Nevin Manimala

Acta Pharm. 2025 Jan 9;74(4):613-633. doi: 10.2478/acph-2024-0039. Print 2024 Dec 1.

ABSTRACT

Biowaste produced in urban parks is composed of large masses of organic matter that is only occasionally used economically. In this work, extracts of six plants widely distributed in urban parks in Central Europe (Achillea millefolium, Cichorium intybus, Malva sylvestris, Medicago sativa, Plantago lanceolata, and Trifolium pratense), prepared using 10 % and 50 % ethanol, were screened for their antidiabetic and related properties. HPLC and UV-Vis analysis revealed the presence of caffeic acid, quercetin, luteolin, and apigenin derivatives. The extracts were active in DPPH antiradical, .-carotene-linoleic acid, ORAC, and reducing power assay. They inhibited lipoxygenase, collagenase, as well as heat-induced ovalbumin coagulation. They were also able to hinder carbohydrate degradation. For example, IC ₅₀ of anti-α-amylase activity of 10 % and 50 % ethanol extract of M. sativa extracts (204.10 ± 2.11 µg mL-1 and 78.27 ± 0.99 µg mL-1, respectively) did not statistically differ from the activity of the positive control, acarbose (284.74 ± 3.81 µg mL^-1). Similar results were observed for their anti-.-glucosidase activity. In most assays, the use of 50 % ethanol was shown to be better suited for the extraction of active metabolites. The results indicate that the biowaste obtained from urban parks represents a potential source of plant material for the preparation of high-value antidiabetic products.

PMID:39787626 | DOI:10.2478/acph-2024-0039

Cir Cir. 2025 Jan 9. doi: 10.24875/CIRU.23000648. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to elucidate the histopathological pre-diagnosis of cranial gliomas with magnetic resonance imaging (MRI) techniques in gliomas.

METHOD: A total of 82 glioma patients were enrolled to our study. Pre-operative conventional MRI images (non-contrast T1/T2/flair/contrast-enhanced T1) and advanced MRI images (DAG and ADC mapping, MRI spectroscopy and perfusion MRI [PMRI]) were analyzed.

RESULTS: Conventional MRI alone is useful in radiological pre-evaluation in low-grade glioma in 54.8% and 86.3% in high-grade glioma. Additional advanced MRI techniques were beneficial in comparing low-grade gliomas in 98% and 83.9% in high-grade glioma. On ROC analysis, ADC cutoff value 0.905 mm2/s (p = 0.001), rCBV cutoff value 1.77 (p = 0.001), Cho/NAA cut-off value 2.20 (p = 0.001), and Cho/Cr cutoff value 2.01 (p = 0.001) were achieved. Significant results were obtained when ADC, Cho/NAA, and Cho/Cr were analyzed into four histopathologically grade groups besides (p = 0.001). NAA/Cr values were not significant in pathological grading. rCBV measurements were statistically significant between Grades I and IV and between II and IV.

CONCLUSION: Using additional advanced MRI techniques such as PMRI, magnetic resonance spectroscopy, and DWI with conventional MRI could enhance the accuracy of histopathological grading in cranial glioma.

PMID:39787621 | DOI:10.24875/CIRU.23000648

Obstet Gynecol. 2025 Jan 9. doi: 10.1097/AOG.0000000000005819. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe the presentation, outcomes, and management strategies for cases of subcapsular liver hematoma associated with preeclampsia, eclampsia, or HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome.

METHODS: This was a case series of individuals with subcapsular liver hematoma managed at a single level IV center over a 10-year period, from 2013 to 2024. Presenting signs and symptoms, laboratory findings, time of onset, management strategies, acute perinatal and maternal outcomes, and long-term outcomes such as subsequent pregnancies were reviewed in the medical record and recorded. Data were summarized using descriptive statistics, with results reported as means, standard deviations, and ranges. Categorical variables were summarized as counts and percentages.

