Peyronie's disease (PD) is a fibroproliferative disorder of the tunica albuginea characterized by localized plaque formation, penile curvature, and erectile dysfunction, most commonly affecting men between 40 and 70years of age. Although François Gigot de La Peyronie is credited with the first formal description of the disease in 1743, depictions of penile curvature predate his description by millennia. This review aims to provide a comprehensive understanding of the historical and contemporary evolution of therapeutic strategies for PD, highlighting the shift from anecdotal remedies to evidence-based approaches. PubMed, Cochrane, and Embase databases were searched without restrictions on publication date, using keywords related to PD and its therapies. Key interventions, including oral and topical agents, intralesional injections, penile traction therapy (PTT), and surgical techniques, were analyzed in the context of clinical trial data and guideline recommendations. Early therapeutic approaches focused on oral and topical agents, which failed to demonstrate consistent efficacy in randomized trials. Intralesional injection (ILI) therapy has emerged as a leading option for nonsurgical management, with collagenase Clostridium histolyticum (CCH) as the standard treatment supported by robust evidence of significant improvements in penile curvature. PTT has undergone considerable refinement, with second-generation devices yielding excellent outcomes, particularly when combined with CCH. Surgical intervention remains the gold standard for definitive treatment of severe or complex deformities. Technical modifications have developed, including the use of biologic grafts, inflatable prosthesis placement with manual modeling, and graftless techniques such as tunica expansion and auxetics. A review of the historical progression of PD management demonstrates the shift from anecdotal claims of treatment efficacy to evidence-based practice. Current guidelines recommend ILI and PTT as first-line nonsurgical management, with surgery providing exceptional outcomes. Future progress aims to gain a greater molecular understanding of fibrosis and tissue remodeling to foster targeted therapies.

This review explored the development and use of injectable medications for cardiovascular disease (CVD), focusing on adherence and persistence rates, as well as barriers and facilitators to their use from the perspectives of patients and healthcare professionals. A systematic search was conducted across Web of Science, Academic Search Complete, CINAHL, PubMed and Medline for English-language studies published between January 2005 and March 2025. Eligible studies included those examining injectable CVD therapies which reported on adherence and persistence metrics, and stakeholder perspectives on their use. A total of 54 studies were included. Reported adherence and persistence rates varied widely across therapies, with PCSK9 inhibitors (typically administered once every 2-4 weeks) and once-weekly GLP-1 receptor agonists generally associated with higher persistence compared to daily injectable regimens. Key barriers included injection-related discomfort, needle anxiety, side effects, cost and limited knowledge of healthcare professionals (i.e. physicians). Patients have highlighted emotional and physical concerns, while healthcare professionals emphasized the need for education and support. Injectable therapies may improve cardiovascular risk management, and are often dosed less frequently than oral formulations, offering advantages in terms of adherence. However, challenges remain. Addressing both psychological and structural barriers through enhancing healthcare professionals training, patient education and system-level support may help improve adherence rates and improve long-term outcomes.

Efficacy of conservative treatment strategies for partial distal biceps tendon ruptures: a case-control study.

To determine the association between the absence of an elevated temperature and mortality in dogs with septic peritonitis. This was a retrospective cohort study evaluating dogs treated surgically for septic peritonitis confirmed by abdominal effusion culture, cytology, or direct visualization intraoperatively at a private referral hospital (April 2022 to May 2025). Information collected included signalment, vitals, triage diagnostics, treatment timing (antibiotic administration, surgical intervention), diagnosis method, etiology, and survival. 22 of 60 dogs had elevated temperatures at presentation, 37 of 60 had a normal temperature, and 1 of 60 was hypothermic. The median Acute Patient Physiologic and Laboratory Evaluation (APPLEfast) score for all dogs was 23. There was no difference in APPLEfast score for dogs with or without elevated temperatures at presentation. The median time to injectable antibiotic therapy and surgical intervention for all dogs following presentation was 4 hours, with no difference between dogs with or without elevated temperatures. There was no significant correlation between temperature or APPLEfast score and time to injectable antibiotic therapy or time to surgery. Forty-nine of 60 dogs (82%) survived to discharge (18 of 22 [82%] with elevated temperature, 31 of 38 [82%] without elevated temperature). The absence of an elevated temperature, time to injectable antibiotic therapy, time to surgery, and APPLEfast score were not significantly associated with survival. Absence of an elevated temperature was not associated with mortality in dogs with septic peritonitis. In this study population, septic peritonitis carried an overall fair prognosis in dogs, but temperature at admission was not associated with mortality.

