Displaying publications 81 - 100 of 111 in total

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  1. Bushi G, Balaraman AK, Gaidhane S, Ballal S, Kumar S, Bhat M, et al.
    Brain Behav Immun Health, 2025 Feb;43:100931.
    PMID: 39867846 DOI: 10.1016/j.bbih.2024.100931
    BACKGROUND AND OBJECTIVE: Lyme disease, caused by Borrelia burgdorferi, presents major health challenges worldwide, leading to serious neurological and musculoskeletal issues that impact patients' lives and healthcare systems. This systematic review and meta-analysis aim to determine the prevalence and link between Lyme disease and these complications, aiming to enhance clinical and public health approaches.

    METHODS: We systematically searched PubMed, EMBASE, and Web of Science up until April 01, 2024, to find studies reporting the prevalence and severity of neurological and musculoskeletal complications associated with Lyme disease. Screening and data extraction were conducted using Nested Knowledge software. Two independent reviewers performed the quality assessment using the Newcastle-Ottawa Scale. Meta-analyses were performed using R software v4.3, employing a random-effects model.

    RESULTS: Out of 3576 records, 17 studies were included, involving 3932 participants. These studies revealed significant prevalence of musculoskeletal symptoms (21.1%) and neurological disabilities (18%) among Lyme disease patients. The analysis showed a notable increase in risk for both complications in individuals with Lyme disease, with pooled Risk Ratios (RR) of 1.82 for musculoskeletal symptoms and 1.64 for neurological disabilities, indicating a significantly higher risk compared to control groups. Although heterogeneity across the studies was high, sensitivity analysis confirmed the consistency of our findings. Additionally, there was evidence of publication bias.

    CONCLUSION: The study reveals significant neurological and musculoskeletal complications in Lyme disease patients, emphasizing the importance of early diagnosis, comprehensive treatment, and supportive care. The noted heterogeneity and potential publication bias highlight the need for transparent research and further study on long-term outcomes.

