Introduction: Obstructive sleep apnoea (OSA) is characterised by recurrent pharyngeal collapses that occur five or more times per hour of sleep or more and reduce or completely block airflow for at least 10 seconds. Obesity predis-poses individuals to and potentiates OSA. Materials and methods: As a pre- and post-training activity measure, 30 obese people between the ages of 25 and 45 were asked to complete the STOP-BANG questionnaire and a 6-minute walk test. After that, they engaged in aerobic activity. Results: The scores for the six-minute walk test and the stop-bang questionnaire were 0.0005 and 0.0003, respectively with a “p” value- ≤0.001 (significant). In our investigation, the effects of aerobic exercise on exercise tolerance and obstructive sleep apnoea were significantly different. Con-clusion: Aerobic exercise is a better intervention for increasing exercise tolerance and obstructive sleep apnoea in obese patients. This intervention may be a significant contributor to cardiorespiratory fitness and can be considered a useful tool for enhancing quality of life.

Objectives: Catastrophic health expenditures (CHE) is a well-established indicator of financial risk protection. This study aimed to examine the contribution of medication expenditure to CHE and the associated socioeconomic inequalities. Methods: Data were drawn from 6 nationally representative income and expenditure surveys covering the period 2019–2024. Using the budget share method, CHE was defined as out-of-pocket (OOP) health payments exceeding 25% of a household’s total consumption expenditure. The contribution of medication expenditures to CHE was then calculated as the difference in the proportion of households experiencing CHE with and without medication payments. Socioeconomic inequalities were quantified using the Concentration Index (CI), and decomposition analysis was conducted to identify the primary drivers of overall socioeconomic inequality in the contribution of medication expenditures to CHE. Results: During the study period, medications represented a substantial share of household health expenditures and contributed to CHE. In 2024, OOP spending on medications accounted for 31.2% of total health expenditures, while the contribution of medication expenditures to CHE was 1.28%. The CI indicated that the contribution of medication expenditures to CHE was concentrated among poorer households. Decomposition analysis further identified medium-sized households, male-headed households, households with employed heads, insured households, and urban households as the main contributors to this socioeconomic inequality. Conclusions In Iran, OOP payments for medications constitute a substantial share of household healthcare expenditures and contribute to CHE. Because the roots of inequality extend beyond the healthcare system, addressing this issue requires a comprehensive, cross-sectoral strategy that integrates broader social and economic policies.

Background: The mortality of severe dengue infections is approximately 23%. In the management of dengue shock syndrome (DSS), aggressive fluid resuscitation is recommended. The primary objective of our study was to assess the factors associated with 30-day mortality in DSS patients. Methods: Adult patients >18 years old, who were admitted with DSS were included. DSS was diagnosed in patients who required vasopressors or had lactic acidosis >4 mmol/L. Patients were divided into three different groups based on cumulative fluid balance at death or extubation: group I (<3.5 L), group II (3.5–8.0 L), and group III (>8.0 L). Results: A total of 135 patients with DSS was included, with an overall 30-day mortality of 74.8%. The average Sequential Organ Failure Assessment (SOFA) score on intensive care unit admission was 12.2. Mechanical ventilation was required in 112 patients (83.0%), with 61 patients (45.2%) being intubated without a noninvasive ventilation trial. Respiratory failure was the most common reason for requiring intubation (65 patients, 48.2%). In survivors, the median cumulative fluid balance was 1,493 ml (interquartile range [IQR], 0–4,501 ml), whereas that in the mortality group was 7,797 ml (IQR, 3,700–13,600 ml). On multivariate analysis, SOFA score (odds ratio [OR], 1.220; 95% CI, 1.011–1.472; P=0.038) and having received >8.0 L cumulative fluid balance (OR, 6.682; 95% CI, 1.808–24.689; P=0.004) were associated with increased risk of mortality. Conclusions DSS patients have high mortality rates. High SOFA scores and >8.0 L cumulative fluid balance may indicate worse outcomes.

Background: Coal miners are highly prone to occupational health risks, such as black lung disease. This study aims to assess the prevalence of black lung disease and the factors associated with black lung disease among coal miners in Asia.MethodThis systematic review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, searched through the scientific literature of the following databases: EBSCO, ScienceDirect, PubMed, and Scopus. We selected articles that studied black lung disease among coal miners from 48 countries in Asia and were published between 2014 and 2023. Article quality was evaluated using the Critical Appraisal Skills Program.ResultThe seven articles that we review studied a total of 653,635 coal miners from various types of coal mines from three countries in Asia. Of these miners, 59,998 experienced black lung disease. Black lung disease is prevalent among 9.18% of coal miners in Asia, which is approximately four times higher than the worldwide prevalence. Common factors that influence black lung disease in Asia include age, years of dust exposure, smoking, drinking, working types, and sizes of mines, type of mines, respiratory functions, spirometry parameters, tenure, lack of attention to occupational health, inefficient surveillance, and weak occupational health service. Conclusion Although the prevalence of black lung disease among coal miners in Asia is considerably high, it can be addressed through effective prevention measures, monitoring, control, and case reporting.

