Risk Factors Research Articles

Lifestyle related health risk factors regarding non-communicable diseases among adults in Morang District

Introduction: Non-communicable diseases are the leading causes of disease burden worldwide. According to World Health Organization estimates, NCDs are responsible for 74% of all deaths globally, with around 77% of premature deaths from NCDs occurring in low- and middle-income countries. This study aims to assess the lifestyle related health risk factors of non-communicable diseases among adults in Nepal, in which two- third of annual deaths are attributable to non-communicable diseases. Methods: A cross sectional study was conducted among adults in Morang district, Nepal. Data collection involved the assessment of the risk factors of obesity, smoking, alcohol consumption, inadequate fruits and vegetable consumption, inadequate physical activity, are raising blood pressure. Ethnical approval was obtained. Results: Two hundred forty participants participated in the study, of which the most prevalent risk factor was obesity (58.3%). Out of total participants, 41.6% had consumed tobacco, 31.2% had consumed alcohol, 41.6% had consumed inadequate fruits and vegetables, 30.4% had inadequate physical activity, and 29.1% had raised blood pressure. Similarly, education is statistically associated with lifestyle risk factors. Male participants of age above 40 years were found to be statistically associated with current tobacco and alcohol consumption. Conclusion: Health related risk factors are causes of non-communicable disease. Most of the participants had two or more risk factors for non-communicable disease. Education is significantly associated with all the risk factors among the participants.

ОЦЕНКА И ПРОГНОЗИРОВАНИЕ РИСКА ПАЦИЕНТСКОГО НОН-КОМПЛАЕНСА В СИСТЕМЕ СПЕЦИАЛИЗИРОВАННОЙ ФАРМАЦЕВТИЧЕСКОЙ ПОМОЩИ НАСЕЛЕНИЮ С ОНКОЛОГИЧЕСКИМИ ЗАБОЛЕВАНИЯМИ

Cardiovascular, oncological and other diseases occupy a significant place in the structure of morbidity and causes of death of the population, the growth of which largely depends on lifestyle and risk factors. Identification of risk factors contributing to the development of cancer is one of the main achievements of epidemiology of the 21st century. Subsequent research helped scientists to build multifactorial algorithms for predicting the risks of cancer and mortality from them, which greatly facilitated the work of practitioners in the field of risk stratification. The above indicates that the research results of many foreign and domestic authors confirm that significant predictors of cancer are risk factors such as old age, pre-existing cancer in blood relatives, smoking, obesity, alcohol, certain types of viral infections, certain chemicals, ionizing radiation, including UV rays of the sun and others. It is known that reducing the influence of risk factors leads to a decrease in morbidity and mortality from cancer. An important condition in the treatment of oncological diseases is the rational and effective use of medicines. Pharmaceutical specialists play an active role in this process. In the treatment of long-term or lifelong diseases, such as cancer, great importance is attached to the process of daily pharmacotherapy, compliance with the rules of adherence to treatment or compliance. Thus, problems with patients performing medical appointments are based on a complex of factors, including psychological and behavioral ones, including patients' adherence to treatment.

Comparison of NFHS 4 and 5 data in Tamil Nadu for diarrhoeal disease and risk factors among children under 5 years