  2. Balaraman AK, Moglad E, Afzal M, Babu MA, Goyal K, Roopashree R, et al.
    Clin Chim Acta, 2025 Feb 01;567:120105.
    PMID: 39706249 DOI: 10.1016/j.cca.2024.120105
    Pancreatic cancer is a highly fatal malignancy due to poor early detection rate and resistance to conventional therapies. This review examines the potential for liquid biopsy as a transformative technology to identify diagnostic and therapeutic targets in pancreatic cancer. Specifically, we explore emerging biomarkers such as exosomal non-coding RNAs (ncRNAs), circulating tumor DNA (ctDNA), and circulating tumor cells (CTCs). Tumor-derived exosomes contain nucleic acid and protein that reflect the unique molecular landscape of the malignancy and can serve as an alternative diagnostic approach vs traditional biomarkers like CA19-9. Herein we highlight exosomal miRNAs, lncRNAs, and other ncRNAs alongside ctDNA and CTC-based strategies, evaluating their combined ability to improve early detection, disease monitoring and treatment response. Furthermore, the therapeutic implications of ncRNAs such as lncRNA UCA1 and miR-3960 in chemoresistance and progression are also discussed via suppression of EZH2 and PTEN/AKT pathways. Emerging therapeutic strategies that target the immune response, epithelial-mesenchymal transition (EMT) and drug resistance are explored. This review demonstrates a paradigm shift in pancreatic cancer management toward personalized, less invasive and more effective approaches.
  3. Hussain MS, Mujwar S, Babu MA, Goyal K, Chellappan DK, Negi P, et al.
    PMID: 39862263 DOI: 10.1007/s00210-025-03809-5
    As a promising candidate for tackling drug-resistant cancers, triptolide, a diterpenoid derived from the Chinese medicinal plant Tripterygium wilfordii, has been developed. This review summarizes potential antitumor activities, including the suppression of RNA polymerase II, the suppression of heat shock proteins (HSP70 and HSP90), and the blockade of NF-kB signalling. Triptolide is the first known compound to target cancer cells specifically but spare normal cells, and it has success in treating cancers that are difficult to treat, including pancreatic, breast, and lung cancers. It acts against the tolerance mechanisms, including efflux pump upregulation, epithelial-mesenchymal transition, and cancer stem cells. Triptolide modulates important cascades, including PI3K/AKT/mTOR, enhancing the efficacy of conventional therapies. Nonetheless, its clinical application is constrained by toxicity and bioavailability challenges. Emerging drug delivery systems, such as nanoparticles and micellar formulations, are being developed to address these limitations. It has strong interactions with key anticancer targets, like PARP, as determined in preclinical and computational studies consistent with its mechanism of action. Early-phase clinical trials of Minnelide, a water-soluble derivative of triptolide, are promising, but additional work is necessary to optimize dosing, delivery, and safety. This comprehensive analysis demonstrates that triptolide may constitute a repurposed precision medicine tool to overcome tolerance in cancer therapy.
  4. Balaraman AK, Afzal M, Moglad E, Babu MA, Priya GP, Bansal P, et al.
    Biogerontology, 2025 Feb 05;26(2):50.
    PMID: 39907830 DOI: 10.1007/s10522-025-10194-2
    p16INK4a is a crucial tumor suppressor and regulator of cellular senescence, forming a molecular bridge between aging and cancer. Dysregulated p16INK4a expression is linked to both premature aging and cancer progression, where non-coding RNAs (ncRNAs) such as long non-coding RNAs (lncRNAs), microRNAs (miRNAs), and small interfering RNAs (siRNAs) play key roles in modulating its function. These ncRNAs interact with p16INK4a through complex post-transcriptional and epigenetic mechanisms, influencing pathways critical to senescence and tumor suppression. In this review, we explore ncRNAs, including ANRIL, MIR31HG, UCA1, MALAT1, miR-24, miR-30, and miR-141, which collectively regulate p16INK4a expression, promoting or inhibiting pathways associated with cancer and aging. ANRIL and MIR31HG modulate p16INK4a silencing via interactions with polycomb repressive complexes (PRC), while miRNAs such as miR-24 and miR-30 target p16INK4a to influence cellular proliferation and senescence. This regulatory interplay underscores the therapeutic potential of ncRNA-targeted strategies to restore p16INK4a function. We summarize recent studies supporting that ncRNAs that control p16INK4a may be diagnostic biomarkers and therapeutic targets for age-related diseases and cancer.
  5. Balaraman AK, Altamimi ASA, Babu MA, Goyal K, PadmaPriya G, Bansal P, et al.
    Biogerontology, 2025 Jan 20;26(1):46.
    PMID: 39832057 DOI: 10.1007/s10522-025-10190-6
