Nevin Manimala

Int J Ophthalmol. 2026 Jan 18;19(1):132-139. doi: 10.18240/ijo.2026.01.17. eCollection 2026.

ABSTRACT

AIM: To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey (NHANES) database combined with Mendelian randomization (MR).

METHODS: Initially, 20 497 subjects from the complete questionnaire cycle in the NHANES database from 2005 to 2008 were included. By exclusion criteria, 8460 subjects were screened with 1676 myopia samples and 6784 control samples. Subsequently, baseline characteristics, association analyses, risk stratification analyses, and receive operating characteristic curve (ROC) were used to investigate the associations between covariates and myopia. Then, the causal relationship was explored in depth by MR analysis, and was estimated the reliability by sensitivity analyses and directionality tests.

RESULTS: Baseline characteristics illustrated a significant difference between myopia and controls for both asthma and covariates (excluding gender; P<0.05). The results in all three models indicated that asthma was strongly associated with myopia and the effect on myopia was not significantly confounded by other covariates [model 3: odd ratio (OR)=1.31; 95%CI=1.07-1.62; P=0.0133]. The risk stratification analysis again verified that asthma remained strongly associated with myopia and was a risk factor for myopia (P<0.05, OR>1). ROC proved that the model was accurate in its prediction [area under curve (AUC)=0.7]. Subsequently, the causal relationship between them was statistically significant (P<0.05) according to the inverse variance weighted (IVW) method in MR. Scatterplot showed that asthma and myopia had significant positive causality and were not affected by confounders. Forest plot displayed an increasing risk of myopia on asthma (OR>1). The funnel plot demonstrated compliance with Mendel’s second law. Sensitivity analysis and directional analysis further confirmed the confidence of the MR analysis results and a unidirectional causal relationship between them.

CONCLUSION: A significant association and causality between asthma and myopia is found through the NHANES database and MR analysis, which is important implications for public health policy development and clinical practice.

PMID:41524007 | PMC:PMC12782071 | DOI:10.18240/ijo.2026.01.17

Int J Ophthalmol. 2026 Jan 18;19(1):77-82. doi: 10.18240/ijo.2026.01.10. eCollection 2026.

ABSTRACT

AIM: To evaluate the therapeutic effects of ranibizumab on optic disc and macular microvascular perfusion in central retinal vein occlusion (CRVO) with macular edema (ME).

METHODS: Optical coherence tomography angiology (OCTA) parameters, including optic disc vessel density (VD; including whole-disc VD, intra-disc VD, and peripapillary VD), superficial/deep capillary plexus (SCP/DCP) VD, and central macular thickness (CMT) were analyzed. Additional assessments included best-corrected visual acuity (BCVA) via Early Treatment Diabetic Retinopathy Study (ETDRS) chart and hemorheological profiling. CRVO patients received monthly intravitreal ranibizumab injections for three consecutive months. Pre- and post-treatment parameters were statistically compared.

RESULTS: The study comprised 60 CRVO-ME patients (28 males; 32 females), aged 50-78y (mean 63.3±7.6y) and 60 age-/sex-matched healthy controls. As compared with participants exhibiting normal funduscopic findings, CRVO patients demonstrated significantly elevated levels of low-shear-rate whole blood viscosity (LSR-WBV), high-shear-rate whole blood viscosity (HSR-WBV), and aggregation index (AI, all P<0.05). In CRVO-affected eyes, vertical cup-to-disc (C/D) ratio and optic cup volume were significantly smaller, whereas retinal nerve fiber layer (RNFL) thickness was significantly greater, compared to both unaffected contralateral eyes and normal control eyes (all P<0.05). Following treatment, VD of the entire optic disc (P<0.05), intra-disc VD (P<0.05), and peripapillary VD (P<0.05) all increased significantly relative to baseline. CMT decreased significantly (P<0.05), whereas macular SCP-VD and macular DCP-VD showed non-significant slight reductions (P>0.05). At baseline, BCVA of CRVO eyes correlated with whole-disc VD (r=-0.276, P=0.033), intra-disc VD (r=-0.342, P=0.009), and peripapillary VD (r=-0.335, P=0.007), with intra-disc VD demonstrating the strongest association. Besides, BCVA improvement, after the treatment, correlated positively with whole-disc VD (r=0.342, P=0.008) and intra-disc VD (r=0.396, P=0.002).

