Tag: nevin manimala

Europace. 2025 Nov 14:euaf289. doi: 10.1093/europace/euaf289. Online ahead of print.

ABSTRACT

BACKGROUND: Antiarrhythmic drugs are used during cardiopulmonary resuscitation (CPR) to improve the chances of return of spontaneous circulation (ROSC) in shockable rhythms. To date, their impact on clinical outcomes remains uncertain. This review aimed to provide an evaluation of respective up-to-date evidence.

METHODS: We searched Embase, MEDLINE(R), and Cochrane Central Register of Controlled Trials. Data on study design, population characteristics, antiarrhythmic drugs used, and predefined outcomes were extracted. A meta-analysis was conducted in groups with at least three studies reporting the same outcome. Additionally, we performed subgroup analysis according to the study design.

RESULTS: Initially, 5,080 studies were identified, and 29 were included, with, in total, 60,205 patients. A statistically significant difference in achieving ROSC was found comparing 1) lidocaine and no lidocaine, favouring lidocaine (OR = 1.61, 95% CI: 1.11 – 2.32, p=0.01), 2) nifekalant and lidocaine, favouring nifekalant (OR = 4.18, 95% CI: 2.23 – 7.83, p<0.00001), and 3) esmolol and no esmolol, favouring esmolol (OR = 3.0, 95% CI: 1.40 – 6.40, p=0.005). For the effect on survival to hospital discharge, a significant difference between lidocaine and no lidocaine, favouring lidocaine (OR = 1.66, 95% CI: 1.02 – 2.7, p=0.04), was found.

CONCLUSION: Evidence supporting the use of any antiarrhythmic drugs during CPR remains limited and is partly inconclusive. For the effect on survival to hospital discharge, a statistically significant difference was only found favouring the administration of lidocaine compared to no lidocaine. Further research with improved trial design and into novel drug options should be conducted.

PMID:41233941 | DOI:10.1093/europace/euaf289

Alzheimer Dis Assoc Disord. 2025 Nov 14. doi: 10.1097/WAD.0000000000000704. Online ahead of print.

ABSTRACT

Dementia is a global health issue and its effects on family caregivers are substantial. This study investigated the relationship between cohabitation with patients and the mental health of families in South Korea. On the basis of the nationwide data, 24,874 individuals with dementia within their families were included in the analysis. Multivariate logistic models were used to compare the 3 mental health issues (stress, depression, and suicidal ideation) between the cohabiting and noncohabiting groups. Approximately 15% of participants cohabited with patients with dementia. Members of the cohabiting group had a more stressful status and a higher rate of suicidal ideation than those in the noncohabiting group; however, this association remained significant only for older caregivers (≥65 y). In conclusion, the mental health of family members living with patients with dementia, particularly older caregivers, should be carefully assessed.

PMID:41233930 | DOI:10.1097/WAD.0000000000000704

Perioper Med (Lond). 2025 Nov 13;14(1):125. doi: 10.1186/s13741-025-00578-w.

ABSTRACT

BACKGROUND: Preoperative anemia is a major clinical problem that increases perioperative patient morbidity and mortality. Additionally, preoperative anemia causes hemodynamic instability, delayed recovery after anaesthesia and surgery, prolong length of hospital stay and increases risk of postoperative infection. However, the prevalence of preoperative anemia remains unexplored in conflict affected areas.

OBJECTIVE: To assess prevalence and severity of preoperative anemia and associated factors among orthopedic patients in Bahir Dar city Comprehensive Referral Hospitals, Northwest Ethiopia, 2024.

METHODS: Multi-center cross-sectional study was conducted. Data was collected using questionnaire and checklist. All consecutive scheduled emergency and elective patients were included in the study. Data was transformed from Epi data to SPSS and logistic regression analysis was done. Both crude and adjusted odds ratio were used to assess the strength of association. Hosmer -Lemeshow test and multi collinearity were checked. Variables with a p-value of less than 0.05 were considered as statistically significant.

