To explore the association of nutrition education and exercise with cardiometabolic health risk factors among overweight and obese adolescents. This quasi-experimental study utilised a pretest-posttest design to evaluate changes in body mass index (BMI), blood pressure, and fasting biochemical markers [(glucose, insulin, high-density lipoprotein cholesterol (HDL-C); low-density lipoprotein cholesterol (LDL-C); triglycerides, glycated haemoglobin (HbA1c); homeostatic model assessment of insulin resistance (HOMA-IR)] among 41 participants. The intervention combined supervised aerobic and resistance exercise sessions thrice weekly with a weekly nutrition education session over 10 weeks. The Statistical Package for the Social Sciences was used for data analysis, with p<0.05 indicating statistical significance. Post-intervention, males had lower triglyceride (p=0.045) and LDL-C concentrations (p=0.043). In female adolescents, the intervention reduced diastolic blood pressure (p=0.045), LDL-C (p=0.012), insulin (p<0.001), and HOMA-IR concentrations (p=0.001). The intervention was a significant predictor of reduced LDL-C (p=0.003), HOMA-IR (p=0.010), blood glucose concentrations (p=0.020), and HbA1c levels (p=0.011). The improvements in CMD risk factors suggest potential long-term benefits supporting the usefulness of such an intervention. However, divergent sex-specific responses to the intervention underscore the importance of developing sex-specific intervention programs.

The aim of this study was to investigate the effects of hypermobility on scoliosis degree, trunk rotation, lower extremity length difference, pes planus status, static and dynamic balance, and fall risk in individuals diagnosed with adolescent idiopathic scoliosis (AIS). This case-control study included 33 individuals with AIS (18 hypermobile, 15 non-hypermobile), aged 10-18 years, with Cobb angles ranging from 10° to 45°. Hypermobility was assessed using the Beighton Score, and those scoring 5 or higher were considered the hypermobile group. The degree of scoliosis was measured using the Cobb angle method, and trunk rotation was measured using a scoliometer. Lower extremity length discrepancy was assessed using a tape measure, and pes planus was assessed using the Navicular Drop Test. Static balance was determined using the Single-Leg Balance Test (eyes open/closed), dynamic balance using the Functional Reach Test (FUT), and fall risk was measured using the Morse Fall Scale. Data were analyzed using SPSS, and intergroup comparisons and correlations were evaluated. Lumbar trunk rotation was significantly lower in the hypermobile group (p=0.02). No group differences were observed in other physical parameters. Positive correlations were found between the Cobb angle and upper thoracic and lumbar trunk rotation; a significant positive correlation was also found between the Cobb angle and pes planus status. Hypermobility was linked to gender, and better dynamic balance was associated with a lower risk of falling. In individuals with AIS, hypermobility was determined to affect trunk rotation angle, particularly in the lumbar region, and to be associated with pes planus. Routine evaluation of hypermobility and pes planus is recommended, alongside exercises targeting dynamic balance to help reduce fallrisk.

To ascertain the frequency of obesity, levels of physical activity, and related determinants in adolescent learners. The study was conducted among 5th, 6th, and 7th-grade students aged 10-14years at a secondary school in Karatay district, Konya, using a descriptive and correlational design. Participants were selected through a stratified sampling method. Data were collected using a socio-demographic questionnaire, the Physical Activity Questionnaire for Children (PAQ-C), and direct measurements of height and weight. Descriptive statistics, independent t-test, Mann-Whitney U, Kruskal-Wallis, One-Way ANOVA, Chi-square test, and correlation analyses were performed using SPSS 2020, with a significance level set at p<0.05. Among the participants, 12.9 % were categorized as overweight, and 3.8 % as obese. A negative relationship was identified between age and PAQ-C scores. Male students demonstrated notably higher PAQ-C scores compared to females. Additionally, a significant negative correlation was observed between Body Mass Index (BMI) and PAQ-C scores (r=-0.313, p<0.05). As physical activity levels rise, BMI values decline. Given the critical developmental stage of adolescence, promoting physical activity is vital for preventing obesity and establishing lifelong healthy behaviors. School healthcare professionals should implement evidence-based interventions within educational settings to foster active lifestyles and reduce obesity-related risks. This connection and the contributing factors are essential for reducing obesity rates and enhancing physical activity behaviors. Early intervention during adolescence may significantly impact public health outcomes in the longterm.

