Nevin Manimala

Med Trop Sante Int. 2024 Aug 5;4(3):mtsi.v4i3.2024.557. doi: 10.48327/mtsi.v4i3.2024.557. eCollection 2024 Sep 30.

ABSTRACT

INTRODUCTION: Scabies is an often-neglected skin parasitosis which can affect patients’ quality of life, and its treatment may be delayed in some poor African countries due to a lack of trained healthcare personnel or a lack of financial resources. The aim of this study was to describe the treatment-seeking paths of patients seen in dermatological consultations in Lomé for scabies, the direct costs of treatment and the impact of this condition on the quality of life of patients suffering from it.

PATIENTS AND METHOD: This was a descriptive and analytical study of patients diagnosed with scabies in one of Lomé’s dermatology departments from January 1 to December 31, 2021. The variables studied were sociodemographic; the patient’s therapeutic course prior to the dermatology consultation; the direct cost of the present consultation and the patient’s quality of life. The Dermatology Life Quality Index (DLQI) was used. Statistical analysis was performed with EPI Info software version 7.2.5.0.

RESULTS: A total of 157 patients were selected, including 114 cases of clinical scabies. The median age of patients was 26 years, and 29.3% were under 15 years of age. The sex-ratio M/F = 1.03. Out of them, 139 patients had one or more courses of treatment prior to the dermatological consultation, including self-medication (80.9%), consultations with non-dermatological healthcare personnel (62.4%). The average cost to the patient and family of drugs prescribed during the dermatological consultation was 19,817 CFA francs (30.2 €). The mean DQLI score for adults was 7.4, and 34.9% had moderate impairment of quality of life. The mean CDQLI score for children was 7.2, and 71.4 % had moderate impairment of quality of life.

CONCLUSION: Scabies is a parasitosis that impair patients’ life quality. In the absence of subsidized treatment and financial resources for patients, treatment remains limited, which could contribute to the spread of the disease.

PMID:39931727 | PMC:PMC11809070 | DOI:10.48327/mtsi.v4i3.2024.557

Med Trop Sante Int. 2024 Jul 3;4(3):mtsi.v4i3.2024.431. doi: 10.48327/mtsi.v4i3.2024.431. eCollection 2024 Sep 30.

ABSTRACT

BACKGROUND: Vaccination adherence among populations is a complex process involving, on the one hand, the expected benefit of a vaccine, and on the other, the perceived risk. To develop an evidence-based communication strategy aimed at improving vaccination coverage in Niger, we conducted a mixed socio-anthropological study of the perceptions among the population on the benefit and the risk of the childhood (Expanded Program on Immunization, EPI) and the Covid-19 vaccines. While the vaccine coverage for some of the EPI vaccines is above 80%, only 33% of the children are fully vaccinated, according to the national vaccination schedule. The first objective of our study was to understand the perceptions that might explain this drop off.The second objective was to identify the drivers of the low adherence to the Covid-19 vaccination, 22% of the illegible population being vaccinated.

MATERIALS AND METHODS: In March 2023, we interviewed 509 people for the quantitative study and 40 people through focus groups and individual interviews for the qualitative one, in Niamey (80% of the interviewees) and two villages.

RESULTS: 96.9% of the interviewees think that childhood vaccines are “a good thing,” even though 30.6% know that they might have negative side effects. While 87.8% think that it is “easy” or “very easy” to get children vaccinated, 21.4% point out as “annoying” the lack of amiability by the health care workers and 16.9% the waiting time. The qualitative study showed that these two complaints drive some women not to complete the vaccination schedule. We might also hypothesize that, given the perceived lack of amiability, some women don’t get enough information on the side effects and their management. Surprisingly, 73.3% of the interviewees think that vaccines against the disease are a good thing, and 83% of those who have heard messages promoting the vaccination approve them. This apparent contradiction with the low vaccine uptake is explained by a very low perception of the Covid-19 risks. More than half of the population surveyed believe that the disease is not present in the country, a very large majority believe that only ill people can transmit the disease, while only 12.8% think they know anybody who has ever been sick with Covid-19. According to our results, the circulating rumors on the vaccines don’t play a significant role in the low adherence to Covid-19 uptake, nor in the insufficient completeness of the EPI vaccination schedule.

CONCLUSION: The communication efforts on EPI vaccination should focus on the explanation of the side effects and their management, as well as improving the organization of the vaccination sessions. The communication on Covid-19 vaccination should focus on the reality of the disease in the country and the groups at risk for severe forms.

