Student's Journal of Health Research Africa

Downregulation of PAX1 in OSCC enhances stemness and immunosuppression via IFIT1 and PD-L1 pathways. A systematic review.

2025-10-29T06:03:24+00:00

Background:

Oral squamous cell carcinoma (OSCC) remains a leading cause of cancer-related morbidity and mortality worldwide. Epigenetic alterations, particularly the hypermethylation-mediated downregulation of paired box gene 1 (PAX1), have been implicated in OSCC progression. Recent evidence suggests that PAX1 silencing may enhance stemness and immunosuppression through the interferon-induced protein with tetratricopeptide repeats 1 (IFIT1) and programmed death-ligand 1 (PD-L1) pathways, thereby promoting tumor aggressiveness and immune evasion.

Aim:

To systematically review and synthesize the available evidence on the downregulation of PAX1 in OSCC, with a focus on its role in enhancing stemness and immunosuppression via IFIT1 and PD-L1 pathways.

Materials and Methods:

A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies published up to 15 May 2025. Inclusion criteria comprised original research studies on human OSCC samples or relevant experimental models, evaluating PAX1 expression or methylation status in relation to stemness, immunosuppression, IFIT1, or PD-L1 signaling. Exclusion criteria included reviews, editorials, conference abstracts without full data, studies on non-OSCC malignancies (unless OSCC-specific data were provided), and studies lacking direct assessment of PAX1 status.

Results:

Seven studies met the inclusion criteria. PAX1 hypermethylation was consistently associated with transcriptional downregulation in OSCC tissues, correlating with advanced tumor stage, lymph node metastasis, and poor prognosis. Mechanistic studies revealed that PAX1 silencing activated IFIT1-driven signaling and upregulated PD-L1 expression, leading to enhanced cancer stem cell properties and suppression of anti-tumor immunity.

Conclusion:

Downregulation of PAX1 through promoter hypermethylation plays a critical role in OSCC progression by enhancing stemness and immunosuppressive mechanisms via IFIT1 and PD-L1 pathways. These findings highlight PAX1 as a promising biomarker for risk stratification and as a potential therapeutic target to counteract tumor aggressiveness and immune evasion.

PD-L1 upregulation and tumour progression in conjunction with lncRNA UCA1 about oral squamous cell carcinoma. A systematic review.

2025-10-29T06:10:34+00:00

Background:

Oral squamous cell carcinoma (OSCC) remains a lethal malignancy with a poor prognosis, particularly in advanced stages. The tumour microenvironment (TME), rich in cancer-associated fibroblasts (CAFs) and immune checkpoint molecules like PD-L1, is critical in OSCC progression. This review investigates the specific role of long non-coding RNA UCA1 in orchestrating PD-L1 upregulation and tumour progression within the OSCC TME.

Methodology:

This systematic review followed PRISMA guidelines. A comprehensive search of five electronic databases (PubMed, Scopus, Web of Science, Embase, and Lilacs) was conducted from 2020 to 2024. The search strategy used Boolean operators with terms related to "Oral cancer," "long non-coding RNA," "UCA1," "cancer-associated fibroblasts," and "PD-L1." Four original research articles meeting the inclusion criteria were selected for final analysis.

Results:

The included studies demonstrate that LncRNA UCA1 influences OSCC prognosis through genetic variants. Furthermore, CAFs, whose prevalence increases with tumour grade, contribute to an immunosuppressive TME. Key mechanisms identified include CAF-derived extracellular vesicles promoting epithelial-mesenchymal transition and collagen crosslinking, and stromal enzymes like NNMT regulating angiogenesis. Crucially, these CAF-driven processes are implicated in the upregulation of PD-L1, facilitating immune evasion.

Conclusion:

LncRNA UCA1 and CAFs are pivotal in driving OSCC progression and immune evasion via PD-L1 upregulation. Their interplay creates a pro-tumorigenic and immunosuppressive niche that supports disease advancement and resistance.

Recommendation:

Future research should prioritize elucidating the precise molecular cascade linking UCA1, CAF activation, and PD-L1 expression. Targeting this axis holds significant promise for developing novel diagnostic biomarkers and combination immunotherapies for OSCC.

Functional outcomes and complication patterns in adult distal radius fractures managed with volar locking plates: A prospective hospital-based observational study.

2025-12-12T08:03:00+00:00

Background
Distal radius fractures remain among the most frequent upper-limb injuries in adults. Volar locking plates have become a preferred treatment option due to their stable fixation and predictable functional recovery.

Aim: To assess functional outcomes and complication patterns in adults with distal radius fractures managed using volar locking plates.

Methods
This hospital-based observational study included 100 adult patients treated with volar locking plate fixation. Demographic features, fracture types, mechanism of injury, and operative details were recorded. Functional outcomes were assessed at 6 weeks, 3 months, and 6 months using the Modified Mayo Wrist Score (MMWS). Complications were documented throughout follow-up. Data were summarised using descriptive statistics.

Results
The mean age of participants was 44.6 ± 12.8 years, with a male predominance. Road-traffic accidents were the major cause of injury. AO Type C fractures formed the largest subgroup. Anatomical reduction was achieved in 90% of cases. Functional performance improved across follow-up, and 84% demonstrated excellent or good outcomes by 6 months. The mean final MMWS was 86.3 ± 9.4, reflecting favourable wrist function in most individuals. Complications occurred in 18% of patients. Transient median nerve neuropathy, superficial infection, tendon irritation, malunion, and implant loosening were the main issues; however, no case of tendon rupture or deep infection was recorded. Functional independence was regained by 92% at the end of follow-up.

Conclusion
Volar locking plate fixation offers stable anatomical restoration, reliable union, and robust functional recovery in distal radius fractures. The complication rate remained low, and most issues were manageable with timely intervention.

Recommendations
Future practice should incorporate early presentation, consistent radiographic monitoring, and structured physiotherapy to enhance long-term functional gains. Detailed preoperative planning is advisable for complex fractures to minimise malalignment. Strengthening postoperative surveillance can help detect implant-related issues early.

Clinical and radiological outcomes of distal one-third tibial fractures treated with minimally invasive plate osteosynthesis using anatomical locking plates: A prospective observational study.

2026-01-23T09:55:34+00:00

Background
Fractures of the distal one-third of the tibia are associated with significant treatment challenges due to limited soft-tissue coverage, compromised vascularity, and proximity to the ankle joint. Conventional open reduction techniques are linked to higher rates of wound complications and delayed union. Minimally invasive percutaneous plate osteosynthesis aims to preserve fracture biology while providing stable fixation.

Objective: To evaluate the clinical and radiological outcomes of distal one-third tibial fractures treated using minimally invasive osteosynthesis with anatomical locking plates.

Methods
A prospective observational study was conducted on 30 adult patients with distal one-third tibial fractures treated between January 2021 and January 2024 at Vels Medical College and Hospital, Tiruvallur, Tamil Nadu. Fractures were classified according to the AO/OTA classification. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society ankle–hindfoot score. Radiological union, time to union, alignment, and complications were documented over a minimum follow-up of 12 months.

Results
The mean age of patients was 56 ± 15 years. Road traffic accidents accounted for 60% of injuries. The mean time to radiological union was 17.4 ± 5 weeks. Excellent functional outcomes were observed in 83.3% of patients, while 16.7% achieved good outcomes. Complications included superficial infection (10%), deep infection (3.3%), malreduction (6.7%), and delayed union (10%). No cases of nonunion were recorded.

Conclusion
Minimally invasive plate osteosynthesis using anatomical locking plates results in reliable fracture union, excellent functional outcomes, and acceptable complication rates in distal one-third tibial fractures.

Recommendation
Minimally invasive plate osteosynthesis using anatomical locking plates is recommended for adult distal one-third tibial fractures where preservation of soft tissue and fracture biology is critical, particularly in fractures unsuitable for intramedullary nailing.

Evaluation of functional recovery after intertrochanteric fractures treated with proximal femoral nailing: a prospective cross-sectional study.

2025-12-12T08:19:52+00:00

Background:

Intertrochanteric fractures in older adults continue to pose a major challenge due to their association with reduced mobility, prolonged dependency, and increased morbidity. Proximal femoral nailing (PFN) has emerged as a preferred fixation method owing to its biomechanical stability and minimally invasive nature.

Aim:

To assess the functional outcomes, radiological union, and complication profile in patients with intertrochanteric fractures treated using proximal femoral nailing.

Methods:

This prospective cross-sectional study included 80 patients with radiologically confirmed intertrochanteric fractures managed with PFN. Baseline characteristics, AO/OTA fracture patterns, surgical timing, and early mobilisation status were documented. Radiological union was monitored at regular intervals. Functional outcomes were measured at six months using the Harris Hip Score (HHS). Complications were also recorded. Data were analysed descriptively and presented in structured tables.

Results:

The mean age of participants was 67.4 ± 9.8 years, and women accounted for 56% of the study population. AO/OTA 31-A2 fractures were the most common. Radiological union was achieved at 13.8 ± 2.4 weeks, with 90% consolidating within 16 weeks. Functional evaluation at six months revealed 40% excellent, 35% good, 17.5% fair, and 7.5% poor outcomes. Superficial infection occurred in 5% of cases, while minor implant-related complications were observed in 3.8%. No deep infections or implant failures were recorded.

Conclusion:

Proximal femoral nailing provides reliable fixation, predictable union, and favourable functional recovery in intertrochanteric fractures, with a low rate of complications. Early mobilisation and optimal implant positioning appear to support better long-term outcomes.

Recommendations:

Strengthening postoperative rehabilitation pathways, ensuring precise intraoperative screw placement, and initiating early weight-bearing under supervision can further enhance recovery. Wider adoption of patient-specific physiotherapy schedules, periodic functional assessment, and community-based fall-prevention programs may additionally reduce disability and improve overall quality of life in this population.

A relational turn in one health: A systematic review of environmental determinants, equity, and governance frameworks

2025-09-17T13:16:49+00:00

Background:

The One Health framework, originally developed for zoonotic disease prevention, has faced criticism for insufficient engagement with environmental and social determinants of health. As transnational crises from climate change, pollution, and biodiversity loss accelerate worldwide, there is an urgent need to re-vision One Health as a more equity-oriented and systems-based approach.

Methods:

Following PRISMA 2020 guidelines, this systematic review examined peer-reviewed review articles published between January 2021 and May 2025 that explicitly applied a One Health lens to environmental determinants of health. The review combined elements of the Mixed Methods Appraisal Tool (MMAT) and the Scale for the Assessment of Narrative Review Articles (SANRA) for quality appraisal. A hybrid synthesis process was employed to identify conceptual innovations and thematic domains.

Results:

Seven studies were included. The most commonly identified environmental determinants of One Health were climate change, biodiversity loss, and water insecurity. Three themes were identified: (i) Taking One Health beyond zoonoses; (ii) Building relational and context-specific approaches centered in equity and Indigenous knowledges; and (iii) Ongoing governance silos and marginalization of environmental actors in favour of biomedical and veterinary voices. Building on these insights, we propose a Relational One Health Framework, which centres justice, governance, and interdependence for health.

Conclusions:

This review conceptualises a Relational One Health Framework which reconceptualises health as an emergent property of interdependent human–animal–environment relationships, through equity and participatory governance. Buoyed by global momentum for “one health governance,” the framework provides a timely pathway for policymakers, practitioners, and researchers to embed environmental determinants within holistic governance of health.

Recommendation:

Future research should expand coverage of databases, integrate empirical case studies, and create integrative metrics that assess both environmental and health equity benefits. In policy platforms, environmental knowledge should be incorporated as a core interest in One Health implementation.

An analysis of how South African legislation National Environmental Management Biodiversity Act (NEMBA), regulates the use of indigenous medicinal plants: A desktop-based qualitative review design.

2025-11-05T15:36:35+00:00

Background
Indigenous medicinal plants are widely used in South Africa for traditional healing, pharmaceutical research, and commercial trade. Their increasing demand has raised concerns over biodiversity loss, bioprospecting, and the protection of traditional knowledge. To safeguard these resources, the National Environmental Management: Biodiversity Act (NEMBA) and the Biodiversity Act provide legal mechanisms for sustainable use, conservation, and benefit-sharing. This study analyses how South African legislation regulates the collection, trade, and commercialization of indigenous medicinal plants.

Methods

A qualitative desktop review design was adopted. Relevant documents were sourced from government legislation, South African National Biodiversity Institute (SANBI) reports, peer-reviewed articles, policy briefs, and legal case studies. Data were thematically analysed to identify regulatory measures, compliance requirements, and enforcement challenges related to the use of indigenous medicinal plants.

Results

Findings revealed that NEMBA regulates indigenous plant harvesting through permit systems, biodiversity management plans, and restricted species lists. The Biodiversity Act reinforces compliance by ensuring equitable benefit-sharing with indigenous knowledge holders, consistent with the Nagoya Protocol. However, challenges exist, including illegal harvesting, limited awareness among traditional healers, weak enforcement capacity, and slow processing of bioprospecting permits. Successful examples of benefit-sharing agreements demonstrate the potential for fair compensation, conservation funding, and research partnerships.

Conclusion

South Africa has strong legal frameworks governing the use of indigenous medicinal plants, balancing cultural practices, commercialization, and conservation. Despite this, gaps in enforcement and community awareness limit effective implementation, resulting in ongoing illegal harvesting and biodiversity threats.

Recommendations

The study recommends increased community education on permit requirements, improved enforcement capacity, streamlined bioprospecting procedures, and stronger partnerships between government, traditional healers, and research institutions. Expanding benefit-sharing agreements could incentivize conservation and ensure that indigenous communities receive fair economic and cultural benefits.

platelet-rich plasma versus topical 5% minoxidil in the treatment of androgenetic alopecia: A comparative observational study.

2025-11-14T06:27:40+00:00

Background:
Androgenetic alopecia is the most common cause of patterned hair loss in both men and women and has a significant psychosocial impact. Platelet-rich plasma (PRP) therapy has gained attention as a regenerative treatment, while topical 5% Minoxidil remains the conventional first-line therapy.

Objectives:

To compare the efficacy and safety of PRP therapy versus topical 5% Minoxidil in patients with androgenetic alopecia over 12 weeks.

Methods:

This comparative observational study included 50 patients with androgenetic alopecia, allocated into two groups: PRP (n = 25) and topical 5% Minoxidil (n = 25). PRP was administered through four intradermal sessions at three-week intervals, while Minoxidil was applied twice daily for 12 weeks. Outcomes assessed were change in hair density (hairs/cm²), patient satisfaction using a 5-point Likert scale, dermatologist global assessment, and adverse effects. Statistical analysis was performed, with p < 0.05 considered significant.

Results:

Baseline demographic and clinical parameters were comparable between groups. At 12 weeks, the PRP group demonstrated a significantly greater increase in mean hair density (18.4 ± 4.6 hairs/cm²) compared with the Minoxidil group (10.2 ± 3.9 hairs/cm²; p < 0.01). Patient satisfaction scores were higher in the PRP group (4.1 ± 0.7) than in the Minoxidil group (3.2 ± 0.8; p < 0.01). Moderate to marked clinical improvement was observed in 68% of PRP-treated patients compared with 36% in the Minoxidil group. Adverse effects were mild and transient in both groups.

Conclusion:

PRP therapy showed superior improvement in hair density and patient satisfaction compared with topical 5% Minoxidil over 12 weeks, with good tolerability.

Recommendations:

PRP may be considered an effective therapeutic option for early to moderate androgenetic alopecia, either as monotherapy or as an adjunct to topical Minoxidil. Larger studies with

Lichen planopilaris with drug-induced lichen planus: A Case Report

2025-12-30T11:03:40+00:00

Background:

Lichenoid drug eruption is a known adverse reaction to several medications, including anti-tubercular therapy, and may clinically resemble idiopathic lichen planus. Lichen planopilaris is a scarring inflammatory disorder of hair follicles that can result in permanent alopecia. The coexistence of these two conditions is rare and presents diagnostic and management challenges.

Case presentation:

A 25-year-old female receiving first-line anti-tubercular therapy for pulmonary tuberculosis developed progressive scarring alopecia of the scalp along with pruritic violaceous papules over the neck, trunk, and axillae. Dermoscopy and histopathological examination confirmed a lichenoid drug eruption with coexisting lichen planopilaris. Given the near completion of tuberculosis treatment, anti-tubercular drugs were continued, and the patient was managed with topical corticosteroids, emollients, and oral antihistamines, with planned initiation of hydroxychloroquine after therapy completion.

Conclusions:

Early identification of drug-induced lichenoid reactions is crucial to prevent irreversible scarring. A conservative, multidisciplinary approach can allow continuation of essential anti-tubercular therapy while effectively managing cutaneous manifestations.

A prospective observational study on the efficacy of narrowband UVB phototherapy combined with oral antioxidants in the management of vitiligo.

2025-11-14T05:58:19+00:00

Background:
Vitiligo is a chronic depigmenting disorder, often requiring prolonged therapy due to slow and variable repigmentation. Narrowband ultraviolet B (NB-UVB) is an established treatment approach, and interest has grown in combining it with oral antioxidant supplementation to enhance melanocyte recovery and reduce oxidative stress.

Aim:

To evaluate the efficacy and tolerability of NB-UVB phototherapy combined with oral antioxidants in patients with vitiligo.

Methods:

This prospective observational study included 50 clinically diagnosed vitiligo patients. All participants received NB-UVB phototherapy three times weekly, along with a daily oral antioxidant regimen, for 24 weeks. Demographic and clinical parameters were recorded. Repigmentation was assessed using the Vitiligo Area Scoring Index (VASI) at baseline, 12 weeks, and 24 weeks. Treatment response was categorized as excellent (>75%), moderate (50–75%), mild (25–49%), or minimal (<25%). Adverse events were documented throughout the study period.

Results:

The mean age of participants was 28.6 ± 9.4 years, with females comprising 56% of the cohort. Non-segmental vitiligo accounted for 74% of cases. The mean baseline VASI score was 6.8 ± 2.1, which reduced progressively to 4.3 ± 1.9 at 12 weeks and 2.7 ± 1.6 at 24 weeks. Excellent repigmentation was achieved in 28% of patients, moderate in 36%, and mild in 24%, while 12% showed minimal improvement. Facial and truncal lesions responded better compared to acral sites. Treatment was well tolerated, with only mild transient erythema and pruritus reported.

Conclusion:

NB-UVB combined with oral antioxidants resulted in meaningful repigmentation with good safety and patient acceptance.

Recommendations:

This combination may be considered as a preferred therapeutic strategy in the routine management of non-segmental vitiligo, especially when aiming for gradual yet sustained repigmentation.

Histopathological patterns and molecular alterations in surface epithelial ovarian tumors: A retrospective study from tertiary care centre in central India.

2026-01-06T08:44:22+00:00

Background

Surface epithelial ovarian tumors constitute the most common group of ovarian neoplasms and demonstrate marked heterogeneity in morphology, biological behavior, and molecular profile.

Objective

To evaluate histopathological patterns of surface epithelial ovarian tumors and correlate them with immunohistochemical and molecular alterations.

Methods

A retrospective cross-sectional study was conducted at a tertiary care teaching hospital in eastern India. All histologically confirmed surface epithelial ovarian tumors diagnosed between January 2020 and December 2023 were reviewed. Tumors were classified according to the WHO 2020 criteria. Immunohistochemistry panels were applied based on morphological suspicion. Targeted molecular analysis was performed in malignant tumors with adequate tissue to assess TP53, BRCA1/2, KRAS, BRAF, PIK3CA, ARID1A, and CTNNB1 alterations.

Results

Benign, borderline, and malignant tumours made up 32.8%, 14.4%, and 52.8% of the 180 cases, respectively. The most common type of cancer was high-grade serous carcinoma (61.2%). A TP53 mutation was found in 92% of high-grade serous carcinomas, and it was very similar to the abnormal p53 immunostaining. Eighteen percent of high-grade serous carcinomas had BRCA1/2 mutations. KRAS mutations were primarily identified in mucinous and low-grade serous tumours, whereas ARID1A loss and PIK3CA mutations were prevalent in endometrioid and clear cell carcinomas.

Conclusion

Different histomorphological patterns of surface epithelial ovarian tumours are closely linked to certain immunohistochemical and molecular changes. Combining morphology with targeted supplementary testing enhances diagnostic precision and enables tailored therapeutic approaches.

