allocation. Governments must integrate targeted interventions with global aging policies to address this dual burden of epidemiological transition and health inequity.

PMID:40533844 | DOI:10.1186/s41043-025-00915-1

Arch Public Health. 2025 Jun 18;83(1):159. doi: 10.1186/s13690-025-01656-7.

ABSTRACT

BACKGROUND: Abortion is one of the leading causes of maternal death in developing countries, particularly in sub-Saharan Africa (sSA,). In this region, abortion is responsible for 38,000 maternal deaths, making the area with the highest rate of abortion-related mortality in the world. This study aimed to examine the prevalence and associated factors of induced abortion in 33 countries in the region.

METHOD: We used data from the most current Demographic and Health Surveys (DHS) conducted in 33 sSA countries between 2012 and 2022. A total 367,881 of women were included in the analysis. The Bayesian multilevel logistic regression model was used to determine the factors associated to induced abortion because of the hierarchical nature of the DHS data.

RESULTS: The overall prevalence of induced abortion was 16.50% in sSA. The random effects model revealed that about 75% of the variation in the induced abortion was caused by community and individual-level factors. Based on the Bayesian multilevel logistic regression model, women who smoke cigarettes(AOR = 1.044; 95%CI: 1.020, 1.070), 24-month and above birth interval(AOR = 5.747; 95%CI: 5.595, 5.889), rich women(AOR = 1.470, 95%CI: 1.436, 1.510), secondary and above-educated women (AOR = 2.640, 95%CI: 2.567, 2.707), being exposed to the media (AOR = 1.099, 95%CI: 1.083, 1.115), rural women (AOR = 1.025, 95%CI: 1.004, 1.047) and having pregnancy complications (AOR = 1.095, 95%CI: 1.067, 1.124) were associated with higher odds of induced abortion. But, the odds of an induced abortion were lower for women 35-49 years of age(AOR = 0.019, 95% CI: 0.018, 0.019), having 2-3 birth history(AOR = 0.105, 95%CI: 0.102, 0.107), having family size of 4-6 (AOR = 0.747; 95%CI: 0.735, 0.760), using contraception (AOR = 0.747; 95%CI: 0.735, 0.760), being married (AOR = 0.642; 95%CI: 0.628, 0.654), and being a working woman(AOR = 0.673; 95%CI: 0.658, 0.687).

CONCLUSION: The prevalence of induced abortion was high in the sSA countries with a significant country-specific variations. Therefore, public health programs shall focus on sexual and reproductive health education for young women, rural women, unmarried women, and rich women, in order to address this problem. Furthermore, it is crucial to formulate policies and initiatives that consider regional disparities in the prevalence of induced abortion and to actively pursue their implementation.

PMID:40533838 | DOI:10.1186/s13690-025-01656-7

J Pharm Health Care Sci. 2025 Jun 18;11(1):52. doi: 10.1186/s40780-025-00461-2.

ABSTRACT

BACKGROUND: Women often experience a decline in sexual desire as they age, particularly during menopause. An increase in sexual dysfunction is associated with the worsening of genitourinary symptoms that occur with menopause. Anxiety, fear, and depression in postmenopausal women may further deteriorate sexual dysfunction. Utilizing modern and effective methods to enhance sexual desire in these women is a priority in midwifery care. Given previous studies, ginseng is a herbal medicine that may be suitable in this regard. This study aimed to determine the effect of ginseng on sexual function (primary outcome), menopause symptoms, depression symptoms and side events (secondary outcomes) in postmenopausal women with major depression.

METHODS: This triple-blind randomized controlled trial was conducted on postmenopausal women with major depression in Tabriz, Iran between December 2022 and March 2024. A total of 66 postmenopausal women aged 45 to 60 with major depressive disorder were randomly assigned to intervention and control groups using block randomization. The intervention group received a 250-mg ginseng capsule twice daily after meals for eight weeks, while the control group received two gelatin placebo capsules (containing liquid edible paraffin) daily, similar in appearance to the ginseng capsules. Data collection was performed using the Female Sexual Function Index (FSFI), the Beck Depression Inventory (BDI), and the Greene Climactric Scale (GCS). The independent t-test and ANCOVA were used for data analysis.

