Nevin Manimala

Diabetes Metab Syndr. 2025 Nov 19;19(10):103328. doi: 10.1016/j.dsx.2025.103328. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: This systematic review and meta-analysis was conducted to evaluate the effects of artichoke supplementation on cardiometabolic health markers in adults.

METHODS: A comprehensive literature search of PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials was conducted up to September 2024.

RESULTS: Artichoke supplementation significantly reduced body mass index (WMD = -0.51 kg/m², 95 % CI: 0.93 to -0.09) and waist circumference (WMD = -1.21 cm, 95 % CI: 2.24 to -0.17), while its effects on body weight and hip circumference were not statistically significant. Blood pressure outcomes revealed significant reductions in both systolic (WMD = -2.49 mmHg, 95 % CI: 4.33 to -0.65) and diastolic (WMD = -1.53 mmHg, 95 % CI: 3.01 to -0.05) pressures. Significant lipid profile improvements were observed in total cholesterol (WMD = -12.29 mg/dL, 95 % CI: 19.92 to -4.65), low-density lipoprotein cholesterol (WMD = -10.31 mg/dL, 95 % CI: 18.57 to -2.04), and triglycerides (WMD = -12.85 mg/dL, 95 % CI: 24.77 to -0.93), with no significant effect on high-density lipoprotein cholesterol. Regarding glycemic indices, insulin (WMD = -1.83 mU/L, 95 % CI: 3.33 to -0.32) and homeostatic model assessment for insulin resistance (WMD = -0.92, 95 % CI: 1.33 to -0.51) were significantly reduced, whereas fasting blood glucose and HbA1c were unaffected. Among liver function markers, alanine aminotransferase (WMD = -8.47 U/L, 95 % CI: 14.71 to -2.23) and alkaline phosphatase (WMD = -7.86 U/L, 95 % CI: 15.26 to -0.45) were significantly reduced, while aspartate aminotransferase showed a borderline non-significant effect. No significant change was observed in creatinine levels.

CONCLUSION: Artichoke supplementation may offer modest but significant improvements in several cardiometabolic risk markers.

PMID:41270328 | DOI:10.1016/j.dsx.2025.103328

J Emerg Med. 2025 Oct 24;80:74-80. doi: 10.1016/j.jemermed.2025.10.019. Online ahead of print.

ABSTRACT

BACKGROUND: There are only two antivenoms on the market approved for North American pit viper envenomations; crotalidae polyvalent immune Fab (ovine) and crotalidae immune F(ab’)₂ (equine). There is currently no consensus on which agent may be more effective.

OBJECTIVES: This study aimed to investigate the efficacy and safety of F(ab’)₂ compared with Fab regarding systemic and local effects of North American pit viper envenomation.

METHODS: Patients two years of age and older were retrospectively included and separated into groups if they received Fab or F(ab’)₂. The primary outcome compared the amount of Fab or F(ab’)₂ doses needed to achieve initial control. Secondary outcomes included incidence of recurrent coagulopathies, skin and soft tissue injury, 30-day readmission, length of stay, cost of drug therapy, and adverse events. Statistical significance was set at p < 0.05.

RESULTS: 114 patients were included, 57 in each group. F(ab’)₂ patients required less doses to achieve initial control (1 vs. 4 doses; p < 0.01) and had a shorter length of stay (36 vs. 46 hours, p < 0.01). There were no differences in recurrent coagulopathies [20 (F(ab’)₂) vs. 13 (Fab)], serious adverse events [1 (F(ab’)₂) vs. 0 (Fab)] and readmission within 30 days [1 (F(ab’)₂) vs. 0 (Fab)]. Non-serious adverse events were significantly greater in the F(ab’)₂ group (10 vs. 1 event; p < 0.01).

CONCLUSIONS: Patients treated with F(ab’)₂ antivenom for North American pit viper envenomation required less doses to achieve initial control, but experienced a greater incidence of non-serious adverse events.

PMID:41270323 | DOI:10.1016/j.jemermed.2025.10.019

J Emerg Med. 2025 Oct 14;80:44-50. doi: 10.1016/j.jemermed.2025.10.003. Online ahead of print.

ABSTRACT

BACKGROUND: The epidemiology of boxing-related upper extremity injuries in the United States (US) has been minimally described, with only one prior study examining data up to 2016.