RESULTS: A total of 820 patients were included in this study with a response rate of 99.9%. Prevalence of preoperative anemia was 46.7% (n = 383/820) with (95%, CI = 0.33353- 0.5987) in this study. Emergency orthopedic cases (AOR = 3.014, CI = 2.480-5.717), traumatic related orthopedic cases (AOR = 2.01, CI = 1.480- 3.21), repeated history of anesthesia and orthopedic surgery (AOR = 3.11, CI = 1.480- 3.54), presence of coexisting diseases (AOR = 1.501, CI = 1.002- 3.74) and preoperative blood loss greater than 500 ml (AOR = 3.001, CI = 2.012- 5.104) were associated with preoperative anemia. CONCLUSION AND RECOMMENDATION: The prevalence of preoperative anemia among orthopedic patients was high in the study area. Orthopedic patients should be screened for preoperative anemia routinely. Additionally, nutritional and iron therapy should be given for mild to moderate anemia. Moreover, blood transfusion should be considered for patients with severe anemia.

PMID:41233925 | DOI:10.1186/s13741-025-00578-w

J Eat Disord. 2025 Nov 13;13(1):262. doi: 10.1186/s40337-025-01341-8.

ABSTRACT

BACKGROUND: This study aims to investigate whether individuals with Avoidant/Restrictive Food Intake Disorder (ARFID) experience unhelpful cognitions that overlap with Anorexia Nervosa (AN). It also examines whether these cognitions play a role in driving problematic eating behaviours that are typically associated with AN because they are designed to prevent weight gain.

METHODS: There were 184 participants (68 individuals with AN, 61 individuals with ARFID, and 55 people with no eating disorder) who were screened using Diagnostic Statistical Manual (DSM-5) criteria. Participants were an adult community sample who completed an anonymous online survey. Questionnaires measured core beliefs, assumptions and automatic thoughts that are associated with AN, and an assessment of concerns about weight and shape was completed. An observational design was used to compare how responses varied according to diagnosis.

RESULTS: Individuals with ARFID were found to have significantly higher levels of disordered core beliefs, assumptions, automatic thoughts, and weight/shape concerns than people with no eating disorder. They showed lower levels of these cognitions relative to individuals with AN. Disordered assumptions and automatic thoughts explained a large proportion of variance in behaviours intended to prevent weight gain in this group.

CONCLUSIONS: The findings have implications for the diagnosis and treatment of ARFID. They challenge diagnostic conceptualisations of ARFID as entirely separable from other eating disorders and any associated weight/shape concerns. They also highlight the need for clinicians to assess and treat unhelpful cognitions that may be maintaining disordered patterns of eating. Future research directions are discussed.

PMID:41233924 | DOI:10.1186/s40337-025-01341-8

Nutr Metab (Lond). 2025 Nov 13;22(1):140. doi: 10.1186/s12986-025-01037-5.

ABSTRACT

BACKGROUND: The prevalence of metabolic disorders such as obesity, type 2 diabetes, and dyslipidemia has increased globally. Postbiotics as non-viable microbial products or metabolites, have recently emerged as potential modulators of metabolic health due to their anti-inflammatory and insulin-sensitizing properties. In order to obtain a better viewpoint from them, this study aimed to comprehensively investigate the effects of postbiotics on metabolic health.

METHODS: This systematic review and meta-analysis, adhering to PRISMA 2020 guidelines, synthesized data from 25 RCTs assessing the effects of postbiotic supplementation on metabolic parameters. Databases including PubMed, Embase, Web of Science, and Scopus were searched up to June 2025. Outcomes included glycemic indices, anthropometric measures, lipid profiles, inflammatory markers, and blood pressure.

RESULTS: Postbiotic supplementation significantly reduced serum insulin levels (WMD: – 2.76 µU/mL), triglycerides (TG) (-8.46 mg/dL), waist circumference (WC) (-1.47 cm), and C-reactive protein (CRP) (-0.99 mg/L). However, changes in fasting blood glucose (FBG), homeostatic model assessment for insulin resistance (HOMA-IR), HbA1c, other profile lipids, blood pressure as well as weight and body mass index (BMI) were not statistically significant. Subgroup analyses revealed more pronounced benefits in younger participants, bacterial-based formulations, and interventions longer than 8 weeks. Risk of bias was low to moderate, and no major publication bias was detected.