Recommendations

Routine integration of immunohistochemistry with targeted molecular testing is recommended in malignant ovarian tumors.

Role of high-risk human papillomavirus in oropharyngeal squamous cell carcinoma: A clinicopathological and molecular study from a tertiary centre in India.

2026-01-06T09:18:23+00:00

Background

High-risk human papillomavirus (hrHPV) has emerged as a major etiological agent in a biologically distinct subset of oropharyngeal squamous cell carcinoma (OPSCC), associated with improved clinical outcomes. However, Indian data on HPV-associated OPSCC remain heterogeneous and limited.

Objective

To determine the prevalence of hrHPV-driven OPSCC and evaluate its clinicopathological, molecular, and prognostic correlates.

Methods

A retrospective cross-sectional study was conducted at a single tertiary care teaching hospital in eastern India. Consecutive primary OPSCC cases diagnosed between January 2020 and December 2023 were analyzed. p16 immunohistochemistry was used as a screening tool, followed by hrHPV DNA polymerase chain reaction (PCR). Discordant cases underwent E6/E7 mRNA analysis when tissue permitted. Clinicopathological parameters and progression-free survival were evaluated.

Results

Among 180 OPSCC cases, hrHPV positivity was identified in 52.2%. HPV-positive tumors were significantly associated with younger age, lower tobacco exposure, non-keratinizing morphology, lower T stage, higher nodal stage, and superior two-year progression-free survival (81% vs. 65%, p=0.03).

Conclusion

hrHPV-driven OPSCC constitutes a substantial proportion of OPSCC in India. Integrated p16 and molecular testing offers reliable classification with important prognostic implications.

Recommendations

Routine p16 screening with confirmatory molecular testing should be incorporated into OPSCC diagnostic protocols. Prospective multicentric Indian studies are recommended.

Secretory carcinoma in labial minor salivary gland of pediatric patients. A systematic Review.

2025-10-29T05:51:17+00:00

Background:

Secretory carcinoma (SC), formerly referred to as mammary analogue secretory carcinoma (MASC), is a rare malignant salivary gland neoplasm most frequently identified in the parotid gland but also reported in minor salivary glands. It is strongly associated with the ETV6:NTRK3 fusion, which has therapeutic implications due to the advent of TRK inhibitors. Pediatric SC is exceedingly rare, with even fewer cases reported in the labial minor salivary glands, making systematic analysis crucial.

Objective:

To synthesize available evidence on pediatric SC of the labial minor salivary glands, focusing on presentation, diagnosis, management, and outcomes.

Methods:

Electronic databases (PubMed, Scopus, Google Scholar) were searched until 2025. Studies were included if they described SC of the labial minor salivary glands in patients aged ≤18 years with histopathologic and immunohistochemical confirmation. Two case reports met the inclusion criteria.

Results:

Both patients presented with upper lip masses. A 9-year-old girl had a well-circumscribed, 2 cm lesion confirmed as SC (CK7+, mammaglobin+, S100+); managed by excision with margin extension, she remained disease-free at 36 months. A 17-year-old male had a high-grade SC of the philtrum with nodal metastasis, treated by wide excision, bilateral selective neck dissection, and adjuvant chemoradiotherapy; he remained disease-free at 6 months. Both tumors displayed classical SC morphology, though molecular fusion testing was not universally performed.

Conclusions:

Pediatric labial SC is exceptionally rare but clinically significant. It should be considered in the differential diagnosis of circumscribed pediatric lip nodules. Management is primarily surgical, with aggressive multimodal therapy indicated for high-risk disease. Awareness is vital to avoid misdiagnosis as acinic cell carcinoma and to facilitate timely recognition of ETV6-NTRK3 fusions, which may enable targeted therapies.

Usefulness of trappin-2 level in cervicovaginal secretion in predicting spontaneous preterm birth in asymptomatic high-risk women: A prospective case–control study at a tertiary care centre.

2025-12-08T10:31:24+00:00

Background:

Spontaneous preterm birth (SPTB) remains a major contributor to neonatal morbidity and mortality, especially in developing countries. Identifying reliable early biomarkers in asymptomatic high-risk women could improve risk stratification and perinatal outcomes. Trappin-2, an antiprotease and innate immune modulator, plays a critical role in mucosal defense and inflammation within the cervicovaginal environment.

Objectives:

To assess cervicovaginal fluid (CVF) Trappin-2 levels in predicting spontaneous preterm birth in asymptomatic high-risk pregnant women and across two mid-trimester sampling windows.

Methods:

This prospective case–control study included 100 pregnant women (50 preterm and 50 term) enrolled between 14 and 20 weeks of gestation and followed through delivery. Cervicovaginal secretions were collected twice, at 14–20 and 22–28 weeks, respectively, using sterile dacron swabs. Trappin-2 concentrations were quantified using an ELISA assay, and the sensitivity, specificity, and predictive value were evaluated.

Results:

The majority of participants were aged 20–30 years (66%), and 70% had regular antenatal care visits. Mean CVF Trappin‑2 levels were significantly higher in women who delivered preterm compared with term controls at both visits (14–20 weeks: 6124 ± 1102 pg/ml vs 3100 ± 1529 pg/ml; 22–28 weeks: 7915 ± 2112 pg/ml vs 4100 ± 1602 pg/ml; p < 0.001). Sensitivity and specificity at the second visit were 76.4% and 66.2%, respectively, with a high negative predictive value (>90%).

Conclusion:

Cervicovaginal Trappin-2 can be used as a promising early biomarker for identifying women at risk of spontaneous preterm birth. Its reproducible mid-trimester elevation and high negative predictive value support its integration into antenatal screening to guide timely interventions and improve neonatal outcomes.

Recommendation:

Routine mid-trimester screening of cervicovaginal Trappin-2 levels in asymptomatic high-risk pregnant women is recommended to aid early risk stratification. Integration of this biomarker into antenatal care may facilitate timely preventive interventions and improve perinatal outcomes.

Spectrum of endometrial pathologies in abnormal uterine bleeding: A retrospective descriptive study.

2025-10-26T11:46:05+00:00

Background

Abnormal uterine bleeding (AUB) is one of the most frequent gynecological complaints affecting women of all reproductive and perimenopausal ages. Histopathological evaluation of the endometrium remains the cornerstone for identifying the underlying causes, which may range from benign hormonal imbalance to premalignant or malignant lesions.

Objectives

To describe the histopathological spectrum of endometrial lesions in women presenting with abnormal uterine bleeding (AUB) over two years

Methods

This retrospective study included 50 cases of AUB evaluated over two years. Endometrial biopsy and curettage specimens were reviewed, and histopathological patterns were categorized as functional, structural, inflammatory, or neoplastic. Clinical data such as age, menopausal status, and bleeding pattern were retrieved from medical records and analyzed descriptively.

Results

The mean age of participants was 42.3 ± 8.1 years, with the highest incidence (46%) in the 41–50-year age group. Menorrhagia (46%) was the most common clinical presentation. Histopathological examination revealed proliferative endometrium (20%), secretory endometrium (16%), endometrial hyperplasia (16%), and disordered proliferative pattern (12%) as the major findings. Structural lesions included endometrial polyps (8%) and carcinoma (4%), while atrophic and inflammatory changes accounted for 6% each. Hyperplasia was most frequent in the perimenopausal group, whereas carcinoma was confined to postmenopausal women.

Conclusion

The predominance of functional and hyperplastic endometrial patterns in AUB underscores the hormonal etiology of bleeding in most women, particularly during the perimenopausal transition. Routine histopathological evaluation of endometrial samples is essential to detect precancerous and malignant conditions early.

Recommendations

All women with persistent or recurrent AUB—especially those aged ≥40 years or postmenopausal should undergo endometrial sampling for definitive diagnosis. Integrating histopathological assessment with hormonal evaluation and imaging improves diagnostic accuracy and guides targeted management.

Clinical evaluation of early and delayed post-operative complications following tonsillectomy. A prospective longitudinal observational study.

2025-12-06T08:16:24+00:00

Background:
Tonsillectomy remains one of the most frequently performed ENT procedures, yet postoperative complications continue to influence recovery, patient safety, and resource utilization. Understanding the pattern of early and delayed complications helps refine perioperative practices and improve outcomes.

Aim:

To evaluate the early and delayed postoperative complications following tonsillectomy and determine their association with demographic and clinical variables.

Methods:

A prospective observational study was conducted among 50 patients aged 8–30 years undergoing tonsillectomy by the dissection and snare method. Baseline data, preoperative symptoms, tonsillar hypertrophy grade, early complications (≤24 hours), and delayed complications (up to 6 months) were recorded. Statistical analysis was performed using the Chi-square test, with p < 0.05 considered significant.

Results:

Most participants belonged to the 11–20-year group (74%), and females constituted 56%. Odynophagia (88%) and throat pain (84%) were the most common preoperative symptoms. Grade III tonsillar hypertrophy predominated (46%). Early complications were frequent, with oropharyngeal pain (82%), uvular edema (24%), and referred otalgia (22%) being the most common. Reactive hemorrhage occurred in 6%. Delayed complications included secondary hemorrhage (8%) and infection (6%), while no cases of tonsillar remnants or postoperative voice change were observed. Age showed a significant association with both early and delayed complications (p = 0.04), with higher rates in younger patients. Gender and tonsillar grade showed no statistically significant correlation.

Conclusion:

Oropharyngeal pain and uvular edema were the predominant early postoperative events, while secondary hemorrhage represented the most frequent delayed complication. Younger age groups exhibited higher susceptibility to postoperative morbidity.

Recommendations:

Strengthening preoperative counselling for younger patients, standardising analgesic protocols, ensuring meticulous surgical technique, and implementing structured postoperative monitoring may reduce complication rates. Regular auditing of outcomes is recommended to enhance patient safety and refine clinical practice.

Arterial blood gas analysis in chronic kidney disease, acute exacerbation of chronic obstructive pulmonary disease, and acute coronary syndrome. A cross-sectional observational study.

2026-02-04T19:51:59+00:00

Background:
Arterial blood gas (ABG) analysis plays a critical role in evaluating acid–base disturbances in emergency patients with chronic kidney disease (CKD), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and acute coronary syndrome (ACS).

Methods:
Three observational cross-sectional studies were conducted at Darbhanga Medical College and Hospital between 2020 and 2025 involving 420 patients. ABG parameters were assessed at admission and correlated with clinical outcomes.

Results:
No linear correlation was observed between estimated creatinine clearance and pH in CKD patients. In AECOPD, ABG-guided management significantly reduced hospital stays and improved survival (96.7% vs 81.7%, p=0.023). In ACS, metabolic acidosis was present in 42% of patients and was associated with higher mortality (40.5%). A strong association between pH correction and clinical improvement was noted (p<0.001).

Conclusion:
Routine ABG-guided management significantly improves outcomes across CKD, AECOPD, and ACS.

Recommendation:
Regular ABG monitoring should be incorporated into emergency protocols for early diagnosis and targeted intervention.

Effect of pain assessment scale integration and nurse training on knowledge, attitudes, and practices in postoperative pain management at a low-resource facility quantitative quasi-cross-sectional study.

2025-11-01T14:25:01+00:00

Background

Post-operative pain remains one of the greatest concerns for patients following surgery. Failure to promptly assess and manage pain may result in postoperative complications like hypertension, depression, and overall poor health outcomes.

Objective

To describe the effect of integrating the pain assessment scale on the nurse’s knowledge, attitude, and practice toward post-operative pain management in the surgical ward in a low-resource facility.

Method

This was a quasi-experimental study using pre- and post-intervention evaluation carried out from June to November 2022. The nurses included were educated on post-operative pain management using a numeric pain assessment scale during a CME. They completed a pre- and post-test to assess their knowledge and attitude towards post-operative pain management. Data was analyzed using SPSS version 20. A student paired t-test was performed to assess for change in knowledge, attitude, and practice.

Results

The researcher surveyed 60 participants, and the majority (70%) were aged between 24 and 33 years. In the pretest and posttest, the mean total knowledge scores about post-operative pain treatment were (M= 62.83, SD= 9.583, t = -59, P=0.01), pretest attitude (M = 60.72, SD=7.095) and the posttest (M=71.65.SD= 7.688, t =-7.479, dt= 59, p=.000). Majority of respondents had their post-operative practices (POP) management practices improved (87%) and were able to use the PQRST to evaluate POP, more than seventy-three percent (73.3%) used the PAS to manage POP and 75% of the respondents gave POP patients direct nursing care.

Conclusion

The results revealed a great improvement, which was statistically significant in the nurses’ knowledge, attitude, and practice towards post-operative pain management.

Recommendations

Create educational initiatives that emphasize pain evaluation and management, put in place standardized instruments for pain assessment, and create quality improvement initiatives in addition to procedures for efficient pain management and documentation.

A CASE CONTROL STUDY TO COMPARE THE EFFICACY OF PRE-OPERATIVE INTRAVENOUS TRANEXAMIC ACID IN THE CONTROL OF INTRAOPERATIVE TONSILLECTOMY BLEEDING.

2025-10-29T11:25:31+00:00

INTRODUCTION

Tonsillectomy is one of the most performed surgeries all over the world. Modern methodologies, use of bipolar scissor dissection, bipolar radio frequency ablation, harmonic scalpel, micro-debrider endoscopic tonsillectomy, laser tonsillectomy, and the like, have revolutionized the tonsillectomy procedure. To compare the efficacy of preoperative intravenous Tranexamic acid in the control of intraoperative tonsillectomy bleeding.

MATERIALS AND METHODS:

This prospective clinical study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Adichunchanagiri Institute of Medical Sciences, B. G. Nagara, Mandya District. The study period was from November 2016 to May 2018. A sample size of a minimum of 107 patients who satisfied the inclusion criteria was included in the study. Dissection tonsillectomy was done in all cases. In the study group, pre-operative intravenous Tranexamic acid will be given in the dosage of 10mg/kg/body weight.

RESULTS:

The most common age group in the study and control group was 11-20 years. In the study group, 30 females (56.6%) and 23 males (43.4%), and in the control group, 33 females (61.1%) and 21 males (38.9%). The grading was done according to Brodsky's grading scale; in the study group, maximum cases (39.6%) had grade 3 tonsillar hypertrophy, and in the control group, maximum cases (31.5%) had grade 2 and grade 3, respectively. Mean intraoperative blood loss was 135.96 ml in the study group and 159.81 ml in the control group. P value was calculated to be <0.001, thus statistically proving significance.

CONCLUSION:

In this study, we have proved the efficacy of pre-operative intravenous use of Tranexamic acid in the control of intra-operative tonsillectomy bleeding with no recorded side effects. No side effects of tranexamic acid were noted during the study. So, it is a safe drug to be used.

Critical Review of Commercial Influences, Ethical Concerns, and Impact on Rational Healthcare

2026-01-04T08:28:00+00:00

Medical conferences in India have evolved from small academic gatherings to large-scale events attracting thousands of participants. While ostensibly serving as platforms for continuing medical education (CME) and knowledge dissemination, these conferences increasingly reflect the commercial interests of pharmaceutical companies and other healthcare industry stakeholders. This critical review examines the current landscape of medical conferences in India, analyzing the extent of pharmaceutical industry involvement, associated ethical concerns, regulatory frameworks, financial implications, and the impact on rational prescribing and healthcare delivery. Through examination of existing literature, regulatory guidelines, and documented cases from the Indian context, this article argues that many medical conferences have transformed into marketing platforms that prioritize commercial interests over genuine academic advancement, raising serious questions about medical professionalism and patient welfare.

Cardiovascular responses to pleasure-based versus task-based screen engagement: An experimental crossover study.

2025-12-06T07:38:52+00:00

Background:
Digital screen use is pervasive, yet different engagement modes, relaxing versus task-focused, may have distinct acute cardiovascular and emotional effects. Comparative within-subject data are limited.

Aim:
To compare cardiovascular and affective responses to pleasure-based versus task-based screen engagement in healthy young adults.

Materials and Methods:
This experimental crossover study was conducted on Sixty-three healthy regular screen users (18–35 years) who completed two randomized conditions in a single 60-minute session: pleasure-based viewing (entertaining videos) and task-based engagement (cognitive tasks). Each protocol included a 10-minute seated baseline, 15-minute first condition, 10-minute washout, and 15-minute second condition. Heart rate (HR) and heart rate variability (HRV) were recorded continuously, and blood pressure (BP) was measured pre- and post-condition. Subjective stress and enjoyment (VAS 0–10) and affect (PANAS) were assessed after each condition. Paired t-tests were applied, with p < 0.05 considered significant.

Results:
Participants (32 males, 31 females; mean age 24.1 ± 3.9 years; BMI 23.4 ± 3.1 kg/m²) reported a mean daily screen time of 4.8 ± 1.3 hours. HR increased from 74.3 ± 7.8 bpm during pleasure-based viewing to 82.9 ± 8.5 bpm during task-based engagement (p < 0.001). Systolic/diastolic BP rose from 115.6 ± 8.1/74.9 ± 6.4 mmHg to 121.8 ± 8.9/78.7 ± 6.9 mmHg (all p < 0.001). HRV indices showed reduced SDNN and RMSSD and a higher LF/HF ratio during task-based use, indicating sympathetic predominance. VAS stress was higher (5.8 ± 1.7 vs 2.3 ± 1.3) and enjoyment lower (5.1 ± 1.5 vs 7.9 ± 1.1), with decreased positive and increased negative affect (all p < 0.001).

Conclusion:
Task-based screen engagement produces greater cardiovascular activation and a less favourable emotional profile than pleasure-based viewing in healthy young adults.

Recommendations:
Digital work schedules should limit prolonged, uninterrupted task-based screen use, incorporate short breaks, and promote screen hygiene.

Effectiveness of intermittent fasting for weight loss in obese individuals: A randomized controlled trial.

2025-12-03T10:56:14+00:00

Background:
Obesity remains a major public health concern globally, with lifestyle modification forming the cornerstone of management. This randomized clinical trial evaluated the impact of intermittent fasting on weight reduction and metabolic parameters in obese individuals.

Methods:
Sixty obese adults were randomly assigned to either an Intermittent Fasting (IF) group (n=30) or a Standard Calorie Restriction (SCR) group (n=30) for eight weeks. The IF group followed a 16:8 fasting schedule, while the SCR group reduced daily caloric intake by approximately 20%. Anthropometric measurements (weight, BMI, waist circumference, body fat percentage) and biochemical parameters (fasting glucose and lipid profile) were recorded at baseline and at the end of the study. Adherence and tolerability were monitored throughout the trial. Statistical comparison between groups was performed, and significance was set at p < 0.05.

Results:
Baseline characteristics were similar across groups (Table 1). The IF group achieved greater weight loss (−4.1 ± 2.1 kg) compared to the SCR group (−2.7 ± 1.9 kg), with statistically significant differences (p=0.012). Reductions in BMI, waist circumference, and body fat percentage were also more pronounced in the IF group (Table 2). Improvements in fasting glucose (−7.2 ± 9.1 mg/dL vs. −3.1 ± 8.7 mg/dL; p=0.041) and triglyceride levels (p=0.048) were observed with IF, while changes in total cholesterol and LDL-C were modest in both groups (Table 3). Adherence was satisfactory, and no serious adverse events occurred (Table 4).

Conclusion:
Intermittent fasting demonstrated superior benefits in weight reduction and selected metabolic markers compared to standard calorie restriction over eight weeks. It was well-tolerated and feasible for regular clinical practice.

Recommendations:
Intermittent fasting may be considered a structured dietary intervention for weight management in obese adults. Long-term studies are recommended to assess sustained outcomes and adherence patterns.

Efficacy of intra-articular injection of Steroid plus High Molecular Weight Hyaluronate in Primary Osteoarthritis of the Knee in a Tertiary Care Hospital in Eastern India

2025-12-23T05:17:23+00:00

Background

Knee primary osteoarthritis is a degenerative joint disease creating pain and stiffness, and disability among elderly people. Non-surgical therapies can be effective in offering partial disease-modifying and unpredictable symptomatic relief. The objective of the study was to assess the effectiveness of intra-articular steroid with high molecular weight hyaluronate in the reduction of pain and patient-reported outcomes.

