Tag: nevin manimala

Front Neurol. 2025 May 21;16:1601778. doi: 10.3389/fneur.2025.1601778. eCollection 2025.

ABSTRACT

BACKGROUND: Parkinsonism is a progressive neurodegenerative disorder characterized by motor and non-motor impairments, significantly impacting quality of life (QoL). Transcranial direct current stimulation (tDCS) has shown promise in improving motor and cognitive functions when combined with physical therapy. This study aimed to explore the association between tDCS exposure and disability levels, as well as its impact on self-reported QoL in individuals with Parkinsonism undergoing physical therapy.

METHODS: This cross-sectional study enrolled 51 participants diagnosed with Parkinsonism from a tertiary care hospital’s neurology outpatient clinic. Based on clinical records of tDCS sessions, participants were stratified into tDCS-exposed and non-exposed groups. Disability was assessed using the World Health Organization Disability Assessment Schedule, and QoL was measured using the Parkinson’s Disease Questionnaire (PDQ-39). Statistical analyses included t-tests for comparing means and Pearson correlation coefficients for assessing relationships between tDCS exposure, disability, and QoL.

RESULTS: The tDCS-exposed group demonstrated lower mean disability scores (WHODAS 2.0: 42.50 ± 8.12) and better quality of life scores (PDQ-39: 35.10 ± 6.45) compared to the non-exposed group (WHODAS 2.0: 45.30 ± 9.21; PDQ-39: 40.15 ± 7.32); however, these differences were not statistically significant (disability: p = 0.131; QoL: p = 0.236). Subgroup analyses revealed statistically significant improvements among participants under 65 years of age (disability mean difference = -3.3, 95% CI: -6.17 to -0.43, p = 0.023) and those in Hoehn and Yahr stages 1-2 (QoL mean difference = -3.7, 95% CI: -6.16 to -1.24, p = 0.004). Additionally, a moderate negative correlation was observed between tDCS session frequency and disability scores (r = -0.60, 95% CI: -0.78 to -0.30, p = 0.04), and a weak negative correlation with quality of life scores (r = -0.43, 95% CI: -0.66 to -0.11, p = 0.039).

CONCLUSION: These findings suggest possible associations between tDCS exposure and clinical outcomes in individuals with Parkinsonism; however, due to the cross-sectional design and underpowered subgroup analyses, results should be interpreted with caution and viewed as hypothesis-generating.

PMID:40470495 | PMC:PMC12133549 | DOI:10.3389/fneur.2025.1601778

Front Neurol. 2025 May 21;16:1562079. doi: 10.3389/fneur.2025.1562079. eCollection 2025.

ABSTRACT

BACKGROUND: Epilepsy affects approximately 70 million people globally, with a prevalence in Mexico of 10.8 to 20 cases per thousand. Antiseizure Medications (ASM) are the first line of treatment for people with epilepsy (PWE), aiming to achieve early seizure control while minimizing adverse effects that could impact quality of life.

MATERIALS AND METHODS: This retrospective cohort study analyzed data from 2020 to 2024 collected from medical records, clinical histories, and electronic systems, using REDCAP^® and SPSSV21^®. It included all epilepsy patients treated at the National Institute of Neurology and Neurosurgery “MVS” in Mexico City. Descriptive statistics were reported as means ± standard deviations for quantitative variables and percentages for categorical variables. Bivariate analysis used the Q Cochran test for dichotomous variables and the chi-square or Fisher’s exact test for qualitative variables.

RESULTS: Of 1,192 prescriptions, third-generation ASMs accounted for the majority (53.7%), led by levetiracetam (24.1%), lamotrigine (14%), and lacosamide (6%). Second-generation ASMs comprised 42.4%, including valproate (21.5%), carbamazepine (11.3%), and clonazepam (5.5%). First-generation ASMs were less frequently prescribed (3.9%), primarily phenytoin (2.3%), primidone (1.0%), and phenobarbital (0.3%). Third-generation ASMs were the most prescribed for focal seizures (38.6%), generalized seizures (13.3%), and seizures of unknown (1.9%) or unclassified types (2.1%).

