Tag: pubmed

BMC Med Educ. 2025 Oct 3;25(1):1353. doi: 10.1186/s12909-025-07542-8.

ABSTRACT

BACKGROUND: Medical students face significant psychological distress due to academic, financial, and social pressures. While global studies highlight the mental health challenges of medical students, limited data is available for Moroccan medical students.

OBJECTIVES: This study aims to assess the prevalence of psychological distress, identify associated factors, and explore coping strategies among Moroccan medical students.

METHODS: A cross-sectional study was conducted at the Faculty of Medicine and Pharmacy of Fez, involving 632 clinical-year students. Data were collected using the validated GHQ-12 questionnaire to assess psychological distress and self-reported measures of functional and dysfunctional coping strategies. Statistical analysis included chi-square tests and logistic regression to identify significant associations.

RESULTS: The mean GHQ-12 score was 5.00 (SD: 3.61), with 50.6% of students scoring above the threshold of 4, indicating psychological distress. The most frequently reported stressors were academic challenges (34.1%), emotional problems (12.3%), and financial difficulties (9.6%). Female students experienced significantly higher levels of distress compared to males (P < 0.001). Among the participants, 52.6% reported using coping strategies; of these, 26.5% relied exclusively on functional strategies, such as prayer, relaxation, and seeking social support, while 26.1% used at least one dysfunctional strategy. Dysfunctional coping strategies, such as dietary changes and smoking, were significantly associated with distress (P < 0.001).

CONCLUSION: This study underscores the substantial mental health burden among Moroccan medical students, with significant associations between distress, gender, stressors, and dysfunctional coping strategies. These findings highlight the need for targeted mental health interventions and the development of supportive programs within medical education settings to promote well-being and resilience.

PMID:41044557 | DOI:10.1186/s12909-025-07542-8

BMC Public Health. 2025 Oct 3;25(1):3327. doi: 10.1186/s12889-025-24607-x.

ABSTRACT

BACKGROUND: Given the physiological decline in late life, coupled with an elevated risk of various diseases and anticipated adverse events, frail and vulnerable older persons in nursing homes are a principal group that is vulnerable to health risks, thereby manifesting a triple vulnerability comprising “physical-mental-economic” aspects. However, standardized assessments of health vulnerability in frail and vulnerable older persons within nursing homes in China are currently lacking, and an evaluation index system has not yet been undeveloped. Therefore, the aim of this study was to construct an index system for comprehensively evaluating the health vulnerability of frail and vulnerable older persons in nursing homes, aiming to offer personalized elderly care services as a reference for predicting health vulnerability risks among this demographic population.

METHODS: On the basis of the “sensitivity‒response capacity” vulnerability analysis framework, multidimensional risk indicators for health vulnerability were preliminarily established through policy literature analysis and semistructured interviews. Between April and August 2023, a Delphi study involved 20 expert representatives from four provinces and municipalities, spanning multiple research domains, for participation. Using a five-point Likert scale, they assessed the value of predefined indicators and provided qualitative feedback. Subsequent to each round of expert input, revisions were enacted upon the evaluation index system.

RESULTS: After three rounds of expert consultation, a consensus on the evaluation index system was reached; it contains two primary indicators, individual sensitivity and antifragility capacity, with 12 affiliated secondary indicators and 56 tertiary indicators. The expert authority coefficients ranged from 0.934 to 0.935, and Kendall’s coefficient of concordance ranged from 0.310 to 0.360. These differences were statistically significant (P < 0.05).

CONCLUSION: The evaluation index system for assessing the health vulnerability of frail and vulnerable older persons in nursing homes developed in this study covers a range of health threats and indicators of health coping capacity faced by frail and vulnerable older persons from individual to societal perspectives. This evaluation index system employs the “sensitivity‒responsiveness” vulnerability analysis framework, addressing the limitations of single-dimensional assessment indicators in capturing a comprehensive overview. This study provides a novel research perspective for assessing health vulnerability in frail and vulnerable older persons. This evaluation index system provides a practical tool for nursing home staff to assess health vulnerability, enabling early risk identification and targeted interventions. Policy-makers and administrators can use it to optimize resource allocation and enhance elderly care services. Future research should validate its real-world applicability and integrate it into existing health monitoring and intervention programs to improve older persons’ health outcomes.

