Acute chest syndrome (ACS) and pulmonary hypertension (PH) are major factors of morbidity and mortality in patients with sickle cell disease (SCD). This prospective observational study aimed to evaluate the clinical profile and identify laboratory, radiological, and echocardiographic parameters associated with adverse outcomes in SCD. 120 adults with laboratory-confirmed SCD participated in the study. Clinical assessment, echocardiogram, and relevant laboratory tests were conducted to correlate with patient outcome, and the respective associations were analysed. The study indicated that 32 patients (26.7
Baclofen is a γ-aminobutyric acid type B receptor agonist primarily used for spasticity. It is increasingly prescribed orally at high off-label doses for conditions such as alcohol use disorder, raising concerns regarding severe toxicity and withdrawal syndromes. This systematic review comprehensively characterizes the clinical presentations, management strategies, and outcomes associated with oral baclofen toxicity and withdrawal. MEDLINE, Embase, and CENTRAL databases were searched from inception through October 2024. Eligible studies included clinical trials, observational studies, case series, and case reports describing oral baclofen toxicity or withdrawal in humans. Excluded were studies on intrathecal baclofen, non-human or preclinical data, gray literature, and reports lacking sufficient clinical data. Three reviewers independently performed study screening, data extraction, and quality assessments. The Joanna Briggs Institute Critical Appraisal Checklists for case reports, case series, and observational studies were used to evaluate methodological quality and risk of bias across included studies. Discrepancies were resolved by consensus among reviewers, with senior author verification when needed. Outcome measures included clinical presentation, management strategies, need for intensive care or mechanical ventilation, length of hospital stay, recovery status, and mortality. Because of study heterogeneity, data were synthesized narratively without a formal certainty assessment. Sixty-six case reports (44 toxicity cases from 38 case reports, 34 withdrawal cases from 28 case reports) and 18 retrospective studies (n = 1540) were included (total n = 1618 individuals). Baclofen toxicity commonly presented with central nervous system depression (68
BACKGROUND:As the global population is aging, the impact of cancer among the elderly have become critical areas of study. This demographic shift is expected to continue, necessitating detailed analysis for effective planning and resource allocation in cancer control and prevention. This research aims to predict the rise in cancer rates among older adults across various United Nations (UN) regions from 1970 to 2050, aiming to highlight the significant challenges posed by cancer within this demographic. METHODS:Data on cancer incidence and mortality were extracted from the Global Cancer Database (GLOBOCAN), of both current statistics and projections up to 2050. Additionally, world population figures were obtained from United Nations population estimates to analyze demographic shifts between younger and older populations. A time-series analysis was conducted to calculate and compare trends in cancer burden among the elderly compared to the young across various regions and Human Development Index (HDI) categories as defined by the UN. With the predictive modelling, we calculated the quantitative cancer statistics, including rate ratios and case fatality rates (per 100,000), and compared incidence and mortality rates along with demographic and socioeconomic data to assess disparities and temporal trends. RESULTS:Cancer incidence and mortality rates are markedly higher in the elderly across UN regions. In Africa, the incidence rate for the elderly is 748.59 per 100,000, compared to 59.41 for the young, while mortality rates are 582.82 for the elderly versus 34.54 for the young. In Northern America, the elderly incidence is 2623.83 per 100,000, with mortality at 800.70, compared to 308.35 and 58.55 for the young, respectively. Prostate cancer incidence among elderly men is significant, while breast cancer is predominant in elderly women. By 2050, Northern America's elderly incidence is projected to rise to 2905.74 per 100,000, with mortality increasing to 961.07. Latin America anticipates a rise in elderly incidence from 1257.84 to 1313.00 per 100,000 and mortality from 732.15 to 782.65. CONCLUSION:The analysis indicates significant demographic shifts, with the elderly population projected to markedly increase across all UN regions from 1970 to 2050, highlighting the urgent need for targeted healthcare strategies to address the rising cancer burden, particularly in higher HDI regions. By analyzing the interplay between demographic shifts, socioeconomic factors, and cancer trends, this study provides valuable insights for policymakers and healthcare providers, advocating for proactive planning and resource allocation to effectively tackle the anticipated rise in cancer incidence and mortality among the elderly.