DISCUSSION: Compared to a 2012 study in the same population, which showed second-generation ASM as dominant, this study highlights a significant shift toward third-generation ASM, now representing over half of prescriptions. While valproate and carbamazepine remain versatile second-generation options, newer ASMs, such as levetiracetam, are increasingly favored.

CONCLUSION: These findings demonstrate a preference for second- and third-generation ASMs in tertiary hospitals in Latin America, which is concordant with global trends. First-generation ASMs are still prescribed but at lower rates. These results provide insights into changing prescription practices and access to newer medications, informing future research and hospital policies.

PMID:40470492 | PMC:PMC12135803 | DOI:10.3389/fneur.2025.1562079

Front Neurol. 2025 May 21;16:1499407. doi: 10.3389/fneur.2025.1499407. eCollection 2025.

ABSTRACT

OBJECTIVE: Quantitative evaluation of the effect of exercise intervention in amyotrophic lateral sclerosis (ALS).

METHODS: The CNKI, WOS, PubMed, and Scopus databases were searched by computer, and randomized controlled trials (RCTs) of exercise intervention in ALS were screened out according to the inclusion and exclusion criteria of the PICOS principle. Stata 12.0 software was used for statistical analysis.

RESULTS: A total of 12 RCTs including 430 participants were included. Meta-analysis results show that exercise intervention can significantly improve the overall function, walking test (WT) distance and maximum expiratory pressure (MEP) of ALS patients (p < 0.05). However, exercise interventions did not show significant effects on fatigue, maximum inspiratory pressure (MIP), forced vital capacity (FVC), and peak expiratory flow (PEF) in ALS patients (p > 0.05). Subgroup analysis showed that resistance exercise is the most effective intervention for improving the function of ALS patients, while aerobic exercise is the most effective intervention for improving FVC in ALS patients.

CONCLUSION: Exercise intervention in ALS has a positive effect, but due to the small number of included studies and possible heterogeneity, risk of bias and sensitivity issues, further research is needed.

PMID:40470490 | PMC:PMC12133518 | DOI:10.3389/fneur.2025.1499407

Cureus. 2025 May 4;17(5):e83478. doi: 10.7759/cureus.83478. eCollection 2025 May.

ABSTRACT

Background Research has revealed that numerous adolescent girls start menstruating without adequate information or readiness. Nevertheless, there is a lack of literature regarding the impact of educational interventions on improving the knowledge of adolescent girls in this regard. Thus, this study aimed to evaluate how a nurse-led intervention influences stress levels and menstrual parameters among adolescent girls in a chosen school in Navi Mumbai. Methodology The study employed a quantitative research approach and utilized a simple random sampling technique, specifically the lottery method, to select 80 (sample size calculated on the basis of the prevalence of a previous similar study) adolescent girls, with 40 in each group. Data collection involved the use of a self-structured questionnaire. Pre-hemoglobin levels for both the control and study groups were measured using a digital hemoglobin meter. A pre-test was conducted for both groups, focusing on demographic information, perceived stress, and menstrual health parameters. The study group received instruction in stretching exercises for alleviating dysmenorrhea, delivered by two nurse researchers, along with a booklet on menstrual parameters and daily distribution of two servings (100 g each) of iron-rich supplements in the form of laddoos. Results Analysis of the data utilized both descriptive and inferential statistics. The results indicated that the exercise intervention significantly reduced stress levels among adolescent girls in the study group regarding pain management during menstruation (mean=87.900, SD=8.53), with a high level of significance at p<0.001. Additionally, the changes in hemoglobin levels for both the control and study groups were 9.55 ± 2.1477 (p=0.058) and 10.225 ± 1.0975 (p=0.017), respectively, indicating a notable effectiveness of the nutritional supplement in improving anemia-related parameters in the study group. Furthermore, the distribution of booklets addressing menstrual parameters among adolescent girls in the study group resulted in a mean score of 6.20 ± 0.723, reflecting a positive change in menstrual health awareness and practices. The findings were extremely significant, with a p-value of less than 0.001, leading to the rejection of the null hypothesis H01. Conclusion The study suggests that replicating and implementing similar nurse-led educational interventions across all secondary schools in Navi Mumbai could systematically improve adolescents’ understanding of menstruation and menstrual hygiene.