Methods

The proposed interventional study was an 18-month prospective study in the Department of Physical Medicine and Rehabilitation at IPGME & R, SSKM Hospital, Kolkata, India. The inclusion and exclusion criteria were used to recruit fifty patients with primary knee osteoarthritis. A single intra-articular injection of steroid and high molecular weight hyaluronate was administered to all the patients. Pain was measured by the use of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale, and overall well-being was measured by the Patient Global Assessment scale. At the baseline, six weeks, and twelve weeks, the evaluations were conducted. The Tukey multiple comparison test was conducted as a statistical test.

Results

Both the WOMAC pain scores and Patient Global Assessment scores were significantly different at six weeks and twelve weeks versus the baseline. The data on the mean differences showed a clinically significant decrease in pain and better patient-reported outcomes. Nonetheless, no significant increase in the interval between six and twelve weeks was observed, indicating that most improvement in symptoms took place during the first six weeks, and beyond was not significant.

Conclusions

Intraarticular injection of steroid plus HMWH in primary OA knee is effective in terms of reduction of pain in the WOMAC scale and reduction of Patients Global Assessment scale, and negligible adverse effect occurs in this regimen.

Recommendation

Future multi-center randomized controlled trials with a larger sample and longer follow-up should verify these results.

Quantitative diagnosis of salivary gland tumors with contrast-enhanced ultrasound. A systematic review.

2025-10-29T11:37:53+00:00

Salivary gland tumors pose diagnostic challenges, with fine-needle aspiration cytology showing limitations in accuracy. Contrast-enhanced ultrasound (CEUS) has emerged as a promising alternative for preoperative differentiation. This systematic review aims to evaluate the diagnostic value of CEUS in distinguishing between benign and malignant salivary gland tumors. Electronic databases (PubMed, Embase, Scopus, Web of Science, Lilacs) were searched up to October 2024. Inclusion criteria comprised original studies (2020–2024) evaluating CEUS for salivary gland lesions. Exclusion criteria included non-English articles, reviews, and irrelevant studies. The STROBE checklist was used for quality assessment. Data were synthesized narratively. Eight studies were included. CEUS demonstrated high diagnostic value, with features such as blurring enhancement margins and increased lesion size aiding malignancy risk assessment. It effectively differentiated pleomorphic adenomas from Warthin tumors and benign from malignant lesions. CEUS is a valuable, non-invasive tool for the quantitative diagnosis of salivary gland tumors, enhancing preoperative planning and differential diagnosis.

Clinical profile and risk factors of acute coronary syndrome in young adults: A hospital-based cross-sectional observational study.

2025-11-19T14:16:58+00:00

Background
Acute Coronary Syndrome (ACS) in young adults is being recognized more frequently, particularly in low- and middle-income countries. Understanding clinical presentation and modifiable risk factors in younger individuals is essential for timely prevention and targeted intervention.

Objectives: To assess the clinical profile and identify predominant risk factors among young adults presenting with ACS in an internal medicine department.

Methods
This observational study included 100 consecutive patients aged 20–45 years admitted with ACS. Diagnosis and classification into STEMI, NSTEMI, or Unstable Angina were based on clinical assessment, ECG changes, and cardiac biomarkers. Relevant history, risk factors, lipid profiles, and coronary angiography findings were recorded using a structured proforma. Descriptive statistics were applied for analysis.

Results
The mean age of the cohort was 34.8 ± 4.2 years; males comprised 78%. Chest pain was the most frequent presenting symptom (89%), followed by sweating (63%) and dyspnea (41%) (Table 1). Smoking or tobacco use emerged as the predominant risk factor (54%), followed by family history of coronary artery disease (37%), dyslipidemia (35%), and hypertension (31%) (Table 2). STEMI was the most common presentation (48%), with NSTEMI and Unstable Angina accounting for 32% and 20%, respectively (Table 3). Coronary angiography revealed single-vessel disease in 52% of cases, while 11% had normal or minimal disease (Table 4).

Conclusion
ACS in young adults is strongly associated with modifiable lifestyle factors, especially smoking and dyslipidemia. The predominance of single-vessel involvement suggests a potentially reversible early disease process if timely intervention and long-term risk reduction strategies are adopted.

Recommendations
Smoking cessation counseling, routine lipid screening in individuals with a family history of CAD, community-based lifestyle modification programs, and early cardiac evaluation for atypical symptoms in young adults should be prioritized. Longitudinal follow-up studies are needed to evaluate long-term outcomes.

Prevalence and pattern of thyroid dysfunction among adults with metabolic syndrome: A cross-sectional observational study.

2025-11-19T14:25:48+00:00

Background

Metabolic syndrome is linked with endocrine disturbances, including thyroid dysfunction, which may influence metabolic control and cardiovascular risk. This study assessed the prevalence and pattern of thyroid dysfunction among patients with metabolic syndrome.

Methods

A cross-sectional observational study was conducted in 100 adults who met the diagnostic criteria for metabolic syndrome. Thyroid function was evaluated using serum TSH, FT3, and FT4 levels. Thyroid status was classified as euthyroid, subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, or overt hyperthyroidism. Clinical details, metabolic parameters, and the number of metabolic syndrome components present were recorded. Data were analyzed, and results were presented using descriptive statistics.

Results

Thyroid dysfunction was observed in 36% of the study population. The most common abnormality was subclinical hypothyroidism (22%), followed by overt hypothyroidism (8%). Hyperthyroid patterns were less frequent (subclinical hyperthyroidism 4%, overt hyperthyroidism 2%). Females showed a significantly higher prevalence of dysfunction (57.1%) compared to males (20.7%). The age group of 40–59 years demonstrated the highest proportion of thyroid abnormalities (40.4%). A rising trend of thyroid dysfunction was noted with increasing metabolic load: 25.5% in those with three metabolic components, 45.7% with four components, and 60.0% with five components. These findings indicate a close association between metabolic burden and thyroid imbalance, as reflected by a significant positive correlation between BMI and TSH levels (r = 0.42, p < 0.001) and a significant inverse correlation between waist–hip ratio and serum T3 levels (r = −0.36, p = 0.002)

Conclusion

Thyroid dysfunction, particularly subclinical hypothyroidism, is common among patients with metabolic syndrome and is associated with female sex, middle age, and greater clustering of metabolic components.

Recommendations

Routine screening of thyroid function should be considered in patients with metabolic syndrome. Clinicians should maintain a proactive approach in counseling, early follow-up, and lifestyle modification to minimize disease progression.

Prevalence and predictors of tuberculosis among patients with diabetes mellitus: A cross-sectional hospital-based study.

2025-10-28T07:02:28+00:00

Background
Diabetes mellitus (DM) is increasingly recognized as a significant risk factor for tuberculosis (TB), particularly in developing countries where both conditions are highly prevalent. The coexistence of these diseases complicates clinical outcomes and challenges TB control efforts. This study aimed to determine the prevalence of TB among diabetic patients and to identify the major predictors associated with its occurrence.

Methods

A hospital-based cross-sectional study was conducted over 18 months (April 2024–September 2025). A total of 100 adult patients with type 2 diabetes mellitus were enrolled. Detailed demographic, clinical, and laboratory data were recorded. Tuberculosis was diagnosed based on clinical findings, radiological evidence, sputum smear microscopy, GeneXpert assay, and histopathological confirmation when necessary. Statistical analysis included descriptive statistics and chi-square tests to identify significant predictors.

Results
The overall prevalence of TB among diabetic patients was 14%, with pulmonary TB (11%) being more frequent than extrapulmonary TB (3%). The mean age of participants was 54.7 ± 10.8 years, and 58% were male. Univariate analysis revealed that age ≥ 60 years (p=0.02), duration of diabetes >10 years (p=0.002), poor glycemic control (HbA1c ≥8%, p=0.02), low BMI (<18.5 kg/m², p=0.003), and HIV co-infection (p=0.02) were significant predictors of TB. Smoking and gender were not statistically significant.

Conclusion
The prevalence of TB among diabetic individuals remains considerably high, underscoring the bidirectional link between chronic hyperglycemia and infection risk.

Recommendations
Routine TB screening should be integrated into diabetes clinics, and strict glycemic control with nutritional support is essential to reduce TB risk. Interdisciplinary collaboration between TB and diabetes programs is strongly recommended. Early screening for TB should be prioritized among diabetics with prolonged disease duration, poor glycemic control, or low BMI.

Fungal isolates and their antifungal susceptibility in cases of chronic rhinosinusitis: A hospital-based observational study.

2025-11-10T04:03:45+00:00

Background:
Chronic rhinosinusitis (CRS) is a persistent inflammatory disorder of the paranasal sinuses, and fungal involvement has gained increasing attention in recent years. Early identification of fungal etiological agents and their antifungal susceptibility patterns is essential for guiding effective therapy and improving outcomes.

Objectives:

To isolate and identify fungal pathogens in patients with chronic rhinosinusitis and to determine their antifungal susceptibility patterns along with associated clinical factors.

Methods:

This hospital-based observational study included 100 clinically diagnosed CRS patients. Sinonasal samples were obtained and processed using direct microscopy and fungal culture. Fungal isolates were identified by standard morphological methods. Antifungal susceptibility testing was performed using the CLSI guidelines. Patient demographics, clinical features, and associated comorbidities were recorded and analyzed.

Results:

The majority of patients belonged to the 31–45 year age group (44%), and 58% were males. Nasal obstruction (82%), post-nasal drip (67%), and facial pain (59%) were the common presenting symptoms. Fungal culture positivity was observed in 42% of cases. Among the isolates, Aspergillus species predominated, with Aspergillus flavus (42.9%) being the most frequent, followed by A. fumigatus (21.4%) and A. niger (9.5%). Candida albicans and Mucor species accounted for 14.3% and 11.9% of isolates, respectively. History of allergic rhinitis (47.6%), diabetes mellitus (28.6%), and prior steroid use (33.3%) were more frequent among fungal-positive cases. Voriconazole showed the highest susceptibility for Aspergillus isolates (85%), while Amphotericin-B was consistently effective for Mucor species.

Conclusion:

Fungal involvement in CRS is significant, with Aspergillus species being the dominant pathogens. Antifungal susceptibility testing plays a key role in guiding appropriate therapy to prevent complications.

Recommendations:

Routine fungal culture should be incorporated in CRS evaluation, especially in patients with nasal polyposis, allergic rhinitis, or diabetes. Judicious use of steroids is advised.

In vitro experimental antimicrobial and phytochemical evaluation of unsukumbili (Hypericum aethiopicum) against MRSA in wound sepsis.

2025-10-13T10:55:23+00:00

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of nosocomial infections, contributing to severe wound sepsis and high treatment failure rates due to multidrug resistance, resulting in a strain that the healthcare system faces as an uncontrollable, fatal pandemic with a high mortality rate. The increasing prevalence of MRSA necessitates alternative therapeutic strategies, including plant-derived antimicrobials.

Aim: This study evaluated the antimicrobial efficacy of aqueous and ethanolic extracts of Hypericum aethiopicum (unsukumbili) against Methicillin-resistant Staphylococcus aureus (MRSA), assessing its potential for wound infection management.

Methodology

An in vitro experimental design was employed, following standardized antimicrobial testing protocols. H. aethiopicum leaves were extracted using ethanol and water, and antimicrobial activity was assessed via disk diffusion, Minimum Inhibitory Concentration (MIC), and Minimum Bactericidal Concentration (MBC) assays.

Results

Ethanolic extracts exhibited superior antibacterial activity (mean inhibition zone: 26mm) compared to aqueous extracts (4 mm). No significant difference was observed between fresh and dried leaf extracts. The MIC for MRSA was achieved at a 1:8 dilution, demonstrating potent bactericidal effects.

Conclusion

aethiopicum ethanol extract shows promising activity against MRSA, suggesting its potential as an alternative treatment for Methicillin-resistant Staphylococcus aureus (MRSA) infected wounds.

Recommendation

Further studies are needed to isolate bioactive compounds and assess in vivo efficacy, identifying levels of the plant toxicity against human cells.

The prevalence of Neisseria gonorrhoeae in KwaZulu-Natal: A retrospective cross-sectional analysis of laboratory-confirmed cases.

2025-11-21T13:36:27+00:00

Background:

Neisseria gonorrhoeae remains a public health challenge in South Africa. This challenge is exacerbated by antimicrobial resistance and under-reporting, especially among women and neonates. Surveillance targets adult populations. Neonatal infections are rarely documented. Reliance on syndromic treatment without laboratory confirmation leads to undetected infections and the spread of resistant strains. This results in adverse long-term health outcomes and increased healthcare costs. Laboratory data from the National Health Laboratory Service provides a complementary source for surveillance.

Aim:

To describe the demographic, temporal, and facility-level distribution of laboratory-confirmed N. gonorrhoeae cases in KwaZulu-Natal during 2024.

Methods:

A retrospective cross-sectional analysis of all laboratory-confirmed cases of N. gonorrhoeae diagnosed at public healthcare facilities in KZN between January 2024 and December 2024. Data included patient age, sex, specimen source, healthcare facility, diagnosis date, and temporal trends were summarised using descriptive statistics. GeneXpert® CT/NG assay was used for laboratory confirmation.

Results:

Twenty-two laboratory-confirmed cases were identified. The median patient age was 26 years. Interquartile Range: 4 days–47 years, with neonates (<10 days old) comprising 27% (n = 6) of cases. Males accounted for 55% (n = 12). McCord’s Hospital reported the highest proportion (45%) (n = 10) of cases, followed by Addington Hospital (18%) (n = 4). A temporal cluster occurred in July 2024, affecting 27% (n = 6) of cases. Most specimens were pus samples (81%; n = 18).

Conclusions:

The high proportion of neonatal cases indicates failures in antenatal screening and prevention of mother-to-child transmission, leading to ophthalmia neonatorum. Facility clustering suggests unequal diagnostic capacity across KZN. Reliance on syndromic management may mask the true burden and economic impact of the disease.

Recommendations:

Strategic integration of laboratory-confirmed data can complement syndromic approaches, improve surveillance strategies, and inform targeted public health interventions.

Assessing the effect of selected cleaning agents (jik, ethanol and liquid soap) on isolated nosocomial organisms at Bukewa health centre III Manafwa district. A cross-sectional study.

2025-08-26T03:12:37+00:00

Background

Hospital-acquired infections are significant reasons for increased morbidity and mortality, and even costs. This study assessed the effect of selected cleaning agents (Jik, Ethanol, and Liquid soap) on isolated nosocomial organisms at Bukewa Health Centre III Manafwa District

Methodology

A cross-sectional, laboratory-based study was conducted. Swabs were taken from environmental surfaces, and a total of 112 environmental swabs were collected from within the health facility. The swabs were cultured to isolate nosocomial organisms and characterized using standard microbiological techniques (Gram stain, biochemistry tests) to identify isolates. The cleaning agents were then applied onto the contaminated surfaces to determine if Jik, ethanol, and liquid soap reduced the CFU of each organism. The pre- and post-treatment CFU were compared for percentage reduction. The data that was collected was entered and analysed using Microsoft Excel 2013.

Results

The four nosocomial organisms identified were Staphylococcus aureus (37.0%), Escherichia coli (27.2%), Enterococcus faecalis (19.6%), and Proteus mirabilis (16.3%), respectively. In the cross-comparison among disinfecting agents, Jik had the highest total antimicrobial effectiveness, with a CFU reduction of 90% or higher for all isolates. Ethanol had moderate effectiveness (78% - 86.7%), and liquid soap had the lowest effectiveness of each disinfecting agent, with percentage reductions of 56.7% to 64.8%. The cross-comparison demonstrated that Jik was the only and most effective agent for all organisms compared.

Conclusion

Jik is the most effective disinfectant against common nosocomial organisms isolated from Bukewa Health Center III. Revisions in cleaning protocols should emphasize, where applicable, their use for infection prevention and control purposes.

Recommendations

Health care and cleaning staff with infection prevention and control responsibilities must receive continual training about disinfecting procedures that include dilution, contact time, and frequency of use specific to each cleaner.

Assessment of aflatoxin contamination in peanuts of selected markets in Kampala. A cross-sectional study.

2025-05-05T18:53:42+00:00

Background

Aflatoxin is a mycotoxin that is frequently known to contaminate peanuts. Aflatoxins are secondary toxic metabolites primarily produced by A.flavus and A. parasiticus. This study was hence aimed at evaluating the level of aflatoxin contamination in peanuts from selected markets in Kampala.

Methodology

Twelve (12) samples were collected by a simple random technique from Nakawa, Banda, Kireka, and Bweyogerere markets. The samples were collected from different sales points, and three samples were collected per market. These samples were prepared and extracted using a suitable solvent to achieve an effective extract. The solvent used was 70% methanol. Thin layers plated were activated, spotted, and developed under a chloroform/acetone mobile phase system. The plates were analyzed for aflatoxin using a thin-layer chromatography mobile phone-based technique.

Results

The results obtained from the analysis of samples collected from the selected markets of Kampala show that five out of the twelve samples had bright spots when viewed under UV light. For the Nakawa market, sample N1 had 0 (Ppb), N2 had 0 (Ppb), and N3 (88Ppb). Banda market, B1 had 0(Ppb), B2 had 0(Ppb), B3 had 0(Ppb). Kireka market, K1 had 101(Ppb), K2 had 101.5(Ppb), and K3 had 88(Ppb). Bweyogerere market, BW1 had 0(Ppb), BW2 had 0(Ppb), and BW3 had 81(Ppb). 42% of the total samples were contaminated with aflatoxins, and these were found to be above the permissible levels by UNBS.

Conclusion

The level of contamination of 42% of the total samples was highly above the permissible levels as stipulated by UNBS and FDA.

Recommendation

Therefore, peanuts sold in the different Markets need to be continually evaluated to ensure food safety and public health concerns.

Working Class Diabetes: The World Forgot

2025-12-05T11:05:34+00:00

Diabetes mellitus is becoming more common around the world, and it affects low- and middle-income groups the most. Most of the time, current diabetes management guidelines tell everyone to eat and live in the same way. These guidelines are mostly for people who don't move around much. This general approach often doesn't take into account the specific physical needs, job-related stressors, and financial limitations of working-class people who do physically demanding work. This kind of mismatch can cause low blood sugar, dehydration, not following treatment, and faster disease progression to happen over and over again. This prospective observational study looks at how the amount of work a person does affects their blood sugar levels, nutritional needs, and health outcomes in people with diabetes who work. The results show that standard diabetes care models and the way people actually work are very different. The study emphasises the imperative for occupation-specific diabetes management strategies that incorporate energy expenditure, hydration needs, and meal timing to improve metabolic stability and long-term outcomes in this underserved population.

Evaluation of Para-Aortic Lymph Node Involvement and Its Correlation with Different Pelvic Factors in Carcinoma Cervix Assessed by PET-CT

2025-12-30T10:45:27+00:00

Background: In India, cervical cancer continues to be a major cause of cancer-related death for women, especially in the eastern state of Odisha. A crucial prognostic marker, the condition of the para-aortic lymph nodes (PALN) can dramatically change the staging (FIGO 2021) and treatment options from locoregional radiation to systemic therapy or extended-field radiotherapy (EFRT). The gold standard for nodal staging is Positron Emission Tomography-Computed Tomography (PET-CT), yet there is little information linking particular pelvic characteristics to PALN involvement in the eastern Indian population.

Objectives: The purpose of this study is to assess the prevalence of PALN involvement in locally advanced cervical cancer (LACC) using 18F-FDG PET-CT and to ascertain the relationship between PALN metastasis and other pelvic variables, such as tumor size, parametrial invasion, and pelvic lymph node (PLN) features.

Methods: At the Acharya Harihar Post Graduate Institute of Cancer (AHPGIC), Cuttack, a combined retrospective and prospective study was carried out between January 2021 and December 2023. Pre-treatment whole-body 18F-FDG PET-CT was performed on 165 histopathologically confirmed cases of cervical cancer (FIGO stages IB–IVA). Chi-square and logistic regression tests were used in statistical analysis to evaluate correlations.

Results: 52 years old was the median age. 18.2% (n=30) of individuals had PALN involvement (Stage IIIC2). PALN positive was found to be statistically significantly correlated with multiple () pelvic nodes (), parametrial invasion (), and pelvic
lymph nodes . Based on pelvic nodal burden, PET-CT had a sensitivity of 86.6% and a specificity of 94.1% for predicting PALN involvement.

Conclusion: PET-CT is a crucial technique for non-invasive cervical cancer staging. Parametric invasion and a high pelvic nodal load are strong markers of para-aortic metastases. In resource-constrained settings like in Odisha, identifying these high-risk pelvic characteristics can assist guide the wise use of EFRT, potentially improving survival results.