    Aging is associated with a marked increase in cardiovascular diseases, such as myocardial infarction (MI). Cellular senescence is also a crucial factor in the development of age-related MI. Matrix metalloproteinases (MMPs) interaction with cellular senescence is a critical determinant of MI development and outcomes, most notably in the aged heart. After experiencing a heart attack, senescent cells exhibit a Senescence-Associated Secretory Phenotype (SASP) and are involved in tissue regeneration and chronic inflammation. MMPs are necessary for extracellular matrix proteolysis and have a biphasic effect, promoting early heart healing and detrimental change if overexpressed shortly. This review analyses the complex connection between senescence and MMPs in MI and how it influences elderly cardiac performance. Critical findings suggest that increasing cellular senescence in aged hearts elevates MMP activity and aggravates extended ventricular remodeling and dysfunction. Additionally, we explore potential therapeutics that address MMPs and senescence to enhance old MI patient myocardial performance and regeneration.
  6. Balaraman AK, Babu MA, Moglad E, Mandaliya V, Rekha MM, Gupta S, et al.
    Pathol Res Pract, 2025 Feb;266:155785.
    PMID: 39708520 DOI: 10.1016/j.prp.2024.155785
    Several molecular strategies based on targeted gene delivery systems have been developed in recent years; however, the CRISPR-Cas9 technology introduced a new era of targeted gene editing, precisely modifying oncogenes, tumor suppressor genes, and other regulatory genes involved in carcinogenesis. However, efficiently and safely delivering CRISPR-Cas9 to cancer cells across the cell membrane and the nucleus is still challenging. Using viral vectors and nanoparticles presents issues of immunogenicity, off-target effects, and low targeting affinity. Naturally, extracellular vesicles called exosomes have garnered the most attention as delivery vehicles in oncology-related CRISPR-Cas9 calls due to their biocompatibility, loading capacity, and inherent targeting features. The following review discusses the current progress in using exosomes to deliver CRISPR-Cas9 components, the approaches to load the CRISPR components into exosomes, and the modification of exosomes to increase stability and tumor-targeted delivery. We discuss the latest strategies in targeting recently accomplished in the exosome field, including modifying the surface of exosomes to enhance their internalization by cancer cells, as well as the measures taken to overcome the impacts of TME on delivery efficiency. Focusing on in vitro and in vivo experimentation, this review shows that exosome-mediated CRISPR-Cas9 can potentially treat cancer types, including pancreatic, lymphoma, and leukemia, for given gene targets. This paper compares exosome-mediated delivery and conventional vectors regarding safety, immune response, and targeting ability. Last but not least, we present the major drawbacks and potential development of the seemingly promising field of exosome engineering in gene editing, with references to CRISPR technologies and applications that may help make the target exosomes therapeutic in oncology.
  7. Balaraman AK, Arockia Babu M, Afzal M, Sanghvi G, M M R, Gupta S, et al.
    Regen Ther, 2025 Mar;28:558-572.
    PMID: 40034540 DOI: 10.1016/j.reth.2025.01.019
    Recently, increasing interest has been in utilizing mesenchymal stem cell-derived extracellular vesicles (MSC-EVs), especially exosomes, as nanocarriers for miRNA delivery in cancer treatment. Due to such characteristics, nanocarriers are specific: biocompatible, low immunogenicity, and capable of spontaneous tumor accumulation. MSC-EVs were loaded with therapeutic miRNAs and minimized their susceptibility to degradation by protecting the miRNA from accessibility to degrading enzymes and providing targeted delivery of the miRNAs to the tumor cells to modulate oncogenic pathways. In vitro and in vivo experiments suggest that MSC-EVs loaded with miRNAs may inhibit tumor growth, prevent metastasis, and increase the effectiveness of chemotherapy and radiotherapy. However, these improvements present difficulties such as isolation, scalability, and stability of delivered miRNA during storage. Furthermore, the issues related to off-target effects, as well as immunogenicity, can be a focus. The mechanisms of miRNA loading into MSC-EVs, as well as their targeting efficiency and therapeutic potential, can be outlined in this manuscript. For the final part of the manuscript, the current advances in MSC-EV engineering and potential strategies for clinical application have been described. The findings of MSC-EVs imply that they present MSC-EVs as a second-generation tool for precise oncology.
  8. Sushith S, Krishnamurthy HN, Reshma S, Janice D, Madan G, Ashok KJ, et al.
    Rep Biochem Mol Biol, 2020 Jul;9(2):241-249.
    PMID: 33178875 DOI: 10.29252/rbmb.9.2.241
    Background: The objective of this study was to determine the levels of serum ischemia-modified albumin (IMA), fibrinogen (FIB) and high sensitivity C-reactive protein (hs-CRP) in type 2 diabetes mellitus (T2DM) patients with hypertension (HT) (DMT2HTN) and without HT (DMT2). Also, their association with certain biochemical and physical factors were studied to identify possible risk factors that lead to cardiovascular complications.

