Nevin Manimala

BMC Palliat Care. 2025 Mar 8;24(1):59. doi: 10.1186/s12904-025-01697-3.

ABSTRACT

BACKGROUND: The negative impact of over-treatment in end-of-life individuals has led to attention to the value of death. Reassessing the attitude of death and dying can improve care and improve the quality of life. Therefore, the use of multidimensional tools to comprehensively assess the attitudes of individuals on dying and death, identify attitude tendencies and causes meaningful, and evaluate the effectiveness of the tools is an important prerequisite.

OBJECTIVES: We aimed to obtain MODDI-F-C through cross-cultural translation and to evaluate its psychometric characteristics among mainland China participants.

METHODS: In order to obtain MODDI-F-C, a cross-cultural translation of MODDI- F/eng was performed using the Brislin model. The items quality, factor structure, reliability and validity were assessed among 2105 participants from mainland China. The concurrent validity was assessed using the Chinese version of DAP-R for the first time.

RESULTS: MODDI-F-C consists of 27 items, and five common factors were identified through factor analysis, accounting for 56.79% of the overall variance.The total consistency coefficient was 0.949.The correlation coefficient between DAP-R-C-Z and the overall scale was 0.55 (p < 0.001), between DAP – R-C – Z and the subscale 0.37-0.56 (p < 0.001).Most of the methods used for psychometric evaluation meet acceptable criteria.

CONCLUSIONS: Our research has initially confirmed that MODDI-F-C is an effective tool to evaluate the fear dimension of death and dying attitude, which can identify individuals’ tendencies and causes related to dying and death. However, the acceptance dimension needs further assessment.

PMID:40057793 | DOI:10.1186/s12904-025-01697-3

AIDS Res Ther. 2025 Mar 8;22(1):31. doi: 10.1186/s12981-025-00726-8.

ABSTRACT

BACKGROUND: Vaccine acceptance among People Living with HIV (PLWH) is crucial for managing and mitigating the spread of infectious diseases, including Mpox. This systematic review and meta-analysis assess the rate of vaccine acceptance for Mpox among PLWH and identify factors influencing these rates.

METHODS: We searched major databases including PubMed, Embase, and Web of Science up to 30 August 2024 for observational studies involving PLWH that reported on mpox vaccine acceptance rates. A random-effects model was employed for the meta-analysis, utilizing R software version 4.4. Heterogeneity among the studies was quantified using the I² statistic, and the methodological quality of each study was assessed using a modified version of the Newcastle-Ottawa Scale.

RESULTS: Out of 1,123 articles identified, 17 studies met the inclusion criteria and included 7,248 participants. The pooled estimate of the Mpox vaccine acceptance rate was 61.1% (95% CI: 44.2-75.7%), with high heterogeneity (I² = 99%). Additionally, a pooled vaccine hesitancy prevalence was 13.2%, (95% CI: 2.4-48.6%), reflecting substantial variability and had high heterogeneity (I² = 98%).

CONCLUSION: This systematic review and meta-analysis reveal moderate Mpox vaccine acceptance and considerable hesitancy among PLWH. To further increase vaccine uptake and address any remaining hesitancy in this at-risk population, targeted public health strategies and ongoing research are necessary. Strengthening vaccine acceptance is critical to safeguarding PLWH against emerging infectious diseases such as Mpox.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40057788 | DOI:10.1186/s12981-025-00726-8

Syst Rev. 2025 Mar 8;14(1):57. doi: 10.1186/s13643-025-02760-z.

ABSTRACT

BACKGROUND: Double gloving is recommended for protecting surgical personnel from infections, but it is not a universal practice, especially in low- and middle-income countries where risk is very high. Evidence for double gloving is still only moderate, and for indicator double gloves, it is even rare. This systematic review and meta-analysis includes recent trials to analyse outcomes like glove perforations (inner/outer/matched/intraoperatively detected) and hand contamination rates for single versus double including indicator double-gloved conditions and identify factors to be considered for deciding double gloving.