CONCLUSION: Postbiotic supplementation demonstrates modest but clinically relevant benefits on insulin sensitivity, central adiposity, TG, and systemic inflammation. These effects suggest a promising adjunctive role for postbiotics in metabolic health interventions, though further trials with standardized formulations and longer durations are warranted.

PMID:41233893 | DOI:10.1186/s12986-025-01037-5

Cancer Cell Int. 2025 Nov 14;25(1):400. doi: 10.1186/s12935-025-04014-3.

ABSTRACT

Endometrial cancer (EC) is the fourth most abundant gynecological cancer. There is an increase in the incidence of mortality from uterine cancers in the past few decades. A comprehensive systematic study to provide an overview on the relationship between autophagy, metabolomics and the risk of oestradiol valerate (OV) induced endometrial cancer was conducted correlated with the use of liposomal loaded-resvida as an innovate drug delivery system. This article explores how metabolomic technology can offer valuable insights on autophagy molecular aspects in EC by identifying new possible metabolite biomarkers that has the potential to improve the accuracy of diagnosis, prognosis and disease monitoring. Metabolomics approach, included orthogonal partial least squares discriminant analysis (OPLS-DA), thus revolutionizes the management of endometrial cancer. Autophagy described in endometrial cancer, includes the role of HSP-70/C-fos/PTEN/mTOR/ERDj-4/p53 signaling pathways that trigger/inhibit the process and consequently represent a potential molecular targets in therapeutic approaches. Endometrial cancer exhibits a molecular complexity and heterogeneity coherent with histopathologic and metabolomic variability. Multivariate statistical analyses pointed out a noteworthy deviation in serum chemical profiles among control, oestradiol valerate, and Resvida and liposomal-Resvida treated groups. Loading plot guided the selection of differential metabolites, elucidating significant variation in metabolite concentration. Improved characterization of molecular alterations of each histological type provides relevant information about the prognosis and potential response to new liposomal therapies. CA125 as EC biomarker was ameliorated post Resvida (108.7 IU/mL) and liposomal Resvida (82.2 IU/Ml) treatment at P ≤ 0.05 in addition to up regulating autophagy biomarkers including mTOR/Cfos/ERDj-4/ PTEN by 20, 25, 14, and 17 fold change respectively and down regulating p53 protein expression by 0.4 ng/ml at P ≤ 0.05 post OV intoxication with liposomal regimen reflecting the most significant impact in modulating these altered genes. The current metabolomics study is the integration of histopathologic and autophagy molecular factors to improve the diagnosis, prognosis, and treatment of endometrial cancer in coherent with liposomal drug delivery system as a targeted therapy.

PMID:41233892 | DOI:10.1186/s12935-025-04014-3

BMC Nurs. 2025 Nov 13;24(1):1394. doi: 10.1186/s12912-025-04058-w.

ABSTRACT

OBJECTIVES: Childhood obesity prevention is a public health priority to reduce the burden of chronic diseases. This study assessed the impact of a capacity-building program designed to enhance school nurses’ competencies in adolescent obesity prevention in the Sousse region of Tunisia.

TRIAL DESIGN: A randomized controlled trial was conducted among all school nurses in the region for nine months, from January to September 2024, in the Sousse region health district. Eligible participants were stratified by the school district and randomly assigned to either the intervention (IG) or control group (CG) using a random number generator.

METHODS: The target population was school nurses actively engaged in school health services, including health promotion and obesity prevention, with a minimum of six months of professional experience. Ninety-five participants were allocated to the intervention. The intervention was multidisciplinary, including expert-led trainers on nutrition, communication, physical activity, and obesity. The primary outcome was perceived skills, and the secondary outcomes were professional attitudes and challenges regarding childhood obesity prevention. Blinding was not used in this study.