Background: Globally, 4 billion cases of diarrhea occur every year and 88% of these can be attributed to unsafe water, inadequate sanitation and poor hygiene. One out of ten babies born in developing countries do not reach their fifth birthday as they die from diarrhoeal diseases. Diarrhoeal diseases remain the number one cause of child mortality in India even though it is a preventable illness. The study aims to compare the prevalence of diarrhoeal diseases and enumerate its risk factors among children aged below 5 years in different districts of Tamil Nadu from NFHS 4 and 5. Methods: This study is a secondary data analysis based on the NFHS 4 & 5 data of Tamil Nadu, which has data available in round 4 for 26,033 households and for 27,929 households in round 5. The analysis pertains to children aged below 5 years who were 7,658 in round 4 and 6,283 in round 5. Results: Overall there was a 53.8% decrease in prevalence in Tamil Nadu. Prevalence in Salem had reduced by 92.1%. Erode, Kanniyakumari and Krishnagiri achieved 84.5%, 86.6%, 89.2% reductions respectively. Nagapattinam and Virudhunagar experienced a higher number of prevalence with 7.5% and 12% increase of cases respectively. Overall Tamil Nadu 71.6% improvement in sanitation from NFHS-4. Tiruvannamalai achieved the highest improvement (96.5%), while Erode did not achieve much improvement (7.8%). Overall Tamil Nadu had 0.92% improvement in drinking water facility from NFHS-4. Nagapattinam and Perambalur have the highest improvement (6.8 and 6.5% respectively) and have achieved 100%. Ariyalur has had a 6.1% decline in quality of drinking water facility. Conclusion: Between NFHS 4 and 5, the prevalence of diarrhoeal cases among children under 5 has dropped by 53.8% and child mortality has reduced by 16.8% in Tamil Nadu. We can also see that there is an overall improvement in of 27.4% in sanitation and 0.92% in drinking water quality.

Exploring risk and resilience in school environments for students in kinship care

ABSTRACT Kinship care is provided by members of a child’s extended family or friend network when they can no longer live with their parents. This study explores risk and resilience in UK school environments for students in kinship care. Eight professionals experienced in working with students in kinship care and their schools took part in individual, semi-structured interviews. Interviews focussed on kinship students’ needs and how professionals perceive schools respond to those needs. Reflexive thematic analysis generated over-arching themes indicating that: children in kinship care have multiple needs and are looked after by kinship carers who find themselves “between a rock and a hard place”; in some schools kinship care is “under the radar”; other schools respond to kinship families with the attitude of “the apple doesn’t fall far from the tree”; and in some schools kinship care is “on the agenda”. A model is presented that integrates risk and protective factors within schools, generated from this study, with risk and protective factors for kinship students within families, identified by previous literature. Implications for educational psychology (EP) practice are presented, and further research needs discussed.

Clinical practices and treatment preferences in chronic coronary syndrome management among Indian physicians

Introduction: Chronic coronary syndrome (CCS) is a significant contributor to morbidity and mortality worldwide, particularly in India, where risk factors such as hypertension and diabetes are increasingly prevalent. Effective management of CCS typically involves lifestyle modifications, pharmacotherapy, and sometimes interventional procedures. Methods: A digital questionnaire-based survey was conducted across multiple sites in India, involving cardiologists and consultant physicians. The survey comprised nine questions addressing the prevalence of CCS, preferred treatments, and factors influencing prescribing decisions for novel oral anticoagulants (NOACs). Results: A total of 66 physicians were enrolled. Approximately 40.30% of physicians reported that more than 40% of their patients had CCS. The majority of physicians (57.81%) reported that dual antiplatelet therapy (DAPT) was most preferred treatment for CCS. Around 51% of physicians reported bleeding risk as the primary hindrance in prescribing rivaroxaban and aspirin for CCS patients. The majority of physicians (42.19%) preferred rivaroxaban with a prescription rate of 40%. Apixaban was most commonly prescribed at a rate of 30% by 33.87% of physicians, while dabigatran was typically prescribed at rates of 10% and 20% (41.82% each). Warfarin was prescribed for 10% of patients by 51.79% of respondents. In non-valvular atrial fibrillation cases, 73.13% preferred rivaroxaban primarily for its once-daily dosing advantage. Conclusion: The present study reveals current trends in the management of CCS and the utilization of NOACs among physicians in India. It underscores the growing significance of NOACs, particularly rivaroxaban, in enhancing treatment outcomes for patients with CCS.

