Nevin Manimala

Ther Adv Musculoskelet Dis. 2025 Jul 14;17:1759720X251354898. doi: 10.1177/1759720X251354898. eCollection 2025.

ABSTRACT

BACKGROUND: Hormonal changes in menopause might interact with the presentation of underlying autoimmune diseases, such as systemic sclerosis (SSc).

OBJECTIVES: Our study aimed to evaluate the association of (1) current menopausal status, (2) early menopause, and (3) disease onset during fertile or post-menopausal age on SSc clinical phenotype in a large SSc cohort from the Italian Systemic sclerosis Progression INvestiGation (SPRING-SIR) registry.

DESIGN: Female SSc patients from the SPRING-SIR registry, fulfilling the American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) 2013 classification criteria, with data on SSc disease onset, menopausal status, and menopausal age, were eligible. SSc onset was categorized as pre-menopausal if SSc onset happened >1 year before menopause or as post-menopausal onset if it occurred >1 year after menopause. An early menopause was defined by a menopausal age <45 years.

METHODS: Descriptive statistics and regression models were built to test the association between current menopausal status, pre-menopausal disease onset, and early menopause with SSc-related features.

RESULTS: At baseline, 1157/1538 (75%) patients were in menopause, 632 (50.4%) had a pre-menopausal SSc onset, and 130 (14.4%) reported an early menopause. Post-menopausal patients had more frequent limited cutaneous SSc, anti-centromere antibody positivity, interstitial lung disease, and gastrointestinal manifestations. Pre-menopausal onset cases showed more frequent diffuse cutaneous involvement and peripheral vasculopathy. Patients with early menopause had more frequent peripheral vasculopathy and interstitial lung disease, being early menopause an independent risk factor for digital ulcers and lower diffusing capacity of the lung for carbon monoxide.

CONCLUSION: Current post-menopausal status and early menopause may impact SSc presentation, being associated with vascular and gastrointestinal manifestations. Menopausal status and age should therefore be thoroughly addressed, aiming at better disease management.

PMID:40667478 | PMC:PMC12260299 | DOI:10.1177/1759720X251354898

Front Neurol. 2025 Jul 1;16:1542833. doi: 10.3389/fneur.2025.1542833. eCollection 2025.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of remote ischemic conditioning (RIC) in improving neurological function and short-term prognosis in patients with acute ischemic stroke (AIS).

METHODS: This randomized, controlled, single-blind study aimed to evaluate the short-term (7-day) effects of RIC on neurological function in patients with AIS. 264 AIS patients (median age 65 years, 63.3% male) with ischemic symptoms <72 h post-onset were randomly assigned to either the RIC group (n = 65) or the control group (n = 199). RIC was administered manually using a cuff sphygmomanometer, while the control group received a sham RIC treatment. Patients with cardioembolic sources or a history of prior stroke were excluded from the study. Primary outcomes were the proportion of patients with an mRS score of ≤2 at 7 days, as well as changes in the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Activities of Daily Living (ADL), and Rancho Los Amigos (RLA) scores. Data were collected at baseline and 7 days post-enrollment, with in-person follow-up visits conducted by blinded clinicians.

RESULTS: At 7 days, the RIC group showed a significantly higher proportion of patients with an mRS score of ≤2 compared to the control group (41.5% vs. 28.1%, p = 0.043). Significant improvements were observed in the RIC group compared to the control group in NIHSS (p = 0.004) and ADL scores (p = 0.005), but not in RLA scores (p > 0.05). Binary Logistic Regression Analysis indicated that, after adjusting for baseline factors, the treatment effect of RIC remained statistically significant.

CONCLUSION: RIC treatment enhances neurological function and improves short-term prognosis in AIS patients. These findings support the potential clinical application of RIC in AIS management.

PMID:40667471 | PMC:PMC12259425 | DOI:10.3389/fneur.2025.1542833

Front Neurol. 2025 Jul 1;16:1539407. doi: 10.3389/fneur.2025.1539407. eCollection 2025.

ABSTRACT

BACKGROUND AND PURPOSE: Serum ferritin, a well-established biomarker of iron status, has been inconsistently linked to stroke risk in previous studies. This meta-analysis aims to systematically evaluate the association between serum ferritin levels and the risk of stroke.

METHODS: We conducted a systematic literature search across the PubMed and Embase databases to identify relevant studies. Studies meeting predefined eligibility criteria were selected, and relevant data were extracted. Statistical analysis was performed using Stata 12.0.