PMID:40470459 | PMC:PMC12134149 | DOI:10.7759/cureus.83478

Cureus. 2025 May 5;17(5):e83519. doi: 10.7759/cureus.83519. eCollection 2025 May.

ABSTRACT

The transition to residency training in the United States presents distinct challenges for both American Medical Graduates (AMGs) and International Medical Graduates (IMGs), particularly in the context of the rapid response team (RRT) involvement. This study investigates the effect of a structured educational intervention entitled “Enhancing the Rapid Response Team’s Understanding” on the performance of postgraduate year-one (PGY-1) Internal Medicine residents at the Ascension Saint Joseph Hospital, Chicago. The intervention aimed to enhance the theoretical knowledge and practical competencies related to RRT activation, fostering better integration into multidisciplinary teams during acute clinical deteriorations. A total of 29 PGY-1 residents participated. Five pre-intervention and four post-intervention responses were received, with both assessments evaluating knowledge acquisition, task performance, and confidence levels. The intervention involved didactic sessions on RRT protocols, followed by supervised inpatient floor rotations. The pre- and post-intervention results indicated a significant improvement in task performance, with a 45.83% increase in mean scores (from 48 to 70), though this change did not reach statistical significance (p=0.1096). Despite an increase in the number of tasks performed by participants (p=0.0397), no significant differences were observed in overall knowledge, awareness (p=0.119), or confidence (p=0.722) regarding the RRTs. Feedback from the participants highlighted the intervention’s value, with 75% rating the sessions as important and of good quality. While the small sample size limited statistical power, the findings suggest that structured educational interventions for interns may positively impact their ability to perform critical tasks during RRT activations. Further research with larger cohorts is needed to comprehensively assess the long-term effects of such interventions on clinical preparedness and patient care outcomes.

PMID:40470455 | PMC:PMC12136531 | DOI:10.7759/cureus.83519

Cureus. 2025 May 5;17(5):e83486. doi: 10.7759/cureus.83486. eCollection 2025 May.

ABSTRACT

Background Violence and stress significantly contribute to the growing mental health crisis in Pakistan. However, access to appropriate care remains limited for many. This study aimed to evaluate the impact of violence and trauma on mental health, identify the prevalence of trauma-related psychiatric disorders, and assess gaps in mental healthcare integration. Methodology A cross-sectional study was conducted at the Abbas Institute of Medical Sciences, Muzaffarabad, Pakistan, from April 2024 to December 2024. The study included 316 participants who had a history of exposure to violence or trauma and associated mental health issues. Data were collected using a structured questionnaire that assessed demographic characteristics, trauma exposure, and mental health conditions. Standardized diagnostic tools were employed to screen for post-traumatic stress disorder (PTSD), anxiety, and depression. Data analysis was carried out using Statistical Product and Service Solutions (SPSS, version 26.0; IBM SPSS Statistics for Windows, Armonk, NY). Chi-square and t-tests were used to assess associations between trauma exposure and mental health outcomes. A p-value of less than 0.05 was considered statistically significant. Results The most prevalent form of trauma exposure was domestic violence (n=102; 32.28%), followed by terrorism-related trauma (n=68; 21.52%) and natural disasters (n=60; 18.99%). PTSD was the most common mental health condition, affecting 34.81% of participants (n=110). Anxiety disorders were present in 31.01% of participants, while 26.90% (n=85) experienced depression. Statistical analysis revealed a significant association between exposure to trauma and an increased prevalence of mental health disorders (p<0.001). Conclusion The findings underscore the need for improvements in the integration of mental health services into primary healthcare systems in Pakistan. There is a need for the development of community-based programs and the implementation of policy reforms aimed at providing comprehensive support to individuals affected by trauma-related mental health conditions.

PMID:40470449 | PMC:PMC12134703 | DOI:10.7759/cureus.83486

Cureus. 2025 May 5;17(5):e83526. doi: 10.7759/cureus.83526. eCollection 2025 May.