Assessment of Prevalence of Obesity with associated risk factors among school-going children attending a tertiary care hospital of West Bengal: A cross-sectional study.

2025-10-25T19:27:45+00:00

Background

Childhood obesity is a growing public-health concern, driven by rapid lifestyle transitions and environmental factors. This study aimed to estimate the prevalence of obesity and identify associated risk factors among school-going children attending a tertiary care hospital in West Bengal.

Methods

A cross-sectional study was conducted among 300 children aged 6–12 years at Malda Medical College from July 2023 to June 2024. Anthropometric measurements were obtained, and BMI-for-age was interpreted using WHO and CDC references. Sociodemographic data, dietary habits, physical activity, screen-time patterns, sleep duration, and family history were assessed using a structured questionnaire. Statistical analysis was performed using SPSS 21.0, applying Chi-square tests with p < 0.05 as significant.

Results

According to the WHO BMI-for-age criteria, 15% of children were obese and 20% overweight; CDC charts classified 14.3% as obese and 17.7% as overweight. The mean age was 9.1 years, with boys comprising 52% of participants. Most children belonged to middle or upper-middle socioeconomic strata. Obesity was significantly higher among boys (19.9%) than girls (10.4%). Inadequate physical activity (<60 minutes/day) and excessive screen time (>2 hours/day) were strongly associated with obesity (p < 0.05). Frequent fast-food intake, upper socioeconomic status, higher skinfold thickness, and positive family history were key contributors. Exclusive breastfeeding for six months showed a protective effect. Common comorbidities observed among obese children included hypothyroidism, fatty liver, hypertension, asthma, and dyslipidaemia.

Conclusion

Childhood obesity in this setting is closely linked to modifiable lifestyle factors, particularly limited physical activity, excessive screen exposure, and high-calorie dietary patterns. Early identification and targeted interventions are essential to prevent long-term metabolic risks.

Recommendations

Strengthening school- and community-based programmes that promote daily physical activity, balanced diets, reduced screen time, and parental involvement is crucial.

Pattern and risk factors of acute respiratory infections in children under five years: A hospital-based cross-sectional observational study.

2025-11-08T10:58:10+00:00

Background:

Acute respiratory infections (ARIs) remain one of the leading causes of morbidity and hospitalization among children under five years, particularly in low- and middle-income countries. Identifying demographic, environmental, and nutritional risk factors is essential to guide preventive strategies and optimize health outcomes.

Objectives:

To determine the clinical pattern and assess the key risk factors associated with acute respiratory infections in children under five years of age attending a tertiary care hospital.

Methods:

A hospital-based observational study was conducted among 100 children aged below five years clinically diagnosed with ARI. Data were collected using a structured proforma covering demographic details, clinical presentation, nutritional and immunization status, and environmental conditions. Statistical analysis was performed using descriptive measures and percentage distribution.

Results:

The majority of cases occurred in the 1–3-year age group (46%), with males (58%) slightly predominating. Upper respiratory tract infections (64%) were more frequent than lower respiratory infections (36%). The most common presenting symptoms were cough (94%), fever (86%), and nasal discharge (72%). Undernutrition was identified in 42% of children, and 58% belonged to the lower socioeconomic class. Major risk factors included indoor air pollution (68%), overcrowding (52%), passive smoking (36%), and lack of exclusive breastfeeding (46%). Incomplete immunization was observed in 28%, and low birth weight (<2.5 kg) in 34%. ARI incidence peaked during the monsoon and winter months (62%). The mean hospital stay was 4.6 ± 2.1 days, with full recovery in 92% of cases and no mortality reported.

Conclusion:

Acute respiratory infections in children were predominantly associated with modifiable risk factors such as undernutrition, indoor air pollution, overcrowding, and incomplete immunization. Most cases were mild and preventable through early intervention.

Recommendations:

Community-level interventions such as promoting exclusive breastfeeding, complete immunization, improving

A cross-sectional observational study on the association of serum ferritin with growth and thyroid profile in transfusion-dependent β-thalassemia patients.

2026-01-07T16:50:19+00:00

Background:
Transfusion-dependent β-thalassemia (TDT) is associated with progressive iron overload due to repeated blood transfusions. Excess iron deposition, reflected by elevated serum ferritin levels, contributes significantly to endocrine complications, particularly growth impairment and thyroid dysfunction, which remain under-recognized in routine clinical care.

Aim:
To assess the association of serum ferritin levels with growth parameters and thyroid profile in transfusion-dependent β-thalassemia patients.

Methods:
This hospital-based cross-sectional observational study was conducted in the Department of Paediatrics, M.R. Bangur Hospital, Kolkata, from August 2017 to April 2019. Seventy-five transfusion-dependent children (≤12 years) with β-thalassemia major or HbE/β-thalassemia were enrolled using simple random sampling. Serum ferritin, thyroid-stimulating hormone (TSH), and free thyroxine (fT4) were measured using electrochemiluminescence immunoassay. Anthropometric parameters (height and weight) were assessed and interpreted using CDC growth charts. Statistical analysis was performed using Epi-Info 7.2.2.2, with p < 0.05 considered significant.

Results:
Of the 75 children studied, 50.7% were males and 49.3% females; 56% had β-thalassemia major, and 44% had HbE/β-thalassemia. Hypothyroidism was detected in 10.7% of patients, predominantly subclinical. Low fT4 was observed in 5.3%, while elevated TSH was noted in 10.7%. Growth assessment showed that 37.3% of children were underweight and 9.3% were stunted. Mean serum ferritin levels were markedly elevated (overall mean ≈1595 ng/mL), with no significant gender difference.

Conclusion:
Thyroid dysfunction, particularly subclinical hypothyroidism, and growth impairment are common in transfusion-dependent β-thalassemia and are associated with elevated serum ferritin levels.

Recommendations:

Regular monitoring of serum ferritin, thyroid function, and growth parameters should be integrated into the routine follow-up of TDT patients. Early detection of endocrine dysfunction and optimization of iron chelation therapy are essential to reduce long-term morbidity and improve quality of life.

Association of infant and young child feeding practices with diarrheal morbidity and hospitalization outcomes among under-five children in eastern India: A cross-sectional analytical study.

2025-11-07T17:06:16+00:00

Background
Diarrheal illnesses remain a major cause of morbidity and hospitalization among children under five years of age in India. Infant and young child feeding (IYCF) practices strongly influence illness severity and recovery. However, adherence to optimal feeding practices remains low in several regions.

Objective
To assess the association between IYCF practices and diarrheal morbidity and hospitalization outcomes among under-five children admitted with acute diarrhoea in Eastern India.

Methods
A cross-sectional analytical study was conducted among 228 children aged 1 month to 5 years presenting with acute diarrhoea to a tertiary care hospital in West Bengal during 2023–24. Information regarding feeding habits, nutritional status, immunization profile, and clinical course was obtained from caregiver interviews and medical records. Data were analysed using Chi-square, Mann-Whitney U, and Kruskal-Wallis tests, with significance set at p<0.05.

Results
Early initiation of breastfeeding (52.2%) and exclusive breastfeeding for the first 6 months (33.3%) were associated with milder diarrheal episodes (p=0.005 and p=0.004). Children who were top-fed (52.2%) or received mixed feeding (40.6%) had higher rates of dysentery and persistent diarrhoea (p=0.001). Under-feeding was linked with prolonged hospitalization and a greater likelihood of complications (p<0.01). Inadequate immunization status also showed significant association with complicated diarrhoea (p=0.001).

Conclusion
Suboptimal IYCF practices substantially contribute to increased diarrheal severity and longer hospital stays among under-five children in Eastern India. Strengthening breastfeeding support and improving complementary feeding guidance can help reduce disease burden.

Recommendations
Community-level counselling, antenatal and postnatal breastfeeding support, growth monitoring during immunization visits, and targeted awareness programs are essential to improve feeding behaviours and prevent recurrent diarrheal episodes.

Correlation between serum vitamin D levels, glycemic variability, and insulin resistance in prediabetic subjects. A retrospective study.

2025-12-29T16:35:56+00:00

Background

Impaired glucose tolerance or impaired fasting glucose are hallmarks of prediabetes, a crucial transitional stage that frequently precedes Type 2 Diabetes Mellitus (T2DM). There is growing evidence that glucose homeostasis is significantly impacted by deficiencies in micronutrients, especially vitamin D (25-hydroxyvitamin D). In India, vitamin D insufficiency is still common despite the country's abundant sunshine.

Objective

In a prediabetic cohort in Keonjhar, Odisha, this study attempts to assess the relationship between serum vitamin D levels, insulin resistance (HOMA-IR), and glycemic variability.

Methods

Over the course of a year, a retrospective observational study was carried out at a tertiary medical facility in Keonjhar. 250 participants with prediabetes (HbA1c 5.7–6.4%) between the ages of 30 and 60 were enrolled in the study. Medical records were consulted for information on anthropometry, fasting plasma glucose (FPG), post-prandial glucose (PPG), HbA1c, fasting insulin, and serum 25(OH)D. The Homeostatic Model Assessment (HOMA-IR) was used to calculate insulin resistance. The standard deviation of FPG (SD-FPG) over the follow-up period was used to measure glycemic variability (GV).

Results

Widespread insufficiency was shown by the mean blood vitamin D level of
. Vitamin D levels and HOMA-IR showed a significant inverse connection
Additionally, glycemic variability (SD-FPG) was considerably higher in patients with severe vitamin D insufficiency () than in those with sufficient levels ().

Conclusion

In prediabetic individuals in Keonjhar, vitamin D deficiency is substantially linked to increased insulin resistance and unstable glycemic control. In this area, treating hypovitaminosis D may be a good way to postpone the onset of type 2 diabetes.

Recommendation

Given the significant frequency of vitamin D insufficiency and its correlation with metabolic dysregulation in prediabetes, including vitamin D status assessment into standard prediabetes screening techniques may provide a cost-effective means for early metabolic risk stratification. Additional prospective studies are necessary.

The overlooked triad: interrelationship between diabetes mellitus, diabetic foot, and acute diarrhoea. A systematic review of clinical and pathophysiological correlates.

2025-10-18T19:18:17+00:00

Background:

Diabetes mellitus (DM) and its complications, particularly diabetic foot disease (DFD), substantially increase morbidity through vascular, immune, and microbiome dysfunction. Acute diarrhoeal illnesses, including Clostridioides difficile infection (CDI), antibiotic-associated diarrhoea (AAD), and cholera, can further destabilize metabolic and infectious trajectories in diabetic patients. Despite this overlap, integrated evidence on their interrelationship remains limited.

Objective:

To systematically evaluate current evidence on (1) the role of diabetes as a risk factor for CDI and other diarrhoeal diseases; (2) the impact of antibiotic exposure and metabolic instability on outcomes; (3) the potential protective effect of metformin therapy; and (4) the broader clinical implications for diabetic foot and inpatient management.

Methods:

Following PRISMA-2020 guidelines, open-access observational studies were identified in PubMed, DOAJ, PMC, Google Scholar, and OpenAIRE up to July 2025. Eligible studies included adults (≥18 years) with DM experiencing diarrhoeal illness. Outcomes analyzed were CDI incidence or recurrence, AAD occurrence, in-hospital mortality, and length of stay (LOS). Quality was assessed using the Newcastle–Ottawa Scale (NOS).

Results:

Six studies (2011–2024) met the inclusion criteria. Diabetes independently increased CDI risk and recurrence (OR ≈ 2.0–2.5), with antibiotic and PPI exposure as key cofactors. “4C” antibiotic use in diabetic foot ulcer patients quintupled CDI risk. Metabolic decompensation, such as diabetic ketoacidosis (DKA), significantly elevated mortality (5.8 % vs 2.7 %) and LOS. Conversely, metformin therapy reduced CDI odds by ~42 %, likely through gut-microbiota modulation. Diabetic patients with cholera showed prolonged hospitalization (IRR ≈ 2.0) without excess mortality. NOS scores (6–8/9) indicated moderate–high methodological quality.

Conclusion:

Diabetes amplifies susceptibility and worsens outcomes of CDI and related enteric infections, while metformin may offer partial protection. Incorporating glycaemic optimization, antibiotic stewardship, and microbiome-preserving strategies into diabetic care could mitigate infection-related morbidity and healthcare burden.

Knowledge, Attitude and Practice of Pharmacovigilance among Prescribers in a Tertiary Care Hospital

2025-12-13T10:05:01+00:00

Background:
Pharmacovigilance plays a pivotal role in ensuring medication safety by detecting, assessing, and preventing adverse drug reactions (ADRs). Despite being a professional and ethical responsibility, ADR reporting remains suboptimal worldwide, particularly among undergraduate prescribers.

Objectives:
To assess the level of knowledge, attitude, and practice regarding pharmacovigilance among MBBS student prescribers in a tertiary care hospital and to identify key barriers contributing to under-reporting of ADRs.

Methods:
A descriptive, cross-sectional, questionnaire-based study was conducted among 150 MBBS students actively involved in prescription writing during clinical postings. Data were collected using a validated 20-item KAP questionnaire covering fundamental concepts of pharmacovigilance, attitudes toward ADR reporting, reporting practices, and perceived barriers. Data were analyzed using descriptive statistics and presented as frequencies and percentages.

Results:
Among the participants, 112 (74.7%) were aware of the term pharmacovigilance, and 98 (65.3%) correctly identified its primary objective as the detection and prevention of ADRs. A positive attitude was observed, with 124 students (82.7%) acknowledging ADR reporting as a professional obligation and a vital component of patient safety. However, practical engagement was limited, as only 18 students (12%) had ever reported an ADR. The major barriers identified were lack of knowledge regarding reporting procedures (44.6%), difficulty in diagnosing ADRs (32%), time constraints (14%), and non-availability of reporting forms (9.3%).

Conclusion:
Although MBBS prescribers demonstrated satisfactory knowledge and a favorable attitude toward pharmacovigilance, actual ADR reporting practice was notably poor. This highlights a significant knowledge–practice gap that requires targeted educational and system-level interventions.

Recommendations:
Incorporating structured pharmacovigilance training into the undergraduate curriculum, conducting regular hands-on workshops on ADR identification and reporting, integrating ADR reporting into routine clinical teaching, and implementing user-friendly digital reporting platforms are strongly recommended to improve reporting behavior and enhance patient safety.

Keywords: Pharmacovigilance; Adverse Drug Reactions; Knowledge–Attitude–Practice; MBBS students

Prevalence and factors influencing the development of hypertension among people living with HIV and AIDS attending TASO at Mulago Hospital. A Cross-sectional study.

2025-12-02T08:29:56+00:00

Background:
Hypertension has devastated the lives of many people living with HIV/AIDS (PLWHIV) globally, yet its prevalence in Uganda is not known. This study aimed to determine the prevalence and factors influencing hypertension among PLWHIV and AIDS at TASO Mulago.

Methodology:

A cross-sectional design was employed with qualitative and quantitative approaches on 80 randomly sampled participants. Qualitative data was collected through interviews. Blood pressure measured by a sphygmomanometer, Height, and weight data by anthropometry were used to compute the body mass index (BMI). Descriptive statistics were run to report frequencies, means, and standard deviations for continuous variables, chi-square tests, and binary logistic regressions with adjusted odds ratios (AORs). Statistical significance was considered for p-values < 0.05. Ethical clearance obtained from Mild May Uganda Research Ethics Committee and study authorization from TASO.

Results:

In a sample of 80 PLWHIV attending TASO Mulago, the majority were females, 56(70.0%), while 50 (30%) were males. The majority 45.0% were married, 10(12.5%) single, 16(20.0%) divorced and 18(22.5%) widowed. The prevalence of hypertension was 37.5% (95% CI [27.5, 48.8]). In multivariable analysis, having secondary or higher education was independently associated with lower odds of hypertension (AOR = 0.27, 95% CI [0.08, 0.94], p = .040), whereas an undetectable viral load was associated with higher odds of hypertension (AOR = 2.83, 95% CI [1.00, 7.99], p = .049). Age ≥45 years, male sex, marital status, employment, socioeconomic status, ART regimen, and over-nutrition were not significantly associated with hypertension in the adjusted model.

Conclusion:

Hypertension is a prevalent comorbidity among PLWHIV at TASO Mulago, highlighting the dual burden of HIV and cardiovascular disease.

Recommendation:

Integration of HIV care through routine hypertension screening, nutritional counseling, adherence support, and targeted lifestyle interventions, to reduce cardiovascular complications and improve long-term health outcomes for PLWHIV in Uganda.

Bridging the literacy gap: A cross-sectional study evaluating the impact of the Funda Nathi literacy project on primary school learners.

2025-07-28T17:51:07+00:00

Background
Literacy is a foundational skill essential for academic success and socio-economic mobility. Yet many learners in underserved communities continue to struggle with basic reading and writing due to limited resources, inconsistent instructional support, and socio-economic constraints. Despite national literacy interventions, reading proficiency remains low in early grades. The FundaNathi Literacy Project was established to strengthen literacy development among Grade 2–7 learners through structured reading programs, interactive activities, and community engagement.

Methods
A cross-sectional quantitative research design was employed. Quantitative data were collected from 180 learners (intervention group = 120; comparison group = 60) using pre- and post-intervention literacy assessments measuring reading fluency (words per minute), comprehension scores, and writing accuracy. Qualitative data were obtained through classroom observations and semi-structured interviews with 12 educators, 20 learners, and 15 parents. Descriptive statistics summarised quantitative findings, while qualitative data were analysed thematically.

Results
Participants had a mean age of 10.4 years (SD = 1.8), with 55% female and 45% male. At baseline, average reading fluency among intervention learners was 42 wpm; post-intervention scores increased to 68 wpm (a 62% improvement). Comprehension scores rose from a mean of 38% to 64%, while writing accuracy improved by 41%. Compared with the non-participating group, intervention learners showed significantly greater gains across all literacy domains. Educators reported improved learner confidence and engagement. Parental involvement strengthened reading habits at home, although inconsistent support, limited materials, and funding constraints hindered project scalability.

Conclusion
The Funda Nathi Literacy Project significantly improves foundational literacy skills among learners in low-resource settings, especially when supported by educators and caregivers.

Recommendations
Strengthen school, community partnerships, secure sustainable funding, and integrate digital learning tools to enhance program reach and long-term impact.

Prevalence and associated factors of severe malaria-hemoglobinuria among children below 15 years: A retrospective cross-sectional study at a tertiary regional referral hospital in Uganda.

2025-09-29T12:56:02+00:00

Background:

The World Health Organization (WHO) report of 2022 showed that Uganda accounted for 5.1% of the global case burden. Severe malaria presenting with hemoglobinuria is characterized by tea coloured urine, jaundice, and anemia. This study aimed to understand the prevalence and associated factors of severe malaria-hemoglobinuria among children below 15 years admitted to a tertiary hospital in Uganda.

Methods:

A retrospective study that involved reviewing patient files of children aged 15 years and below admitted at Kayunga regional referral hospital in Uganda during 2023. Data was extracted using a standardized checklist developed according to the WHO 2015 clinical surveillance criteria for severe malaria. Sociodemographic, clinical, and laboratory data were collected and analyzed using Stata 18. Logistic regression analysis was used to evaluate the factors associated with severe malaria-hemoglobinuria. A p-value <0.05 indicated statistical significance.

Results:

The prevalence of severe malaria-hemoglobinuria was 27.7% with the majority (48.2%) in the age group of 5-9 years. Males were the majority (54.7%). The associated factors of severe malaria-hemoglobinuria were hyperparasitemia (p-value=<0.001), convulsions (p-value=0.051), and anemia (p-value=0.012). The mortality rate among the study participants was 1.4%. The average hospitalization duration for patients was 3 days. There was no difference in mortality and duration of hospital stay among patients who received standard treatment alone versus those who received an adjuvant like steroids.

Conclusions:

The prevalence of severe malaria-hemoglobinuria was 27.7% higher than in earlier studies in central Uganda, with the overall mortality rate of 1.4%. Hyperparasitemia, anemia, and convulsions were the associated factors. The higher prevalence among children aged 5 and above highlights the need for enhanced surveillance and targeted interventions in this age group to improve outcomes in similar settings.

Recommendation:

Further prospective studies are recommended to explore causal relationships and optimize care strategies.

Postgraduate students’ interpretations of research misconduct and their views on enabling research integrity at universities.

