Nevin Manimala

Chin Med. 2025 Nov 24;20(1):199. doi: 10.1186/s13020-025-01258-z.

ABSTRACT

BACKGROUND: Chlorhexidine is widely used as a chemical antibacterial mouthwash, but its potential side effects have spurred interest in safer natural alternatives.

PURPOSE: This study aimed to evaluate the anticariogenic efficacy and inhibitory effects of a functional mouthwash containing Clematis chinensis Osbeck (C. chinensis Osbeck) extract in a randomized controlled clinical trial.

STUDY DESIGN AND METHODS: In this randomized, double-blind, controlled clinical trial conducted at Busan M Dental Clinic, 69 participants were randomly assigned to three groups: saline gargle (n = 23), chlorhexidine gargle (n = 23), and C. chinensis Osbeck extract gargle (n = 23). Participants used 15 mL of the assigned mouthwash four times daily for 2 weeks. The oral environment was standardized with professional scaling and a 1-week recovery period before the intervention. Clinical outcomes were evaluated using the O’Leary index and the Cariview™ test kit (AIOBIO Co. Ltd., Seoul, South Korea) at baseline, 1 week, and 2 weeks, respectively, to evaluate dental plaque acidogenicity and user satisfaction. Saliva tests (including cariogenic bacterial counts, acidogenicity, and buffering capacity) were performed using the SillHa Oral Wellness System (ARKRAY Inc., Kyoto, Japan). Subgingival plaque samples were analyzed by quantitative real-time polymerase chain reaction (PCR) analysis to detect cariogenic bacteria (Streptococcus mutans [S. mutans] and Gram-positive cariogenic bacteria [GS group], comprising S. mitis, S. sobrinus, and Lactobacillus casei). Statistical analyses were performed using analysis of variance (ANOVA) and Duncan’s post hoc test, with significance set at P < 0.05.

RESULTS: The C. chinensis Osbeck extract gargle group showed reductions in the O’Leary index score and cariogenic activity, alongside a progressive increase in user satisfaction. Saliva analysis revealed significant decreases in caries-causing bacterial numbers and acid production and improved buffering capacity, enhancing salivary defense. Only the C. chinensis Osbeck extract gargle group showed a significant reduction in S. mutans and the GS group. Compared with the saline and chlorhexidine groups, this group demonstrated a continuous decrease in caries risk over the 2 weeks.

CONCLUSION: C. chinensis Osbeck extract significantly improved clinical parameters related to dental caries, suggesting its potential as a safe and effective natural alternative to chemical antibacterial agents for caries prevention and oral health maintenance.

TRIALS REGISTRATION: ClinicalTrials.gov, KCT0008539. Registered on June 21, 2023, https://cris.nih.go.kr/cris/search/detailSearch.do/23816 ).

PMID:41276841 | DOI:10.1186/s13020-025-01258-z

Gut Pathog. 2025 Nov 24;17(1):93. doi: 10.1186/s13099-025-00763-8.

ABSTRACT

BACKGROUND: The incidence of an infection with Helicobacter pylori, or H. pylori rises with age, mostly affecting children.The infection rate of Helicobacter pylori increases with age, primarily affecting children. The rate of cases of disease of the hands, feet, and mouth (HFMD), an infectious illness that mostly affects newborns and young children and is ubiquitous throughout the Asia-Pacific area, declines with age. Asthma, shigellosis, TB, anaphylactic disease, and other diarrheal illnesses are all prevented by H. pylori. It also has a strong correlation with infectious disorders brought on by infection with pathogens including Orientia tsutsugamushi, HIV, HCV, and Brucella abortus. Nonetheless, the status of infection with H. pylori in individuals already infected with HFMD and the clinical implications of CagA⁺ H. pylori strains remain unreported.

METHODS: From October 2020 to October 2023, 130 children clinically diagnosed with HFMD enrolled in the observation group at the Affiliated Hospital of Youjiang Medical University for Nationalities Affiliated Hospital of Youjiang Medical College of Nationalities and the People’s Hospital of Beihai. With respect to gender, age, and location of residence, 150 chronologically matched healthy children made up the control group. Serum H. pylori antibodies in patients were measured, and the strain was identified through the Western blot technique.

RESULTS: 1. The frequency of infections with H. pylori with the prevalence of CagA + strains were found to be 16.2% and 8.5%, respectively, in patients with HFMD. These figures are lower than the 29.3% and 18.0% that are seen in healthy children, respectively (P-value < 0.05 for both). 2. The infection rate of the bacteria H. pylori and CagA + strains was found to be 18.5% and 9.3% in HFMD patients over 5 years of age, which is lower than the 41.5% and 26.2% observed in healthy children over 5 years, respectively (P-value < 0.05). In contrast, the rate of H. pylori and CagA + strains in HFMD patients aged 5 years and below was comparable to that of healthy children in the same age group, with both results showing no statistically significant differences. 3. H. pylori and CagA + strain prevalence were similar in primary and subsequent HFMV infections, although neither was statistically significant. 4.The findings of the univariate and multivariate analyses indicated that vaccination against HFMD and infection with H. pylori CagA + were protective factors against HFMD (0.203; 0.069-0.593; 0.004).

