Nevin Manimala

Drug Des Devel Ther. 2025 May 29;19:4517-4525. doi: 10.2147/DDDT.S503714. eCollection 2025.

ABSTRACT

BACKGROUND: Emergence agitation(EA) is common in the early phase of recovery from general anesthesia in adults, which can potentially cause unpredictable harm to both patients and medical staff. This study aimed to examine the effects of preoperative magnesium sulphate infusion on emergence agitation and postoperative quality of recovery in patients undergoing thoracoscopic lobectomy.

PATIENTS AND METHODS: 84 patients undergoing thoracoscopic lobectomy were randomly assigned to either the magnesium sulphate group (group M) or the control group (group C). Group M received a 50 mg/ kg intravenous bolus of magnesium sulphate 20 minutes before induction, whereas group C was administered an equivalent volume of saline. The Riker Sedation-Agitation Scale (SAS) and the 40-item Quality of Recovery questionnaire (QoR-40) were used to evaluate emergence agitation and postoperative quality of recovery, respectively.

RESULTS: In comparison to group C, group M demonstrated a significantly lower incidence of EA (9.5% vs 42.9%; OR, 0.14; 95% CI, 0.04-0.47; P < 0.001) and dangerous agitation (0% vs 14.3%; OR, 2.17; 95% CI, 1.71-2.75; P =0.011), along with a reduction in the maximal SAS score (P < 0.05). Group M exhibited higher global QoR-40 scores than group C on postoperative day 1 (POD 1)(168.3±13.8 vs 155.6±16.5, P<0.001). Additionally, group M displayed lower Numerical rating scale (NRS) pain scores both at rest and during coughing in PACU and on POD 1 (P < 0.001). There were no significant statistically differences between the two groups in terms of time to extubation, incidence of delayed recovery and residual sedation (P > 0.05).

CONCLUSION: Preoperative magnesium sulphate infusion effectively decreased the incidence and severity of EA in patients undergoing thoracoscopic lobectomy. Furthermore, it alleviated postoperative pain and improved postoperative quality of recovery, without an increase in adverse events.

PMID:40458810 | PMC:PMC12129083 | DOI:10.2147/DDDT.S503714

Front Pharmacol. 2025 May 19;16:1537679. doi: 10.3389/fphar.2025.1537679. eCollection 2025.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of Shuxuening injection (SXNI) in the treatment of patients with intracerebral hemorrhage (ICH).

METHODS: This study included randomized controlled trials published before 1 June 2024 in eight databases. Patients with ICH were included, with the control group receiving conventional treatment (CT) and the treatment group receiving additional SXNI on this basis. The primary outcome was neurological impairment score. The secondary outcomes were overall efficacy, cerebral hematoma volume, cerebral edema volume, activities of daily living (ADL) score, erythrocyte sedimentation rate (ESR), hematocrit (HCT), hypersensitive C-reactive protein (hs-CRP), low cut whole blood viscosity, high cut whole blood viscosity and adverse events (AE). The methodological quality of the included studies was assessed using the revised Cochrane Risk of Bias tool (ROB 2.0). For binary variables, risk ratios (RR) were calculated, while for continuous variables, mean differences (MD) or standardized mean differences (SMD) were calculated, based on 95% confidence intervals (CI).

RESULTS: A total of 29 trials involving 3,012 participants were included. Compared with the control group, the treatment group demonstrated better performance in reducing neurological impairment score [SMD = -0.99, 95% CI -1.24, -0.73], improving overall efficacy [RR = 1.22, 95% CI 1.14, 1.30] and ADL score [SMD = 2.01, 95%CI 1.55, 2.46], as well as decreasing the cerebral hematoma volume [MD = -6.98, 95% CI -8.76, -5.20] and cerebral edema volume [MD = -3.67, 95%CI -5.27, -2.06], with statistically significant differences observed. Meanwhile, the incidence of AE in the treatment group was lower than that in the control group, with a statistically significant difference [RR = 0.63, 95%CI 0.41, 0.96].

