Quality Of Life Research Articles

Watch your eyes: Workplace ocular hazards presenting at a tertiary eye care centre in south India

: Eye injuries can majorly affect individuals by reducing quality of life. In this study we report the prevalence of ocular trauma and the proportion of vision loss due to trauma presenting in tertiary care center.To evaluate the prevalence of occupational ocular injuries and the degree of visual loss in patients attending a tertiary eye care hospital in South India.The study was a retrospective observational study, which included patient’s aged 16 years and older attending Outpatient department of a tertiary eye care hospital following ocular trauma at workplace. The study took place across a six-month duration. A detailed demographic profile and history of the patient was documented. Patient underwent comprehensive ocular examination and further orbital imaging if necessary. The ocular injuries were classified using the Birmingham Eye Trauma Terminology System.This study included 210 patients, with a mean age group of 21-30 years. Men had a more than five-times higher rate of eye injury at work than women; with the most common mode of injury being metallic foreign body (75%). The predominant ocular injuries were categorized as closed globe injuries with 83 % incidence. 67% of the patients needed surgical intervention.Most work-related eye injuries often result from inadequate eye protection, with the majority of affected patients being young men, which highlights the importance of implementing preventive measures early in their careers. This study underscores the need of awareness and prevention programs for eye protection at workplace.

The potential mechanism of action of gut flora and bile acids through the TGR5/TRPV1 signaling pathway in diabetic peripheral neuropathic pain

Diabetic peripheral neuropathic pain (DPNP) is a major complication of diabetes that markedly affects the quality of life and health status of patients. Recent studies have investigated the potential regulatory influence of gut flora and bile acids on DPNP via the TGR5/TRPV1 signaling pathway. Dysbiosis of the gut flora not only directly affects bile acid metabolism but also significantly correlates with diabetes-associated neuropathy through interactions with the bile acid receptor TGR5 and the ion channel TRPV1. This review describes how alterations in the gut flora and bile acid metabolism contribute to the pathogenesis of DPNP through the TGR5/TRPV1 signaling pathway, revealing potential applications for this pathway in DPNP management. Furthermore, experimental and clinical studies have demonstrated the modulation of gut flora and bile acid metabolism as well as targeting the TGR5/TRPV1 signaling pathway as an innovative therapeutic approach. Further studies are warranted to elucidate the underlying mechanism and develop treatment modalities based on gut flora regulation and signaling pathway interventions, thus providing novel insights and approaches for DPNP therapy.

Role of myofiber-specific FoxP1 in pancreatic cancer-induced muscle wasting.

Cancer cachexia affects up to 80% of cancer patients and results in reduced quality of life and survival. We previously demonstrated that the transcriptional repressor Forkhead box P1 (FoxP1) is upregulated in skeletal muscle of cachectic mice and people with cancer, and when overexpressed in skeletal muscle is sufficient to induce pathological features characteristic of cachexia. However, the role of myofiber-derived FoxP1 in both normal muscle physiology and cancer-induced muscle wasting remains largely unexplored. To address this gap, we generated a conditional mouse line with myofiber-specific ablation of FoxP1 (FoxP1SkmKO) and found that in cancer-free mice, deletion of FoxP1 in skeletal myofibers resulted in increased myofiber size in both males and females, with a significant increase in muscle mass in males. In response to murine KPC pancreatic tumor burden, we found that myofiber-derived FoxP1 is required for cancer-induced muscle wasting and diaphragm muscle weakness in male mice. In summary, our findings identify myofiber-specific FoxP1 as a negative regulator of skeletal muscle with sex-specific differences in the context of cancer.

Potentially traumatic events, posttraumatic stress symptoms, and skin-related quality of life among adults with self-reported skin disease symptoms.

The connection between stress and skin disease has been extensively documented; however, there are no empirical studies investigating the incidence of traumatic event exposure and posttraumatic stress (PTS) symptoms among dermatology patients. To address this gap in the literature and begin to understand the associations between PTS symptoms and skin disease symptoms, this study used a sample of adults with self-reported skin disease symptoms to examine: (1) rates of potentially traumatic event (PTE) exposure and PTS symptoms; and (2) the association between PTS symptoms and skin-related quality of life, controlling for relevant covariates. Data were collected online through Cloud Research, and participants completed a battery of self-report measures. The sample included 310 participants (68.4% female) who endorsed current skin disease symptoms. Results indicated that 47.1% of participants endorsed clinical levels of PTS symptoms. Consistent with hypotheses, greater levels of PTS symptoms were associated with worse skin-related quality of life, and this association was particularly robust for arousal-related symptoms. Results shed light on the occurrence of trauma-related experiences among individuals with self-reported skin disease and indicate a link between PTS symptoms and the perceived burden of skin disease symptoms on daily living. However, this study was cross-sectional and relied on self-report measures; therefore, findings should be interpreted with caution, particularly since diagnoses could not be verified. Replication of this work in dermatology patients is needed to further understand these connections.

