Nevin Manimala

J Res Med Sci. 2025 Apr 30;30:22. doi: 10.4103/jrms.jrms_154_24. eCollection 2025.

ABSTRACT

BACKGROUND: To evaluate the safety of propofol and sevoflurane for general anesthesia in elderly.

MATERIALS AND METHODS: All studies on sevoflurane, propofol, and hyperamylasemia from the establishment of Embase, Ovid, Cochrane Library, and Google Scholar from database establishment to December 2024 were searched. Literatures were screened, and data were extracted on the grounds of inclusion and exclusion criteria. Review Manager (RevMan) (Version 5.4. The Cochrane Collaboration.) was used for statistical analysis. Outcomes assessed included time to spontaneous eye opening, extubation time, incidence rate of postoperative cognitive dysfunction (POCD), postoperative delirium, agitation, nausea and vomiting.

RESULTS: Fourteen trials were identified and included in this meta-analysis. The results showed no significant difference in time to spontaneous eye opening (P = 0.54), the incidence of POCD (P = 0.07), postoperative delirium (P = 0.37), and postoperative nausea and vomiting (P = 0.8) between the sevoflurane and propofol groups. Compared with propofol groups, extubation time (P < 0.0001) was significantly shortened by sevoflurane groups. Conversely, compared with sevoflurane, the incidence of postoperative agitation in the propofol group was significantly reduced (P = 0.04).

CONCLUSION: There was no difference in time to spontaneous eye-opening, the incidence of POCD, postoperative delirium, postoperative nausea, and vomiting between the sevoflurane and propofol groups. However, compared with propofol, sevoflurane can significantly shorten intubation time. The incidence of postoperative agitation (P = 0.04) was significantly lower in the propofol group compared with sevoflurane.

PMID:40391341 | PMC:PMC12087908 | DOI:10.4103/jrms.jrms_154_24

J Diabetes Res. 2025 May 12;2025:3148242. doi: 10.1155/jdr/3148242. eCollection 2025.

ABSTRACT

Background: Elderly patients with Type 2 diabetes mellitus (T2DM) often experience prolonged length of stay (LOS) and 30-day readmission. This study was aimed at identifying factors influencing these outcomes and develop predictive models for them. Methods: The least absolute shrinkage and selection operator (LASSO) combined with logistic regression was utilized to construct the prediction models, which were subsequently visualized through nomograms. The performance of these models was comprehensively evaluated in terms of discrimination, calibration, and clinical utility. Specifically, the discrimination capacity was assessed using the area under the receiver operating characteristic curve (AUROC), while calibration was evaluated via calibration curves and the Brier score. Clinical utility was examined through decision curve analysis (DCA) and clinical impact curve (CIC). Additionally, to verify the robustness and generalizability of the developed prediction models, subgroup analyses were conducted across various strata of the study population. Results:A total of 24 variables for 8800 patients were included for predicting prolonged LOS, and 38 variables were used for 30-day readmission prediction. In the training set, 28.42% of patients had prolonged LOS and 13.68% were readmitted within 30 days. The prolonged LOS model had an AUROC of 0.720 (95% CI: 0.703-0.737), while the 30-day readmission model achieved 0.766 (95% CI: 0.745-0.787). The Brier scores were 0.174 (95% CI: 0.168-0.180) and 0.102 (95% CI: 0.096-0.108), respectively. Both models showed good clinical utility in DCA and CIC analyses. Subgroup validation across different age groups showed consistent performance, with all AUROCs above 0.60. Albumin was identified as the most significant predictor in both models. Conclusion: The predictive models developed in this study demonstrated robust performance in forecasting common outcomes in elderly patients with T2DM. Moreover, albumin level was strongly associated with both prolonged LOS and 30-day readmission, making it a key factor in patient management.

PMID:40391336 | PMC:PMC12088840 | DOI:10.1155/jdr/3148242

J Caring Sci. 2024 Sep 29;14(1):42-51. doi: 10.34172/jcs.025.33745. eCollection 2025 Feb.

ABSTRACT

INTRODUCTION: Internet addiction is a growing phenomenon that has harmful psychological-behavioral effects on users. The present study was conducted with the aim of investigating the relationship between moral intelligence and communication skill s with the mediation of psychological distress in secondary school students of Tabriz city.

METHODS: In this descriptive cross-sectional correlational study, 431 adolescents (female=227, male=204) in Tabriz, Iran schools were selected using cluster sampling and responded to psychological distress questionnaires DASS21, Internet addiction KDAI, communication skill s of Queen dam and moral intelligence of Lenik Vakil. Structural equation modeling (SEM) was used to analyze the data. SPSS 26 and LISREL 8.80 statistical software were used to classify, process and analyze data and test research hypotheses.

