Tag: nevin manimala

Glob Health Res Policy. 2025 Jan 14;10(1):2. doi: 10.1186/s41256-024-00393-8.

ABSTRACT

BACKGROUND: As population aging intensifies, it becomes increasingly important to elucidate the casual relationship between aging and changes in population health. Therefore, our study proposed to develop a systematic attribution framework to comprehensively evaluate the health impacts of population aging.

METHODS: We used health-adjusted life expectancy (HALE) to measure quality of life and disability-adjusted life years (DALY) to quantify the burden of disease for the population of Guangzhou. The HALE and DALY projections were generated using both the Bayesian age-period-cohort models and the population prediction models. Changes in HALE and DALY between 2010-2020 and 2020-2030 were decomposed to isolate the effects of population aging. Three scenarios were analyzed to examine the relative relationship between disease burden and population aging. In Scenarios 1 and 2, the disease burden rates in 2030 were assumed to either remain at 2020 levels or follow historical trends. In Scenario 3, it was assumed that the absolute numbers of years of life lost (YLL) and years lived with disability (YLD) in 2030 would remain unchanged from the 2020 levels.

RESULTS: Between 2010 and 2020, 56.24% [69.73%] of the increase in male [female, values in brackets] HALE was attributable to the mortality effects in the population aged 60 and over, while – 3.74% [- 9.29%] was attributable to the disability effects. The increase in DALY caused by changes in age structure accounted for 72.01% [46.68%] of the total increase in DALY. From 2020 to 2030, 61.43% [69.05%] of the increase in HALE is projected to result from the mortality effects in the population aged 60 and over, while – 3.88% [4.73%] will be attributable to the disability effects. The increase in DALY due to changes in age structure is expected to account for 102.93% [100.99%] of the total increase in DALY. In Scenario 1, YLL are projected to increase by 45.0% [54.7%], and YLD by 31.8% [33.8%], compared to 2020. In Scenario 2, YLL in 2030 is expected to decrease by – 2.9% [- 1.3%], while YLD will increase by 12.7% [14.7%] compared to 2020. In Scenario 3, the expected YLL rates and YLD rates in 2030 would need to be reduced by 15.3% [15.4%] and 15.4% [15.6%], respectively, compared to 2020.

CONCLUSIONS: The disability effects among the elderly population hinder improvements in quality of life, while changes in age structure are the primary driver of disease burden accumulation. To mitigate the excess disease burden caused by population aging, it is essential to achieve a reduction of more than 15% in the disease burden by 2030 compared to 2020. Our proposed attribution framework evaluates the health impacts of population aging across two dimensions: quality of life and disease burden. This framework enables comparisons of these effects over time and across different regions.

PMID:39810282 | DOI:10.1186/s41256-024-00393-8

J Orthop Surg Res. 2025 Jan 15;20(1):46. doi: 10.1186/s13018-024-05419-y.

ABSTRACT

BACKGROUND: Wound repair methods are commonly used in clinical practice, such as skin graft and flap repair, which can cause secondary injuries, and high costs. Many methods for skin stretching and repair have been reported domestically and internationally. However, their clinical use is limited owing to lack of equipment, complexity, and high costs. Therefore, we introduce a novel technique to repair wound.

METHODS: We collected 125 patients with skin defects of lower limb from January 2019 to June 2024. Among them, 77 cases were repaired using our novel technique (suture-stretching technique, we designed a simple and feasible skin traction device that used 2-0 (polydioxanone sutures) PDS sutures, 2.0 mm Kirschner wires, and nylon binding tapes to repair skin defects and accommodate irregular wounds according to Ilizarov’s “tension-stress” law, SS group); skin grafting (SG group) was used for repairing 48 cases of wounds. We collected the data of the two groups, including wound size, number of debridements, operation time, wound healing time, hospital stays, and surgury cost, and the data were analyzed statistically.

RESULTS: There was no statistically significant difference between the two groups in terms of age, gender, wound size and wound healing time (p > 0.05).However, the number of debridements (p < 0.0001), operation time (p < 0.0001), hospital stays (p < 0.0001) and surgery time (p < 0.0001) in the suture group were better than those in the skin grafting group with statistically significant difference.

