Nevin Manimala

Tidsskr Nor Laegeforen. 2025 Jun 17;145(8). doi: 10.4045/tidsskr.25.0025. Print 2025 Jun 24.

ABSTRACT

BACKGROUND: For patients with Crohn’s disease, surgery can be appropriate when medical treatment fails to adequately control the condition, or in cases of stenosis, fistulas or abscesses. We aimed to investigate the types of bowel surgery these patients undergo, as well as waiting times and the prevalence of serious complications.

MATERIAL AND METHOD: This is a retrospective observational study investigating the surgical treatment of Crohn’s disease at the University Hospital of North Norway, Tromsø, in the period 1 January 2013 to 31 December 2021.

RESULTS: A total of 179 patients were included in the study: 92 women and 87 men, with a median age of 44 years (interquartile range: 26-57). Of these, 151 patients (84 %) underwent elective surgery with a median waiting time of 89 days (interquartile range: 43-142), while 28 patients (16 %) underwent emergency surgery.

INTERPRETATION: There was considerable variation in the types of surgery performed on patients with Crohn’s disease in this cohort. The prevalence of complications was high and waiting times for surgical treatment were long.

PMID:40575820 | DOI:10.4045/tidsskr.25.0025

J Diabetes Metab Disord. 2025 Jun 24;24(2):155. doi: 10.1007/s40200-025-01666-w. eCollection 2025 Dec.

ABSTRACT

BACKGROUND: Diabetes increases healthcare load and seriously compromises quality of life. This study aimed to develop a hospital-based educational and follow-up strategy at Ziaeian Hospital and assess how it affected the diabetic patients’ health outcomes.

METHODS: This study was a community-level intervention based on Compassion-Focused Therapy (CFT). The study was conducted from 2020 to 2022 at Ziaeian Hospital in District 17 of Tehran, involving 312 diabetic patients. Participants were randomly allocated to two groups: the intervention group (n = 156) and the control group (n = 156). The intervention group received structured education, continuous follow-up, and family engagement, while the control group underwent standard treatment. Data were collected using a researcher-developed questionnaire and the SF-36 quality of life assessment. Statistical analyses were performed using STATA version 14.02, with significance set at P < 0.05. The statistical tests employed included t-tests, Chi-squared tests, Fisher’s exact test, and paired t-test.

RESULT: The mortality rate in the control group was therefore 9.03%, higher than the 5.52% noted in the intervention group. Baseline clinical markers (FBS, HbA1c, triglycerides, cholesterol, and BMI) showed no appreciable differences across the groups. Though no significant changes in social functioning, mental health, or physical performance, the intervention group showed notable improvements in overall quality of life (p = 0.0053), general health (p < 0.0001), energy/fatigue (p < 0.0001).

CONCLUSION: In conclusion, systematic instruction and continuous monitoring improved quality of life and lower mortality among diabetics. These results highlight the need of patient monitoring in diabetes management as well as of hospital-based training programs.

PMID:40575801 | PMC:PMC12187616 | DOI:10.1007/s40200-025-01666-w

Front Pharmacol. 2025 Jun 12;16:1626274. doi: 10.3389/fphar.2025.1626274. eCollection 2025.

ABSTRACT

INTRODUCTION: Chinese patent medicine is a crucial component of traditional Chinese medicine, significantly promoting public health. Despite the extensive research on Chinese patent medicine for children, various issues persist in its application. Leveraging the national drug coding standard code database of the National Medical Products Administration (NMPA), this investigation delved into the accessibility of Chinese patent medicines tailored for children, offering a comprehensive overview of the current landscape in China. This analysis serves as a valuable resource for formulating targeted policies to promote the use of Chinese patent medicines for children, guiding drug selection, and facilitating the development of pediatric pharmaceuticals.

METHODS: Taking Chinese patent medicines with “National Medicine Approval Number Z” and “National Medicine Approval Number B” from the NMPA National Drug Coding Database as the research subjects, this study systematically analyzed the distribution, characteristics, and existing issues of Chinese patent medicines for children using descriptive statistical methods.

