High Prevalence Research Articles

Association Between Functional Dyspepsia and Binge Eating Disorder: A Frequent, Often Overlooked Overlap Clinical Presentation.

This study aims to investigate the association between Binge Eating Disorder and functional dyspepsia in a Mexican population, focusing on symptomatology and demographic characteristics. We conducted a cross-sectional study on 1016 subjects, evaluating binge eating disorder (BED) and functional dyspepsia based on the Rome IV criteria. Data collection included sociodemographic information, gastrointestinal symptom severity, and anxiety/depression screening using validated tools. A multivariate logistic regression analysis with the χ2 test was conducted for comparison analysis. The prevalence of dyspepsia in BED was 53.6% (95% CI, 46-56). Postprandial fullness (OR, 1.52; 95% CI, 1.06-2.17; P = 0.021) and overlap syndrome (OR, 1.80; 95% CI, 1.25-2.60; P = 0.002) were significantly associated with BED. Patients with BED also presented more severe postprandial distress syndrome (P = 0.027). Anxiety was prevalent in BED patients, while depression was more prominent in patients with BED and dyspepsia overlap. BED patients have a high prevalence of dyspepsia with an association between postprandial fullness and this eating disorder. BED appears to be more prevalent in younger individuals and males. These findings underscore the importance of considering dyspepsia in the management of BED and highlight the need for further research on this association.

Unveiling Hepatitis C: Causes, Impact and advances in treatment

Hepatitis C Virus (HCV) infection continues to pose a major global health issue, with around 58 million chronic cases reported worldwide and about 1.5 million new infections each year. This virus is a primary contributor to chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC), leading to approximately 290,000 deaths annually (WHO, 2022). The introduction of direct-acting antiviral (DAA) therapies has transformed HCV treatment, with sustained virologic response (SVR) rates surpassing 95% across various genotypes. However, challenges remain in meeting the World Health Organization's target of eliminating HCV as a public health threat by 2030. Key obstacles include low diagnosis rates, as only 21% of those infected with HCV are aware of their condition, and restricted access to treatment, especially in low- and middle-income countries (LMICs). This article reviews the latest epidemiological trends related to HCV, focusing on the disparities in disease burden and access to healthcare. It discusses innovative diagnostic methods, such as point-of-care testing, and emphasizes the importance of universal screening programs in areas with high prevalence. Additionally, we look at new therapeutic strategies, including pan-genotypic DAAs and their effects on marginalized communities. Lastly, we examine public health initiatives aimed at enhancing HCV prevention, such as harm reduction programs and vaccination efforts for co-infections like hepatitis B. By integrating findings from recent studies and reports, this article highlights the necessity for collaborative global efforts to address the challenges of HCV elimination. Strategies that emphasize prevention, early detection, and fair access to treatment are crucial for alleviating the HCV disease burden and reaching elimination goals.

Use of biomarkers in the early detection of Alzheimer’s disease

In 1906, Alois Alzheimer described the disease bearing his name, a progressive neurodegenerative pathology with high prevalence. This condition is characterized by progressive cognitive impairment, particularly memory loss, resulting from the degeneration and death of neurons in cortical and subcortical regions. Late diagnosis remains one of the main factors negatively impacting the prognosis of patients with Alzheimer’s disease (AD). Evidence from studies using positron emission tomography (PET) and cerebrospinal fluid (CSF) analysis indicates that neuropathological changes associated with AD begin up to 20 years before the onset of clinical symptoms. This study aims to present the growing role of biomarkers in the early detection of Alzheimer’s disease, emphasizing their importance in identifying early pathological changes before the appearance of clinical symptoms. This review seeks to investigate the use of biomarkers in the early detection of Alzheimer’s disease, focusing on articles from the last five years, both national and international. The methodology will be conducted systematically and structurally. The development of biomarkers for Alzheimer’s disease has advanced considerably, providing essential tools for the prevention, diagnosis, and monitoring of disease progression. Among the most studied biomarkers are Beta-Amyloid and phosphorylated Tau protein, which serve as biological indicators of the underlying pathological processes of the disease. These biomarkers can be measured objectively; however, obtaining this information often requires invasive methods, such as the collection of cerebrospinal fluid (CSF) to quantify protein levels. Phosphorylated Tau protein (p-tau), for instance, has proven particularly useful when combined with other biomarkers, offering a more accurate evaluation of the pathology. The integration of protein, genetic, and lipid biomarkers, together with new measurement platforms, will likely be essential in transforming the clinical approach to AD, providing a more comprehensive understanding of the disease from its early stages to its more advanced phases.