ABSTRACT

Background Sickle cell disease (SCD) is a serious inherited disorder that affects millions of people worldwide. Zinc and magnesium are essential micronutrients involved in many cellular processes. Several studies have found that their deficiencies are common in SCD patients and may further complicate the disease. This study was conducted to examine plasma levels of zinc and magnesium in a group of SCD patients in Latakia. Methods A total of 85 SCD patients (52 males and 33 females) with both sickle cell anemia (HbSS) and hemoglobin sickle-beta-thalassemia (Hb S/β-Thal) genotypes at the steady state, and 30 healthy controls, were enrolled in this cross-sectional study with no age limits. Plasma zinc and magnesium levels were measured using colorimetric methods. Results Plasma zinc and magnesium levels were significantly lower in SCD patients compared to the controls (P < 0.05). Twelve SCD patients (14.1%) were zinc-deficient, and 37 (43%) had magnesium deficiency. Plasma zinc and magnesium levels were higher in HbSS patients than those with Hb S/β-Thal patients, but with no statistical significance (P > 0.05). Notably, all zinc-deficient SCD patients were < 16 years old. There was no significant (P > 0.05) difference in zinc deficiency distribution between males and females. Age and gender had no significant statistical relations with magnesium deficiency in SCD patients (P > 0.05). Conclusion This study has shown that plasma zinc and magnesium levels were significantly lower in SCD patients compared to the controls, with no significant difference between HbSS and Hb S/β-Thal genotypes. Zinc and magnesium administration may be required in SCD patients from an early age, especially zinc, to mitigate the adverse effects of their deficiencies.

PMID:40470433 | PMC:PMC12136722 | DOI:10.7759/cureus.83526

Cureus. 2025 May 5;17(5):e83493. doi: 10.7759/cureus.83493. eCollection 2025 May.

ABSTRACT

Background Depression and anxiety are common psychological challenges among cancer patients, particularly those receiving palliative care. These conditions significantly impact the quality of life but are often underdiagnosed and undertreated. This study evaluates depression and anxiety prevalence in Saudi palliative patients using the Arabic Hospital Anxiety and Depression Scale (HADS), identifies psychological distress factors, and proposes clinical recommendations to improve regional mental health screening protocols in palliative patients. Methods A cross-sectional study was conducted with 130 palliative care patients at King Fahad Medical City, Riyadh. The Arabic version of the Hospital Anxiety and Depression Scale (HADS) was used to assess depression and anxiety levels. Data were analyzed using the Statistical Package for Social Sciences (SPSS) (IBM Corp., Armonk, NY), with a significance level of p<0.05. Results Sixty-five participants (50%) had HADS for depression (HADS-D) scores of ≥8 (indicating depression), while 40 (31%) had HADS for anxiety (HADS-A) scores of ≥8 (indicating anxiety). Women exhibited higher levels of depression and anxiety compared to men, though this difference was not statistically significant. Pain and fatigue were strongly associated with higher rates of depression (p=0.014 and p=0.002, respectively). Patients with metastatic disease showed lower levels of anxiety (p=0.011). Patients taking antidepressants had significantly higher rates of depression and anxiety (p=0.024). Conclusion The high prevalence of depression and anxiety among cancer patients receiving palliative care emphasizes the importance of implementing a routine psychological screening in oncology settings. The study findings recommend that individuals exhibiting persistent and severe physical symptoms be assessed for possible mood disorders. Contrary to expectations, metastatic patients reported lower anxiety levels. However, this warrants further study to disentangle the roles of coping mechanisms, palliative interventions, and cultural factors.

PMID:40470430 | PMC:PMC12135104 | DOI:10.7759/cureus.83493

Child Adolesc Psychiatry Ment Health. 2025 Jun 4;19(1):63. doi: 10.1186/s13034-025-00927-z.

ABSTRACT

INTRODUCTION: Suicide is a major public health problem and one of the top causes of death among adolescents worldwide. The Ethiopian government works to ensure healthy lives and promote well-being in adolescents through the National Adolescent and Youth Mental Health Strategy. Despite these efforts, suicide in adolescents remains pressing in Ethiopia; however, study findings regarding suicidal ideation and suicide attempts and their associated factors in high school adolescents have been inconsistent and non-conclusive. Therefore, this review aimed to assess the pooled national prevalence and risk factors of suicidal ideation and suicide attempts among high school adolescents in Ethiopia.

