Nevin Manimala

BMC Complement Med Ther. 2025 Feb 12;25(1):49. doi: 10.1186/s12906-025-04780-7.

ABSTRACT

BACKGROUND: This study focuses on the investigation of the antioxidant and anti-inflammatory activities of alcohol extracts from Ribes nigrum leaves on murine BV-2 microglial Wt and Acyl-CoA oxidase 1 deficient (Acox1^-/-) cell line models, useful for the investigation of some neurodegenerative disorders.

METHODS: The extract chemical composition was analyzed via LC-Q-Orbitrap HRMS. Various assays, including DPPH, MTT, and H₂DCFDA, were used to assess the extract’s antioxidant capacity, cell viability, and reactive oxygen species (ROS) production. Immunoblotting and RT-qPCR techniques were employed to measure protein expression and gene transcription in treated cells. Statistical analysis was conducted using GraphPad Prism, with significance determined at p < 0.05.

RESULTS: Investigations showed the presence of phenolic compounds in this extract, among which flavan-3-ols, flavonols, furanocoumarins, hydroxycinnamates were major components, which are known for their biological activity in various test systems. The MTT test revealed a concentration of 0.125 mg/mL of R. nigrum extract as the highest non-toxic. The investigated extract showed high antioxidant activity in chemical-based tests. The antioxidant potential of the R. nigrum leaf extract was furtherly explored using the BV-2 microglial cell line models. Moreover, the extract was found to alter the activity of the main antioxidant enzyme, catalase and fatty acid oxidation enzyme, Acyl-CoA oxidase 1 (ACOX1) as well as the expression of appropriate genes in Wt and Acox1^-/- BV-2 microglial cells such as Cat, iNos, Il-1β, Tnf-α, and Abcd1. In Wt cells, after the 24-hour treatment with R. nigrum leaf extract, ACOX1 activity was downregulated, meanwhile the catalase activity remains unchanged. Further treatment led to the downregulation of catalase and the upregulation of ACOX1 activity. However, in Acox1^-/- cells, which represent a model of oxidative stress, an increase in catalase activity was observed only after 48 h of treatment. It was also observed the reduced ROS and NO formation in cells, showing the pronounced antioxidant capacity of R. nigrum extract in the investigated cell-models.

CONCLUSION: Our study demonstrated the protective effects of R. nigrum leaf extracts on BV-2 microglial cells by reducing oxidative and nitrosative stress, decreasing pro-inflammatory gene expression, and normalizing peroxisomal function, highlighting the potential of these extracts as therapeutic agents for managing oxidative stress and inflammation.

PMID:39939952 | DOI:10.1186/s12906-025-04780-7

Virol J. 2025 Feb 13;22(1):34. doi: 10.1186/s12985-025-02633-w.

ABSTRACT

BACKGROUND: In Ethiopia, hepatitis B virus infections are prevalent and highly endemic. Additionally, there has been a significant increase in hospital admissions, morbidity, and mortality associated with hepatitis B virus infections. This study aimed to assess the prevalence of hepatitis B virus infection and associated factors among adult intrafamilial household contacts of pregnant women index cases attending antenatal care clinics in the central Ethiopian region.

METHODS: A community-based cross-sectional study was conducted between October 1, 2023, and March 1, 2024. Three hundred eighty-five adult intrafamilial household contacts were randomly selected via lottery methods. A 3 ml venous blood sample was taken from adult intrafamilial household contacts and checked for hepatitis B virus infection through hepatitis B surface antigen. An interviewer-administered questionnaire was used to collect the data. A logistic regression model predicted the relationship between predictor and outcome variables. A p-value of < 0.05 indicated statistical significance.

RESULTS: The overall response rate was 96.1%. Two-thirds of the adults of intrafamilial household contacts (n = 229; 61.9%) were aged between 18 and 28 years, with a mean age of 28 years. The prevalence rate of hepatitis B virus infection among adults of intrafamilial household contacts with pregnant women as the index case was 11.6% (95% CI, 8.6 to 15.1). Being male (AOR: 0.09; 95% CI: 0.03, 0.37) and a duration of stay with the index case of less than six months (AOR: 0.30; 95% CI: 0.11, 0.81) were associated with a reduced risk of hepatitis B virus infection. Meanwhile, large family sizes (≥ 7) (AOR: 4.32; 95% CI: 1.34, 13.98), genital discharge (AOR: 3.14; 95% CI: 1.60, 6.15), engagement in unsafe sex (AOR: 2.37; 95% CI: 1.13, 4.97), and a history of mortality due to hepatitis in the family (AOR: 3.03; 95% CI: 1.09, 8.42) were associated with an increased risk of hepatitis B virus infection.

