Association Between Type 1 Diabetes Mellitus and Eating Disorders: A Systematic Review and Meta-Analysis.

BACKGROUND: Previous meta-analyses have shown mixed results regarding the association between eating disorders (EDs) and type 1 diabetes mellitus (T1DM). Our paper aimed to analyse different EDs and disordered eating behaviours that may be practiced by patients with T1DM. METHODS: A literature search of PubMed, Scopus and Web of Science was conducted on 17 January 2023, using the key terms "T1DM," "Eating Disorders" and "Bulimia." Only observational controlled studies were included. The Revman software (version 5.4) was used for the analysis. RESULTS: T1DM was associated with increased risk of ED compared with nondiabetic individuals (RR = 2.47, 95% CI = 1.84-3.32, p-value < 0.00001), especially bulimia nervosa (RR = 2.80, 95% CI = 1.18-6.65, p-value = 0.02) and binge eating (RR = 1.53, 95% CI = 1.18-1.98, p-value = 0.001). Our analysis has shown that increased risk of ED among T1DM persisted regardless of the questionnaire used to diagnose ED; DM-validated questionnaires (RR = 2.80, 95% CI = 1.91-4.12, p-value < 0.00001) and generic questionnaires (RR = 2.03, 95% CI = 1.27-3.23, p-value = 0.003). Prevalence of insulin omission/misuse was 10.3%; diabetic females demonstrated a significantly higher risk of insulin omission and insulin misuse than diabetic males. CONCLUSION: Our study establishes a significant and clear connection between EDs and T1DM, particularly bulimia and binge eating, with T1DM. Moreover, female diabetics are at higher risk of insulin misuse/omission. Early proactive screening is essential and tailored; comprehensive interventions combining diabetes and ED components are recommended for this population, with referral to a specialised psychiatrist.

A Novel COVID-19 Diagnostic System Using Biosensor Incorporated Artificial Intelligence Technique.

COVID-19, continually developing and raising increasingly significant issues, has impacted human health and caused countless deaths. It is an infectious disease with a high incidence and mortality rate. The spread of the disease is also a significant threat to human health, especially in the developing world. This study suggests a method called shuffle shepherd optimization-based generalized deep convolutional fuzzy network (SSO-GDCFN) to diagnose the COVID-19 disease state, types, and recovered categories. The results show that the accuracy of the proposed method is as high as 99.99%; similarly, precision is 99.98%; sensitivity/recall is 100%; specificity is 95%; kappa is 0.965%; AUC is 0.88%; and MSE is less than 0.07% as well as 25 s. Moreover, the performance of the suggested method has been confirmed by comparison of the simulation results from the proposed approach with those from several traditional techniques. The experimental findings demonstrate strong performance and high accuracy for categorizing COVID-19 stages with minimal reclassifications over the conventional methods.

Is the maternal health voucher scheme associated with increasing routine immunization coverage? Experience from Bangladesh.

Bangladesh initiated the Maternal Health Voucher Scheme (MHVS) in 2007 to improve maternal and child health practices and bring equity to the mainstream of health systems by reducing financial and institutional barriers. In this study, we investigated whether the MHVS has an association with immunization coverage in a rural area of Bangladesh. Between 30 October 2016 and 15 June 2017, we carried out a cross-sectional survey in two low performing areas in terms of immunization coverage- Chattogram (erstwhile Chittagong division) and Sylhet division of Bangladesh. We calculated the coverage of fully immunized children (FIC) for 1151 children aged 12-23 months of age. We compared the coverage of FIC between children whose mothers enrolled in MHVS and children whose mother did not. We analyzed immunization coverage using crude odds ratio (OR) and adjusted OR (aOR) from binary logistic regression models. The overall coverage of FIC was 86%. Ninety-three percent children whose mothers were MHVS members were fully immunized whereas the percentage was 84% for the children of mothers who were not enrolled in MHVS. Multivariate analysis also shows that FIC coverage was higher for children whose mothers enrolled in MHVS compared to those children whose mothers did not; the aOR was 2.03 (95% confidence interval 1.11-3.71). MHVS provides a window for non-targeted benefits of childhood vaccination. Providing health education to pregnant mothers during prenatal care may motivate them to immunize their children. Programmes targeted for mothers during pregnancy, childbirth and post-natal may further increase utilization of priority health services such as childhood immunization.