RESULTS: The fit indices of the proposed model show its optimal fit (χ²/df=2.93, CFI=0.97, GFI=0.91, AGFI=0.88, RMSEA=0.06, RMR=0.03). The results showed that moral intelligence (β=-0.167, P<0.001) and communication skill s (β=-0.525, P<0.001) have a significant indirect relationship with Internet addiction.

CONCLUSION: The present study showed that healthcare organizations should take preventive interventions more seriously to reduce the possibility of Internet addiction and pay attention to the issue of increasing the level of moral intelligence and communication skill s with regard to the mediating role of psychological distress in order to reduce psychological distress. We can reduce the increasing prevalence of internet addiction.

PMID:40391314 | PMC:PMC12085762 | DOI:10.34172/jcs.025.33745

J Caring Sci. 2024 Aug 6;14(1):14-24. doi: 10.34172/jcs.025.33510. eCollection 2025 Feb.

ABSTRACT

INTRODUCTION: Patients with coronary artery disease (CAD) can improve quality of life by undergoing coronary artery bypass graft (CABG), but they may face various complications. Early mobilization can help prevent these complications. This study aimed to evaluate the effects of two early mobilization protocols on pain and hemodynamic outcomes in patients who had CABG surgery.

METHODS: This was a randomized, blinded clinical trial with a three-arm parallel design, conducted on 105 patients who underwent CABG at Shahid Madani hospital in Tabriz. The patients were randomly assigned to three groups: control, first intervention, and second intervention. The control group received standard care, while two intervention groups received early mobilization based on passive and active range of motion (ROM) activities and early mobilization based on deep breathing exercises respectively. Data were collected using a questionnaire that measured pain intensity using a facial pain scale and hemodynamic indicators using a monitor device. Data analysis was performed using SPSS version 24 software and descriptive and inferential statistics methods.

RESULTS: According to the study, the second intervention group is more effective than the first intervention group. The results indicated that in both morning and evening shifts, the mean of systolic blood pressure (SBP) increased significantly in three groups. Also, the mean of diastolic blood pressure (DBP) increased significantly in both shifts in intervention group 1 and control. The mean of DBP decreased (MD=-26.0, 95% CI: -5.6 to -1.2; P=0.003) significantly among intervention group 2 compared to control group in the evening. The results also indicated that the mean of heart rate (HR) raised significantly in both shifts in all three groups. In the morning, there was a significant difference between intervention group 2 and 1 compared to control. The mean of arterial oxygen saturation was a significant difference between intervention group 2 and intervention group 1 and control group in the both shifts. The mean of pain decreased significantly in the morning in two intervention groups. Similarly, in the evening, the mean of pain decreased significantly in intervention group 1, and intervention group 2. Both in the morning and evening, there was a significant difference between intervention group 2 and intervention group 1 (P<0.001).

CONCLUSION: This study provides valuable insights into the effects of early mobilization interventions on patients after CABG, but more research is needed to determine the optimal timing and intensity of mobilization protocols for patients after CABG and to explore the long-term effects and cost-effectiveness of these interventions.

PMID:40391311 | PMC:PMC12085765 | DOI:10.34172/jcs.025.33510

J Caring Sci. 2025 Mar 9;14(1):52-57. doi: 10.34172/jcs.025.33337. eCollection 2025 Feb.

ABSTRACT

INTRODUCTION: This study aimed to investigate health anxiety and its relationships with academic performance and learning styles among nursing students during the COVID-19 pandemic.

METHODS: A cross-sectional design was employed, involving 365 participants selected through stratified random sampling in Iran in 2021. Data were collected using Health Anxiety Inventory, Visual, Aural, Reading/Writing, and Kinesthetic Learning Styles Questionnaire and students’ self-reported grade point average (GPA). Data were analyzed using descriptive and inferential statistics (independent samples t-test, one-way ANOVA, Pearson correlation coefficient and chi-square test) by SPSS version 13.

RESULTS: The mean (SD) health anxiety score among nursing students was 24.33(9.79) on a range of 0-54; and the mean (SD) of GPA was 15.60 (1.51) on a range of 0-20. The majority of students (85.8%) had a unimodal learning style, with the dominant pattern being kinetic-motor (39.7%). The study found a negative correlation between health anxiety and academic performance (r=-0.19, P≤0.05). However, no significant association was identified between health anxiety and learning style (r=-0.27, P=0.42). The analysis of health anxiety among participants indicated notable differences based on demographic factors such as sex, interest in nursing, and education level (P<0.001).