OBJECTIVE: To update and extend national estimates of these injuries through 2023, highlighting post-2016 trends and the impact of the COVID-19 pandemic.

METHODS: The National Electronic Surveillance System database was queried for upper extremity boxing-related injuries presenting to US emergency departments from January 1, 2014, to December 31, 2023. Injuries were categorized by body part, diagnosis, and disposition. National estimates (NE) were calculated based on each hospital’s assigned statistical sample weight. Linear regression assessed trends over time.

RESULTS: A total of 106,903 boxing-related upper extremity injuries were identified. The hand (48.3%), wrist (18.9%), and shoulder (14.2%) were the most commonly affected areas. Fractures were the most frequent diagnosis (26.4%), followed by strains/sprains (24.1%), other injuries (21.3%), and contusions/abrasions (17.9%). Only 3.3% of cases required hospital admission. Injury counts dropped sharply in 2020 during the COVID-19 pandemic (NE = 7282; p < 0.01 compared to pre-COVID years of 2014-2019), followed by a rebound in subsequent years, peaking in 2023 (NE = 13,258). Linear regression showed a nonsignificant annual decrease of 76 injuries over 10 years (p = 0.70; coefficient = -75.6; 95% CI: -508.7 to 357.5).

CONCLUSION: Boxing-related upper extremities most commonly involve the hand, with fractures representing the most common diagnosis. In conclusion, the rebound in injury rates in 2023, which diverges from the pre-COVID trend of gradual decline, warrants attention.

PMID:41270318 | DOI:10.1016/j.jemermed.2025.10.003

J Emerg Med. 2025 Oct 22;80:23-32. doi: 10.1016/j.jemermed.2025.10.017. Online ahead of print.

ABSTRACT

BACKGROUND: While disparities in care between demographic groups (e.g., race/ethnicity, gender, age) have been demonstrated across the spectrum of health care, limited research exists for ST-segment elevation myocardial infarction (STEMI) patients in the prehospital setting.

OBJECTIVE: The purpose of this study was to describe disparities specific to the prehospital care of STEMI using data from a large urban fire-based emergency medical services (EMS) system.

METHODS: Electronic patient care records for all STEMI activations from 02/01/2020 to 09/01/2022 were reviewed. National benchmark variables evaluated included administration of analgesia (either fentanyl or nitroglycerin), nitroglycerin administration, aspirin administration, scene time, transport time, STEMI alert time, and electrocardiogram (ECG) time. Analyses were conducted using logistic and linear regression.

RESULTS: A total of 888 patients were evaluated. The average age was 63.9 years, 575 (63.9%) were male, and 479 (53.9%) were White. Black patients were less likely than White patients to be administered analgesia, as were patients 75 years and older compared to patients 60-74. Female patients were less likely than male patients to receive nitroglycerin or aspirin. Both Black and Hispanic patients were less likely to receive aspirin compared to White patients. Differences in age groups emerged for two-time metrics: Patients 75 years and older had longer scene times and STEMI alert times than patients 60-74. None of the demographic variables were statistically significant predictors of transport time or ECG time.

CONCLUSIONS: This evaluation of comprehensive demographic information from a large fire-based EMS system revealed disparities among STEMI patients in analgesia administration, specifically aspirin and nitroglycerin based on gender and race/ethnicity.

PMID:41270316 | DOI:10.1016/j.jemermed.2025.10.017

Psychoneuroendocrinology. 2025 Nov 15;184:107692. doi: 10.1016/j.psyneuen.2025.107692. Online ahead of print.

ABSTRACT

BACKGROUND: The maternal hypothalamic-pituitary-adrenal (HPA) axis undergoes substantial physiological changes during pregnancy and postpartum, reflected in altered cortisol secretion patterns. However, research has shown considerable heterogeneity in cortisol patterns across the peripartum period and in part contradictory findings. Individual courses of cortisol secretion and their determinants remain poorly understood.

METHODS: In a longitudinal cohort of 127 healthy pregnant women, we assessed salivary cortisol at five time points from late pregnancy (gestational weeks 34-36 and 40) to eight weeks postpartum. Group-based trajectory modeling was applied to three cortisol measures to identify distinct cortisol secretion patterns. Associations with sociodemographic and psychological covariates were explored.