Risk factors threatening children’s safety in the school environment

School safety encompasses risk reduction efforts to ensure that children act in an environment that is safe and promotes the well-being of the students to achieve their full potential. Therefore, a safe and secure environment is a prerequisite for effective teaching and learning. This scoping review aims to address a range of school safety risk factors and introduce the complexity of school safety. School is believed to be a safe learning and growing environment; however, various conditions can threaten children’s safety in a school setting and lead to injuries caused by accidents, risky or/ aggressive behavior, or environmental exposure. In addition to the physical, psychological, and behavioral characteristics of children that make them particularly vulnerable to accidents, there are several unpredictable risks associated with natural or man-made conditions or disasters that can also put children at extreme risk. A balance between safety, surveillance, and emergency preparedness measures may be beneficial to create a safety culture in schools that will enable student behavioral and intervention support.

Glaucoma - A Window into Future Neurodegeneration

Glaucoma is the leading cause of irreversible blindness in the world. Recent studies propose glaucoma to be a neurodegenerative disease due to overlap with diagnoses such as Alzheimer’s, Parkinson’s, and amyotrophic lateral sclerosis. Emerging reports have linked glaucoma as a risk factor for future certain neurodegenerative diseases, however, results have been conflicting. The development of degenerative brain disease consists of both a genetic and environmental component. If diagnosed with glaucoma, patients should take additional measurements to reduce the likelihood of developing additional nerve cell loss.

Differences in Prevalence and Psychosocial Characteristics of Irritable Bowel Syndrome According to Rome III and Rome IV Criteria in Medical and Nursing Students.

In Korea, changes in the prevalence of irritable bowel syndrome (IBS) after the Rome IV update have not been extensively studied. The aim of this study is to compare the prevalence and psychosocial risk factors of IBS according to Rome III and Rome IV criteria in medical and nursing students. From August 13, 2021 to October 22, 2021, participants were enrolled and surveyed online. The survey includes general and specific questions for disease diagnosis and regarding participants' social and psychological characteristics using the 36-item short form survey, the Brief Encounter Psychosocial Instrument-Korean version, and the Hospital Anxiety and Depression Scale. In total, 338 medical students and 102 nursing students completed the survey. IBS was diagnosed in 78 students (17.7%) using Rome III criteria and in 51 students (11.6%) using Rome IV criteria. Significant differences in physical functioning score and severity score were observed between patients diagnosed using Rome IV criteria and patients diagnosed using Rome III criteria. Multiple logistic regression revealed that severity score (adjusted odds ratio = 1.01; 95% confidence interval: 1.00-1.21; P = 0.022) is the only predictor of IBS that differentiates Rome IV criteria from Rome III criteria. Even after updating the Rome IV diagnostic criteria, the prevalence of IBS in medical and nursing students in Korea remained high. Patients who met the Rome IV criteria had more severe symptoms and lower quality of life than patients who met the Rome III criteria.

Evaluation of risk factors for obesity among HIV positive adults on antiretroviral therapy in Delta State, Nigeria

Evaluation of risk factors for obesity among HIV positive adults on antiretroviral therapy in Delta State, Nigeria

Assessment of drug therapy problems in pediatric patients using Cipolle/Morley/strand classification: A hospital based study

Drug plays an important role in treating diseases and improving health. However, inappropriate drug use can lead to the occurrence of drug-Therapy problems (DTPs). According to Cipolle/Morley/Strand classification DTPs are any undesirable event experienced by the patient that involves or is suspected to involve drug therapy and that actually or potentially interferes with a desired patient outcome. The purpose of this study was to assess the drug therapy problems in a pediatric ward of Srinivas institute of medical science and research centre and to identify associated factors for drug therapy problems. A retrospective observational study was carried out to assess drug therapy problems (DTPs) in paediatric patients using Cipolle/Morley/Strand classification from January to June 2024. Ethical approval was obtained, and informed consent was signed by each study participant's parent before the commencement of the study. All paediatric out patients and patients admitted to the paediatric ward during the study period were included in the study. Data were collected through medical record reviews of patients and using semi structured questionnaire. Data was analysed using Microsoft Excel. The participants mean age was 2.32 years. Among 150 patients, 116 (77.33%) of them had at least one drug therapy problem per patient which indicates that the prevalence of the drug therapy problem was substantially high. On the other hand, Adverse drug reaction was the least 4 (3.38%) drug therapy problem. Hence to ensure optimum care in paediatric patients, a targeted approach is essential. Thus, the present study concluded that pharmacists can be helpful in the identification of the drug therapy problems, their causes and the risk factors involved and thus lead to a better health care outcome.