RESULTS: There were 13 cases of subcapsular liver hematoma associated with preeclampsia, eclampsia, and HELLP syndrome between 2013 and 2024. In 10 of the 13 pregnancies (76.9%), delivery was preterm. The most common presenting symptoms were epigastric or right upper quadrant pain (53.8%), followed by abdominal distention (38.5%). Diagnosis of subcapsular liver hematoma was made in the antepartum period for six patients and was made in the postpartum for seven patients. The diagnosis was confirmed in all cases by computed tomography. Conservative management with close hemodynamic monitoring and transfusion of blood and blood products was sufficient in 11 (84.6%) patients; two patients underwent surgical exploration. The mean duration of hospital stay was 10 days (range 2-21 days). Maternal complications included pleural effusions, acute kidney injury, and pulmonary edema. There were no maternal deaths. There were four stillbirths and no neonatal deaths. Four people had five subsequent pregnancies; delivery was preterm in all five pregnancies, two pregnancies were complicated by subsequent HELLP syndrome, and one patient developed recurrent subcapsular liver hematoma.

CONCLUSION: Subcapsular liver hematoma is a rare complication of preeclampsia, eclampsia, and HELLP syndrome that is associated with substantial maternal and perinatal morbidities. Conservative management with hemodynamic monitoring and transfusion of blood and blood products was sufficient for management in the majority of cases. All subsequent pregnancies resulted in preterm births.

PMID:39787605 | DOI:10.1097/AOG.0000000000005819

J Med Internet Res. 2025 Jan 9;27:e57263. doi: 10.2196/57263.

ABSTRACT

BACKGROUND: Intensive care units (ICUs) handle the most critical patients with a high risk of mortality. Due to those conditions, close monitoring is necessary and therefore, a large volume of data is collected. Collaborative ventures have enabled the emergence of large open access databases, leading to numerous publications in the field.

OBJECTIVE: The aim of this scoping review is to identify the characteristics of studies using open access intensive care databases and to describe the contribution of these studies to intensive care research.

METHODS: The research was conducted using 3 databases (PubMed-MEDLINE, Embase, and Web of Science) from the inception of each database to August 1, 2022. We included original articles based on 4 open databases of patients admitted to ICUs: Amsterdam University Medical Centers Database, eICU Collaborative Research Database, High time resolution ICU dataset, Medical Information Mart for Intensive Care (II to IV). A double-blinded screening for eligibility was performed, first on the title and abstract and subsequently on the full-text articles. Characteristics relating to publication journals, study design, and statistical analyses were extracted and analyzed.

RESULTS: We observed a consistent increase in the number of publications from these databases since 2016. The Medical Information Mart for Intensive Care databases were the most frequently used. The highest contributions came from China and the United States, with 689 (52.7%) and 370 (28.3%) publications respectively. The median impact factor of publications was 3.8 (IQR 2.8-5.8). Topics related to cardiovascular and infectious diseases were predominant, accounting for 333 (25.5%) and 324 (24.8%) articles, respectively. Logistic regression emerged as the most commonly used statistical model for both inference and prediction questions, featuring in 396 (55.5%) and 281 (47.5%) studies, respectively. A majority of the inference studies yielded statistically significant results (84.0%). In prediction studies, area under the curve was the most frequent performance measure, with a median value of 0.840 (IQR 0.780-0.890).

CONCLUSIONS: The abundance of scientific outputs resulting from these databases, coupled with the diversity of topics addressed, highlight the importance of these databases as valuable resources for clinical research. This suggests their potential impact on clinical practice within intensive care settings. However, the quality and clinical relevance of these studies remains highly heterogeneous, with a majority of articles being published in low-impact factor journals.

PMID:39787600 | DOI:10.2196/57263

J Med Internet Res. 2025 Jan 9;27:e67627. doi: 10.2196/67627.

ABSTRACT

BACKGROUND: The mental health crisis among college students intensified amid the COVID-19 pandemic, suggesting an urgent need for innovative solutions to support them. Previous efforts to address mental health concerns have been constrained, often due to the underuse or shortage of services. Mobile health (mHealth) technology holds significant potential for providing resilience-building support and enhancing access to mental health care.

OBJECTIVE: This study aimed to examine the trends in mental health and well-being outcomes over 3 years among college students, with an exploratory aim to assess the potential impact of the Roadmap mHealth app on these outcomes.

METHODS: A fully automated longitudinal observational study was conducted remotely from a large public academic institution in the Midwestern United States, evaluating mental health and well-being outcomes among college students using the Roadmap mHealth app over 3 fall semesters from 2020 to 2022. The study enrolled 2164 college students in Year I, with 1128 and 1033 students returning in Years II and III, respectively. Participants completed various self-reported measures, including the Patient Health Questionnaire-9 for depression, Generalized Anxiety Disorder-7 for anxiety, and additional metrics for coping, flourishing, and loneliness.