    Methods: Fasting blood samples were collected from 35 DMT2 or DMT2HTN patients each to analyze differences in serum and plasma levels of IMA, hs-CRP, FIB, total cholesterol (TC), high and low density lipoproteins (HDL and LDL), triglyceride (TG), hemoglobin A1c (HbA1C), glycated hemoglobin and creatinine.

    Results: In DMT2 and DMT2HTN patients, IMA, hs-CRP, FIB, TC, TG, HDL, LDL, glycated hemoglobin and creatinine levels, including body mass index (BMI) and waist-to-hip ratio (WHR), were significantly higher relative to healthy controls. In addition, the levels of IMA, hs-CRP and FIB levels showed a strong link to BMI, WHR, TC, TG, LDL and glycated hemoglobin. Lastly, both DMT2 and DMT2HTN patients demonstrated a significant reduction in HDL.

    Conclusion: DMT2 and DMT2HTN patients have a greater risk of developing cardiovascular related complications. This study suggests that quantifying hs-CRP, IMA and FIB levels can help diagnose the risk of developing complications during the early stages of metabolic and cardiovascular disease. Overall, the specific risk factors may be used for early identification of cardiovascular complications to decrease mortality and morbidity in T2DM patients.

  9. Mangla S, Zohra Makkia FT, Pathak AK, Robinson R, Sultana N, Koonisetty KS, et al.
    Behav Sci (Basel), 2021 Oct 28;11(11).
    PMID: 34821609 DOI: 10.3390/bs11110148
    As the world tries to cope with the devastating effects of the COVID-19 pandemic and emerging variants of the virus, COVID-19 vaccination has become an even more critical tool toward normalcy. The effectiveness of the vaccination program and specifically vaccine uptake and coverage, however, is a function of an individual's knowledge and individual opinion about the disease and available vaccines. This study investigated the knowledge, attitudes, and resulting community practice(s) associated with the new COVID-19 variants and vaccines in Bangladesh, Colombia, India, Malaysia, Zimbabwe, and the USA. A cross-sectional web-based Knowledge, Attitudes, and Practices (KAP) survey was administered to respondents living in six different countries using a structured and multi-item questionnaire. Survey questions were translated into English, Spanish, and Malay to accommodate the local language in each country. Associations between KAP and a range of explanatory variables were assessed using univariate and multiple logistic regression. A total of 781 responses were included in the final analysis. The Knowledge score mean was 24 (out of 46), Attitude score 28.9 (out of 55), and Practice score 7.3 (out of 11). Almost 65% of the respondents reported being knowledgeable about COVID-19 variants and vaccination, 55% reported a positive attitude toward available COVID-19 vaccines, and 85% reported engaging in practices that supported COVID-19 vaccination. From the multiple logistic models, we found post-graduate education (AOR = 1.83, 95% CI: 1.23-2.74) and an age range 45-54 years (AOR = 5.81, 95% CI: 2.30-14.69) to be significantly associated with reported COVID-19 knowledge. In addition, positive Attitude scores were associated with respondents living in Zimbabwe (AOR = 4.49, 95% CI: 2.04-9.90) and positive Practice scores were found to be associated with people from India (AOR = 3.68, 95% CI: 1.15-11.74) and high school education (AOR = 2.16, 95% CI: 1.07-4.38). This study contributes to the identification of socio-demographic factors associated with poor knowledge, attitudes, and practices relating to COVID-19 variants and vaccines. It presents an opportunity for collaboration with diverse communities to address COVID-19 misinformation and common sources of vaccine hesitancy (i.e., knowledge, attitudes, and practices).
  10. Jena MK, Khan FB, Ali SA, Abdullah A, Sharma AK, Yadav V, et al.
    Artif Cells Nanomed Biotechnol, 2023 Dec;51(1):491-508.
    PMID: 37694522 DOI: 10.1080/21691401.2023.2252872
    The mammary gland is a dynamic organ with various physiological processes like cellular proliferation, differentiation, and apoptosis during the pregnancy-lactation-involution cycle. It is essential to understand the molecular changes during the lactogenic differentiation of mammary epithelial cells (MECs, the milk-synthesizing cells). The MECs are organized as luminal milk-secreting cells and basal myoepithelial cells (responsible for milk ejection by contraction) that form the alveoli. The branching morphogenesis and lactogenic differentiation of the MECs prepare the gland for lactation. This process is governed by many molecular mediators including hormones, growth factors, cytokines, miRNAs, regulatory proteins, etc. Interestingly, various signalling pathways guide lactation and understanding these molecular transitions from pregnancy to lactation will help researchers design further research. Manipulation of genes responsible for milk synthesis and secretion will promote augmentation of milk yield in dairy animals. Identifying protein signatures of lactation will help develop strategies for persistent lactation and shortening the dry period in farm animals. The present review article discusses in details the physiological and molecular changes occurring during lactogenic differentiation of MECs and the associated hormones, regulatory proteins, miRNAs, and signalling pathways. An in-depth knowledge of the molecular events will aid in developing engineered cellular models for studies related to mammary gland diseases of humans and animals.
  11. Rahman M, Afzal O, Ullah SNMN, Alshahrani MY, Alkhathami AG, Altamimi ASA, et al.
    ACS Omega, 2023 Dec 26;8(51):48625-48649.
    PMID: 38162753 DOI: 10.1021/acsomega.3c07345
    Breast cancer (BC) is a malignant neoplasm that begins in the breast tissue. After skin cancer, BC is the second most common type of cancer in women. At the end of 2040, the number of newly diagnosed BC cases is projected to increase by over 40%, reaching approximately 3 million worldwide annually. The hormonal and chemotherapeutic approaches based on conventional formulations have inappropriate therapeutic effects and suboptimal pharmacokinetic responses with nonspecific targeting actions. To overcome such issues, the use of nanomedicines, including liposomes, nanoparticles, micelles, hybrid nanoparticles, etc., has gained wider attention in the treatment of BC. Smaller dimensional nanomedicine (especially 50-200 nm) exhibited improved in vivo effectiveness, such as better tissue penetration and more effective tumor suppression through enhanced retention and permeation, as well as active targeting of the drug. Additionally, nanotechnology, which further extended and developed theranostic nanomedicine by incorporating diagnostic and imaging agents in one platform, has been applied to BC. Furthermore, hybrid and theranostic nanomedicine has also been explored for gene delivery as anticancer therapeutics in BC. Moreover, the nanocarriers' size, shape, surface charge, chemical compositions, and surface area play an important role in the nanocarriers' stability, cellular absorption, cytotoxicity, cellular uptake, and toxicity. Additionally, nanomedicine clinical translation for managing BC remains a slow process. However, a few cases are being used clinically, and their progress with the current challenges is addressed in this Review. Therefore, this Review extensively discusses recent advancements in nanomedicine and its clinical challenges in BC.
  12. Bushi G, Khatib MN, Balaraman AK, Ballal S, Bansal P, Tomar BS, et al.
    BMC Public Health, 2024 Nov 18;24(1):3200.
    PMID: 39558300 DOI: 10.1186/s12889-024-20746-9
    BACKGROUND: As e-cigarettes gain popularity as potential tobacco cessation aids, concerns arise about their dual use with traditional cigarettes, especially among pregnant women, potentially subjecting both women and fetuses to heightened risks. This systematic review and meta-analysis aimed to determine the overall prevalence of dual use of tobacco smoking and e-cigarette use in pregnant women.