Evaluation of serum apolipoprotein concentrations and atherogenic indices in menopausal and premenopausal women in Nkwelle-Ezunaka

Background of study: The hormonal change in menopause affects lipid metabolism which could lead to dyslipidaemia, a risk factor for cardiovascular disease. Aim of study: To evaluate the levels of apolipoprotein A1, apolipoprotein B, Castelli risk index-1, Castelli risk index-11, atherogenic index of plasma and atherogenic coefficient in menopausal and premenopausal women. Materials and Methods: In this cross-sectional study ninety females were selected which consisted of 45 premenopausal, and 45 menopausal women using simple random sampling technique. Levels of apolipoprotein A1 and B were determined spectrophotometrically using enzyme linked immunosorbent assay (ELISA). Atherogenic indices were calculated with their respective formulas. Results: There was no significant difference in the mean levels of apo B (134.83±28.90 vs 130.73±30.55; p>0.05), apo A1, atherogenic index of plasma, Castelli risk index-1, Castelli risk index-11 and atherogenic coefficient in the menopausal women compared with the premenopausal women but the mean values of both groups were outside the normal range of apo B, Castelli risk index-1, atherogenic index of plasma and atherogenic coefficient. Conclusion: Apo B, atherogenic index of plasma, Castelli risk index-1 and atherogenic coefficient are better indicators of cardiovascular risk.

Cardiovascular disease risk reduction for all-cause mortality benefit in low-risk individuals

Background: Current recommendations for the primary prevention of cardiovascular disease (CVD) are based solely on 10-year CVD risk assessment. However, CVD mortality is not compared with all-cause mortality, which could provide insights into the potential benefits of CVD risk interventions on overall mortality. Methods: CVD risk for average American white and black males and females is calculated using the 2013 American Heart Association equations. CVD death risk is determined by combining CVD risk with the death rate following a CVD diagnosis. This CVD death risk is then compared with all-cause mortality data from National Vital Statistics Reports. A larger ratio indicates that most deaths are attributed to CVD, suggesting that intervention may be more beneficial. Results: The CVD mortality ratio is highest for white men and lowest for black men, indicating that white male likely to benefit most from CVD risk modification, while black males will benefit the least. Additionally, the ratio, and the potential benefit, decreases with age for all groups, especially after the age of 70. Conclusion: For the average U.S. population without a CVD diagnosis, the potential mortality benefit from interventions targeting CVD risk factors varies significantly based on patient characteristics such as race, age, and gender. The potential benefit is greatest for white males and decreases with age for all groups.

Exploring the impact of obesity and community health programs on enhancing endometrial cancer detection among low-income and native American women through a public health lens

This review examines the intricate relationship between obesity, endometrial cancer detection, and the role of community health programs, with a particular focus on low-income and Native American populations. Obesity is identified as a significant modifiable risk factor for endometrial cancer, disproportionately affecting vulnerable communities, which exacerbates existing health disparities. The paper explores the epidemiological link between obesity and endometrial cancer, highlighting disparities in detection and the compounded risks faced by underserved populations. It also reviews the effectiveness of public health initiatives aimed at improving cancer screening rates and obesity prevention among these groups. Despite the progress made through various community health programs, substantial gaps remain, particularly in ensuring culturally competent, accessible, and sustainable care. A lack of longitudinal studies evaluating the long-term impact of these programs on cancer detection and obesity management underscores the need for more robust research. Additionally, social, psychological, and systemic barriers continue to hinder screening uptake, further perpetuating health inequities. This review concludes by emphasizing the need for integrated public health approaches that combine obesity prevention with cancer screening, as well as policy reforms to enhance healthcare access and provider availability in underserved communities. Recommendations are provided for future research that addresses these gaps, with the goal of improving early detection and overall health outcomes for low-income and Native American women.