CONCLUSION: This study found that hepatitis B surface antigen seropositivity among adult intrafamilial household contacts with pregnant women index cases in the central Ethiopia region was high at 11.6%. These findings suggest that interventions to prevent HBV infection should prioritize educational campaigns targeting adult intrafamilial household contacts of HBV-positive index cases, focusing on risk factors associated with HBV transmission, prevention, counselling, testing, and vaccination.

PMID:39939946 | DOI:10.1186/s12985-025-02633-w

BMC Pediatr. 2025 Feb 12;25(1):111. doi: 10.1186/s12887-025-05467-1.

ABSTRACT

BACKGROUND: To validate the effectiveness of the application of a transition programme for adolescents with chronic kidney disease based on the Integrated Theory of Health Behavior Change.

METHODS: This study was a quasi-experiment study. We included 76 adolescents with chronic kidney disease, and based on their willingness to undergo transition intervention, participants were assigned to either the intervention group or the control group. The intervention group received the transition intervention guided by the Integrated Theory of Health Behavior Change, while the control group received standard care and education, remaining unaware of the intervention group’s existence. The data of the intervention group were collected before and after the intervention. Because the total intervention lasted approximately 4 weeks, the data of the control group were collected at baseline (T0) and 1 month (T1). We chose transition readiness as the primary outcome. The secondary outcomes included medication adherence and self-efficacy.

RESULTS: At the final assessment (T1), the scores related to transition readiness, medication adherence, self-care self-efficacy, and adolescent exercise and eating behavior self-efficacy in the intervention group were significantly higher than those in the control group (P < 0.05). Compared with those at T0, the scores of all the constructs in the intervention group increased at T1, and these differences were statistically significant. There was a weak positive correlation between participants’ transition readiness and their medication adherence (r = 0.389, P < 0.01), self-care self-efficacy (r = 0.501, P < 0.01), exercise behavior self-efficacy (r = 0.237, P < 0.05), and eating behavior self-efficacy (r = 0.481, P < 0.01).

CONCLUSIONS: Based on the Integrated Theory of Health Behavior Change, the transition program for adolescents with chronic kidney disease significantly improved participants’ transition readiness, self-care self-efficacy, and exercise and eating behavior self-efficacy. While the study’s design limits definitive conclusions on the program’s impact on medication adherence, the observed improvements suggest that potential benefits warrant further investigation.

TRIAL REGISTRATION: The study obtained approval from the local institutional review board and was registered on https://www.chictr.org.cn (Clinical Trial Number: ChiCTR2300077149) prior to the enrollment of the first subject on October 31, 2023.

PMID:39939945 | DOI:10.1186/s12887-025-05467-1

BMC Med Educ. 2025 Feb 12;25(1):227. doi: 10.1186/s12909-025-06832-5.

ABSTRACT

BACKGROUND: Retaining anatomical knowledge is crucial for safe and effective medical practice, yet many medical graduates struggle to apply this knowledge in clinical settings over time. This study aimed to evaluate and compare the retention of gross anatomy and clinical anatomy knowledge among medical graduates in Sudan.

METHODS: A cross-sectional study was conducted in a sample of 385 medical graduates from various Sudanese universities, estimated using the Cochrane formula. The participants completed a self-administered questionnaire assessing their knowledge of gross and clinical anatomy, as well as demographic and educational factors. The data were analyzed via descriptive statistics, paired t-tests, and ANOVA.

RESULTS: Clinical anatomy knowledge was significantly better retained (mean score: 68.39%) than gross anatomy knowledge was (mean score: 45.35%). The retention of gross anatomy is influenced by academic background, with integrated and hybrid learning approaches showing better outcomes than traditional methods do. In contrast, clinical anatomy retention was more consistent across demographic factors but varied by speciality, with emergency medicine, general practice, surgery and radiology showing the highest retention levels.

CONCLUSION: Clinical anatomy is retained more effectively due to its frequent application in practice, whereas gross anatomy requires greater integration with clinical relevance to enhance retention. The study recommends medical curricula that merge gross and clinical anatomy through active learning strategies and continuous education to improve long-term retention and clinical competency.