A digital duplicating obturator with 3D printing technology

Obturators are vital for restoring function and appearance in patients with maxillofacial defects, though traditional fabrication involves multiple clinical visits and extended production time. This technique report details a digital approach using computer-aided design/manufacturing (CAD/CAM) and 3D printing to duplicate an obturator for a 74-year-old patient with maxillary bone necrosis. By using a chairside intraoral scanner, we obtained a digital model of the existing obturator, avoiding traditional impression-taking and reducing procedural discomfort. A 3D-printed obturator was fabricated, adjusted with a tissue conditioner, and refined to ensure optimal fit. Laboratory processes included using specialized materials and retention techniques. The digital workflow minimized patient visits and improved comfort, underscoring CAD/CAM and 3D printing's potential to enhance clinical efficiency and quality of life for patients requiring complex prosthetic rehabilitation. This approach highlights the practical benefits of integrating digital and analog methods in maxillofacial prosthetics. (Int J Maxillofac Prosthetics 2024;7:16-19)

Dissection of the lymph nodes along the recurrent laryngeal nerve in robotic esophagectomy

Lymph node (LN) metastasis serves as a pivotal prognostic determinant in esophageal cancer, particularly in cases of squamous cell carcinoma (SqCC). The involvement of LN metastasis frequently extends to the LNs along the recurrent laryngeal nerve (RLN). Radical dissection of these nodes is imperative for precise staging and the prevention of loco-regional recurrence. Historically, the emphasis on RLN node dissection has been evident in numerous literature, establishing it as a mandatory procedure in different countries. Nevertheless, the risk of RLN palsy following such dissection is a substantial concern, given its association with significant postoperative complications and long-term implications for quality of life. Recent literature has highlighted RLN node dissection in robotic surgery, demonstrating favorable outcomes in comparison to alternative surgical modalities. This review paper aims to comprehensively assess prior publications on this subject, elucidating the outcomes and implications of RLN node dissection in robotic esophagectomy (RE).

Case report: Long remission and survival following immunotherapy in a case of pulmonary pleomorphic carcinoma

In 2020, we reported on a case involving a 68-year-old male patient with a rare instance of pulmonary pleomorphic carcinoma exhibiting high PD-L1 expression. The patient experienced significant therapeutic success with the use of pembrolizumab, achieving partial tumor remission. Following the publication of that report, the patient continued on pembrolizumab at a dose of 200 mg/dl for 27 cycles, subsequently transitioning to a combination of pembrolizumab and bevacizumab for eight cycles. Due to elevated blood pressure, the regimen was adjusted back to monotherapy with pembrolizumab. As of July 9, 2024, the patient remains alive with a satisfactory quality of life. This follow-up report, coupled with a review of the literature from 2021 to 2024 on pulmonary pleomorphic carcinoma and its immunotherapeutic approaches, aims to present new insights and innovative strategies for treating this rare form of cancer.

Screening for Frailty According to Rural and Suburban Health Areas in the Context of Adapted Integrated Care for Older People Approach: The FRAGING Study.

The integrated care for older people (ICOPE) program, developed by the World Health Organization, serves as a public health initiative to maintain older adults' functional abilities and promote healthier aging. Here, we adapted the ICOPE approach to assess overall prevalence of frailty in rural and semi-urban areas. We also investigated health-related quality of life and physical activity and sedentary behavior in older people. The FRAGING multicenter cohort study was performed on screening days dedicated to older adults (≥65 years) without chronic disease in a rural area (RU) and in a semi-urban area (SU). The study included a total of 105 participants: 98.4% of participants were frail, with a mean of 4.3 [SD:2.5] frailties per participant. RU participants had higher number of frailties (p = 0.02) and a higher percentage of frail participants in the dimensions of health-related quality of life (p<0.0001), socioeconomical level (p = 0.008), colorectal cancer screening (p = 0.022), and tetanus booster doses (p = 0.008). Globally, women were less sedentary than men (p = 0.02) and engaged more in low physical activity (LPA) than men (p = 0.01). RU participants engaged more in LPA than SU participants (p = 0.03). The prevalence of frailty is alarmingly underestimated in older adults without chronic disease. This study demonstrated the need to propose appropriate, validated screening tests that consider territorial issues and organization of care delivery. The ICOPE framework serves as a good startpoint for reorganizing person-centered healthcare pathways.