Articular cartilage lesions of the knee, ranging from focal defects to tricompartmental osteoarthritis, present significant clinical challenges because of cartilage's limited regenerative capacity. It is important to highlight modern surgical advancements in the treatment of chondral pathology beyond injection therapy, traditional osteotomies, and arthroplasty options. Surface- and cell-based repair techniques, including matrix-induced autologous chondrocyte implantation, offer improved long-term outcomes, with emerging fourth-generation variants facilitating single-stage arthroscopic implantation. Off-the-shelf cartilage repair strategies, such as particulated juvenile cartilage, micronized allografts, and viable cartilage allografts, represent promising alternatives that bypass the need for two-stage procedures. For osteochondral defects, osteochondral autograft transfer and fresh allograft transplantation remain the gold standard, although decellularized and cryopreserved viable allografts are under investigation. Recently approved artificial osteochondral scaffolds, such as Agili-C, offer an FDA-cleared, acellular biphasic implant with promising midterm results. For patients with malalignment-associated osteoarthritis, patient-specific instrumentation in high tibial and distal femoral osteotomies enhances accuracy, particularly in biplanar corrections, and reduces intraoperative variability. Novel load-sharing implants, such as fiber-reinforced rafting nails and the MISHA knee system, provide less invasive alternatives to osteotomy, showing early success in reducing medial compartment load and improving functional outcomes. There is an expanding arsenal of biologically and biomechanically innovative treatments for articular cartilage restoration and osteoarthritis management.

This retrospective observational investigation comprehensively compared cardiovascular event rates among individuals with Type 2 Diabetes Mellitus (T2DM) whose first injectable therapeutic regimen consisted of either premixed insulin or contemporary oral glucose-lowering medications, specifically sodium-glucose cotransporter-2 inhibitors (SGLT2i) or glucagon-like peptide-1 receptor agonists (GLP-1 RA). Data from 427 patients managed at a single center were critically analyzed from August 2024 to November 2025. The principal endpoint comprised a composite of heart failure hospitalization, non-fatal acute myocardial infarction, or non-fatal cerebrovascular accident. After statistical adjustment for baseline variables via propensity score matching, initiation of contemporary oral agents (n=142) was strongly associated with a substantially lower occurrence of the primary cardiovascular composite compared to initiation of premixed insulin (n=142) (12.0% versus 22.5%; Hazard Ratio: 0.48; 95% Confidence Interval: 0.29–0.79). This divergence was predominantly attributable to a profoundly pronounced decrease in hospitalizations for heart failure (3.5% versus 12.0%; Hazard Ratio: 0.28). Glycemic management, assessed by HbA1c reduction, was significantly more effective with contemporary oral agents, consistently accompanied by a markedly lower incidence of significant hypoglycemic episodes. These findings from clinical practice strongly indicate that selecting newer oral agents with clearly documented cardiometabolic advantages as the initial injectable therapy may reliably confer superior cardiovascular protection relative to traditional premixed insulin, offering a highly persuasive rationale for urgently reevaluating established therapeutic sequences.

Obesity is a global health crisis strongly linked to increased risk of type 2 diabetes, cardiovascular diseases, and other metabolic disorders. Glucagon-like peptide-1 (GLP-1) has emerged as an effective macromolecular therapeutic agent for weight management. This study addressed obesity management from three distinct perspectives: enhancing drug dispersion and bioavailability through a novel drug delivery device, extending drug half-life by developing sustained-release formulations, and sustaining the weight loss through implementation of structured dietary protocols. A new technology, micro-needle jet injection (MNJI) was developed to deliver both standard semaglutide formulations and highly viscous sustained-release formulations, achieving 100% subcutaneous delivery with predictable results. Modulation of MNJI parameters enabled the generation of various dispersion profiles, resulting in higher bioavailability compared to both needle injection (NI) and needle-free jet injection (NFJI). Sustained-release formulations, effectively administered via MNJI, exhibited higher bioavailability than the non-sustained release formulation, and positively impacted weight management efficacy in two distinct ways. First, a single injection achieved the same weight loss as five daily administrations of non-sustained release formulation. Second, a subsequent injection of the sustained-release formulations resulted in a further body weight reduction to 18%, contrasting sharply with the plateau at 13% observed in the standard formulation administered daily (p < 0.05). Finally, dietary management, particularly time-restricted feeding, successfully maintained weight loss at ∼18% below baseline levels. Collectively, the combination of MNJI delivered sustained-release formulations and structured dietary protocols offers a promising and patient-friendly strategy for long-term obesity management, improving both adherence and therapeutic outcomes.