Correlation of obesity indices with metabolic syndrome among Igbos in Enugu and their optimal cut-off points

Background: Metabolic syndrome also known as insulin resistance syndrome or Syndrome X, represents an association of risk factors for cardiovascular disease and type 2 diabetes mellitus. Its central diagnostic criteria include obesity, impaired fasting glucose, low HDL-cholesterol; elevated triglycerides levels and high blood pressure. Insulin resistance is believed to be the main cause of Metabolic Syndrome and is connected to the level of visceral or intra-abdominal adipose tissue, which could be assessed either by calculating body mass index or by measuring waist circumference. Objectives: This study aimed at determining the correlation of indices of obesity with metabolic syndrome among Igbos in Enugu and their optimal cut-off points. Method: This was a cross-sectional community-based descriptive survey carried out in Enugu Metropolis involving 469 apparently healthy adult volunteers age range 18-75 screened for metabolic syndrome using the Joint Interim Statement definition. Stratified random sampling technique was used in the selection of participants. The data obtained were coded and analyzed into percentages, mean and standard deviation using the Statistical Package for Social Sciences (SPSS), version 23. t-test was used to compare continuous variables for associations, while Youden index and Receiver Operating Characteristic analysis were used to determine optimal cut-off point of the obesity indices that best balances sensitivity and specificity of the obesity indices. Pearson correlation coefficient was used to examine correlation between obesity indices and cardiovascular risks. Statistical significance is set at p< 0.05 and 95% confidence interval. Result: The study revealed that all indices of obesity showed positive correlation with metabolic syndrome. BMI showed the least strength of correlation while WC is the best discriminator for predicting Metabolic Syndrome however, the optimal cut-off point of the obesity indices differ from the standard cut-off points. Conclusion: All the obesity indices used in the study showed positive correlation with metabolic syndrome however, WC is to be preferred in screening for metabolic syndrome. The optimal cut-off point obtained can be applied specifically for Igbos in Enugu

The association of osteoarthritis with metabolic disorders

Osteoarthritis (OA) is the most common form of synovial joint arthritis that causes chronic pain and disability to a large number of people worldwide. Most often, osteoarthritis affects the joints of the knees, hips, spine and hands. The Global Burden of Disease (GBD, 2021) estimates that osteoarthritis will be the fourth leading cause of disability by 2030, with enormous healthcare costs for treatment, as well as significant indirect costs due to loss of productivity and premature retirement. The aim of our research is to determine in what way prevalent metabolic syndrome is among participants with osteoarthritis of one of the synovial joints (knees, hips, hands), and whether metabolic disorders are a risk factor for the development and worsening of osteoarthritis. A prospective clinical study was conducted at the Public Health Institution Health Center Živinice, from July 2022 to May 2024, on a random sample of 200 participants with a confirmed clinical diagnosis of osteoarthritis (OA), who were divided into a group with metabolic syndrome and a group without metabolic syndrome based on the NCEP ATP III panel criteria for metabolic syndrome. The prevalence of knee osteoarthritis is significantly higher compared to the prevalence of hip and hand osteoarthritis, and it is greater among participants with a higher BMI (in participants with the highest BMI, knee osteoarthritis occurs with a 100% probability) and with the presence of metabolic syndrome, especially in more severe forms, specifically radiologically confirmed osteoarthritis, regardless of age and gender. Unlike OA knees the prevalence of OA hips and hands shows no correlation with BMI and metabolic syndrome. Multiple comparative analysis of differences in the average severity of osteoarthritis of the knee of subjects with normal glycemia / prediabetes / diabetes type 2 it showed a statistically significant difference in the average severity of knee osteoarthritis in subjects with regular blood sugar compared to subjects with prediabetes/diabetes mellitus type 2 regardless of age and gender. This means that with an increase in blood sugar levels, the degree of severity of osteoarthritis of the knee increases, since each subsequent Group has a higher average value of this indicator (p<0.05; CI 95%).