2025-09-18T14:59:01+00:00

Background

Upholding research ethics is critical within the landscape of postgraduate research in South African higher education. This study, conducted at a University of Technology with postgraduate students in Health Sciences, sought to explore their understanding of research misconduct, strategies to prevent misconduct, and the need for a dedicated module on ethics in Health Sciences.

Method

This study employed a qualitative exploratory research design. The sample consisted of postgraduate students from the Faculty of Health Sciences who registered in 2022. Data were collected from 15 postgraduate students between April and October 2022 using semi-structured interviews to explore their views on research misconduct, strategies to prevent it, and the need for a research ethics module for health science research. Thematic analysis was used to analyse the data.

Results

Participants comprised 11 females and 4 males, representing disciplines such as Biomedical and Clinical Technology, Chiropractic, Child and Youth Care, Emergency Medical Care and Rescue, Nursing, and Radiography. Ten were master’s students, and five were doctoral candidates, including those enrolled in the generic PhD programme. Three main themes emerged from the data: Research Misconduct, Preventing Research Misconduct, and Research Ethics Training.

Conclusion

Postgraduate students are aware of research misconduct risks, but universities must enforce robust policies, agreements, and ethics training to uphold academic integrity. Misconduct threatens credibility, funding, and participant safety, underscoring the need for proactive institutional safeguards. The absence of a dedicated ethics module reveals a critical curricular gap, warranting urgent integration into health science education.

Recommendations

A comprehensive Research Ethics Module should be developed and implemented across the Faculty of Health Sciences and made compulsory for all postgraduate students upon registration. The University should also formalize a misconduct agreement for students to sign at the start of their research, reinforcing the consequences of misconduct and the importance of upholding ethical standards.

Patient satisfaction with Tuberculosis treatment services at Kawaala Health Centre III, Kampala, Uganda, January-June 2017: A cross-sectional study.

2024-07-22T07:49:31+00:00

Introduction

Supervised treatment of TB in an urban setting (Urban Directly Observed Therapy) is part of a support package that is sensitive and supportive of patients’ needs. Patient satisfaction with DOT is one of the measures to support patient adherence and treatment completion, thus its importance to treatment outcomes. Assessing patient satisfaction with urban DOT and applicability of the service quality tool (SERVQUAL) hasn’t been done, and so, there is insufficient knowledge for implementers of the strategy. We determined the level of patient satisfaction and applicability of the tool at Kawaala Health Centre III, Rubaga division, Kampala, Uganda.

Methods

We conducted a cross-sectional study in June 2017 and collected quantitative data using the SERVQUAL tool. We used factor analysis and reliability testing to determine the tool’s applicability among TB patients and mean score analysis to determine the level of patient satisfaction. Patients aged ≥18 years with confirmed smear-positive pulmonary tuberculosis (PTB) and on treatment under Urban DOT at Kawaala Health center III were included in the study.

Results

We found the SERVQUAL tool to have Cronbach's alpha coefficients of 0.83 for expectations and 0.76 for perceptions. A quality gap of -0.46 was also found.

Conclusion

The tool applies to TB patients in a Ugandan urban setting. Forty-six percent of patients were dissatisfied with tuberculosis treatment services. We recommend improvement in the dimensions of urban DOT components, reliability, and responsiveness.

Recommendation

Effective diagnostics, such as a functional genexpert machine, should be explored to improve service delivery.

Exploring the therapeutic uses of African wormwood (Artemisia afra): A cross-sectional ethnobotanical study in KwaZulu-Natal, South Africa.

2025-07-22T17:55:51+00:00

Background
A cross-sectional ethnobotanical study was conducted with 120 participants from rural and peri-urban communities in KwaZulu-Natal. Participants were selected through purposive and snowball sampling. Quantitative data were collected through structured questionnaires assessing frequency, preparation methods, and perceived effectiveness. Qualitative data were obtained through in-depth interviews with traditional healers, herbalists, and elderly community members.

Results
African Wormwood was widely used for treating flu (76%), chest congestion (65%), fever (48%), digestive ailments (33%), and as a steaming herb (51%) during COVID-19. Most respondents prepared it as a tea (57%) or via inhalation (steaming) (38%). 81% of participants reported moderate to significant health improvement after use. Traditional healers emphasized their role in spiritual cleansing, immune support, and malaria prevention. However, some concerns emerged around overuse and the lack of dosage guidelines, particularly for pregnant women and children.

Conclusion
The findings affirm African Wormwood’s role in community health practices, reflecting cultural trust and wide therapeutic application. Its use during the COVID-19 pandemic highlights contemporary relevance. Nevertheless, further scientific evaluation is urgently needed to establish its bioactivity, safety, and appropriate dosage.

Recommendations
Pharmacological studies should validate efficacy and safety across demographic groups. National health policies could strengthen collaboration with Indigenous knowledge holders to integrate traditional remedies such as A. afra into formal systems. Education campaigns are needed to promote safe preparation and use, while conservation strategies must be implemented for sustainable harvesting.

Household pharmaceutical waste in South Africa: A Scoping Review of disposal practices, drivers, challenges, and potential solutions.

2025-10-14T21:47:12+00:00

Background

Improper disposal of household pharmaceutical waste (HPW) poses significant health and environmental risks. In South Africa, many households retain unused and expired medicines, with unsafe disposal practices driven by limited awareness, over-prescribing, and easy access to medicines, particularly in rural communities. This review synthesises current evidence on disposal practices, drivers, challenges, and risks to inform policy development and support interventions for safer HPW management.

Methods

Following the Arksey and O’Malley scoping review framework and PRISMA guidelines, English peer-reviewed studies published between 2014 and 2024 were identified through PubMed, Google Scholar, ScienceDirect, and Sabinet. Studies addressing HPW generation, disposal, or management were included, while those published before 2014, not in English, or without full text were excluded. Data were extracted, charted, and synthesised thematically.

Results

Households frequently retained unused or expired medicines due to non-adherence, over-prescribing, large pack sizes, self-medication, and stockpiling. Unsafe disposal practices, such as discarding in household waste or flushing, were common. Structural and systemic factors, including limited public awareness, inadequate take-back systems, insufficient healthcare guidance, and weak regulatory enforcement, contributed to unsafe practices. The management of HPW is constrained by a combination of systemic, infrastructural, and behavioural factors. Together, these challenges impede the adoption of safe and sustainable disposal practices.

Conclusion

The HPW is influenced by multifaceted behavioural, structural, and systemic factors. Addressing these challenges requires coordinated interventions, including public education, improved regulatory frameworks, accessible take-back programs, and integration of disposal counselling into routine healthcare practice. These measures are critical to reduce risks, prevent environmental contamination, and promote sustainable HPW management.

Recommendations

Future efforts to manage HPW should prioritise the expansion of accessible take-back programs and the integration of disposal counselling into healthcare services. Continuous research and environmental monitoring should be conducted to inform interventions and support sustainable household waste management.

A cross-sectional study on factors associated with self-medication among residents in Kasubi parish, Kampala district.

2025-04-23T12:56:10+00:00

FACTORS ASSOCIATED WITH SELF MEDICATION AMONG RESIDENTS IN KASUBI PARISH, KAMPALA DISTRICT

A scoping review of family caregivers' experiences in caring for patients with kidney failure undergoing haemodialysis: evidence from Sub-Saharan Africa.

2025-09-03T21:03:28+00:00

Background
Kidney failure (KF) poses a significant burden and role changes on family caregivers who provide essential support to patients undergoing haemodialysis.

Objective
This scoping review synthesises available evidence on the caring experiences, challenges, and support needs of family caregivers of patients with kidney failure receiving haemodialysis treatment in Sub-Saharan Africa.

Charting Methods
Two reviewers independently selected articles based on the agreed search strategy and inclusion criteria. Following the selection process, both reviewers independently extracted data from the included studies to ensure accuracy and reliability of the findings.

Eligibility Criteria
The review included qualitative primary studies written in English that focused on family caregivers of patients with kidney failure receiving haemodialysis in Sub-Saharan Africa.

Sources of Evidence
Literature was searched across three relevant databases: PubMed, Medline, and ScienceDirect. The search strategy was designed to capture studies examining the experiences of family caregivers in the Sub-Saharan African context.

Results
The final review included two qualitative studies conducted in Rwanda and Tanzania between 2021 and 2025. Analysis of these studies revealed four major themes: healthcare provider-family caregiver interactions, challenges within the healthcare system and accessibility of dialysis treatment, the multidimensional impact of long-term caregiving, and coping mechanisms and adaptation strategies.

Conclusions
Family caregivers experience significant physical, emotional, social, and financial burdens while caring for kidney failure patients. Healthcare systems in Sub-Saharan Africa need to develop comprehensive support frameworks that address the needs of caregivers and improve patient outcomes.

Recommendations
Healthcare providers should prioritise the implementation of family-centred care training programs and establish structured communication protocols with caregivers.

Ethnopharmacological evaluation of the African potato (Hypoxis hemerocallidea): A community-based cross-sectional study on its role in promoting good health and well-being in KwaZulu-Natal, South Africa.

2025-07-22T18:02:51+00:00

Background:
The African Potato (Hypoxis hemerocallidea), a medicinal plant deeply rooted in African Indigenous Knowledge Systems (AIKS), has long been used by traditional healers for immune support, chronic illnesses, and infection management. However, limited empirical evidence exists to validate its therapeutic benefits within modern scientific frameworks. This study explores traditional uses, community knowledge, and perceived health outcomes associated with African Potato among residents of KwaZulu-Natal.

Methods:
A cross-sectional mixed-methods design was employed, involving 150 participants selected through purposive and snowball sampling in rural and peri-urban communities. Quantitative data were collected through structured questionnaires on usage frequency, health purpose, and perceived outcomes, while qualitative insights were obtained from semi-structured interviews with traditional healers, herbalists, and community elders. Descriptive statistics and thematic analysis were used to interpret the data.

Results:
Participants ranged from 21 to 74 years old, with the majority being female (62%) and unemployed or self-employed in informal trade. Over 80% reported using African Potato as part of household health remedies, primarily for managing symptoms of HIV/AIDS, diabetes, arthritis, and infections. Traditional practitioners emphasized its immune-boosting, spiritual, and cleansing properties. Community knowledge strongly aligned with the plant’s recognized anti-inflammatory and antioxidant functions. Despite widespread reliance and positive perceptions, participants noted inconsistent dosage, lack of standardized preparation, and uncertainty regarding contraindications, highlighting a gap between traditional practice and scientific validation.

Conclusion:
African Potato remains a cornerstone of Indigenous healing in KwaZulu-Natal, supported by lived experiences and communal trust. While its ethnomedicinal value is widely acknowledged, further scientific research is needed to validate therapeutic claims and ensure safe integration into primary healthcare systems.

Recommendations:
Interdisciplinary research between scientists and traditional healers is essential to document preparation methods, determine safe dosage, and enhance the credibility of Indigenous knowledge for formal health applications.

Healing from the wild: An ethnopharmacological assessment of Aloe ferox in rural KwaZulu-Natal. A cross-sectional mixed-methods study.

2025-07-22T17:34:12+00:00

Background

Aloe ferox (Cape Aloe or Bitter Aloe) is one of Southern Africa’s most valued medicinal plants, widely used within Indigenous Knowledge Systems (IKS) for treating digestive, dermatological, and immune-related ailments. This study investigates the traditional applications, usage patterns, and local perceptions of A. ferox to support the integration of Indigenous healing knowledge into public health frameworks.

Methods

A cross-sectional mixed-methods study was conducted among 140 participants from rural KwaZulu-Natal communities, selected through purposive and snowball sampling. Participants included 80 women (57%) and 60 men (43%), aged 22–78 years (mean = 46.3 years). Most participants (65%) were small-scale farmers or informal traders, while 25% were traditional healers or herbalists. Quantitative data were gathered using structured questionnaires on usage frequency and preparation methods, while qualitative data were collected through 20 semi-structured interviews with healers, elders, and community herbalists. Descriptive statistics and thematic analysis were applied.

Results

Approximately 79% of respondents used A. ferox for digestive cleansing and constipation, 60% for wound healing, 42% for skin infections, and 38% for immune support. Common preparation methods included boiling the leaf sap (55%) and topical gel application (35%), with 83% reporting symptom relief. Qualitative findings revealed that A. ferox is also perceived as a spiritual cleanser, used in rituals to remove “impurities” and restore balance. Healers emphasized its cultural symbolism and warned against overharvesting for commercial trade. Participants expressed concern over the loss of Indigenous harvesting knowledge among youth and the absence of dosage regulation in home-based use.

Conclusion
The study confirms A. ferox as a cornerstone of traditional healthcare and cultural identity in KwaZulu-Natal.

Recommendations

To ensure its sustainability, pharmacological validation, community-based conservation, and policy inclusion of IKS are recommended to safeguard both human health and biodiversity.

Evaluation of placental thickness at 32nd and 36th weeks for predicting fetal outcome: A hospital-based cross-sectional observational study.

2025-12-29T12:38:09+00:00

Background:
Placental thickness (PT) is an important ultrasonographic parameter reflecting placental growth and function. Abnormal placental thickness has been associated with adverse perinatal outcomes such as low birth weight, poor APGAR scores, and increased neonatal intensive care unit (NICU) admissions.

Aim:
To evaluate placental thickness at 32nd and 36th weeks of gestation and determine its predictive value for fetal outcome.

Methods:
This hospital-based cross-sectional observational study was conducted at Gayatri Vidya Parishad Institute of Health Care and Medical Technology, Visakhapatnam, from January to June 2025. One hundred singleton pregnant women aged 18–40 years were included. Placental thickness was measured using ultrasonography at 32 and 36 weeks. Fetal outcomes assessed were birth weight, APGAR score, and NICU admission. Statistical analysis was performed using SPSS version 20.

Results:
Mean placental thickness was 30.8 ± 3.2 mm at 32 weeks and 36.2 ± 3.8 mm at 36 weeks. A strong positive correlation was observed between placental thickness and birth weight (r = 0.71, p < 0.001). Thin placentas (<30 mm) were significantly associated with low birth weight and poor APGAR scores (p = 0.005). NICU admission was required in 22% of neonates, predominantly among those with abnormal placental thickness (p = 0.03).

Conclusion:
Placental thickness is a reliable predictor of fetal outcome. Abnormally thin or thick placentas are associated with adverse neonatal outcomes. Routine assessment of placental thickness in the third trimester may help identify high-risk pregnancies early.

Recommendations

Regular ultrasonographic assessment of placental thickness during the third trimester should be incorporated into routine antenatal protocols to identify pregnancies at risk for adverse fetal outcomes.

A prospective observational study of histopathology of endometrium in abnormal uterine bleeding in perimenopausal and postmenopausal women.

2026-01-19T18:48:15+00:00

Background

An understanding of the varieties in the normal morphological appearance of the endometrium provides an essential background of the evaluation of endometrial pathology and early diagnosis of malignant and premalignant lesions.

Methods

Histopathological examination was done after endometrial biopsy for 340 women of age above 40 years presenting with abnormal uterine bleeding and with endometrial thickness > 4 mm on transvaginal ultrasonography, 260 of which were perimenopausal group and 80 were postmenopausal group and incidences of respective pathological outcomes in each group and their associations with specific demographic and patient comorbidities was studied.

Results

Proliferative endometrium was the most common finding among perimenopausal women (45.76%), while atrophic endometrium predominated in postmenopausal women (47.5%). Endometrial carcinoma was significantly higher in postmenopausal women (16.25%) compared to perimenopausal women (3.46%). Obesity, diabetes mellitus, and hypertension were significantly associated with malignant endometrial pathology.

Conclusion

Histopathological examination is mandatory in perimenopausal and postmenopausal abnormal uterine bleeding to detect lesions like polyps, hyperplasia, atypical hyperplasia and cancer. Obesity, history of chronic anovulation, diabetes mellitus,

hypertension are important risk factors for endometrial carcinoma.

Recommendations

Routine endometrial biopsy should be considered in perimenopausal and postmenopausal women with abnormal uterine bleeding, particularly those with metabolic risk factors.

Measles in pregnancy: clinical considerations & challenges. Systematic review.

2026-01-27T08:29:16+00:00

Background:

Measles remains a highly contagious viral infection with significant morbidity and mortality. Pregnant women constitute a high-risk group, with infection associated with severe maternal illness, adverse pregnancy outcomes, and neonatal complications. Recent outbreaks and immunity gaps among women of reproductive age necessitate a synthesis of current evidence.

Objective:

To systematically review maternal, fetal, and neonatal outcomes associated with measles infection during pregnancy and summarize clinical and preventive considerations.

Methods:

A systematic search of PubMed, Embase, Google Scholar, and the Cochrane Library was conducted from inception to December 2025. Observational studies, outbreak investigations, case series (≥5 cases), and systematic reviews reporting measles during pregnancy were included. Outcomes assessed included maternal morbidity and mortality, pregnancy loss, preterm birth, neonatal morbidity, and congenital measles. Quality appraisal used the Newcastle-Ottawa Scale, Joanna Briggs Institute tools, and AMSTAR-2. This review was not prospectively registered.

Results:

Fifteen studies involving over 1,000 pregnant women with measles were included. Hospitalization rates ranged from 60% to 96%. Pneumonia occurred in 18–40% of cases and encephalitis in up to 5%. Maternal mortality reached 12% in outbreak settings, with pooled estimates of 4.3%. Adverse pregnancy outcomes were frequent, including spontaneous abortion, intrauterine fetal death, preterm birth (13–31%), and low birth weight. Adjusted risks for fetal loss and neonatal morbidity were significantly higher compared with uninfected pregnancies. Early gestational infection was associated predominantly with pregnancy loss, whereas late gestational infection increased the risk of preterm birth and congenital malformation. Neonatal outcomes included increased NICU admission and prolonged hospitalization.

Conclusion:

Measles in pregnancy is associated with substantial maternal and perinatal risk. Preconception immunization and timely post-exposure prophylaxis remain central preventive strategies.

Implications and Future Research:

Prospective pregnancy registries, vaccine-era cohort studies, and gestation-specific management protocols are required.

“EFFECT OF SILDENAFIL ON ENDOMETRIAL THICKNESS AND UTERINE ARTERY BLOOD FLOW IN INFERTILE WOMEN

2026-01-07T13:27:29+00:00

Background: The increasing infertility in women, the present study was undertaken to evaluate and compare the effect of sildenafil citrate and Estradiol valerate on the endometrial thickness, endometrial pattern, and uterine blood flow of infertile women undergoing ovulation induction by Clomiphene citrate.

Methods: This was a 1-year prospective study on infertile females attending OPD at KNMH, Prayagraj.Study who were screened on the basis of inclusion and exclusion criteria

Results:

In the sildenafil group, there was a significant(p<0.05) improvement in endometrial thickness, uterine artery blood flow(Pulsatility Index of uterine artery), and endometrial

pattern and pregnancy rates as compared to the only estradiol valerate group.

Conclusion: There was a significant statistical difference between the two groups in terms of endometrial thickness, uterine artery blood flow(Pulsatility Index of uterine artery), and endometrial pattern before and after sildenafil citrate administration. Though both estradiol valerate and sildenafil citrate are effective in improving endometrial thickness, uterine artery blood flow, and endometrial pattern, sildenafil citrate is superior to estradiol valerate.

Factors influencing exclusive breastfeeding among lactating mothers aged 15-19 years attending the postnatal clinic at Entebbe regional referral hospital in Wakiso district. A cross-sectional study.

2025-10-29T19:20:21+00:00

Background.

EBF is a global health priority due to its proven benefits for both infant survival and maternal well-being; however, its practice remains minimal in many regions, particularly among adolescent mothers. This study determined the factors influencing exclusive breastfeeding among lactating mothers aged 15-19 years attending the postnatal clinic at Entebbe regional referral hospital in Wakiso district.

Methodology.

A quantitative descriptive cross-sectional study design was used to select 36 mothers using a simple random sampling method, collecting data using a structured questionnaire. Data was analyzed using SPSS computer programs for presentation of tables and figures. Responses for open-ended questions were summarized and given themes before tallying them for analysis.

Results.