Background: Hepatic encephalopathy (HE) is an adverse prognostic indicator of liver cirrhosis, often triggered by various precipitating factors, with gastrointestinal bleeding being the most common. Comparing the Child–Pugh and Model for End-Stage Liver Disease (MELD) scores to predict the severity and outcome of complications in patients with cirrhosis could help establish an accurate prognosis. Methods: We retrospectively reviewed the records of patients with cirrhosis aged 18 and older who were referred to the Gastroenterology Department at Imam Khomeini Hospital in Ahvaz from April to September 2023. A statistical analysis was conducted to compare MELD and Child-Pugh score (CPS) in 95 patients with cirrhosis. Results: The in-hospital mortality rate was strongly correlated with certain complications of cirrhosis. Gastrointestinal bleeding and HE showed statistical significance (P < 0.05). Additionally, the co-occurrence of cirrhosis complications, particularly HE in conjunction with others, was associated with increased mortality rates. Abnormal levels of the international normalized ratio, prothrombin time, partial thromboplastin time, bilirubin, and liver enzymes (alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase) were also associated with mortality (P < 0.05). Specific laboratory factors in ascites fluid, namely total cell count and red blood count, were linked to the 6-month survival rate (P < 0.05). Furthermore, CPS was identified as a more specific and sensitive independent predictor of 6-month in-hospital survival than the MELD score (logistic regression: odds ratio, 2.3; standard error, 0.0189; P < 0.05). Conclusion We recommend continuing to use the CPS for predicting in-hospital mortality in patients with cirrhosis and for the individual evaluation of liver disease in daily clinical practice.

Background: Hepatic encephalopathy (HE) is an adverse prognostic indicator of liver cirrhosis, often triggered by various precipitating factors, with gastrointestinal bleeding being the most common. Comparing the Child–Pugh and Model for End-Stage Liver Disease (MELD) scores to predict the severity and outcome of complications in patients with cirrhosis could help establish an accurate prognosis. Methods: We retrospectively reviewed the records of patients with cirrhosis aged 18 and older who were referred to the Gastroenterology Department at Imam Khomeini Hospital in Ahvaz from April to September 2023. A statistical analysis was conducted to compare MELD and Child-Pugh score (CPS) in 95 patients with cirrhosis. Results: The in-hospital mortality rate was strongly correlated with certain complications of cirrhosis. Gastrointestinal bleeding and HE showed statistical significance (P < 0.05). Additionally, the co-occurrence of cirrhosis complications, particularly HE in conjunction with others, was associated with increased mortality rates. Abnormal levels of the international normalized ratio, prothrombin time, partial thromboplastin time, bilirubin, and liver enzymes (alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase) were also associated with mortality (P < 0.05). Specific laboratory factors in ascites fluid, namely total cell count and red blood count, were linked to the 6-month survival rate (P < 0.05). Furthermore, CPS was identified as a more specific and sensitive independent predictor of 6-month in-hospital survival than the MELD score (logistic regression: odds ratio, 2.3; standard error, 0.0189; P < 0.05). Conclusion We recommend continuing to use the CPS for predicting in-hospital mortality in patients with cirrhosis and for the individual evaluation of liver disease in daily clinical practice.

Stem cells transplantation (SCT) is known as a newfound strategy for multiple sclerosis (MS) treatment. Human umbilical cord mesenchymal stem cells (hUCMSCs) contain various regenerative features. Experimental autoimmune encephalomyelitis (EAE) is a laboratory model of MS. This meta-analysis study was conducted to assess the overall therapeutic effects of hUCMSCs on reduction of clinical score (CS) and restoration of active movement in EAE-induced animals. For comprehensive searching (in various English and Persian databases until May 1, 2024), the main keywords of “Experimental Autoimmune Encephalomyelitis”, “Multiple Sclerosis”, “Human”, “Umbilical Cord”, “Mesenchymal”, and “Stem Cell” were hired. Collected data were transferred to the citation manager software (EndNote x8) and duplicate papers were merged. Primary and secondary screenings were applied (according to the inclusion and exclusion criteria) and eligible studies were prepared for data collection. CS of two phases of peak and recovery of EAE were extracted as the difference in means and various analyses including heterogeneity, publication bias, funnel plot, and sensitivity index were reported. Metaanalysis was applied by CMA software (v.2), P<0.05 was considered a significant level, and the confidence interval (CI) was determined 95% (95% CI). Six eligible high-quality (approved by ARRIVE checklist) papers were gathered. The difference in means of peak and recovery phases were –0.775 (–1.325 to –0.225; P=0.006; I2 =90.417%) and –1.230 (–1.759 to –0.700; P<0.001; I2 =93.402%), respectively. The overall therapeutic effects of SCT of hUCMSCs on the EAE cases was –1.011 (95% CI=–1.392 to –0.629; P=0.001). hUCMSCs transplantation through the intravenous route to the animal MS model (EAE) seems a considerably effective procedure for the alleviation of motor defects in both phases of peak and recovery.