PMID:39931726 | PMC:PMC11809066 | DOI:10.48327/mtsi.v4i3.2024.431

Clin Cosmet Investig Dermatol. 2025 Feb 6;18:345-353. doi: 10.2147/CCID.S502333. eCollection 2025.

ABSTRACT

BACKGROUND: Psoriasis is an immune-mediated skin disease with a chronic relapsing-remitting course. Hyperglycemia has been shown to correlate with psoriasis severity. However, whether it could trigger psoriasis flares is not known.

OBJECTIVE: To investigate the association between hyperglycemia and psoriasis exacerbation.

METHODS: We conducted a retrospective cohort study at a university-affiliated hospital in Bangkok, Thailand, between 2008 and 2022 to examine the effects of elevated HbA1c on psoriasis flares. Patients with psoriasis vulgaris and either type 2 diabetes mellitus (T2DM) or impaired fasting glucose (IFG) who had at least 2 HbA1c values were identified. Statistical analyses were performed using mixed-effects logistic regression.

RESULTS: A total of 201 psoriasis patients (95 with severe psoriasis and 106 with mild psoriasis) with 1,717 follow-up visits were included in the analysis. In patients with severe psoriasis, HbA1c ≥ 7% (adjusted odds ratio (OR): 1.905 (95% confidence interval: 1.328-2.731)) and alcohol consumption status (adjusted OR: 3.328 (1.235-8.965)) were identified as independent prognostic factors for psoriasis flares. Meanwhile, in mild psoriasis patients, none of the variables were independently associated with psoriasis flares.

CONCLUSION: Hyperglycemia and alcohol consumption were associated with exacerbation in patients with severe psoriasis who had T2DM/IFG.

PMID:39931717 | PMC:PMC11809405 | DOI:10.2147/CCID.S502333

Circ Rep. 2025 Jan 21;7(2):76-85. doi: 10.1253/circrep.CR-24-0152. eCollection 2025 Feb 10.

ABSTRACT

BACKGROUND: This study assessed the prognostic value of submaximal cardiopulmonary exercise testing (CPET) in cardiac amyloidosis and explored CPET as an alternative to the 6-min walk test (6MWT).

METHODS AND RESULTS: In this single-center prospective observational study, 160 patients with cardiac amyloidosis (87% male; mean age 78±7 years) were evaluated. A total of 145 performed maximum symptom limited CPET. The V̇E/V̇CO₂ slope was 39±8, submaximal power output (SPO) was 24.75±11.50 W, and V̇O₂ at anaerobic threshold (AT) was 8.13±2.29 mL/min/kg. During follow up, 34 (21.25%) patients died, and another 34 (21.25%) experienced heart failure (HF)-related hospitalization, with 15 (9.38%) patients experiencing both events. Univariate analysis showed that V̇E/V̇CO₂ slope (hazard ratio [HR] 0.89; 95% confidence interval [CI] 0.86-0.93; P<0.001) and SPO (HR 0.91; 95% CI 0.87-0.96; P<0.001) were predictors of mortality. In multivariate analysis, V̇E/V̇CO₂ slope remained a significant predictor (HR 0.92; 95% CI 0.88-0.97; P<0.001) for both all-cause mortality and HF-related hospitalization independently. A SPO cut-off of <28 W predicted a worse outcome for both measures independently. Moderate correlations for V̇E/V̇CO₂ slope (-0.56 [CI -0.67, -0.42]) and SPO (0.55 [CI 0.42, 0.67]) with 6MWT distance have been found.

CONCLUSIONS: These findings highlight CPET parameters, particularly V̇E/V̇CO₂ slope and SPO with a cut-off <28 W, as predictors of survival and HF-related hospitalization in cardiac amyloidosis.

PMID:39931706 | PMC:PMC11807689 | DOI:10.1253/circrep.CR-24-0152

Clin Ophthalmol. 2025 Feb 6;19:407-416. doi: 10.2147/OPTH.S489669. eCollection 2025.

ABSTRACT

PURPOSE: Report the clinical effects and discomfort of using 0.1% hyaluronic acid (HA [Kynex 1^®, Alcon, Seoul, S. Korea]) and 0.3% HA (Kynex 3^®, Alcon, Seoul, S. Korea) to treat dry eye disease (DED).

METHODS: This study was designed as a prospective, crossover, randomized, and double-blind study. Patients aged >19 years with DED level 2 or higher, corneal staining score > 1, and tear break-up time (TBUT) < 10s were included. Sixty patients were randomly assigned to two groups. Patients in group 1 were instilled with 0.1% HA for four weeks and then 0.3% HA for the next four weeks. Group 2 patients were instilled with the eye drops in the reverse order of group 1. Patients were evaluated using a corneal staining score, TBUT, and the Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire at baseline, four weeks, and eight weeks.