METHOD: Six databases PubMed, EBESCO, Embase, CINAHL, Scopus, Web of Science, and CENTRAL were searched up to May 2024. The quality of included trials was assessed using Cochrane risk-of-bias tool (version 5.1.0). Heterogeneity among trials was estimated using the chi-squared (I²) test. RevMan 5.3 was used for meta-analysis and subgroup analysis. Odds ratio at 95% confidence interval was used as statistical measure to compare outcomes and calculate effect size. Publication bias was assessed through a funnel plot.

RESULT: A review of these total of 18 randomized controlled trials showed that deep/major/emergent surgeries, primary surgeons, and longer surgical duration are prone to have higher glove perforations. Impaired dexterity is not a constraint for double gloving and has no impact on glove perforations. Meta-analysis of outcomes suggests that double gloving (standard or indicator) provides significant protection against infections compared to single gloves in terms of reduced inner (OR = 0.2, 95% CI 0.14-0.31) and matched glove perforations (OR = 0.1, 95% Cl 0.07-0.13) and lower incidences of hand contamination (OR = 0.28, 95% Cl 0.14-0.54). Standard double gloves were more effective in reducing matched glove perforations than indicator double gloves. But for detecting glove perforations intraoperatively, only the indicator double glove (OR = 8.64, 95% Cl 4.78-15.61) was effective.

CONCLUSION: Double gloving is recommended over single gloving for better safety of surgical personnel and indicator gloves for better detection of perforations during surgery so that it can be changed timely, but it does not provide any additional protection. In the future, there should be high-quality trials for specific surgeries, surgical personnel, and different surgical durations taking into consideration the cost-effectiveness of indicator gloving over standard double gloving so that specific recommendations can be made.

PMID:40057774 | DOI:10.1186/s13643-025-02760-z

Alzheimers Res Ther. 2025 Mar 8;17(1):58. doi: 10.1186/s13195-025-01708-8.

ABSTRACT

BACKGROUND: The influence of duration of type 2 diabetes mellitus (T2DM) on the likelihood of developing new-onset dementia in post-stroke population is not well understood. Therefore, we aimed to clarify the relationship between the duration of T2DM and the risk of developing dementia in the post-stroke population.

METHODS: Leveraging the Korean National Health Insurance Database, this study included 118,790 individuals with a history of stroke but no previous dementia diagnosis. We classified diabetes status into five categories: normoglycemia, impaired fasting glucose (IFG), newly diagnosed T2DM, and established T2DM with durations of less than 5 years and 5 years or more. The primary endpoint was the incidence of all-cause dementia.

RESULTS: Among 118,790 participants (average age 64.26 ± 9.95 years, 48% male), 16.7% developed dementia during an average follow-up of 7.3 ± 2.3 years. Participants with a history of T2DM for less than five years at cohort entry had a 26.7% higher risk of developing all-cause dementia compared to those with normoglycemia. Those with T2DM for five years or longer had a 46.7% increased risk, with an adjusted hazard ratio (aHR) of 1.466 (95% confidence interval [CI], 1.408-1.527). Specifically, the risk of developing Alzheimer’s disease (AD) and vascular dementia (VaD) rose by 43.4% and 51.4%, respectively, for individuals with T2DM lasting more than five years (aHR 1.434, 95% CI 1.366-1.505; aHR 1.514, 95% CI 1.365-1.679, respectively).

CONCLUSIONS: Our findings demonstrated a significant association between an extended duration of T2DM and an increased risk of developing all-cause dementia, including AD and VaD in post-stroke population. These results emphasize proactive dementia prevention approaches in stroke survivors, particularly those with longstanding T2DM.

PMID:40057772 | DOI:10.1186/s13195-025-01708-8

J Health Popul Nutr. 2025 Mar 8;44(1):71. doi: 10.1186/s41043-025-00774-w.

ABSTRACT

BACKGROUND: Like other Sub-Saharan Africa (SSA) countries, Tanzania is undergoing socio-economic changes that impact lifestyles and dietary choices. Traditionally, differences in dietary habits between rural and urban areas in Tanzania and other SSA countries were prominent. However, recent research indicates converging lifestyles and dietary choices associated with increased risk of cardiometabolic diseases. The objective of the current study was hence to investigate differences and similarities in dietary patterns, energy, and food groups intake in urban and rural Tanzania.

