Association between body mass index and hemoglobin levels among university students: a cross-sectional study

Introduction: Obesity is a major global health challenge it is estimated that by 2035, approximately 1.77 billion adults will be overweight 1.53 billion will be obese. Anemia has long been recognized in relation to underweight and malnutrition. However, recent studies have found a paradoxical relationship between obesity and iron deficiency which is mediated by chronic inflammation. Objective: This study aimed to determine the association between Body Mass Index (BMI) and Hemoglobin (Hb) levels in university students. Method: An analytical cross-sectional study was carried out at Al-Furat Al-Awsat Technical University in Iraq on 413 students using non-probability purposive sampling. Data were collected using a validated self-administered questionnaire for socio-demographic and lifestyle factors, and anthropometric measurements for calculating BMI, and venous blood analysis for hemoglobin estimation using a hematology analyzer. Data analysis was performed using SPSS version 26 software with Chi-square and One-Way ANOVA tests to find associations at a significance level of p<0.05. Results: The result of 413 students (mean age 20.51 ±1.72 years) showed a high prevalence of anemia (40.7%) and malnutrition, with 17.4% of students being underweight and 32.2% being overweight/obese. There was a statistically significant relationship between BMI and hemoglobin concentration (p<0.001); the prevalence of anemia was significantly higher in both underweight and overweight/obese students than in normally weighted students. In addition, hemoglobin concentration was significantly different according to sex, breakfast and dietary habits, sleep duration and physical activity (p<0.05). Conclusion: The study results revealed a double burden of malnutrition among student anemia posed a serious problem for both underweight and overweight individuals. This condition was closely linked to unhealthy eating habits such as skipping breakfast, high caffeine consumption, and lack of exercise. Therefore, the study recommended integrating anemia screening into all BMI categories and raising nutritional awareness to mitigate the negative health effects of university life

A systematic review on marine-derived fucoidan as a nutritional therapeutic in periodontal disease

Introduction: Fucoidan is a naturally occurring sulfated polysaccharide derived from brown seaweeds such as Fucus vesiculosus, Laminaria japonica, and Undaria pinnatifida.  As a nutritive agent, fucoidan modulates tsystemic health through its bioactive components that influence metabolic, immune, and cellular functions.  Its anti-inflammatory properties have a promising role in mitigating chronic low-grade inflammation, which underlies many systemic and oral diseases.  Fucoidan is recently reported to possess significant antibacterial activity and the evidence regarding its use for periodontal diseases is scattered. Objective: Critical evaluation of the efficacy of fucoidan on periodontal pathogens using the existing evidence. Methods: Literature search was done on PubMed, Cochrane, Scopus, etc, according to PRISMA guidelines. Relevant articles were collected and evidence was tabulated. Results: The collected evidence indicated that fucoidan shows multifaceted therapeutic potential regarding periodontal diseases through multiple mechanisms like modulation of microbial virulence, reduction of inflammation, and boosting host–pathogen balance. Conclusion: Fucoidan exhibited promising antimicrobial, antibiofilm, and anti-inflammatory properties against periodontal pathogens

Barriers encountered by nurses while caring of mechanically ventilated adult patients: a cross-sectional study

