BMC Public Health. 2025 Dec 26. doi: 10.1186/s12889-025-26055-z. Online ahead of print.
NO ABSTRACT
PMID:41454364 | DOI:10.1186/s12889-025-26055-z
Tag: pubmed
J Health Popul Nutr. 2025 Dec 26;44(1):426. doi: 10.1186/s41043-025-01192-8.
ABSTRACT
BACKGROUND: Despite advancements in the use of maternity care services, certain nations in sub-Saharan Africa continue to record unacceptable rates of maternal and perinatal morbidity and mortality, particularly in the postnatal period. This study aimed to assess the level of postnatal care service utilisation and associated factors among multiparous women in Buyamba County, Rakai District, Uganda.
METHOD: A community-based cross-sectional study involving women who had two or more children was conducted in four sub-counties of Buyamba County. Study participants were recruited using a systematic sampling technique. A structured and pre-tested questionnaire was used to gather data. Descriptive, bivariate and modified poisson regressions were computed using STATA version 14. Statistical significance was considered at p < 0.05 and the strength of statistical association was assessed by prevalence ratios with 95% confidence intervals.
RESULT: Out of 321 women who participated in the study, (81.9%) were married, (30.8%) were aged 35-44 years, (71.0%) attended antenatal care (ANC) during their previous pregnancy, (94.7%) delivered normally, and (94.4%) utilised postnatal care (PNC) services of which (67.2%) received immunisation for the children, (26.2%) acquired family planning counseling and (70.3%) had four or more PNC visits. Attending antenatal care (aPR = 1.750; 95% CI: 1.029-2.981), being aware of PNC services (aPR = 1.380; 95% CI: 1.016-1.875), receiving PNC education (aPR = 1.421; 95% CI: 1.048-1.923), having a normal delivery (aPR = 1.538; 95% CI: 1.055-2.241), and residing within 5 km of a health facility (aPR = 1.282; 95% CI: 1.006-1.632) were significantly associated with a higher likelihood of utilising postnatal care services. In contrast, being younger in age (aPR = 0.511; 95% CI: 0.347-0.752) and having a husband without formal education (aPR = 0.622; 95% CI: 0.454-0.853) were significantly associated with a lower likelihood of postnatal care services utilisation.
CONCLUSION: The study identified several maternal, spousal, and accessibility factors influencing postnatal care utilisation. Enhancing maternal health education, improving facility access, involving partners, and strengthening antenatal counseling and community sensitisation can increase PNC utilisation and improve maternal and neonatal health outcomes.
PMID:41454360 | DOI:10.1186/s41043-025-01192-8
BMC Musculoskelet Disord. 2025 Dec 26. doi: 10.1186/s12891-025-09408-y. Online ahead of print.
ABSTRACT
BACKGROUND AND AIM: The Ponsetimethod has been popularized for treating recurrent idiopathic clubfoot and, more recently, recurrent clubfoot following posteromedial (PMR) or posterior (PR) release. A retrospective study was performed to determine the functional outcome in Ponseti treatment of recurrent idiopathic clubfoot after PMR or PR. The study also aimed to determine whether clinical scoring systems (Pirani and Dimeglio scores) could be predictive for the initial numbers of casts, Achilles tenotomy, ankle dorsiflexion after initial treatment, relapse, and functional outcomes following the Ponseti method of treatment.
METHODS: This was a retrospective study of 17 consecutive patients (27 feet) treated with the Ponseti method for recurrent clubfoot after PMR or PR. Clinical charts were reviewed for sex, laterality, age at initial visit to our institution, age at the first surgery, initial number of casts, undergoing a percutaneous Achilles tenotomy (PAT) or not, clinical presentation, Pirani and Dimeglio scores, range of motion of ankle dorsiflexion after initial treatment, the International Clubfoot Study Group (ICFSG) rating system, and recurrences following the Ponseti method of treatment. We conducted descriptive statistical analyses between patients who rated as excellent, or good and fair in the ICFSG rating system following the Ponseti method of treatment. Outcome and demographic data were analyzed using an independent student’s t-test for means and Fisher exact test for proportional data.