RESULTS: In both groups, 0.3% HA showed an increasing trend in TBUT, although the difference was not statistically significant. Changes in the Schirmer test were greater in group 2, but this difference was also not statistically significant. The corneal staining score improved in both groups, with no statistically significant difference. While 0.3% HA was more effective than 0.1% HA according to the absolute value, this difference was not statistically significant. There was no difference between the two groups in the SPEED questionnaire evaluation that assessed aspects of discomfort, such as blurred vision, foreign body sensation, and burning sensation.

CONCLUSION: 0.3% HA was more effective for treating DED, although the difference was not statistically significant. In terms of discomfort, 0.3% HA showed no difference compared to 0.1% HA. Using both 0.1% HA and 0.3% HA in a tailored treatment approach can improve patient comfort and treatment outcomes.

PMID:39931678 | PMC:PMC11809210 | DOI:10.2147/OPTH.S489669

Diabetes Obes Metab. 2025 Feb 10. doi: 10.1111/dom.16238. Online ahead of print.

ABSTRACT

AIMS: The associations of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and outcomes among patients with obesity according to the presence of cardiovascular risk factors (metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUHO)) remain unclear. We examined the associations of GLP-1RAs with mortality and adverse cardiovascular events in patients with MHO and MUHO.

METHODS: The TriNetX network was utilized to select a cohort of patients with MHO or MUHO, and use or non-use of GLP-1RAs with propensity score matching (1:1). Cardiovascular events were identified during follow-up.

RESULTS: A total of 2 983 151 patients with obesity (512 434 with MHO and 2 470 717 with MUHO) were included in the study. Among these, 416 713 (13.9%) were GLP-1RA users. After propensity score matching, GLP-1RA use in MUHO was associated with a significantly lower risk of mortality (HR 0.580 [95% CI, 0.566-0.595]), ischemic stroke (HR 0.921 [0.890-0.953]), AF (HR 0.913 [0.888-0.938]) and hospitalization for HF (HR 0.925 [0.900-0.949]) during follow-up compared with non-use of GLP-1RA. Patients with MHO had a markedly lower risk of clinical events than those with MUHO. A trend towards a lower risk of cardiovascular events associated with GLP-1RA was seen among patients with MHO. There was no statistical interaction in the risk of cardiovascular outcomes with GLP-1RA use for MHO and MUHO patients.

CONCLUSIONS: The use of GLP-1RAs was associated with lower rates of cardiovascular events than no use in patients with MUHO. Similar but non-statistically significant trends were seen in patients with MHO.

PMID:39930557 | DOI:10.1111/dom.16238

Diabetes Obes Metab. 2025 Feb 10. doi: 10.1111/dom.16231. Online ahead of print.

ABSTRACT

AIM: This post hoc analysis of ONWARDS 1-5 assessed the efficacy and hypoglycaemia outcomes with once-weekly insulin icodec (icodec) versus once-daily basal insulin comparators (degludec, glargine U100 or glargine U300) in insulin-naive (ONWARDS 1, 3 and 5) and insulin-experienced (ONWARDS 2 and 4) adults (aged ≥18 years) with type 2 diabetes (T2D) by kidney function subgroup.

MATERIALS AND METHODS: Treatment outcomes were analysed by trial according to kidney function subgroup (estimated glomerular filtration rate [eGFR] ≥90; eGFR 60-<90; eGFR 30-<60; eGFR <30; all mL/min/1.73m²). Severe kidney function impairment (eGFR <30) at screening was an exclusion criterion for ONWARDS 1-4, but not ONWARDS 5.

RESULTS: ONWARDS 1-5 included 3765 participants; 3763 were included in this analysis. In ONWARDS 1, 3 and 5, there were no statistically significant treatment interactions by kidney function subgroup for change in glycated haemoglobin (HbA1c) from baseline to end of treatment (EOT); there were statistically significant subgroup interactions in ONWARDS 2 and 4 (both p-interaction <0.05). Change in body weight (baseline to EOT) across kidney function subgroups was comparable between treatment arms. Across trials, there was no consistent trend by kidney function subgroup for mean weekly insulin dose during the last 2 weeks of treatment or rates of combined clinically significant or severe hypoglycaemia. There were no statistically significant treatment interactions by kidney function subgroup for the achievement of HbA1c <7% without clinically significant or severe hypoglycaemia; all p-interaction >0.05.

CONCLUSIONS: Efficacy and hypoglycaemia outcomes of icodec versus once-daily comparators were generally consistent among adults with T2D, regardless of kidney function.