RESULTS: Across all cortisol indices, two distinct trajectory groups emerged. The majority of women (79-86 %) exhibited stable, relatively lower cortisol levels during late pregnancy and postpartum, while a smaller subgroup (14-21 %) exhibited a consistently elevated and more variable cortisol trajectory. Trajectory groups showed high classification stability (98-99 %), but no sociodemographic or psychological variables significantly predicted group membership.

CONCLUSIONS: Our findings reveal two distinct maternal cortisol trajectory subgroups across the peripartum period, reflecting heterogeneity in HPA axis regulation. The lack of significant associations with the measured covariates raises the possibility that unmeasured mechanisms, such as genetic or epigenetic influences, may contribute to these patterns. These distinct cortisol trajectories may reflect differing modes of neuroendocrine regulation, offering a potential explanation for inconsistencies in prior peripartum cortisol research.

PMID:41270314 | DOI:10.1016/j.psyneuen.2025.107692

Arch Oral Biol. 2025 Oct 14;181:106426. doi: 10.1016/j.archoralbio.2025.106426. Online ahead of print.

ABSTRACT

OBJECTIVE: Dental caries is a significant global issue, which affects approximately 44 % of the global population. The objective of this research is to extract crude phytochemicals from Psidium guajava, Acacia nilotica, Syzygium aromaticum, and Salvadora persica and also optimizing using RSM. Therefore, this aims to maximize the antibacterial potential of the extracts at effective inhibition of dental caries METHOD: The crude extracts from the plants samples, with varying extraction parameters, such as ethanol concentrations, temperatures, and solid-solvent ratios was done using Soxhlet method and antibacterial activity was determined through well and disc diffusion methods along with optimization was performed by Response Surface Methodology (RSM).

RESULTS: The results depict that Psidium guajava exhibited the strongest antibacterial activity against S. mutans and Lactobacillus, with inhibition zones of 36 mm & 20 mm and 32 mm & 24 mm for both well and disc diffusion. Similarly, Syzygium aromaticum also shows slight stronger inhibition zones, Acacia nilotica exhibited moderate activity and in contrast, Salvadora persica showed limited activity. RSM optimization was validated and with well fitted quadratic models R² values ranging from 0.69 to 0.79. Predicted and experimental values are in close agreement between with differences below 0.5 %.

CONCLUSION: These findings suggest that P. guajava, S. aromaticum and A. nilotica have strong potential as natural antibacterial agents in oral care formulations.

PMID:41270298 | DOI:10.1016/j.archoralbio.2025.106426

Hum Reprod. 2025 Nov 21:deaf219. doi: 10.1093/humrep/deaf219. Online ahead of print.

ABSTRACT

STUDY QUESTION: What is the effect of progesterone administered via vaginal oil capsules versus pessaries, on clinical outcomes, when used for luteal phase support (LPS) in ART?

SUMMARY ANSWER: Our study findings indicate a higher live birth rate with vaginal oil capsules compared with pessaries, in both fresh and frozen cycles. In the frozen cycles, a lower miscarriage rate was observed with vaginal oil capsules compared with pessaries.

WHAT IS KNOWN ALREADY: Sufficient LPS, with exogenous progesterone, is essential during ART to improve implantation and pregnancy rates. Micronized vaginal progesterone (MVP) is the most commonly used form of luteal support worldwide. There are no head-to-head comparisons of vaginal oil capsules versus pessaries, with a focus on clinical efficacy, for LPS.

STUDY DESIGN, SIZE, DURATION: Retrospective cohort study of patients who completed ART cycles with either only vaginal oil capsules 600-800 mg/day or only pessaries 800 mg/day for LPS. Primary outcomes were live birth and miscarriage. Data for fresh IVF/ICSI cycles and frozen embryo transfer cycles with hormone replacement therapy (HRT-FET) were analysed separately. Multivariable regression analyses were performed with adjustment for female age, BMI, ethnicity, ovarian reserve, duration and cause of subfertility, stimulation protocol, number of previous cycles, number of oocytes, number of embryos transferred, previous live births, and previous miscarriages.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Our study population consisted of women undergoing treatment across 14 Care Fertility clinics in the UK, from January 2017 to December 2022. We included women with stimulated IVF/ICSI cycles with fresh embryo transfer and autologous HRT-FET cycles. A total of 42 291 cycles were analysed; vaginal oil capsules were exclusively used in 25 738 cycles and pessaries exclusively in 16 553 cycles.