RESULTS: Dimeglio and Pirani scores were not helpful in predicting whether or not a PAT was performed (p > 0.01), ankle dorsiflexion after initial treatment (p > 0.01), and relapse after initial treatment (p > 0.01). There was no statistical correlation between functional outcomes and the number of serial casts (p > 0.01), undergoing a PAT or not, (p > 0.01), ankle dorsiflexion (p > 0.01), and relapse (p > 0.01) after initial treatment. We found a statistical relationship between the initial clinical severity and the number of casts required for clubfoot correction (p = 0.005), and a significant statistical correlation between the initial scores of Pirani (p = 0.001) and Dimeglio (p < 0.001) with the final scores of the ICFSG rating system.
CONCLUSIONS: Ponseti treatment for recurrent idiopathic clubfoot following PMR or PR achieved a satisfactory functional outcome in most patients. The Dimeglio and Pirani scoring systems provided a prognostic value for the initial number of casts and functional outcomes for clubfeet recurring after PMR or PR treated by the Ponseti method. The better functional outcomes were attributed to less initial severity of the previously operated clubfeet.
LEVEL OF EVIDENCE: Level IV, therapeutic study.
PMID:41454357 | DOI:10.1186/s12891-025-09408-y
Child Adolesc Psychiatry Ment Health. 2025 Dec 26. doi: 10.1186/s13034-025-00975-5. Online ahead of print.
ABSTRACT
BACKGROUND: Secondary schools are increasingly delivering a range of mental health interventions with varied success. This trial examined the effectiveness of two implementation strategies, allocation of class time and provision of financial incentives, on the engagement of secondary students with a universal web-based mental health service, Smooth Sailing.
METHODS: A three-arm, cluster-randomised trial was conducted over 12 weeks with Grade 8 and 9 students from 20 schools in two Australian states. Schools were randomised to: (1) the standard Smooth Sailing service, (2) the standard service plus extra class time, or (3) the standard service plus financial incentives. The primary outcome was student engagement, measured by the number of modules accessed at 12-weeks post-baseline. Secondary outcomes included uptake, retention, help-seeking intentions for mental health problems, service satisfaction, and barriers to use.
RESULTS: A total of 20 schools consented, and 1295 students participated. Students accessed a higher number of modules in the enhanced conditions compared with the standard service, but the differences were not statistically significant (p = 0.14). There were no significant differences in uptake (p = 0.55) or retention (p = 0.95) between conditions. Help-seeking intentions significantly improved at 6- and 12-weeks in the standard service and class time conditions only. Common barriers to service use among students were forgetfulness and low motivation.
CONCLUSIONS: Neither class time allocation nor financial incentives significantly increased student engagement, as measured by modules accessed, highlighting the challenges of optimising engagement with digital mental health services in schools and emphasising the need to consider the broader school context. Trial registration Australian New Zealand Clinical Trial Registry (ACTRN12621000225819) and Universal Trial Number (U1111-1265-7440).
PMID:41454356 | DOI:10.1186/s13034-025-00975-5
Mol Autism. 2025 Dec 26. doi: 10.1186/s13229-025-00692-y. Online ahead of print.
NO ABSTRACT
PMID:41454355 | DOI:10.1186/s13229-025-00692-y
Eur J Med Res. 2025 Dec 26. doi: 10.1186/s40001-025-03707-9. Online ahead of print.
ABSTRACT
OBJECTIVES: Aimed to reveal the complex associations between Life’s Essential 8 (LE8), depressive symptoms and nonalcoholic fatty liver disease (NAFLD), and to explore the mediating role of depressive symptoms in the pathways of LE8 components affecting NAFLD.
METHODS: Based on nationally representative data of 8908 adults ≥ 20 years from the 2005-2018 National Health and Nutrition Examination Survey (NHANES), weighted logistic, regression, restricted cubic spline(RCS), threshold effect and bootstrap mediated-effects analyses were used to assess the association between LE8, NAFLD and depressive symptoms associations, and stratified analysis reveals the heterogeneity of the association in population.