PMID:41044556 | DOI:10.1186/s12889-025-24607-x

BMC Surg. 2025 Oct 3;25(1):425. doi: 10.1186/s12893-025-03168-1.

ABSTRACT

BACKGROUND: Monitors that can provide 2-dimensional (2D) or 3-dimensional (3D) images, as well as high-definition (HD) or 4 K-HD image quality, offer various conveniences to surgeons. While studies comparing 2D and 3D screens exist in the literature, studies are needed to investigate the effects of different monitor sizes on surgical success. This study aimed to examine the impact of screen size on surgical parameters in patients who have undergone a hysterectomy using either a 55-inch or a 27-inch monitor.

METHODS: Patients who underwent laparoscopic hysterectomy and salpingectomy/salpingo-oophorectomy between May 2022 and July 2023 were retrospectively screened. Two groups were created. GroupA consisted of patients who underwent surgery using a 55-inch (140 cm) monitor with both 2D and 4 K-HD features. GroupB consisted of patients whose surgery was performed using a 27-inch (69 cm) monitor with both 2D and 4 K-HD features. A total of 72 women (n(GroupA) = 36, n(GroupB) = 36) were included in the study.

RESULTS: No statistically significant difference was observed between groups regarding age, number of cesarean sections, or body mass index (p > 0.05). Additionally, no statistically significant difference was found between groups regarding the total surgery duration (GroupA, GroupB; (126.86 ± 50.42), (128.97 ± 44.29), p = 0.851, respectively). When evaluating the percentage decrease in hemoglobin values before and after surgery, no statistically significant difference was observed between groups (GroupA, GroupB; (-0.11 ± 0.06), (-0.11 ± 0.07), p = 0.746, respectively). There were no statistically significant differences between groups regarding hematocrit changes, frequency of intraoperative complications, postoperative infections, the time to first gas passage, and length of hospital stay (p > 0.05).

CONCLUSIONS: In laparoscopic monitor systems with 4 K-HD resolution, the screen size, whether 27-inches or 55-inches, may not significantly affect surgical parameters.

PMID:41044554 | DOI:10.1186/s12893-025-03168-1

BMC Public Health. 2025 Oct 3;25(1):3334. doi: 10.1186/s12889-025-24685-x.

NO ABSTRACT

PMID:41044545 | DOI:10.1186/s12889-025-24685-x

BMC Surg. 2025 Oct 3;25(1):429. doi: 10.1186/s12893-025-03134-x.

ABSTRACT

BACKGROUND: Laparoscopic inguinal hernia repair is now widely performed worldwide. However, there is no consensus on the most appropriate surgical operation for inguinal hernia in adult males. This study aims to evaluate the clinical efficacy and applicability of laparoscopic free vas deferens separation with transabdominal preperitoneal (LFVD-TAPP) repair for inguinal hernia in adult males, in comparison to the conventional transabdominal preperitoneal prosthesis (TAPP) approach.

METHODS: A retrospective analysis was conducted on 189 adult male patients who underwent laparoscopic inguinal hernia repair at the First Affiliated Hospital of Soochow University between February 2020 and January 2023. Patients were divided into two groups that included the LFVD-TAPP (n = 95) and the conventional TAPP (n = 94). Observation targets included surgical and postoperative recovery, complication rates, recurrence and chronic pain. Data were analyzed using SPSS 27.0, with statistical significance defined as p < 0.05.