Prevalence and determinants of intestinal parasitic infection among primary school children in Iraq 2022

Introduction: Intestinal parasitic infections are still common in developing countries including Iraq, particularly in children. They are mostly associated with unsafe, low-quality drinking water and poor personal and environmental sanitation. Objective: To determine the prevalence and risk factors of intestinal parasitic infection among primary school children. Methods: A cross-sectional study was conducted on 450 primary school students selected randomly using a stratified sampling technique. The list of all students from grades 1–6 was arranged alphabetically and served as a sampling frame. In this study, undertaken between September 2021 and March 2022 A structured questionnaire was used together with data on environmental, socio-demographic and behavioural factors. Stool specimens were collected from all study subjects and were examined for intestinal parasites using direct smear (mount examination) and Formal-ether concentration techniques. Results: Among 450 primary school children 60% (268) had intestinal parasites. Male: Female ratio is 1:1. Most infected children were from rural areas (63.1%), students whose mothers were housewives (72.4%), and about half of the parents had primary or intermediate educational levels. Enterobiusvermicularis was the most common intestinal helminth infection (27.6%), whereas Entamoebahistolytica was the most common protozoa infection (16.4%). On applying binary logistic regression analysis, rural residence of the students, not enough family income, Conclusion: low educational level of the mothers, Poor hand washing practice before eating, after playing outside and hand washing without soap and similar material, poor hygienic facilities like faulty sewage carriage system at school, sharing the same bed, mixed sources of drinking water were the sole factors significantly associated with increased odds of high prevalence of intestinal parasitic infection among primary school children.

Assessment of serum levels of 8-hydroxy-2’ deoxyguanosine and f2-isoprostanes in newly diagnosed adult hypertensive with clinical depression in NAUTH, Nnewi, Nigeria

Despite the high prevalence of depression and hypertension, the relationship between the two diseases has received little attention. The potential roles of some biomarkes of oxidative stress in disease progression and management is very crucial. Aim: The present study therefore, evaluated the serum levels of 8-hydroxy-2’ deoxyguanosine (8-OHdG) and F-2 isoprostanes in newly diagnosed hypertensive individuals with and without depression at Nnamdi Azikiwe University Teaching Hospital, Nnewi. Method: This was a cross sectional study carried out on randomly selected 121 consented adult male and female participants within the ages of 18-65 years which comprises 30 newly diagnosed hypertensive individuals without depression (Hypertensive), 31 hypertensive individuals with depression selected from the department of internal medicine. 30 non hypertensive with depression (Depressive) and 30 apparently healthy non-hypertensive individuals without depression which served as control selected among the hospital staff. Their bio-data was obtained from their hospital records. 3 ml of venous blood were collected from each of the participants, dispensed into a plain container, centrifuged and serum separated into another container and stored at -20 0C for the assessment of serum 8-OHdG using Enzyme Linked Immunosorbent Assay (ELISA) Method. Result: The result showed that Hypertensive individuals with and without clinical depression (107.08±22.05, 129.16±82.49) had significantly higher serum level of 8-OHdG when compared with control group (53.95±28.25) (P<0.05 respectively). Hypertensive individuals (129.16±82.49) also had significantly higher 8-OHdG level when compared with non-hypertensive with depression (63.31±37.30) (P<0.05). Hypertensive individuals with depression (9.94±7.14) and depressive individuals (8.99±5.84) also had significantly higher F2-Isoprostanes level when compared with control (5.15±1.47) (P<0.05 respectively). There was a moderately strong positive correlation between 8-OHdG level and body mass index in both hypertensive and depressive individuals (r=0.682, P<0.05). Conclusion: The study observed higher 8-OHdG and F2-Isoprostanes in individuals with hypertension with and without clinical depression. In addition, there is evidence that oxidative stress is related to inflammation and endothelial activation in individuals with both conditions leading to disease severity.