CONCLUSION: This study indicates that the combined use of SXNI and CT may be beneficial for the treatment of patients with cerebral hemorrhage compared to the use of CT alone. However, due to the moderate to very low certainty of evidence, it is advisable to conduct highquality clinical trials to validate the findings of this study.

PMID:40458793 | PMC:PMC12127381 | DOI:10.3389/fphar.2025.1537679

Diabetol Metab Syndr. 2025 Jun 3;17(1):187. doi: 10.1186/s13098-025-01759-9.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a global health burden, often leading to microvascular complications such as neuropathy, retinopathy, and nephropathy. These complications may contribute to cognitive impairment and depression, further complicating disease management and adversely affecting quality of life. This systematic review and meta-analysis aimed to assess the prevalence and association between diabetic microvascular complications and cognitive impairment and depression among individuals with T2DM.

METHODS: A systematic search of PubMed, Embase, and Web of Science was conducted through November 15, 2024, following PRISMA guidelines. Observational studies examining the association between microvascular complications and mental health outcomes were included. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) scale. Meta-analyses were performed using standard statistical software, with pooled odds ratios (ORs) and 95% confidence intervals (CIs) calculated.

RESULTS: Out of 5,640 articles screened, 7 studies met inclusion criteria. The prevalence of cognitive impairment was 34.9% in patients with neuropathy, 55.29% with retinopathy, and 40.97% with nephropathy. Depression prevalence was 43.30% for neuropathy, 40.17% for retinopathy, and 18.92% for nephropathy. Associations with cognitive impairment showed ORs of 0.878 (95% CI, 0.298-2.585) for neuropathy, 1.358 (95% CI, 0.957-1.927) for retinopathy, and 1.421 (95% CI, 1.086-1.858) for nephropathy. For depression, ORs were 1.291 (95% CI, 0.613-2.721) for retinopathy and 6.200 (95% CI, 0.029-1305.771) for neuropathy.

CONCLUSION: Microvascular complications in T2DM contribute substantially to the burden of cognitive impairment and depression, with nephropathy showing a particularly strong link to cognitive decline. Standardized assessment approaches are needed, and integrated mental health care should be prioritized in the management of individuals with diabetes.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40457490 | DOI:10.1186/s13098-025-01759-9

Matern Health Neonatol Perinatol. 2025 Jun 3;11(1):16. doi: 10.1186/s40748-025-00213-y.

ABSTRACT

OBJECTIVES: Poor prenatal health is of particular concern among minoritized individuals who may experience adverse social determinants of health contributing to the intergenerational transmission of health disparities. The purpose of this study was to investigate associations between psychosocial resources, and mental and physical health among a prenatal sample, and to explore if these relationships vary by race.

METHODS: English-speaking pregnant individuals living in the United States were recruited using Centiment (n = 340). Participants completed a 121-item cross-sectional survey. We conducted a single- and multi-group structural equation model to test hypothesized relationships, and then investigated differences by pregnant White individuals versus Black, Indigenous, and People of Color (BIPOC).

RESULTS: Our final single-group model exhibited good model fit (χ2 (43) = 99.07, p < .01, CFI = 0.97, SRMR = 0.04, and RMSEA = 0. 06 (0.05-0.08)). After controlling for demographic characteristics and social determinants of health, higher levels of mindfulness were statistically significantly related to lower anxiety and depression scores (both p < .01). Higher levels of social supports were statistically significantly related to lower anxiety scores. Scale measurement invariance was confirmed for the multi-group model and the structural model was statistically significantly different between pregnant White individuals and BIPOC in this sample (Δ χ2 (27) = 116.71, p < .01).

CONCLUSIONS: Identification of core components of psychosocial resource interventions, consideration of upstream structural determinants, mindfulness and valued-living (MVL)-based strategies, cultural adaptation, and an emphasis on resilience rather than psychopathology may result in improved prenatal health among pregnant individuals traditionally underrepresented in research.