18(50%) of the study participants were self-employed, and 52.8% of the respondents were Baganda tribe. 20(55.6%) of the respondents reported to receive breastfeeding counselling at the health facility, 28(77.8%) of the respondents that their hospital stays when receiving proper breast-feeding education and support was sufficient, 26(72.2%) of the respondents said there was no any promotion of formula supplementation at the health facility, 20(55.6%) of the respondents had 3 and more antenatal visits, 18(50%) of the respondents reported that sometimes cultural or social background affect the decision to exclusively breastfeed and 18(50%) of the respondents were never concerned about the image of their babies due to EBF.

Conclusion.

Health facility support, particularly through antenatal counseling and hospital policies that discourage formula supplementation, plays a key role in promoting EBF.

Recommendation.

Providing follow-up EBF counseling after hospital discharge, through phone calls or community health workers, to assist adolescent mothers in maintaining EBF.

Prevalence and associated factors of obstructed labor among mothers delivered at a tertiary care hospital in Uganda: A descriptive retrospective cross-sectional study.

2025-10-11T10:58:27+00:00

Background:

Obstructed labor (OL) is a major contributor to the high maternal and neonatal morbidity and mortality rates, especially in low and middle-income countries (LMICs) where structural barriers to accessing quality obstetric services are commonplace. This study aimed to document the magnitude of obstructed labor and its associated factors at a public regional referral hospital in Uganda.

Methods:

A descriptive retrospective cross-sectional study was conducted at Kayunga Regional Referral Hospital in Uganda that involved a review of 2,176 hospital records of mothers who delivered from 1st January to 31st December 2023. A pretested data extraction tool was used for data collection from the patient charts. A Multivariate Modified Poisson Regression model was employed to identify determinants of obstructed labor.

Results:

This study's prevalence of obstructed labor was 18.57% (405 out of 2176). Women referred from lower health facilities were likelier to experience OL, with a prevalence ratio of 1.83 (95% 1.43-2.34, p-value <0.001). Primipara mothers were 3 times more likely to encounter obstructed labor when compared to multigravidas (95% 1.94-6.35, p-value <0.001). Women of >42 weeks of gestation were 7 times more likely to encounter obstructed labor compared to those with 37-42 weeks (95% CI: 5.69-10.89, <0.001). The likelihood of encountering obstructed labor among mothers where a partograph was not used during labor was 3.55 times higher (95% CI: 2.68-4.70, p-value = <0.001) compared to those where a partograph was completed.

Conclusion:

The prevalence of obstructed labor is still high in LMICs. Referral from a lower health facility, parity, and partograph utilization were significantly associated with obstructed labor.

Recommendation:

Therefore, improving partograph use, training and equipping healthcare workers to diagnose OL, as well as early and timely interventions to prevent complications of OL, are recommended.

Adverse maternal-fetal outcomes among mothers with obstructed labor delivered at a tertiary care hospital in Central Uganda: A descriptive retrospective cross-sectional study.

2025-10-11T10:26:28+00:00

Background:

Obstructed labor is the single most common cause of adverse maternal and fetal outcomes, including urinary bladder trauma, ruptured uterus, sepsis, post-partum hemorrhage (PPH), birth asphyxia, septicemia, and stillbirth, among others. This study aimed to determine the frequency and types of adverse maternal and fetal outcomes associated with obstructed labor at Kayunga Regional Referral Hospital, a tertiary care hospital located in Central Uganda.

Methods:

A descriptive retrospective cross-sectional study was conducted at Kayunga Regional Referral Hospital in Uganda that involved a review of 2,176 hospital records of mothers who delivered from 1st January to 31st December 2023. A pretested data extraction tool was used for data collection from the patient charts. Variables with p-values <0.2 in the bivariate analysis were included in a multivariate analysis using a Modified Poisson Regression model to identify determinants of adverse maternal-fetal outcomes of obstructed labor.

Results:

The most commonly reported adverse maternal outcome was puerperal sepsis (21, 55.4%), while birth asphyxia (65, 70.7%) was the commonest adverse fetal outcome. Being referred from a lower health center, non-use of partograph during labor, history of herbal medicine use, and visiting a traditional birth attendant were strongly correlated with the adverse maternal-fetal outcomes (p-value = <0.001).

Conclusions:

This study revealed a high prevalence of adverse maternal-fetal outcomes associated with obstructed labor. Being referred from a lower health facility, non-use of partograph during labor, history of herbal medicine use, and visiting a traditional birth attendant were associated with adverse maternal-fetal outcomes among women with obstructed labor. Sepsis, perineal tears, birth asphyxia, and stillbirth were the commonest adverse outcomes of obstructed labor.

Recommendation:

This calls for improving the referral system from lower health facilities, improving infrastructure to support timely access to critical emergency obstetric care, and emphasizing the need for patrograph use during labor.

A cross-sectional study on the relationship between arm span and height among adolescents: An anthropometric approach.

2025-11-27T07:29:51+00:00

Background

Height measurement is essential in adolescent health assessment, yet it becomes challenging when individuals present with postural abnormalities, trauma, disability, or acute illness. This study evaluated the relationship between arm span and height using a standardized anthropometric approach.

Objective

To determine the association between arm span and height among adolescents and to develop regression equations for height estimation.

Methods

A cross-sectional study involving 100 adolescents aged 13–18 years was conducted. Height and arm span were measured following standard anthropometric protocols. Sex-wise comparisons were analyzed using independent t-tests. Pearson’s correlation assessed the strength of association between the two parameters. Linear regression equations were constructed for the total sample and stratified by sex to estimate height from arm span.

Results

The mean age was 15.6 ± 1.7 years, and males constituted 52% of the sample. Overall mean height was 159.8 ± 8.2 cm, while mean arm span measured 161.4 ± 8.7 cm. Both parameters were significantly higher in males (p < 0.001). Most participants demonstrated arm span values exceeding their height. A strong correlation existed between arm span and height in the total group (r = 0.89, p < 0.001), with similarly high correlations in males (r = 0.91) and females (r = 0.87). The primary regression model for the sample was: Height = 24.3 + 0.84 × Arm Span (R² = 0.79). Sex-specific models showed R² values of 0.82 and 0.76 for males and females, respectively.

Conclusion

Arm span is a reliable predictor of height among adolescents and demonstrates strong validity across sexes. The developed regression equations can assist in clinical, field, and resource-limited settings where height cannot be directly measured.

Recommendations

Routine inclusion of arm span measurement is encouraged in adolescent anthropometric assessments. Larger multicentric studies are recommended to enhance the external validity of the predictive equations.

Evaluation of anthropometric indices for obesity prediction and classification in indian adults: A cross-sectional comparative analysis of waist-to-height ratio, body roundness index, and traditional measures.

2025-12-18T21:12:43+00:00

Background
Obesity is a major public health challenge worldwide and is strongly associated with cardiovascular diseases, type 2 diabetes mellitus, and metabolic syndrome. Although Body Mass Index (BMI) is widely used for obesity classification, it has limitations in reflecting body fat distribution, particularly central adiposity.

Objective

To evaluate the effectiveness of selected anthropometric indices in predicting obesity among Indian adults and to determine optimal cutoff values for obesity classification.

Methods

A cross-sectional study was conducted among 241 adults (133 females and 108 males) at Coimbatore Medical College, Coimbatore, Tamil Nadu, India. Standard anthropometric measurements were obtained, and derived indices, including WHtR, BRI, WHR, and A Body Shape Index (ABSI) were calculated. Pearson correlation analysis assessed relationships between indices, independent t-tests evaluated gender differences, and Receiver Operating Characteristic (ROC) curve analysis determined predictive accuracy and optimal cutoff values.

Results

WHtR and BRI demonstrated the highest predictive accuracy for obesity classification, each with an AUC of 0.88. BRI showed the highest sensitivity (91%) with 78% specificity, followed by WHtR (sensitivity 87%, specificity 78%). Optimal cutoff values were identified as WHtR ≥ 0.55 and BRI ≥ 4.21. Hip circumference also showed strong predictive performance (AUC 0.89; cutoff 108 cm). Waist circumference exhibited high specificity (92%) with an optimal cutoff of 97 cm but moderate sensitivity (65%). WHR and ABSI were the weakest predictors. Combining indices, particularly waist circumference with BRI, improved classification accuracy (AUC 0.90).

Conclusion

WHtR and BRI are superior to BMI for obesity classification in Indian adults, offering better reflection of central adiposity and improved risk stratification.

Recommendation

Waist-to-Height Ratio and Body Roundness Index should be incorporated into routine clinical and community-based obesity screening programs to facilitate early detection and timely intervention.

Anthropometric study of hand length and its correlation with stature in an adult population: A cross-sectional study.

2025-11-27T07:08:01+00:00

Background:
Anthropometric indicators such as hand length play a valuable role in estimating stature when complete body measurements are unavailable, particularly in forensic identification, emergency settings, and anthropological profiling.

Objectives:
To measure hand length among adults and examine its correlation with stature, and to develop a regression equation for height estimation in the study population.

Methods:
A cross-sectional study was conducted among 100 healthy adults aged 18–45 years. Stature was measured using a stadiometer, and hand length was recorded bilaterally using a standard sliding caliper. Mean values for both hands were used for analysis. Participants were categorized into stature groups for comparative evaluation. Pearson’s correlation assessed the relationship between hand length and stature, while linear regression generated a predictive equation. Results were stratified by sex to examine variability across gender.

Results:
The mean stature of the participants was 165.4 ± 8.2 cm, whereas the mean hand length measured 18.7 ± 1.2 cm. Males exhibited higher values for both parameters compared with females. A consistent rise in hand length was observed across increasing stature categories. Pearson’s correlation demonstrated a strong positive association between hand length and stature in the total sample (r = 0.71, p < 0.001). Correlation values remained significant among males (r = 0.68) and females (r = 0.63). Linear regression identified hand length as a significant predictor of stature, yielding the equation: Stature (cm) = 54.12 + 5.94 × Hand Length (cm) with an R² of 0.51.

Conclusion:
Hand length shows a robust linear relationship with stature and can serve as a practical parameter for height estimation in adults. The regression model developed in this study provides a reliable reference for clinical, forensic, and anthropological use.

Recommendations:
Further studies with larger, multi-center samples and inclusion of additional limb anthropometric markers are recommended to enhance predictive accuracy.

Talocalcaneal coalition in dry bones: An observational descriptive morphological study.

2025-12-18T21:01:48+00:00

Background:
Tarsal coalition is an abnormal union between two or more tarsal bones and may be fibrous, cartilaginous, or osseous. Among its variants, talocalcaneal coalition (TCC) is one of the most common and is clinically significant because progressive ossification can restrict subtalar joint mobility and alter foot biomechanics, often becoming symptomatic after skeletal maturity.

Aim:
To determine the occurrence, type, and morphological characteristics of talocalcaneal coalition in dry human tali and calcanei.

Materials and Methods:

This observational descriptive study examined 150 dry calcanei and 150 dry tali obtained from the Department of Anatomy, Coimbatore Medical College. Intact bones from both sides were included irrespective of age and sex, while damaged or eroded specimens were excluded. Each specimen was evaluated by visual inspection and morphometric assessment for evidence of talocalcaneal fusion, facet involvement, bony bridges, traction spurs, and obliteration of the subtalar joint space.

Results:
Talocalcaneal coalition was identified in two talus–calcaneum pairs, one right and one left, representing 1.33% of the examined dry bone sample. Both were osseous coalitions. The left-sided specimen showed complete synostosis predominantly involving the middle subtalar facet with extension into the anterior facet, resulting in obliteration of the subtalar joint space and associated traction spur formation. The right-sided specimen demonstrated complete medial fusion at the middle facet with incomplete lateral osseous bridging and a small residual unfused gap, along with traction spurs and an indistinct middle facet.

Conclusion:
Osseous talocalcaneal coalition was uncommon in this dry bone series but consistently involved the middle subtalar facet with possible anterior facet extension. Such coalitions are clinically relevant, as they may contribute to rigid flatfoot, restricted subtalar movements, recurrent ankle sprains, and peroneal muscle spasm.

Recommendations:
Routine emphasis on subtalar facet morphology should be incorporated into anatomical teaching and radiological training.

Effect of oral anticoagulation on left atrial appendage thrombus resolution in patients with rheumatic mitral stenosis: A prospective observational study.

2025-12-26T09:14:03+00:00

Background:
Rheumatic mitral stenosis (MS) remains a major cause of cardiovascular morbidity in developing countries and is frequently complicated by atrial fibrillation and left atrial appendage (LAA) thrombus formation. The presence of LAA thrombus significantly increases thromboembolic risk and contraindicates interventional procedures such as percutaneous transvenous mitral commissurotomy (PTMC).

Objectives:
To evaluate the effect of oral anticoagulation on the resolution of left atrial appendage thrombus in patients with rheumatic mitral stenosis and to identify clinical and echocardiographic predictors of thrombus clearance.

Methods:
This prospective hospital-based observational study was conducted in the Department of Cardiology, Indira Gandhi Institute of Medical Sciences, Patna. Thirty patients with severe isolated rheumatic mitral stenosis and documented LAA thrombus on transesophageal echocardiography (TEE) were enrolled. All patients received oral anticoagulation with acenocoumarol and were followed for 12 weeks with weekly INR monitoring, targeting a therapeutic range of 2.0–2.5.

Results:
Most patients were young adults with a female predominance, and atrial fibrillation was present in 73.3%. Oral anticoagulation led to a significant reduction in mean LAA thrombus size from 5.34 ± 4.42 cm² at baseline to 3.82 ± 4.03 cm² after treatment. A substantial proportion of patients achieved complete thrombus resolution, while others demonstrated partial clearance. Reduction in spontaneous echo contrast intensity was also observed. Thrombus resolution was more likely in patients with smaller baseline thrombus size, sinus rhythm, lower left atrial dimensions, higher LAA emptying velocities, and sustained therapeutic INR levels.

Conclusion:
Oral anticoagulation with acenocoumarol is effective in achieving complete or partial resolution of left atrial appendage thrombus in patients with rheumatic mitral stenosis. Adequate INR control and favorable echocardiographic parameters play a critical role in thrombus clearance.

Recommendation:
Structured vitamin K antagonist therapy with strict INR monitoring and repeat transesophageal echocardiography should be routinely employed before considering interventional procedures in this high-risk population.

Relationship between Tei index and prognosis in patients with non-ST-segment elevation myocardial infarction: A prospective cohort study.

2025-12-17T10:33:24+00:00

Background:

Non-ST-segment elevation myocardial infarction (NSTEMI) constitutes a diverse subgroup of acute coronary syndromes characterised by inconsistent short-term outcomes. Early prognostic evaluation is crucial for enhancing management techniques. The Tei index, a Doppler-derived myocardial performance indicator, combines systolic and diastolic ventricular function and might provide additional prognostic value.

Objective:

To assess the correlation between the Tei index and in-hospital clinical outcomes in individuals with non-ST-segment elevation myocardial infarction.

Methods:

This prospective cohort research comprised 160 patients diagnosed with non-ST-segment elevation myocardial infarction. Transthoracic echocardiography was conducted within 48 hours of admission to ascertain the Tei index. Patients were monitored during hospitalisation for negative clinical outcomes.

Results:

Greater Tei index values were strongly linked to greater rates of heart failure, arrhythmias, cardiogenic shock, longer hospital stays, and deaths in the hospital. In multivariate analysis, the Tei index was identified as an independent predictor of negative in-hospital outcomes.

Conclusion:

The Tei index is a straightforward, non-invasive echocardiographic metric that autonomously forecasts short-term outcomes in individuals with non-ST-segment elevation myocardial infarction.

Recommendations:

Regular measurement of the Tei index during the initial echocardiographic assessment of patients with non-ST-segment elevation myocardial infarction may enhance risk classification and inform early therapeutic decision-making.

Prognostic Implication of Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) in Carcinoma Cervix Patients

2025-12-29T13:24:49+00:00

Background: In India, cervical cancer continues to be the primary cause of cancer-related death for women, especially in the state of Odisha. Even while molecular markers and advanced imaging are developing, there is a clear need for easily accessible prognostic techniques in settings with limited resources. Hematological markers have emerged as potential indicators of the crucial role that systemic inflammation plays in tumor development and survival, according to recent findings.

Objective: This study's main goal was to ascertain if pre-treatment Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) could function as accurate prognostic indicators for patients with cervical cancer's Overall Survival (OS) and Disease-Free Survival (DFS).

Methods: Using a combination of retrospective and prospective data, we carried out this observational study at the Acharya Harihar Post Graduate Institute of Cancer (AHPGIC), Cuttack, over a three-year period (2021–2024). There were 260 individuals in the trial group, all of whom had cervical cancer verified by histology. We examined complete blood count (CBC) data obtained before to the start of any treatment in order to calculate the NLR and PLR. To determine the best cut-off settings, we employed Receiver Operating Characteristic (ROC) curves. Finally, we used Cox proportional hazards models and Kaplan-Meier survival curves to assess Overall Survival (OS) and Disease-Free Survival (DFS).

Results: The median age of the study group was fifty-two. The ideal cut-off values were found to be 2.85 for NLR and 145.5 for PLR. Larger tumor size, lymph node metastasis (), and advanced FIGO stage () were among the aggressive disease traits significantly associated with elevated levels of both markers. Three-year Overall Survival was significantly poorer in patients with high NLR ( vs. ; ) and high PLR ( vs. ; ). Furthermore, multivariate analysis confirmed that high NLR (;
) and PLR (; ) are independent predictors of lower survival.

Conclusion: For cervical cancer, NLR and PLR are reliable, independent, and easily accessible prognostic indicators. At AHPGIC, stratifying patients according to these inflammatory indicators may aid in identifying high-risk patients in need of more intensive therapy measures.

Prevalence and Phenotypic Clusters of Heart Failure with Preserved Ejection Fraction (HFpEF): A Prospective Observational Cohort Study from a Tertiary Care Centre

2025-12-26T09:26:29+00:00

Background:
Heart failure with preserved ejection fraction (HFpEF) accounts for nearly half of all heart failure cases worldwide and is characterized by marked clinical, metabolic, and echocardiographic heterogeneity. This diversity has limited the effectiveness of uniform therapeutic strategies. Identification of distinct phenotypic clusters may improve risk stratification and enable individualized management.

Objectives:
To determine the prevalence of HFpEF and to identify distinct phenotypic clusters among patients presenting to a tertiary care center in eastern India.

Methods:
This was a prospective observational cohort study conducted over a 12-month period at a tertiary care teaching hospital. Consecutive adult patients diagnosed with HFpEF based on guideline-recommended criteria were enrolled. Detailed demographic, clinical, laboratory, electrocardiographic, and echocardiographic data were collected. Unsupervised cluster analysis using key clinical and echocardiographic variables was performed to identify distinct HFpEF phenotypes.

Results:
HFpEF constituted a substantial proportion of heart failure admissions during the study period. The mean age of patients was 63.4 ± 9.8 years, with a predominance of females. Hypertension (78%), diabetes mellitus (46%), and obesity (41%) were the most common comorbidities. Echocardiography demonstrated preserved systolic function with significant diastolic dysfunction, left atrial enlargement, and increased left ventricular mass. Cluster analysis identified three distinct phenotypes: a metabolic–obese phenotype, a hypertensive–atrial remodeling phenotype, and a cardiorenal–high-risk phenotype. These clusters differed significantly in metabolic burden, renal function, atrial size, diastolic indices, functional status, and hospitalization trends.

Conclusion:
HFpEF is a prevalent and heterogeneous condition in the tertiary care setting. Phenotypic clustering reveals clinically meaningful subgroups with distinct structural remodeling and disease severity, underscoring the limitations of a uniform treatment approach.

Recommendation:
Routine phenotype-based assessment of HFpEF patients should be encouraged to facilitate personalized management strategies and improve clinical outcomes.

Epidemiological Profile and Prevalence of Hyponatremia in Pulmonary Tuberculosis: A Cross-Sectional Study from Rajasthan, India”

2025-11-04T12:59:26+00:00

Background:

Hyponatremia is one of the most common electrolyte disturbances seen in hospitalized pulmonary tuberculosis (PTB) patients and may reflect disease severity. Indian data are limited, particularly from high-burden states such as Rajasthan.

Objectives:

To determine the prevalence and severity of hyponatremia in newly diagnosed sputum smear–positive pulmonary tuberculosis patients and to describe their demographic and clinical profile.