Mechanisms and research progress of motor imagery combined with action observation in cognitive rehabilitation

Introduction：Cognitive deficits refer to impairments in the brain's ability to process information, memory, attention, reasoning, decision-making, and other cognitive functions.Cognitive rehabilitation (CR) is a therapeutic approach aimed at improving cognitive function through various strategies, training, and interventions, ultimately enhancing quality of life. Motor imagery (MI) and action observation (AO) are key rehabilitation methods in the cognitive domain and have been widely used in related studies. Recently, the combination of motor imagery and action observation therapy (AO+MI) has emerged as a promising research direction, receiving increasing support in the academic community. Aim of the study: This study aims to explore the mechanisms behind the combination of action observation and motor imagery (AO+MI) and assess the effectiveness of this innovative approach in cognitive rehabilitation. Material and methods: A literature review was conducted by searching databases such as PubMed, Web of Science, and Google Scholar for English-language articles. Keywords including "motor imagery," "action observation," and "cognitive rehabilitation" were used in the search. Conclusions: Both motor imagery (MI) and action observation (AO) have demonstrated positive effects on cognitive function. However, the combination of MI and AO may produce three distinct states that require further investigation. Preliminary findings suggest that AO+MI has shown promising results in enhancing corticospinal excitability (CE), benefiting children with developmental coordination disorder (DCD), and improving outcomes in stroke patients. However, some scholars have raised concerns, emphasizing the need for further experimental validation.

STUDIES OF ASTHMA CONTROL IN PATIENTS WITH METABOLIC SYNDROME

Every day, a practitioner is faced with the problem of patient comorbidity. Bronchial asthma is a common problem, as is metabolic syndrome. Due to the increase in allergic diseases and lifestyle changes, patients may have a combination of metabolic syndrome and bronchial asthma. This combination has been shown to aggravate the course of asthma. Therefore, we wanted to confirm or refute this with our study. The study design included 94 patients with a diagnosis of asthma. A comparative analysis of the spirographic study data revealed that patients with asthma + MetS had statistically significant differences (p&lt;0.05). The analysis of anthropometric data revealed that patients with the highest BMI and body weight had a significantly more severe course of asthma (p&lt;0,05), which is consistent with the data of available world studies [24, 25], and a positive correlation was found between BMI, percentage of body fat and lower percentage of body fat in patients with severe asthma (ρ=0,89, ρ=0,90, ρ=0,87; r=0,88, r=0,91, r=0,90, respectively). The data obtained indicate the need for individual management of patients with comorbidities, including MetS and asthma, to prevent severe asthma, which is associated with inadequate asthma control and poor quality of life.

Pain chronification risk assessment: advanced phenotyping and scoring for prediction and treatments tailored to individualized patient profile

AbstractAcute pain is a physiologic, protective life-important warning neurological signal indicating multi-level tissue modulations caused by a broad spectrum of health adverse events such as stress overload, mechanical trauma, ischemia–reperfusion, sterile and infection-triggered inflammation, single- and multi-organ damage, acute and chronic wounds, tissue remodeling and degeneration, amongst others. On the other hand, pain chronification results in a pathologic transformation from the protective pain signaling into persistent debilitative medical condition with severe consequences including but not restricted to phenotype-specific behavioral patterns, reduced quality of life, and cognitive and mood disorders. Who is predisposed to an increased vs. decreased pain sensitivity and to the pain chronification? The motivation of personalized medicine that “same size does not fit all” is getting obvious also for an advanced approach in algesiology. Consequently, an in-depth patient stratification is essential for the paradigm change in overall pain management from currently applied reactive medical services to the cost-effective predictive, preventive, and personalized medicine (PPPM/3PM) in primary (reversible damage to health and targeted protection against health-to-disease transition) and secondary (personalized protection against disease progression) care. To this end, specifically innovative concepts of phenotyping elaborated in this study play a crucial role in patient stratification for predicting pain-associated outcomes, evidence-based targeted prevention of the pain chronification, and creation of treatment algorithms tailored to individualized patient profiles.