PMID:39939944 | DOI:10.1186/s12909-025-06832-5

BMC Cardiovasc Disord. 2025 Feb 12;25(1):95. doi: 10.1186/s12872-025-04498-x.

ABSTRACT

BACKGROUND: This study explores the relationship between angiotensin-converting enzyme (ACE) gene polymorphisms and early diastolic dysfunction in patients with hypertension utilizing four-dimensional echocardiography and assesses the prognosis.

METHODS: This study consecutively selected 470 patients with hypertension who visited the Fourth Affiliated Hospital of Soochow University between September 2021 and August 2022, with 274 meeting the inclusion criteria. Hypertension gene testing was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques, and the Hardy-Weinberg equilibrium test was used to confirm genetic equilibrium. Patients were categorized into the D allele group (n = 163) and the non-D allele group (n = 111). Diastolic function was assessed using four-dimensional echocardiography, which included averaging the E/e’ ratio over three cardiac cycles, measuring the left atrial (LA) maximum volume index (LA volume), tricuspid regurgitation velocity (TR velocity), LA strain, and left ventricular isovolumic relaxation time (IVRT). Patients were subsequently classified into the diastolic dysfunction group (n = 133) and the normal diastolic function group (n = 141). Chi-square tests were used to analyze differences in diastolic function indicators between the groups, Logistic regression was applied to control for potential confounding factors, and receiver operating characteristic (ROC) curves were plotted to assess the predictive value of different ACE alleles for diastolic dysfunction in patients with hypertension.

RESULTS: The genotype distribution in both the D allele group and the non-D allele group was consistent with Hardy-Weinberg equilibrium (P > 0.05). Compared to the non-D allele group, echocardiographic indicators in the D allele group showed a decline in diastolic function: the average E/e’ ratio over three cardiac cycles (14.67 [13.82, 15.80] vs. 9.30 [8.12, 12.00]), LA volume (32.76 [29.34, 34.61] vs. 25.61 [22.63, 29.64] ml/m²), TR velocity (2.90 [2.40, 2.90] vs. 1.40 [1.10, 2.40] cm/s), LA strain (18.00 [14.00, 25.00] vs. 37.00 [24.00, 40.00] %), and IVRT (104.25 [95.87, 106.25] vs. 88.09 [80.99, 96.56] ms). Differences between each group were statistically significant (all P < 0.05). The number of patients with diastolic dysfunction was higher in the D allele group (n = 102; 62.6%) compared to the non-D allele group (n = 31; 27.9%). In the logistic regression model, the D allele was associated with an increased risk of early diastolic dysfunction in hypertension (OR = 4.32, 95% CI = 2.56-7.27, P < 0.01). In the adjusted model, the D allele remained associated with an elevated risk of early diastolic dysfunction in hypertension (OR = 3.83, 95% CI = 2.24-6.54, P < 0.01). ROC curve analysis indicated that the D allele has predictive value for early diastolic dysfunction in patients with hypertension (area under the curve [AUC], 0.667; 95% confidence interval [CI], 0.608-0.723; sensitivity, 76.7%; and specificity, 56.7%; P < 0.05).

CONCLUSIONS: The ACE-D allele is associated with early diastolic dysfunction in hypertension. ACE gene testing can enhance the predictive value for diastolic dysfunction in patients with hypertension.

PMID:39939942 | DOI:10.1186/s12872-025-04498-x

Eur J Cancer. 2025 Feb 7;218:115292. doi: 10.1016/j.ejca.2025.115292. Online ahead of print.

ABSTRACT

BACKGROUND: The use of surrogate endpoints may expedite the reporting of study outcomes of clinical trials. The validity of disease-free survival (DFS) as a surrogate for overall survival (OS) in the neoadjuvant treatment of esophageal (E) or gastroesophageal junctional (GEJ) carcinomas remains uncertain.

OBJECTIVE: To evaluate DFS as a surrogate end-point for OS in E/GEJ using the meta-analytical approach DESIGN, SETTING, AND PARTICIPANTS: individual patient data from an international meta-analysis on operable locally advanced E/GEJ, which including randomized trials comparing at least two of the neo-adjuvant treatment strategies: upfront surgery (S), chemotherapy followed by surgery (CS), and/or chemoradiotherapy followed by surgery (CRS).

MAIN OUTCOMES AND MEASURES: Individual (Kendall’s tau) and trial-level (R2) correlations between DFS and OS were estimated using a Clayton copula.