PMID:40457470 | DOI:10.1186/s40748-025-00213-y

Reprod Biol Endocrinol. 2025 Jun 2;23(1):84. doi: 10.1186/s12958-025-01423-x.

ABSTRACT

BACKGROUND: Oocyte vitrification, a widely utilized assisted reproductive technology for fertility preservation, can address emergencies arising from the unavailability of sperm from the male partner on the day of oocyte retrieval. However, the infrequent and unpredictable nature of emergency oocyte cryopreservation leads to a scarcity of literature on its reproductive outcomes, complicating the provision of informed patient counseling.

METHODS: This study, conducted between January 2017 and December 2022, included 137 emergency oocyte cryopreservation cycles involving 136 patients and their respective thawed cycles. Descriptive statistics were used to analyze cycle characteristics and oocyte thaw and transfer outcomes, grouped by indication of oocyte vitrification. Univariate and multivariate analyses were performed to identify predictors associated with reproductive outcomes by indication of oocyte vitrification.

RESULTS: A total of 137 emergency oocyte cryopreservation-thaw cycles were analyzed, with a median oocyte survival rate of 84.2%, fertilization rate of 57.7%, and high-quality Day-3 embryo formation rate of 33.3%. Of all cycles, 15.3% resulted in no transferable embryos. The cumulative live birth rate (CLBR) for the entire cohort was 29.2%, with 40 live births achieved through both fresh and frozen embryo transfers. Stratified analysis revealed that cycles due to absolute male factor infertility had higher reproductive efficiency, including more oocytes retrieved, a greater number of high-quality embryos, higher implantation rates, and a CLBR of 39.5%, compared to 11.8% in the relative male factor group. Multivariate analysis identified female age, infertility duration, sperm source, number of mature oocytes retrieved and the presence of male infertility factors as key determinants of live birth outcomes.

CONCLUSIONS: Emergency oocyte vitrification yielded a cumulative live birth rate of 29.2%, with rates differing by clinical indication: 39.5% in the absolute male factor group and 11.8% in the relative male factor group. Moreover, the factors associated with reduced live birth rates differed depending on the underlying indication for vitrification. These findings support the clinical utility of emergency oocyte vitrification and underscore the significant contributions of both female and male factors to reproductive outcomes of oocyte cryopreservation.

PMID:40457462 | DOI:10.1186/s12958-025-01423-x

Orphanet J Rare Dis. 2025 Jun 2;20(1):265. doi: 10.1186/s13023-025-03797-y.

ABSTRACT

BACKGROUND: This study aimed to investigate the relationship between lung volumetry, thoracic scoliosis, and anthropometric data (height, weight, BMI) in patients with Osteogenesis Imperfecta (OI) Type 3. Three hypotheses were tested: H1 predicted lower lung volumes in patients with OI Type 3 compared to controls, H2 predicted differences between right and left lung volumes in patients with OI Type 3 due to chest deformities, and H3 predicted a correlation between lung volumes in patients with OI Type 3 and their thoracic scoliosis and anthropometric data.

METHODS: Age, biological sex, weight, height, body mass index (BMI), Cobb angle of thoracic scoliosis, left and right lung volumes, and total lung volume were recorded. CT scans were performed on all participants, and lung volumetry was analysed using specialised software. The intraclass correlation coefficient was used to assess measurement reliability, and statistical analysis was conducted to examine correlations between variables.

RESULTS: Patients with OI had significantly lower total lung volumes than controls (p < 0.001). However, no significant correlation was found between lung volumetry and scoliosis (r =- 0.406; p = 0.244), age (r = 0.201; p = 0.578), height (r = 0.479; p = 0.162), weight (r = 0.358; p = 0.310), or BMI (r = – 0.042; p = 0.907) in OI patients. In the control group, significant correlations were observed between lung volume and height (r = 0.756; p = 0.011) and weight (r = 0.638; p = 0.047).

CONCLUSION: OI type 3 patients have lower lung volumes than healthy subjects, but have no left and right lung volume differences. In addition, they did not present any correlation between lung volumes and scoliosis, height, weight, and body mass index.