RESULTS: The findings indicated an evolving trajectory in students’ mental health. In Year I, depression and anxiety levels were higher compared with levels reported between 2014 and 2019, remaining stable into Year II. However, significant decreases were noted by Year III for both depression (Year I mean 7.78, SD 5.65 vs Year III mean 6.21, SD 4.68; t₁₀₈=-2.90; P=.01) and anxiety (Year I mean 6.61, SD 4.91 vs Year III mean 5.62, SD 4.58; t₁₁₆=-2.02; P=.046). Problem-focused coping decreased initially from Year I (mean 2.46, SD 0.58) to Year II (mean 2.36, SD 0.60; t₁₀₇₃=-5.87; P<.001), then increased by Year III (mean 2.40, SD 0.63; t₇₀₆=2.26; P=.02). Emotion-focused (Year I mean 2.33, SD 0.41 vs Year III mean 2.22, SD 0.47; t₉₉₄=-7.47; P<.001) and avoidant coping (Year I mean 1.76, SD 0.37 vs Year III mean 1.65, SD 0.38; t₉₉₇=-8.53; P=.02) consistently decreased. Loneliness significantly decreased from Year I (mean 5.79, SD 1.74) to Year III (mean 5.17, SD 1.78; t₁₀₁₃=-10.74; P<.001), accompanied by an increase in flourishing from Year I (mean 63.78, SD 14.76) to Year III (mean 66.98, SD 15.06; t₉₉₄=7.22; P<.001). Analysis of app usage indicated that the positive piggy bank and gratitude journal were the favored activities. Greater engagement with the app was positively correlated with enhanced flourishing, even after adjusting for demographic and sociobehavioral factors (β=.04, SE .016; t₃₉₇₄=2.17; P=.03).

CONCLUSIONS: In this study, students’ mental health and well-being improved, with notable reductions in depression, anxiety, and loneliness, associated with an increase in flourishing. The app did not appear to worsen students’ mental health. Based on the usage pattern, it is possible the app enhanced positive psychology-based practices. Future research should explore the efficacy of mHealth interventions through randomized controlled trials to further understand their impact on college students’ mental health outcomes.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04766788; https://clinicaltrials.gov/ct2/show/NCT04766788.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/29561.

PMID:39787592 | DOI:10.2196/67627

JMIR Form Res. 2025 Jan 9;9:e63948. doi: 10.2196/63948.

ABSTRACT

BACKGROUND: Hypnotherapy has been shown to be a safe, nonhormonal intervention effective for treating menopausal hot flashes. However, women experiencing hot flashes may face accessibility barriers to in-person hypnotherapy. To solve this issue, a smartphone app has been created to deliver hypnotherapy. The Evia app delivers audio-recorded hypnotherapy and has the potential to help individuals experiencing hot flashes.

OBJECTIVE: This study aims to determine user outcomes in hot flash frequency and severity for users of the Evia app.

METHODS: This study is a retrospective analysis of a dataset of Evia app users. Participants were divided into 2 groups for analysis. The first group reported daytime hot flashes and night sweats, while the second group was asked to report only daytime hot flashes. The participants in the first group (daytime hot flashes and night sweats) were 139 women with ≥3 daily hot flashes who downloaded the Evia app between November 6, 2021, and June 9, 2022, with a baseline mean of 8.330 (SD 3.977) daily hot flashes. The participants in the second group (daytime hot flashes) were 271 women with ≥3 daily hot flashes who downloaded the Evia app between June 10, 2022, and February 5, 2024, with a baseline mean of 6.040 (SD 3.282) daily hot flashes. The Evia program included a 5-week program for all participants with daily tasks such as educational readings, hypnotic inductions, and daily hot-flash tracking. The app uses audio-recorded hypnosis and mental imagery for coolness, such as imagery for a cool breeze, snow, or calmness.