CONCLUSION: Optic disc blood perfusion is more closely associated with visual acuity than macular perfusion, suggesting intra-disc VD may serve as a potential biomarker for monitoring visual acuity changes in CRVO. Multiple ranibizumab injections significantly improve optic disc perfusion but may have exerted detrimental effects on the macula. CRVO patients shows higher hemorheological parameters than those with normal fundi. Reduced vertical C/D ratio and optic cup volume may be linked to CRVO incidence, potentially acting as susceptibility factors.

PMID:41524002 | PMC:PMC12782078 | DOI:10.18240/ijo.2026.01.10

Alpha Psychiatry. 2025 Dec 22;26(6):49341. doi: 10.31083/AP49341. eCollection 2025 Dec.

ABSTRACT

OBJECTIVE: This study compared addiction severity, psychotic symptoms, suicide risk, and craving in patients with heroin use disorder, with and without methamphetamine use. We also investigated the reasons for methamphetamine use in these patients, and assessed 3-month clinical follow-up and treatment compliance.

METHODS: This cross-sectional study included 166 inpatients diagnosed with heroin use disorder (DSM-5). Patients were divided into two groups: heroin use only (H), and heroin use + methamphetamine use (H+M). Clinical assessments included the Addiction Profile Index-Clinical Form (API-C), Brief Psychiatric Rating Scale (BPRS), and Suicide Probability Scale (SPS). Statistical analyses were conducted with Statistical Package for the Social Sciences (SPSS) and included descriptive statistics, Kolmogorov-Smirnov test, Chi-square test, Mann-Whitney U test, and logistic regression. Three-month follow-up results and treatment compliance were compared between the two groups.

RESULTS: The H and H+M groups included 80 and 86 participants, respectively. The H+M group had higher BPRS total scores, API-C subscale scores (craving, risky behaviors, excitement-seeking, impulsiveness, depression), addiction severity, additional substance use, anxiety, depressive symptoms, suicidal ideation, and 3-month lapse rate. Craving and excitement-seeking were independent predictors of methamphetamine use.

CONCLUSION: The H+M group showed more severe addiction, novelty-seeking personal characteristics, and suicidal ideation compared to the H group. Craving scores were higher in the H+M group and should not be overlooked, along with a greater risk of early lapse. Our study found that craving, risky behaviors, depressive and psychotic symptoms, and suicidal thoughts are the most critical issues to be addressed in the treatment and follow-up of the H+M patient group.

PMID:41523975 | PMC:PMC12781224 | DOI:10.31083/AP49341

Alpha Psychiatry. 2025 Dec 22;26(6):49352. doi: 10.31083/AP49352. eCollection 2025 Dec.

ABSTRACT

OBJECTIVE: To explore the molecular mechanisms underlying clozapine-induced metabolic syndrome (MetS) in schizophrenia patients, providing scientific evidence for clinicians to prevent and manage metabolic syndrome during the treatment of psychiatric disorders.

METHODS: Ten schizophrenia patients with MetS and ten matched controls were recruited from Shanghai Mental Health Center according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for schizophrenia and the 2016 Chinese Adult Dyslipidemia Prevention and Treatment Guidelines for MetS. Peripheral blood RNA sequencing was performed to identify differentially expressed genes (DEGs). Weighted gene co-expression network analysis (WGCNA) and protein-protein interaction (PPI) network were used to pinpoint hub genes. Mendelian randomization (MR) was conducted to validate causal relationship between serum brain-derived neurotrophic factor (BDNF) levels and MetS components.