PMID:40457460 | DOI:10.1186/s13023-025-03797-y

BMC Chem. 2025 Jun 2;19(1):156. doi: 10.1186/s13065-025-01528-9.

ABSTRACT

This study develops and validates an eco-friendly ultraviolet (UV)-spectrophotometric method employing augmented least squares chemometric models for the simultaneous determination of three hepatitis C antiviral drugs-sofosbuvir, simeprevir, and ledipasvir. Two multivariate approaches were compared: Concentration Residual Augmented Classical Least Squares (CRACLS) and Spectral Residual Augmented Classical Least Squares (SRACLS). The experimental design utilized a 5-level partial factorial design for calibration (25 samples) and a central composite design for validation (20 samples). SRACLS models demonstrated superior analytical performance with lower detection limits (0.5171, 0.5175, 0.2950 μg/mL), higher precision (relative bias corrected mean square error of prediction, RBCMSEP: 0.1481-0.2509%), and better predictive capability (relative root mean square error of prediction, RRMSEP: 1.0285%, 1.2668%, 1.8933%) compared to CRACLS models (RRMSEP: 3.0655%, 1.9264%, 2.7201%). The SRACLS models also exhibited lower complexity with fewer principal components (3, 2, and 3) versus CRACLS iterations (4, 4, and 6). Application to commercial pharmaceuticals yielded excellent recoveries (99.70-100.39%) with no statistically significant difference from reference high-performance liquid chromatography (HPLC) methods. Greenness assessment confirmed the method’s environmental advantages with superior scores in multiple sustainability metrics (Analytical GREEnness metric, AGREE: 0.75; Modified Green Analytical Procedure Index, MOGAPI: 78; RGB12 whiteness score: 94.2) compared to conventional chromatographic techniques (AGREE: 0.63-0.65, MOGAPI: 66-72, RGB12: 76.9-83.3). These findings establish the proposed method as a rapid, sensitive, and eco-friendly alternative for routine quality control of these critical hepatitis C drugs.

PMID:40457449 | DOI:10.1186/s13065-025-01528-9

BMC Oral Health. 2025 Jun 2;25(1):880. doi: 10.1186/s12903-025-06320-8.

ABSTRACT

BACKGROUND: Tongue position plays a vital role in craniofacial development, influencing skeletal structure and dental alignment. This study aims to assess tongue position and investigate its relationship with various dentofacial skeletal patterns using a novel cephalometric analysis method.

METHODS: This cross-sectional study included 550 orthodontic patients (ages 6-50) with pre-treatment lateral cephalograms. Participants were divided into mixed dentition (6-11 years) and permanent dentition (12-50 years) groups and classified into three sagittal skeletal patterns (Class I, II, III) based on ANB angle and three vertical patterns (high, average, low angle) based on FMA angle. Statistical analyses were selected according to data distribution and variance. Correlation analysis included Spearman’s rank and partial correlation, the latter of which adjusted for age, FMA, and adenotonsillar hypertrophy.

RESULTS: In the mixed dentition group, tongue position showed no significant variation by vertical pattern. In the permanent group, patients with low angles had a lower tongue tip. Class III patients exhibited an anterior and inferior tongue tip, while Class II patients had a higher tongue tip in the permanent group, after controlling for adenotonsillar hypertrophy, age, and FMA.

CONCLUSIONS: This study introduces a simplified method for measuring tongue position. A superior tongue tip correlates with skeletal Class II malocclusion, while an anterior and inferior tongue tip and lower tongue position are linked to skeletal Class III malocclusion. A lower tongue tip is also associated with low angle skeletal patterns.

PMID:40457430 | DOI:10.1186/s12903-025-06320-8

Thromb J. 2025 Jun 2;23(1):56. doi: 10.1186/s12959-025-00745-5.

ABSTRACT

BACKGROUND: The elevated prevalence of venous thromboembolism (VTE) among individuals diagnosed with inflammatory bowel disease (IBD) necessitates thorough investigation. Analyzing the genetic association mechanisms between these conditions is essential for comprehending their concurrent manifestation.