CONCLUSION: This study revealed a moderate level of health anxiety among Iranian nursing students during the COVID-19 pandemic and identified a significant negative correlation between health anxiety and academic performance. These findings underscore the need for interventions targeting health anxiety to potentially improve academic outcomes for nursing students, as reducing anxiety levels can enhance focus, learning capacity, and overall academic performance.

PMID:40391308 | PMC:PMC12085760 | DOI:10.34172/jcs.025.33337

J Caring Sci. 2025 Feb 11;14(1):1-4. doi: 10.34172/jcs.025.33575. eCollection 2025 Feb.

ABSTRACT

INTRODUCTION: In order to avoid bias in systematic reviews (SRs), the accuracy in selection of risk of bias (RoB) assessment tools is essential to obtain highest level of evidence for evidence-based decision making in health care. We aimed to review how ‘CONSORT statement’, as a reporting quality of randomized controlled trials, has been misused in recent SRs as a ROB tool.

METHODS: A mini-review was performed in international databases including PubMed, Google Scholar and hand-searches for published and unpublished literature from 2000 to 2021 and written in English. The following keywords: risk of bias, “Consolidated Standards of Reporting Trials”, CONSORT, “systematic review” were used. Citations were screened and those meeting our inclusion criteria were retained.

RESULTS: A total of 11 SRs were identified that misused CONSORT as a ROB tool, four of which were used only CONSORT as ROB tool. Different authentic magazines from various countries were recognized.

CONCLUSION: The CONSORT statement aims to increase clarity and consistency of transparency of reporting in randomized controlled trials. It is quite essential to draw the attention of SR researchers, journal editors/reviewers as well as the reading audience to the fact that CONSORT statement CONSORT statement is not a ROB tool.

PMID:40391306 | PMC:PMC12085767 | DOI:10.34172/jcs.025.33575

J Endocr Soc. 2025 Apr 2;9(5):bvaf054. doi: 10.1210/jendso/bvaf054. eCollection 2025 May.

ABSTRACT

CONTEXT: Postprandial hepatic glycogen synthesis and glycolysis are reduced in hepatic insulin resistance. However, the physiologic interpretation of the reduction in hepatic glucose uptake (GU) during the gold-standard measurement of insulin sensitivity, hyperinsulinemic euglycemic clamp, in insulin resistance is unclear. This is because the peripheral route of glucose and insulin delivery during a clamp study differs greatly from the physiological route.

OBJECTIVE: We hypothesized that hepatic GU during hyperinsulinemic euglycemic clamp would predict glycemia during oral glucose tolerance test (OGTT).

DESIGN: We analyzed cross-sectional data of 120 individuals (70 men and 50 women) who did not have diabetes from the CMgene study cohort. Hepatic GU was measured with [¹⁸F]fluorodeoxyglucose ([¹⁸F]FDG) and positron emission tomography.

RESULTS: In a multiple regression analysis, hepatic GU, endogenous glucose production, insulin secretion capacity, and serum triglycerides predicted OGTT glucose area under the curve (P for all <.05), whereas skeletal muscle GU, the antilipolytic insulin index, and insulin clearance were not statistically significant predictors (P > .05).

CONCLUSIONS: Hepatic GU measured during hyperinsulinemic euglycemic clamp is an independent predictor of OGTT glucose area under the curves even when accounting for well-known other factors affecting glycemic control. This finding supports the idea that insulin-mediated hepatic GU, and more broadly, first-pass glucose extraction, have a meaningful contribution to glycemic control. Thus, this measurement provides useful information about hepatic insulin sensitivity in the more physiologic conditions of the OGTT which may be useful when studying the pathophysiology of impaired glucose tolerance and when evaluating potential treatments for impaired glycemic control.

PMID:40391305 | PMC:PMC12086998 | DOI:10.1210/jendso/bvaf054

Int J Dermatol. 2025 May 19. doi: 10.1111/ijd.17848. Online ahead of print.

ABSTRACT

BACKGROUND: Although the data on psoriasis epidemiology included in the Global Psoriasis Atlas (GPA) provide valuable information on psoriasis prevalence worldwide, the GPA database is still incomplete. Therefore, the aim of the study was to assess the prevalence, incidence, and mortality rates of psoriasis and its types in Poland based on the data registered by the National Health Fund (NHF).

METHODS: The study included psoriasis patients registered at least twice in the Polish NHF database between 2010 and 2023.