RESULTS: A total of 116 nurses participated, predominantly female, with one-third aged 40-49 years. Forty-nine participants were randomised to the IG and 46 to the CG (n = 46). At baseline, the intervention group reported significantly lower self-perceived competency in obesity management than the control group (p = 10^-3). After six months, there is a significant difference between the intervention and the control group in terms of perceived skills, including significant improvements in educating adolescents about physical activity, promoting healthy eating habits, and addressing obesity-related concerns with confidence (p = 10^-3). Regarding perceived challenges, the IG expressed an increased need for further training, particularly in counseling and motivational interviewing (p = 10^-3), higher than the CG.

CONCLUSION: This capacity-building program significantly improved school nurses’ skills, confidence, and motivation in adolescent obesity prevention. Nevertheless, skills related to family dynamics and behavioral management require more targeted interventions. Sustained professional training is crucial for addressing structural barriers and ensuring the long-term effectiveness of the program.

TRIAL REGISTRATION: This clinical trial was registered with the Pan African Clinical Trial Registry on April 7, 2025, under reference number PACTR202504907833519.

PMID:41233857 | DOI:10.1186/s12912-025-04058-w

BMC Med Educ. 2025 Nov 13;25(1):1595. doi: 10.1186/s12909-025-08143-1.

ABSTRACT

BACKGROUND: The admission of graduate students (GS) into medical courses is seen as a mechanism that allows students to have better academic performance during the medical course and to become more competent professionals. For these reasons, specific programs for this purpose agree that GS may have better academic performance in medical courses than nongraduate students (NGS). This study aimed to assess whether graduate-entry students (GS) outperformed admission test (AT) and transfer (Tr) students in both the pre-clinical and clinical phases of an undergraduate medical program that adopts a hybrid Problem-Based Learning (PBL) methodology.

METHODS: A retrospective longitudinal cohort study was carried out, collecting and analysing non-academic data upon entry into the course, as well as academic and non-academic data during the course, from medical students enrolled at the time of the study (2016-2023). We analysed the data relating to the students who, at the beginning of the course, were previously graduates (GS) or nongraduates (NGS), which were composed of students submitted to the admission test (AT) and transferred (Tr). Continuous variables were presented as the median, the interquartile ranges (IR) was used to calculate the measure of dispersion of the data and Cohen’s d was used to estimate effect size. Differences were evaluated using the Kruskal‒Wallis test and post hoc multiple comparisons were carried out with Dunn’s test. The Bonferroni correction was used to control for Type I error across the three pairwise comparisons, in most of the data presented, setting a revised significance threshold of α = 0.0167 for each test (0.05 / 3). Thus, only p-values below 0.0167 were deemed statistically significant.

RESULTS: GS students performed better than AT and Tr students in terms of overall grades, in the Tutorial sessions, in special in attitudinal performance, and on areas of Clinical skills, Primary care and Clerkship, better than Tr. In Clinical skills and Clerkship, AT performed better than Tr. In the progress test (PT), GS performed better than all the other groups and AT performed better than Tr also in the OSCE. In the GS group, male and female students performed similarly, and both groups performed better than male and female students in all the other groups (except for the both gender of the GS group that performed similarly to both gender of the AT group). GS students had a greater median age than did all the other students. On the other hand, Tr students presented the lowest scores for all analysed parameters and presented, except for the AT in the Primary care and Attitudinal, for GS in the OSCE. Tr presented a greater median age than did the AT group.

CONCLUSION: This study suggests that there are advantages of adapting programs to integrate GS students into medical courses that adopt the hybrid PBL model before the clerkship.

PMID:41233855 | DOI:10.1186/s12909-025-08143-1

Thromb J. 2025 Nov 13;23(1):109. doi: 10.1186/s12959-025-00766-0.