    METHODS: A literature search was conducted across databases including PubMed, Embase, Web of Science, and Cochrane on October 20, 2023. The included studies reported the number of pregnant women and the count of those who were dual users. Quality assessment was undertaken using the JBI tool. The pooled prevalence of dual use was determined via a random-effects model. All statistical analyses were executed using R software, version 4.3.

    PROSPERO: CRD42023486020.

    RESULTS: Eighteen studies were analyzed, encompassing 5,983,363 pregnant women. The meta-analysis indicated an overall prevalence of 4.6% (95% CI: 2.0-10.3) for dual users with significant heterogeneity (I2 = 100%). Subgroup analysis based on the country showed a prevalence of 4.9% (95% CI: 2.0 to 11.6) for USA and 8.1% (95% CI: 0.00 to 1.00) for UK. Meta-regression revealed reduction of prevalence of dual use from 2019 to 2023. A potential publication bias was indicated by the LFK index and the Doi plot.

    CONCLUSION: The dual consumption of e-cigarettes and traditional tobacco in pregnant women is a significant health concern, with a notable prevalence. Given the established risks of tobacco smoking during pregnancy and the uncertainties surrounding e-cigarettes, more comprehensive research and public health interventions are urgently needed to address this issue.

  13. Yappalparvi A, Balaraman AK, Padmapriya G, Gaidhane S, Kaur I, Lal M, et al.
    Respir Med, 2025 Jan;236:107863.
    PMID: 39557208 DOI: 10.1016/j.rmed.2024.107863
    BACKGROUND: Chronic obstructive pulmonary disease (COPD) significantly impacts global health due to persistent airflow limitation and inflammation. Despite standard therapies, symptoms persist. Ensifentrine, targeting both bronchoconstriction and inflammation as a dual phosphodiesterase 3 and 4 inhibitor, offers a promising therapeutic advancement for COPD management. This meta-analysis evaluates the safety and efficacy of ensifentrine in improving lung function, dyspnea, and quality of life in COPD patients.

    METHODS: We searched PubMed, Embase, and Web of Science through August 2024 for randomized controlled trials evaluating ensifentrine in COPD patients over a minimum of four weeks. Data extraction and screening utilized Knowledge software, and meta-analyses were performed using R v4.4 with a random-effects model.

    RESULTS: From 206 studies identified, four met our inclusion criteria. Ensifentrine improved FEV1 significantly at a dose of 3 mg (LS mean difference: 40.90 mL; 95 % CI: 19.65-62.15). It also improved dyspnea as measured by the Transition Dyspnea Index (TDI) (LS mean difference: 0.91; 95 % CI: 0.61-1.21) and quality of life according to the St. George's Respiratory Questionnaire-C (SGRQ-C) scores (LS mean difference: -1.92; 95 % CI: -3.28 to -0.55). Safety profiles were comparable between the ensifentrine and placebo groups, with no significant increase in treatment-emergent adverse events (TEAEs) (RR: 1.02; 95 % CI: 0.94-1.10).