Generally, task performance and cognitive function begin to decline from around the age of 80, and dementia prevalence rises steeply thereafter. Nevertheless, multiple daily injections (MDIs) are still prescribed for many patients aged ≥ 80. MDI can improve glycemic control compared with a single injection or none; however, the risks of hypoglycemia and adverse events also increase. Therefore, when considering MDI in very old adults, a comprehensive assessment of physical function, performance status, and cognition is essential. In patients with cognitive impairment, initiating therapy with a longacting insulin and gradually transitioning to MDI may enhance adherence. Above all, expansion of community and social resources is needed to support patients who cannot self-inject.

While vocal fold steroid injection (VFSI) is emerging as a therapeutic approach for vocal fold nodules (VFNs), its comparative efficacy relative to standard voice therapy remains unestablished. This study aimed to evaluate and contrast treatment findings between VFSI and voice therapy for VFNs. In a randomized controlled trial, 50 female patients with VFNs received either percutaneous intralesional triamcinolone injection or Accent method voice therapy. Serial evaluations-including videoendoscopic (nodule size, mucosal wave, glottic gap), subjective (auditory perceptual assessment, Voice Handicap Index), and objective (acoustic, aerodynamic) measures-were conducted at baseline and at 1 week and 1-, 2-, 3-, and 6-months post-treatment. Both groups demonstrated significant reductions in nodule size and improvements in mucosal wave patterns and glottic gaps over the 6 months (p < 0.05). Most subjective and objective measures also enhanced significantly in both groups over the same study period (p < 0.05). However, voice therapy outperformed VFSI in most parameters (videoendoscopic, subjective, and objective) by the end of the third month (p < 0.05) and in nodule size reduction by the sixth month (p = 0.049). VFSI is a rapid and reliable therapeutic solution for VFNs with outcomes comparable to voice therapy. Long-term data, however, demonstrate voice therapy better prevents nodule recurrence. Therefore, subsequent voice therapy or repeated injections may enhance the long-term efficacy of VFSI.

The use of anesthetics may cause damage to the human nervous system, leading to cognitive and motor dysfunction in severe cases. The role of lncRNAs in anesthesia-induced nerve injury have been reported, but their specific regulatory mechanism remains to be explored. By analyzing the GSE160299 and GSE235357 datasets, LINC01187 was screened as our target lncRNA. With the aid of bioinformatics methods, hsa-miR-6069 and IGF2BP3 were predicted as possible downstream molecules of LINC01187. Their expressions were detected by RT-qPCR or western blotting. The dual-luciferase reporter assay was used to determine the targeted association among them. The CCK-8, Annexin V/PI staining, and ROS detection kit were used to evaluate the viability, apoptosis, and oxidative damage of cells. The Rota-Rod and Morris water maze tests were used to measure the motor and learning abilities of rats. LINC01187 showed a low expression in propofol (PPF)- or ketamine (KTM)-treated human cortex neuron cells (hCNCs) and in the hippocampal tissues of KTM-treated rats. Overexpression therapy with LINC01187 alleviated the damage caused by KTM to the motor and learning abilities of rats. LINC01187 targeted hsa-miR-6069 and downregulated it. Hsa-miR-6069 inhibited IGF2BP3 expression by binding to its mRNA. The overexpression of LINC01187 rescued the viability decrease, apoptosis increase, and oxidative damage in PPF/KTM-induced hCNCs by inhibiting hsa-miR-6069 to promote IGF2BP3 expression. In conclusion, intrathecal injection therapy of the LINC01187 vector restored the impairment of motor and learning abilities in KTM-treated rats. LINC01187 protected nerve cells and rats from anesthetic-induced impairment by regulating the hsa-miR-6069/IGF2BP3 axis.