RESULTS: Each one-point increase in the LE8 was associated with a reduced risk of NAFLD, OR (95% CI) = 0.19(0.16, 0.23), with health factor score showing particularly protective effect, OR (95% CI) = 0.09 (0.07, 0.10). These associations were stronger among women, older, and PIR (poverty-to-income ratio) > 3.5. A dose-response relationship was evident, with a positive correlation between severe depression and NAFLD, OR (95% CI) = 2.01(1.05, 3.85). Crucially, depressive symptoms constituted a significant mediating pathway in health behaviors, accounting for 46.78%, 17.74%, and 5.79% of the protective effects of optimal sleep health, adequate physical activity, and diet on NAFLD, respectively. Regarding nicotine exposure, depressive symptoms exerted a partial inhibitory effect, with the mediating effect accounting for -27.55%. However, for the association between health factors and NAFLD, depressive symptoms do not play a mediating role in the association.
CONCLUSIONS: This study is the first to confirm that depressive symptoms mediate the relationships between specific LE8 components and NAFLD. LE8 components are significantly correlated with NAFLD, possibly via depression-supporting a “physiological-psychological” integrated approach to NAFLD management. Targeted interventions for depressive symptoms may augment the benefits of optimized LE8 in high-risk populations.
PMID:41454340 | DOI:10.1186/s40001-025-03707-9
BMC Oral Health. 2025 Dec 27. doi: 10.1186/s12903-025-07567-x. Online ahead of print.
ABSTRACT
Odontogenic keratocyst (OKC) is a challenging jaw lesion known for its aggressive behavior and high recurrence rate. Concerns about the safety and effectiveness of existing adjuvant treatments have encouraged the search for safer alternatives such as 5-Fluorouracil (5-FU). This systematic review and meta-analysis evaluated the efficacy of 5-FU as an adjunctive therapy for OKC. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, a comprehensive search was conducted in PubMed, Embase, Scopus, and Google Scholar up to August 1, 2024. Eligible studies included OKC cases treated with 5-FU, alone or combined with surgery. Risk of bias was assessed using the Cochrane ROB-2 tool for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies. Data were pooled using inverse variance weighting, and heterogeneity was evaluated using the I² statistic. Fourteen studies (282 lesions) were included, comprising randomized controlled trials, cohort studies, and case reports of varying quality. Moderate heterogeneity was observed (I² = 37-57%). In five comparative studies, no recurrences occurred in the 5-FU group versus 24.21% in the modified Carnoy’s solution (MCS) group (p < 0.001). Postoperative paresthesia as also lower with 5-FU (18.82% vs. 37.89%, p = 0.012). Compared with segmental resection, 5-FU achieved similar recurrence prevention but with much lower morbidity, including fewer permanent sensory deficits (9.09% temporary in 5-FU vs. 100% permanent in segmental resection, p < 0.001). Bone density was significantly higher after 5-FU treatment than with enucleation alone (p < 0.001). No systemic or severe local side effects were reported. 5-FU appears to be a highly promising adjunctive therapy for OKC, offering effective recurrence prevention with minimal morbidity However, current evidence remains limited by small sample sizes, study heterogeneity, and non-randomized designs. Larger, well-designed trials with long-term follow-up are needed to confirm these findings.
PMID:41454329 | DOI:10.1186/s12903-025-07567-x
BMC Neurol. 2025 Dec 26. doi: 10.1186/s12883-025-04572-z. Online ahead of print.
NO ABSTRACT
PMID:41454312 | DOI:10.1186/s12883-025-04572-z
BMC Endocr Disord. 2025 Dec 26. doi: 10.1186/s12902-025-02134-5. Online ahead of print.
ABSTRACT
BACKGROUND: This study aimed to compare the reduction in hospital admissions due to hypoglycemia and the decrease in HbA1c levels between empagliflozin and sulfonylurea, alongside the standard care provided to patients with type 2 diabetes during fasting.
METHODOLOGY: A single-center prospective observational cohort study was conducted from March to June 2022. Patients were treated with stable doses of empagliflozin, sulfonylureas, metformin, and DPP-4 inhibitors at least two months before fasting. Stability was defined as unchanged doses for at least one month. Participants’ BMI distribution and treatment regimens were clarified. The eGFR cutoff of < 60 ml/min/1.73 m² was chosen based on international standards for renal function in diabetes.