CONCLUSION: The application of suture-stretching technique to repair skin defect wounds of lower limb have good clinical efficacy, which can reduce the number of operations, shorten the operation time, and avoid secondary injuries caused by skin graft or skin flaps. Meanwhile, it also has obvious advantages regarding hospital stays and surgery costs.

PMID:39810267 | DOI:10.1186/s13018-024-05419-y

Arch Public Health. 2025 Jan 14;83(1):13. doi: 10.1186/s13690-024-01497-w.

ABSTRACT

BACKGROUND: A preterm neonate is defined by the World Health Organization as a child delivered before 37 weeks of gestation. In low- and middle-income countries, including Ethiopia, preterm-related complications are serious health problems due to increases in the mortality and morbidity of newborns and children under 5 years of age. The aim of this study was to assess the time to neonatal mortality and its predictors among preterm neonates admitted to the neonatal intensive care unit in northern Ethiopia, 2023/2024.

METHODS: An institution-based retrospective cohort study was conducted among 495 randomly selected preterm neonates in six out of the fourteen general hospitals of Tigray, Ethiopia from October 2023 to June 2024. Epi Data version 4.6 and STATA version 14 were used for data entry and analysis, respectively. Descriptive statistics were carried out to determine the distribution. Kaplan-Meier analysis, life table, and log rank were computed. Cox proportional hazards models were fitted to identify independent predictors of preterm mortality.

RESULTS: The proportion of preterm neonatal mortality was 109 (22.7%). The overall median survival time was 21 (95% CI: 20, 28) days. Initiation of breast milk (AHR = 0.38 (95% CI: 0.24, 0.61)), respiratory distress syndrome (AHR = 1.9 (95% CI: 1.07,3.63)), perinatal asphyxia (AHR = 2.05 (95% CI: 1.05, 4.00)), receiving kangaroo mother care practice (AHR = 0.5 (95% CI: 0.34, 0.83)), and gestational age (AHR = 1.6 (95% CI 1.07, 2.59) were the predictors of time to death.

CONCLUSION: Respiratory distress syndrome, gestational age less than 32 weeks, and perinatal asphyxia at admission were found to be independent risk factors for preterm neonatal mortality. Breastfeeding and receiving kangaroo-mother care were independent preventive predictors of preterm neonatal mortality. It is better to give full emphasis and close follow-up to preterm neonates, especially during the early neonatal period.

PMID:39810265 | DOI:10.1186/s13690-024-01497-w

Malar J. 2025 Jan 14;24(1):15. doi: 10.1186/s12936-025-05246-4.

ABSTRACT

BACKGROUND: The increased occurrence of malaria among Africa’s displaced communities poses a new humanitarian problem. Understanding malaria epidemiology among the displaced population in African refugee camps is a vital step for implementing effective malaria control and elimination measures. As a result, this study aimed to generate comprehensive and conclusive data from diverse investigations undertaken in Africa.

METHODS: This review adhered to PRISMA standards, involving searches across electronic data bases such as Google Scholar, PubMed, Web of Science, Scopus, and Science Direct. In addition, grey literature was retrieved from several professional associations. The quality of selected studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Data extraction was executed using Microsoft Excel, and the meta-analysis was performed with STATA 14 software. A random-effects model was used to estimate the pooled prevalence and associated factors of malaria. Meta-regression and subgroup analysis were used to identify heterogeneity, while funnel plots and Egger’s statistical tests assessed the publication bias. Furthermore, a sensitivity analysis was performed.

RESULTS: The overall random-effects pooled prevalence of malaria infection (comprising symptomatic and asymptomatic cases) across all included studies was 35.93% (95% CI 24.71-47.15). This study showed a high level of heterogeneity between studies (I2 = 97.1; P < 0.001). Of the identified Plasmodium species, Plasmodium falciparum constituted 99.3%. The frost plot indicated that the overall prevalence of P. falciparum was 34.94% (95% CI 24.34-45.53). Subgroup analysis revealed significant variation (P < 0.001) in malaria prevalence between asymptomatic and symptomatic cases, with a prevalence of 4.39% (95% CI 2.57-6.21) and 45.10% (95% CI 27.28-62.92), respectively. Lack of insecticide-treated mosquito net utilization (AOR 2.43; 95% CI 1.01-5.88) and living near mosquito breeding sites (AOR 2.76, 95% CI 1.56-4.87) were risk factors of malaria.