RESULTS: No significant differences were found in baseline characteristics between groups. The LFVD-TAPP group showed significantly shorter operative times for both unilateral and bilateral hernias compared to the TAPP group (0.97 ± 0.20 h vs. 1.60 ± 0.21 h; 1.21 ± 0.17 h vs. 2.01 ± 0.30 h; P < 0.001). No significant differences were observed in postoperative blood loss, length of hospital stay, or hospitalization costs (P > 0.05). However, the LFVD-TAPP group exhibited a higher incidence of temporary groin induration (11 vs. 4; P < 0.05),but significantly lower rates of scrotal hematoma (5 vs. 17; P < 0.05), and chronic pain (6 vs. 11; P < 0.05). No differences were observed in other complications or recurrence rates. Follow-up over 12-24 months revealed no cases of ischemic orchitis, testicular atrophy, or ejaculatory dysfunction in the LFVD-TAPP group.

CONCLUSIONS: LFVD-TAPP presents clinical advantages over conventional TAPP, including simplified intraoperative separation, reduced surgical difficulty, and lower rates of postoperative scrotal hematoma and chronic pain, without increasing the risk of recurrence. Therefore, the LFVD-TAPP provides better protection of the vas deferens, suggesting its potential for clinical application and broader promotion.

PMID:41044539 | DOI:10.1186/s12893-025-03134-x

BMC Public Health. 2025 Oct 3;25(1):3319. doi: 10.1186/s12889-025-24687-9.

ABSTRACT

INTRODUCTION: Tetanus is a public health concern in East Africa, impacting pregnant women and infants since vaccination rates are below acceptable levels. Despite several studies examining tetanus toxoid vaccine coverage in East Africa, the total pooled vaccination coverage rate remains unknown, and the results of these studies are related to these variables. The purpose of this meta-analysis is to estimate the pooled tetanus toxoid vaccination coverage rates among pregnant women in East Africa and identify contributing variables.

METHODS: We searched PubMed, Scopus, Embase, and Google Scholar for studies published between March 10, 2015, and March 10, 2025. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) criteria. The study quality was assessed using a modified version of the Newcastle-Ottawa quality assessment tool. The data were retrieved separately by two authors using Microsoft Excel and analyzed with Stata version 17. A random effects model was used to calculate the pooled vaccination coverage and related covariates. Publication bias is assessed using funnel plots and Egger’s test, while heterogeneity is evaluated through Cochran’s Q test and the I² statistic, helping to ensure the reliability of meta-analytic findings. The PROSPERO registration number for this evaluation was CRD420251008125.

RESULT: The meta-analysis included 25 articles and 70,592 participants. Pregnant women in East Africa had at least two doses of tetanus toxoid vaccination, with a pooled estimate of 47% (95% CI: 41%-54%). The meta-analysis revealed that maternal education (OR = 0.63), media exposure (OR = 1.14), ANC service follow-up (OR = 1.06), place of delivery (OR = 1.17), wealth index (OR = 1.25), family planning use (OR = 0.55), number of ANC visits (OR = 3.12), place of residence (OR = 0.88), and need for indexed birth status (OR = 1.36) were significant predictors of tetanus toxoid vaccination coverage.

CONCLUSION: The findings indicate that receiving at least two doses of tetanus toxoid immunization coverage among pregnant women in East Africa was low. Furthermore, various factors were significantly associated.

PMID:41044529 | DOI:10.1186/s12889-025-24687-9

BMC Public Health. 2025 Oct 3;25(1):3326. doi: 10.1186/s12889-025-24701-0.

ABSTRACT

BACKGROUND: Masturbation is a common practice across various demographics worldwide. However, its prevalence among the general population in Nigeria remains unknown. This study investigates the prevalence of self- and mutual masturbation and their associated factors among sexually active Nigerians.

METHODS: Data were obtained from the Sexual Behaviour and HPV Infection in Nigerians in Ibadan cross-sectional study, including males and females aged 18-45 years. After obtaining consent, participants were asked during face-to-face interviews whether they had ever touched their genitals or inserted fingers into the vagina or anus for sexual pleasure (self-masturbation) or whether they and their sexual partners had ever touched each other’s genitals by hand for sexual pleasure (mutual masturbation). The prevalence of self- and mutual masturbation was reported using percentages, while their associations with participants’ demographic, lifestyle, and biological characteristics were examined using chi-square tests. Poisson regression with robust variance was performed to identify associated factors. Statistical significance was set at p < 0.05.