RESULTS: The two groups did not show statistically significant differences in terms of demographic and baseline outcome measures. After the intervention, the mean overall sexual function score in the ginseng group was significantly higher than in the control group (adjusted mean difference (AMD): 2.17; 95% confidence interval (95%CI): 1.32 to 3.03, P = 0.001). The mean overall menopause symptoms score (AMD: -3.61; 95% CI: -5.47 to -1.74, P < 0.001) and depression score (AMD: -3.96; 95% CI: -5.76 to -2.20, P < 0.001) were significantly lower in the ginseng group compared to the placebo group.

CONCLUSION: Ginseng is effective in improving sexual function and reducing menopause symptoms and depression in women with major depression. However, further research is needed to draw definitive conclusions.

TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N74. Date of registration: 10/12/2022; URL: https://irct.behdasht.gov.ir/user/trial/65711/view ; Date of first registration: 20/12/2022.

PMID:40533832 | DOI:10.1186/s40780-025-00461-2

Head Face Med. 2025 Jun 18;21(1):46. doi: 10.1186/s13005-025-00522-9.

ABSTRACT

BACKGROUND: Temporomandibular disorders (TMD) are multifactorial conditions that involve pain, dysfunction, and impaired jaw movement, significantly impacting patients’ quality of life. Emerging evidence suggests that psychological factors, including anxiety, depression, and stress, play a crucial role in the onset and progression of TMD. However, the exact nature of this relationship remains unclear. This study aims to systematically analyze and quantify the association between psychological factors and TMD, providing clinically relevant insights to improve patient management and therapeutic strategies.

METHODS: This study was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY202420084) to ensure methodological transparency and adherence to systematic review standards. The study design and protocol followed the Preferred Reporting of Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The National Institutes of Health (NIH) Quality Assessment Tool was used to assess the methodological quality of the included studies. The data were systematically extracted and analyzed.

RESULTS: The literature search yielded 2392 potential articles, of which 21 were included in this study. A significant correlation was found between TMD and anxiety, depression, stress, and somatization. Statistically significant differences in anxiety and depression scores were observed between patients with TMD and the controls (p < 0.00001). Stress increased TMD development and severity. In addition, subgroup analyses revealed gender differences, with depression significantly correlating with TMD in males. Similarly, students showed significant correlations between TMD and anxiety, while adults demonstrated strong associations with both anxiety and depression. Adolescents showed correlations between TMD development and somatization and obsessive-compulsiveness.

CONCLUSION: Anxiety, depression, and stress are significant risk factors for the development and progression of TMD. Subgroup analyses demonstrated significant correlations between particular psychological factors and TMD in different sub-populations.

PMID:40533828 | DOI:10.1186/s13005-025-00522-9

Diabetol Metab Syndr. 2025 Jun 18;17(1):231. doi: 10.1186/s13098-025-01810-9.

ABSTRACT

PURPOSE: To examine the association between dietary fiber intake and mortality risks (all-cause and cardiovascular) among U.S. adults with diabetes or prediabetes, and to evaluate the dose-response patterns of these associations.

MATERIALS AND METHODS: This longitudinal cohort study analyzed data from 3259 adults with diabetes or prediabetes from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Dietary fiber intake was assessed using two 24-hour dietary recall interviews. Mortality data were obtained through December 31, 2019. Multiple Cox proportional hazards models were used to evaluate associations between fiber intake and mortality outcomes, adjusting for demographic and health-related covariates.

RESULTS: Higher dietary fiber intake was significantly associated with reduced all-cause mortality risk (HR = 0.98, 95% CI: 0.97-0.99, P = 0.0039). For cardiovascular mortality, a non-linear relationship was identified with a threshold at 26.2 g/day. Below this threshold, each gram increase in fiber intake was associated with a 3% reduction in cardiovascular mortality risk (HR = 0.97, 95% CI: 0.94-0.99, P = 0.0352), while no significant benefit was observed above this threshold.

CONCLUSIONS: Dietary fiber intake shows a protective effect against all-cause mortality in U.S. adults with diabetes or prediabetes. For cardiovascular mortality, moderate fiber intake up to 26.2 g/day appears beneficial, while higher intake may not provide additional cardiovascular benefits. These findings provide important evidence for developing targeted dietary recommendations in diabetes management.

PMID:40533827 | DOI:10.1186/s13098-025-01810-9

Eur J Med Res. 2025 Jun 18;30(1):489. doi: 10.1186/s40001-025-02778-y.