MAIN RESULTS AND THE ROLE OF CHANCE: In the IVF/ICSI group, the live birth rate was higher in those taking vaginal oil capsules compared with pessaries: 34.3% vs 27.8%; adjusted risk ratio (aRR) 1.11 (95% CI 1.04-1.19; P < 0.001). In the HRT-FET group, the live birth rate was also higher in those taking vaginal oil capsules compared to pessaries: 36.7% vs 32.9% (aRR 1.09; 95% CI 1.04-1.14; P < 0.001). The miscarriage rate was lower in those taking vaginal oil capsules compared to pessaries for both IVF/ICSI (13.4% vs 14.5%, P < 0.05) and HRT-FET cycles (17.2% vs 19.7%, P < 0.001) in the crude analysis. The adjusted analysis for miscarriage found a statistically significant difference only for HRT-FET cycles (aRR 0.87; 95% CI 0.82-0.93).

LIMITATIONS, REASONS FOR CAUTION: This is a retrospective cohort study. Whilst we have extensively adjusted for confounding, there can still be residual confounding.

WIDER IMPLICATIONS OF THE FINDINGS: An appropriately powered randomized controlled trial directly comparing the two drugs, focusing on clinical efficacy, is required to determine if one is superior to the other.

STUDY FUNDING/COMPETING INTEREST(S): This study has been delivered through the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC). R.K.D.S. is in receipt of honoraria for lectures and presentations from Ferring Pharmaceuticals and Besins Healthcare UK. R.K.D.S. has received travel support from IBSA Pharma and Theramex UK and payment for participation on an advisory board for educational meetings for Ferring Pharmaceuticals and IBSA Pharma. A.C. has contributed to the scientific advisory boards of Ferring Pharmaceuticals, Theramax UK, Besins Healthcare UK, and Organon Pharma UK. M.K. has received travel support from Besins Healthcare UK and Merck. A.H.B. is on an advisory board and has received speaker fees from NovoNordisk Pharmaceuticals and is a shareholder at Care Fertility UK and Care Fertility Leeds. T.B. is in receipt of honoraria for lectures and presentations from Merck and Gedeon Richter. T.B. has received travel support from IBSA Pharma, Vitrolife, and Theramex and payment for participation on an advisory basis for IBSA Pharma and Conceivable Life Sciences. A.R. has received honoraria for lectures and presentations from Gedeon Richter. A.R. has received travel support from Gedeon Richter and payment for participation on an advisory board for educational meetings for Ferring Pharmaceuticals. V.S. has received travel support from IBSA Pharma and payment for educational meetings and participation in an advisory role for Theramex.

TRIAL REGISTRATION NUMBER: n/a.

PMID:41270285 | DOI:10.1093/humrep/deaf219

JMIR Dermatol. 2025 Nov 21;8:e76523. doi: 10.2196/76523.

ABSTRACT

BACKGROUND: Laser hair removal is a noninvasive cosmetic procedure that targets melanin in hair follicles through selective photothermolysis.

OBJECTIVE: This study aims to evaluate the long-term efficacy and safety of the 755-nm alexandrite laser for axillary hair removal by comparing single- and dual-flash lamp systems.

METHODS: In total, 40 women aged 20 to 35 years with Fitzpatrick skin types II and III participated in a study on laser hair removal for their axillae. Participants underwent 3 treatment sessions, each spaced 4 weeks apart, from January to April 2024. They were divided into 2 groups, both receiving treatments with an alexandrite laser (755 nm, 14 mm spot size). The first group was treated with a dose of 8 J/cm² using a single-flash lamp device operating at 5 Hz, with a pulse duration of 10 ms. The second group received doses between 9 and 11 J/cm² from a dual-flash lamp device operating at 2.5 Hz, with pulse durations ranging from 10 to 15 ms. Photographs and hair counts were taken at baseline and 1 month after the final session. A 2-tailed t test was used to assess statistical significance, and regression analysis evaluated treatment effects. Pain scores and side effects were assessed using a visual analog scale in a satisfaction questionnaire.

RESULTS: The dual-flash lamp laser achieved an overall hair reduction of 94%, while the single-flash lamp laser resulted in a 91% reduction in the axilla. The difference was not statistically significant (P=.14). No serious adverse effects were reported with either device, indicating effective safety features.

