African Health Sciences

Editor’s choice: Infections, sexual reproductive health and non-communicable diseases

James K Tumwine — Sat, 11 Jan 2025 00:00:00 +0000

Nil.

Genomic variations in Mycobacterium tuberculosis from the lungs and blood of HIV-infected individuals in Uganda: insights into compartmentalization

Hellen Nakabuye, Dickson Aruhomukama, Ronald Galiwango, David P Kateete — Sat, 11 Jan 2025 00:00:00 +0000

Mycobacterium tuberculosis (MTB) clinical strains are relatively varied at the genome level. This in-silico study analyzed genomic differences between MTB isolates from the blood and lungs of TB-HIV positive cohorts in Uganda. The hypothesis was that isolates from the blood have distinct SNPs and INDELs that make them better survivors. Twenty-four MTB-blood and -lung sequences were aligned against the H37Rv reference genome and analyzed using BWA-MEM, IGV, SAMtools, FreeBayes, and SnpEff. Comparative analysis revealed that MTB-blood isolates had 11 virulence genes with distinctive non-synonymous SNPs involved in increasing colony-forming units, lowering host survival, enhancing tissue pathology, and allowing for human host persistence. The majority of INDELs were found in non-virulence genes, with the remainder in both MTB-blood and -lung sequences. The study suggests that MTB-blood isolates have distinctive SNPs that explain their capacity to persist outside of the lungs. However, further research is needed to understand the significance of these SNPs in the pathogenesis of MTB.

Impact: Mycobacterium tuberculosis (MTB) clinical strains have high genomic variability, and there is a knowledge gap on the genomic differences between MTB isolates from the blood and lungs of TB-HIV positive patients in Uganda. This study found that MTB-blood isolates had 11 virulence genes with distinctive non-synonymous SNPs that may contribute to their capacity to persist outside of the lungs. These findings provide insight into the genomic basis of MTB adaptation in different host environments, but further research is needed to fully understand the significance of these SNPs in MTB pathogenesis.

Keywords: Mycobacterium tuberculosis; genomic variations; bioinformatics; Uganda.

Oncogenic human papillomavirus infection (HPV 16/18) and associated factors among women in East Gojjam Zone, NorthWest Ethiopia 2021

Mamaru Getinet — Sat, 11 Jan 2025 00:00:00 +0000

Background: Human papillomavirus is a common pathogen that infects the skin and mucosal epithelium, is transmitted sexually; causes condylomas or squamous cell carcinomas. Two (16 and 18) of the 150 HPV serotypes are oncogenic types. Studies have been done on the infection by oncogenic human papillomavirus 16/18 and associated factors are found to be very limited in Ethiopia. This study aimed to assess the prevalence of oncogenic human papillomavirus infection (HPV 16/18) and associated factors among women.

Methods: An institutional-based cross-sectional study was conducted among 337 women screened for cervical cancer in two hospitals in East Gojjam Zone from February to April 2021 G.C. Four BSc-qualified nurses who worked in the chosen hospitals collected the data using pretested questionnaire and an HPV test (OncoE6TM Cervical Test) specific to HPV16/18 in cervical swabs. Descriptive analysis was performed to determine the prevalence and a multivariate logistic regression model was used to identify the associated factors of HPV16/18 infection. Finally, statistical significance was declared at P < 0.05.

Results: The prevalence of HPV infection was 14.2% (95% CI: 10.7% -18.1%). The mean age of the respondents was 36.7±9.1 years. Women with the age group of 55-65 years (AOR = 7.91, 95% CI: 1.95-32.09), early initiation of sexual intercourse (AOR = 5.36, 95% CI: 1.58-18.13), history of sexually transmitted infection (STI) (AOR = 3.52, 95% CI: 1.27-9.72), human immunodeficiency virus (HIV) positive status (AOR = 6.8, 95% CI: 1.99-23.54), and number of lifetime sexual partners (AOR = 4.37, 95% CI: 1.15-17.3) were important independent factors associated with the presence of oncogenic HPV infection.

Conclusion and Recommendation: We found a relatively low prevalence of high-risk HPV infection. Age, early initiation of sexual intercourse at less than 18 years, STI of women, being HIV seropositive, and a number of sexual partners were important factors for high-risk HPV infection. Women aged > 46 years, women with early initiation of sex, a history of STI, being HIV positive, and a history of multiple sexual partners should be encouraged to be screened and vaccinated for HPV infection. Wider-ranging studies are also needed in HPV-infected women in association with the cervical lesion.

Keywords: OncoE6TM cervical test; HPV; East Gojjam zone; prevalence; associated factors.

Recent updates on molecular epidemiology of hepatitis C virus in Gujranwala, Pakistan

Sat, 11 Jan 2025 00:00:00 +0000

Background: Hepatitis C infection (HCV) remains a leading cause of liver cirrhosis, posing a critical health threat worldwide.

Objective: This research aimed to provide a contemporary overview of HCV infection and its genotypic distribution in Gujranwala, Punjab, Pakistan. Additionally, it sought to explore the interrelation between HCV genotypes and associated risk factors among individuals infected with HCV.

Method: To examine the prevalence of antibodies against HCV, blood samples were collected from 1004 patients and tested using an immunochromatographic test (ICT). Positive ICT samples were subsequently confirmed through a chemiluminescence technique and then subjected to amplification and genotyping.

Results: The study revealed that females (54.68%) were more affected by HCV than males (45.32%). Notably, the highest incidence of HCV infection (27%) was observed in the 50-59 age group. Among HCV RNA-positive patients, genotype 3a predominated, accounting for 71.81% of cases. High rate of untypable genotypes was also detected (20.82%), along with mixed (3.29%), 1a (2.09%), 1b (0.79%), 2b (0.70%), and 3b (0.50%).

Conclusion: The study highlights the prevalence of genotype 3a as the most common HCV genotype in the sampled population. This information is crucial for informing public health interventions and further research in the field of HCV infection.

Keywords: Hepatitis C Virus; molecular epidemiology; genotypes.

Sero-prevalence of Hepatitis B and C at a Primary Health Care Facility in Ghana

Sat, 11 Jan 2025 00:00:00 +0000

Background: The advent of emerging global infections such as SARS-CoV-2 has brought forth the public health crises of neglected diseases in the LMICs. Viral hepatitis infections remain a public health problem especially in the advent of emerging. Viral hepatitis which preponderantly afflicts citizens of LMICs is one such group of diseases which exerts considerable burden in these countries, especially, hepatitis B and C. There is an effective vaccine against Hepatitis B and curative treatment to hepatitis C, however, access has been hampered resulting in deleterious sequalae. Identifying population afflicted by these infections could lead to prevention of the complications.

Materials and Methods: Retrospective review of electronic data on individuals screened for hepatitis B and C at the University of Cape Coast Hospital were abstracted. Data abstracted included hepatitis B and C test status, age, sex, previous immunisation history and region of residence. Overall prevalence and prevalence in different categories were calculated.

Results: Data for 6,006 were collected and used for the analyses. The overall prevalence for hepatitis B in the study group was 5.06%. The prevalence for hepatitis C was 0.93%.