ABSTRACT

BACKGROUND: To compare the demographic characteristics, maternal and perinatal outcomes and hemoglobin parameters according to stages diagnosed with placental abruption.

METHODS: Patients who underwent cesarean delivery due to clinical suspicion of placental abruption after the 20th week of gestation were included in the study. We eliminated patients with persistent hematological disorders, those on anticoagulant medications, and individuals with uterine deformities. Demographic information, body mass index, initial laboratory results, duration of hospitalization, fetal APGAR scores, and transfers to maternal and neonatal critical care units were all documented from the data system. Patients were categorized into categories based on the stages of placental abruption as outlined in the 2022 emergency obstetric care guide. Stage 0: Asymptomatic patient. Stage I: There is vaginal bleeding, clinical pain in abdomen, no signs of maternal shock or fetal distress. Stage II: There may be vaginal bleeding, no maternal shock. Fetal distress is present. Stage III: There may be maternal shock, intrauterine fetal demise is present. Presence of coagulopathy (30%). The patients were categorized as follows: Group 1 stage 0-I; Group 2 stage II; and Group 3 stage III, and the gathered data were compared among the groups.

RESULTS: A total of 150 patients were involved, with 50 patients in group 1. Group 2 comprised 59 patients, whereas Group 3 had 41 patients. Abruptions were most prevalent in group 3. The neutrophil/lymphocyte ratio (NLR) was statistically significantly elevated in groups 2 and 3. The platelet/lymphocyte ratio (PLR) was statistically significantly reduced in group 1. Hemoglobin and fibrinogen levels were deemed statistically significantly reduced in group 3. In group 2, the Apgar scores at 1 min and 5 min were the lowest, and the demand for newborn intensive care was the highest.

CONCLUSIONS: The analysis of hemogram parameters at the initial assessment may aid in the diagnosis of abruption, complementing ultrasonography, particularly in cases of early clinical suspicion. We believe that commonly conducted, cost-effective, and straightforward hemogram parameters, when augmented by artificial intelligence, can provide therapeutic support through the interpretation of data such as PLR and NLP in instances of ambiguous laboratory diagnoses, such as placental abruption.

PMID:40533823 | DOI:10.1186/s40001-025-02778-y

Diabetol Metab Syndr. 2025 Jun 18;17(1):222. doi: 10.1186/s13098-025-01760-2.

ABSTRACT

BACKGROUND: Icariin (ICA), a bioactive flavonoid derived from Epimedium species, has demonstrated anti-inflammatory and anti-fibrotic properties in preclinical studies, suggesting potential therapeutic effects on diabetic nephropathy (DN). However, systematic evaluation of its efficacy remains unclear.

OBJECTIVE: The purpose of this study is to evaluate the efficacy of Icariin on DN by preclinical evidence and meta-analysis. Meanwhile, the main possible action mechanisms of Icariin against DN were also summarized.

METHODS: As of October 1, 2024, we conducted a systematic search across seven prominent Chinese and English databases (CNKI, Wanfang, CBM, PubMed, Cochrane Library, Embase, and Web of Science) to identify studies investigating the therapeutic effects of icariin on DN. PROSPERO has released a summary protocol (registration number: CRD42024564001).

RESULTS: This meta-analysis encompassed nine studies, involving a total of 308 animals, and revealed that icariin significantly reduced blood glucose, SCR, BUN, 24 h UP, 24 h UV, KI, MDA, and IL-1β levels, while augmenting antioxidant enzyme activities (SOD and GPX). Furthermore, ICA lowered TG and TC, indicative of its potential in mitigating risk factors. However, direct comparisons between ICA and angiotensin II receptor blockers (ARB) yielded no statistically significant differences in DN treatment outcomes (p > 0.05). The greatest effects were recorded in high-dose (> 30 mg/kg/day) groups rather than in low-dose (< 30 mg/kg/day) groups. For time-response effects, subgroup analysis indicated that intervention duration of ICA can influence the treatment effect, and more beneficial effects were observed when studies had a drug administration time of < 8 weeks.

CONCLUSION: Based on an analysis of existing experimental evidence, icariin displays promise in slowing the progression of diabetic nephropathy. To validate its anti-diabetic nephropathy efficacy with greater precision and ensure its readiness for clinical translation, further confirmatory animal studies are warranted.

PMID:40533818 | DOI:10.1186/s13098-025-01760-2