ABSTRACT

BACKGROUND: Plasma coagulation factor XIII (OMIM#134570 (F13A1) and 134580(F13B), synthesized in haematopoietic cells (FXIII-A) and hepatocytes (FXIII-B); stabilizes and protects fibrin clots against fibrinolytic breakdown, ensuring haemostasis. Inherited FXIII deficiency is a rare inherited autosomal recessive bleeding disorder affecting 1-3 million people globally and demonstrating strong consanguinity contributing to high incidence of cases in Pakistan. Patients manifesting severe illness are homozygotes or compound heterozygotes.

AIMS: This study aims to estimate phenotypic traits, genetic alterations, and carrier rates in families with known genetic abnormalities in individuals with Factor XIII deficiency.

METHODS: This cross-sectional study was approved by Advanced Studies Research Board and Ethical Review Committee of LUMHS, Jamshoro and conducted in concordance with Declaration of Helsinki 2000 in collaboration at the Biochemistry Department of LUMHS and Haematology Department, Baqai medical university, Karachi. Written informed consent obtained from all participants included in the study. Pedigree was constructed. Direct DNA sequencing performed via big dye terminator by using selective exon as per previously identified mutations in the patients of their families. FXIII confirmed with clot solubility testing and Elisa performed for Assay antigen detection for FXIII. Pathogenicity scoring done by using different software.

RESULTS: All the families had a history of consanguineous marriages and history of bleeding. From the six families, four families show same mutation in patient i.e. IVS11 (+ 1) G > A while two families showed c.2045G > A mutation in their homozygous patient.

CONCLUSION: The results of this study highlight how crucial it is to combine biochemical, clinical, and statistical approaches to increase the precision of diagnoses, improve patient treatment, and make genetic counselling easier for families who are at risk.

PMID:41233847 | DOI:10.1186/s12959-025-00766-0

BMC Ophthalmol. 2025 Nov 13;25(1):640. doi: 10.1186/s12886-025-04505-x.

ABSTRACT

BACKGROUND: Diabetes mellitus is a chronic condition that affects various organs, including the eyes. Corneal endothelial dysfunction, a key factor in ocular health, can be influenced by long-term diabetes. Early detection of corneal changes, such as central corneal thickness (CCT), endothelial cell density (CD), coefficient of variation (CV), and hexagonality (HEX), may provide insights into diabetic ocular complications. This study evaluates the differences in corneal endothelial parameters between diabetic and non-diabetic individuals.

AIM: To compare the corneal endothelial parameters, including CCT, CD, CV, and HEX, in diabetic patients and non-diabetic controls, and assess the correlation between these parameters and the duration of diabetes.

METHODOLOGY: This cross-sectional comparative study was conducted at a tertiary eye care hospital with 100 eyes from 50 diabetic patients and 100 eyes from 50 age-matched non-diabetic controls. All participants underwent a comprehensive ophthalmological evaluation, including intraocular pressure measurement, refraction, best corrected visual acuity, and slit-lamp biomicroscopy. Corneal endothelial imaging was performed using non-contact specular microscopy to assess CCT, CD, CV, and HEX. Statistical analysis was performed using SPSS, with a p-value of < 0.05 considered statistically significant.

RESULTS: In our study, diabetic patients had significantly higher central corneal thickness (CCT) in both eyes (OD: 593.9 ± 60.2 μm; OS: 610.5 ± 60.7 μm) compared to non-diabetics (OD: 550.9 ± 66.1 μm; OS: 593.9 ± 60.2 μm). Hexagonality (HEX) was lower in diabetics (OD: 43.2 ± 12.5%; OS: 42.3 ± 15.8%) vs. non-diabetics (OD: 52.1 ± 10.5%; OS: 41.7 ± 11.9%). HbA1C was significantly higher in diabetics (7.31 ± 1.13%) than non-diabetics (5.48 ± 0.67%; p = 0.012). Cell density (CD) and coefficient of variation (CV) showed no significant differences.

CONCLUSION: Diabetic patients exhibit significant changes in corneal endothelial parameters, which may indicate early endothelial dysfunction. Regular monitoring of these parameters could provide valuable insights into the ocular health of diabetic individuals.

PMID:41233814 | DOI:10.1186/s12886-025-04505-x