Depression and antidepressant use among Iraqi doctors, an investigative study using beck depression inventory

Introduction: Doctors are more likely to experience depression because they are subjected to more stress at work than members of many other professions. Long hours, heavy workloads, increasing severity and difficulty of the work and ongoing patient interaction with illness and emergencies, high level of accountability, fast shift within healthcare, organizational limitations such as discriminatory practices and intimidation a lack of independence, inadequate assistance, a decrease in job satisfaction, low morale, and an inability to handle personal responsibilities are just some of the stresses that healthcare workers face. Objectives: The present study aims to evaluate the prevalence of depression and antidepressant utilization among Iraqi doctors, an investigative study using the Beck Depression Inventory. Method: This is a cross-sectional study with a convenience sample conducted on Iraq's medical population using a multi-item questionnaire over 6 months (March – September 2022). Beck's Depression Inventory was used, which contains 21 questions. We used this scale to screen for depression based on self-report. The answers were collected by an online questionnaire that was aimed at the medical population. The test link was distributed amongst doctors groups and answers were limited to one response. Results: The results revealed that there was a high prevalence of depression and use of antidepressants among Iraqi doctors Conclusion: Due to the stressful nature of their line of work, doctors have a higher risk of developing depression and are more likely to seek treatment with antidepressants.

Inadequate Therapy Response on Advanced Therapy in Ulcerative Colitis Adult Patients: A Retrospective Analysis of German Health Claims Data.

The treatment landscape for active ulcerative colitis is rapidly evolving and current real-world evidence on response to advanced therapy is limited. This study aimed to determine indicators of inadequate therapeutic response among patients with ulcerative colitis in Germany initiating advanced therapy. This retrospective analysis used German claims data (2015-2022) from adult patients (≥18years). The prevalence and incidence of ulcerative colitis (ICD-10-GM: K51.X) were estimated. Inadequate response to therapy was evaluated in patients initiating advanced therapy based on eight predefined indicators observed for 12months following dispensation of index treatment. Mean ulcerative colitis patient age in 2016-2022 ranged from 49.6 to 51.5years, 47.6%-48.3% were female. Administrative prevalence ranged from 0.45% in 2016 to 0.53% in 2022. The number of patients initiating advanced treatment ranged from 157 to 347 across the study years (3.2%-4.9% of overall treated study population). On average from 2016-2021, 78.8% had inadequate response in the 12months following index treatment. Common indicators included prolonged use of corticosteroids (46.2%) and augmentation with conventional therapies (43.9%). Adult ulcerative colitis patients showed a high prevalence of inadequate response to advanced therapies. Our findings reveal a need for improved UC advanced therapy options, providing insight into inadequate response patterns. This may help identify patients who could benefit from a change in therapy to improve long-term outcomes.

Anxiety Disorders, Anxious Symptomology and Related Behaviors Associated With Migraine: A Narrative Review of Prevalence and Impact.

The purpose of this study was to review the literature on the relationship between migraine, anxiety and related disorders, anxious symptomology and related behaviors. Generalized anxiety, other anxious disorders and migraine are comorbid. In addition, anxious symptomology and behaviors are common in people with migraine even if they do not meet diagnostic criteria or threshold. Anxiety including diagnosed disorders such as generalized anxiety, phobias, panic disorder, as well as behaviors such as catastrophizing, avoidance behaviors, and higher fear of headache/migraine or anxiety sensitivity are comorbid and/or common in migraine. Anxiety is associated with negative outcomes such as migraine progression, medication overuse, stigma and migraine-related disability. The association between migraine, anxiety, and fear and avoidance behaviors has an extensive empirical basis. Awareness of the high prevalence of comorbidity and symptomology as well as the negative outcomes associated with anxiety and related symptoms and behaviors is important in the comprehensive management of people with migraine. Better understanding the relationship between migraine and anxiety symptoms and behaviors and their effects on outcomes is essential to provide more effective treatment for people with migraine. The review emphasizes the necessity of screening and more comprehensive evaluation in patients with migraine using psychological diagnostic tools. Thus, prevention and management of anxiety, fear, and anxiety-related behaviors in the context of migraine management may be considered an essential treatment goal and strategies may include non-pharmacological and pharmacological approaches.

Molecular epidemiology of chicken and turkey parvovirus in Turkiye: high risk, genetic recombination signals, and first complete genome analysis.