CONCLUSION: When compared to children in good health, individuals with HFMD had much lower levels of Helicobacter pylori infection. Additionally, H. pylori that carries the CagA gene could be able to prevent the development of HFMD.

PMID:41276838 | DOI:10.1186/s13099-025-00763-8

BMC Prim Care. 2025 Nov 24. doi: 10.1186/s12875-025-03117-0. Online ahead of print.

ABSTRACT

AIMS: Chronic kidney disease (CKD) is a major global health concern, often underdiagnosed in primary care settings. This study aimed to assess CKD screening practices using estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) among individuals in a primary care population in Girona Sud, Catalonia.

METHODS: A cross-sectional analysis was conducted using anonymised electronic health records from Girona Sud primary care centres. We included active patients aged ≥ 15 years with a recorded medical history. Demographic, clinical, and laboratory data, including eGFR and UACR, were analysed. CKD was defined as eGFR < 60 ml/min/1.73 m² and/or UACR ≥ 30 mg/g. Descriptive and inferential statistical analyses were performed.

RESULTS: Among the studied population (N = 230,922), 37% had mildly decreased eGFR (60-89 ml/min/1.73 m²), while 3% had more advanced CKD (G3b-G5). Albuminuria was mostly A1 (89%), with moderate (9.4%) and severe (1.8%) cases observed. Screening was more frequent in patients with type 2 diabetes, hypertension, and dyslipidaemia. Renal protective drugs, such as ACE inhibitors, ARBs, and SGLT2 inhibitors, were mainly prescribed in early CKD stages.

CONCLUSIONS: Early-stage CKD is prevalent in our primary care population, particularly among those with cardiometabolic conditions. It is important to optimize the CKD detection and management in primary care. Despite the availability of renal protective treatments, their underutilization in advanced stages of CKD highlights missed opportunities for timely and optimal intervention.

PMID:41276836 | DOI:10.1186/s12875-025-03117-0

J Orthop Surg Res. 2025 Nov 24. doi: 10.1186/s13018-025-06531-3. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to compare radiological and clinical outcomes between midline lumbar fusion (MIDLF) and minimally invasive transforaminal lumbar interbody fusion (MITLIF) in patients with L4/5 lumbar spinal stenosis and concomitant osteoporosis.

METHODS: A retrospective cohort study was performed involving patients with osteoporosis who underwent either MIDLF or MITLIF. Participants were stratified into two groups based on the surgical technique. Primary outcome measures included operative duration, intraoperative blood loss, postoperative hemoglobin reduction, time to extubation, length of hospital stay, postoperative complication rate, fusion rate, and radiographic parameters: lumbar lordosis (LL), intervertebral disc height (HOD), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Clinical outcomes were assessed using the Visual Analogue Scale (VAS) for back and leg pain, Japanese Orthopaedic Association (JOA) scores, and the Oswestry Disability Index (ODI).

RESULTS: The MIDLF group comprised 22 patients with a mean follow-up duration of 32.48 months, while the MITLIF group included 21 patients with a mean follow-up of 35.32 months. Both groups demonstrated statistically significant postoperative improvements in VAS, JOA, and ODI scores relative to baseline. The MIDLF group exhibited significantly higher JOA scores at 3 and 12 months postoperatively. Intraoperative blood loss was significantly lower in the MITLIF group (p < 0.021), and time to extubation was also significantly shorter (p < 0.001). Although not statistically significant, the MIDLF group exhibited reduced surgical and hospitalization durations. No significant differences were observed between groups in terms of complication or fusion rates. Radiological evaluation indicated significant postoperative improvements in LL, HOD, and SS, along with reductions in PT and PI-LL mismatch; however, no statistically significant differences were observed between the surgical techniques.

CONCLUSION: Both MIDLF and MITLIF are effective in improving sagittal alignment and alleviating symptoms in patients with L4/5 lumbar spinal stenosis and osteoporosis. MITLIF may offer perioperative advantages, including reduced intraoperative blood loss and a shorter extubation times.

PMID:41276834 | DOI:10.1186/s13018-025-06531-3

Cogn Neurosci. 2025 Nov 23:1-4. doi: 10.1080/17588928.2025.2591254. Online ahead of print.