RESULTS: Mutual masturbation (83.7%) was more common than self-masturbation (64.9%) among participants. The prevalence of self-masturbation was significantly higher among males than females (69.9% vs. 62.4%, p = 0.022), while mutual masturbation was significantly higher among females than males (86.6% vs. 78.1%, p = 0.001). Occupation, smartphone ownership, and alcohol consumption were significantly associated with self-masturbation, while ethnicity, location, number of penile-vaginal sex partners, and receiving oral sex were associated with mutual masturbation.

CONCLUSION: Self- and mutual masturbation are highly prevalent among sexually active Nigerians, with distinct factors influencing each behaviour.

PMID:41044527 | DOI:10.1186/s12889-025-24701-0

BMC Public Health. 2025 Oct 3;25(1):3335. doi: 10.1186/s12889-025-24746-1.

ABSTRACT

OBJECTIVES: Although previous research has established a strong link between sarcopenia and fall risk in middle-aged and older adults, the effects of sarcopenic obesity and possible sarcopenic obesity on fall risk remain underexplored in large-scale studies. This longitudinal analysis aimed to examine these associations using nationally representative cohort data.

METHODS: We analyzed data from the China Health and Retirement Longitudinal Study (CHARLS), including 9,996 participants aged 45 and older with available body composition measurements. Participants were categorized into four groups based on Asian Working Group for Sarcopenia (AWGS) criteria and median waist circumference (WC): (1) normal WC without sarcopenia (control group), (2) normal WC with sarcopenia, (3) obesity without sarcopenia, and (4) obesity with sarcopenia. Cox proportional hazards model was used to estimate adjusted hazard ratios (HRs), 95% confidence intervals (CIs), and P-values, with the control group as the reference. The model was sequentially adjusted for demographic (age, sex, residence), socioeconomic (education), and behavioral (smoking, alcohol) variables.

RESULTS: Compared to participants with normal WC and no sarcopenia (reference group), those with sarcopenic obesity had a significantly higher risk of falls (HR = 1.25; 95% CI: 1.00-1.56; P = 0.048), even after adjusting for demographic, socioeconomic, and behavioral factors. Similarly, possible sarcopenic obesity was linked to a modest but statistically significant increase in fall risk (HR = 1.12; 95% CI: 1.02-1.24; P = 0.021). Subgroup analyses revealed that the fourth quartile showed a trend toward higher fall risk across all subgroups, especially among individuals aged ≥ 60 years and males. However, in most Subgroups, the 95% CIs cross 1, suggesting limited statistical significance in some strata.

CONCLUSIONS: Both sarcopenic obesity and possible sarcopenic obesity are associated with an elevated risk of falls. Middle-aged and older adults should adopt preventive strategies, such as maintaining regular physical activity, to preserve muscle mass and reduce the risk of falls.

PMID:41044525 | DOI:10.1186/s12889-025-24746-1

BMC Pulm Med. 2025 Oct 3;25(1):448. doi: 10.1186/s12890-025-03756-0.

ABSTRACT

BACKGROUND AND HYPOTHESIS: Sarcoidosis (SAR) and lymph-node tuberculosis (LNTB) are granulomatous diseases that present diagnostic challenges, especially in TB-endemic regions. We hypothesized that serum-metabolic profiles would help in differentiating SARs from LNTBs.

OBJECTIVE: This study aimed to identify serum metabolic biomarkers to distinguish SAR from LNTB using NMR-based metabolomics analysis.