Clinical and Demographic Profile of Syrian Patients with Malignant Glioma: A Six-Month Retrospective Analysis

This study presents a retrospective analysis of glioblastoma cases admitted to Tishreen University Hospital in Lattakia, Syria, between February and August 2024. The study examines the several potential risk factors including age, sex, genetic predispositions, and lifestyle factors such as smoking and alcohol consumption. It also explores the most commonly encountered tumor grade and the presence of various neurological symptoms, as well as treatment outcomes. A total of 30 glioblastoma were enrolled in this study, 63% of which were males, and the highest age incidence was between 40 and 50 years. Only 6% had a family history of glioblastoma, and 66% of the patients were smokers. Memory disorders, visual impairments, and headaches were common symptoms, with 100% of the patients reporting nausea and vomiting. Glioblastoma diagnosis was primarily established through MRI with contrast (76%), and the predominant treatment modality was surgery combined with radiotherapy and chemotherapy (80%). Post-treatment relapse occurred in 26% of the patients, with a median remission period of four months. These findings provide important insights into the clinical characteristics and treatment outcomes of glioblastoma patients in this region.

РЕГИОНАЛЬНЫЙ МОНИТОРИНГ ФАКТОРОВ РИСКА РАЗВИТИЯ ХРОНИЧЕСКИХ НЕИНФЕКЦИОННЫХ ЗАБОЛЕВАНИЙ ПОСЛЕ ПЕРЕНЕСЕННОГО COVID-19

Annotation. Chronic non-communicable diseases (NCD) represent a major public health problem in recent decades. NCD kill 41 million people annually, accounting for 74% of all deaths worldwide. WHO predicts that the total number of deaths from NCD will rise to 55 million by 2030 unless drastic measures are taken. Cardiovascular disease, cancer, chronic respiratory disease and diabetes are the four leading causes of premature mortality among NCD. Multimorbidity affects 65% of people over 65 years of age, requiring more patient-centred and complex models of care. The aim of the study was to conduct regional monitoring of risk factors for chronic noncommunicable diseases in geriatric patients. Outpatient charts of 152 patients aged 60 years and older who had undergone COVID-9 and had undergone an in-depth adult check-up were used for the study. The average age of the patients who underwent the dispensary was 70.0±5.7 years. Questionnaire survey of 152 patients aged 65 years and older to identify NCD and senile asthenia showed that the highest proportion of patients had risk factors for cardiovascular diseases - 63.2%, osteoporosis - 40.8%, GI diseases - 28%, senile asthenia - 27% and polypragmasia - 20.4%. 32.2% of respondents noted a decrease in memory, perception of material, impaired comprehension, loss of ability to distribute time, 30.9% experienced a decrease in mood, loss of energy, depressive state, 24.3% each experienced vision and hearing problems that impair the quality of life, and 22.4% of persons over 65 experienced difficulty in walking. Based on the results of the study, data collection modules based on the STEPS system were identified for the step-by-step assessment of risk factors for the development of chronic non-communicable diseases, and a model for a comprehensive approach to improving the health of citizens aged 60 years and older, who have the highest risk of developing NCD, was proposed.

The impact of anemia on prolonged ventilator use in critically ill patients: A literature review

Anemia is a common condition associated with critically ill patients admitted to intensive care unit (ICU), where 60% of ICU patients experience anemia and 61% of anemic and tranfused patients present in the ICU require mechanical ventilation. The presence of anemia in critically ill patients is associated with increased risk of mortality, cardiovascular morbidity, and decreased oxygen-carrying capacity, potentially prolonging the need for mechanical ventilation. Mechanical ventilation is the primary method of supporting organ function for patients receiving treatment in the ICU. According to epidemiological studies, up to 70% of patients hospitalized to the ICU require mechanical ventilation at some time during their stay. Studies regarding the correlation between anemia and the length of ventilator use are rarely known. Therefore, researchers are interested in conducting research on the correlation between anemia and length of ventilator use. This review is expected to be useful for enriching knowledge about the relationship between anemia and length of ventilator use in critically ill patients. However, further research is needed with more comprehensive variables to determine the impact of anemia on prolonged ventilator use, risk factors of weaning failure, pathogenesis of anemia, and treatment used in critically ill patients.