The aim of this study was to detect chicken parvovirus (ChPV) and turkey parvovirus (TuPV) on Turkish poultry farms and examine the molecular epidemiology of these viruses. In 2023, a total of 1,060 fecal samples were collected from 76 broiler farms and 30 turkey farms across various regions of Turkiye. The overall positivity rate was 72.3% (55/76) in broiler flocks and 70% (21/30) in turkey flocks. Among these, the positivity rate was 35% (7/20) in birds showing no signs of enteritis. The findings of this study suggest that, depending on the genetic variability of regional strains or the viral load, nested-PCR-based methods may prove more effective than single-step PCR for detecting ChPV and TuPV cases. Therefore, it is recommended to incorporate nested PCR in molecular epidemiological studies to minimize the risk of overlooking positive cases. Phylogenetic analysis of the VP1, VP2, and complete genome sequences of TUR/2023/ChPV and TR/2023/TuPV revealed that both strains clustered with American strains in distinct lineages. Analysis using the recombination detection programs RDP4.0 and SimPlot 3.5.1 strongly suggested that TUR/2023/ChPV may be a recombinant of strains from China and Brazil. Despite the observed genetic variability in the VP2 protein, an examination of B-cell epitopes showed a high degree of similarity between ChPV and TuPV strains. This study represents the first documentation of the emergence and prevalence of TuPVs in Turkiye, providing complete genome sequences for both ChPV and TuPV. Given the high prevalence and genetic diversity of these viruses and their presence in clinically asymptomatic birds, it is crucial for stakeholders in the poultry industry to implement regular flock screenings for these and similar viral pathogens. Proactive measures like these are essential for mitigating the economic impact of these important pathogens and developing effective preventive strategies.

The mediating role of coping strategies in the relationship between illness perception and quality of life among hashish users

Purpose Hashish consumption is one of the most widespread public health concerns due to its extensive use and high prevalence. This study aims to investigate the association between illness perception and quality of life among hashish users, while also assessing the mediating role of coping strategies. Design/methodology/approach Male hashish users’ with a mean age of 37.9 years (SD = 12.3) were screened from public and private addiction and rehabilitation centers in Districts Peshawar, Kohat and Karak. Data were collected through the Brief Illness Perception Questionnaire, the World Health Organization Quality of Life scale and the Brief Cope scale to assess illness perception, quality of life and coping strategies. Stepwise regression and mediation analysis were performed. Findings The findings suggest that illness perception has a significant reverse association with quality of life (r = −0.16, p < 0.01). However, coping strategies have a significantly positive association with quality of life (r = 0.51, p < 0.01) while subcategories, that is, problem-focused, emotion-focused and active avoidance coping were not significantly associated with quality of life. Practical implications Lower quality of life increases vulnerability to illness perception, and effective coping strategies improve quality of life. This study emphasizes the importance of addressing illness perception and enhancing coping strategies in interventions aimed at improving the quality of life for hashish users. Originality/value This novel view provide valuable insights for developing targeted interventions that enhance the well-being of hashish users by addressing both their psychological and behavioral aspects.

The prevalence of PD-L1 expression in patients with advanced oesophageal cancer: the EXCEED observational study

AimsThere are limited data on programmed death ligand 1 (PD-L1) expression in oesophageal cancer (OC) from multicentre studies conducted across China. We aimed to determine the prevalence of high PD-L1...

Can hearing screening criteria at general health checkups be an indirect indicator of frailty and cognitive deficit in the older population? - with prevalence estimates based on updated World Health Organization hearing loss classification.

This study aimed to reestimate the prevalence of hearing loss based on the updated World Health Organization hearing loss classification and investigate whether existing hearing screening criteria could efficiently screen for frailty or cognitive deficit. Data collected from community dwellers aged 40-91 years included 2325 samples. Health checkup hearing screening used were as follows: (A) 30 dB both at 1 and 4 kHz and (B) 30 dB at 1 kHz and 40 dB at 4 kHz were used. For participants aged ≥60 years, frailty according to the modified Cardiovascular Health Study criteria and cognitive deficit defined by a Mini-Mental State Examination score <28 were assessed. Logistic regression was performed to obtain odds ratios for frailty and cognitive deficit. The rates of hearing loss using the updated World Health Organization classification in men were 8.6, 24.1, 54.2, 79.0 and 96.0% in their 40s, 50s, 60s, 70s and 80s and 3.7, 12.7, 36.4, 72.1 and 90.4% in women, respectively. Failing hearing screening using criterion A was associated with an increased risk of frailty, a sex-adjusted odds ratio of 4.136 (95% confidence interval, 2.182-7.838) and an increased risk of cognitive deficit: 1.753 (95% confidence interval, 1.346-2.283). After adjusting for age and sex, the effects on frailty and cognitive deficit were no longer significant. The results were similar when criterion B was used. Because of the high prevalence of hearing loss and the ability to utilize existing devices and methodologies, hearing screening for the elderly should be reviewed. Geriatr Gerontol Int 2025; ••: ••-••.

The prevalence of food addiction and its association with type 2 diabetes: a systematic review with meta-analysis.