METHODS: Serum samples were collected from 26 SAR and 22 LNTB patients. The serum metabolic profiles were measured using 800 MHz NMR spectroscopy and quantified using the commercial software CHENOMX. The serum metabolic profiles were compared using multivariate partial least squares discriminant analysis (PLS-DA), and potential discriminatory metabolites were identified using variable importance in projection (VIP) scores and subsequently evaluated for statistical significance using a volcano plot. The diagnostic potential of the discriminatory metabolites was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS: PLS-DA demonstrated significant metabolic disparity between the SAR and LNTB groups. The key metabolic features identified included elevated levels of glutamate, pyroglutamate, acetate, and leucine and a decreased glutamate-to-glutamine ratio (EQR) and decreased levels of glutamine, pyruvate, and myo-inositol in TB patients. These metabolic changes suggest that TB-infection involves activated glutaminolysis and elevated host lipid metabolism. ROC curve analysis revealed several metabolites with high diagnostic potential (AUC > 0.8), including glutamate, pyroglutamate, and glutamine (AUC > 0.98).

CONCLUSION: In conclusion, this study underscores the potential of serum metabolic profiling as a noninvasive tool for distinguishing SARs from LNTBs. However, further studies are imperative to validate these findings on independent patient cohorts and to facilitate their integration into routine clinical practice.

PMID:41044523 | DOI:10.1186/s12890-025-03756-0

BMC Surg. 2025 Oct 3;25(1):435. doi: 10.1186/s12893-025-03176-1.

ABSTRACT

BACKGROUND: Appendicitis, as a prevalent acute abdominal condition in general surgery, has established a comprehensive diagnostic and therapeutic framework. However, significant academic debate persists regarding the optimal treatment strategy. With advancements in minimally invasive techniques, endoscopic retrograde appendicitis therapy (ERAT) has emerged as an innovative therapeutic approach, providing new options for clinical decision-making. This study employed network meta-analysis to systematically evaluate and compare the clinical efficacy and safety profiles of three treatment modalities: conventional appendectomy, the ERAT, and pharmacological conservative therapy.

METHODS: We systematically reviewed randomized controlled trials (RCTs) published through 2024 that evaluated the three treatment strategies for acute uncomplicated appendicitis. Databases searched included PubMed, Web of Science, Embase, CNKI, Cochrane Central Register of Controlled Trials, and Wanfang. The surface under the cumulative ranking curve (SUCRA) was used to rank the comparative effectiveness of each intervention.

RESULTS: A total of 23 RCTs were included. Regarding complications, the ERAT group (SUCRA, 99.7%) demonstrated significantly lower rates than antibiotics (SUCRA, 37.8%; OR, 0.20; 95% CI, 0.06-0.67), while appendectomy (SUCRA, 12.5%) showed significantly higher rates versus the ERAT (OR, 6.33; 95% CI, 2.35-17.03), with no significant difference between appendectomy and antibiotics. For recurrence, appendectomy (SUCRA, 99.9%) exhibited lower rates than both antibiotics (SUCRA, 2.2%; OR, 0.06; 95% CI, 0.03-0.11) and the ERAT (SUCRA, 53.2%; OR, 0.27; 95% CI, 0.12-0.64), while the ERAT showed significantly lower recurrence than antibiotics (OR, 0.22; 95% CI, 0.08-0.57). Treatment failure analysis revealed appendectomy (SUCRA, 94.6%) had significantly lower rates than antibiotics (SUCRA, 2.2%; OR, 0.05; 95% CI, 0.02-0.15), with no other significant intergroup differences. Hospital stay showed no statistical differences. Cochrane RoB 2.0 assessment indicated overall sound methodological quality. Network meta-analysis demonstrated good consistency (P > 0.05) with low heterogeneity (τ² low-to-moderate; I² < 50%), and adult subgroup analysis yielded similar trends.

CONCLUSION: Each treatment modality demonstrates unique value in specific clinical scenarios. Conventional appendectomy remains the most reliable definitive treatment approach at present. As a minimally invasive alternative, the ERAT shows promising potential in select patient populations, though broader clinical implementation requires further evidentiary support. While antibiotic therapy avoids surgical intervention, it carries significantly higher risks of recurrence and treatment failure. Additional rigorously designed multicenter randomized controlled trials are needed to optimize current therapeutic decision-making frameworks.

TRIAL REGISTRATION: The network meta-analysis and systematic review were registered in PROSPERO on December 2, 2024. (CRD42024616515).

PMID:41044518 | DOI:10.1186/s12893-025-03176-1