RESULTS: DFS and OS data were available for a total of 4518 pts: 2222 pts included in CS vs S, 1908 pts in CRS vs S, and 388 in CS vs CRS comparisons. 3440 patients had a DFS event and 3303 patients died. Kendall’s tau was 0.73 [95 % CI 0.71 – 0.75] and R2 trial-level correlation was 0.95 [0.84 – 0.99] for CS vs S, Kendall’s tau was 0.76 [0.74 – 0.77] and R2 was 0.96 [0.87 – 0.99] for CRS vs S, Kendall’s tau was 0.87 [0.78 – 0.92] and R2 was 0.93 [0.43 – 1] for CRS vs CS. In a multistate model, the median time in the recurrence state was shorter in older vs more recent trials: mean time of 10.8 [10.2 – 11.4] vs 16.5 months [15.4-17.6].

CONCLUSIONS AND RELEVANCE: DFS is a validated surrogate endpoint for OS in trials evaluating neoadjuvant chemotherapy or chemoradiotherapy in E/GEJ. DFS may be more useful as an endpoint when delays between recurrences and death become larger.

PMID:39938127 | DOI:10.1016/j.ejca.2025.115292

JMIR Form Res. 2025 Feb 12;9:e65206. doi: 10.2196/65206.

ABSTRACT

BACKGROUND: Decreasing aggression through stress reduction is an important part of forensic psychiatric treatment. DEEP is an experience-based virtual reality intervention that uses biofeedback to train diaphragmatic breathing and increase relaxation. Although DEEP has shown promising results in reducing stress and anxiety in students and adolescents in special education, it has not been examined in forensic psychiatric populations.

OBJECTIVE: This study aimed to evaluate DEEP’s potential to reduce stress, emotional tension, and anger in forensic psychiatric inpatients.

METHODS: A mixed methods, alternating treatment, single-case experimental design was conducted with 6 Dutch forensic inpatients. For 20 days, participants engaged in 4 DEEP sessions. Experience sampling was used for continuous monitoring of stress, emotional tension, and anger twice daily. A repeated linear mixed model was used as a primary statistical approach for analyzing the experience sampling data as well as visual analyses. Finally, semistructured interviews were conducted with participants and health care professionals to compare quantitative with qualitative results.

RESULTS: Of the 6 participants, 3 (50%) completed all 4 DEEP sessions, while the other 3 (50%) missed one session due to technical difficulties or absence from the inpatient clinic. P1 showed a significant reduction of stress after session 2 (β=-.865; P=.005). No significant changes over time were found, although an experienced effect was reported during the interviews. P2 showed no significant results. They reported the sessions as being repetitive, with no experienced effect. P3 showed a momentary increase of emotional tension after the first session (β=-.053; P=.002), but no changes were observed over time. No experienced effects were reported in the interview. P4 did not show significant results over time, and was hesitant to report clear experienced effects. P5 showed a significant decline of emotional tension (β=-.012; P=.006), stress (β=-.014; P=.007), and anger (β=-.007; P=.02) over time. They also reported short-term experienced effects in the interview. P6 showed a significant decline of stress over time (β=-.029; P<.001) and reported experiencing substantial effects. Finally, health care professionals reported a relaxing effect of DEEP in their patients but did not expect many long-term effects because no clear behavioral changes were observed.

CONCLUSIONS: DEEP shows promise in teaching deep breathing techniques to forensic psychiatric inpatients, potentially decreasing stress, emotional tension, and anger in some patients. However, DEEP is not a one-size-fits-all intervention that supports every patient because the effectiveness on the outcome measures varied among participants. To increase effectiveness, emphasis should be put on supporting patients to transfer deep breathing skills into their daily lives. This highlights the importance for the structural integration of DEEP into current treatment protocols.

PMID:39938081 | DOI:10.2196/65206

J Mother Child. 2025 Feb 11;28(1):113-128. doi: 10.34763/jmotherandchild.20242801.d-24-00038. eCollection 2024 Feb 1.

ABSTRACT

BACKGROUND: Women with sensory disabilities, including deafness and blindness, face significant barriers to equitable healthcare in pregnancy, childbirth, and postnatal care. Representing over 5% of the global population-a number expected to rise-these women often encounter discrimination, limited information access, and inadequate childbirth support, increasing pregnancy-related risks.