    CONCLUSION: Ensifentrine significantly enhances lung function, reduces dyspnea, and improves quality of life in COPD patients, especially at a 3 mg dose. These benefits, coupled with a stable safety profile, support its use as an adjunctive therapy in COPD management.

  14. Satapathy P, Gaidhane S, Bishoyi AK, Ganesan S, Jayabalan K, Mishra S, et al.
    Int Urol Nephrol, 2025 Jan 09.
    PMID: 39786704 DOI: 10.1007/s11255-025-04370-z
    BACKGROUND: Sex hormone-binding globulin (SHBG) plays a critical role in regulating androgen bioavailability and has been hypothesized to influence prostate cancer risk, though existing evidence is inconsistent. This systematic review and meta-analysis aimed to evaluate the association between SHBG levels and prostate cancer risk.

    METHODS: A comprehensive search was conducted across PubMed, Embase, and Web of Science for studies published up to December 1, 2024. Observational studies assessing SHBG levels and prostate cancer risk were included. Effect sizes were pooled using random-effects meta-analysis. Heterogeneity was evaluated using the I2 statistic, and quality assessment was performed using the Newcastle-Ottawa Scale. Statistical analysis was performed using R software version 4.4.

    RESULTS: Sixteen studies, including 720,298 participants and 90,799 prostate cancer cases, were analyzed. The pooled odds ratio (OR) for prostate cancer risk per unit increase in SHBG was 0.907 (95% CI 0.799-1.030), indicating no statistically significant association. Substantial heterogeneity was observed among the included studies (I2 = 79%; P 

  15. Bushi G, Gaidhane S, Balaraman AK, Padmapriya G, Kaur I, Lal M, et al.
    J Geriatr Oncol, 2025 Feb 15;16(3):102202.
    PMID: 39955892 DOI: 10.1016/j.jgo.2025.102202
    INTRODUCTION: Falls are a significant health concern among older adults, particularly those with cancer, due to aging-related frailty, treatment-related adverse effects, and comorbidities. Existing reviews have highlighted the burden of falls in this population; however, the absence of a comprehensive meta-analysis to synthesize pooled results from relevant studies has limited the generalizability of their findings. This systematic review and meta-analysis aimed to estimate the global prevalence of falls among older adults with cancer and provide evidence to guide prevention efforts.

    MATERIALS AND METHODS: A systematic search of PubMed, Embase, and Web of Science databases was conducted through October 2024, following PRISMA 2020 guidelines. Studies reporting fall prevalence in patients with cancer aged 65 years or older were included. Pooled prevalence estimates were calculated using a random-effects meta-analysis.

    RESULTS: Seventy-six studies, including 177,212 participants, met the inclusion criteria. The pooled prevalence of falls was 24 % (95 % confidence interval [CI], 20; 28), with significant heterogeneity (I2 = 100 %). Fall prevalence increased with follow-up duration: short-term 12 % (95 % CI, 5.2; 28.4), medium-term 23 % (95 % CI, 18.9; 29.5), and long-term 54 % (95 % CI, 14.9; 89.1) studies (p = 0.13). Older adults with breast cancer had the highest prevalence of falls at 31 % (95 % CI, 17; 48), while patients with colorectal cancer had the lowest at 15 % (95 % CI, 1; 78) (P ≤0.001). Fall prevalence ranged from 19 % in Australia to 24 % in North America (p = 0.89).

    DISCUSSION: Falls are frequent among older adults with cancer, with prevalence varying by cancer type, geographic region, and follow-up duration.

  16. Rohilla S, Gaidhane S, Balaraman AK, Padmapriya G, Kaur I, Lal M, et al.
    J Infect Dis, 2025 Feb 06.
    PMID: 39913333 DOI: 10.1093/infdis/jiaf066
    BACKGROUND: Recent outbreaks of monkeypox (Mpox) have raised concerns about its complications, including ophthalmic manifestations such as conjunctivitis, keratitis, and potential vision impairment. The lack of comprehensive data on these ocular complications hinders the development of effective clinical guidelines. This review aim to synthesize existing evidence on the prevalence and characteristics of Mpox-related ocular complications.