ABSTRACT

Ritchie and colleagues propose that the functional organization of higher visual cortex is best understood through the lens of behavioral relevance, advocating for a shift away from theories that center around category selectivity. Building on this, I suggest the statistical structure of visual inputs acts as an additional critical constraint on visual cortex, and that a complete understanding of visual system organization must account for input statistics and how they interact with behavioral relevance. I discuss this using cortical food selectivity as a case study, and additionally describe how deep neural networks can provide new avenues for testing these theories.

PMID:41276824 | DOI:10.1080/17588928.2025.2591254

BMC Med Educ. 2025 Nov 24. doi: 10.1186/s12909-025-08324-y. Online ahead of print.

ABSTRACT

BACKGROUND: Generative artificial intelligence chatbots have become increasingly popular in the nursing education. Numerous academics have integrated them into their courses to assess the effects of artificial intelligence-supported teaching method. However, few researches have examined the impact of generative artificial intelligence chatbots in nursing education in conjunction with a particular teaching methodology. This study introduced a novel teaching method called “generative artificial intelligence chatbots + project task driven teaching” and investigated the potential effects of the teaching method on nursing undergraduates’ nursing research ability and nursing research self-efficacy.

METHODS: The study was conducted among 108 nursing undergraduates at Ningxia Medical University who participated in the “generative artificial intelligence chatbots + project task driven teaching” in the Nursing Research Course from September to November 2023. Sociodemographic characteristics questionnaire, Nursing research capacity of self-evaluation questionnaire, Nursing research self-efficacy questionnaire, and Curriculum effectiveness evaluation form were used to collect data. The analysis included the descriptive statistics and the paired t-test. The demographic data was summarized using descriptive statistics, and the change in nursing research capacity and nursing research self-efficacy of nursing undergraduates before and after the Nursing Research Course was compared using the paired t-test. The significance level was set at P < 0.05.

RESULTS: Following the training, students’ nursing research capacity and nursing research self-efficacy significantly improved (P < 0.05), with the exception of data processing capacity (P = 0.165). The curriculum effectiveness evaluation form showed that only a few students believed that the teaching mode was ineffective, which indicated that most students still had a favorable opinion of it.

CONCLUSIONS: Nursing undergraduates can better adapt to the “generative artificial intelligence chatbots + project task driven teaching”, and the teaching mode had also achieved positive results in nursing research courses, which has improved students’ nursing research ability and nursing research self-efficacy. This also provides a credible reference for using generative artificial intelligence chatbots in subsequent nursing education reform.

PMID:41276820 | DOI:10.1186/s12909-025-08324-y

BMC Womens Health. 2025 Nov 24. doi: 10.1186/s12905-025-04165-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Cardiovascular diseases remain the leading cause of death globally, with hypertension representing a major modifiable risk factor. Medication adherence persists as a major challenge in hypertension management, particularly among women, who often face unique barriers to adherence. This study aimed to estimate the prevalence of antihypertensive medication adherence and to identify its associated factors among Moroccan women with hypertension.

METHODS: A cross-sectional study was conducted in January 2025 among women attending three urban primary health care facilities in Inezgane, Morocco. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used to assess medication adherence. Descriptive statistics summarized participants’ characteristics, and logistic regression analyses were performed to identify adherence-related factors.

RESULTS: Among 364 hypertensive Moroccan women with a median age of 58 years (IQR: 48-65), 53.3% were non-adherent to their antihypertensive treatment. Multivariable analyses revealed that having health insurance (AOR 1.87; CI 1.19-2.95; p = 0.007) and participation in therapeutic education sessions (AOR 2.21; CI 1.27-3.83; p = 0.005) were associated with improved adherence. Conversely, polytherapy (AOR 0.14; CI 0.06-0.30; p < 0.001) and multiple daily doses (AOR 0.35; CI 0.20-0.61; p < 0.001) were associated with lower adherence.

CONCLUSION: More than half of the population of this study exhibited low adherence to antihypertensive medication. Multifaceted interventions, including enhanced patient education, simplified drug protocols, and improved healthcare accessibility, are required to improve adherence among Moroccan hypertensive women.

PMID:41276806 | DOI:10.1186/s12905-025-04165-5

J Orthop Surg Res. 2025 Nov 23. doi: 10.1186/s13018-025-06496-3. Online ahead of print.

ABSTRACT

OBJECTIVES: Oblique placement of tension band plates is a common surgical variance in guided growth, raising concerns about its clinical safety, particularly the potential for inducing iatrogenic deformities. This study aimed to evaluate the comprehensive impact of this plate autocorrection on limb torsion, as well as on coronal and sagittal plane alignment.