METHODS: Dietary habits were assessed by use of a Food Frequency Questionnaire (FFQ) for 442 respondents aged 44-65 years in urban (Ubungo -Dar es Salaam) and rural (Kilindi- Tanga) districts of Tanzania. Dietary patterns were determined using Principal Components Analysis (PCA). Bivariate analyses identified determinants of dietary patterns in urban and rural Tanzania.

RESULTS: Two dietary patterns, a “mixed pattern” characterized by whole grains, potatoes, fruits, vegetables, meat, fried potatoes and tubers, alcohol, sugar-sweetened beverages (SSB), sugar and sweets, and added oils and a “plant-rich pattern” characterized by whole grains, fruits, pulses and peas, seasoning vegetables and salads, SSB, sugar and sweets, and added oils were identified. Urban residents contributed more to the mixed pattern, while rural residents had a higher contribution to the plant-rich pattern. Overall, dietary diversity was greater in urban than rural Tanzania. The estimated median daily energy intake was 2,902 kcal (IQR: 1449.2) with a lower energy intake in rural (2,817 kcal, IQR: 1,274) as compared to urban residents (3,052 kcal, IQR: 1558) (p = 0.021). The percent contribution to the median average daily energy intake for grains, fruits, and milk was higher in rural than urban participants. No differences were observed for meat, poultry and eggs.

CONCLUSION: We identified two distinct dietary patterns: a “mixed pattern” prominent in urban and a “plant-rich pattern” more common in rural. Urban diets were more diverse with slightly higher energy intake. These findings underscore the effects of urbanization on diets and the need for targeted nutritional intervention for both rural and urban populations.

PMID:40057768 | DOI:10.1186/s41043-025-00774-w

Virol J. 2025 Mar 8;22(1):66. doi: 10.1186/s12985-025-02668-z.

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus disease 2019 (COVID-19), which is a huge global health threat. Interleukin27 (IL-27) gene is a cytokine that produces antiviral proteins in an IFN-independent manner and stimulates both pro- and anti-inflammatory responses. Interferon induced transmembrane protein 3 (IFITM3) inhibits SARS-CoV2 infection by blocking SARSCoV-2 spike proteins which facilitate viral entrance and cell-to-cell fusion. The association between genetic variants and COVID-19 in Egyptians is still unclear. Hence, we sought to investigate the impact of the single nucleotide polymorphism of IL-27P28 rs153109 and IFITM3 rs12252 on the susceptibility and severity of SARS-CoV-2 in Egyptian patients.

METHODS: Our study included 242 SARS-CoV-2 patients were recruited from Main University Hospital, Alexandria University, Egypt, and 187 healthy controls. We subdivided the patient group into two subgroups: group A comprised mild/moderate cases (N = 42) (17.4%), and group B included severe/critical cases (N = 200) (82.6%). Genomic DNA was extracted from blood samples using the QIAamp DNA Blood Mini kit, then the PCR products of IL27 and IFITM3 were cut by FastDigest XhoI and MScI, respectively, for detection of SNPs of IL-27P28 rs153109 (-964A/G) and IFITM3 rs12252 (T>C).

RESULTS: The present study found a significant association between IL27 rs153109 (-964A/G) and SARS-CoV-2 infection susceptibility after adjusting for the risk factor (advanced age), IL27 rs153109 (-964A/G) AG genotype (OR = 2.791, 95% CI: 1.237-6.295, P = 0.013), AA genotype (OR = 2.385, 95% CI: 1.075-5.291, P = 0.033), and (AG+AA vs. GG) genotypes (OR = 2.558, 95% CI: 1.186-5.517, P = 0.017). On the other hand, the IFITM3 rs12252(T>C) CT genotype (OR = 1.419, 95% CI: 0.843-2.391, P = 0.188), CC genotype (OR = 2.132, 95% CI: 0.436-10.415, P = 0.350), and (C/T+C/C vs. TT) genotypes (OR = 1.466, 95% CI: 0.884-2.432, P = 0.138) did not show a statistically significant association with either susceptibility or the severity of SARS-CoV-2.