To determine the prevalence of FA in individuals with type 2 diabetes and to assess the association between FA and type 2 diabetes. MEDLINE, EMBASE, Web of Sciences, Latin American and Caribbean Literature in Health Sciences, ScienceDirect, Scopus, and PsycINFO were searched until November 2024. This study was registered with PROSPERO (CRD42023465903). Cross-sectional studies, case-control, cohorts, and clinical trials that were carried out with individuals with type 2 diabetes, regardless of age and sex, were included. The complete data extracted included the prevalence, odds ratio, and/or risk ratio of FA, the number of individuals evaluated, age, sex, weight, presence of comorbidities, age of participants, and FA symptoms. A pooled prevalence of FA of 30% (95% CI [18; 44] with estimated predictive interval [0; 85]; I2 = 99.51; 12 studies; 15947 participants) was identified. For the associations between FA and type 2 diabetes, we found a grouped crude odds ratio value of 2.35 (95%CI [1.71; 2.98]). The pooled odds ratio adjusted for age and sex was 2.60 (95% CI [1.77; 3.42]). Finally, the odds ratio adjusted for age, sex, and body mass index (BMI) was 2.01 (95%CI [1.39; 2.64]). The results of the meta-analyses showed a high prevalence of FA in individuals with type 2 diabetes and that the associations between these two conditions remained even after adjustment for age, sex, and BMI, although with a high heterogeneity among individual estimates.

Using Social Media to Promote Life Skills Among Adolescents: A Debate on Opportunities, Challenges, and Implications for Health and Education.

The digitalization of society increasingly blurs boundaries between analog and digital worlds, offering opportunities such as telemedicine and global connectivity through digital platforms. However, it also presents risks, including cyberbullying, addiction potential, harmful content, misinformation, and privacy concerns from data breaches and surveillance technologies. Social media, with its global reach, amplifies both opportunities for positive engagement and the responsibility to navigate largely unregulated content. Adolescents, due to their developing critical evaluation skills and high prevalence of mental health challenges, are particularly vulnerable in this space and must navigate the risks associated with social media while simultaneously leveraging it for essential developmental tasks, such as identity formation and building social connections. To support them in this challenge, we propose adapting the traditional life skills approach to address the challenges of social media use, empowering adolescents to navigate both digital and analog environments effectively. These life skills include critical thinking, communication, and managing emotions and stress - all of which are essential for navigating social media. Despite its complexities, social media offers a unique platform for health promotion and prevention interventions due to its wide accessibility and reach. It holds significant promise for adolescent health by providing information, motivation, and social support. However, evidence-based, youth-centered prevention strategies on these platforms are still in early development and require further research to ensure effectiveness. Prevention programs integrating proven behavior change techniques, aligning with the preferences and needs of adolescents, and teaching essential life skills can empower them to navigate digital and analog challenges effectively.

Jealousy or Abuse? Dispositional Mindfulness Helps Chinese College Students Understand and Save From Cyber Dating Abuse.

Technology advances lead to a high prevalence of cyber dating abuse among youth. Previous studies had demonstrated its detrimental outcomes and predictors, but neglected the characters in Eastern countries. Therefore, exploring the comprehensive mechanisms of cyber dating abuse in different cultures and mitigating it are necessary. The current study first recruited 242 participants (65.7% women, Mage = 20.79 years, SD = 1.89) through social media to revise a localized Cyber Dating Abuse Questionnaire. Then, we conducted a moderated mediation model with 300 participants (60.0% women, Mage = 20.92 years, SD = 1.86) recruited through snowball sampling to examine the utilities of anxious attachment, jealousy, and dispositional mindfulness on cyber dating abuse perpetration. The two samples were integrated to examine the prevalence of cyber dating abuse, including 542 Chinese college students who were in heterosexual relationships the past year. The results showed that both perpetrators and victims of cyber dating abuse were 48.5% respectively. Women reported more perpetration behaviors (men = 40.9%; women = 53.1%) and less victimization (men = 56.2%; women = 44.0%) than men. Jealousy mediated the association between anxious attachment and cyber dating abuse perpetration. Moreover, dispositional mindfulness, particularly its non-judgment facet, could be a protective factor. These findings underscored the commonalities and expanded theories in understanding cyber dating abuse, facilitating the development of preventive and interventive strategies. Future studies should focus on this phenomenon and provide more comprehensive protection and psychosocial education for youth and adolescents.

Challenges of poor sleep quality and mental health issues among Syrian medical residents in 22 major hospitals across Syria.

