Saanvi Singireddy

Background: Mild cognitive impairment (MCI) represents an intermediate state between normal cognitive ageing and dementia. Given the increasing dementia burden in the country, there is a critical need for early detection through the assessment of MCI. However, studies that comprehensively examined the associations between micronutrients, neuronal markers, and cognitive impairment are scarce. Methods: A community-based cross-sectional study was conducted among 184 adults aged 55–85 years in Hyderabad between January 2024 and March 2025. Sociodemographic, anthropometric, biochemical, nutritional, and neuronal biomarkers were estimated. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) tool. Results: The study reported an MCI prevalence of 36.4% among older adults, significantly associated with higher HbA1c and systolic blood pressure, and elevated neuronal markers such as β-Amyloid, T tau, and Nfl. Vitamin D, B1, B2, B6, and B9 levels were significantly lower in the MCI group, with a higher burden of deficiency. Higher vitamin levels were correlated with better MoCA scores and a lower predicted probability of MCI, especially vitamins D and B6. In particular, B2 and B6 have shown associations with BDNF, tau, and Nfl markers. Conclusions: Lower levels of circulatory vitamins were significantly associated with a higher probability of MCI. Also, neuronal biomarkers were significantly associated with micronutrient deficiencies. These findings suggest that micronutrient deficiencies may be associated with MCI in older adults, highlighting the potential importance of maintaining adequate micronutrient status to support healthy cognitive aging and possibly reduce the risk of dementia. However, given the cross-sectional design of the present study, causal relationships cannot be established. Future longitudinal studies are warranted to validate these associations and further clarify the temporal relationship between micronutrient status and cognitive decline.

Headache management after acute brain injury (ABI) is challenging. Although opioids are commonly used, selective cyclooxygenase 2 inhibitors (COXIBs) may be promising alternatives. However, concerns about cardiovascular effects and bleeding risk have limited their use. We aimed at summarizing available data on efficacy of COXIBs for headache management following ABI. A systematic review was conducted through MEDLINE and Embase for articles published through September 2023 (PROSPERO identifier: CRD42022320453). No language filters were applied to the initial searches. Interventional or observational studies and systematic reviews assessing efficacy of COXIBs for headache in adults with ABI were eligible. Article selection was performed by two independent reviewers using DistillerSR. Descriptive statistics were used for data analysis, and meta-analysis was unfeasible because of study heterogeneity. Of 3190 articles identified, 6 studies met inclusion criteria: 4 randomized controlled trials and 2 retrospective cohort studies, all conducted in elective cranial neurosurgical patients (total N = 738) between 2006 and 2022. Five studies used COXIBs in the intervention group only. Of the six studies, four found a reduction in overall pain scores in the intervention group, whereas one showed improvement only at 6 h postoperatively, and one did not find significant differences. Pain scores decreased between 4 and 15%, the largest shift being from moderate to mild severity. Three studies found an overall opioid use reduction throughout hospitalization in the intervention group, whereas one reported a reduction at 12 h postoperatively only. Opioid consumption decreased between 9 and 90%. Two studies found a decrease in hospital length of stay by ~ 1 day in the intervention group. The one study reporting postoperative hemorrhage found a statistically nonsignificant 3% reduction in the intervention group. COXIBs may serve as opioid-sparing adjunctive analgesics for headache control after elective cranial surgery. Limited or no literature exists for other forms of ABI, and additional safety data remain to be elucidated.

Background: Headache management after acute brain injury (ABI) is challenging. While opioids are commonly used, selective cyclooxygenase-2 inhibitors (COXIBs) may be promising alternatives. However, concerns about cardiovascular effects and bleeding risk have limited their use. We aimed at summarizing available data on efficacy of COXIBs for headache management following ABI. Methods: A systematic review was conducted through MEDLINE and Embase for articles published through 09/2023 (PROSPERO CRD42022320453). No language filters were applied to the initial searches. Interventional or observational studies and systematic reviews assessing efficacy of COXIBs for headache in adults with ABI were eligible. Article selection was performed by two independent reviewers using Distiller SR®. Descriptive statistics were used for data analysis, while meta-analysis was unfeasible due to study heterogeneity. Results: Of 3190 articles identified, six studies met inclusion criteria: four randomized controlled trials and two retrospective cohort studies, all conducted in neurosurgical patients (total n=738) between 2006-2022. Five studies used COXIBs in the intervention group only. Of the six studies, four found a reduction in overall pain scores in the intervention group, while one showed improvement only at 6 hours postoperative, and one did not find significant differences. Pain scores decreased between 4-15%, the largest shift being from moderate to mild severity. Three studies found an overall opioid use reduction throughout hospitalization in the intervention group, while one reported a reduction at 12 hours postoperative only. Opioid consumption decreased between 9-90%. Two studies found a decrease in hospital-length-of-stay by ~1 day in the intervention group. The one study reporting postoperative hemorrhage found a statistically non-significant 3% reduction in the intervention group. Conclusions: In adults with ABI, COXIBs may serve as opioid-sparing adjunctive analgesics for headache control, with limited but pointed data to indicate efficacy in the post-neurosurgical setting. However, further safety data remains to be elucidated.