Conclusion: The burden of hepatitis B and C infection in Ghana is still high.

Keywords: Hepatitis B and C; Primary Health Care Facility; Ghana.

Effect analysis of entecavir on serum hyaluronic acid, laminin and IV collagen in the treatment of hepatitis B E-antigen-positive chronic hepatitis B

Jiancheng Qian, Xiaoyong Sun, Yue Cheng — Sat, 11 Jan 2025 00:00:00 +0000

Background: To observe and analyse the clinical effects of entecavir on serum hyaluronic acid (HA), laminin (LN), and type IV collagen (IVC) in patients with hepatitis B e-antigen (HBeAG)-positive chronic hepatitis B during clinical treatment.

Methodology: The patients in the control group received clinical treatment with entecavir monotherapy, while those in the observation group underwent thymalfasin + entecavir combination therapy. The clinical curative effects of immune checkpoint inhibitors at different concentrations on diseases were compared from all aspects.

Results: There were lower levels of total bilirubin (TBIL) and alanine transaminase (ALT) in the observation group, a more satisfactory improvement in immune function-related indicators, and lower levels of HA, LN, and IVC in the observation group, which were statistically different between the two groups (P<0.05). The levels of liver function indicators, immune function-related indicators (CD3+, CD4+, CD8+, CD4+/CD8+, CD4+/CD8+), and HA, LN and IVC were not statistically different between the two groups before treatment.
Conclusion: Entecavir is highly effective in the clinical treatment of HBeAG-positive chronic hepatitis B. However, entecavir + thymalfasin combination therapy can alleviate the clinical symptoms. In this way, liver fibrosis can be prevented in patients with HBeAG-positive chronic hepatitis B, and the clinical curative effect can be enhanced.

Keywords: Entecavir; e antigen-positive chronic hepatitis B; serum hyaluronic acid (HA); laminin (LN); type IV collagen (IVC); clinical outcome analysis.

Diagnostic task shifting for NTDs: outcome of a preliminary quasi-experimental study for microfilaria detection using a novel diagnostic device in Nigeria

Sat, 11 Jan 2025 00:00:00 +0000

Background: Lymphatic filariasis (LF) is a Neglected Tropical Disease (NTD) with high morbidity. Tools for detecting LF are either not readily available or used by Community Health Extension Workers (CHEWs) at Primary Health Centers. A newly developed diagnostic device, the AiDx Assist, is targeted for use by CHEWs.

Objective: The study aims to determine the efficiency (speed) and effectiveness (diagnostic capacity) of CHEWs compared to laboratory scientists for detecting LF with the new device, using the World Health Organization’s Target Product Profile (TPP) for LF diagnostics as a guide.

Methods: This study utilized a Quasi-experimental design. 7 students undergoing the CHEW program (intervention group) were randomly selected while 2 laboratory scientists (control group) were purposively recruited and were trained to use the device. Thereafter, both groups were tested based on 64 sample slides provided.

Results: The intervention group’s efficiency (speed) was similar to the control group. Computed Effectiveness (diagnostic capacity ) parameters for the intervention group demonstrated a sensitivity of 85.7% and a specificity of 82.5%.

Conclusion: Given this preliminary result, task shifting to CHEWs for the diagnosis of LF is highly likely to be successful, thereby reducing the prevalence of LF in low-resource settings.

Keywords: NTDs; quasi-experimental study; novel diagnostic device; Nigeria.

Epidemiology and future risk estimates of cutaneous leishmaniasis in district Dera Ismail Khan, Pakistan: analysis of data from 2019-2022

Aqsa Mansoor, Kiran Afshan, Ghulam Narjis, Sabika Firasat — Sat, 11 Jan 2025 00:00:00 +0000

Background: Cutaneous leishmaniasis (CL), despite not being a life-threatening condition, has a devastating impact on the public health. CL is widely distributed, exhibiting a distinct epidemiological pattern all over the world. The aim of this study was to investigate CL in District Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan, and to estimate the risk of epidemics.

Materials and Methods: From 2019 to 2022, 1135 CL patients' epidemiological data were collected from district health facilities. For epidemiological characterization, descriptive statistics were used. The spatial analysis was done using ArcGIS V.10.3. The relationship between CL occurrence and climatic variables was investigated using liner regression analysis.

Results: Between 2019 and 2022, there was a decline in the annual CL incidence trend. Males and people under the age of 20 were particularly susceptible. A total of 1204 lesions were identified, with 76.1% of individuals having a single lesion and 23.9% having multiple lesions. Most of the lesions were nodular and ulcerative in nature and were found on exposed body parts such as the lower extremity (34.2%) and the face (30.7%). A choropleth map revealed an increased incidence of CL in Tehsil D.I.K (63%) and Paharpur (10%). According to a digital elevation model, high altitudes have a lower prevalence of CL. For focal transmission and high-risk zones, Inverse Density Weight (IDW) spatial interplation, focal statistics, cluster, and outlier analysis validated that CL cases were high in D.I.K, Kulachi, and Paharpur tehsils. Increased temperature, relative humidity, and precipitation were not significantly associated with CL infection.

Conclusions: The study provided essential details for public health sectors to develop intervention strategies for future CL outbreaks.

Keywords: Cutaneous leishmaniasis; spatiotemporal analysis; Pakistan.

The burden of schistosomiasis among school-aged children in Ogoja, Nigeria: current level of infection years after mass drug administration with Praziquantel

Edema E Imalele, Ekanem I Braide, Ubleni E Emanghe, Chinyere Osondu-Anyanwu — Sat, 11 Jan 2025 00:00:00 +0000

Background: Despite various chemotherapy efforts and national-level regulations implemented by the Nigerian government and health sector stakeholders, Schistosoma infections persist as a public health issue.

Objective: This study assessed schistosomiasis prevalence among school-aged children in Ogoja Local Government Area, Cross River State, and identified risk factors for the disease.

Methods: Urine and faecal samples were examined using microscopy involving centrifugation and Kato-Katz techniques respectively.

Results: The overall prevalence of schistosomiasis was 9.7% (49/504). The prevalence of schistosomiasis was 10.8% and 8.7% among females and males, respectively. Schistosoma haematobium infection was higher in the 14-16 year age group (12.7%). Overall mean parasite load for urogenital schistosomiasis was 6.40 eggs/10 mL of urine and 36.00 eggs per gram (EPG) for intestinal schistosomiasis. Infection with schistosomiasis was higher among those who had not heard about schistosomiasis (17.8%) (p=0.000) and who did not know the cause of the infection (12.4%) (p=0.002). Swimming/bathing in open water (OR = 1.199), fetching water from streams/rivers (OR = 1.202), parents/guardians who had no formal education (OR = 2.722) and unemployment (OR = 2.904) were risk factors significantly associated with schistosomiasis (p P<0.05).

Conclusion: Although intensities of infections were generally low, prompt integrated control efforts are still required to lower helminth infection in the study area.

Keywords: School attendance; schistosomiasis; school-age children; urogenital schistosomiasis; intestinal schistosomiasis.