The renal-retinal connection - The eye in chronic kidney disease

Chronic kidney disease (CKD) is linked with several systemic complications, including ocular manifestations that can adversely affect quality of life. The prevalence and types of ocular changes in CKD patients, particularly their correlation with disease stages, are not well-documented. This study aims to evaluate the ocular manifestations in CKD and their association with different stages of the disease.A cross-sectional study on 70 CKD patients revealed a high prevalence of ocular abnormalities, including diabetic retinopathy, hypertensive retinopathy, and age-related macular degeneration. These conditions often worsened as CKD progressed, emphasizing the need for regular eye exams in CKD patients to prevent vision loss and address complications promptly. To investigate the prevalence and types of ocular manifestations in patients with chronic kidney disease (CKD) and to analyse their correlation with the stages of CKD. This cross-sectional, descriptive, non-interventional, hospital-based study was conducted over four months from May 2024 to August 2024 in the Department of Nephrology. Seventy patients with diagnosed CKD, aged 18 years and older, were included. Exclusion criteria were patients with reversible causes of renal failure, those who had undergone renal transplantation, and those who did not consent. A comprehensive ocular examination was performed on 140 eyes from the enrolled patients, assessing anterior and posterior segment findings, including visual acuity, eyelid conditions, conjunctival status, lens status, and fundus examination. The study included 38 males (54.3%) and 32 females (45.7%) with a mean age of 57 years. Hypertension and diabetes mellitus were the most common comorbidities, present in 71.4% and 64.3% of patients, respectively. Visual acuity deteriorated with advancing stages of CKD, with significant impairment and blindness observed predominantly in CKD stages 4 and 5. Anterior segment examination revealed that 62% of eyes had immature cataracts, and 38% were pseudophakic. Fundoscopic examination showed that 51.4% of patients had abnormal findings, including non-proliferative and proliferative diabetic retinopathy, hypertensive retinopathy, age-related macular degeneration, and glaucomatous disc changes. The severity of fundus abnormalities increased with the progression of CKD, highlighting a strong correlation between the degree of renal dysfunction and ocular health. Ocular manifestations are common in CKD patients and correlate with the severity of kidney disease. The prevalence of both anterior and posterior segment abnormalities underscores the need for regular ophthalmic evaluations in CKD patients to prevent vision loss and manage ocular complications early.

Comparison of the smiley face rod method versus intervertebral fusion for the treatment of L5 spondylolysis in adults

PurposeFor patients who suffered from L5 spondylolysis and fail to improve using conservative treatment, the best surgical strategy remains controversial. This study compares the efficacy of the treatment of L5 spondylolysis using the smiley face rod (SFR) method versus intervertebral fusion (IF).MethodsWe analyzed 38 patients with L5 spondylolysis who underwent surgery in our department between January 2017 and June 2019. Of these, 32 patients were included in our study: 14 patients in the SFR group and 18 patients in the IF group. The operation time, intraoperative blood loss, postoperative drainage time, length of stay and postoperative complications were compared. The pain visual analog scale (VAS) and Oswestry dysfunction index (ODI) were evaluated before operation and at 3 months, 6 months, and 1 year postoperatively. The changes in range of motion (ROM) in L4/5 and L5/S1 in these two groups before and after surgery were measured through imaging examinations and the bone graft fusion rate was assessed according to the Brown standard.ResultsThe operation time of the SFR group was much shorter than that of the IF group (98.8 ± 8.3 vs. 113.8 ± 8.6 min, P &amp;lt; 0.05), and the blood loss of the SFR group was significantly lower than that of the IF group (90.0 ± 43.9 vs. 175.0 ± 81.2 ml, P &amp;lt; 0.05). Length of stay in the SFR group was less than that of the IF group (9.5 ± 2.5 vs. 12.6 ± 3.2 d, P &amp;lt; 0.05). No difference was found in the VAS and ODI scores between the two groups at 3 months, 6 months, and 1 year after surgery. In the IF group, the ROM in L4/5 showed an obvious increase after surgery compared to that before surgery, and it was much bigger than that of the SFR group (P &amp;lt; 0.05). A notable reduction of ROM was seen in L5/S1 in the IF group compared to the SFR group (P &amp;lt; 0.05). The fusion rate of the isthmus in the SFR group was 79% at 3 months and 86% at 6 months after surgery. In the IF group, one patient suffered from adjacent segment degeneration (ASD), which caused compression symptoms in the lower extremity, and one patient suffered from an internal fixation fracture; these complications were not seen in the SFR group.ConclusionThe SFR and IF both improve the clinical symptoms and quality of life of patients with L5 spondylolysis. However, the SFR technique had the advantages of a shorter operation time and less blood loss than IF; it could also preserve the ROM of the surgical segment and had little influence on adjacent segments in short-term follow-ups.