CONCLUSION: IL27P28 rs153109 AG and AA genotypes of IL27 may be associated with the susceptibility of SARS-CoV-2 infection but not the severity. Concerning the IFITM3 rs12252 SNP, we could not confirm its influence on either susceptibility or the severity of SARS-CoV-2 in this Egyptian population.

PMID:40057761 | DOI:10.1186/s12985-025-02668-z

J Health Popul Nutr. 2025 Mar 8;44(1):72. doi: 10.1186/s41043-025-00811-8.

ABSTRACT

BACKGROUND AND OBJECTIVE: Conflicting results exist regarding the associations between dietary acid load (DAL) and cancer risk. This study aimed to investigate the association between DAL and the odds of prostate cancer (PC) in the Iranian population.

METHODS: One hundred and twenty participants (60 controls and 60 newly diagnosed PC patients) engaged in a hospital-based case-control study conducted from April to September 2015. A validated, 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. DAL was calculated using potential renal acid load (PRAL) and net endogenous acid production (NEAP). Multivariate logistic regression was performed to estimate odds ratios (ORs).

RESULTS: Both PRAL (OR = 5.44; 95% CI = 2.09-14.17) and NEAP (OR = 4.88; 95% CI = 2.22-13.41) were associated with increased odds of PC in the crude model. After adjusting for potential confounders (energy intake, smoking, physical activity, ethnicity, job, education, and medication use), being in the third category of PRAL (OR = 3.42; 95% CI = 1.11-8.65) and NEAP (OR = 3.88; 95% CI = 1.26-9.55) were significantly associated with increased odds of PC.

CONCLUSION: Our findings suggest that dietary acid load may be linked to an increased risk of PC; however, further prospective studies with larger sample sizes and longer durations are necessary to validate these findings.

PMID:40057760 | DOI:10.1186/s41043-025-00811-8

BMC Health Serv Res. 2025 Mar 8;25(1):356. doi: 10.1186/s12913-025-12460-y.

ABSTRACT

BACKGROUND: Effective tuberculosis (TB) management requires timely diagnosis and immediate treatment initiation. The urgency for diagnosing and treating TB is particularly acute among immigrants, who face heightened health risks due to factors such as poverty, hazardous working conditions, and limited healthcare access. The objective of this study was to examine the characteristics of patient and health care delays among migrant and local TB patients in Istanbul and to identify factors associated with delays in the diagnosis and treatment of TB in both migrant and local patients.

METHODS: This cross-sectional study was conducted in six Tuberculosis Control Dispensaries (TCDs) in Istanbul, the city with the highest number of TB cases in Turkey. A total of 211 TB patients, including 140 local residents and 71 migrants, participated. Data were collected through interviews via a structured questionnaire and patient files, following the patients’ consent.

RESULTS: Among migrant patients, the time from the onset of TB-related symptoms to the first contact with a health institution (patient delay) was 4.7 times longer (95% Confidence Interval [CI] = 1.1-20.9) than that in local resident patients. Compared with local patients, migrant patients were predominantly male, younger, had lower education levels, had a history of previous TB, and were less likely to smoke. Additionally, the frequency of working without insurance and unemployment was greater among migrant patients than among those employed with insurance.

CONCLUSION: Our research underscores the importance of focusing on the migrant community to achieve tuberculosis control goals, potentially through interventions to increase knowledge of healthcare system access and the significance of working conditions, including health insurance. While we profiled migrant TB patients, qualitative research is needed to elucidate the underlying reasons for delays in diagnosis and treatment.

PMID:40057758 | DOI:10.1186/s12913-025-12460-y

BMC Med Educ. 2025 Mar 8;25(1):352. doi: 10.1186/s12909-025-06898-1.

ABSTRACT

BACKGROUND: Diabetic ketoacidosis (DKA) is a common emergency associated with significant morbidity and mortality in low resource settings. Prompt diagnosis and correct management improves outcomes. To improve clinician knowledge and confidence in DKA management, we designed a novel curriculum for training local clinicians in a low-resource setting. This curriculum aligned to international guidelines, adapted for local resources. Our aim was to assess if the curriculum improved clinician knowledge and confidence.