    METHODS: A systematic literature search was conducted across PubMed, Embase, Web of Science, and Scopus, covering studies up to September 8, 2024. Studies focusing on conjunctivitis, keratitis, eye lesions, visual impairment, and other ophthalmic outcomes in Mpox cases were included. Meta-analyses were performed using a random-effects model to estimate pooled prevalence rates, with heterogeneity assessed using the I² statistic. Sensitivity analyses and publication bias assessments were also conducted.

    RESULTS: A total of 25 studies were included, with 22 contributing to the meta-analysis. The pooled prevalence of conjunctivitis in Mpox cases was 8.9% (95% CI: 4.4%-17.1%), keratitis 3.4% (95% CI: 1.4%-7.7%), eye lesions 3.4% (95% CI: 1.4%-7.7%), and visual impairment 4.3% (95% CI: 0.8%-20.6%). Other ocular manifestations had a pooled prevalence of 12.4% (95% CI: 0.6%-76.9%). Significant heterogeneity was observed, particularly for conjunctivitis and other ocular manifestations, suggesting variability in presentation.

    CONCLUSION: Conjunctivitis is the most common ophthalmic complication of Mpox, followed by notable rates for keratitis, eye lesions, and visual impairment. These findings emphasize the need for early recognition, routine ocular exams, and effective management of Mpox-related eye complications. Further high-quality research is necessary to better understand and address these ocular complications.

  17. Akashanand, Khatib MN, Balaraman AK, Roopashree R, Kaur M, Srivastava M, et al.
    J Asthma, 2025 Feb 01.
    PMID: 39817407 DOI: 10.1080/02770903.2025.2453810
    OBJECTIVE: Asthma poses a significant health burden in South Asia, with increasing incidence and mortality despite a global decline in age-standardized prevalence rates. This study aims to analyze asthma trends from 1990 to 2021, focusing on prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across South Asia. The study also assesses the impact of risk factors like high body mass index (BMI), smoking, and occupational exposures on asthma outcomes.

    METHOD: We extracted asthma data from the Global Burden of Disease database for South Asia (1990-2021). Joinpoint regression analysis was used to assess temporal trends in asthma burden. Total Percentage change (TPC) in age-standardized rates of incidence, mortality, and DALYs were calculated. Data were stratified by gender, and the contribution of risk factors was evaluated.

    RESULTS: Asthma-related mortality in South Asia decreased by 37%, from 27.78 per 100,000 (1990) to 17.54 per 100,000 (2021). The Maldives showed the most significant reduction in mortality (78.31%), while Bangladesh recorded a 47.44% reduction in prevalence and a 62.64% decrease in DALYs. High BMI, smoking, and environmental risks contributed significantly to DALYs, with environmental factors playing a major role in countries like Afghanistan (20.73%) and Bhutan (18.58%). Females, particularly those over 20, experienced higher asthma-related DALYs than males.

    CONCLUSION: Asthma burden in South Asia has reduced over the past three decades, yet the absolute number of cases continues to rise, driven by population growth and environmental risk factors. Targeted interventions addressing risk factors and healthcare disparities are essential for further reducing asthma burden.

  18. Malvi A, Khatib MN, Balaraman AK, Roopashree R, Kaur M, Srivastava M, et al.
    BMC Pulm Med, 2025 Jan 29;25(1):48.
    PMID: 39881272 DOI: 10.1186/s12890-025-03516-0
    BACKGROUND: Cannabis is the third most widely used psychoactive substance globally, and its consumption has been increasing, particularly with the growing trend of legalization for medicinal and recreational use. Recent studies have raised concerns about the potential impact of cannabis on respiratory health, specifically the risk of asthma, a significant public health concern. This systematic review aimed to consolidate research on the association between cannabis use and the risk of asthma.

    METHODS: A comprehensive search was conducted across PubMed, Embase, and Web of Science, covering studies published up to September 30, 2024. We included peer-reviewed observational studies evaluating the link between cannabis consumption and the risk of asthma diagnosis. Data synthesis employed a random-effects meta-analysis to account for heterogeneity. R statistical software (version 4.4) was used for statistical analyses.

    RESULTS: The search yielded 8 relevant studies after screening 1,887 records. The pooled odds ratio (OR) for the association between cannabis consumption and the risk of asthma diagnosis was 1.31, 95% confidence interval (CI): 1.19-1.44, indicating greater odds of having asthma compared to non-users. Moderate heterogeneity was observed (I² = 46%), and sensitivity analysis confirmed the robustness of the findings.