BACKGROUNDFunctional gastrointestinal disorders (FGIDs) are common gastrointestinal conditions that significantly impair patient quality of life. Current clinical treatment methods are relatively limited, making the search for more effective therapeutic strategies critically important. Latent myofascial trigger points (MTrPs) injection, as an emerging minimally invasive treatment method, has shown potential in alleviating muscle pain and improving function, but its application in FGIDs remains insufficiently validated.AIMTo assess improvements in gastrointestinal symptom severity, quality of life indices, and treatment-related adverse events between the two therapeutic approaches.METHODSThis single-blind randomized controlled study recruited 60 FGIDs patients from Qilu Hospital of Shandong University, randomly divided into an injection group (TI group) and an oral medication group (PO group) at a 1:1 ratio. The TI group received abdominal wall latent MTrPs injection therapy, while the PO group received oral symptomatic medication treatment. Primary outcome measures were gastrointestinal symptom severity scores (Gastrointestinal Symptom Rating Scale, Irritable Bowel Syndrome Severity Scoring System scales) at 2 weeks and 4 weeks after treatment completion. Secondary outcome measures included Gastrointestinal Quality of Life Index scores. Both groups underwent rigorous follow-up and assessment.RESULTSThe TI group is anticipated to significantly outperform the PO group in gastrointestinal symptom relief and quality of life improvement. TI group patients are expected to show a notable decrease in symptom scores, increased quality of life index, and higher clinical effectiveness rate. Additionally, the TI group is projected to have a low adverse event rate and good safety profile.CONCLUSIONLatent MTrPs injection therapy may represent an effective and safe new method for treating FGIDs. Compared to traditional oral medication treatment, this method demonstrates significant advantages in improving patient symptoms and quality of life.

Objective: To explore the clinical efficacy and safety of endoscopic rubber band ligation (ERBL) and endoscopic injection sclerotherapy (EIS) in the treatment of grade I-III internal hemorrhoids, to provide a basis for the individualized treatment of patients with internal hemorrhoids in clinical practice. Methods: A retrospective cohort study was conducted. A total of 613 patients with grade I to III internal hemorrhoids who underwent ERBL or EIS at The Sixth Affiliated Hospital of Sun Yat-sen University from December 2019 to November 2023 were retrospectively collected. Inclusion criteria: (1) Patients diagnosed with symptomatic grade I-III internal hemorrhoids who failed conservative treatments such as diet adjustment and medication; (2) Patients who were unable or unwilling to receive surgical treatment due to multiple underlying systemic diseases. Exclusion criteria: (1) Patients with grade I-III internal hemorrhoids complicated with incarceration, thrombosis or other complications; (2) Patients with a history of hemorrhoid surgery; (3) Patients complicated with perianal abscess, anal fistula, active proctitis, rectal tumor, polyp, radiation proctitis or inflammatory bowel disease; (4) Patients with incomplete clinical data or lost to follow-up. This study was divided into the ERBL group and the EIS group based on different treatment. Baseline characteristics, postoperative effective rate, recurrence rate, pain score, anal distension, anal edema, complication rate, and treatment satisfaction were compared between the two groups. Results: After balancing with propensity score matching (PSM), a total of 313 patients were included, including 200 in the ERBL group and 113 in the EIS group. There were no statistically significant differences in baseline characteristics, such as gender, age, body mass index, Goligher classification, and laboratory test indicators, between the two groups (all P > 0.05), indicating that the two groups were comparable. The cure rates of the ERBL group and the EIS group were 64.0% (128/200) and 62.8% (71/113), respectively. The marked effective rates were 31.5% (63/200) and 34.5% (39/113), and the ineffective rates were 4.5% (9/200) and 2.7% (3/113), respectively. Statistical analysis revealed no statistically significant difference in efficacy between the two groups within 3 months after the operation (χ²=0.858, P=0.651). The recurrence rate of the ERBL group was lower than that of the EIS group [13.1% (25/191) vs. 18.2% (20/110)], but the difference was not statistically significant (χ²=1.424, P=0.233). Subgroup analysis showed that the recurrence rates of ERBL and EIS were similar in grade I-II internal hemorrhoids [10.3% (15/146) vs. 10.5% (9/86), χ²=0.002, P=0.963]; in grade III internal hemorrhoids, the recurrence rate of the ERBL group was lower than that of the EIS group [22.2% (10/45) vs. 45.8% (11/24), χ²=4.121, P=0.042]. Still, the difference was not statistically significant after Bonferroni correction (χ²=4.121, corrected P>0.025). Compared with the ERBL group, the EIS group had a lower pain score on the first day after operation [0 (0, 0) vs. 1 (0, 3), Z=-8.211, P<0.001] and a lower incidence of anal distension [25.7% (29/113) vs. 61.5% (123/200), χ²=37.122, P<0.001], with statistically significant differences. The total incidence of complications in the ERBL group was significantly higher than that in the EIS group [29.5% (59/200) vs. 4.4% (5/113), χ²=27.910, P<0.001], mainly reflected in postoperative bleeding [18.0% (36/200) vs. 3.5% (4/113), χ²=13.544, P<0.001] and urinary retention [8.5% (17/200) vs. 0, χ²=10.157, P=0.001], with statistically significant differences. There were no statistically significant differences in postoperative satisfaction, health status score, and the proportion of returning to everyday life within 1 month between the two groups (all P>0.05). Conclusions: Both ERBL and EIS are effective minimally invasive therapies for grade I-III internal hemorrhoids. EIS is preferred for grade I and II internal hemorrhoids to reduce complications, while ERBL shows a trend in reducing the recurrence rate of grade III internal hemorrhoids. Clinical decisions should be made comprehensively based on the classification, patient tolerance, and prognosis.

