Background:The aim of this study was to investigate the effect of Ramadan fasting (RF) on markers of endothelial function and metabolic parameters in patients with type 2 diabetes mellitus (T2DM) and healthy controls. Methods:This cohort study involved 305 subjects: 167 T2DM and 138 healthy volunteers subjects. The following parameters were evaluated: body mass index (BMI), diet inflammatory index (DII), serum glucose and lipid profile and high-sensitivity C-reactive protein (hs-CRP) during three separate visits, before Ramadan (baseline), the last week of Ramadan, and during the last week of the month following Ramadan. In each visit, reactive hyperaemia index (RHI) in all participants was assessed. In diabetic patients, serum homocyteine (Hcys) was mesured at baseline and during RF. The primary endpoint was change in RHI, a validated and non-invasive measure of endothelial function. The secondary end point was change in clinical, metabolic parameters, and Hcys. Analyses used non-parametric tests and multivariable regression with multiple imputation. Results:RF significantly decreased RHI [-0.2 UI (95% CI -0.3 to -0.09); p < 0.001] and increased serum homocysteine [1.2 µmol/L (95% CI 0.7-1.8); p < 0.001] in T2DM compared to baseline levels.RF did not significantly change RHI in healthy volunteers. A significant increase in blood glucose (p < 0.001) and LDL cholesterol (p = 0.003) was observed during Ramadan compared to baseline, whereas HDL cholesterol, DII, and BMI decreased. Among healthy volunteers, similar changes in metabolic parameters were observed, with hs-CRP increasing during Ramadan compared to baseline (p = 0.01). Conclusion:RF seems to be associated with unfavorable effects on endothelial function in diabetic patients but not in healthy subjects. RHI testing could help identifying diabetic patients who should not observe RF or should be closely monitored during fasting.
Introduction Psychological distress—such as anxiety, depression, and stress—is common in coronary artery disease (CAD) and contributes to worse outcomes, yet it is often overlooked in standard cardiac care. Objective To assess the relationship between mental health disorders and clinical outcomes in CAD patients, and to compare findings between acute coronary syndrome (ACS) and chronic coronary syndrome (CCS) groups. Method This prospective study was conducted between Novembre 2023 and April 2025 at the Department of Cardiology in a tertiary care center. We included patients with CAD admitted for ACS, those undergoing coronary angiography (CAG) for CCS, and patients seen in routine follow-up. Stress, anxiety, and depression were assessed using the PSS, GAD-7, and PHQ-9 scales, respectively. We aim to compare the characteristics of the two groups: ACS and CCS. Patients were followed for a period ranging from 9 months to 1 year after inclusion. Major adverse cardiovascular events (MACE) were recorded. Psychological scores were monitored over the follow-up period. Results This study included 51 patients with a mean age of 57.86 years. No significant differences were found between the ACS and CCS groups regarding Cardiovscular Risk Factors. However, sedentarity was more prevalent in the CCS group (P=0.03). Both anxiety (GAD-7≥9) (P=0.024) and depression (PHQ-9≥9) (P=0.020) were significantly more prevalent in the ACS group than in the CCS group, whereas stress levels (PSS≥15), although higher in ACS, did not differ significantly (P=0.44) (Fig. 1). Over the 9–12-month follow-up, the prevalence of depression, anxiety and stress declined. However, persistent depression was significantly associated with major adverse cardiovascular outcomes (ACVo) (P=0.041) while anxiety and stress were not (P=0.43 and 0.59, respectively). Treatment non-adherence tended to cluster with psychological distress—83%had at least one elevated score—but this trend did not reach statistical significance (P=0.13). Conclusion CAD patients, particularly with ACS, face significant psychological challenges. Persistent depression predicts ACVo. Mental health integration in CAD care may improve overall prognosis, warranting further research.
The aim of this study was to describe patterns of cigarette smoking and to determine its associated factors among medical students in the university of Monastir, Tunisia. We conducted a cross-sectional survey among medical students of the faculty of medicine of Monastir in October 2020. The data were collected through a self-administered anonymous questionnaire. We collected data on the students’ smoking status, age of first cigarette use, intention to quit smoking and the level of nicotine dependence among smokers. Chicha, e-cigarette, alcohol, cannabis use and other addictive behavior were also investigated through the questionnaire. A multivariate logistic regression model was employed to identify associated factors with cigarette smoking. The threshold of statistical significance was set at p < 0.05. A total of 748 students participated in this study. Of all respondents, 12.6
Late-onset neonatal sepsis (LONS) remains a leading cause of morbidity and mortality in neonates, particularly among preterm and low birth weight infants. Interleukin-6 (IL-6) has emerged as a promising biomarker for early detection of LONS, yet the diagnostic performance of IL-6 remains inconsistent across studies. This meta-analysis aimed to evaluate the overall diagnostic accuracy of IL-6 in detecting LONS and to assess the certainty of evidence using the GRADE approach. A comprehensive search of five databases was conducted up to July 15, 2025. Twenty-two studies were eligible for inclusion, of which 20 (n = 3527 neonates) were included in the meta-analysis. A bivariate random-effects model was used to estimate pooled sensitivity and specificity, and the area under the SROC curve was used to assess overall diagnostic accuracy. Pooled sensitivity and specificity were 85.2