METHODS: The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guideline was followed for this systematic review. We searched PubMed, Embase, ScienceDirect, and Google Scholar databases. We included all observational studies that report the prevalence and associated factors of suicidal ideation and suicide attempts among high school adolescents in Ethiopia. Using a standard data extraction format, two authors separately extracted all required data. The meta-analysis was conducted using Stata version 17 statistical software. The Cochrane Q test and I² statistics were employed to evaluate the heterogeneity among the included studies. Pooled prevalence estimates, along with their 95% confidence intervals, were calculated using a random-effects model. Potential sources of heterogeneity across studies were further explored through subgroup analyses, sensitivity analysis, and meta-regression analysis.

RESULT: The review comprised ten studies with 8,620 participants. Out of 1,451 studies identified, 10 studies were included in the analysis. As the random effect model indicated that the pooled prevalence of suicide ideation and suicide attempt among high school adolescents in Ethiopia was 16% (95% CI: 12%, 19%) and 10% (95% CI: 6%, 13%), respectively. The highest prevalence of suicidal ideation was observed after the country’s implementation of HSTP II [18 (95% CI: 15-22), I²=83.94, P-value < 0.001], while the lowest prevalence was depicted in adolescents aged 10-19 years [11% (95% CI 10, 13), I²=93.3, P-value < 0.001]. Similarly, the highest pooled prevalence of suicide attempt was observed after the country’s implementation of HSTP II [12% (95% CI: 10-13), I²=67.77, P-value < 0.03], while the lowest prevalence was depicted in adolescents aged 10-19 years [5% (95% CI 1, 9), I²=94.43, P-value < 0.001]. The sensitivity analysis indicated that none of the point estimates were outside of the overall 95% confidence interval. No publication bias was seen in suicide ideation. But evidence of publication bias for suicide attempts was identified through the left trim and fill analysis. Gender, disappointment with school results, family history, alcohol use, the presence or absence of family or social support, history of abuse, living arrangement of adolescent, anxiety, and depression were significantly associated with suicide ideation and suicide attempts among high school adolescents in Ethiopia.

CONCLUSION: This review revealed that a significant proportion of high school adolescents had suicidal ideation and suicide attempts in Ethiopia. Therefore, the government and all stakeholders should track the outcome of the suicide prevention project under HSTP II and other initiatives. In addition, emphasis should be given to disadvantaged adolescents, including females, orphans, alcohol users, and mentally challenged adolescents. Furthermore, school-based interventions like social support and suicide prevention initiatives shall be promoted.

PMID:40468442 | DOI:10.1186/s13034-025-00927-z

Adv Simul (Lond). 2025 Jun 4;10(1):32. doi: 10.1186/s41077-025-00358-y.

ABSTRACT

BACKGROUND: The rise in virtual reality (VR) applications in healthcare has introduced immersive VR simulations as a valuable training tool for medical professionals. Despite its advantages, VR use can induce cybersickness, characterized by symptoms such as nausea and disorientation. This study examines the relationship between cybersickness and the degree of physical movement in VR simulations used for psychiatric education.

METHODS: The study involved two VR simulations offered at a Canadian mental health hospital: an opioid overdose response (OO) (high movement VR) and suicide risk assessment (SRA) (low movement VR). Participants’ experiences were measured using the Simulator Sickness Questionnaire (SSQ) before and after the training sessions. A nonparametric Mann-Whitney U-test was conducted to compare SSQ scores between the two VR simulations.

RESULTS: A total of 91 participants, including healthcare practitioners and students, were involved. The mean SSQ score for the OO training was 4.59/48 (SD = 5.78), while for the SRA, it was 3.10/48 (SD = 3.48). Mann-Whitney U-test revealed a significant increase in nausea scores in OO simulation compared to SRA simulation (p = 0.0275), with higher nausea reported in the OO simulation. No significant increases were found in oculomotor symptoms.

CONCLUSIONS: Participants in the OO training experienced higher levels of nausea compared to those in the SRA simulation, likely due to increased need for physical movement. These findings underscore the importance of considering the degree of physical movement in the VR training design, specifically the educational value of these movements and the risk of cybersickness negatively impacting VR tolerability for learners.

PMID:40468438 | DOI:10.1186/s41077-025-00358-y