RESULTS: Ten studies, including eight longitudinal and three cross-sectional, were included in our meta-analysis. Cross-sectional studies showed that stroke patients had significantly higher serum ferritin levels than controls. Longitudinal studies suggested a 22% increase in stroke risk in individuals with higher serum ferritin. Subgroup analysis indicated that further high-quality population-based cohort studies are warranted to validate these findings. Dose-response meta-analysis confirmed a positive association between serum ferritin levels and stroke risk.

CONCLUSION: This meta-analysis provides evidence of a positive association between increased serum ferritin levels and stroke incidence. While these results are promising, definitive conclusions cannot be drawn at this time. Therefore, additional robust, prospective cohort studies are imperative to substantiate this relationship.

PMID:40667468 | PMC:PMC12259440 | DOI:10.3389/fneur.2025.1539407

HIV AIDS (Auckl). 2025 Jul 11;17:185-194. doi: 10.2147/HIV.S527111. eCollection 2025.

ABSTRACT

PURPOSE: Men who have sex with men are at high risk of Human immunodeficiency virus (HIV) infection and bear the highest burden of the disease in Tanzania. Although pre-exposure prophylaxis (PrEP) has demonstrated high efficacy in the prevention of HIV infection in clinical trials, challenges with retention threaten its effectiveness. Therefore, we assessed the extent and predictors of retention in PrEP care among men who have sex with men in Tanga, Tanzania.

METHODS: This study included 369 men who have sex with men who were recruited using respondent-driven sampling. Baseline data were collected using structured questionnaires that captured socio-demographic and behavioral characteristics. The primary outcome was one-month retention in PrEP care. A statistical analysis using modified Poisson regression was conducted to identify independent factors associated with 1-month retention.

RESULTS: A total of 369 men (mean age, 24.7 (± 5.5 years)) participated in the study. After one month, 87 participants (23.6%) were retained in PrEP care. Independent factors associated with retention included assuming a receptive position in anal sex (aPR 1.6, 95 CI: 1.0-2.6, p = 0.030), having initiated sexual activity with anal, oral, or thigh sex (aPR 2.1, 95% CI: 1.2-3.8, p = 0.011), and having adequate social support (aPR: 1.6, 95% CI: 1.0-2.6, p = 0.030).

CONCLUSION: Tailored interventions that improve social support and address the varying needs of men who have sex with men with diverse sexual behavior patterns are essential for improving retention and maximizing the effectiveness of PrEP in HIV prevention. Practically, this highlights the need to strengthen supportive environments within communities and healthcare systems to enhance retention in PrEP, reduce HIV transmission, and advance progress toward ending HIV as a public health threat by 2030.

PMID:40667454 | PMC:PMC12262076 | DOI:10.2147/HIV.S527111

Front Child Adolesc Psychiatry. 2025 Jul 1;4:1544344. doi: 10.3389/frcha.2025.1544344. eCollection 2025.

ABSTRACT

INTRODUCTION: This Clinical Experimental Study aimed to evaluate the effectiveness of Cooperative Parent Mediated therapy (CPMT), a targeted parent-coaching program for Autism Spectrum Disorder (ASD), in Community Healthcare Service in Italy.

METHODS: Forty children with ASD and their parents were randomly assigned to treatment conditions: the Control group received Individual Treatment As Usual (TAU Control group); while CPMT group received weekly parent-child sessions in addition to Individual TAU. Primary blinded outcomes were 6-months post-intervention change in parent-child interaction scores. Secondary outcomes included ASD symptom severity, adaptive functioning and parental stress levels. Baseline and post-treatment evaluations, at 6 months of follow up, were performed by an independent team.

RESULTS: CPMT group showed significant add-on benefits on parent-child interactions, severity of autism symptoms, adaptive skills and parental stress level.

DISCUSSION: This study provides preliminary evidence for the effectiveness of the CPMT model also in community services, representing a further step forward in research on the implementation of therapy for ASD in community healthcare service.

PMID:40667447 | PMC:PMC12259642 | DOI:10.3389/frcha.2025.1544344

Front Nutr. 2025 Jul 1;12:1583556. doi: 10.3389/fnut.2025.1583556. eCollection 2025.

ABSTRACT

PURPOSE: This study aimed to assess the effect of acupoint catgut embedding therapy (ACET) on anthropometric parameters and endocrine function in obese women through a systematic review and meta-analysis.