This study aimed to investigate the early effects of cigarette smoke exposure on endothelial function in healthy adolescents by analyzing blood endocan levels and urinary cotinine concentrations. A novel endocan/cotinine ratio was proposed to enhance the assessment of endothelial response to tobacco exposure. In this cross-sectional case-control study, 88 adolescents aged 13-18years were recruited from Istanbul University between January and August 2021. Participants were divided into two groups: exposed (n=44) and non-exposed (n=44) to cigarette smoke. Blood endocan and urine cotinine levels were measured using ELISA. Statistical analysis included the Mann-Whitney U test and Spearman's correlation. Among the exposed participants, 11.4 % (n=5) were active smokers and 88.6 % (n=39) were passive smokers. Systolic blood pressure was significantly higher in the exposed group (p=0.03). Although endocan levels did not differ significantly between groups (p=0.74), median values were higher in the exposed group (1847.5 pg/mL, range: 14.79-3,121.63) compared to controls (1806.2 pg/mL, range: 116.83-4,618.90). Urinary cotinine levels were markedly elevated in the exposed group (p<0.001).Significant positive correlations were found between exposure duration (pack-years) and both endocan levels (r=0.318, p=0.01) and cotinine levels (r=0.524, p<0.001). A significant negative correlation was identified between cotinine and endocan levels specifically in the exposed group (r=-0.435, p=0.003), with regression analysis showing that each 1 ng/mL increase in urinary cotinine was associated with a 3.23 pg/mL reduction in serum endocan (R2=0.189, p=0.003), suggesting that cotinine levels accounted for 18.9 % of the variability in endocan concentrations. No such correlation was observed in the control group (r=-0.015, p=0.925).The endocan/cotinine ratio showed a decreasing trend in the exposed group (median: 25.69, mean: 28.76± 21.45) compared to non-exposed participants (median: 34.24, mean: 47.31± 53.89), though this difference did not reach statistical significance (U=1,149.0, p=0.132). A negative correlation was found between BMI and endocan levels (r=-0.337, p=0.001), while a weak positive correlation was observed between age and cotinine concentration (r=0.222, p=0.038). Cigarette smoke exposure in adolescents leads to elevated cotinine levels and increased blood pressure (p=0.03), indicating early vascular changes. The observed negative correlation between cotinine and endocan levels (r=-0.435, p=0.003) may reflect a compensatory endothelial response. The endocan/cotinine ratio could serve as a novel, early biomarker for endothelial dysfunction in youth exposed to cigarettesmoke.

Premenstrual syndrome (PMS) commonly affects adolescent and young women in educational settings, making it an important public health issue. Lifestyle is one of the essential subjects in health. This study assesses how PMS affects the lifestyle of young and adolescent students. This analytical cross-sectional study utilized a multi-stage cluster sampling method to recruit 450 students from various faculties at Babol University of Medical Sciences. The data collection instruments were self-administered questionnaires that captured variables related to demographics, fertility, anthropometry, premenstrual symptoms screening tool (PSST), and health-promoting lifestyle profile (HPLP). All instruments were completed by the student participants. For all statistical analyses, the threshold for significance was set at p<0.05. The results of this study showed that a significant percentage (81.1 %) experienced severe symptoms of PMS. The total lifestyle score was significantly higher in the non-PMS group (131.01 vs. 124.03, p=0.002). A significant negative correlation was reported between lifestyle scores and PSST (r=-0.236, p<0.001). On multiple regression analysis, the income satisfaction (β=-9.644, p=0.007) and PSST (β=-4.142, p=0.070) acted as negative predictors of lifestyle. On the other hand, dissatisfaction with income adequacy and PSST indicated a lower level of lifestyle. PMS had a tremendous impact on students' lifestyles. On the other hand, students who had PMS also had lower lifestyles. These results can help health policymakers to provide appropriate intervention strategies to reduce the severity of PMS and promote healthier lifestyles.

The COVID-19 pandemic led to widespread public health measures such as quarantine and social distancing. While critical for disease mitigation, these interventions might have exacerbated stress, anxiety, and other adverse mental health outcomes among youth. This study examined the association between COVID-19-related stressors and Obsessive-Compulsive Disorder (OCD) symptoms among adolescents. Data were drawn from three waves of a cohort study in Southern California, collected during lockdown due to COVID-19 (spring 2021; n=2,235), and in the following two years (spring 2022; n=3,765; spring 2023; n=3,917). Adjusted logistic regression models estimated cross-sectional associations between COVID-19-related stressors (participant COVID diagnosis [2021-2022], disease severity among friends/family [2021-2022], perceived COVID-related stress [2021, 2023], life stressors during lockdown [2021]), and OCD symptoms measured using the Revised Children's Anxiety and Depression Scale (RCADS). The prevalence of OCD symptoms declined over time, from 15.1 % in 2021 to 9.7 % in 2023. In 2021, adolescents who had COVID themselves, had friends or family who died from COVID, expressed extreme stress related to COVID, or experienced any of several COVID life stressors had higher odds of OCD symptoms (OR range=1.48-15.8; p<0.05). In 2022, having friends or family who had severe COVID (OR=1.42; 95 % CI=1.00, 2.00), required hospitalization (OR=1.82; 95 % CI=1.17, 2.82), or died from COVID (OR=1.68; 95 % CI=1.14, 2.47) was associated with greater odds of OCD symptoms. In 2023, adolescents reporting somewhat (OR=1.56; 95 % CI=1.11, 2.18), very (OR=2.28; 95 % CI=1.43, 3.64), or extremely high stress over COVID-19 (OR=3.02; 95 % CI=1.58, 5.75) had significantly elevated odds of OCD symptoms. These findings underscore the significant association of pandemic-related stressors and adolescent OCD symptoms, even several years after the onset of the pandemic. Targeted mental health interventions are needed to support vulnerable youth during and after public health crises.