RESULTS: A total of 1019 DEGs were identified, grouped into eight mRNA modules through WGCNA. Key hub genes included RP11-611O2.6, acid phosphatase-like 2 (ACPL2), T cell receptor alpha variable 12-2 (TRAV12-2), matrix metallopeptidase 8 (MMP8), piggyBac transposable element derived 4 pseudogene 1 (PGBD4P1), transmembrane protein 261 (TMEM261), and BDNF, with BDNF and MMP8 further validated by PPI network analysis. MR analysis confirmed a causal association between BDNF levels and MetS risk, reinforcing its role in metabolic dysregulation. Gene Ontology (GO) annotation and pathway enrichment analysis highlighted immune response, morphological changes, and metabolic processes as key biological processes, with pathways such as biological oxidation and defensins significantly enriched.

CONCLUSION: Significant differences in gene expression are observed between schizophrenia patients with and without MetS. Individual variability in clozapine-induced MetS may be linked to DEGs.

PMID:41523972 | PMC:PMC12781211 | DOI:10.31083/AP49352

Alpha Psychiatry. 2025 Dec 23;26(6):49375. doi: 10.31083/AP49375. eCollection 2025 Dec.

ABSTRACT

BACKGROUND: The objective of this study is to develop an easily applicable scale to measure the course of treatment and the level of recovery for mental problems in various dimensions, which can be used in clinical practice and research.

METHODS: The validity and reliability test of Moodist Outcome Inventory (MOI) were conducted with 293 participants. Criterion-related validity was investigated by assessment with the Brief Psychiatric Rating Scale (BPRS), Disability Assessment Schedule (WHO-DAS-II), and Psychological Distress Scale (K10-PDS). Factor analysis was investigated by assessment with clinical and non-clinical samples. The sample was followed for six clinical assessments and evaluated by repetitive analysis of Variance (ANOVA) measurement.

RESULTS: The Cronbach’s alpha coefficient of the total scale was noted to be 0.89 in the reliability analysis. In the exploratory factor analysis, the single factor explaining 75.64% of the total variance was attained, and all items were included in this factor. Forty cases completed six clinical assessments, and the change between the MOI scores during the time interval was noted to be statistically significant. The correlation of the MOI scale with the K-10, WHO-DAS-II, and BPRS scales was noted to be 0.62, 0.73, and 0.65, respectively. In six consecutive assessments, the mean scores of all scales dropped significantly. The cut-off point of the scale was recorded as 7.27, and the reliable change index (RCI) was noted as 2.5.

CONCLUSION: MOI was assessed as a valid and reliable scale for evaluating the course of treatment. The strengths of the scale are that it assesses both symptoms and well-being, is short, and can be implemented in clinical practice.

PMID:41523968 | PMC:PMC12781210 | DOI:10.31083/AP49375

Malays Fam Physician. 2025 Dec 11;20:78-100. doi: 10.51866/oa.880. eCollection 2025.

ABSTRACT

INTRODUCTION: Women with a history of gestational diabetes mellitus (GDM) have an increased risk of developing glucose intolerance. This study aimed to assess the prevalence of glucose intolerance and its associated factors among postpartum women with a history of GDM in Penang.

METHODS: This cross-sectional study was conducted at five government primary care clinics in Penang. Postpartum women with a history of GDM who underwent a 75-g oral glucose tolerance test (OGTT) at 6-12 weeks postpartum were recruited from August to October 2023. Data collected included sociodemographic details, clinical characteristics, physical activity levels measured using the International Physical Activity Questionnaire-Short Form and OGTT results. Descriptive and multiple logistic regression analyses were performed using IBM SPSS Statistics version 29.

RESULTS: A total of 204 women participated, with a mean age of 31.7 (SD=5.05) years. The prevalence of prediabetes and type 2 diabetes mellitus was 23.5% and 3.9%, respectively. Among the participants, 47.5% were inactive, while 27.5% were physically active. The participants on oral medication or insulin had higher odds of developing postpartum glucose intolerance. Conversely, the participants who were minimally active or active had a lower likelihood of developing glucose intolerance than those who were inactive.

CONCLUSION: Among women attending primary care clinics in Penang, 27.5% had abnormal glucose tolerance postpartum. Physical inactivity was a significant risk factor. This study highlights the need to promote physical activity during pre-pregnancy care to reduce postpartum glucose intolerance and its complications.