METHODS: A comprehensive search was conducted across international and Chinese databases [CNKI, Wanfang, Weipu, Sinomed, PubMed, Embase, Cochrane Library, Web of Science (WOS), and Scopus]. The search terms included “female,” “women,” “catgut implantation at acupoint,” “catgut embedding,” “acupoint embedding therapy,” “obesity,” “adiposity,” and “body weight,” etc. Studies included in this analysis were randomized controlled trials (RCTs) assessing the effects of ACET on obesity indicators such as body mass index (BMI), waist-to-hip ratio (WHR), lipid profiles such as triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), and hormone levels such as luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), and estradiol (E2). We used ROB 2.0 to assess the risk of bias. Data was analyzed using weighted mean differences (WMD) and risk ratios (RR) to measure effect sizes, and heterogeneity was assessed using I ² statistics. Conduct sensitivity analysis, publication bias testing, and subgroup analysis on indicators with high heterogeneity to explore the sources of heterogeneity.

RESULTS: Twenty-three studies involving over 2,000 obese women were included. Risk of bias assessment revealed generally low bias in randomization and measurement domains, though selective reporting and missing data handling raised concerns in some studies. ACET significantly reduced BMI [-1.72 (95% CI: -2.13, -1.31)] and WHR [WMD -0.016 (95% CI: -0.034, 0.001)], with high heterogeneity in BMI analysis (I ² = 92.3%). Subgroup analyses suggested that heterogeneity decreased in different control groups and different treatment courses, such as diet guidance (I ² = 0.0%) and 12-week treatment duration (I ² = 32.9%). Publication bias assessments (Begg’s and Egger’s tests) indicated no significant bias for most indicators. However, the clinical efficacy rate showed potential publication bias upon trim-and-fill adjustment, though the effect remained significant. ACET significantly reduced TG and TC but not HDL, LDL, or insulin resistance. Hormonal changes included decreased LH and FSH and increased E2.

CONCLUSION: Our meta-analysis demonstrates that ACET significantly improves anthropometric parameters and endocrine function in obese women, though it does not significantly impact lipid metabolism or insulin resistance. The therapy’s influence on female hormones may contribute to its efficacy in obesity treatment, highlighting the need for further studies to explore long-term effects and mechanisms.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO, identifier: CRD42025640157.

PMID:40667439 | PMC:PMC12259452 | DOI:10.3389/fnut.2025.1583556

Front Nutr. 2025 Jul 1;12:1624173. doi: 10.3389/fnut.2025.1624173. eCollection 2025.

ABSTRACT

BACKGROUND: The cross-sectional association of dietary fiber intake with gallstone disease in United States adults remains to be comprehensively elucidated.

METHODS: We used the National Health and Nutrition Examination Survey (NHANES) data from 2017-2023. The assessment of dietary fiber intake was derived from 24-h dietary recalls. Stratified analyses were then used to demonstrate dietary fiber intake corresponding to different groups of gallstone and non-gallstone conditions. The use of weighted logistic regression was employed to explore the correlation between dietary fiber intake and gallstone disease. Subgroup and interaction analyses were used to identify potential interacting factors. Additionally, restricted cubic spline was used to assess the dose-response between dietary fiber and gallstone risk.

RESULTS: The study population comprised 9,273 patients, with a gallstone prevalence of 10.47% (971 cases). In the context of various subgroups, patients diagnosed with gallstones exhibited a reduced dietary fiber intake in comparison with individuals not bearing gallstones. In the fully adjusted model, an inverse association was observed between dietary fiber intake and gallstone disease (odds ratio (OR), 95% confidence interval (CI); 0.98 (0.96,1.00), p value = 0.039). The highest quartile of dietary fiber intake exhibited a lower risk of gallstone disease in comparison with the lowest quartile (quartile 4 vs. quartile 1: 0.65 (0.45, 0.94), p value = 0.022). The inverse correlation between dietary fiber intake and the prevalence of gallstones was found to be statistically significant in several subgroups, including males, Hispanic individuals, those with less than a high school education, alcohol consumers, and individuals diagnosed with diabetes. Furthermore, the analysis of dose-response curves indicated a nearly linear correlation between dietary fiber intake and the risk of gallstone development.

CONCLUSION: Dietary fiber intake is inversely associated with gallstone disease in United States adults. Adequate dietary fiber intake may be beneficial in reducing gallstone prevalence.