Risk factors for invasive mold infection after COVID-19: case-control study

Sat, 11 Jan 2025 00:00:00 +0000

Background: Invasive mold infections (IMI) have become common in patients with severe COVID-19 pneumonia, which are difficult to diagnose and treat, with a high mortality rate.

Objective: The aim of this study was to determine risk factors for invasive mold infections associated with COVID-19.

Methods: In this prospective, case-control study, patients treated for severe COVID-19 pneumonia in intensive care units with invasive mold infection were compared with severe COVID-19 pneumonia patients with no secondary infection (bacterial or fungal). Demographics, treatments received and outcomes were compared.

Results: Twenty patients were included in the IMI group and 19 patients in the control group. Invasive aspergillosis was observed in 13 patients (65.0%) while mucormycosis was observed in seven patients (35.0%). Demographics and clinical characteristics were similar between IMI and control group (p>0.005). The 28-day mortality was 60.0% in the IMI group and 15.8% in the control group (p=0.005). The use of steroids has been identified as the most important risk factor for developing IMI (90.0% vs. 15.8%, OR: 25.712, p=0.009).

Conclusion: Rationale use of steroids, with appropriate indication, dose and duration is important in the treatment of severe COVID-19 pneumonia.

Keywords: Invasive mold infections; COVID-19; mucormycosis; invasive fungal sinusitis; invasive pulmonary aspergillosis.

The effectiveness of COVID-19 Heterologous Vaccination: the experience from a Regional Hospital in Cameroon

Sat, 11 Jan 2025 00:00:00 +0000

Background: With most COVID-19 vaccines requiring at least 2 doses, heterologous vaccination will facilitate vaccination programs where vaccine supplies fluctuate. However, with insufficient data on effects of heterologous vaccination in our setting, people remain reluctant to mix.

Objectives: We seek to assess the effects of heterologous vaccination on morbidity and mortality.

Methods: This was a 7 months retrospective study for COVID-19 patients managed by the Bamenda Regional Hospital, Cameroon, running from the 18th August 2021 to 28th February 2022. Logistic regression used to asses relationship between predictors and outcome.

Results: Our 1254 participants had a mean age of 50.1(±19.6) years, we had 24 (1.9%) being fully vaccinated, where 7 (29.2%) took heterologous vaccines. Also, 721 (57.5%) had the moderate/severe form of the disease. Those fully vaccinated had lower odds of having severe disease (p=0.037). However, heterologous vaccination compared to homologous vaccination had no significant difference on morbidity (p=0.729). Among patients who died, none was fully vaccinated.

Conclusion: The protective effect of vaccination on morbidity was similar in those with heterologous vaccination as well as those who took

Keywords: COVID-19 vaccine; heterologous vaccination; homologous vaccination.

Surgical site infections following abdominal surgery: incidence, risk factors and outcomes

Sat, 11 Jan 2025 00:00:00 +0000

Background: Abdominal surgeries especially open surgeries are associated with high risk of surgical site infections. This invariably leads to increased morbidity, prolonged hospital stay with its attendant financial burden and mortality.

Objectives: To describe the incidence, risk factors and outcome in patient with surgical site infection following open abdominal surgery.

Methods: This was a prospective study involving consecutive 100 patients across surgical sub-specialties and gynaecology over 6 month period. Variables analyzed included; biodata, type of surgery, American Society of Anaesthesiologists (ASA) grade, hair removal
at wound site, specialty, degree of intraoperative contamination, presence of surgical site infection (SSI) and mortality.

Results: Majority of the patients (64%) were women and the age range was 11 to 73 years, mean age was 36.41 ± 10.9 years. About 60% of the cases were emergency procedures, indication for surgery were benign in 89 (89%) patients, malignant in 7% and trauma
in 4%. Majority (55%) had clean-contaminated wounds while 45% had contaminated and dirty wounds, 54% were solely general
surgery patients, 66% of the patients had hair removal before theatre arrival. SSI was recorded in 20% of the patients and mortality
rate was 7% at 30 days follow up.
The risk of SSI was higher in emergency procedures, (p =0.041) with an odd ratio of 2. SSI risk increases with the ASA grade,
general surgical procedures, hair removal at wound site before theatre arrival and also in contaminated and dirty wounds. Emergency
procedures and SSI were found to increase the odds of mortality.

Conclusion: Emergency procedures, general surgery (bowel surgeries), and significant degrees of intraoperative contamination are associated with higher risk of SSI, which is an independent predictor of mortality. More efforts should be put in place to prevent SSI in
these categories of patients.

Keywords: Surgical site infections; abdominal surgery.

Evaluation of the effect of a novel nursing intervention in the treatment of vacuum sealing drainage in patients with chronic orthopedic wounds

Lan Chen, Dong Li, Xiaodong Lei, Bixia Zhou, Lili Chen — Sat, 11 Jan 2025 00:00:00 +0000

Background: To explore the application effect of "4+1" nursing intervention in the treatment of chronic orthopaedic trauma with negative pressure vacuum sealing drainage.

Methodology: Patients before the implementation of the "4+1 nursing intervention" program were selected as the control group (60 cases). 60 patients after the implementation of the "4+1 nursing intervention" program were selected as the research group. Control group was given routine care. Research group adopted the "4+1" nursing intervention. Hamilton Depression score, wound healing time, pain visual analogue scale, treatment compliance, Self-Rating Anxiety Scale, and nursing satisfaction were compared between the two groups.

Results: After the intervention, the Self-Rating Anxiety Scale and Hamilton Depression scores in the study group were lower than those in the control group; visual analogue scale on the 3rd and 5th days after the study were lower than those in the control group, and the wound healing time was shorter than that in the control group. The treatment compliance rate and nursing satisfaction of the study group were higher than those of the control group (P<0.05).

Conclusion: The application of "4 + 1" nursing intervention in treatment of orthopaedic chronic wounds has a good effect.

Keywords: Orthopedics; chronic wounds; pattern construction; vacuum sealing drainage; wound care.

A case of toxoplasmic encephalitis in a patient on cancer chemotherapy in Uganda

Sat, 11 Jan 2025 00:00:00 +0000

Background: Reactivation of central nervous system (CNS) toxoplasmosis can be caused by immunosuppression (ISS) of any kind. However, anti-cancer chemotherapy combined with human immunodeficiency virus (HIV) induced ISS results in an atypical presentation that is fatal.

Case presentation: A 46 years old man with a well-controlled infection of the human immunodeficiency virus presented with generalized tonic-clonic seizures following the second dose of anti-cancer chemotherapy for esophageal cancer. His brain's computerized tomography (CT) scan showed enlarged ventricles with no space-occupying lesions. Cerebrospinal fluid (CSF) smears stained with hematoxylin and eosin (H&E) revealed numerous bradyzoites and tachyzoites consistent with central nervous system toxoplasmosis.

Conclusion: With a double burden of cancer and Human immunodeficiency virus (HIV) infection in low-income countries, this case raises awareness about the atypical presentation of CNS toxoplasmosis reactivation among patients on cancer chemotherapy.

Keywords: Toxoplasmosis; Uganda; sub-Saharan Africa; case report.