CONCLUSION: This study determined that the pooled prevalence of malaria among displaced individuals in refugee camps was high and exhibited variations across different population groups. This signifying there is still a need to improve and recheck existing malaria prevention and control strategies to establish an effective malaria control and elimination programme in Africa.

PMID:39810255 | DOI:10.1186/s12936-025-05246-4

BMC Psychol. 2025 Jan 14;13(1):37. doi: 10.1186/s40359-025-02347-2.

ABSTRACT

INTRODUCTION: Mental health is crucial for overcoming obstacles, completing tasks, and contributing to society. Mental, social, and cognitive healths are included. In demanding fields like medicine, academic pressure can cause exhaustion, poor performance, and behavioral changes. Mental health must be addressed to improve student success and well-being. Medical students’ coping strategies, anxiety, depression, and behavioral changes in uncontrollable situations will be studied.

METHODOLOGY: A cross-sectional study involved 393 medical students from various universities in Khartoum. Data was collected using an online questionnaire to assess mental health responses during both controllable and uncontrollable situations across all academic years.

RESULTS: Data analysis using SPSS 27 indicated minimal missing data (0.25%) among the 393 participants. PHQ-4 scores assessed psychological distress, anxiety, and depression. The study found that 74.2% of participants experienced behavioral, cognitive, and emotional changes. Significant associations were observed between PHQ-4 scores and these changes (p < .05) using Chi-Square testing. Most participants were females aged 20 to 22, primarily from the Medicine and Pharmacy departments. The study revealed that most individuals utilized pharmacological coping strategies following significant life changes due to uncontrollable situations.

CONCLUSION: The study highlights that women experienced stress, dissatisfaction, concern, and anger more frequently than men during ongoing war and the post-COVID-19 lockdown. Medical students faced substantial challenges in behavior, emotions, and cognition during societal unrest, including fatigue, feelings of failure, and sleep disturbances. Over 74% reported multiple changes in their emotions and behaviors. Coping strategies included nicotine, sleeping aids, socializing, exercise, venting, meditation, and journaling.

PMID:39810254 | DOI:10.1186/s40359-025-02347-2

Arthritis Res Ther. 2025 Jan 14;27(1):8. doi: 10.1186/s13075-024-03465-9.

ABSTRACT

BACKGROUND: Axial spondyloarthritis (SpA) leads to structural bone lesions in every part of the vertebral column. These lesions are only partially visualized on conventional radiographs, omitting posterior parts of the vertebral column and the thoracic spine, that may nevertheless contribute to impaired spinal mobility and function in patients with axial SpA.

METHODS: In this prospective and blinded investigation, we assessed the distribution of structural spinal lesions using magnetic resonance imaging (MRI) of the whole spine in 55 patients with axial SpA classified according to the Assessment in Spondyloarthritis International Society (ASAS) criteria. After assessment of spinal mobility and function two blinded radiologists independently evaluated MRIs of 23 vertebral units in every patient. Non-parametric statistical methods, Spearman’s correlation and linear regression models were used to analyze structural lesion distribution and the relationship with clinical spinal mobility and function parameters.

RESULTS: In 55 patients with axial SpA (13 females, average disease duration 14.9 years) 657 ventral and 139 dorsal vertebral body structural bone lesions and, notably, 534 facet joint lesions could be visualized. The median number of lesions per patient was higher in the thoracic (8.5, range 1.0-41.0) than in the lumbar (7.5, range 0.0-27.5) and the cervical spine (3.5, range 0.0-24.5). A negative correlation was noted between the number of osteoproliferative structural bone lesions and impairment of spinal mobility and function in univariate, but not in multivariate analyses.