The future of artificial intelligence in neurosurgery: A narrative review.

Background: Artificial intelligence (AI) and machine learning (ML) algorithms are on the tremendous rise for being incorporated into the field of neurosurgery. AI and ML algorithms are different from other technological advances as giving the capability for the computer to learn, reason, and problem-solving skills that a human inherits. This review summarizes the current use of AI in neurosurgery, the challenges that need to be addressed, and what the future holds. Methods: A literature review was carried out with a focus on the use of AI in the field of neurosurgery and its future implication in neurosurgical research. Results: The online literature on the use of AI in the field of neurosurgery shows the diversity of topics in terms of its current and future implications. The main areas that are being studied are diagnostic, outcomes, and treatment models. Conclusion: Wonders of AI in the field of medicine and neurosurgery hold true, yet there are a lot of challenges that need to be addressed before its implications can be seen in the field of neurosurgery from patient privacy, to access to high-quality data and overreliance on surgeons on AI. The future of AI in neurosurgery is pointed toward a patient-centric approach, managing clinical tasks, and helping in diagnosing and preoperative assessment of the patients.

Effects of polyphenol-rich traditional herbal teas on obesity and oxidative stress in rats fed a high-fat-sugar diet.

Hibiscus rosa-sinensis and Zingiber officinalis teas are traditionally used for the therapies of various diseases, including obesity. The present research work was planned to appraise the potential of polyphenol-rich extracts of selected herbal plants in obesity and related biochemical parameters of high-fat-sugar diet-induced obese rats. Three herbal teas were prepared from Hibiscus rosa-sinensis flowers and Zingiber officinalis rhizomes and their mixture (3:1, respectively). Total phenolic contents (TPC) of Hibiscus rosa-sinensis and Zingiber officinalis extracts were found to be 5.82 and 1.45 mg/g of dry plant material, measured as GAE, while total flavonoid contents (TFC) were 9.17 and 1.95 mg/g of dry plant material, measured as CE, respectively. Two doses (250 and 500 mg/kg BW) of each tea were administered and body weight, BMI, kidney, liver, and atherogenic indices, TC, TG, HDL, LDL, VLDL, BT, AST, ALT, AP, SC, MDA, SOD, GSH, and TAC of rats groups were measured. Data showed that higher doses of Hibiscus rosa-sinensis significantly reduced the rat's BMI (0.50 g/cm2) in comparison with the high-fat-sugar diet group (0.79 g/cm2). All treatment groups, especially H-500 group, showed a significant decrease in the elevated kidney and liver weights and atherogenic index in comparison with HFSDC groups. Higher doses of Hibiscus rosa-sinensis significantly decreased the levels of AST, ALT, AP, and SC in comparison with the HFSDC group. A significant decrease in the levels of serum TC, TG, LDL, and VLDL was observed in all the treatment groups in comparison with the HFSDC group. Furthermore, all the teas, especially higher doses of Hibiscus rosa-sinensis, prevented the alterations in MDA, SOD, and GSH levels of experimental groups, thus showing the potential against oxidative stress. It can be concluded from these results that Hibiscus rosa-sinensis teas exhibited strong protective effects against obesity and oxidative stress, especially at higher doses.

Millions of Bangladeshi Children Missed Their Scheduled Vaccination Amidst COVID-19 Pandemic.

The Government of Bangladesh imposed a movement control order as a mass quarantine strategy to control the outbreak of coronavirus disease 2019 (COVID-19). Adherence to the home quarantine may put children at risk by missing routine vaccination. In this study, we investigated the impact of COVID-19 on child routine immunization in a rural area of Bangladesh and consider the broader implications. Data for this study comes from the Chakaria Health and Demographic Surveillance System (HDSS) of icddr,b with a population of 90,000 people residing in 16,000 households in 49 villages in a rural, coastal area of Southeast Bangladesh. We used an explanatory sequential mixed methods design which involved two phases between March 1, 2020, and May 31, 2020: first, we observed 258 outreach sessions of 86 EPI centers. We calculated the number of Expanded Program on Immunization (EPI) outreach sessions suspended and the number of children who missed their routine vaccination due to the COVID-19. We extrapolated the number of Bangladeshi children who missed their routine vaccination using Chakaria HDSS observations. Secondly, we conducted in-depth interviews to explain the quantitative results. The EPI outreach session (EOS) declined to 74.42% (95% CI 63.97-83.22), 10.45% (95% CI 5.00-18.94), and 3.45% (95% CI 1.00-9.75) from 2019 levels in March, April, and May 2020, respectively. By extrapolation, in Bangladesh, between March and May 2020, 3.2 million children missed their scheduled vaccination compared to 2019. Results from in-depth interviews showed that the unwillingness of villagers to hold EOS and the absenteeism of the vaccinators due to social distancing recommendations and lack of personal safety measures were the main reasons for the discontinuation of the EOS. Resuming EPI outreach sessions and introducing a special catch-up program is essential to prevent future outbreaks and deaths due to vaccine-preventable diseases in Bangladesh and the countries where children missed their routine vaccination due to COVID-19. This health system failure should be considered a factor in all future pandemic preparedness plans.