    CONCLUSION: This systematic review and meta-analysis identifies a significant association between cannabis use and greater odds of having asthma. These findings emphasize the importance of raising awareness about the potential respiratory risks associated with cannabis use. Future research should prioritize identifying moderating factors, such as the frequency and mode of cannabis consumption, to enhance understanding of this association and provide a stronger evidence base for potential public health interventions.

    CLINICAL TRIAL NUMBER: Not applicable.

  19. Kumar V, Singh M, Khatib MN, Balaraman AK, Roopashree R, Kaur M, et al.
    Expert Rev Respir Med, 2025 Feb 12.
    PMID: 39917855 DOI: 10.1080/17476348.2025.2464882
    BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally, particularly in low- and middle-income countries like India. This study aims to analyze regional trends and project future burden of COPD in India using data from the Global Burden of Disease (GBD) 1990-2021.

    METHODS: This analysis utilized data from the GBD study to assess age-standardized prevalence (ASPR), incidence (ASIR), disability-adjusted life years (DALYs) (ASDR), and mortality rates (ASMR) for COPD across Indian states. Joinpoint regression was used to analyze temporal trends, while ARIMA models predicted future incidence rates.

    RESULTS: In 2021, the highest ASIR was observed in Rajasthan at 306.28, and the highest ASMR was observed in Uttarakhand at 227.19. Projections suggest that the ASIR for COPD in India will decrease from 265.16 in 2022 to 258.19 by 2031. The heatmap analysis identified states like Uttarakhand and Rajasthan as having the highest DALYs attributable to COPD risk factors, including air pollution and tobacco use.

    CONCLUSION: COPD remains a public health challenge in India, with regional variability. Targeted interventions addressing air pollution, smoking cessation, and improved healthcare access are essential to mitigate the disease's future burden, particularly in high-risk regions.

  20. Shabil M, Khatib MN, Ballal S, Bansal P, Tomar BS, Ashraf A, et al.
    J Med Virol, 2024 Dec;96(12):e70122.
    PMID: 39707867 DOI: 10.1002/jmv.70122
    Mpox, formerly known as monkeypox, has re-emerged as a significant global health concern, particularly during the widespread outbreak of 2022. As an orthopoxvirus related to the eradicated smallpox virus, mpox has been primarily managed with smallpox vaccines and treatments, including the antiviral agent Tecovirimat. This systematic review aims to evaluate the effectiveness and safety of Tecovirimat in treating mpox, focusing on its use during the 2022 outbreak, especially among high-risk populations, including men who have sex with men and people living with HIV. We conducted a comprehensive search across databases, such as Embase, PubMed, and Web of Science, up to August 30, 2024. The selection involved a two-stage review process utilizing the Nested Knowledge platform, which helped streamline the screening and data extraction. We included studies that focused on the clinical efficacy and safety of Tecovirimat in human patients with confirmed mpox infections. Our analysis mainly synthesized data narratively due to the heterogeneity of study designs and outcomes. Fifteen studies met the inclusion criteria, providing data on 1031 mpox cases. The preliminary analysis of the PALM 007 RCT indicated that tecovirimat did not significantly outperform placebo in lesion resolution for all patients. Lesions healed faster than expected, regardless of tecovirimat or placebo treatment. A lower mortality rate of 1.7% among those enrolled in the PALM 007 RCT was observed, compared to the general mpox mortality rate of 3.6% or higher in the DRC. Observational studies revealed that early administration of Tecovirimat, especially within the first week of symptom onset, significantly improves symptom resolution, reduces the severity of the disease, and decreases the likelihood of hospitalization and complications in observational studies. However, the impact on viral clearance was inconsistent, and some studies suggested limited efficacy in severely immunocompromised patients. Regarding safety, Tecovirimat was generally well-tolerated as indicated by the RCT; however, mild adverse effects such as fatigue, headache, and nausea were commonly reported among observational studies. Serious adverse events were rare but included elevated liver enzymes and psychiatric symptoms, particularly in patients with pre-existing conditions. Tecovirimat demonstrates some potential benefits in treating mpox, particularly when administered early. The PALM 007 RCT failed to meet the efficacy point. Tecovirimat is generally well-tolerated with a favorable safety profile, although monitoring is advisable for those with existing liver or renal conditions. Despite promising results, further large-scale randomized controlled trials are needed to fully ascertain the drug's effectiveness across diverse populations and to explore its impact on viral clearance and transmission dynamics.
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