Balancing solidarity, normality and trust: reasons for (non-)participation in an injectable HIV antiretroviral therapy study in the United Kingdom.

Injection therapy is commonly used for symptom relief in hip osteoarthritis (OA). However, treatment responses vary among patients. Single-photon emission computed tomography combined with CT (SPECT-CT) can visualize bone metabolic activity, potentially reflecting disease severity. This study investigated whether SPECT-CT uptake could predict clinical outcomes after steroid injection in early hip OA.We prospectively enrolled patients with early to moderate hip OA scheduled for intra-articular steroid injection. Prior to the procedure, all patients underwent SPECT-CT imaging. Patients were categorized into two groups based on the presence or absence of increased uptake in the femoral head or acetabulum. Pain and functional outcomes were assessed using the visual analog scale (VAS) and Harris Hip Score (HHS) at baseline and three months post-injection.A total of 48 patients were included. Among them, 28 patients (58%) showed increased SPECT-CT uptake. Patients with uptake demonstrated significantly less improvement in VAS scores compared to those without uptake (mean change: -1.2 vs -3.5, p < 0.02). Similarly, the HHS improvement was lower in the uptake group (mean change: +5.3 vs +14.1, p < 0.01). No serious adverse events were reported.The presence of SPECT-CT uptake in hip OA patients was associated with a poorer response to steroid injection therapy. SPECT-CT imaging may serve as a useful tool to predict clinical outcomes and guide patient selection for injection treatments.

To investigate the relationship between visual functioning as measured by the National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25) and geographic atrophy (GA) imaging characteristics including foveal involvement, multifocal lesions, and GA size. This cross-sectional cohort study included patients from the University of Colorado Age-related macular degeneration (AMD) registry, enrolled between July 2014 and May 2023, who had GA in at least one eye and completed the VFQ-25 at time of study enrollment. GA size was averaged between the two eyes for each patient. General linear modeling was used to assess the association between GA imaging characteristics with the outcome of Rasch-transformed VFQ-25 scores. A total of 140 AMD patients with GA and VFQ-25 scores were included in the study. LogMAR visual acuity for the better-seeing eye of each patient was negatively associated with Rasch-transformed VFQ scores (-3.03, standard error (SE): 0.46, p < 0.0001). Foveal involvement in both eyes was significantly associated with worse Rasch-transformed scores when compared to those without foveal involvement in either eye (-1.33, SE: 0.38, p = 0.0006). Multifocal lesions in both eyes compared with unifocal lesions in both eyes had no significant difference in score (p = 0.179). GA size was significantly associated with worse VFQ-25 scores (-0.09, SE: 0.02), p < 0.0001), which did not remain significant after adjustment for LogMAR of both eyes (p = 0.137). We found bilateral foveal involvement and averaged GA size were significantly associated with worse Rasch-transformed VFQ-25 scores, but these associations did not remain significant after adjustment for visual acuity. Unilateral GA was significantly associated with better scores. This study highlights the impact GA imaging characteristics and bilateral involvement have on visual functioning. WHAT IS KNOWN: Geographic atrophy (GA) in age-related macular degeneration negatively impacts visual functioning, and prior studies suggest that both lesion characteristics and visual acuity contribute to patient-reported outcomes.The gold-standard for Telangiectatic capillaries (TelCaps) detection is indocyanine green angiography, which is invasive and may not be readily available in all settings. Bilateral foveal involvement and larger GA size were significantly associated with worse visual functioning as measured by Rasch-transformed VFQ-25 scores.Infrared reflectance imaging complemented by optical coherence tomography B-scans are effective in the detection and measurement of TelCaps, which appeared to be dynamic lesions that remodel over time. Patients with unilateral GA reported better visual functioning, underscoring the importance of preserving vision in the better-seeing eye.Eyes with DME and TelCaps with at least one year of follow-up ended up with persistent edema and stable or worse vision after injection therapy.