RESULTS AND DISCUSSION: As of May 2023, 8,903 approved “National Medicine Approval Number Z” Chinese patent medicines, 951 approved “National Medicine Approval Number B” Chinese patent medicines in China, with 1,164 Chinese patent medicines for children identified. Chinese patent medicines for children are predominantly administered orally (92.87%), while external preparations are limited. The taste profile is primarily bitter or sweet, with some medications having other undesirable flavors. The therapeutic focus is skewed toward pulmonary system diseases (31.9%) and spleen-stomach diseases (26.5%). Notably, 49.66% of the medications mention Western medical disease names, and 63.92% reference traditional Chinese medicine (TCM) syndrome types. Critical gaps include unclear age-specific dosage instructions (56.70%), lack of specified treatment duration (92.01%), and incomplete safety information, with adverse reactions mainly involving the gastrointestinal system. Current issues include the limited availability of Chinese patent medicines for children, poor suitability for children, imbalanced research and supply (over-concentration in pulmonary and spleen-stomach disorders), and inadequate safety labeling in drug instructions, posing potential risks. Recommendations include developing new Chinese patent medicines for children, improving drug suitability, conducting post-marketing evaluations, and refining drug labeling to ensure safe and rational pediatric medication use.

PMID:40575788 | PMC:PMC12198179 | DOI:10.3389/fphar.2025.1626274

Int J Gen Med. 2025 Jun 22;18:3289-3300. doi: 10.2147/IJGM.S522911. eCollection 2025.

ABSTRACT

BACKGROUND: Hypertension is the leading cause of preventable deaths globally. However, reports on its prevalence and risk factors in rural sub-Saharan Africa have been inconsistent, making targeted interventions challenging. This study examines the prevalence, awareness, and associated factors of hypertension among adults in a rural community in southwestern Uganda.

METHODS: We conducted a baseline survey in Ngango, Mbarara district, enrolling adults aged 18-79 years from eleven villages. Research assistants and community health workers recruited participants from their homes using the WHO STEPS questionnaire, collecting data on demographics, lifestyle behaviors (tobacco and alcohol use, diet, and physical activity), and other risk factors. Blood pressure (BP) was measured three times, with hypertension defined as BP ≥140/90 mmHg or self-reported antihypertensive use. Logistic regression was applied to identify factors associated with hypertension.

RESULTS: A total of 953 adults were enrolled, with a median age of 43 years (IQR: 30-57). Women accounted for 61.5%, and only 43.5% recalled ever having their blood pressure measured. Hypertension prevalence was 27.3%, with 61.5% of cases undiagnosed. Among those receiving treatment (27.7%), 65.3% had controlled blood pressure. Despite 66.8% of participants reporting regular physical activity, 63.7% were overweight. The key factors associated with hypertension included age over 40 years (OR: 2.26), consuming fewer than three servings of fruits or vegetables per week (OR: 1.62), and being overweight (OR: 1.57) or obese (OR: 2.73).

CONCLUSION: Hypertension is highly prevalent in rural southwestern Uganda, underscoring the need for targeted interventions-especially within a relatively young and physically active population.

PMID:40575767 | PMC:PMC12199733 | DOI:10.2147/IJGM.S522911

Utah Womens Health Rev. 2025 May;3(1):40-48. doi: 10.26054/d-k952-0keb. Epub 2025 Jan 17.

ABSTRACT

OBJECTIVES: The objective of this study is to test the association between preconception polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM) using Utah’s Pregnancy Risk Assessment Monitoring System (2016-2021). In addition, pre-pregnancy hypertension will be tested as a potential effect moderator.

METHODS: This cross-sectional study utilizes data from Phase 8 of the Utah Pregnancy Risk Assessment Monitoring System (PRAMS) survey (2016-2021). The association between PCOS and GDM was tested using Poisson regression to generate adjusted prevalence ratios and 95% confidence intervals.

RESULTS: PCOS was associated with higher prevalence of GDM in all models, regardless of whether the outcome data (GDM) came from the infant’s birth certificate, the PRAMS survey, or the combined measure. When adjusting for sociodemographic characteristics, lifestyle factors, reproductive history, and comorbidities, women with PCOS were 1.50 (1.16-1.95) times as likely to have GDM (reported on birth certificate and/or survey) compared to women without PCOS. Pre-pregnancy hypertension was not found to be a statistically significant effect moderator.

CONCLUSIONS: The findings from this study were consistent with the majority of research indicating that women with PCOS have increased risk for GDM. This is also the first known study to test pre-pregnancy hypertension as an effect moderator between PCOS and GDM. More research is needed on the role of comorbidities such as chronic hypertension as effect modifiers between PCOS and GDM.

IMPLICATIONS: These findings show that women with PCOS are at high risk for GDM, among a population-based sample of mothers. Interventions to reduce the risk of GDM among women with PCOS need to be developed and evaluated.