Purpose: Sodium is essentially required for homeostasis and physiological functions, but excessive sodium consumption increases the risk of obesity and other chronic disorders.Korean studies on the sodium-obesity relationship are limited, and thus, this study was undertaken to determine the nature of the relationship between sodium intake and obesity in Korean adults. Methods: Forty-two participants were divided into 2 groups according to body mass index (BMI, non-obese BMI < 25 kg/m2 , obese BMI ≥ 25 kg/m2 ). Dietary intakes and eating habits were analyzed using 3-day food records and a food frequency questionnaire. Anthropometric data were obtained from bioimpedance results, and fasting glucose and lipid levels were measured. Results: Mean weight, BMI, waist and hip circumferences, and body fat mass were greater in the obese group than in the non-obese group for men and women. Skeletal muscle mass and body fat mass were higher in obese women than in non-obese women. Biochemical data were no different in these two subgroups except triglycerides (TGs), which were higher in obese women. Nutrient intakes were not significantly different in obese and non-obese groups.However, obese men consumed excessive sodium, while obese women consumed slightly more than non-obese women. Obese men preferred salty foods and tended to overeat.Positive correlations were found between sodium intake and weight in men and percent body fat mass (PBFM) in women. Correlation analysis (adjusted for energy intake) of the relation between sodium intake and obesity-related factors showed sodium intake was positively correlated with PBFM and TG in women. Conclusion This anthropometric and biochemical data analysis emphasizes the need for awareness and interventions to mitigate the health risks of elevated sodium consumption.Our findings should aid future studies on the relationship between sodium and obesity and contribute to preventing and managing this metabolic condition.

Purpose: Korean patients with type 2 diabetes mellitus (T2DM) and obesity are at a high risk of developing severe non-alcoholic fatty liver disease (NAFLD). This study examined the dietary intakes and compared the risks of NAFLD-related complications in Korean patients with T2DM and obesity. Methods: Data from the Korean National Diabetes Program cohort were used to study patients with T2DM. Two hundred and sixty-five obese patients with T2DM (body mass index ≥ 25 kg/m2 ) were classified into NAFLD and non-NAFLD groups. The nutrient intake was analyzed using a 24-hour dietary recall questionnaire. Anthropometric and biochemical data were also obtained. Statistical analyses were performed to determine the significant differences between the 2 groups. Results: The serum gamma-glutamyl transpeptidase levels in obese patients with T2DM and NAFLD were significantly higher than in obese T2DM patients without NAFLD (p < 0.05). The serum glucose and lipid profiles showed no significant differences between the NAFLD and non-NAFLD groups. The carbohydrate, protein, and fat levels also did not differ significantly. The results showed that the fiber intake of the NAFLD and non-NAFLD groups was 14.11 ± 3.86 g/100 kcal and 15.70 ± 4.56 g/1,000 kcal, respectively, showing that the dietary fiber intake of the non-NAFLD group was significantly higher (p < 0.05). A correlation was observed between total fiber intake and γ-glutamyl transpeptidase in either patient group. In addition, the odds ratio of developing NAFLD was 0.29× lower when the fiber was consumed at 125% of adequate intake. Conclusions A higher dietary fiber intake may reduce the risk of NAFLD in obese patients with T2DM. The dietary intake of Korean obese patients with T2DM should include and be enriched in dietary fiber to aid in preventing and treating NAFLD.

Objectives: This study aimed to identify workstation factors influencing work-related musculoskeletal disorders (WMSDs) among information technology (IT) professionals in Indonesia. Methods: A cross-sectional study was conducted among 150 IT workers at small-enterprise companies who were randomly selected across East Java, Indonesia. The data were modeled using multiple linear regression, with a 95% level of confidence for determining statistical significance. Results: The respondents reported that the neck had the highest level of discomfort and was the most at risk of WMSDs, followed by the lower back, right shoulder, and upper back. Screen use duration (p=0.040) was associated with whole-body WMSDs, along with seat width (p=0.059), armrest (p=0.027), monitor (p=0.046), and a combined telephone and monitor score (p=0.028). Meanwhile, the factors significantly related to the risk of WMSDs in the hands and wrist were working period (p=0.039), night shift (p=0.024), backrest (p=0.008), and mouse score (p=0.032). Conclusions Occupational safety authorities, standards-setting departments, and policymakers should prioritize addressing the risk factors for WMSDs among IT professionals.