RESULTS: Females were in the majority (60.3%) in the intervention (case) group. Most had ages ranging from 41 to 60 years; the empagliflozin group reported slightly fewer hypoglycemic events (26.5%) compared to the sulfonylurea group (31%), and both groups demonstrated statistically significant reductions in HbA1c levels (p < 0.0001), with a similar mean decrease of approximately 0.5%, during fasting, without changes in baseline antidiabetic medications. An odds ratio of 0.387 indicated a trend toward further HbA1c reduction with increasing empagliflozin dose. However, differences in baseline weight between groups may have influenced outcomes. Separate data for modern versus conventional sulfonylureas were analyzed, showing consistency in hypoglycemic event rates across both types.
CONCLUSIONS: Empagliflozin is effective for type 2 diabetic patients during Ramadan fasting in modestly reducing the hypoglycemic events requiring hospital admissions. While both empagliflozin and sulfonylureas led to comparable reductions in HbA1c, larger, controlled studies are warranted to further evaluate clinical outcomes and control for baseline differences.
CLINICAL TRIAL NUMBER: Not applicable.
PMID:41454305 | DOI:10.1186/s12902-025-02134-5
BMC Ophthalmol. 2025 Dec 26. doi: 10.1186/s12886-025-04589-5. Online ahead of print.
ABSTRACT
BACKGROUND: Diabetic retinopathy (DR) is a prevalent microvascular complication of diabetes mellitus and a significant cause of blindness worldwide, In Sub-Saharan Africa (SSA), the epidemic of diabetes is rapidly expanding, with hundreds of millions expected by 2045, and DR is approximated to afflict about one-third of individuals with diabetes in the region Nevertheless, the total burden of DR in SSA has not been methodically estimated.
OBJECTIVE: We sought to estimate the pooled prevalence of DR in adults with diabetes in SSA and investigate sources of variation.
METHODS: We performed a systematic review and meta-analysis according to PRISMA 2020 guidelines. We searched PubMed, AJOL, Google Scholar, and other sources through mid-2024 for observational studies (cross-sectional or cohort) that reported DR prevalence in adults with diabetes in SSA. Two reviewers screened records, extracted data (study, country, design, sample size, DR cases), and evaluated quality using the JBI checklist. Random-effects meta-analysis (logit transformation) estimated pooled prevalence and 95% confidence intervals (CI), Heterogeneity was measured by Cochran’s Q and I2, and τ2 was reported. Subgroup meta-analysis by region (East, West, Central, and Southern Africa) and meta-regression by country (fixed categorical moderator) were conducted. Funnel plots and Egger’s test (p < 0.05) examined publication bias.
RESULTS: We pooled 30 studies (N = 16,329 individuals) from 18 SSA countries, Most were hospital-based and cross-sectional; no study was excluded due to high bias. The overall pooled prevalence of DR among individuals with diabetes was 25.5% (95% CI: 20.7%-31.0%) (Logit = -1.072, 95% CI -1.345 to -0.799; p < 0.001). Heterogeneity was very high (I2 ≈ 96%, τ2 = 0.433). Subgroup analysis revealed differences by sub region: East Africa 31.8%, Southern Africa 29.6%, West Africa 27.4%, and Central Africa 13.7%. A meta-regression with country as moderator was not statistically significant (F = 0.94, p = 0.560). Egger’s test demonstrated significant asymmetry (p < 0.001), although the weighted regression test was no significant (p = 0.154), which suggests potential publication bias.
CONCLUSION: About a quarter of diabetics in SSA have DR. This is similar to regional estimates (28% in East Africapubmed.ncbi.nlm.nih.gov) but slightly lower than the overall Africa average (~36%)pubmed.ncbi.nlm.nih.gov. The high heterogeneity suggests that the prevalence of DR is highly variable throughout SSA. Restricted access to eye care, late diagnosis, and inadequate glycemic control in SSA are probably responsible for this, these findings highlight the urgent need for systematic diabetic retinopathy screening and management programs in sub-Saharan Africa.
PMID:41454302 | DOI:10.1186/s12886-025-04589-5