PMID:40575759 | PMC:PMC12201940 | DOI:10.26054/d-k952-0keb

Caspian J Intern Med. 2025 Mar 21;16(2):297-304. doi: 10.22088/cjim.16.2.297. eCollection 2025.

ABSTRACT

BACKGROUND: Patient management and necessary supportive treatments, an accurate prognosis of the illness is essential for patients with acute pancreatitis. Thus far, no diagnostic technique has demonstrated superiority over the other in terms of clinical judgment. The aim of this study was to examine the predictive accuracy of the Bedside Index for Severity in Acute Pancreatitis (BISAP) score in contrast to Ranson’s criteria.

METHODS: Our research is a retrospective cross-sectional analysis. Inclusion criteria encompassed patients admitted to the emergency department with acute pancreatitis. Exclusion criteria comprised individuals with liver, heart, or renal failure upon admission or during hospitalization. Each patient’s demographic data, including age, gender, education level, and consciousness level, were considered. Statistical analysis was conducted using SPSS 16 software with a significance level set at p <0.05.

RESULTS: Out of 286 patients, 221 were diagnosed with moderate acute pancreatitis, while 65 were diagnosed with severe acute pancreatitis. Among these patients, 5 (7.1%) succumbed to complications related to pancreatitis, including 3 males and 2 females. Both the BISAP and Ranson criteria demonstrated significant capability in assessing the severity of both moderate and severe acute pancreatitis with a 95% confidence level. The analysis revealed a statistically significant area under the curve for both criteria (P= 0.002).

CONCLUSION: Although BISAP and Ranson have both good accuracy and efficacy to determine the severity of pancreatitis, BISAP scoring criteria have higher prognostic accuracy.

PMID:40575756 | PMC:PMC12189003 | DOI:10.22088/cjim.16.2.297

Pediatr Pulmonol. 2025 Jun;60(6):e71175. doi: 10.1002/ppul.71175.

ABSTRACT

BACKGROUND: The COVID-19 pandemic caused dramatic changes in daily routines, healthcare access, and utilization in children with asthma, particularly urban minority children with poorly controlled asthma.

OBJECTIVES: In this study, we aimed to elucidate changes in healthcare utilization, lung function, and weight as a result of the COVID-19 “shutdown” in patients followed at the Pediatric Asthma Center at the Children’s Hospital at Montefiore.

STUDY DESIGN: We conducted a retrospective cohort study including children aged 2-21 with physician-diagnosed persistent asthma. We compared healthcare utilization, lung function, asthma control, and weight changes before and after the COVID-19 lockdown (March 16, 2020 to June 1, 2020).

RESULTS: This study included 101 children (61% Hispanic, 28% Black) with an average age of 9.2 (±4.7) years. There was a statistically significant decrease in hospitalization rates, emergency department visits, oral steroid use, urgent care visits and office visits pre- and post-COVID-19 shutdown, which was associated with improvement in asthma control (p < 0.001) but there was no significant improvement in lung function. Obesity rates increased overall from 29.7% to 43.9%, but weight gain did not differ based on asthma severity. Weight gain was disproportionally higher in a small sub-population of patients who needed step-up therapy.

CONCLUSION: Inner-city children with high asthma morbidity saw a significant reduction in healthcare utilization during the COVID-19 pandemic, with improved asthma control but no change in spirometry results. Despite an increase in obesity rates overall, weight changes did not differ across asthma severities, suggesting increase in obesity was not mediated by asthma severity.

PMID:40571979 | DOI:10.1002/ppul.71175

Neurointervention. 2025 Jun 27. doi: 10.5469/neuroint.2025.00297. Online ahead of print.

ABSTRACT

PURPOSE: The Woven EndoBridge (WEB) was introduced in Japan in January 2021 and approved for all subtypes of wide-neck bifurcation aneurysms (WNBA). This retrospective study evaluated the safety and efficacy of the WEB device for all subtypes of WNBA.

MATERIALS AND METHODS: All patients treated with the WEB at our facility between January 2021 and May 2024 was reviewed. We selected the WEB device according to an oversizing policy, based on cumulative clinical evidence from global experience.