Modified first-level reconstruction and reinforcement during laparoscopic total hysterectomy for prevention of post-operative pelvic organ prolapse: a randomized clinical trial

Xiangru Chen, Hongbo Gao — Sat, 11 Jan 2025 00:00:00 +0000

Objective: This paper investigated that the clinical value of modified first-level reconstruction reinforcement in the prevention and treatment of pelvic floor dysfunction after laparoscopic total hysterectomy.

Methods: A total of 360 patients undergoing laparoscopic total hysterectomy from December 2018 to September 2021 were selected and divided into three groups (A, B, C) according to POP-Q criteria: This is a randomized clinical trial in which women with first- and second-degree pelvic organ prolapse, and women without pelvic organ prolapse were each randomized into 3 arms of the study. According to the informed consent of patients, three groups are as following: Arm 1: 60 cases in the non-suspension group (vaginal stump was only sutured continuous absorbable suture); Arm 2: 60 cases in traditional suspension group (as in Arm 1, plus suspension of vaginal stump with non-absorbable sutures to cardinal and round ligaments); Arm 3: 60 cases in the modified suspension group (vaginal stump reinforced with horizontal reconstruction). POP-Q score, sexual life quality questionnaire, urinary incontinence questionnaire and pelvic floor ultrasound were compared before and at 6 and 12 months after operation.

Results: (1) in the non-prolapse group and the prolapse group, the POP-Q score of the modified suspension group c was superior to that of the non-suspension group and the traditional suspension group b at 6 and 12 months after surgery (P < 0.05), and the postoperative POP-Q score of the prolapse group was significantly improved compared with that before surgery. (2) In both the non-prolapse and the prolapse study groups, the participants that were randomized to the modified suspension treatment (arm 3) had significantly better sexual function scores than those in arm 1 and arm 2 six and twelve months after surgery (p <0.05). (3) Similarly, participants in both the non-prolapse and the prolapse groups that were randomized to the modified suspension treatment arm (arm 3) were significantly less prone to. urinary incontinence than those randomized to arm 1 and arm 2 at 6 and 12 months after surgery.

Conclusions: Compared with traditional vaginal stump suture and traditional vaginal stump suspension, the modified first-level reconstruction and consolidation method can effectively prevent and cure pelvic floor dysfunction after laparoscopic total hysterectomy, and significantly improve the quality of life of patients.

Keywords: laparoscopy; total hysterectomy; vaginal stump; pelvic floor dysfunction.

Role of HE4 in evaluation of adnexal masses and its comparison with CA125, ROMA and RMI in premenopausal women

Sat, 11 Jan 2025 00:00:00 +0000

Background: Ovarian cancer is the seventh most common cancer in women and is ranked third among gynaecological malignancies after cervical and uterine cancers. Prospective studies have failed to establish a definite screening programme based on tumour markers or ultrasonography.

Objective: To evaluate potential role of Human Epididymis protein 4 (HE4) as a biomarker for diagnosis of various ovarian malignancies in premenopausal age group, either alone or as a part of diagnostic algorithm like Risk of Malignancy Algorithm (ROMA) and to analyse if it has any advantage over Cancer Antigen 125 (CA125) or Risk of Malignancy Index (RMI).

Methods: It was an observational cross-sectional study which included 100 premenopausal women having ovarian mass and underwent surgery. The diagnostic performances of CA125, HE4, ROMA score and RMI for ovarian cancer were evaluated.

Results: Postoperative histopathology confirmed 30% (n=30) women to have malignant ovarian tumors. According to receiver operating characteristic (ROC) analysis; area under curve (AUC) was maximum for ROMA (0.791) followed by HE4 (0.784), RMI (0.750) and CA125 (0.715).

Conclusion: HE4 is not superior to CA125 but, it can be used in series or as part of diagnostic algorithm (ROMA) along with CA125 to get higher diagnostic accuracy for premenopausal women.

Keywords: Adnexal mass; CA125; HE4; Ovarian neoplasms; Risk of malignancy index (RMI); Risk of malignancy algorithm (ROMA).

Pattern and determinants of endometrial thickness among asymptomatic postmenopausal women in an African population

Sat, 11 Jan 2025 00:00:00 +0000

Background: The occurrence of endometrial cancer may be on the increase among African population due to lifestyle changes. Measurement of endometrial thickness (ET) in postmenopausal women may enhance timely diagnosis of endometrial pathology to improve prognosis and quality of life.

Objectives: To determine the relationship between anthropometric measurements hypertension and diabetes mellitus on ET.

Methods: A cross-sectional study conducted at the outpatient clinics of a tertiary facility among asymptomatic postmenopausal women (no malignancy, abnormal vaginal bleeding or hormone replacement therapy). Participants recruited by purposive sampling were sub-categorized into those with chronic hypertension, diabetes mellitus or no chronic medical disorder. All participants had anthropometric measurements, fasting blood glucose and transvaginal ultrasonography. The main outcome measure was the ET while p-value <0.05 was significant.

Results: The mean ET was 2.17±2.57 and prevalence of ET (>5mm) was 1.1%. Mean ET was significantly higher among women <5 years post-menopause (2.53±1.61 vs. 2.06±2.79; P0.048); chronic hypertension (2.82±4.07mm vs. 1.42±1.16mm; P0.026) or diabetes mellitus (2.27±1.08mm vs. 1.42±1.16; P0.005). Parity was inversely related to ET (P0.005); body mass index (P0.191), duration of hypertension (P0.213) or diabetes mellitus (P0.085) were not statistically significant.

Conclusion: Parity, number of years post-menopause, hypertension and diabetes mellitus were important determinants of ET.

Keywords: Endometrial thickness; postmenopausal women; biosocial characteristics; determinants; asymptomatic women.

Fertility outcome of intravaginal insemination in women with unconsummated marriages

Rubina Izhar, Samia Husain, Zubaida Masood — Sat, 11 Jan 2025 00:00:00 +0000

Aim: To assess the fertility outcome of intravaginal insemination in women with unconsummated marriages.

Methods: We conducted a prospective observational study from January 2017 to October 2020. The study population comprised of couples with unconsummated marriages. Participants were divided into three groups: (1) women with vaginismus (2) men with erectile dysfunction(ED); and (3) men who suffered from premature ejaculation (PE). The couple was educated about the fertility period and advised to perform insemination at home on every alternate day for at least twelve cycles. Pregnancy was defined as a positive urine pregnancy test. The couple was asked to report a positive pregnancy test or follow up at the end of twelve months in case conception did not occur.

Results: The study comprised of 769 couples. There were 371 couples with vaginismus, 258 with premature ejaculation and 140 with erectile dysfunction. Pregnancy was achieved in 270(72.8%) couples with vaginismus, 181(70.2%) with premature ejaculation and 72(51.4%) with erectile dysfunction. The time to conception was shortest for couples with vaginismus, 7.72±3.02 months and longest for couples with erectile dysfunction 10.81±1.53 months.

Conclusion: Couples with unconsummated marriages conceive with intravaginal insemination. At home insemination is a treatment option for such couples before embarking on artificial reproductive techniques.

Keywords: Fertility outcome; intravaginal insemination; unconsummated marriages.