Lateral epicondylitis is one of the most common musculoskeletal disorders of the upper extremity, characterized by lateral elbow pain and functional disability. Despite the wide range of available treatments, the comparative effectiveness of invasive and non-invasive interventions remains controversial. To compare the short-term clinical effectiveness of low-level laser therapy (LLLT), platelet-rich plasma (PRP) injection, splinting, and extracorporeal shock wave therapy (ESWT) with corticosteroid (CS) injection in patients with lateral epicondylitis. In this prospective, single-blind, randomized controlled trial, 98 patients with clinically diagnosed lateral epicondylitis were randomly assigned to five treatment groups: LLLT, PRP, splinting, ESWT, and CS injection. Clinical outcomes were assessed using the Numeric Rating Scale (NRS), Patient-Rated Tennis Elbow Evaluation (PRTEE), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and hand-grip strength (HGS). Assessments were performed at baseline, 1 month, and 3 months after treatment. All treatment groups demonstrated significant improvements in pain and function at 1 and 3 months (p < 0.05). HGS improved in all groups except PRP, where no significant gain was observed. No statistically significant differences were found between the groups across outcome measures. Conservative and injection-based modalities provided clinically meaningful short-term improvements in patients with lateral epicondylitis. While CS injection produced rapid analgesic effects, non-invasive interventions such as LLLT, splinting, and ESWT achieved comparable functional benefits without the risks of invasive therapy. Although PRP improved pain and functional scores, its limited effect on HGS suggests that it may be best considered as a supportive option in selected patients.

An overview of seasonal variations in glycaemic patterns in children and young adults with type 1 diabetes has been addressed in a previous work, which paved the way for an in-depth study involving not only traditional Multiple Dose Injection (MDI) therapy, but also a comparative analysis with the use of Advanced Hybrid Closed-Loop (AHCL) insulin pumps. The widespread use of Flash Glucose Monitoring (FGM) and Continuous Glucose Monitoring (CGM) systems, as well as dedicated platforms for synchronizing and storing CGM reports, has facilitated an efficient approach to analyzing glycaemic patterns. The effect of environmental parameters on glycemic trends undoubtedly has a clinical relevance, which however can be appropriately managed by knowing the responses in patients treated with different therapeutic approaches. In this sense, it is possible to evaluate how the glycemic trend in diabetic patients, in relation to external temperatures, responds differently to therapies. In this work, the response, in terms of glucose level, in diabetic patients was analyzed, according to the different therapeutic approaches and in relation to variations in external temperature. For the same period of the previous work (one year: Autumn 2022-Summer 2023), seasonal variations in CGM metrics (i.e., Time In Range-TIR, Time Above Range-TAR, Time Below Range-TBR and Coefficient of Variation-CV) were analyzed. The results show a better metabolic control, linked to the effect of the algorithm on the trend of glycaemia. However, the analysis focused on the heatwave of July 2023 highlights the role of extreme temperatures as a stress factor in the insulin pumps performance. A further focus was carried out on the comparison of glycaemic patterns during the school and non-school period for all patients until 21 years old. Results suggest that during the school period, glycaemic patterns, in patients treated with MDI, show a greater onset of hyperglycaemia. From all that has emerged, it appears clear that structured education on diabetes self-management for patients and their families is fundamental and must take into account multiple factors (type of therapy, daily activities, atmospheric temperature) in order to keep their effects under control.