RESULTS: We analyzed 120 aneurysms in 117 patients (56 males and 61 females with a mean age of 65.5±12.7 years). There were 45 anterior communicating artery aneurysms, 27 middle cerebral artery aneurysms, 17 internal carotid artery-posterior communicating artery aneurysms, 15 basilar artery top aneurysms, and 16 aneurysms in other locations. Aneurysm characteristics included a maximum diameter of 6.5 [5.3, 7.7] mm, height of 4.9 [3.9, 6.0] mm, width of 4.8 [4.0, 6.2] mm, and dome/neck ratio of 1.2 [1.1, 1.4]. All data are expressed in median [interquartile range]. Angiographic follow-up at 12 months in 96 cases showed complete obliteration in 68.8% and adequate obliteration in 90.6% of cases. Intraoperative ischemic events occurred in 5 cases (4.2%). Hemorrhagic events occurred in 2 cases (1.7%), with symptoms resolving by discharge, except for 1 case of mild paralysis. During follow-up, 1 patient developed a major stroke, resulting in morbidity (0.8%). Retreatment was required in 3 cases (2.5%). On multivariate analysis for complete occlusion at 12 months following WEB treatment, age was statistically associated with the outcome (odds ratio, 0.957 per year; 95% confidence interval, 0.919-0.996; P=0.033).

CONCLUSION: WEB is safe and effective for all subtypes of WNBA, with a low retreatment rate using an oversizing policy. This is the first report in a Japanese population.

PMID:40571967 | DOI:10.5469/neuroint.2025.00297

Pediatr Pulmonol. 2025 Jun;60(6):e71177. doi: 10.1002/ppul.71177.

ABSTRACT

BACKGROUND: Food insecurity is increasing in prevalence throughout the general population and has been noted to substantially exist within the cystic fibrosis (CF) community as well. Nutritional grant programs are in place to provide additional support to people with cystic fibrosis (PwCF). This study was designed to determine the current usage rate of nutritional grant funding as well as clinical outcomes such as body mass index (BMI). We aim to describe our CF center’s enrollment and usage of privately funded nutritional grants and explore potential correlations to nutrition clinical outcomes.

METHODS: A single center retrospective chart review of the electronic health records (EHR) to collect requested data points was completed for all PwCF seen at that center between the dates of March 1, 2017 and February 29, 2024.

RESULTS: Two hundred and nineteen individuals met inclusion criteria. Over the course of the study period, the total number of PwCF enrolled in supplemental nutritional grant program(s) and amount of grant utilization increased steadily from 9% enrolled with 17% utilization in 2017 to 27% enrolled with 44% utilization in 2022, respectively. The percentage of PwCF with a BMI below Cystic Fibrosis Foundation (CFF) recommended goals also decreased over the course of the study period from 39% in 2017 to 31% in 2022.

CONCLUSIONS: We conclude that the results of our study support continued efforts to identify and remediate the presence of food insecurity within the CF community.

PMID:40571964 | DOI:10.1002/ppul.71177

BMC Public Health. 2025 Jun 26;25(1):2174. doi: 10.1186/s12889-025-23467-9.

ABSTRACT

BACKGROUND: The COVID-19 pandemic led to a global shutdown, with most countries implementing widespread lockdowns. While such measures were essential in curbing the spread of COVID-19, their impact on the mental health of parents with preschool-aged children is not yet sufficiently understood. This study aimed to assess anxiety and depression symptoms in parents during and after the COVID-19 lockdowns, and to examine how demographic and pandemic-related factors influenced these outcomes.

METHOD: A sample of 128 parents in Germany with preschool children (aged 2 to 6 years) participated in an online survey. The survey assessed three key periods: before the nationwide lockdowns (retrospectively), during the most challenging phase of the lockdown (retrospectively), and after the lockdowns were lifted. Symptoms of depression and anxiety were investigated with validated questionnaires and pandemic-specific stressors (e.g., isolation of child) with a self-developed set of 23 items. Descriptive statistics, group comparisons, and hierarchical multiple regression analyses were conducted.

RESULTS: Symptoms of anxiety and depression significantly increased during lockdowns in comparison to before pandemic onset and remained elevated after restrictions eased. Key predictors of poorer mental health included pre-pandemic symptoms, lower parental education, concerns about access to primary care, and children’s social isolation during lockdowns. Demographic factors alone were not consistently significant predictors.

CONCLUSIONS: Symptoms of anxiety and depression significantly increased during lockdowns compared to before pandemic onset and remained elevated after restrictions eased. COVID-19-related stressors played a greater role in parental mental health outcomes than demographic variables. These findings emphasize the need for early identification of at-risk families and the development of targeted interventions to support parental well-being in future public health emergencies.

PMID:40571934 | DOI:10.1186/s12889-025-23467-9