Cervical cancer remains a significant public health challenge in low- and middle-income countries like India. Despite the efficacy of HPV vaccination, its uptake remains suboptimal. This qualitative study aimed to explore parental attitudes, knowledge, and decision-making regarding HPV vaccination for school-going adolescents in Ganjam, Odisha, to inform effective intervention strategies. This qualitative study utilized semi-structured interviews, conducting Focus Group Discussions (FGDs), In-Depth Interviews (IDIs), and Key Informant Interviews (KIIs) of total 47 participants. Data were collected from December 2024 to January 2025 in Ganjam, Odisha. Data were analyzed using thematic analysis, aided by MAXQDA 2020 software. Five core themes emerged: Knowledge and Awareness Gaps (low awareness, confusion with other vaccines, information needs); Attitudes Towards HPV Vaccination (mixed institutional trust, accountability demands); Barriers to HPV Vaccination (cultural/social hesitancy, fear-driven hesitancy, individual and systemic barriers); Role of School Authorities (education and communication gaps); and Potential Collaborative Strategies (community engagement, policy and systems alignment). Participants showed positive sentiments towards trusted sources and community engagement, while negative sentiments were associated with fear, cultural norms, and systemic challenges. HPV vaccine uptake is hindered by knowledge gaps, cultural/fear-driven hesitancy, and systemic barriers. Improving coverage and health literacy in resource-limited settings requires intensive communication, school-based education, paternal involvement, intersectoral collaboration, and policy changes, including UIP integration.

Depression is highly prevalent among medical students, especially in resource-constrained settings like Bangladesh, where academic stress serves as a prominent contributing factor. This study aims to explore the predictors of depression among medical students, with a specific focus on academic stress and coping mechanisms, while also evaluating the influence of behavioral and sociodemographic factors on depression in Bangladeshi medical students. This cross-sectional study, conducted from October to December 2022, involved 1,072 undergraduate medical students from six public medical colleges in Bangladesh, selected through simple random sampling. Depression was measured using the PHQ-9, while academic stress, anxiety, insomnia, self-esteem, coping strategies, and internet addiction were assessed using the ASS-40, GAD-7, ISI, RSES, SCSI, and IAT, respectively. Data were analyzed by SPSS and Jamovi software employing chi-square tests, Mann-Whitney U tests, and binary logistic regression. The predicted probabilities were presented as beta coefficients, including crude and adjusted odds ratios (AOR), 95 % confidence intervals, and p-values. Over half of the participants experienced moderate to severe depression. Key predictors of depression included academic stress, coping strategies, and various sociodemographic and behavioral factors. Inadequate study facilities (OR: 1.32, 95 % CI: 1.21-1.44) and feelings of personal inadequacy (OR: 1.33, 95 % CI: 1.23-1.43) significantly increased the likelihood of depression. Among coping strategies, passive problem-focused coping was associated with higher odds of depression (OR: 1.17, 95 % CI: 1.08-1.26), whereas passive emotion-focused coping slightly reduced the risk (OR: 0.91, 95 % CI: 0.85-0.98). Active emotional coping had amarginal effect (OR: 1.07, 95 % CI: 1.00-1.15). Sociodemographic factors also played a significant role. Females were less likely to experience depression than males (OR: 0.35, 95 % CI: 0.19-0.68), and urban residents had lower odds than rural counterparts (OR: 0.40, 95 % CI: 0.19-0.86). Higher paternal education was protective (OR: 0.09, 95 % CI: 0.04-0.21), while maternal education beyond the secondary level was linked to increased risk (OR: 4.07, 95 % CI: 1.61-10.33). Among behavioral factors, insomnia significantly increased the odds of depression (OR: 1.38, 95 % CI: 1.29-1.48), while moderate internet use showed a protective effect compared to no use (OR: 0.26, 95 % CI: 0.13-0.52). Anxiety emerged as a strong predictor (OR: 1.78, 95 % CI: 1.61-1.97). Economically, having a personal income reduced the risk of depression by 49 % (OR: 0.51, 95 % CI: 0.27-0.96). Depression among medical students is significantly associated with academic stress, ineffective coping strategies, insomnia, and anxiety, which may further intensify among high-risk groups such as males, rural residents, and those facing financial challenges. Effective interventions should focus on reducing stress, developing adaptive coping skills, ensuring equitable access to academic resources, and enhancing mental health screening and support services.