Iron deficiency anaemia (IDA) remains a major public health concern among pregnant women in Bangladesh. Given the high prevalence of iron deficiency anaemia in pregnancy among Bangladeshi women injectable iron sucrose therapy during antenatal period may be effective in its treatment. The aim of this study was to evaluate the efficacy and safety of intravenous iron sucrose therapy in antenatal patients with IDA. A cross-sectional study was conducted among 150 pregnant women with mild to moderate IDA (Hb 7–9.9 g/dL, serum ferritin &lt;12 µg/L) at Shaheed Suhrawardy Medical College Hospital from November 2017 to April 2018. Patients received calculated doses of intravenous iron sucrose. All of them received intravenous injection of iron sucrose in a calculated dose according to haemoglobin level. Haemoglobin levels were reassessed after 21 days of injection. Side effects were monitored. Approval of the study was obtained from Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College and Hospital. Written informed consents were obtained. Privacy and confidentiality of data were strictly maintained and preserved anonymously. Mean age was 26.09±5.39 years, 86% were housewife and about 9% were service holder; 58% were from lower socioeconomic condition; about 39% had secondary and higher level of education. Following three weeks of intravenous iron sucrose administration at the calculated therapeutic dose, mean haemoglobin levels rose by 2.35±0.53 g/dL, increasing from 7.52±0.43 g/dL at baseline to 10.88±0.43 g/dL post-treatment. The rise of the mean haemoglobin levels was statistically significant (p&lt;0.001). Mild adverse effects were reported in approximately 13% of participants, including epigastric discomfort (4.7%), abdominal pain (3.3%), nausea and vomiting (2.7%), and allergic reactions (2%). No serious or major side effects were observed. Intravenous iron sucrose is a safe and effective therapy for IDA during pregnancy, with minimal side effects and significant improvement in haemoglobin levels. The administered dose should be calculated based on the patient's body weight and the estimated iron deficit, as determined by haemoglobin concentration and serum ferritin levels. Bangladesh Med J. 2024 Sept; 53(3): 16-22

Sequential addition of oral glucose-lowering therapies, insulin or incretin-based therapy is often required to attain optimal glycemic control and reduce the risk of diabetes-associated complications. Despite advances in treatment, a large proportion of people with type 2 diabetes fail to achieve optimal glycemic control. Recent guidelines emphasize the need to commence injectable options in individuals unable to attain glycemic targets, despite maximal oral therapy. In individuals already on basal insulin, an improvement in glycemic control requires stepwise addition of prandial insulin, full basal-bolus insulin regimen, or additional injectable incretin-based therapy. However, concerns around weight gain and hypoglycemia often limit addition or increase in insulin to improve glycemic control. Treatment simplification i.e. a decrease in treatment complexity, particularly insulin therapy, seeks to alleviate treatment burden without compromising therapeutic efficacy and safety. However, currently there is a lack of guidance on simplifying treatment, particularly for individuals unable to attain glycemic targets. We now provide evidence-based treatment simplification strategies for people with diabetes in the Gulf Cooperation Council region.

Home healthcare services are an essential part of modern health systems, providing continuous support for older adults and individuals with chronic illnesses. This study examined demographic and service utilization patterns among patients receiving home healthcare in Amasya, Turkey, over a 5-year period and assessed temporal trends, including the potential effects of the COVID-19 pandemic. A retrospective analysis was conducted using records from 18,087 patients who received home healthcare services between 2020 and 2024. Because some patients received more than 1 of the 4 service categories (injection therapy, wound care, interventional procedures, and follow-up services), analyses were performed separately for each category rather than by total patient count. Data were analyzed by gender and year using descriptive statistics and chi-square tests, while interrupted time series (ITS) analysis evaluated changes in service utilization during lockdown and reopening periods. Women comprised 58.1% of all patients. Wound care was the most common service (71.2%), followed by interventional procedures (47.2%), follow-up visits (36.3%), and injection therapy (23.6%). The proportion of female patients was higher in all categories except interventional procedures. Male patients more frequently received intravenous injections and catheter management. Service utilization increased during 2021 to 2022, corresponding to pandemic restrictions, and gradually declined until 2024. ITS analysis showed no significant level change but indicated a positive post-intervention trend. This 5-year analysis revealed stable gender-based utilization patterns and a temporary pandemic-related surge in home healthcare use, highlighting system resilience and the need for gender-responsive planning and standardized monitoring.