METHODS: Using genome-wide association study (GWAS) datasets for IBD and VTE, we applied a comprehensive approach to explore the genetic connections between these two diseases. The analysis was conducted in four steps: first, we assessed the overall genetic correlation between IBD and VTE using linkage disequilibrium score regression and genetic covariance analysis; next, we analyzed specific chromosomal regions to understand the genetic characteristics in these areas; then, we used the conditional/conjunctional false discovery rate (cond/conjFDR) method to better identify and quantify the shared genetic loci that contribute to both diseases’ development.

RESULTS: The genome-wide analysis revealed a strong genetic correlation between IBD, especially ulcerative colitis (UC), and VTE, while the correlation between Crohn’s disease (CD) and VTE was weaker. A detailed regional analysis identified specific chromosomal areas with genetic links to both diseases. Using the conjFDR method, we confirmed the shared genetic components between these conditions and identified key genetic variants that influence the development of both diseases.

CONCLUSION: This study provides genetic-level statistical evidence into the comorbidity mechanisms of IBD and VTE from a genetic standpoint, thereby enhancing the understanding of the underlying genetic basis contributing to their concurrent occurrence.

PMID:40457427 | DOI:10.1186/s12959-025-00745-5

AIDS Res Ther. 2025 Jun 2;22(1):56. doi: 10.1186/s12981-025-00741-9.

ABSTRACT

BACKGROUND: Differentiated service delivery (DSD) models in resource-limited settings reduce strain on health services and improve clinical outcomes such as retention and viral suppression, but little is known about the impact of HIV DSD models on quality of life (QoL), which is essential for optimizing person-centered care. This study assessed the impact of DSD models on Quality of life, loss to follow-up (LTFU), and mortality among persons living with HIV (PLHIV) on Antiretroviral therapy (ART) over time at a large urban HIV clinic in Uganda.

METHODS: Records of 1,000 PLHIV enrolled in a 10-year cohort at the Infectious Diseases Institute (IDI) clinic in Kampala, Uganda were retrospectively analyzed. QoL was assessed using an adapted Medical Outcomes Study (MOS-HIV) tool. QoL scores, sustained annual viral suppression (< 200 copies/mL), all-cause mortality and LTFU (≥ 3 months of missed visits) were compared for PLHIV in three DSD models for ≥ 6 consecutive months-fast-track drug refill (FTDR), facility-based groups (FBG), and composite model combining these two-versus facility-based individual management (FBIM) or the standard of care (SOC). Inverse probability treatment weighting was applied for covariate comparability while robustness of results was checked using G-computation. Sustained viral suppression was compared using odds ratios; all-cause mortality and LTFU were compared using hazard ratios from the Cox proportional hazard regression model.

RESULTS: Of the 1,000 PLHIV, 980 had ≥ 1 follow-up and were included in the analysis. Median age was 45 years (IQR: 40-51), 62% were female, and 95% had a suppressed viral load at baseline. Baseline QoL was 90.1% in any DSD model vs. 89.2% in SOC. After eight years of follow-up, weighted mean QoL was higher in participants enrolled in DSD models than the SOC (90.4% vs. 89.1%; weighted mean ratio 3.66, 95% CI 2.10-6.37, p-value < 0.001); there were no statistical differences across DSD models. Participants in DSD models were more likely to have sustained viral suppression (weighted odds ratio 1.69, 95% CI 1.24-2.31), lower mortality (weighted hazard ratio 0.08, 95% CI 0.03-0.20) and lower LTFU rates (weighted hazard ratio 0.08, 95% CI 0.02-0.31).

CONCLUSION: DSD models were associated with modestly higher quality of life, better viral suppression, and lower mortality and LTFU compared to the standard of care. These findings support the broader adoption of DSD models in delivering ART across HIV programs to enhance the QoL and clinical outcomes among PLHIV.

PMID:40457424 | DOI:10.1186/s12981-025-00741-9