Ethical, medico-legal and financial aspects of the legalization of surrogate maternity in Bulgaria

Sat, 11 Jan 2025 00:00:00 +0000

The legalization of surrogacy and reproductive choices is a possible solution for childless families and the specialists in this area prove that this is a great challenge and responsibility. There are many issues on the topic: medical, ethical, as well as socio-psychological, legal and financial. The aim of present survey is to study and analyse the attitudes of society regarding some medical, social and economic and law aspects related to the legalization of surrogate maternity in Bulgaria.
An anonymous survey was conducted involving 387 people. The data was collected via a pen and paper questionnaire pack. The initiative has provoked wide public interest. According to the participants in the present study, in the event of it being legalized, surrogate maternity should not become a profession, a source of surplus income for the surrogate mother, but the costs directly related to the pregnancy, birth and postpartum recovery should be compensated. The rights of the surrogate mother regarding custody of the child after birth and abortion rights should be limited in favor of the intended parents. The aspects discussed concern only the projected legal framework of surrogate maternity in Bulgaria, because at the present, the Bill has not been adopted.

Keywords: Surrogate maternity; reproductive ethics; law regulation.

Sexual behaviour and condom use of older adults living with HIV/AIDS in a treatment centre at Osogbo, south-west Nigeria

Sat, 11 Jan 2025 00:00:00 +0000

Objective: This study assessed the condom use and sexual behaviour of older adults living with HIV/AIDS at Osogbo, Osun State, Nigeria.

Methods: A descriptive cross-sectional study involving all adults receiving care at an HIV treatment centre that completed an interviewer administered questionnaire on their sexual behaviour and condom use. Data were analyzed using descriptive and inferential statistics.

Results: A total of 186 older adults completed the study. Their mean age (SD) was 54.5 (5.6) years. There are 114 (61.3%) females and 72 (38.7%) males. Two fifth 87 (46.8%) were sexually active with over half using condom (45, 51.7%) at last sexual intercourse. The determinants of condom use at last sexual intercourse included age 50-59 years (OR=3.34, 95% CI=1.21-9.25, p=0.020), lower education (OR=3.00, 95%CI=1.04-8.69, p=0.043), being married or have a partner (OR=3.25, 95%CI=1.11-9.52, p=0.031), partner’s awareness of respondents’ HIV status (OR=13.00, 95%CI=4.25-39.80, p<0.0001) and stigma experience from partner (OR=11.70, 95%CI=4.03-33.99, p=0.0001).

Conclusion: Older adults engage in high-risk sexual behaviour. It is necessary to encourage safer sex practices, stigma reduction and couple HIV counseling and testing.

Keywords: Sexual behaviour; condom use; older adults.

Prevalence and pattern of renal complications of uterine fibroids in a Teaching Hospital in Nigeria

Mumuni Amisu, Joy Chionuma, Ayoola Odeyemi, Odewale Odetayo — Sat, 11 Jan 2025 00:00:00 +0000

Background: Symptomatic uterine fibroids causing obstructive nephropathy were thought to be uncommon, but recent prevalence studies showed otherwise. The aim of the study is to determine the prevalence of obstructive uropathy and nephropathy in patients with uterine leiomyoma.

Methodology: The study was a hospital-based cross-sectional retrospective study of 114 patients diagnosed with symptomatic uterine fibroids seen in the gynecology clinic of Lagos State University Teaching Hospital, Ikeja from February 2021 to June 2022.

Results: The overall prevalence of obstructive uropathy and nephropathy was 22.8% and 10.5% respectively. The average level of serum creatinine was 2.2 ± 1.9mg/dl with a creatinine range of 1.8 to 6.7mg dl. The average of the GFR among patients was 29.3 ± 13.4ml/min/1.73m2 with a range of 9 – 54ml/min/1.73m2. There is a positive association between uterine size and uropathy and subjects with uropathy are more likely to develop nephropathy. (CI 95% 3.281 - 108.670).

Conclusion: This study showed that prevalence of obstructive nephropathy in the patients with uterine leiomyomata is 10.5%. Uterine size and myoma diameter were positively associated with development of obstructive nephropathy

Keywords: Fibroids; uropathy; nephropathy; uterine leiomyomata.

Preventive measures of obstetric Fistula: knowledge and practice among service providers in two Nigerian Health Institutions

Sat, 11 Jan 2025 00:00:00 +0000

Background: Obstetric fistula remains a major public health problem which serves as a proxy indicator of the status of Nigerian women and of the availability and accessibility to quality maternal health services. This study aims to assess the knowledge, practice and perceived factors that might hinder preventive interventions to reduce obstetric fistula by service providers in Abakaliki, Ebonyi State Nigeria.

Methods: A cross-sectional survey of 169 service providers (doctors (49) and nurses (120)) in selected health facilities in Abakaliki was conducted using a validated self-administered questionnaire.

Results: Majority (71%) of the participants were registered nurse/midwife while only 29% were doctors. Most (87.0% & 89.9%) of the participants had both adequate knowledge and good practice of preventive measures of obstetric fistula respectively. Major factors perceived to hider the practice of obstetric fistula preventive measures were patient-related factors (mean=2.97) and institutional factors (mean = 2.51). There was significant association between age (p = 0.008), marital status (p = 0.029), profession (p = 0.039), years of experience of work (p = 0.003) and the knowledge of obstetric fistula while none of the demographic characteristics had association (p > 0.05) with the practice of obstetric fistula preventive measures.

Conclusion: Although most participants in this study had adequate knowledge and good practice of obstetric fistula preventive measures, there is still a great need to train and retrain doctors and nurses on current guidelines for obstetric fistula prevention and conservative management. Government should also strengthen the health facilities at all levels to provide emergency obstetric and newborn care.

Keywords: Knowledge; obstetric fistula; practice and prevention.

Influence of mobile phone calls on the compliance of the recommended four antenatal care visits in Kisii County, Kenya: a cluster randomized control trial

Sat, 11 Jan 2025 00:00:00 +0000

Background: Antenatal care attendance is still low in sub-Saharan countries. While mobile phones have shown to improve outcomes in maternal health services, there are few published studies on the use of mobile phone calls in antenatal care.

Objective: To determine the influence of mobile phone calls on pregnant women’s completion of the recommended 4 ANC visits in Kisii County, Kenya.

Methodology: 16 sub county health facilities (clusters) were randomly assigned to either intervention or routine care. A total of 160 pregnant women were recruited in their first antenatal care visit and followed up until delivery. The intervention involved calling mothers through their mobile phones to give health education on antenatal care every month until delivery. The primary outcome measure was the completion of the 4 recommended antenatal care (ANC) visits while secondary outcome measures were; women receiving iron and folate supplements, and completion of all recommended laboratory tests.

Results: 50% of the women in the intervention group and 35% in the control group completed the four recommended ANC visits. The intervention was not a significant predictor of women receiving iron and folate supplements, RR, 1.07 (0.93 – 1.25), p – value = 0.412. However, the intervention was associated with a 46% increase in women completing all required antenatal care laboratory investigations.

Conclusion: The use of mobile phone calls in antenatal health education show promise in improving antenatal care attendance among pregnant women.