Methods:

This descriptive cross-sectional study was conducted in the Department of Respiratory Medicine, Institute of Respiratory Diseases, S.M.S. Medical College, Jaipur, Rajasthan. A total of 140 newly diagnosed sputum smear–positive PTB patients were included over one year. Serum sodium levels were measured at diagnosis and categorized as mild (130–134 mmol/L), moderate (125–129 mmol/L), and severe (<125 mmol/L). Sociodemographic and clinical parameters were recorded and analyzed.

Results:

The prevalence of hyponatremia (<135 mmol/L) was 45%. Severe hyponatremia was seen in 10%, moderate in 14%, and mild in 21% of patients. Most participants were aged 41–60 years (53.6%), male (80.7%), and from rural areas (90%). A statistically significant association was observed between serum sodium and age group (p = 0.00001), gender (p = 3.35×10⁻⁵), BMI (p = 6.22×10⁻⁴), occupation (p = 2.36×10⁻⁴), chest X-ray findings (p = 6.12×10⁻⁴), and sputum AFB grading (p = 0.02).

Conclusion:

Hyponatremia is highly prevalent in PTB patients, particularly among females, underweight individuals, and those with advanced radiological and bacteriological disease. Routine sodium monitoring is recommended for early detection and managem

Assessment of prescription writing skills among undergraduate medical students: A cross-sectional study.

2025-10-18T04:51:54+00:00

Background:

Accurate prescription writing is a vital clinical skill introduced during the second phase of the undergraduate medical curriculum, particularly within Pharmacology and Therapeutics. Although students receive formal instruction during this period, concerns persist regarding their ability to apply these skills effectively in practice, even at this early stage of training.

Objective:

To assess the prescription writing skills of second-year undergraduate medical students and identify common deficiencies in their performance.

Methods:

A cross-sectional study was conducted among second-year MBBS students. Participants were given a clinical case scenario and instructed to write a complete prescription. Each prescription was evaluated for essential components, including patient details, drug name, dose, frequency, route of administration, and prescriber information.

Results:

Out of the total participants, 76% scored in the moderate range for overall prescription writing, while only 18% achieved high scores. Drug-related components were moderately addressed by 58% of students, but prescriber and additional components showed poorer performance. Specifically, 35% scored low in prescriber-related and 51% in additional components. These findings reveal gaps in completeness and adherence to prescription standards.

Conclusion:

Despite formal teaching in Pharmacology, second-year undergraduate medical students show considerable gaps in prescription-writing skills.

Recommendation:

These findings suggest a need for repeated practice sessions, formative assessments, and integration of clinical context to enhance competency and ensure safe prescribing habits early in medical education.

Prevalence and factors associated with offering post-partum contraception by healthcare workers in Kayunga District: A cross-sectional study.

2025-11-26T12:31:10+00:00

Background.

Postpartum contraception is a critical component of maternal health, helping to prevent unintended pregnancies and reduce pregnancy-related risks. Despite high levels of awareness about family planning methods in Uganda, their uptake during the postpartum period remains low. This study sought to determine the prevalence and factors associated with the provision of postpartum contraception by healthcare workers in Kayunga District.

Methodology.

The study employed a cross-sectional design using both quantitative and qualitative methods. The quantitative aspect involved a review of family planning and maternity records from January to June 2024 to determine the proportion of mothers who received postpartum contraceptive methods and their preferred choices. Additionally, self-administered questionnaires were used to assess healthcare workers’ knowledge, attitudes, and practices regarding postpartum contraception. The qualitative component included key informant interviews with facility heads to explore facility-level factors affecting service provision.

Results.

A total of 2,502 women received family planning (FP) services before 6 months postpartum across all facilities. This accounted for 16.4% of all FP users (15,281) and 37.9% of all deliveries (6,597). Facility-level variation was wide, ranging from 0% in some health centers to as high as 290% in others. Overall, 47% demonstrated good knowledge; Attitudes were largely positive: 93% expressed good attitudes, while 73% demonstrated moderately good practices. Basic infrastructure exists in most facilities, but service delivery is constrained by inadequate training and inconsistent method availability.

Conclusions.

Findings demonstrate that low postpartum contraceptive uptake is primarily driven by knowledge and training deficiencies, inconsistent supply systems, and weak supervision frameworks, rather than by a lack of physical infrastructure.

Recommendations

Efforts to improve postpartum contraception should begin by enhancing early uptake through strengthened integration of family-planning counselling and service provision at all contact points along the maternal-child health pathway, including antenatal care, delivery, postnatal, and immunization visits.

Cross-sectional study on the occurrence of menstrual disorders post-tubal sterilization.

2025-11-23T04:03:29+00:00

Background

Tubal sterilization is a common permanent contraceptive method worldwide. However, its potential long-term sequelae, particularly menstrual disorders, remain a subject of debate. This study aimed to determine the occurrence and pattern of menstrual disorders among women who underwent tubal sterilization.

Methods

A hospital-based cross-sectional study was conducted at Bhaarath Medical College and Hospital from October 2024 to October 2025. One hundred parous women aged 25-40 years who had undergone tubal sterilization at least one year prior were enrolled using a consecutive sampling technique. A pre-tested, structured questionnaire was used to collect data on socio-demographic characteristics, surgical history, and menstrual patterns. Data were analyzed using SPSS version 25. Descriptive statistics were presented as frequencies and percentages. The Chi-square test was used to assess associations, with p-values <0.05 considered statistically significant.

Results

The mean age of the participants was 32.4 ± 4.1 years. The overall occurrence of menstrual disorders post-sterilization was 65% (65/100). The most common disorders were menorrhagia (30%), followed by polymenorrhea (18%) and intermenstrual spotting (12%). A statistically significant association (p=0.02) was found between the type of sterilization technique and the occurrence of menorrhagia. Women with a history of postpartum sterilization reported a higher incidence of menstrual irregularities compared to those with interval sterilization (72% vs. 58%, p=0.04).

Conclusion

A high occurrence of menstrual disorders was observed among women following tubal sterilization. Menorrhagia was the most prevalent disorder.

Recommendation

Pre-sterilization counseling should include comprehensive information about the potential risk of menstrual irregularities to ensure informed decision-making.

Effect of problem-focused coping mechanisms on resilience among refugees with ptsd symptoms in Bidibidi Refugee Settlement, Yumbe District–Uganda: A cross-sectional study.

2025-11-22T15:29:55+00:00

Background

Refugees in protracted displacement settings often experience trauma and chronic stress, which heighten their risk of developing post-traumatic stress disorder (PTSD). Problem-focused coping refers to deliberate efforts to address stressors directly and has been shown to enhance resilience. While various coping mechanisms influence psychological recovery, problem-focused coping does require the effort to actively address and resolve stressors. It has also been shown to enhance resilience. This study examined the effect of problem-focused coping mechanisms on resilience among refugees with PTSD symptoms in Bidibidi Refugee Settlement, Yumbe District, Uganda.

Methods

A cross-sectional study using a quantitative approach was employed among 108 refugees with PTSD symptoms selected from all five zones of Bidibidi Settlement between May and June 2025. Data were collected using structured, theory-informed questionnaires with clearly defined items measuring problem-focused coping and resilience. Statistical analysis was conducted using ordinal logistic regression in SPSS (version 25) to determine the predictive effect of problem-focused coping on resilience.

Results

Of the participants, 68.5% were female and 31.5% male, with the majority (50%) aged 18-24 years. Problem-focused coping had a significant positive effect on resilience (β = .353, p < .001). Refugees who engaged in proactive behaviors such as problem-solving, goal setting, and information seeking exhibited higher resilience compared to those who relied on less adaptive strategies. The model explained 38% of the variance in resilience scores, indicating that problem-focused coping is a major determinant of adaptive functioning among refugees experiencing PTSD symptoms.

Conclusion

Problem-focused coping plays a critical role in enhancing resilience among refugees with PTSD symptoms. Actively addressing stressors fosters a sense of control, self-efficacy, and psychological stability despite adversity.

Recommendations

Humanitarian organizations should integrate problem-solving skills training into psychosocial interventions. Mental health practitioners should strengthen resilience-based approaches that emphasize practical coping strategies in refugee settings.

The Contribution of Psychosocial Intervention Towards Perceived Sobriety: A cross-sectional Survey in the selected Hospital and Rehabilitation Centre, Kampala and Wakiso districts, Uganda.

2025-10-21T08:09:23+00:00

Background:

Psychosocial intervention, as a core element driving addicts to desire sobriety as a social identity, plays an important role. The study investigated the contribution of psychosocial intervention towards perceived sobriety. The study aimed at examining the influence of psychosocial intervention on perceived sobriety. The research objective was to establish the effect of psychosocial intervention on perceived sobriety in the selected hospital and rehabilitation centre in Kampala and Wakiso districts, Uganda.

Methods:

A cross-sectional design was used, and a mixed method approach with a sequential exploratory and sequential explanatory design, where a combination of quantitative and qualitative data collection and analysis was used to integrate Findings during the interpretation phase. The researcher used a Concurrent triangulation design where only one data collection phase was used; data collection and analysis were conducted separately.

Results:

The results revealed that the majority of the respondents were in the age range of 31-35 years, 95(33.3%), 26-30 years, 71(24.9%), 36-40 years, 64(22.5%), and 20-25 years, 55(19.3%). The majority of the respondents were male, 213(74.7%), and females were 72(25.3%). The result revealed a weak linear positive but significant relationship between psychosocial intervention and perceived sobriety (r = 0.230, p = 0.000). The findings suggest that psychosocial intervention is likely to lead to perceived sobriety (r = 0.230). This implies that psychosocial intervention significantly positively correlates with perceived sobriety at the level of significance.

Conclusion:

Increasing psychosocial intervention would result in feasible recovery, hence achieving sobriety. Therefore, therapists are encouraged to help recovering addicts manage continued vulnerability and develop healthy, productive, and meaningful lives.

Recommendation:

The Ministry of Health, through the Mental Health Desk, should encourage clinical coordinators and treatment providers to train professionals in clinical counseling and psychology to improve the quality of services in the treatment facilities.

A randomized controlled trial comparing subarachnoid block with 0.75% isobaric ropivacaine (15 mg) and 0.5% hyperbaric bupivacaine (8 mg) in patients undergoing caesarean section.

2025-11-14T10:50:32+00:00

Background:

Subarachnoid block (SAB) remains the preferred anaesthetic technique for lower segment caesarean section (LSCS) because it ensures rapid onset, dense surgical anaesthesia, and minimal drug transfer to the foetus.

Aim:

To compare the clinical efficacy, block dynamics, haemodynamic responses, and safety of 0.75% isobaric ropivacaine (15 mg) and 0.5% hyperbaric bupivacaine (8 mg) in parturients undergoing elective LSCS.

Methods:

A prospective, randomized comparative study was performed on 100 full-term parturients aged 18–35 years scheduled for elective LSCS under SAB. Participants were allocated to either Group I (bupivacaine 0.5%, 8 mg) or Group II (ropivacaine 0.75%, 15 mg). Sensory and motor block characteristics, haemodynamic variables, neonatal APGAR scores, and adverse events were recorded and analyzed.

Results:

Sensory block onset at T10 was faster with bupivacaine (2.28 ± 0.56 min) than with ropivacaine (3.63 ± 0.72 min; p < 0.001). Although the overall duration of sensory block was similar, regression to L1 occurred earlier with ropivacaine (p = 0.047). Motor block reached Grade III more rapidly with bupivacaine (3.06 ± 0.9 min vs 8.46 ± 2.48 min; p < 0.001) and lasted longer (129.30 ± 21.09 min vs 93.20 ± 11.10 min; p < 0.001). Haemodynamic trends and neonatal outcomes showed no significant intergroup differences. Adverse effects were infrequent and comparable.

Conclusion:

Both drugs provided reliable and safe spinal anaesthesia for caesarean delivery. Bupivacaine produced a quicker and more sustained motor block, whereas ropivacaine enabled faster postoperative recovery with stable haemodynamics. Ropivacaine may be advantageous when early ambulation and enhanced maternal comfort are priorities.

Recommendations:

Larger multicentric trials, dose-response evaluations, and assessments of adjunct use with opioids may further refine the choice of intrathecal agents for obstetric anaesthesia.

Incidence and predictors of difficult airway in elective surgical patients: A hospital-based observational study.

2025-11-28T12:16:21+00:00

Background:

Difficult airway remains a major challenge in anesthetic practice and is associated with increased perioperative morbidity when not anticipated. Despite routine preoperative evaluation, unexpected airway difficulty continues to occur in elective surgical patients, highlighting the need to identify reliable predictive parameters.

Objectives:

To determine the proportion of difficult airways among elective surgical patients and to assess the predictive value of commonly used preoperative airway assessment parameters.

Materials and Methods:

This hospital-based observational study included 80 adult patients undergoing elective surgery under general anesthesia with endotracheal intubation. Preoperative airway assessment included Mallampati classification, thyromental distance, inter-incisor distance, cervical spine mobility, and neck circumference. Laryngoscopy was performed using a Macintosh blade. Difficult laryngoscopy was defined as Cormack–Lehane grade III or IV, while difficult intubation was defined by more than two attempts, prolonged intubation time, or need for advanced adjuncts. Data were analyzed using descriptive statistics and multivariate logistic regression.

Results:

The proportion of patients with a difficult airway was 13.8%. Difficult laryngoscopy occurred in 12.5% and difficult intubation in 8.8% of cases. Higher Mallampati grades (III–IV), reduced thyromental distance (<6.5 cm), restricted mouth opening, limited cervical mobility, and increased neck circumference (>40 cm) were significantly associated with a difficult airway. Multivariate analysis identified reduced thyromental distance (Adjusted OR 4.2) and Mallampati Class III–IV (Adjusted OR 3.6) as the strongest independent predictors. Mild desaturation occurred exclusively in the difficult airway group.

Conclusion:

Focused preoperative assessment using Mallampati grading and thyromental distance, supported by complementary airway parameters, can facilitate early identification of high-risk patients and improve perioperative airway safety.

Recommendations:

Standardized airway assessment and readiness with basic airway adjuncts should be ensured for high-risk patients.

Comparative study of remifentanil versus fentanyl for intra-operative analgesia during general anaesthesia. A retrospective comparative study at Bmims Pawapuri.

2026-01-08T19:41:51+00:00

Background

Remifentanil and fentanyl are frequently used opioids for intra-operative analgesia, with differing pharmacokinetic profiles that may influence recovery and haemodynamic stability.

Methodology

A retrospective comparative study was conducted at BMIMS Pawapuri from August to October 2025 involving 70 adult patients undergoing general anaesthesia. Patients were grouped into remifentanil (n=35) and fentanyl (n=35). Mean age was comparable between groups (remifentanil: 42.3 ± 11.2 years; fentanyl: 44.1 ± 10.6 years), with male predominance (58.6%). Outcomes included extubation time, PACU stay, haemodynamic stability, hypotension, and PONV.

Results

Extubation time was significantly shorter in the remifentanil group (8.4 ± 1.8 min) compared to fentanyl (12.8 ± 3.0 min; p<0.001). PACU stay was reduced (62.6 ± 18.3 vs 84.4 ± 18.0 min; p<0.001). MAP stability was higher with remifentanil (77.1 ± 10.2% vs 71.3 ± 11.1%; p=0.024). Hypotension (25.7% vs 20.0%, p=0.78) and PONV (22.9% vs 8.6%, p=0.19) showed no significant difference.

Conclusion

Remifentanil provided faster recovery and improved haemodynamic control with similar safety outcomes.

A prospective clinical study on the efficacy of preoperative intravenous tranexamic acid in reducing operative time and blood loss during tonsillectomy.

2025-10-29T11:13:51+00:00

Background:

Tranexamic acid is widely used in surgical practice to stabilise clot formation by inhibiting fibrinolysis. This study measured the effect of preoperative intravenous tranexamic acid on operative time and intraoperative blood loss during tonsillectomy.

Aim:

To determine whether preoperative intravenous tranexamic acid reduces intraoperative blood loss and shortens operative time during tonsillectomy.

Methods:

A prospective controlled clinical study was conducted in the Department of Otorhinolaryngology, Adichunchanagiri Institute of Medical Sciences, Mandya district. Participants were aged 4 to 50 years and met the inclusion criteria for tonsillectomy. A total of 107 patients were analysed, with 53 receiving tranexamic acid and 54 serving as controls. Blood loss was measured using pre- and postoperative weight assessments of surgical materials. Operative time was recorded from incision to completion of haemostasis. Data were analysed using t-test, chi-square, mean, and standard deviation.

Results:
The study group comprised 53 participants (all age groups and both sexes), and the control group comprised 54 participants. Mean operative time was 58.2 minutes (SD 9.94) in the tranexamic acid group and 63.7 minutes (SD 15) in the control group (P = 0.028). In the study group, the entire cohort achieved haemostasis within 80 minutes, whereas 13 percent of the control group exceeded 80 minutes.

Conclusion:

Preoperative intravenous tranexamic acid reduced operative time and improved haemostasis during tonsillectomy in this cohort. The findings support its use as an adjunct for intraoperative bleeding control.

Recommendation:

Routine use of tranexamic acid can be considered in suitable tonsillectomy candidates to optimise operative efficiency and reduce blood loss.

A prospective cross-sectional observational study of the prevalence and risks for laryngospasm in paediatric patients in four government-funded hospitals in KwaZulu-Natal, South Africa.

2025-10-13T18:31:02+00:00

Background:

Laryngospasm (LS) is a common paediatric anaesthetic respiratory adverse event associated with serious complications if not detected and treated timeously.

Methods:

A prospective observational cross-sectional study was conducted from 15 May to 4 August 2023 in four government-funded hospitals in KwaZulu-Natal, South Africa. The primary outcome measure was the prevalence of laryngospasm, and a further aim was to identify associated factors, using binary logistic regression analyses.

Results:

905 participants were recruited. Mean patient age was 4.2 (SD ± 3.7) years. Most children were ASA physical status I and II (77.7%), presenting for elective surgery. The commonest comorbidity was an ‘airway anomaly’ (12.8%), followed by current or recent upper respiratory tract infection (URTI) in 11.6% of patients. The prevalence of laryngospasm was 10.1% and most occurred at emergence (54.9%). And 69.2% of children with LS had desaturation <91%. Risks independently associated with LS were age (2 to 5 years; adjusted odds ratio [aOR] 2.15, p0.026), an URTI (aOR 2.58, p=0.004), absence of a specialist in theatre (aOR 11.67, p<0.001), inhalational induction (aOR 10.21, p=0.004) or co-induction (aOR 6.34, p=0.020), use of a supraglottic airway device(SGAD) (aOR 2.17, p=0.022), inadequate depth of anaesthesia (aOR 13.98, p<0.001), non-use of neuromuscular blocker (aOR 4.64, p=0.010), and airway (aOR 2.27, p=0.031) and urological surgeries (aOR2.75, p=0.013. No children had a serious complication, although two children were admitted to high care.

Conclusion:

The prevalence of LS in this study was 10-fold higher than in high-income countries, and the presence of a specialist anaesthetist is protective, indicating the importance of training in the reduction of perioperative critical events in children.

Recommendations:

Anaesthetists should be aware of the independent risk associated with laryngospasm as identified in this study and ensure such children are managed by a specialist anaesthesiologist.

A cross-sectional study of fasting practices among paediatric elective surgery patients at Chris Hani Baragwanath Academic Hospital.

2025-09-27T11:32:38+00:00

Background:

All patients are required to fast preoperatively to avoid the risk of pulmonary complications and, in some cases, mortality. Several guidelines have been published worldwide to guide the fasting practices of paediatric patients. Although guidelines are in place, it is essential to study actual fasting practices to determine if they align with current recommendations.

Methods:

This was a cross-sectional study of fasting practices among elective pediatric patients over ten weeks at Chris Hani Baragwanath Academic Hospital (CHBAH), South Africa. Data collected included paediatric elective surgical patients from various surgical specialities, prescribed fasting times for solids and clear fluids, actual fasting times for solids and clear fluids, fasting glucose levels, and timings of anaesthesia commencement and conclusion. The data were analysed using descriptive statistics.

Results:

The dataset included 100 paediatric patients scheduled for elective surgery at CHBAH. Patient ages ranged from infancy to 17 years. Median prescribed fasting times were 9.6 hours for solids and 9.0 clear fluids. However, median actual fasting times were 14.8 hours for solids and 13.7 hours for clear fluids, exceeding recommendations (p<0.001). Only 2.0% of patients complied with the guidelines for clear fluids; there was zero compliance for solids. Guidelines approximated breast milk and formula fasting times but showed wide variability. Eighteen per cent of patients were hypoglycaemic preoperatively.