RESULTS: At the end of 2023, 639,662 living psoriasis patients had been registered in the Polish NHF database, which constituted 1.70% of the Polish general population. The percentage of female psoriasis patients was found to be higher (54.95%) than male patients (45.05%). Of all the Polish NHF-registered psoriasis patients, plaque psoriasis affected 95.66%, pustular psoriasis 3.05%, psoriatic arthritis 7.20%, and guttate psoriasis 0.27%. In comparison to the general Polish population, psoriasis prevalence was observed to be lower in children (0.84%). The all-cause mortality rate among psoriasis patients was found to be higher in comparison to the general Polish population, with a higher mortality rate noted in male psoriasis patients.

CONCLUSIONS: The NHF database we studied suggests a direct relationship between the prevalence, incidence, and all-cause mortality rates in psoriasis and patients’ age and sex. However, the study also revealed a decrease in mortality rates and a slow increase in the prevalence of psoriasis in the Polish population, which calls for further studies.

PMID:40390157 | DOI:10.1111/ijd.17848

Int J Geriatr Psychiatry. 2025 May;40(5):e70089. doi: 10.1002/gps.70089.

ABSTRACT

OBJECTIVES: Aotearoa New Zealand (NZ) is a bicultural nation (Māori and European) with a growing population of Asian and Pacific peoples. Recent analysis of national routinely collected data suggests dementia prevalence is higher in Māori and Pacific peoples when compared with European and Asian, and that inequities in dementia care for Māori, Asian, and Pacific people with dementia exist. A population-based dementia prevalence study is needed to confirm these findings. The aim of this protocol is to describe a dementia prevalence study focussing on the European, Chinese and Indian populations in NZ. The findings will be compared to a separate study on Māori populations using a similar study design.

METHODS: This is a cross-sectional screen-interview survey of people aged ≥ 65 from European, Chinese and Indian/Fijian-Indian backgrounds in sampled meshblocks within two regions of NZ. Stage 1 involves screening eligible participants at the door using the brief cognitive scale of the Community Screening Instrument for Dementia (CSI-D). Stage 2 involves interviewing random samples of screen positive and negative participants using the 10/66 dementia protocol. With a margin of error of approximately 3%, and a confidence level of 5%, a total of 485 European, 410 Chinese and 425 Indian/Fijian-Indian people will be interviewed with the 10/66 protocol. Age-standardised prevalence estimates of 10/66 dementia will be back-weighted for study design.

CONCLUSION: This study will provide evidence for suspected ethnic inequalities in dementia, inform new culturally appropriate dementia management strategies, and contribute to improved outcomes for people with dementia in NZ.

PMID:40390139 | DOI:10.1002/gps.70089

Pilot Feasibility Stud. 2025 May 19;11(1):70. doi: 10.1186/s40814-025-01655-z.

ABSTRACT

BACKGROUND: Pilot and feasibility studies are effective tools for assessing the feasibility of performing larger-scale studies. These are particularly useful in anesthesiology, where the research overlaps with several other medical and surgical fields. The objective of this meta-epidemiological study is to assess the design and methodology of pilot and feasibility randomized controlled trials (RCTs) in anesthesiology.

METHODS: We searched for pilot and feasibility RCTs in anesthesiology indexed in PubMed during a 5-year span between January 1, 2018, and December 31, 2022. We extracted bibliographic information, field of study, type of intervention, trial duration, trial design, use of qualitative data, use of progression criteria, whether the primary objective and primary outcome were related to feasibility, reported feasibility outcomes, and sample size justification. We conducted logistic regression to determine the factors associated with using progression criteria, having primary feasibility outcomes, and using feasibility outcomes to justify the sample size. We controlled for publication year, journal impact factor, source of funding, intervention type, and region.

RESULTS: Our search retrieved 3015 trials, of which 248 were ultimately included and analyzed. Less than a third of studies stated feasibility as the primary objective (n = 77, 31.0%). Feasibility was a primary outcome in 46 (18.6%) studies, progression criteria were used in 27 (10.9%) studies, a sample size justification was listed in 134 (54.0%) studies, and 24 (9.7%) studies used qualitative data. We did not find any statistically significant association between progression criteria and any of the selected variables. Recently published trials had higher odds of having primary feasibility outcomes (odds ratio [OR] 1.39; 95% CI 1.06-1.83). Studies of pharmacological interventions had lower odds primary feasibility outcomes (OR 0.41; 95% CI 0.19-0.90). Recent studies also had higher odds of having a sample size justification based on a feasibility outcome rather than a clinical outcome or similar studies (OR 1.51; 95% CI 1.06-2.15).

CONCLUSIONS: More recently published pilot RCTs were significantly associated with having a primary feasibility outcome and determining sample size based on feasibility, while pharmacological studies were significantly associated with less reporting of primary feasibility outcomes. Future research addressing the factors limiting adherence to current guidelines is warranted.

PMID:40390137 | DOI:10.1186/s40814-025-01655-z