The role of metformin in modulating cardiometabolic risk in obese pediatric populations with metabolic syndrome: A systematic review

Introduction: Obesity significantly increases the risk of developing cardiometabolic complications, which are precursors to cardiovascular diseases (CVD). In children and adolescents, metabolic dysfunctions such as insulin resistance, dyslipidemia, and hypertension are key contributors to early-onset cardiovascular risk. Metformin, a well-established antidiabetic agent, has shown potential benefits in addressing these metabolic imbalances. However, the long-term impact of metformin on cardiovascular outcomes in obese pediatric patients remains unclear. Aim: This systematic review aims to evaluate the effect of metformin on cardiometabolic parameters in obese children and adolescents with metabolic syndrome, focusing on insulin sensitivity, body mass index (BMI), blood pressure, and lipid profiles. Methods: A systematic review was conducted by searching databases including PubMed, Cochrane Library, Embase, and Web of Science. The inclusion criteria targeted randomized controlled trials (RCTs), cohort studies, systematic reviews, and meta-analyses published between 2004 and 2024. Pediatric patients aged 6-18 years with obesity and metabolic syndrome were included. The primary outcomes assessed were BMI, insulin sensitivity, lipid profiles, blood pressure, and cardiovascular outcomes. Results: A total of 23 studies, including 10 RCTs and 1 meta-analysis, were reviewed, involving 777 patients. Metformin demonstrated consistent improvements in insulin sensitivity and BMI in obese children and adolescents. Several studies reported modest reductions in BMI, improved insulin resistance, and better lipid profiles. However, variability in results was observed regarding long-term cardiovascular outcomes. While metformin reduced systolic blood pressure and carotid intimal-medial thickness (CIMT), the long-term impact on preventing major cardiovascular events remained inconclusive. Discussion: Metformin’s benefits on cardiometabolic risk factors in obese children are primarily attributed to its effects on insulin sensitivity, lipid metabolism, and inflammatory pathways. Its ability to activate AMP-activated protein kinase (AMPK) leads to improved metabolic profiles and reduced inflammation and is crucial for mitigating obesity-related cardiovascular risks. Despite these positive effects, the evidence for long-term prevention of cardiovascular events is limited and requires further exploration. Conclusions: Metformin offers significant short-term benefits in improving BMI, insulin sensitivity, and cardiometabolic parameters in obese children and adolescents. However, its long-term efficacy in preventing cardiovascular events remains uncertain. Further studies are necessary to establish its role in long-term cardiovascular protection in pediatric populations

Clinical profiles and outcomes of dengue fever in hospitalized patients: Insights from Purbanchal University Teaching Hospital

Background: Dengue is a mosquito-borne viral infection that poses a significant health threat, particularly in tropical and subtropical regions. This study aims to assess the risk factors and clinical outcomes of dengue fever in hospitalized patients. Methods: This prospective observational study included 110 patients admitted to Purbanchal University Teaching Hospital between May 2023 and July 2024. Patients were classified into three groups based on clinical and laboratory findings: Group I (Dengue without Warning Signs), Group II (Dengue with Warning Signs), and Group III (Severe Dengue). Clinical history and physical examination data were recorded, and various laboratory tests were conducted. Results: Of the 110 patients, 80.9% were classified as Group II, 15.4% as Group I, and 3.7% as Group III. The majority of patients were male, with a male-to-female ratio of 5:1. The mean age of patients in Groups I, II, and III was 29±6.45, 33.3±9.6, and 25±1.8 years, respectively. All patients experienced sudden onset fever, with varying patterns of fever. Common symptoms included headache (100%), myalgia (96%), and gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. Organomegaly was observed predominantly in Group III patients. Conclusion: This study highlights the importance of recognizing clinical profiles and laboratory findings in diagnosing dengue early to reduce morbidity and mortality associated with severe forms of the disease.