Conclusion:

This study revealed widespread over-fasting among paediatric surgical patients at CHBAH, with actual fasting durations far exceeding prescribed times and international guidelines, particularly for clear fluids and solids. These findings indicate a systemic disconnect between prescription and practice, suggesting a need for institutional changes to align perioperative care with best practice standards.

Recommendations:

We recommend implementation of updated institutional fasting guidelines that align with international best practice (6:4:1 rule) and allow clear fluids one hour before induction of anaesthesia.

The nature of student outreach projects related to community engagement in an emergency medical care context.

2025-09-08T15:48:29+00:00

Background:

Community outreach within the context of emergency medical care education plays a salient role in enhancing community health outcomes and improving healthcare access within marginalized communities. This study explored the potential of outreach to strengthen both paramedic students' understanding of health and social issues in the Western Cape.

Method:

Using a qualitative research approach, the study sought the views and experiences of academics in the Western Cape. This study further employed an exploratory, descriptive qualitative research methodology. The study used purposive sampling to collect data. Data was collected using semi-structured interviews and focus group discussions, and was analysed using thematic analysis.

Results:

The study found that through community outreach, paramedic students had the opportunity to grasp the real-world problems within their communities, whilst communities were able to benefit mutually from their interventions. Five main themes emerged from the data. Namely: students working collaboratively in communities; the nature of outreach activities implemented by students; potential outreach programs for health science students; learning within communities through student outreach projects; and the benefits of student engagement.

Conclusion:

This study demonstrated how outreach served as a mechanism to promote health care while improving graduate traits of social responsibility within the paramedic profession. Furthermore, community engagement programs can help to create beneficial changes in the community.

Recommendation:

There is a need to further investigate collaborations and partnerships in emergency medical care among higher education institutions, academics, community stakeholders, NPOs, EMS, and government agencies, focusing on how these alliances generate mutual benefits and contribute to improved health outcomes.

Anaesthetic management and surgical debridement of Fournier’s gangrene in a 65-year-old male in acute decompensated heart failure in a resource-limited tertiary hospital: A case report.

2025-11-09T18:59:22+00:00

Emergency surgical interventions in patients with significant cardiovascular comorbidities present complex anaesthetic challenges, particularly in resource-limited settings. Fournier’s gangrene is a rapidly progressive necrotising infection that requires urgent surgical debridement. This further complicates the management of severe cardiac dysfunction.

This case report presents the anaesthetic management of a 65-year-old male patient with Fournier’s gangrene and acute heart failure. He had dilated cardiomyopathy with an ejection fraction of 26%, with comorbid atrial fibrillation, obesity, hypertension, diabetes, and sepsis. He presented in respiratory distress, renal impairment, and, functionally, New York Heart Association Class IV.

A right radial arterial line and an internal jugular central line were inserted, with a low-dose dobutamine infusion initiated before induction. He was induced slowly with etomidate and midazolam, with fentanyl and lignocaine given for blunting the sympathetic response. Sevoflurane was used for maintenance of anaesthesia, with inotropic support in the form of adrenaline added intra-operatively. Fluid requirements were 11.7ml/kg. He remained intubated and transferred to the ICU, where inotropes were weaned off, and respiratory recovery was achieved. He improved and was followed up post-operatively over a period of three months.

The case illustrates that optimal outcomes are achievable in patients with severe heart failure and sepsis through careful pre-operative optimisation, judicious induction, appropriate inotropic support, and postoperative critical care, in a resource-limited environment.

Factors associated with adherence to anti-retroviral therapy among adult males living with hiv in Lira Regional Referral Hospital, Lira City, Northern Uganda. A cross-sectional study.

2025-10-30T10:47:10+00:00

Background

The use of anti-retroviral therapy (ART) in the management and prevention of HIV/AIDS. This study aims to assess the level of adherence and factors associated with adherence to ART among Adult males living with HIV in Lira Regional Referral Hospital.

Methodology

A cross-sectional study that assessed self-reported treatment adherence among adult males living with HIV who are accessing drugs for the treatment from LRH. Random sampling was employed to select 380 participants, and data were collected using a questionnaire and entered into SPSS software for analysis.

Results

341 respondents were included, 58.7% aged between 18 and 30 years, 24% were in the range of 31-45 years, 17.0% between 46 and 60 years, and a mere 0.3% aged 61years and above. Non-adherence to ART was perceived to result from individual factors such as forgetfulness, alcohol abuse, disclosure, knowledge about HIV and its treatment, among others, and health system-related factors such as distance to the health facility, waiting time at the facility, relationship with the healthcare provider, and privacy, among others. Most respondents (49.9%) take one pill daily, with 31.7% taking two pills, 18.2% taking more than two, and 0.3% not taking any pills. Weekly adherence data showed that 39.0% never miss a dose, while others miss one (23.5%), two (20.5%), or more than two doses (17.0%) per week. This results in 43.1% of respondents having good weekly adherence and 56.9% having poor adherence. Monthly adherence reveals that 37.5% never miss a dose, but 4.1% miss one dose, 15.5% miss two doses, and 42.8% miss more than two doses, leading to 46.9% good adherence and 53.1% poor adherence monthly.

Conclusion

Non-adherence to ART was attributed to 48 various factors, such as alcohol consumption, forgetfulness, and stigma.

Recommendation

Healthcare providers should minimize waiting times in healthcare facilities to improve adherence.

Fluoroscopy-guided peripherally inserted central catheter line insertion: assessment of technical success, complications, and quality metrics in a clinical audit: A cross-sectional study.

2026-01-23T09:12:36+00:00

Background

Objective: To assess the technical success rate, complication profile, and selected quality metrics of fluoroscopy-guided PICC line insertions performed in a clinical setting.

Methodology

This clinical audit was conducted in a hospital-based interventional radiology unit over a defined study period. All patients who underwent fluoroscopy-guided PICC line insertion during the audit period were included. Data were collected retrospectively from procedure records and patient case files. Parameters assessed included technical success, catheter tip position, procedure-related complications, and predefined quality indicators such as procedure time and need for repositioning. Data were analysed using descriptive statistical methods.

Results

Fluoroscopy-guided PICC line insertion demonstrated a high technical success rate with accurate catheter tip placement in the majority of cases. Procedure-related complications were infrequent and predominantly minor in nature. Quality metrics indicated satisfactory procedural efficiency with minimal requirement for catheter repositioning. Overall performance was found to be consistent with established quality benchmarks. The PICC line insertion using fluoroscopy resulted in a technical success rate of 95.9% (70/73 cases) and the optimal catheter tip placement at the cavoatrial junction in 82.2% of the patients. There were very few complications, and only minor ones were observed in 9.6% of cases, and no major complications. The efficiency and safety were confirmed by quality metrics (90.4% first-attempt accuracy, mean procedure time 25 + 6 minutes).

Conclusion

The clinical audit suggests that fluoroscopy-guided PICC line insertion is a safe and effective technique with high technical success and a low complication rate. Regular auditing of procedural outcomes and quality indicators is essential for maintaining standards of care and for continuous quality improvement in vascular access services.

Recommendation

To maintain a high level of technical success, reduce the risk, and enhance the quality control of the services in the sphere of vascular accesses, standardized protocols and constant training are recommended

The correlation between academic staff depression and student course evaluation scores: A cross-sectional quantitative study.

2025-07-17T07:49:13+00:00

Background
Mental health in academia has become an increasing concern due to its impact on teaching quality and student learning. Depression among lecturers can reduce motivation, attendance, and classroom engagement, potentially influencing how students perceive teaching effectiveness. This study examines the relationship between depressive symptoms among academic staff and student course evaluation outcomes at a South African public university.

Methods
A cross-sectional quantitative study was conducted with 30 academic staff across four faculties: Humanities, Science, Engineering, and Management Sciences. Depression levels were assessed using the Beck Depression Inventory-II (BDI-II), and corresponding course evaluation scores were obtained from the university’s evaluation system. Statistical analyses included Pearson’s correlation and faculty-based subgroup comparisons to determine the relationship between depression and teaching evaluations.

Results
A moderate negative correlation was observed between BDI-II scores and student course evaluations (r = -0.41, p < 0.01), indicating that lecturers with higher depressive symptoms received lower evaluation scores. Faculty-level analysis showed that Humanities staff had the highest mean BDI-II score (23.6 ± 8.4), followed by Science (19.2 ± 6.7), Engineering (17.8 ± 7.1), and Management Sciences (16.4 ± 5.9). The mean course evaluation score declined from 82.4% among staff with minimal depression to 67.1% among those with moderate to severe symptoms, a 15.3% difference. The relationship was strongest in first-year courses, where lecturer-student interaction is most intensive.

Conclusion
Depressive symptoms among academic staff are significantly associated with lower student evaluation scores, suggesting that mental health challenges can indirectly affect perceptions of teaching performance.

Recommendations
Universities should integrate mental health support into academic development programmes and avoid relying solely on student evaluations for performance assessment. Early intervention, counselling access, and workload adjustments are crucial to fostering lecturer well-being and sustaining teaching excellence.

Barriers to entrepreneurial development in TVET colleges: A cross-sectional mixed-methods study of student perspectives.

2025-07-21T17:52:14+00:00

Background
Entrepreneurship is increasingly recognized as a pathway to youth empowerment and economic development in South Africa. Technical and Vocational Education and Training (TVET) colleges play a pivotal role in equipping students with practical skills for self-employment. However, despite national policy support, entrepreneurial development within TVET colleges remains constrained. This study investigates the barriers hindering entrepreneurial growth from the perspective of enrolled students, with a focus on identifying institutional, structural, and contextual challenges.

Methods
A cross-sectional mixed-methods study was conducted across four public TVET colleges in KwaZulu-Natal. Quantitative data were collected through structured questionnaires administered to 120 final-year students enrolled in business and engineering programs. Qualitative insights were gathered through focus group discussions (n = 4) and semi-structured interviews with 12 student representatives and academic staff. Descriptive and inferential statistics were used to analyse quantitative data, while thematic analysis was applied to qualitative responses.

Results
Key barriers identified include inadequate entrepreneurial training (reported by 72% of students), limited access to startup funding (68%), lack of mentorship and incubation programs (61%), and insufficient exposure to real-world business environments. Institutional constraints such as outdated curricula and poorly resourced entrepreneurship units further compound the challenge. Qualitative data revealed a strong desire among students for experiential learning and community-based enterprise development models.

Conclusion
The study highlights significant structural and pedagogical gaps within TVET institutions that hinder students' entrepreneurial readiness. While students demonstrate interest and potential for entrepreneurship, systemic limitations restrict the translation of skills into practice.

Recommendations
To strengthen entrepreneurial development in TVET colleges, curriculum reforms should prioritize experiential learning, partnerships with local businesses, and on-campus incubation centres. Additionally, policy frameworks must support funding access and mentorship networks tailored to student-led enterprises.

Belonging and exclusion: Exploring the social and academic adjustment of LGBTQ+ students in South African higher institutions. A cross-sectional mixed method study.

2025-07-21T16:24:33+00:00

Background
LGBTQ+ students in South African higher education institutions often face multifaceted challenges related to their identity, which can influence both their academic success and social integration. Despite South Africa's progressive constitutional protections for sexual minorities, heteronormative attitudes and institutional cultures may perpetuate exclusionary practices. This study investigates how LGBTQ+ students navigate belonging and exclusion within university settings and the effects on their academic and social adjustment.

Methods
A convergent mixed-methods design was adopted. Quantitative data were collected via structured questionnaires from 320 self-identified LGBTQ+ students across three public universities in South Africa. Key variables included academic performance, peer interaction, institutional support, and perceived discrimination. Qualitative data were obtained through 20 in-depth semi-structured interviews, enabling exploration of lived experiences and coping strategies. Quantitative data were analysed using descriptive statistics and regression analysis, while qualitative responses underwent thematic analysis.

Results
Quantitative findings revealed that 63% of respondents experienced moderate to high levels of exclusion, which negatively correlated with academic performance (r = -0.41, p < 0.01). Peer support and institutional inclusivity measures were significantly associated with a sense of belonging and academic engagement. Qualitative themes included: “Invisible Identities in Lecture Halls,” “Microaggressions and Campus Climate,” and “Creating Queer Safe Spaces.” Many participants reported self-censorship, isolation, and reliance on informal support networks to survive emotionally and academically.

Conclusion
LGBTQ+ students in South African universities continue to face systemic and interpersonal challenges that hinder full inclusion and academic success. While some institutions have implemented diversity policies, the gap between policy and practice remains significant.

Recommendation
Higher education institutions must strengthen LGBTQ+ visibility and inclusion through proactive policies, sensitization training for staff and students, and the creation of dedicated support structures such as LGBTQ+ resource centres. Further longitudinal research is recommended to assess the impact of inclusive policies on student outcomes over time.

Nurses' knowledge, practices, and attitudes of intravenous fluid therapy at a healthcare facility in the Volta Region of Ghana: A cross-sectional study.

2025-09-03T20:28:08+00:00

Background:

Intravenous infusion therapy is essential to clinical care but poses risks, including phlebitis, fluid overload, and infections when inadequately managed. Nurses play a crucial role in ensuring safe and effective Intravenous administration. This study assessed nurses' knowledge, practices, and attitudes regarding intravenous infusion therapy at a healthcare facility in the Volta Region of Ghana.

Methods:

A quantitative exploratory-descriptive cross-sectional survey was conducted using convenience sampling to recruit 269 registered nurses through a self-reporting questionnaire. Descriptive statistics and chi-square tests analysed relationships between knowledge, practices, and attitudes.

Results:

Overall knowledge levels were satisfactory; 96.7% identified correct IV insertion sites, 81.4% correctly calculated infusion rates, and 85.5% confirmed drug compatibility. However, gaps existed in recognising air embolism symptoms (43.1%). Practice analysis revealed 81.8% of nurses assess IV sites regularly and 75.1% recognise phlebitis symptoms, yet nearly half (49.1%) do not practice correct peripheral IV dressing change frequency. Additionally, 29.7% provided incorrect responses regarding medication administration through active IV lines. Significant associations were found between self-reported IV competence and phlebitis management knowledge (χ² = 17.342, df = 4, p = 0.002) and between formal IV training and infusion rate adjustment knowledge (χ² = 6.478, df = 1, p = 0.011).

Conclusion:

Nurses demonstrated satisfactory knowledge, practices, and positive attitudes toward IV therapy. Knowledge deficits in key safety areas underscore the need for targeted training and institutional support.

Recommendation:

Healthcare facilities should implement structured in-service training programs that target specific knowledge gaps, particularly in recognising air embolism and preventing phlebitis. Developing and disseminating standardised institutional protocols and national guidelines is essential for enhancing Intravenous infusion practice consistency and safety.

Clinical history, knowledge, and antibiotic use practices among adult patients with cellulitis attending clinical services at Kiruddu Referral Hospital in Kampala. A cross-sectional study.

2025-10-02T16:18:15+00:00

Background:

Cellulitis is a common bacterial skin infection with a high recurrence rate. Patient knowledge, clinical history, and antibiotic use practices are critical factors influencing treatment outcomes and the development of antimicrobial resistance (AMR). This study aimed to describe the clinical characteristics, history, and knowledge of AMR among adult patients with cellulitis at Kiruddu Referral Hospital, Kampala.

Methods:

A descriptive cross-sectional study was conducted from February to June 2025. A structured questionnaire was administered to 279 consecutively enrolled adult patients with a clinical diagnosis of cellulitis. Data on socio-demographics, clinical history of cellulitis, self-medication practices, and knowledge of AMR were collected. Descriptive statistics were computed using Microsoft Excel and presented in frequencies, percentages, and figures.

Results:

The majority of participants were female (56.3%) and aged 36-45 years (31.5%). A significant proportion (57.7%) had a history of cellulitis, with nearly half (48.4%) experiencing a recurrence within the past year. The lower limbs were the most affected site (62.0%). While 36.9% reported self-medication with antibiotics before hospitalization, 63.1% had not. Although 55.2% had heard of AMR and 69.2% understood that incomplete treatment causes resistance, a concerning 51.3% admitted to not always completing their antibiotic courses. Pharmacies and drug shops were a common source of antibiotics outside formal healthcare settings.

Conclusion:

There is a high recurrence of cellulitis and a significant gap between knowledge of appropriate antibiotic use and actual practices, including self-medication and non-adherence.

Recommendation:

The urgent need for targeted patient education and strengthened antimicrobial stewardship programs to bridge this knowledge-practice gap and combat AMR.

Factors associated with the prevalence of intestinal soil-transmitted helminth infections among children under 10 years attending Kabanga Health Centre III in Mukono district. A cross-sectional study.

2025-08-19T06:34:20+00:00

Background
Intestinal soil-transmitted helminth (STH) infections continue to pose a major public health challenge among children under 10 years in resource-limited settings. This study examined the prevalence and related socio-demographic, environmental, and behavioral factors affecting STH infections among children attending Kabanga Health Centre III in Mukono District, Uganda.

Methods
A cross-sectional study of 257 children under 10 collected data via questionnaires, observations, and lab records. Variables included age, sex, parental education, water, sanitation, and hygiene practices. Prevalence was calculated and findings interpreted through descriptive and comparative analyses.

Results
The overall STH infection prevalence was 25.7%, highest among children 4–7 years (32.1%) and males (33%). Children of uneducated parents had the highest burden (66.7%), showing a strong link between parental education and child health. Socioeconomic activities like farming and fishing increased exposure. Water and hygiene practices were poor: only 26% boiled water, 74% treated water inconsistently, and 81% lacked soap. Sanitation was poor, with 27% practicing open defecation and only 23% using improved latrines. Food hygiene was inadequate: 38% ate unwashed raw fruits or salads, increasing exposure risks.

Conclusion
STH infections in Kabanga are moderately common, with risk factors deeply tied to social and economic disparities, poor hygiene infrastructure, and behavioral habits. Despite deworming programs, reinfection remains frequent due to ongoing environmental exposure and lack of sanitation. Tackling these issues through combined WASH initiatives, health education, and policy changes is essential for effective STH control.

Recommendations
Multisectoral approaches are essential to improve latrine access, promote safe water treatment, and establish handwashing facilities with soap. Community awareness and regular deworming every six months should be reinforced. At the policy level, WASH components must be integrated into school and health center-based deworming programs, with ongoing monitoring of sanitation coverage at the sub-county level.

Integrating traditional African medicine into public health systems: A cross-sectional mixed-methods study on the pathway toward universal health coverage in South Africa.

2025-07-21T17:48:13+00:00

Background

Traditional African Medicine (TAM) remains a vital component of healthcare for many South Africans, particularly in rural and peri-urban communities. Despite its widespread use and cultural relevance, TAM remains largely informal and insufficiently integrated into the national health system. The World Health Organization (WHO) advocates for integrating traditional medicine into public healthcare to achieve Universal Health Coverage (UHC), especially in contexts marked by health inequities. This study examines the feasibility, perceptions, and structural needs for integrating TAM into South Africa’s public health system.

Methods

A cross-sectional mixed-methods design was employed. Quantitative data were gathered from 120 participants comprising 60 community members, 30 biomedical professionals, and 30 traditional health practitioners (THPs) across three districts in KwaZulu-Natal. Participants were 52% female and 48% male, with an average age of 44.6 years (SD = 10.2; range: 21–72 years). Most community respondents (68%) resided in rural areas, while 32% lived in peri-urban settings. Fifteen qualitative interviews were conducted with policy experts, health administrators, and representatives from the Traditional Healers Organization (THO).

Results

Findings show that 78% of community members regularly use TAM, primarily for spiritual cleansing and chronic disease management. Sixty-seven percent of THPs expressed willingness to collaborate with biomedical professionals but cited lack of recognition and legal protection as barriers. Only 40% of biomedical professionals supported integration due to concerns about efficacy, safety, and regulation. Qualitative themes revealed mistrust between sectors, lack of herbal standardization, and insufficient documentation, but also highlighted TAM’s cultural importance and preventive health value.

Conclusion

TAM remains central to healthcare access and cultural identity in South Africa, yet systemic, legal, and attitudinal barriers impede integration.

Recommendations

Developing comprehensive policies, establishing collaborative platforms, investing in scientific validation, and promoting community-based engagement are essential for achieving inclusive, culturally responsive UHC.