A nationwide survey in the USA reported that healthcare workers had the highest prevalence of short sleep duration compared with other professions. Moreover, several studies have reported poor sleep quality among healthcare professionals and described insufficient sleep as a potential driver of reduced physician well-being. This study aims to explore sleep quality and mental health issues among Syrian medical residents, with the goal of informing targeted interventions to enhance their well-being and professional performance. This cross-sectional study in Syria involved 2071 residents from 22 major hospitals. Conducted between 27 October 2023 and 4 April 2024, it used face-to-face interviews with validated questionnaires following STROBE guidelines. Hospitals were categorized for comparative analysis. Measures included demographics, Pittsburgh Sleep Quality Index, Patient Health Questionnaire for depression, and Generalized Anxiety Disorder 7-item. In a study involving 2071 hospital residents across Syria's major hospitals, significant findings reveal a high prevalence of poor sleep quality (67.7%), depressive symptoms (46%) and anxiety symptoms (42.2%). Analysis by hospital categories highlighted varied rates, with Damascus and Hama General Hospitals showing notably higher incidences. Females exhibited higher rates of depressive and anxiety symptoms compared with males, with predictors including gender, age and marital status. The relatively high prevalence of poor sleep quality, depressive symptoms and anxiety symptoms among Syrian medical residents necessitates proper action, which will probably include limits on work hours, to enhance mental health outcomes and ensure proper patient care.

Prevalence, predictors and selected outcomes of early sexual initiation among adolescents in secondary schools in Lugbe, Abuja, Nigeria: a mixed methods study

BackgroundEarly sexual initiation is the onset of sexual intercourse below 15 years. Despite many negative effects of early sexual initiation, its prevalence has kept increasing globally over the past decades.ObjectiveThis...

Synovial biomarkers in the diagnosis of post-traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries: protocol for a systematic review

IntroductionThis review aims to synthesise research evidence regarding biomarkers in the synovial fluid that may predict the risk of post-traumatic osteoarthritis (PTOA) in young adults. Considering the high prevalence of...

Proximal humerus fracture dislocations: outcomes of management.

Proximal humerus fracture dislocations are amongst the most severe proximal humerus injuries, presenting a challenging management problem. The aim of this study was to report on long-term outcomes of management of proximal humerus fracture dislocations. Patients with a proximal humerus fracture dislocation managed at a Level 1 trauma centre from January 2010 to December 2018 were included. Patients with isolated tuberosity fracture dislocations or pathological fractures were excluded. Outcome measures were the Oxford Shoulder Score (OSS), EQ-5D-5L, return to work and radiological outcomes. Complications recorded included further surgery, loss of position/fixation, non-union/malunion and avascular necrosis. Sixty-nine patients were included with a proximal humerus fracture dislocation in the study period; 48 underwent surgical management and 21 were managed successfully with closed reduction alone. The mean (SD) age of the cohort was 59.7 (±20.4), and 54% were male. Overall patients reported a mean OSS of 39.8 (±10.3), a mean EQ-5D utility score of 0.73 (±0.20), and 78% were able to return to work at a median of 1.2 months. There was a high prevalence of complications in both patients managed operatively or with closed reduction (25% and 38% respectively). In patients undergoing surgical management, 21% required subsequent surgery. Patient reported outcome measures post proximal humerus fracture dislocations do not return to normal population levels. Further, these injuries are associated with a high prevalence of complications. Appropriate patient counselling should be undertaken before embarking on definitive management.

High metabolic dysfunction-associated steatotic liver disease prevalence in type 2 diabetes: Urgent need for integrated screening and lifestyle intervention.

This letter discusses the recent study by Mukherjee et al, which identifies a significant prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) among newly diagnosed type 2 diabetes mellitus (T2DM) patients in Bihar, India, and underscores the pressing need for integrated MASLD management within T2DM care. With 72.3% of the study cohort affected by MASLD, implementing routine liver function tests and ultrasound screenings is recommended as a standard practice in diabetes care, especially in regions with high prevalence rates. The study also advocates for dietary and lifestyle modifications, particularly the reduction of saturated fats, to slow MASLD progression. Patient education on monitoring body mass index and waist circumference, coupled with the integration of these metrics into digital health records, could enhance patient involvement and support proactive health management. Moreover, the letter emphasizes the advantages of developing a region-specific MASLD risk model that incorporates local dietary patterns and socioeconomic factors. Continued research into genetic and environmental determinants of MASLD remains essential for advancing our understanding of its etiology and informing targeted public health strategies.