Keywords: Influence of mobile phone calls; four antenatal care visits; Kisii County; Kenya.

Knowledge, attitude and use of herbal medicine among pregnant women attending antenatal care in nsukka, Nigeria

Obinna Felix Dim, Chigozie Gloria Anene-Okeke, Chinwe Victoria Ukwe — Sat, 11 Jan 2025 00:00:00 +0000

Objective: To assess the knowledge, attitude and use of herbal medicine among pregnant women attending antenatal in Nsukka, Enugu state Nigeria.

Methods: This was a cross- sectional descriptive study carried out among pregnant women attending ante- natal in selected hospitals in Nsukka, Enugu State from June-August 2022. A 33 item well-structured questionnaire was used as a data collection tool. Data were analyzed using the IBM Statistical Product for Services Solution (SPSS) for Windows, Version 27.0. Descriptive and inferential statistics were utilized. Statistical significance was set at P< 0.05.

Results: Out of 400 consenting pregnant women attending antenatal, above half were between the ages of 25 to 34, 233(58.3%), and are married 371(92.8%) with education within the tertiary category 193(48.2%). Above half had good knowledge 264(66.2%) of herbal medicine. Majority had positive attitude towards the use of herbal medicine 284(71.2%). More than half 226(56.5%) of the pregnant women had used herbal medicine apart from during pregnancy. Only few pregnant women 64(16%) had used herbal medicine in previous pregnancy.

Conclusion: Majority of pregnant women that participated in the study had good knowledge and positive attitude towards herbal medicine.

Keywords: Knowledge; attitude; use; herbal medicine; pregnant women.

Detection of diversity of fetal heart function in pregnancy-induced hypertension patients by ultrasonography in Aljouf Region, Saudi Arabia

Sat, 11 Jan 2025 00:00:00 +0000

Background: The common pregnancy illness known as pregnancy-induced hypertension syndrome (PIH) has the potential to harm both the mother's and the fetus' organs to varying degrees. An essential tool for assessing fetal heart function is ultrasound.

Objective: The goal of this study is to use ultrasound to measure the variety of fetal heart function in patients with pregnancy-induced hypertension.

Material and methods: This hospital-based retrospective study was carried out between January 2021 and January 2022 at the Obstetric Department of Maternity and Children Hospital (MCH), Sakaka, Aljouf, Saudi Arabia, to assess the changes in fetal cardiac function in patients with pregnancy-induced hypertension compared to healthy pregnant women in general. The research process involved screening 60 pregnant women for pregnancy-induced hypertension (PIH) and 40 healthy pregnant women for the control group. Each of the 100 pregnant women had a single fetus, and no prenatal abnormalities were found. All eligible patients underwent prenatal ultrasounds in order to collect the cardiac function measures needed to assess the variety of fetal heart functions rapidly and effectively.

Results: When compared to healthy pregnant women, the results of the ultrasound show a higher significance of the fetal thickness of the cardiac septum, left and right ventricular end-systolic and end-diastolic perimeter and area. Additionally, our ultrasonography findings demonstrate that fetal ventricular systolic fractions 1 and 2 (VSF1 and VSF2) were more significant in patients with pregnancy-induced hypertension (PIH) compared to healthy pregnant women in general.

Conclusion: The cardiac functions of the fetus are negatively affected by pregnancy-induced hypertension (PIH).

Keywords: Ultrasonography; pregnancy induced hypertension; fetal cardiac function.

Prevalence and factors associated with second trimester pregnancy loss among women admitted at a National Referral Hospital in Uganda: a cross-sectional study

Charles Irumba, Dan K Kaye, Justus K Barageine, Rodgers Ampwera, Hope Atwiine — Sat, 11 Jan 2025 00:00:00 +0000

Background: Second trimester pregnancy loss (abortion) refers to induced or spontaneous termination of pregnancy from 13 to the end of 26 weeks of gestation. Second trimester abortions contribute to a high proportion of maternal morbidity, mortality and psychological stress especially in low-resource countries with restricted access to safe abortion services. While globally, the prevalence of second trimester abortions is 10–15%, the prevalence at Kawempe National Referral Hospital was not known. The study objective was to determine the prevalence and factors associated with second trimester abortion at Kawempe National Referral Hospital.

Methods: A hospital based cross-sectional study was conducted among 235 women with abortions admitted at Kawempe National Referral Hospital. Quantitative data was collected using a structured interviewer administered questionnaire. Bivariate and multivariate analysis was done using STATA version 14. The Student’s T- test was used to check for association between the dependent and independent variables.

Results: The prevalence of second trimester abortion was 41.7%.|Factors associated with second trimester abortion were; being HIV positive (aPR = 1.9, 95% CI =1.32 – 2.61), having a urinary tract infection (aPR = 1.9, 95% CI =1.30 – 2.72), malaria infection confirmed by a rapid test (aPR = 2.5, 95% CI= 1.75 – 3.54), no prior history of abortion (aPR = 1.5, 95% CI =1.04 - 2.27) and no condom use in the previous 1 year (aPR = 1.6, 95% CI =1.11 – 2.23).

Conclusion: The prevalence of second trimester abortion was higher than the global estimates. Service providers should actively screen pregnant women for HIV, urinary tract infection, malaria and then offer effective treatment accordingly. The Ministry of Health should develop and disseminate protocols and standard management guidelines for case management of second trimester abortions.

Keywords: Second trimester pregnancy loss or abortion; prevalence; associated factors.

Caesarean sections among East African refugees and their host population: a 20-year retrospective study in western Tanzania

Sat, 11 Jan 2025 00:00:00 +0000

Background: Half of the 35.3 million refugees worldwide are women and a third are of childbearing age, making reproductive healthcare in humanitarian settings indispensable. Caesarean section (CS) is the most common operation worldwide, accounting for 18.6% of births.

Objective: This study provides a descriptive analysis of caesarean sections (CS) in a protracted refugee setting.

Methods: This study is a retrospective review of CS recorded in logbooks between November 2000 and September 2020, inclusive. Data was abstracted from paper logbooks and included date, nationality, sex, age, and indication. Analysis was performed in STATA.

Results: 8,461 CS were performed over the 20-year period. The average age was 24.6 years. Tanzanian patients made up 25% (n=2,116) of the population. The most common indications for CS for both Tanzanians and refugees were cephalopelvic disproportion (CPD), previous scar, and fetal distress. There was a significant difference in the proportion of adolescent and adult patients for the indications of CPD, previous scar, fetal distress, malposition, placenta previa, prolapse, and antepartum hemorrhage (APH).

Conclusion: There is a significant amount of CS performed in this humanitarian setting. Refugees and Tanzanians utilize these services. Outcome data are needed to identify if CS in this setting reduces neonatal and maternal morbidity and mortality.

Funding: American Society of Tropical Medicine and Hygiene; Ruth L. Kirschstein National Research Service Award T32 (Award: 2T32AR67708-6); Association for Academic Surgery

Keywords: Refugee health; caesarean section; humanitarian setting, global surgery; Tanzania.