Evaluation of safety criteria for enoxaparin bridging in patients with left ventricular assist devices in an outpatient care setting.

Appropriate anticoagulation is crucial for the success of left ventricular assist device patients. Currently, there is no consensus on the optimal management of their subtherapeutic INR in ambulatory setting. Our goal is to evaluate both the short-term adverse events and long-term outcomes of enoxaparin bridging at a major transplant center, following the implementation of bridging safety criteria. In total, 85 patients' medical records were reviewed between 7/2019 and 5/2022, with 51 patients meeting safety criteria were bridged with enoxaparin and 34 non-bridged. The primary endpoint was the occurrence of major bleeding/thrombosis events within 30 days of bridging. The secondary endpoint was freedom from events 30 days after enoxaparin initiation and overall patient survivability until the last follow-up. Within 30 days, no major bleeding/thrombotic events were noted. After 30 days, the major bleeding rate was 5.8% in bridged vs. 11.8% in non-bridged patients (p = 0.02). Overall, 3-year survival was 78% in the bridged vs. 49% in non-bridged patients (p < 0.001). In patients with no events, 3-year survival was 80% in bridged vs. 58% in non-bridged (p < 0.001). In the patients with bleeding events, 3-year survival was 55% in bridged vs. 51% in non-bridged (p = 0.11). At 1 year, freedom from bleeding in the bridged patients was 81% in patients with no events vs. 0% in those with an event (p < 0.0001). When eligibility criteria for safe bridging were applied, the use of enoxaparin bridging was associated with no major bleeding/thrombotic events during bridging and improved 3-year survival in LVAD patients. Economically, using outpatient enoxaparin resulted in substantial healthcare savings, fewer readmissions, and improved quality of life.

Assessment of oral disease burden among head and neck cancer patients in the Merseyside region.

Introduction Head and neck cancer (HANC) significantly impacts the oral cavity and dental health issues may complicate cancer treatment and post-treatment quality of life. Pre-treatment dental evaluation is critical for identifying and managing existing oral health problems. However, limited literature exists on the dental health status of patients at the time of HANC diagnosis. This study aims to address this gap and emphasise the importance of dental care in the management of HANC.Methods A retrospective analysis of medical records was conducted on patients scheduled for radiotherapy for HANC. Data on demographic characteristics, tumour characteristics and dental exam findings were extracted from the patient record.Results Of the 191 included patients, the average age was 62.9 years (SD: 10.09), with 80% being men. The prevalence of dental disease revealed 59% of cases presenting with unstable periodontal disease and an average decayed, missing, and filled teeth score of 19.9. Two-thirds of patients exhibited one or more carious lesions.Conclusion This retrospective study sheds light on the dental health status of patients with HANC at their pre-treatment evaluation. The high prevalence rates of dental caries and unstable periodontal disease highlight the importance of dental evaluation and intervention as part of the overall management of HANC patients.

Anticoagulation with warfarin for paediatric cardiac indications: a retrospective study.

Warfarin is used as anticoagulation for children for a wide range of cardiac indications but carries the disadvantage of requiring international normalised ratio monitoring and dose adjustment. Management of warfarin therapy is challenging due to its narrow therapeutic window and is further complicated in children by dietary changes, frequent illnesses, and developing systems of metabolism and haemostasis.A retrospective review was performed of patients' medical records to assess the indication for warfarin use, percentage of international normalised ratio values in target range (%ITR), and frequency of phlebotomy.Twenty-six patients were identified. The most common indication for warfarin use was in patients post-total cavo-pulmonary connection (n = 19, 73%). We demonstrated a variability in duration of warfarin therapy following total cavo-pulmonary connection (median of 11.1 months). Nineteen (73%) patients had used the CoaguChek machine for home measurement of international normalised ratio. The median frequency of phlebotomy for all indications was once every 10 days, and the median %ITR was 55.4 % (29.7-86.4%). Of note, the percentage under target range in the patients with mechanical mitral (n = 2) and aortic valves (n = 1) was found to be 23% and 33%, respectively.These data demonstrate a high frequency of international normalised ratio values outside of the target range as seen in previous studies of warfarin in children. This necessitates frequent phlebotomy and dose changes, which can have a significant effect on the quality of life of these patients and their families highlighting the need to focus on quality improvement in the area of anticoagulation in paediatric cardiac patients.