Retention of implant-supported overdentures at different implant angulations: comparing Locator and ball attachments.

OBJECTIVES: To assess the effect of implant angulation on the retention of two different attachment systems for implant-supported overdentures after a simulated fatigue period of 5.5 years. MATERIAL AND METHODS: Two test set-ups were constructed. A two-implant mandibular implant-supported overdenture design was simulated using acrylic resin blocks to support implant replicas (Model 1 and Model 2). The replicas were set up in the canine regions (22-mm inter-implant distance). In Model 1, the implants were parallel (0° to the vertical axis) and in Model 2 they were divergent (20° to the vertical axis). The Locator and the ball attachment systems were tested at both set-ups. A simulated fatigue period of 5.5 years that equated to 10,000 cycles of insertion and removal of the denture was used. Retention values for each attachment system at each angulation set-up were measured at baseline, every 500 cycles until 4000 cycles and then every 1000 cycles. RESULTS: After simulated fatigue, the retention for both systems at both set-ups reduced. The Locator system reduced from 108.9 to 20.2 N in the parallel set-up and from 82.3 to 17.3 N in the divergent set-up. For the ball system, the retention reduced from 56.2 to 46 N when parallel and from 45.7 to 40.7 N when divergent. CONCLUSION: Both attachment systems showed a significant reduction in retention after simulated fatigue at both parallel and divergent set-ups. The change in implant angulation caused a significant reduction in retention for the ball attachment system only, although this was still higher at the end of testing than the Locator attachment system. The Locators also had a significantly faster rate of loss of retention at both set-ups. Clinically, this may indicate that the ball attachments may perform better with divergent implants.

Robotic-assisted laparoscopic hysterectomy and lymphadenectomy for endometrial cancer: Analysis of surgical performance.

OBJECTIVES: To provide an objective analysis of surgical performance of robotic-assisted laparoscopic hysterectomy (RALH) with lymphadenectomy for endometrial cancer during the learning phase of the procedure and to assess opportunities for improvement. METHODS: From July 2006 to March 2008, 100 patients with endometrial cancer underwent RALH with lymphadenectomy using the da Vinci Robotic Surgical System. Data were analyzed for operative time (OT), estimated blood loss (EBL), length of stay (LOS), intra-operative complications, surgical-pathologic factors, and post-operative complications using an intent-to-treat analysis. A comparison of the data on a quartile (Q) basis was performed for the 100 RALH cases and separately for the 65 cases that had a complete pelvic-and-aortic lymphadenectomy (PAL). RESULTS: Age and body mass index (BMI) did not change significantly during the study. More grade 3 tumors were treated in the last 50 cases (22% vs. 10%, p<0.05). Stage III tumors were identified in 18.7% cases in Q2-4 and none in Q1 (p<0.05). The number of patients undergoing complete PAL and the number of aortic lymph nodes (LN) removed per case increased each quarter. There were 4 (4%) conversions to laparotomy. Delayed vaginal cuff healing decreased from 16% in Q1 to 0% in Q3-4. No case required blood transfusion. Comparing first 10 cases to the last 10 cases, the total LN counts increased from 15 to 21 nodes, the aortic LN counts increased from 4.7 to 8.0, and the OT decreased from 203 to 160 min. Intra-surgeon analysis revealed an improvement in the total LN yields from first 50 to second 50 cases for each surgeon. CONCLUSIONS: Operative times decreased and aortic dissections improved with increasing LN counts during the first 100 cases of RALH. Furthermore, patient safety and improvement in surgical performance was demonstrated.