PMID:41523956 | PMC:PMC12789809 | DOI:10.51866/oa.880

Circ Rep. 2025 Nov 20;8(1):58-67. doi: 10.1253/circrep.CR-25-0156. eCollection 2026 Jan 9.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) after bioprosthetic valve (BPV) replacement is common in older patients with multiple comorbidities and is associated with a heightened risk of thromboembolism. Anticoagulation therapy is often indicated, but renal impairment and other comorbidities elevate bleeding risk, making clinical decisions complex. This study compared clinical outcomes between warfarin and direct oral anticoagulants (DOACs) in this high-risk population.

METHODS AND RESULTS: This subgroup analysis of the BPV-AF Registry included 612 patients treated with oral anticoagulants after BPV replacement, stratified by renal function: normal or mild impairment (creatinine clearance [CCr] ≥50 mL/min), mild-to-moderate impairment (30 mL/min ≤ CCr < 50 mL/min), and moderate-to-severe impairment (15 mL/min ≤ CCr < 30 mL/min). Baseline characteristics and outcomes were analyzed within each stratum. The composite outcome of stroke, systemic embolism, and cardiovascular events was numerically less frequent in the DOAC than warfarin group across all strata, although the differences were not statistically significant. Major bleeding also tended to be lower in the DOAC group.

CONCLUSIONS: In this study from a Japanese nationwide registry comparing outcomes of AF patients after BPV replacement with severe renal impairment between those treated with DOACs and those treated with warfarin, comparative conclusions between DOACs and warfarin cannot be drawn because of the small sample size. Nonetheless, both anticoagulants may be acceptable in clinical practice, highlighting the need for individualized decision-making based on patient risk.

PMID:41523933 | PMC:PMC12782906 | DOI:10.1253/circrep.CR-25-0156

Explor Asthma Allergy. 2025;3:100978. doi: 10.37349/eaa.2025.100978. Epub 2025 Apr 16.

ABSTRACT

AIM: Emerging epidemiological studies have reported a link between allergic diseases, including asthma, and depression. Evidently, the gut microbiota is involved in the pathogenesis of asthma and depression. Therefore, we investigated whether allergic lung inflammation in mice causes gut microbial dysbiosis, via the gut-brain axis, which is potentially associated with depression.

METHODS: Wild-type C57BL/6J female mice were sensitized with intranasal house dust mite (HDM) antigen or phosphate-buffered saline (PBS) for 6 weeks to induce chronic allergic lung inflammation. Sucrose preference tests were performed for assessing depression. Fecal samples were collected, and 16S ribosomal RNA gene sequencing was performed to detect differences in gut microbiota composition between the HDM and PBS groups. The distance calculation, clustering of operational taxonomic units, rarefaction analysis, and estimator calculation (α- and β-diversity) were performed.

RESULTS: There was a significant difference in β-diversity (Bray-Curtis dissimilarity, F-statistics = 6.16, p = 0.001) of the gut microbiota between HDM and PBS groups. However, there was no difference in the α-diversity. We observed multiple differentially abundant bacteria in the HDM and PBS groups. The order class Clostridia (p = 0.0036) and genus Faecalibaculum (p = 0.028) were more abundant in the HDM group, whereas the phylum Firmicutes (p = 0.037) and genera Dubosiella (p = 0.00024) and Turicibacter (p = 0.037) were more abundant in the PBS group. Notably, the relative abundance of some bacteria was correlated with the sucrose preference test results.

CONCLUSIONS: Six weeks of intranasal HDM administration to mimic the chronic status of lung inflammation in asthma changed the gut microbiome in mice and was associated with depression-like behavioral changes.

PMID:41523930 | PMC:PMC12781662 | DOI:10.37349/eaa.2025.100978

Plast Reconstr Surg Glob Open. 2026 Jan 9;14(1):e7375. doi: 10.1097/GOX.0000000000007375. eCollection 2026 Jan.