Introduction: Mechanical ventilation (MV) is a critical and frequently used intervention in intensive care units (ICUs), with up to 70% of ICU patients requiring it. The rates of invasive mechanical ventilation range from 29.1% to nearly 90% in some studies, particularly during the COVID-19 pandemic, with associated mortality rates exceeding 35% to 50%. Providing care for mechanically ventilated adult patients is a complex and high-risk nursing responsibility. Objective: This study aimed to identify the primary barriers encountered by nurses when caring for mechanically ventilated adult patients and to examine how these barriers relate to their demographic and professional characteristics. Methods: A descriptive cross-sectional study was conducted in the Respiratory Care Units (RCUs) of Kirkuk and Azadi Teaching Hospitals to identify barriers encountered by ICU nurses caring for mechanically ventilated adult patients. The study included 93 nurses with at least six months of RCU experience, recruited using a convenience sampling technique. Sample size adequacy was justified using a single-proportion formula at 95% confidence and 5% margin of error. Data were collected via a structured, self-administered questionnaire covering demographics, staffing/ workload, knowledge/training, equipment/ resources, and communication/emotional barriers, measured on a 5-point Likert scale. The questionnaire was validated by experts and piloted (Cronbach’s alpha = 0.87). Ethical approval was obtained, and participants provided informed consent with confidentiality ensured. Data were analyzed using SPSS 26.0, employing descriptive statistics, t-tests, and ANOVA, with p < 0.05 considered statistically significant. Results: The majority of participants were female (62.4%) and aged 30–39 years (43.0%). The most prominent barriers identified were staffing shortages (mean = 4.2), lack of formal ventilator training (mean = 4.1), stress and burnout (mean = 4.1), and equipment shortages (mean = 3.9). Overall mean scores for staffing/workload, knowledge/training, equipment/resources, and communication/ emotional barriers were 3.77, 3.86, 3.71, and 3.82, respectively. No statistically significant relationships were observed between demographic variables and perceived barriers (p > 0.05). Conclusion: ICU nurses face multiple, interconnected barriers when caring for mechanically ventilated adult patients, including inadequate staffing, insufficient knowledge, limited availability of equipment, and work-related psychological stress. Organizational interventions such as improving staffing levels, providing formal training, ensuring resource availability, and supporting nurses’ well-being are essential to enhance the quality of patient care. Graphical abstrac

Prevalence of complications for type 2 diabetes mellitus among patients visiting the diabetes clinic at azadi teaching hospital: a cross-sectional study

Diabetes mellitus, commonly referred to as DM, is a chronic illness that can no longer develop or be transmitted as an epidemic. The research study aims to ascertain the frequency of type 2 diabetes mellitus complications among patients attending the diabetes clinic of Azadi Teaching Hospital. Azadi Teaching Hospital Kirkuk City was conducted the cross-sectional descriptive research. Purposively sampling (non- probability) of 118 samples was done. A strong relationship was found in the current study between the length of diabetes and number of problems. Having a disease for a long period of time is linked with more hypertension, cardiovascular disease, and ischemic heart disease rates, with DM consequences being a particularly important one. More research involving more people will get more accurate results. Graphical Abstrac

Epigenetic modifications in adipose tissue following calorie-restricted diets in adults with obesity: a randomized controlled experimental trial

Obesity is a complex disease that is characterized by an unhealthy proportion of body fat and metabolic diseases. It has also been recently shown that epigenetics (e.g., DNA methylation, histone changes, and non-coding RNAs) must be considered in treating obese clients because epigenetics can manipulate adipocytes and energy metabolism. Calorie-restriction (CR) methods have already been known to yield iweight-loss effects. Recent studies have established that epigenetic modification in adipose tissue are central to CR intervention can initiate a more preferable remodelling of epigenetics in adipose tissue, in a way that will enable a change in metabolic state. The article recounts the effects of CR intervention on the adipose tissue epigenetics in obese adults, and as case illustrations of a clinical nutrology perspective. The recent studies gave significant results, such as coordinated alterations in obesity-related locus CR-induced methylation, histone acetylation, and changes in microRNA expression that result in better insulin sensitivity, reduced inflammation, and lipid metabolism. It means that epigenetic markers can be considered as markers of dietary responsiveness that would allow individualized nutrition in the case of differences in responding to CR interventions, including potential confounders. These are just initiations to the incorporation of epigenetics into the nutrition sciences, and It consider CR not only as a calorie-limiting intervention but also as an intervention that can alter gene regulation. This will enable us to advance the nutrition practice in the future with precision nutrology, developing sustainable obesity management, and providing metabolic health in the long term

Relationship between relative skeletal muscle index (RSMI) in physically active adults and the use of major sports supplements: a retrospective observational study