Abstract South Asian communities in the UK experience disproportionate maternal and child health inequalities linked to non-recommended infant feeding practices, limited health literacy, and socioeconomic constraints. Participatory learning and action (PLA) is effective in low- and middle-income countries, but high-income evidence is scarce. This pilot assessed the feasibility of a community facilitator-led PLA intervention to improve infant feeding among South Asian families in East London. A three-arm pilot feasibility cluster randomised controlled trial ( ISRCTN10234623 ) was conducted in Tower Hamlets and Newham, East London (May–September 2022), with 12 wards randomised 1:1:1 to face-to-face PLA, online PLA, or usual care. Multilingual community facilitators delivered eight biweekly sessions over 14 weeks. Feasibility outcomes were assessed against prespecified Go/Stop criteria; exploratory outcomes included child feeding behaviours (Children’s Eating Behaviour Questionnaire, CEBQ), parental feeding style (Parental Feeding Style Questionnaire, PFSQ), and child BMI Z-scores. Of 263 enrolled participants, 261 had a recorded trial arm allocation; consent to the pilot feasibility study was 70.7% (186/263; 95% CI 65.0–75.9%) meeting the ≥50% Go criterion. Attendance was 37% (Tower Hamlets 59%, Newham 29%), below the ≥80% Go threshold. Six-month retention was 54.8% (Tower Hamlets 78%, Newham 48.5%; 95% CI 41.8–55.3%), triggering the Definite Stop criterion. Significant baseline imbalances included BMI Z-score (p = 0.005), ethnicity, borough, and education; no between-arm BMI differences were observed at follow-up (p = 0.249). CEBQ and PFSQ baseline completion was 24.5% and 23.0%, with no usable follow-up data. PLA Phases 3 and 4 were not completed by any group; all participants providing feedback reported it acceptable. Recruitment was feasible and the intervention acceptable, but a Definite Stop criterion was triggered in Newham, no group completed the full PLA cycle, and outcome data were insufficient for evaluation. A definitive trial requires stratified randomisation, digitised multilingual data collection, participant reimbursement, and explicit PLA phase-completion criteria. Trial registration ISRCTN10234623 (IRAS ID: 296259; Ethics Ref: 21/SW/0142).
Irritable bowel syndrome is a common disorder of gut-brain interaction characterized by chronic abdominal pain and altered bowel habits in the absence of structural pathology. Its pathophysiology reflects a complex interplay between the central nervous system, enteric nervous system, microbiota, immune signaling, epithelial barrier dysfunction etc. Despite advances in the understanding of the mechanisms causing IBS, the diagnosis of IBS remains primarily symptom-based, necessitating the use of objective tools to improve diagnostic precision and personalized management. This review synthesizes highlights existing literature on IBS biomarkers, including inflammatory markers (cytokines, C-reactive protein), microbial signatures (gut microbiota composition, anti-CdtB and anti-vinculin antibodies), metabolic indicators (bile acids, short-chain fatty acids), and markers of intestinal permeability (zonulin) to assess their applications in the diagnosis and management of IBS. We also examined emerging multi-omics technologies that identify the complex patterns linking the gut, the brain and the microbiota. Early research focusing on single biomarkers demonstrated limited diagnostic utility due to the heterogeneous and multifactorial nature of IBS. Recent advances support the development of composite, mechanism-based biomarker panels that integrate multiple biological domains, offering improved representation of underlying pathophysiological processes. These developments mark a shift from a single-marker approach toward multidimensional biomarker strategies. This narrative review synthesizes current evidence and proposes a framework for integrating biomarkers into clinical practice. Biomarkers are best utilized following a positive symptom-based diagnosis and exclusion of alarm features, to stratify patients into biologically relevant subtypes and guide targeted therapy. This supports a transition from exclusion-based diagnosis of IBS towards a positive and more precise one.