CONCLUSION: MRI of the whole spine revealed a high prevalence of lesions in dorsal parts of the vertebral column and in the thoracic spine in patients with axial SpA that may not be adequately visualized on conventional radiographs. These findings could further contribute to a better understanding of reduced mobility of the spine typically associated with axial SpA and assist diagnostics.

PMID:39810235 | DOI:10.1186/s13075-024-03465-9

Crit Care. 2025 Jan 14;29(1):23. doi: 10.1186/s13054-024-05222-5.

ABSTRACT

BACKGROUND: Both quantitative and qualitative aspects of muscle status significantly impact clinical outcomes in critically ill patients. Comprehensive monitoring of baseline muscle status and its changes is crucial for risk stratification and management optimization. However, repeatable and accessible indicators are lacking. We hypothesized that creatinine production rate (CPR) could serve as an integrative indicator of skeletal muscle status.

METHODS: We conducted a series of animal and clinical studies. First, animal experiments were performed to determine whether CPR reflects not only muscle volume, but also qualitative muscle properties. We also evaluated the effects of acute systemic inflammation, a common feature of critical illness, on CPR, as well as its impact on muscle volume and metabolism. In clinical studies, we analyzed CPR, calculated based on urinary creatinine excretion and changes in serum creatinine, of critically ill patients. We assessed the factors affecting CPR on ICU admission and its temporal changes. Finally, we evaluated the clinical utility of CPR by examining the associations of the CPR index (CPR divided by height squared) on ICU admission and its changes with one-year survival.

RESULTS: Animal studies revealed that CPR is determined by muscle volume, creatine content, and metabolic status. Systemic inflammation accompanied by muscle loss led to reduced CPR. Moreover, even without muscle loss, systemic inflammation decreased CPR, likely due to metabolic derangements. In ICU patients, CPR on admission strongly correlated with muscle cross-sectional area (CSA), with age and sex as additional significant factors. In contrast, the percent change in CPR showed a weak correlation with muscle CSA changes. Additionally, the acute-phase CPR trajectories did not show a consistent decline, suggesting multifactorial influences. In a cohort of 629 ICU patients, lower baseline CPR index (hazard ratio [HR] 1.125 per 0.1 g/day/m² less, P < .001) and a decrease in CPR over the first three days (HR 1.028 per 5%, P = 0.032) were independently associated with higher one-year mortality.

CONCLUSIONS: CPR represents an integrative indicator of skeletal muscle status in critically ill patients, reflecting both quantitative and qualitative aspects. Monitoring CPR in the ICU may facilitate risk stratification and optimization of patient care.

PMID:39810218 | DOI:10.1186/s13054-024-05222-5

Syst Rev. 2025 Jan 14;14(1):13. doi: 10.1186/s13643-024-02743-6.

ABSTRACT

BACKGROUND: A systematic appraisal of the comparative efficacy and safety profiles of naso-intestinal tube versus gastric tube feeding in the context of enteral nutrition for mechanically ventilated (MV) patients is imperative. Such an evaluation is essential to inform clinical practice, ensuring that the chosen method of nutritional support is both optimal and safe for this patient population.

METHODS: We executed an exhaustive search across PubMed et al. databases to identify randomized controlled trials (RCTs) that scrutinize the role of naso-intestinal and gastric tubes for mechanically ventilated (MV) patients up to May 30, 2024. The process of study selection, quality assessment, and data extraction was conducted independently by two researchers. RevMan 5.3 software was used for meta-analysis.

RESULTS: Our meta-analysis included 8 RCTs, published between 1992 and 2018, encompassing a total of 676 MV patients. The results indicated that naso-intestinal tube feeding, compared to gastric tube feeding, was associated with a significant reduction in the incidence of ventilator-associated pneumonia (VAP) [Risk Ratio (RR) = 0.69, 95% confidence interval (CI) (0.52, 0.92)] and gastric retention (RR = 0.11, 95% CI (0.04, 0.28)). No statistically significant differences were observed in the incidence of aspiration (RR = 0.93, 95% CI (0.35, 2.50)) vomiting (RR = 0.70, 95% CI (0.23, 2.08)), abdominal distension (RR = 0.87, 95% CI (0.29, 2.63)), or diarrhea (RR = 1.10, 95% CI (0.77, 1.55)).