Introduction: The indiscriminate use of supplements poses a problem for overall health, with Brazil being one of the countries that consumes the most dietary supplements in the world. However, when used as indicated and correctly, supplements can positively influence muscle mass gain, performance, and general health. Objective: This study aimed to evaluate whether there is a relationship between physical exercise and the use of supplements related to physical exercise that are most common in clinical practice (whey protein, creatine, hydroxymethylbutyrate, beta- alanine, glutamine, and caffeine) with relative skeletal muscle indices (RSMI). Methods: The present study employed a retrospective observational design, adhering to the STROBE guidelines. A total of 50 adult patients aged between 18 and 65 years who practice physical exercise were evaluated in medical centers in the city of Brasília between May 2023 and May 2024 using whole-body Bioimpedance Imaging or DEXA analysis. Only patients who used one or more supplements and were non-sedentary according to the criteria of the health organization were included in the study. Results: The general clinical data presented a total of 50 participants, the majority of whom were male (58%), with the DEXA group having 44 participants and the BIO group having 06 participants. The overall mean age was 40.60 years (22 to 60). The amount of physical exercises practiced per week was 4.80 (3 to 9) in general. It was also found that the overall RSMI had a mean of 8.56 ±1.76. The general use of supplements (DEXA and BIO) showed that the use of creatine (34%) and creatine with Whey Protein (24%) were the most frequent. The present study observed that there was an important relationship between the male gender and the RSMI, with OR=4.89 and p=0.000. In addition, the nominal logistic regression analysis of the supplement predictors in general (DEXA and BIO) to the RSMI response predictor showed statistical significance to the combinations of supplements creatine, BCAA, Whey, and Whey, creatine, and beta-alanine, p=0.015 and OR=1.62 for both combinations. There was no statistically significant difference between the mean RSMI values of the DEXA and BIO groups, with p=0.307. Conclusion: It was concluded that there was a relationship between physical exercise and the use of supplements most common in clinical practice, such as Whey protein, creatine, hydroxymethylbutyrate, beta-alanine, glutamine, and caffeine with the increase in the relative skeletal muscle mass index (RSMI) in physically active adults. The general use of supplements (DEXA and BIO) showed that the use of creatine (34%) and creatine with Whey Protein (24%) were the most frequent. Furthermore, there was an important relationship between the male gender and the relative skeletal muscle index (RSMI). In the female gender, no increase was observed. Statistical significance was evidenced by the combinations of supplements creatine, branched-chain amino acids (BCAA), Whey, and Whey, creatine, and beta-alanine. There was no statistically significant difference between the mean RSMI values of the DEXA and BIO group

Randomized controlled clinical study on proteomic analysis of skeletal muscle adaptations to high-protein nutrition in post-bariatric surgery patients with obesity

Introduction: Bariatric surgery can cause complicated metabolic and physiological changes in some patients, leading to a significant amount of loss of lean mass. The preservation of skeletal muscle mass is important for metabolic health, functional performance, and long-term weight maintenance. Proteomics provides detailed information on muscle tissue molecular responses, but can be best utilized when coupled with intentional nutritional interventions such as high-protein diets. Objective: The intent of the present study was to examine skeletal muscle proteomic responses to bariatric surgery in obese males and females using a high-protein nutrition intervention. Methods: Patients with obesity after bariatric surgery followed a standardized high-protein nutritional intervention (≥ 1.5g protein per kg per day). Muscle biopsies were taken at baseline (pre-treatment) and 12 weeks post-surgery. Muscle biopsies were taken, proteins extracted, digested, and analyzed by LC-MS-MS (label-free quantification). It used bioinformatic applications to perform differential quantitative analysis of protein expression, pathway enrichment, and functional annotation of differentially expressed proteins. Results and Conclusion: High protein nutrition resulted in upregulation of proteins associated with mitochondrial function, oxidative phosphorylation, and translation, while demonstrating downregulation of proteins representing catabolic and inflammatory pathways. Also, many of the proteomic adaptations identified were supportive of improved muscle remodelling (i.e., improved structural contractile proteins and regulators of protein synthesis). High protein nutritional support after bariatric intervention promotes advantageous skeletal muscle proteomic remodelling, which promotes retention of lean mass and recovery of metabolic status. The data also demonstrated that high-protein nutrition, after bariatric surgery, was associated with positive molecular adaptations

Major relevances of nutrological therapy and gut microbiota in neurodegenerative diseases: a systematic review