CONCLUSIONS: The outcomes show that both systems provide similar results in terms of efficacy and safety, with no reported side effects, and results were maintained even after 6 and 12 months of follow-up.

PMID:41270270 | DOI:10.2196/76523

Int J Oral Maxillofac Implants. 2025 Nov 21;0(0):1-18. doi: 10.11607/jomi.11600. Online ahead of print.

ABSTRACT

PURPOSE: Morse taper connection presents better functional load distribution than other types of connections. The angle and finishing surfaces are used to prevent components from loosening under direct axial load. The angulation of the connection walls for the Morse effect to exist should be from 6° to 16°. Therefore, there is a lack of consensus regarding the most appropriate conical connection from both biological and mechanical perspectives. This study aimed to evaluate the influence of different conicities (10°, 16°, 22°, and 24°) of implants with conical connections on the adhesive wear of the prosthetic abutment after the application of the tightening torque.

MATERIALS AND METHODS: Twenty implant sets, abutment with different conicities (10, 16, 22, and 24 degrees) were analyzed using five implants and five abutments, divided into four groups according to the taper angle: A-10° (Emfils, São Paulo Brazil); A-16° (SIN, Sao Paulo, Brazil); A-22° (Nobel Biocare, Zurich, Switzerland); and A-24° (Conexão Sistema de Prósteses, São Paulo, Brazil). The 20 implants were installed in specimens with a stability of 60N·cm, and their respective abutments were subjected to an installation torque of 32N·cm. After being subjected to the recommended torque, the abutments were subjected to detorque for scanning electron microscopy (SEM) analysis. The images obtained of the prosthetic abutments were delineated.

RESULTS: The adhesive wear areas outlined in the ImageJ and values of detorque were analyzed. After statistical analysis of the data, it was observed that group A-24° presented a higher detorque value compared to the other groups (p<0.05). In contrast, the others did not show significant differences among them (p>0.05). For the adhesive wear score, it was observed that group A-16° presented the highest adhesive wear scores, with a statistically significant difference compared to group A-10° (p<0.05). For the other conicities, no difference was observed (p>0.05).

CONCLUSION: It is possible to conclude that the conicity of 16° presented a higher adhesive wear score after tightening the torque of the prosthetic abutment.

PMID:41270268 | DOI:10.11607/jomi.11600

Int J Oral Maxillofac Implants. 2025 Nov 21;0(0):1-24. doi: 10.11607/jomi.11614. Online ahead of print.

ABSTRACT

PURPOSE: Implant overdenture rehabilitation has recently become a common treatment for patients. However, few papers present long-term observations (over 10 years) of IOD/IRPD. The purpose of this study was to investigate the clinical results of ‘planned’ IOD/IRPD provided at Tsurumi University Dental Hospital over approximately 20 years, as a retrospective cohort study.

MATERIALS AND METHODS: To investigate the clinical results of ‘planned’ IOD/IRPD, a survey was performed regarding patients who had received IOD/IRPD at our University Dental Hospital and underwent regular maintenance between August 2000 and August 2020. The data of ‘rescue’ overdentures, which have poor survival rates, were excluded in this study. Descriptive statistics show the age and gender ratio of the target patients, the length and diameter of the placed implants, implant position and number, denture designs, types of attachment, marginal bone loss (MBL) around implants, implant survival rate, prosthetic complications, and patient satisfaction. Kaplan-Meier curves were computed for IOD/IRPD survival analysis with implant failure as the endpoint, and log-rank tests were used to assess the IOD/IRPD rehabilitation.

RESULTS: The selected patients were 78 (32 males and 46 females). Eighty-six IODs/IRPDs were manufactured-Maxillary: 31 (IODs: 23, IRPDs: 23); and mandibular: 55 (IODs: 35, IRPD: 20). Regarding the survival rate of IOD/IRPDs, measured by the endpoint of implant failure, the survival rate of mandibular implants was significantly higher than that of maxillary implants (p<0.05). However, there was no significant difference between mandibular IOD and IRPD (p>0.05).

CONCLUSIONS: All ‘planned’ IODs/IRPDs were confirmed to maintain successful conditions for 5 years after the commencement of function. Many implant failures were observed in maxillary IODs/IRPDs with mandibular antagonist teeth. Even when biological and prosthetic complications occurred in IODs/IRPDs more than 5 years after function, higher.

PMID:41270267 | DOI:10.11607/jomi.11614