METHODS: This retrospective study analyzed 56 children who underwent guided growth for genu varum or valgum. At treatment initiation and termination, we measured the plate-diaphysis angle (α), femoral/tibial torsion, and coronal/sagittal plane alignment. Coronal plane correction was assessed using mechanical and anatomic lateral distal femoral angles (mLDFA, aLDFA) and medial proximal tibial angles (mMPTA, aMPTA). Sagittal plane stability was evaluated using the posterior distal femoral angle (PDFA) and posterior proximal tibial angle (PPTA).

RESULTS: A significant autocorrection of the plates toward the diaphyseal axis was observed (p < 0.001). The intended coronal plane correction was successfully achieved, as evidenced by statistically significant improvements in all four coronal alignment parameters (mLDFA, aLDFA, mMPTA, aMPTA; all p < 0.05). Critically, this rotation was not associated with any significant change in femoral or tibial torsion (p > 0.05 for both). Furthermore, sagittal plane alignment remained stable throughout the treatment period, with no significant alterations in PDFA or PPTA (all p > 0.05).

CONCLUSION: Inadvertent obliquity of tension band plates and their subsequent autocorrection is a clinically benign phenomenon. It effectively achieves the desired coronal correction without inducing adverse torsional or sagittal plane deformities. This study provides robust, evidence-based reassurance for surgeons that guided growth remains a safe and effective procedure despite this common surgical variance.

PMID:41276802 | DOI:10.1186/s13018-025-06496-3

BMC Public Health. 2025 Nov 24. doi: 10.1186/s12889-025-25690-w. Online ahead of print.

ABSTRACT

BACKGROUND: Road traffic accidents (RTAs) are a major public health concern, disproportionately affecting low- and middle-income countries. Despite having fewer vehicles per capita, Africa experiences the highest global road traffic fatality rates. This study examines demographic, temporal, and geographic patterns of fatal RTAs in Cape Town to inform targeted safety interventions.

METHODS: A retrospective analysis of Western Cape Government Health and Wellness Emergency Medical Services (WCGHW EMS) data (January 2021-May 2024) was conducted. Data included patient demographics, location, time, and accident type. Geospatial mapping using QGIS identified hotspots, and statistical analyses assessed relative risk and mortality trends.

RESULTS: Of 784 RTA cases, 167 resulted in fatalities. Males accounted for 70.7% of deaths, and pedestrians comprised 65.3% of fatalities. Nighttime fatalities (51.5%) were significantly higher, with hotspot areas showing a two-fold increased mortality risk (RR = 2.09, 95% CI: 1.61-2.72, p < 0.001).

CONCLUSION: This study highlights demographic and pedestrian vulnerabilities, the heightened risk of nighttime fatalities, and the geographic concentration of fatal RTAs in Cape Town. Findings underscore the urgent need for improved pedestrian infrastructure, enhanced street lighting, and optimised emergency medical response strategies. Targeted safety interventions in high-risk areas can significantly reduce RTA fatalities. Further research should explore behavioural and environmental factors over longer timeframes to inform policy and practice.

PMID:41276801 | DOI:10.1186/s12889-025-25690-w

Br J Surg. 2025 Nov 6;112(11):znaf251. doi: 10.1093/bjs/znaf251.

ABSTRACT

INTRODUCTION: In recent years there have been a plethora of new endovascular devices have entered the market, including paclitaxel (PTX) drug-coated balloons (DCB) and drug-eluting stents (DES) for treating patients with chronic limb-threatening ischaemia (CLTI). There have been concerns that the use of PTX is associated with increased all-cause mortality rate in this patient population.

METHODS: In the BASIL-3 trial (ISRCTN14469736) UK patients with CLTI were randomized (1:1:1) to receive femoro-popliteal (FP) plain balloon angioplasty (PBA; with or without bailout bare metal stenting (BMS), DCB angioplasty (DCBA) (with or without BMS), or primary DES. Here, data from the DCBA and DES arms have been pooled into a single ‘drug technologies’ (DT) group and compared with PBA ± BMS. The primary outcome was overall survival (OS). Secondary outcomes included amputation-free survival (AFS), major amputations, major adverse limb events, major adverse cardiovascular events, reinterventions, and 30-day mortality and morbidity rates.

RESULTS: Four hundred and eighty-one participants were randomized (PBA: n = 160; DT: n = 321). At a median follow-up in survivors of 5.6 years, OS was similar between the pooled DT and PBA groups (adjusted hazard ratio (HR): 0.83; 95% c.i.: 0.64 to 1.07). There was no evidence of a statistically significant difference in AFS between the groups (adjusted HR: 0.84; 95% c.i.: 0.66 to 1.06), or other secondary outcomes.

CONCLUSIONS: This further pooled analysis of the BASIL-3 RCT does not support the notion that the use of drug-eluting technologies, when compared to plain balloon angioplasty, increases all-cause mortality rate, or has other clinically important adverse effects, when used in patients with CLTI.

PMID:41276786 | DOI:10.1093/bjs/znaf251