MATERIALS AND METHODS: This systematic review examines childbirth methods for women with sensory disabilities and the healthcare barriers they face during prenatal, perinatal, and postnatal periods. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 methodology, searches were performed in PubMed, Scopus, BioMed Central, and Cochrane Library databases. From 270 relevant studies, 10 met the inclusion criteria, comprising 8 quantitative and 2 qualitative studies. All studies were critically appraised using the Caldwell framework.

RESULTS: The review identified that women with sensory disabilities, particularly those who are deaf or blind, experience higher rates of caesarean sections compared to women without disabilities. However, a significant proportion of women in this demographic group successfully deliver vaginally. The review also highlighted substantial healthcare barriers, including inadequate communication between patients and healthcare providers, limited information regarding childbirth options, and insufficient postnatal care. Discrimination and obstetric violence were reported in several studies, further exacerbating the healthcare experiences of these women.

CONCLUSIONS: This study highlights the urgent need for healthcare systems to enhance communication, accessibility, and support for women with sensory disabilities. An equity and inclusion framework in maternal care should ensure that these women receive adequate and respectful healthcare. Addressing these gaps will improve outcomes for mothers and newborns and reduce discrimination and inequitable treatment.

PMID:39938073 | DOI:10.34763/jmotherandchild.20242801.d-24-00038

Am J Phys Med Rehabil. 2025 Feb 12. doi: 10.1097/PHM.0000000000002715. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the effects of neuromuscular electrical stimulation combined with lumbar stabilization exercises on lumbar multifidus muscle thickness, disability, pain, depression, anxiety, and fear-avoidance beliefs in patients with chronic low back pain; and to examine the correlation between ultrasound and magnetic resonance imaging of the lumbar multifidus.

DESIGN: Forty patients aged 18-65 years were randomized into two groups: Group 1: exercise and Group 2: exercise + neuromuscular electrical stimulation. The participants underwent 15-session electrical stimulation and/or exercise (3 days/week). All outcome measures assessed at baseline, post-treatment, and 3 months after. Multifidus cross-sectional area on magnetic resonance imaging was measured only at baseline.

RESULTS: Multifidus thickness increased, and pain decreased significantly in both groups, more prominent in Group 2. Disability, depression, and fear-avoidance beliefs scores significantly decreased in both groups, while anxiety decreased only in Group 1. Both magnetic resonance and ultrasound measurements demonstrated excellent inter-rater reliability and statistically significant correlations.

CONCLUSION: Both groups improved in terms of pain, disability, psychological status and muscle thickness. Neuromuscular electrical stimulation adjunct to lumbar stabilization exercises demonstrated enhanced effectiveness in increasing lumbar multifidus thickness.

PMID:39938065 | DOI:10.1097/PHM.0000000000002715

Clin Exp Dermatol. 2025 Feb 12:llaf065. doi: 10.1093/ced/llaf065. Online ahead of print.

ABSTRACT

BACKGROUND: Psoriasis is a common autoimmune inflammatory disease. Vitamin B6 is crucial for the body’s inflammatory response, yet the relationship between pyridoxal 5′-phosphate (PLP), 4-pyridoxic acid (4-PA), and vitamin B6 turnover (4-PA/PLP) in psoriasis remains unexplored.

OBJECTIVE: To investigate the relationship of PLP, 4-PA and vitamin B6 catabolism with the risk of psoriasis.

METHODS: This cross-sectional study analyzed 7,540 participants from the National Health and Nutrition Examination Survey. Vitamin B6 catabolism was assessed via the serum 4-PA to PLP ratio (4-PA/PLP). The primary outcome was psoriasis, evaluated using weighted univariate and multivariate logistic regression to determine odds ratios (OR) and 95% confidence intervals (CI). Subgroup analyses were performed by age, gender, body mass index (BMI), hypertension, dyslipidemia, and cardiovascular disease (CVD).

RESULTS: Out of the participants, 208 had psoriasis. After adjusting for confounders, 4-PA levels in cutoff above group were positively associated with psoriasis (OR=1.51, 95% CI: 1.03-2.20). Additionally, 4-PA/PLP correlated with increased psoriasis risk (OR=1.82, 95% CI: 1.02-3.26). However, PLP levels did not show a significant association. The positive link between 4-PA/PLP and psoriasis was consistent in individuals with BMI ≥25 kg/m², hypertension, and those without dyslipidemia.

CONCLUSION: The results revealed significant association of 4-PA and 4-PA/PLP level with the presence of psoriasis. However, further extensive prospective studies are necessary to establish causality.

PMID:39938060 | DOI:10.1093/ced/llaf065