Conservative therapy for lumbar disc herniation

Herniated discs are acommon cause of neurological symptoms that often lead to reduced quality of life. They affect around 20% of 45-56-year olds and, therefore, represent acorrespondingly major challenge for healthcare. Conservative therapy methods are usually used as the first treatment option; surgical interventions should only be considered in special symptom constellations. This study aims to evaluate the effectiveness of conservative therapy methods in the treatment of lumbar disc herniation and to demonstrate their influence on pain reduction and functional improvement. The current valid AWMF guideline was analyzed, and asystematic literature search was conducted to identify relevant information on the conservative treatment of herniated discs. The therapeutic approaches analyzed included physiotherapy, drug treatment, manual therapy and injection therapies. Inclusion criteria covered reviews and meta-analyses from 2019 to 2024. The analysis showed that conservative treatment methods led to asignificant reduction in pain and improvement in functional abilities in the majority of patients. Not all frequently clinical used forms of therapy have been well proven. The results of this study underline the importance of conservative treatment methods as an effective treatment option for herniated discs. In particular, the combination of different treatment approaches can improve treatment outcomes. However, further long-term studies are needed to determine the long-term effects and optimal treatment protocols.

Design Strategies to Minimize Mobile Usability Issues in Navigation Design Patterns

Recent development in mobile technology has significantly improved the quality of life. Everyday life is increasingly becoming dependent on mobile devices as mobile applications are targeting the needs of the end users. However, many end users struggle with navigating mobile applications, leading to frustration, especially with sophisticated and unfamiliar interfaces. This study focuses on addressing specific usability issues in mobile applications by investigating the impact of introducing a floating action button (FAB) and icons with names at the bottom in popular applications such as YouTube, Plex, and IMDb. The current research includes three studies: Study-1 explores the navigation issues that users face; Study-2 measures the experiences of the users with improved navigation designs; and Study-3 compares the results of Study-1 and Study-2 to evaluate user experience with both existing and improved navigation designs. A total of 147 participants participated and the systems usability scale was used to evaluate the navigation design. The experiments indicated that the existing design patterns are complex and difficult to understand leading to user frustration compared to newly designed and improved navigation designed patterns. Moreover, the proposed newly designed navigation patterns improved the effectiveness, learnability, and usability. Consequently, the results highlight the imperativeness of effective navigation design in improving user satisfaction and lowering frustration with mobile applications.

Aberrant intrinsic brain activities in functional gastrointestinal disorders revealed by seed-based d mapping with permutation of subject images

Functional gastrointestinal disorders (FGIDs) are characterized by complex interactions between the gut and brain, leading to altered brain function and symptom manifestation. We used neuroimaging meta-analytic techniques in order to analyze the correlation between FGIDs and aberrant brain activity. A systematic review was performed to ascertain resting-state functional magnetic resonance imaging (rs-fMRI) studies examining brain function in FGIDs. Pooled meta-analyses by seed-based d mapping with permutation of subject images (SDM-PSI) were performed to assess variations in regional brain activity, and sensitivity analyses were applied to evaluate the robustness of findings. Meta-regression analyses were then carried out to examine possible links between demographic factors and neuroimaging changes. Our meta-analysis revealed significant changes in regional brain activities among FGIDs patients compared to healthy controls (HC). Increased brain activation was observed in several regions including the postcentral gyrus, calcarine fissure/surrounding cortex, superior frontal gyrus, and insula, while decreased activity was noted in the left posterior cingulate gyrus, right median cingulate/paracingulate gyri, and the left caudate nucleus. Furthermore, meta-regression analyses indicated negative associations between disease duration and alterations in specific brain regions. These findings underscored the intricate interplay between gut dysfunction and aberrant brain activity in FGIDs. Early intervention and multidisciplinary approaches addressing both gastrointestinal symptoms and associated emotional distress are crucial for improving the quality of life of the patients.

Drooling in developmentally normal children: a review.

Drooling or saliva spillage has been explored widely among children with neurodevelopmental conditions. Yet, the approach to drooling in an otherwise developmentally normal child remains unexplored, as it is regarded as self-limiting. Nonetheless, drooling beyond age 4 in the awake stage should raise concern. This narrative review aims to shed light on drooling in developmentally normal children, also known as 'healthy droolers', and the available evidence on its management. Most notable factors causing saliva spillage include poor oral-motor control and impaired oral sensation. Delayed saliva acquisition may be an early indicator of developmental or intellectual delay. Drooling impairs both the children's and parents' overall quality of life significantly. Healthy droolers can be managed by simple behavioural therapy and reassurance.