The Luganda Edinburgh Postnatal depression scale: cross-cultural adaptation and validation for prenatal screening of depression in a Ugandan sample

Sat, 11 Jan 2025 00:00:00 +0000

Background: Depression affects approximately 364 million people globally. Prenatal depression affects between 26.3% and 32.9% of mothers in Africa. Opportunities for prenatal screening are missed. The gold standard diagnostic, the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) criteria for Major Depressive Disorder (MDD) has higher technical requirement. There is inadequate information on locally adapted and validated user-friendly screening tools in Uganda.

Objective: To Adapt and validate the Luganda Edinburgh Postnatal Depression Scale (EPDS-L) for screening prenatal depression at Kawempe National Referral hospital (KNRH).

Methods: Cross-sectional study in KNRH using International Society for Pharmacoeconomics and Outcomes Research guidelines for adaptation and quantitative approaches for the validation. Consecutive sampling until the desired sample of 100, all participants responded to both EPDS-L and DSM-5 criteria for MDD. Reliability demonstrated using Cronbach’s alpha coefficient, while validity was demonstrated by sensitivity, specificity, Negative Predictive Value (NPV), Positive Predictive Value (PPV) and Area-Under-the-curve (AUC).

Results: EPDS-L had Cronbach’s-Alpha of 0.8515. At cut-off of 13, sensitivity was 62.86%, specificity-100%, PPV-100% and NPV-83.3%. AUC was 0.99. Performance was better at cut-off of 10, with sensitivity-97.14% and specificity-98.46%.

Conclusion: The EPDS-L is reliable at cut-off of 13 but performs even better at cut-off of 10.

Keywords: Mental health; prenatal depression; Edinburgh Postnatal Depression Scale; Luganda.

The predictive prognostic value of serum CEA, CA153, HE4 combined with a variety of immune inflammatory indicators in breast cancer

Ping Zou, Ke Li, Yiting Qian, Tingting Wu, Yue Qian — Sat, 11 Jan 2025 00:00:00 +0000

Objective: To investigate the prognostic value of serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA153), and human epididymal 4 (HE4) combined with a variety of immune inflammatory indicators in breast cancer.

Methods: A sample size of 112 breast cancer patients was selected and all patients underwent surgical treatment. The three year prognosis of the patients was observed. Patients with poor prognoses were included in the poor prognoses group and the patients with good prognosis were included in the good prognosis group. The levels of serum CEA, CA153, HE4, and related immune inflammatory indicators (including Mon, Lym, Neu, Plt, NLR, and SII) were analysed. The predictive value of serum CEA, CA153, HE4, and immune inflammatory indicators on the prognosis of breast cancer was analysed by Logistic regression and ROC curve method. The area under the ROC curve (AUC) was used to evaluate the predictive efficiency. α=0.05 was used as the test standard.

Results: Compared with the good prognosis group, the CEA, CA153, HE4, Mon, Neu, Plt, and SII of the poor prognosis group were higher, all P<0.05. Logistic regression analysis showed that CEA, CA153, HE4, Neu, and Plt were effective indicators for predicting the poor prognosis of breast cancer. The AUC of CEA, CA153, HE4, Neu, and Plt in predicting the prognosis of breast cancer was 0.929, which was higher than the AUC of a single prediction.

Conclusion: Serum CEA, CA153, HE4 combined with Neu and Plt had predictive value for the prognosis of breast cancer.

Keywords: Breast cancer; CA153; CEA; HE4; immune inflammatory indicators; predictive; prognostic.

Adenocarcinoma of the appendix with metastasis to the spine

Sat, 11 Jan 2025 00:00:00 +0000

There are a few reported cases of bone metastasis from adenocarcinoma of the appendix and there is none from Africa. We report this rare case of a 30-year-old man who presented with low back pain following a trivial fall and who subsequently developed generalized peritonitis for which he underwent laparotomy. The histology of the appendix and the mesentery confirmed adenocarcinoma of the appendix with metastasis to the mesenteric lymph nodes while an MRI scan confirmed spine metastasis. Carcinoma of the appendix, should, therefore, be considered as a differential diagnosis in spine metastasis of unknown origin especially with coexisting abdominal symptoms.

Keywords: Adenocarcinoma; appendix; appendix carcinoma; bone metastasis; spine metastasis; Africa.

In-vitro scientific validation of anti-inflammatory activity of Punica granatum L. on Leukemia monocytic cell line

Sat, 11 Jan 2025 00:00:00 +0000

Background: The induction of the inflammatory cascade results in the production of a number of inflammatory mediators, including prostaglandin E2 (PGE2), nitric oxide (NO), and proinflammatory cytokines like TNF-, IL-, and IL-6. This study examined the cytotoxicity and anti-inflammatory properties of a methanolic crude extract of Punica granatum L. peel (PPM) on monocytic leukaemia cell line (THP-1).

Materials and methods: The PPM along with Quercetin as reference was used to assess the cytotoxic effect on THP-1 cells and describe its effect on pro-inflammatory cytokines such as COX-2, TNF-α, IL-6 against cancer cell line by flow cytometry.

Results: The percentage of viable cells significantly decreased which correlates to non-toxicity whereas quercetin was found to be highly toxic, the IC50 could not be calculated because of drug precipitation. There was a significant decrease in the expressions of inflammatory cytokines upon pre-treatment of the cells with PPM prior to LPS stimulation.

Conclusion: Our findings indicate that no cytotoxicity was observed after the treatment of THP-1 cells with PPM (25-400 μg/ml), but at higher concentration (400μg/ml), the cell viability decreased to 84% and attenuated the expression level of inflammatory cytokines. The inhibitory effect of the extract on pro-inflammatory factors production may provide a theoretical source on upcoming treatment of inflammation.

Keywords: Punica granatum L; Monocytic leukaemia cell line; cytotoxicity; anti-inflammation.

The effect of radio-frequency ablation in treating pulmonary ground glass nodule patients and its influence on pulmonary function

Chengwei Zhou, Zixuan Chen, Yuan Zhang, Xiaodong Zhao, Guofang Zhao — Sat, 11 Jan 2025 00:00:00 +0000

Background: With widespread application of low-dose thin-section chest CT screening, the detection rate of patients with subsolid nodules (SNs) as CT findings has increased remarkably.

Objective: To clarify effect of radio-frequency ablation (RFA) in treating pulmonary ground glass nodule (GGN) patients and its impact on pulmonary function.

Methods: A total of 100 patients diagnosed with pulmonary GGN in our hospital from January 2019 to December 2021 by pulmonary thin-section CT + enhanced imaging examination and all underwent simultaneous needle biopsy were enrolled and randomly divided into control group and observation group, with 50 cases each. The control group received treatment with traditional surgery. The observation group received treatment with RFA. The surgical indicators, surgical treatment efficacy, levels of inflammatory cytokines, complications and pulmonary function indicators were assessed between two groups.