RESULTS: A clinically significant reduction, defined as a 50% reduction, in daily hot flashes was experienced by 76.3% (106/139) of the women with hot flashes and night sweats and 56.8% (154/271) of the women with daily hot flashes from baseline to their last logged Evia app survey. On average, the women with hot flashes and night sweats experienced a reduction of 61.4% (SD 33.185%) in their hot flashes experienced at day and night while using the Evia app, and the women with daily hot flashes experienced a reduction of 45.2% (SD 42.567%) in their daytime hot flashes. In both groups, there was a large, statistically significant difference in the average number of daily hot flashes from baseline to end point (women with hot flashes and night sweats: Cohen d=1.28; t₁₃₈=15.055; P<.001; women with daily hot flashes: Cohen d=0.82; t₂₇₀=13.555; P<.001).

CONCLUSIONS: Hypnotherapy is an efficacious intervention for hot flashes, with the potential to improve women’s lives by reducing hot flashes without hormonal or pharmacological intervention. This study takes the first step in evaluating the efficacy of an app-delivered hypnosis intervention for menopausal hot flashes, demonstrating the Evia app provides a promising app delivery of hypnotherapy with potential to increase accessibility to hypnotherapy.

PMID:39787588 | DOI:10.2196/63948

Noise Health. 2024 Oct-Dec 01;26(123):577-583. doi: 10.4103/nah.nah_111_24. Epub 2024 Dec 30.

ABSTRACT

OBJECTIVE: Evaluate the effect of white noise intervention on sleep quality and immunological indicators of patients with breast cancer undergoing neoadjuvant chemotherapy (NAC).

METHODS: From January 2020 to December 2022, 104 newly diagnosed female patients (the number of people who met the inclusion criteria) with breast cancer who were confirmed to be preoperative NAC by puncture pathology were selected for a randomised single-blind trial. The patients were randomly divided into an observation group and a control group, with 52 cases in each group. The control group of patients received routine NAC treatment. The observation group played white noise at regular intervals every night on the basis of routine NAC, covering the entire treatment cycle. We evaluated the clinical efficacy, safety, sleep quality and immunological indicators of the two groups.

RESULTS: We found no statistically significant difference in the objective response rate between the two groups (P > 0.05). There was no statistically significant difference in the incidence of safety events between the two groups (P > 0.05). The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (P < 0.05). After intervention, the sleep latency, subjective sleep quality, sleep duration, daytime function and sleep disorder scores of both groups decreased, and the observation group had significantly lower scores than the control group (P < 0.05). After intervention, both groups showed changes in immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM), C-reactive protein and serum interleukin-6, but the differences between the groups were not statistically significant (P > 0.05).

CONCLUSION: White noise intervention can improve the sleep quality of the NAC population with breast cancer and reduce the incidence of adverse reactions. In addition, it has no effect on the treatment efficacy, safety and immune indicators of patients.

PMID:39787561 | DOI:10.4103/nah.nah_111_24

Noise Health. 2024 Oct-Dec 01;26(123):535-542. doi: 10.4103/nah.nah_39_23. Epub 2024 Dec 30.

ABSTRACT

BACKGROUND: Tinnitus refers to a common disorder affecting older adults frequently. This condition can disturb mental health and psychological well-being and contribute to cognitive decline. Despite recent advances in research, its pathophysiology remains incompletely understood. Therefore, this study aimed to investigate the sensation of tinnitus, its consequences on the quality of life of older adults, and its correlation with cytokine levels.

METHODS AND MATERIAL: This cross-sectional study included a sample of 103 independent older adults. Information regarding clinical history, tinnitus, and hearing loss was obtained through interviews. Assessment of tinnitus intensity and resulting impairments was conducted using Visual Analogue Scale (VAS) and Tinnitus Handicap Index (THI), respectively. Subjects underwent audiological evaluation and were measured for inflammatory markers. Statistical analyses included chi-square, Mann-Whitney, and Kruskal-Wallis tests and calculation of the effect size (Φ).

RESULTS: The condition of older adults with tinnitus (51.5%) was associated with hearing loss and previous noise exposure. No differences were observed in the cytokines between groups with and without tinnitus (P > 0.05), whereas a difference was found in the interleukin-10 (IL-10) of the male group (P = 0.016; r = 0.69). In those with tinnitus, VAS had a median and (interquartile range) of 5 (2-7), and the values were 21 (10-38) for THI. In addition, VAS and minimum masking level exhibited a significant correlation with IL-6 (P = 0.018; rs = 0.335) and IL-2 (P = 0.035; rs = 0.299), respectively. Furthermore, the groups with intense and mild VAS presented different levels of tumour necrosis factor alpha (TNF-α) (P = 0.041; E2R = 0.12).