PMID:40667433 | PMC:PMC12259441 | DOI:10.3389/fnut.2025.1624173

Rwanda J Med Health Sci. 2021 Dec 30;4(3):398-405. doi: 10.4314/rjmhs.v4i3.9. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Unpredictable numbers of patients attending emergency departments highlight the need for Triage. Triage which is the prioritization of patient care based on severity of illness or injury, prognosis, and availability of resources is effective when clinicians are knowledgeable and skilled to perform it.

OBJECTIVE: To assess knowledge and skills on triage among nurses working in emergency departments of Rwandan referral hospitals.

METHODS: Cross-sectional analytical design was adopted. ninety-six (96) nurses working in emergency departments were selected using proportionate stratified sampling method. Each hospital was considered as a stratum. A self-administered questionnaire and observation checklist were use as instruments. Inferential and descriptive statistics were used in analysis.

RESULTS: The majority of participants (63.6%) demonstrated low level of triage knowledge and almost a half (47.9%) of participants had low level of triage skills. Nurses experience in emergency department, level of education and triage training were not found to significantly influence triage knowledge and skills positively (P>0.05).

CONCLUSION: Deficit in triage knowledge and skills were revealed among nurses working in emergency departments in Rwanda. Accredited continuous educational training on triage should be regularly provided to enhance knowledge and skills of emergency department nurses on Triage.

PMID:40667415 | PMC:PMC12257236 | DOI:10.4314/rjmhs.v4i3.9

Rwanda J Med Health Sci. 2021 Dec 30;4(3):334-340. doi: 10.4314/rjmhs.v4i3.2. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic and related social distancing measures have an impact on physical activity levels.

OBJECTIVE: To assess the physical activity (PA) levels of the physiotherapy students in Rwanda during the COVID-19 lockdown period.

METHODS: We used a descriptive cross-sectional quantitative study design. Eighty-one participants were recruited, and data were collected using the International Physical Activity Questionnaire. We used descriptive statistics, Pearson Chi-Square and Kruskal-Wallis tests to assess whether there were statistically significant differences in physical activity levels according to demographic variables.

RESULTS: The median total PA metabolic equivalent of task (MET)-minutes/week score for all the participants together was 3546 (IQR=8714), meaning high PA. The rates for high, moderate, and low PA levels were 54.4%, 31.7% and 13.9% respectively. Male and rural participants had higher median total PA MET score than females (p=0.008) and urban residents (p=0.018) respectively.

CONCLUSIONS: The PA levels of the study participants during the COVID-19 lockdown period were higher than the recommended standards. Females and urban participants appeared to be less physically active than their counterparts. Further similar studies and interventions towards PA promotion among university students in Rwanda during the pandemic are suggested.

PMID:40667412 | PMC:PMC12257235 | DOI:10.4314/rjmhs.v4i3.2

Rwanda J Med Health Sci. 2021 Dec 30;4(3):379-386. doi: 10.4314/rjmhs.v4i3.7. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Surgery cancellation is a challenging and costly event resulting in operating theatre inefficiency and psychological and financial problems for the patients and their families. This study aimed to find out the incidence and reasons for surgical cancellation at a Rwandan hospital.

METHODS: A retrospective study was conducted on 736 patients’ files obtained from theatre registry lists of surgical operations done from January to March 2017. The American Association of Perioperative Nurses (AORN) checklist for documenting cancelled surgical cases was used to establish the rate and reasons for cancellation. Data were analyzed using frequency and percentage descriptive statistics.

RESULTS: Out of the 736 surgeries booked, 179 (24.3%) were cancelled as follows: Orthopedic and general surgeries (28.2%) respectively, gynecology and obstetrics (27.4%), urology surgeries (15.5%), maxillofacial surgeries (15.9%), ENT (15.6%) and plastic surgeries (13.3%). Time constrain/long list (19.6%), acute change in medical status (10.6%), non-turn-up of the patient (8.4%), and abnormal lab findings (7.8%) were the most prevalent reasons.

CONCLUSION: The surgical cancellation rate at the study hospital was 24%, increasing with the number of patients booked and the type of surgical procedure. A prospective study is required to gain more insight into the reason for cancellations, mostly amenable to mitigation measures.

PMID:40667410 | PMC:PMC12257229 | DOI:10.4314/rjmhs.v4i3.7