METHODS: Participants included physicians and nurses in the Emergency Department (ED) at a tertiary academic center in Nairobi, Kenya. Participants completed pre/post-tests of knowledge, which permitted prospective curriculum evaluation based on the second level Kirkpatrick hierarchy, knowledge retention. The cases focused on local evidence-based DKA management pathways. They were delivered using novel in-person with virtual (recorded) teaching techniques, permitting both conventional and independent learning. Outcome measures related to knowledge improvement were analyzed using independent t-tests; clinician confidence was assessed via self-reported survey and analyzed using descriptive statistics.

RESULTS: 125 clinicians (79.8% nurses and 20.2% physicians) completed pre-training assessment; 104 completed post-training assessment. Prior to training, 53.6% of all trainees reported that they were “highly confident” compared with 61.5% of all trainees post-training (p=0.16). Post-training, there were statistically significant increases in knowledge scores related to DKA diagnosis (14% increase, p=0.03), electrolyte management (41% increase, p<0.0001), fluid administration (28% increase, p=0.01) and insulin administration (24% increase, p=0.01). There was a significant increase in overall clinician knowledge scores with 34.4% (n=43) attaining a knowledge score of 7 or above correct responses out of the 10 cases presented pre-training versus 65.4% n=68 post-training (p<0.0001).

CONCLUSION: Our pretest-posttest results demonstrate that our DKA management course improved clinical knowledge among physicians and nurses working in low-resource ED. Future research is underway to evaluate clinical practice changes and patient care outcomes related to this improved knowledge.

PMID:40057747 | DOI:10.1186/s12909-025-06898-1

BMC Complement Med Ther. 2025 Mar 8;25(1):97. doi: 10.1186/s12906-025-04816-y.

ABSTRACT

BACKGROUND: The use of traditional and complementary medicines (T&CM) among menopausal women has become prevalent due to the concerns on the adverse effects and differing opinions regarding hormone replacement therapy’s (HRT) suitability for long-term following the release of Women’s Health Initiative (WHI) results in 2002. To date, there have been no studies conducted on knowledge, attitude and practice towards T&CM among menopausal women in Malaysia. In addition, many women seek relief from menopausal symptoms by using T&CM despite questionable safety and efficacy. The objective of this study was to determine the knowledge, attitude and practice of menopausal women towards T&CM and its correlation with sociodemographic data in Kuala Lumpur and to assess the prevalence, types and perceived effectiveness of T&CM used by menopausal women in Kuala Lumpur.

METHODS: A cross-sectional study was conducted among menopausal women (n = 390) in Kuala Lumpur in the form of self-administered questionnaire. Data was collected using convenience sampling. The questionnaire was adopted from previous studies and some literature reviews with modifications. It was composed of 4 sections. Statistical analyses were performed using the IBM SPSS Statistics Version 26. Data obtained was analysed using descriptive and inferential analysis such as independent t test, one way ANOVA and chi square test.

RESULTS: The prevalence of T&CM used among menopausal women was found to be 27.2%. Evening primrose oil (53.2%), vitamins and minerals (53.2%) and black cohosh (48%) were most frequently used. Black cohosh and phytoestrogens were perceived as effective in relieving menopausal symptoms by 36.6% and 43.4% of respondents, respectively. Over half of the respondents had poor knowledge (51.3%), negative attitude (56.9%) and poor practice (55.7%) regarding the utilization of T&CM in menopause. There was a significant association between knowledge and attitude (p value < 0.05), as well as between attitude and practice (p value < 0.01). Participants with university level education and high income (> RM10,1000) showed higher knowledge and positive attitude.

CONCLUSIONS: Menopausal women in Kuala Lumpur were found to have a low prevalence rate of T&CM utilization. Respondents’ low understanding and unfavourable views might significantly impact the inadequate usage of T&CM.

PMID:40057740 | DOI:10.1186/s12906-025-04816-y