PMID:39930546 | DOI:10.1111/dom.16231

BMC Psychol. 2025 Feb 10;13(1):108. doi: 10.1186/s40359-025-02429-1.

ABSTRACT

BACKGROUND: Parenting today is characterized by numerous challenges and stressors. As a well-researched contextual factor for parenting, social support may help parents reduce parenting stress and adopt more positive parenting practices. However, the direct and indirect pathways linking social support to parenting outcomes remain largely unexplored. This study aimed to investigate whether and how the association between social support and parent-child relationships was mediated by the presence of meaning in parenthood and parental self-efficacy.

METHODS: As part of a parent education project, a total of 1,242 Chinese parents (87.2% female) participated in questionnaire surveys conducted by this cross-sectional study in Hong Kong. Data were analyzed using SPSS Statistics 26.0 and PROCESS Macro v4.1 for correlation analysis and serial mediation analysis.

RESULTS: The results indicated that the presence of meaning in parenthood and parental self-efficacy mediated the association between social support and parent-child relationships, both individually and serially. Furthermore, the mediating effect of the presence of meaning in parenthood was significantly greater than that of parental self-efficacy, as well as the serial mediating effect of the presence of meaning in parenthood and parental self-efficacy.

CONCLUSIONS: Social support is positively associated with parent-child relationships, both directly and indirectly, via the presence of meaning in parenthood and parental self-efficacy. Future research could employ the serial mediation model to explore the effects of social support on the well-being of parents and children. Additionally, future practice may prioritize the presence of meaning in parenthood as a crucial outcome indicator for parenting interventions.

PMID:39930538 | DOI:10.1186/s40359-025-02429-1

BMC Psychol. 2025 Feb 10;13(1):109. doi: 10.1186/s40359-025-02445-1.

ABSTRACT

OBJECTIVES: This study presents the German version of the Bergen Yale Sex Addiction Scale (BYSAS). The questionnaire screens for different risk levels of problematic excessive sexual behavior (“hypersexuality”).

METHODS: Based on an online sample (N = 492), a confirmatory factor analysis as well as other reliability analysis were conducted. Demographic characteristics of the sample were also assessed. The BYSAS was validated with psychiatric symptoms.

RESULTS: Global fit statistics indicate a one-factorial structure of the BYSAS. Cronbach’s α was 0.77. 2.03% of the study participants were categorized as “high risk” regarding sex addiction.

DISCUSSION: Initial results suggest that the German version of the BYSAS is a promising screening instrument for sex addiction. However, further validation in clinical populations is essential to ensure generalizability and clinical utility. In addition, different risk levels as well as the mechanisms underlying hypersexuality need to be examined more closely.

PMID:39930524 | DOI:10.1186/s40359-025-02445-1

BMC Res Notes. 2025 Feb 10;18(1):60. doi: 10.1186/s13104-025-07129-y.

ABSTRACT

INTRODUCTION: Pertussis remains among the top ten most common fatal aetiologies of acute respiratory infections worldwide. This study reports findings from the first laboratory-confirmed pertussis outbreak among primary schoolchildren in Burkina Faso.

METHODS: A cross-sectional study was conducted during an outbreak in the districts of Sabou and Sapouy following an alert from the national surveillance system. Suspected pertussis cases were investigated, with oropharyngeal/nasopharyngeal samples and sociodemographic and clinical data collected. Samples were analyzed using multiplex rRT-PCR and the FTD-33 Kit (Fast Track Diagnostics, Luxembourg). Descriptive statistics were conducted, and factors associated with pertussis positive cases were assessed using the Chi-square test and univariate logistic regression.

RESULTS: A total of 92 suspected pertussis cases with no fatal outcomes were identified among the schoolchildren in two different clusters during the investigation. The overall attack rate of the two clusters were 18.4% (92/499). Fifteen (16.6%) cases were biologically confirmed. The average age was 8.9 years, and 62% (57/92) were female. Rhinovirus (17.3%) and adenovirus (7.6%) were the most prevalent respiratory viruses detected among the suspected cases. Streptococcus pneumoniae (58.7%) and Haemophilus influenzae (56.5%) were the most common bacteria detected. A significant association was found between sore throat and confirmed cases (OR = 3.5, CI 95% [1.01-11.9]).

CONCLUSION: Despite extensive vaccination in several countries, pertussis can still cause outbreaks. Preventive measures, such as booster vaccinations for children outside the Expanded Program of Immunization (EPI) target age, are necessary.

PMID:39930513 | DOI:10.1186/s13104-025-07129-y