ABSTRACT

BACKGROUND: Surgical intervention, particularly sentinel lymph node and lymph node dissection, is essential in managing melanoma, targeting locoregional disease. Our aim was to elucidate risk factors for postoperative lymphatic complications in melanoma patients undergoing lymph node surgery in Peru.

METHODS: A retrospective cohort study was conducted, reviewing records of melanoma patients who underwent lymphatic surgery at the Instituto Nacional de Enfermedades Neoplásicas from 2010 to 2019. Descriptive statistics and logistic regression analyses were performed to identify predictors of lymphatic complications.

RESULTS: The study included 699 melanoma patients (mean age 60.70 y, 51.4% women). Most patients were Hispanic (99.3%) and from Lima (52.8%), with lower extremity involvement being common. Surgical interventions included wide local excision (56.9%), sentinel lymph node surgery (67%), and lymph node dissection (32.3%). Complications at the site of lymph node dissection included wound dehiscence (1.6%), infection (6.2%), lymphoceles (5.7%), and lymphedema (2.7%). Multivariate analysis identified lymphatic invasion (odds ratio [OR] = 2.601, 95% confidence interval [CI]: 1.232-5.491) and positive lymph node pathology (OR = 2.066, 95% CI: 1.034-4.127) as risk factors, whereas primary lesion location in the upper extremity (OR = 0.055, 95% CI: 0.007-0.408) and trunk (OR = 0.106, 95% CI: 0.014-0.818) were protective factors.

CONCLUSIONS: Key risk factors for postoperative lymphatic complications in melanoma patients undergoing lymph node surgery include lower extremity involvement, lymph node dissections, lymphatic invasion, and positive lymph nodes. Understanding these risk factors can help clinicians optimize management strategies to reduce postoperative lymphatic complications.

PMID:41523920 | PMC:PMC12788895 | DOI:10.1097/GOX.0000000000007375

Ther Adv Med Oncol. 2026 Jan 9;18:17588359251411133. doi: 10.1177/17588359251411133. eCollection 2026.

ABSTRACT

BACKGROUND: Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have become a cornerstone in the treatment of HR+/HER2- advanced breast cancer. While their efficacy is well-established, emerging reports of nephrotoxicity warrant further investigation into its incidence, risk factors, and potential impact on survival outcomes.

OBJECTIVES: This study aimed to evaluate the incidence and risk factors for nephrotoxicity in patients receiving CDK4/6 inhibitors (palbociclib or ribociclib) and to analyze its association with progression-free survival (PFS) and overall survival (OS).

DESIGN: This was a single-center, retrospective cohort study.

METHODS: We reviewed the medical records of 120 patients with advanced breast cancer treated with palbociclib or ribociclib between October 2018 and July 2024. Nephrotoxicity was defined as a ⩾20% decline in creatinine clearance (CKD-EPI 2021) from baseline. Statistical analyses included descriptive statistics, chi-square tests, t-tests, Kaplan-Meier survival analysis, and Cox regression models.

RESULTS: Nephrotoxicity occurred in 28 patients (23.3%). Older age (⩾65 years) and higher baseline urea and creatinine levels were significant risk factors (p < 0.001). Paradoxically, patients who developed nephrotoxicity showed a trend toward better survival outcomes: median PFS was 30 months versus 20 months (p = 0.188), and the 3-year OS rate was 77.9% versus 63.8% (p = 0.801), though these differences were not statistically significant. In multivariate Cox analysis, the development of nephrotoxicity showed a trend toward a 71% reduction in mortality risk (HR = 0.293, p = 0.078), but it was not statistically significant.

CONCLUSION: Nephrotoxicity is relatively common in patients treated with CDK4/6 inhibitors, particularly in older individuals and those with elevated baseline renal parameters. Contrary to conventional expectations, its occurrence may be associated with a trend toward improved survival, possibly reflecting higher drug exposure or effective target inhibition. These findings highlight the need for careful renal monitoring and suggest that nephrotoxicity could serve as a potential surrogate marker for treatment efficacy, warranting validation in larger prospective studies.

PMID:41523909 | PMC:PMC12789390 | DOI:10.1177/17588359251411133