CONCLUSIONS: The current evidence indicates that naso-intestinal tube feeding is efficacious in lowering the incidence of VAP and gastric retention among MV patients, without a corresponding escalation in the risk of adverse events, including aspiration, vomiting, abdominal distension, and diarrhea. These insights significantly augment the existing corpus of knowledge pertaining to the optimization of enteral nutrition strategies for patients on mechanical ventilation.

PMID:39810188 | DOI:10.1186/s13643-024-02743-6

BMC Nurs. 2025 Jan 14;24(1):49. doi: 10.1186/s12912-025-02692-y.

ABSTRACT

OBJECTIVE: The objective of this study is to investigate the effect after the application of Failure Model and Effect Analysis (FMEA) in nursing care for patients who have undergone endoscopic submucosal dissection (ESD).

METHODS: A cohort of 40 patients who underwent ESD between July and September 2023 were selected as the control group, while 42 patients who underwent ESD between October 2023 and June 2024 after implementing FMEA were selected as the observation group. A multidisciplinary team was established based on the FMEA model to analyze and create a nursing flowchart. The 3 primary processes and 13 sub-processes were thoroughly analyzed and assessed to identify potential failure models, possible causes of failure, and consequences for each sub-process. Risk Priority Numbers (RPNs) were calculated to determine priority failure models, including medication and item preparation, specimen collection, equipment/instrument/accessory preparation, and nursing coordination. Corresponding improvement measures were formulated and implemented followed by a subsequent analysis of the effects.

RESULTS: After implementing the improvement measures, there was a significant decrease in RPNs in the observation group when compared with the control group. A statistical significance was observed in context of medication and item preparation (P < 0.001), specimen collection (P < 0.001), equipment/instrument/accessory preparation (P < 0.001), and nursing coordination (P < 0.001).

CONCLUSION: The application of the FMEA model can effectively facilitate early nursing interventions for identified risks in patient who have undergone ESD. By instituting suitable corrective measures for aspects deemed high-risk, this approach significantly diminishes surgical nursing hazards, enhances the quality of nursing care, and guarantees patient safety.

PMID:39810186 | DOI:10.1186/s12912-025-02692-y

BMC Endocr Disord. 2025 Jan 14;25(1):11. doi: 10.1186/s12902-024-01819-7.

ABSTRACT

BACKGROUND: Thyroid hormone plays an important role in accumulating bone development and regulating bone metabolism. It is established that hypothyroidism is linked to increased risk of osteoporosis and fracture. However, the effects of levothyroxine (LT4) treatment on bone for hypothyroid patients remain controversial.

METHODS: A systematical search was conducted of several databases, from inception until December 9, 2022, and updated the search using the same search strategy on October 30, 2024, for studies evaluating the effects of LT4 treatment on bone in hypothyroidism including subclinical hypothyroidism (SCH) and overt hypothyroidism (OH). The data were reported using a random-effects model with a standardized mean difference (SMD) and 95% conference interval (CI).

RESULTS: Thirteen of the 5996 published articles were included in this meta-analysis. No significance was found in bone mineral density (BMD) at the lumbar spine between SCH patients treated with LT4 and control group either at baseline or after intervention. For OH, BMD at the lumbar spine was statistically lower in LT4 treatment group compared with healthy controls (HCs) (SMD: -0.28, 95%CI: -0.55, -0.02, P = 0.040, I² = 52%). There were no differences in BMD at the femoral neck, trochanter, and Ward’s triangle between OH patients treated with LT4 and HCs. In addition, BMD at the lumbar spine was significantly lower in males with OH undergoing LT4 treatment for a duration of less than five years compared to those treated over five years. Nevertheless, no significant differences were found in bone metabolism biomarkers between OH patients treated with LT4 and HCs.

CONCLUSION: This systematic review and meta-analysis demonstrated that there is a slight adverse effect of LT4 replacement therapy on bone and mineral metabolism in patients with OH, while no observed effect was found in SCH patients.

PMID:39810175 | DOI:10.1186/s12902-024-01819-7