Introduction: Critical patients, both due to brain injury and neurodegenerative diseases, have an increased risk of developing nutritional malnutrition due to complex problems and deleterious effects of diseases on protein and energy metabolism, resulting in metabolic dysregulation, hypercatabolic state and depletion of energy reserves energy. Objective: It was to carry out a systematic review to externalize and discuss the main findings on the effects of enteral nutritional therapy, as well as on the action of the gut microbiota in patients with brain injuries or neurodegenerative diseases. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from March to May 2025 in the Web of Science, Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 108 articles were found, and 20 articles were evaluated in full, and 08 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies with a high risk of bias and 24 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=88.9%>50%. Enteral nutrition supplemented with probiotics effectively decreases the risk of mortality, gastrointestinal complications, and infection, and shortens the length of stay in the intensive care unit, therefore, it should be widely adopted for the management of these patients. Nasal inspiratory pressure during a sniff at baseline is an early indicator of disease progression and therefore the need for enteral nutrition in amyotrophic lateral sclerosis. Furthermore, problems with tolerance, diarrhea, and abdominal distension decreased between the 3 and 6-month visits in patients who received home enteral nutrition

Interventional radiology in the management of complications following bariatric surgery: a narrative review

Introduction: With over 580,000 procedures carried out globally each year, bariatric surgery has emerged as one of the most successful long-term therapies for obesity, a global health issue that affects over 650 million adults worldwide. In addition to its morbidities, bariatric surgery, a proven treatment for morbid and other forms of obesity, has a number of early and late postoperative problems. Objective: This study aimed to assess the use of interventional radiology in the minimally invasive therapeutic management of problems, in addition to its uses in bariatric treatment. Methods: PubMed, Scopus, and Web of Science databases were utilized for conducting a narrative review. Peer-reviewed articles published in English between 2010 and 2025 have been studied primarily for techniques guided by IR for the treatment of problems post-bariatric surgery. Results: Interventional radiology helps immensely for the treatment of various common post-operative problems such as gastrointestinal leaks, strictures, abscesses, and bleeding. Various image-guided techniques such as percutaneous drainage, angiogram and embolization, balloon dilatation, and stenting have been proven to be successful and have reduced morbidity rates and lower hospital stay time for the patient as compared to certain individuals undergoing surgery. Conclusion: Interventional radiology is already a key component of modern postoperative therapy, with efficient, minimally invasive approaches to a variety of problems after bariatric surgery. A further step toward better patient outcomes would be the more extensive integration of interventions, standardized care pathways, and prospective study based on outcomes

Dyslipidemia among medical college students in Basrah: a cross-sectional study of patterns and risk factors

Introduction: Dyslipidemia is a well-known metabolic derangement closely associated with atherosclerosis and cardiovascular diseases. In recent years, it has been increasingly recognized as an emerging health concern among young populations. Medical college students, due to lifestyle changes coupled with academic and social pressures, are at particular risk. The aim of this study is to assess the extent and pattern of dyslipidemia among medical college students at the University of Basrah, identifying possible preventable lifestyle behaviors and environmental risk factors. Patients and Methods: A total of 330 (241 male and 89 female) randomly selected apparently healthy medical college students were included in this cross-sectional study. Over- night fasting, lipid profile blood samples were collected. Dietary and behavioral information of the participants, in addition to demographic and anthropometric data, were recorded using structured questionnaires and direct measurements.  All biochemical, anthropometric, and demographic data were collected and analyzed. Results: Out of a total number of 330 participants, 175 students (53%) were found to have at least one abnormal lipid profile. Low HDL-C  was the most prevalent form of dyslipidemia among the studied population, representing around 46.97% fallowed by high levels of low-density lipoprotein (LDL-C), which was found in 40.9% of subjects, while 37.88% have elevated triglycerides (TG) levels and 30% have high total cholesterol (TC) levels .  These dyslipidemias were significantly more prevalent in males than females and in smokers than non-smokers. Analysis of demographic and anthropometric data showed that dyslipidemia was significantly more prevalent in participants from the faculty of Medicine and in those who were physically inactive, had unhealthy eating habits, and those with high waist circumference or a BMI value more than 25 kg/m2. Conclusion: Dyslipidemia is a prevalent condition among medical college students. Risk factors that substantially contribute to dyslipidemia include male sex, smoking, junk food eating, central obesity, social stress, and physical inactivity