CONCLUSION: The results reveal an association between tinnitus and hearing loss and previous noise exposure. Moreover, increased sound-masking levels and VAS correlated with IL-2 and IL-6, respectively. TNF-α levels varied between the mild and intense VAS groups.

PMID:39787555 | DOI:10.4103/nah.nah_39_23

Noise Health. 2024 Oct-Dec 01;26(123):523-534. doi: 10.4103/nah.nah_10_24. Epub 2024 Dec 30.

ABSTRACT

OBJECTIVE: Besides psychosocial stressors, teachers are exposed to disturbing noise at work, such as students’ irrelevant speech. Few studies have focused on this issue and its health consequences. We explored occupational noise exposure among teachers within the French workforce and analyzed how noise and work-related stress are related to their health.

MATERIALS AND METHODS: The prevalence of perceived noise exposure, evaluated through the question “Do you work in an environment where you sometimes have to raise your voice to talk to people 2 to 3 m away?” was compared between teachers (n = 13,843) and various occupational groups (n = 34,338) using inclusion data (2012-2020) from the ongoing French population-based CONSTANCES cohort (>217,000 participants). Additionally, the relationships between perceived noise and two health dimensions, perceived health (poor vs. good) and depressive symptoms (Centre for Epidemiologic Studies-Depression Scale, high vs. low/moderate), among teachers were alternately investigated using logistic regressions. Moreover, how perceived noise may interact with work-related stress (effort-reward imbalance/strained relationships) was explored.

RESULTS: Thirty-two percent of teachers reported working in a noisy environment, compared with 14% of noneducation employees (P < 0.001). Primary school teachers were the most likely to report noise exposure (43%). Independent of stress, teachers exposed to noise had poorer perceived health and higher odds of depressive symptoms than nonexposed teachers, with odds ratios (95% confidence interval) of 1.21 (1.07; 1.37) and 1.14 (1.01; 1.28), respectively. Evidence of an interaction between perceived noise and strained relationships was observed on perceived health (P = 0.05).

CONCLUSION: French teachers commonly reported disturbing noise at work, and those exposed showed poorer health indicators, particularly when facing strained relationships. The findings call for further studies on noise in schools, especially longitudinal studies, to ascertain its long-term effect on teachers’ health and its potential interaction with the psychosocial environment.

PMID:39787554 | DOI:10.4103/nah.nah_10_24

Noise Health. 2024 Oct-Dec 01;26(123):495-500. doi: 10.4103/nah.nah_78_24. Epub 2024 Dec 30.

ABSTRACT

PURPOSE: Noise levels may have an impact on the level of fear and anxiety in hospitalized children, which, in turn, may affect the effectiveness of treatment. This retrospective study aimed to investigate the impact of noise levels on medical anxiety in hospitalized children with pneumonia.

METHODS: Children hospitalized for pneumonia in our hospital from January 2020 to December 2023 were consecutively enrolled in this study. They were divided into high- and low-noise groups according to the environmental noise level, using 60 dB as a threshold value. Demographic, clinical, and psychological data were collected from medical records and patient assessments. Statistical analyses, including post-hoc analysis, were performed to conduct relevant research.

RESULTS: A total of 106 patients, including 66 patients with low noise and 40 patients with high noise, were included. Results revealed that children in the high-noise group exhibited significantly higher scores on the Brief Illness Perception Questionnaire compared to those in the low-noise group (32.56 ± 7.14 vs. 29.18 ± 6.25, t = 2.557, P = 0.012), as well as higher scores on the Face, Legs, Activity, Cry, Consolability (FLACC) behavioral pain scale (2.34 ± 0.96 vs. 2.01 ± 0.67, t = 2.081, P = 0.040), indicating higher levels of medical anxiety and pain perception in the high-noise group.

CONCLUSION: This study demonstrates that noise levels in the hospital environment have a substantial impact on the fears and perceptions of hospitalized children with pneumonia. High-noise levels were associated with increased medical anxiety and pain perception in pediatric patients.

PMID:39787550 | DOI:10.4103/nah.nah_78_24