Results: The operation time, hospital stay and intraoperative blood loss in observation group were markedly shorter/less than controls (P < 0.05). No residual recurrence was observed in total 84 nodules of 50 cases in observation group. The size of nodules was observed by CT 1, 3 and 6 months after operation. With prolongation of postoperative time, nodules gradually shrank, and after 6 months, fibrous cord scar residue gradually formed, with statistical significance relative to those before operation (P < 0.05). The postoperative IL-6, CRP and TNF-α in both groups presented elevation, whereas postoperative changes in IL-6, CRP and TNF-α in observation group presented depletion relative to control group, with statistical significance (P < 0.05). The complication rate in observation group presented depletion relative to control group, with statistical significance (P < 0.05). The FVC, FEV1, FEV1%, MVV and PEF in both groups presented depletion 1 month after operation and presented statistical significance relative to those before operation except for FEV1% (P < 0.05), and changes in observation group presented depletion relative to control group. Six months after operation, FVC, FEV1, FEV1%, MVV and PEF in both groups had recovered to preoperative levels and presented no difference relative to preoperative level (P > 0.05), and presented no difference between two groups (P > 0.05).

Conclusion: RFA for the therapy of pulmonary GGN is safe and effective, without surgical scar, and is less traumatic to the body, which has a good application prospect.

Keywords: Radio-frequency ablation; pulmonary ground glass nodule; pulmonary function; inflammatory cytokines.

A cellular schwannoma of the nasal septum: a case report

A K Al-Balasi, O M El Mustafa, A M El Hassan — Sat, 11 Jan 2025 00:00:00 +0000

Background: Cellular schwannoma is a benign variant of classic schwannomas. It is an extremely rare condition to be derived from nasal septum.

Case presentation: A cellular schwannoma of the nasal septum is described in a 10-year-old Sudanese girl presented with nasal obstruction. The tumor was treated surgically by a trans-nasal approach. Pathological examination of the resected tumor showed cellular schwannoma. The tumor cells were immunoreactive for S-100 protein. The patient has been doing well for 10 months with no evidence of tumor recurrence.

Keywords: Nasal septum; cellular schwannoma; childhood tumors.

Efficacy of midnight-noon Ebb-flow hour-prescription method combined with acupuncture at Baihui Bazhen acupoints in the rehabilitation of Aphasia after ischemic stroke

Yunbo Li, Chaoqi Lu, Lin Chen — Sat, 11 Jan 2025 00:00:00 +0000

Background: To investigate the clinical effectiveness of combining the midnight-noon ebb-flow hour-prescription method with acupuncture at the Baihui (GV 20) and Bazhen acupoints for rehabilitating aphasia following ischemic stroke.

Methodology: 196 patients with aphasia after ischemic stroke were divided into two groups: a research group (n=98) that received language rehabilitation training along with the midnight-noon ebb-flow hour-prescription method and acupuncture at Baihui (GV 20) Bazhen acupoints, and a control group (n=98) that received only language rehabilitation training. The study recorded traditional Chinese medicine symptom scores and scores from various scales, as well as clinical efficacy.

Results: The traditional Chinese medicine symptom score and National Institute of Health Stroke Scale (NIHSS) score were lower, and the scores of Stroke-Specific Quality of Life Scale (SS-QOL), Chinese Functional Communication Profile (CFCP), Montreal Cognitive Assessment (MoCA), Chinese Rehabilitation Research Center Standard Aphasia Examination (CRRCAE) were higher in the research group than in the control group after treatment. The research group also had a higher total effective rate compared to the control group.

Conclusion: Midnight-noon ebb-flow hour-prescription method combined with acupuncture at Baihui (GV 20) Bazhen acupoints can effectively ameliorate NIHSS scores in patients with aphasia after ischemic stroke, facilitate language functional recovery, and improve rehabilitation.

Keywords: Ischemic stroke; aphasia; midnight-noon ebb-flow hour-prescription method; Baihui (GV 20) Bazhen acupoints; acupuncture.

The effect of the begining time of the rehabilitation program in stroke patients on functional ambulation and stroke related complications

Gülseren Demir Karakılıç, Esra Şahingöz Bakırcı, Ferda Büyük — Sat, 11 Jan 2025 00:00:00 +0000

Objectives: The aim of this study was to reveal the effect of rehabilitation initiation time on the functional status and complications encountered during the rehabilitation process in stroke patients who underwent rehabilitation program in the physical medicine and rehabilitation clinic of our hospital.

Material and methods: Patients who received outpatient and inpatient rehabilitation treatment with the diagnosis of acute stroke in the Physical Medicine and Rehabilitation Clinic of Yozgat City Hospital between January 2017 and August 2022 were screened. Patients with acute stroke and had a file record were included in the study.
Demographic information such as age, gender, comorbid diseases; type and direction of stroke, time from stroke until the rehabilitation program begins, total rehabilitation period, stroke-related complications, Brunnstrom stages, and functional ambulation scale scores of stroke patients were recorded

Results: A total of 314 patients were included in this study and evaluated improvement in the functional ambulation scale scores according to the beginning time of the rehabilitation program. When the patients were grouped as 0-30 days, 31-60 days, and 61 days or more according to the time elapsed until the rehabilitation program, a significant difference was found in terms of the increase in FAS scores both in the pairwise comparisons and the comparison of all three groups together (p<0.001 for all comparisons). There was a moderate positive correlation between the total number of rehabilitation sessions and improvement in FAS scores (Rho=.316, p<0.01). Complications were observed in almost all patients in our study (97.7%). The comparison of the groups for stroke complications revealed that the frequency of depression, urinary tract infection, urinary incontinence, decubitus ulcer, dysphagia, convulsion, falling and aphasia was lower in the 0-30 days group compared to the other groups (p<0.01). There was also no significant correlation between the presence of stroke complications and improvement in FAS score (p>0.05).

Conclusion: Contrary to popular belief, we showed that early rehabilitation does not increase complications and has a positive effect on function. Despite the perception that complications would negatively affect function, there was no significant relationship between the presence of stroke complications and the improvement in FAS score. We found that the rehabilitation program applied in the early period after stroke is effective and reliable.

Keywords: Stroke; rehabilitation initiation time; rehabilitation period; functional recovery; stroke-related complications.

The interaction between CTGF and VEGF-A in the progression of intervertebral disc fibrosis

Wangbing Xu, Jiqin Zhong, Jianrong Jian, Faming Zhong — Sat, 11 Jan 2025 00:00:00 +0000

Background: Fibrosis in the extracellular matrix of nucleus pulposus (NP) is associated with intervertebral disc degeneration (IVDD). Both connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF)-A are responsible for the pathological basis of NP fibrosis. Our study aims to verify the interaction between CTGF and VEGF-A in a vitro NP cell model.

Methodology: Collected human NP tissues of different degeneration degree and isolated the NP cells from the non-degenerated NP tissues. Analysed the CTGF and VEGF-A gene expression in the naturally degenerated NP and IL-1β-induced degenerated NP cells. Additionally, interfered wit the CTGF and VEGF-A expression by exogenic protein treatment, siRNA transfection, or specific inhibitor. The expression of CTGF, VEGF-A, collagen I/II/III and aggrecan with protein or mRNA level was determined by immunological staining, western blotting and RT-PCR.

Results: CTGF and VEGF-A highly expressed in the late-term of degeneration compared to the middle-term, and their expressions were synergistic. Upregulating one of CTGF and VEGF-A could induce the overexpression of the other one and collagen I/III, but suppressed collagen II and aggrecan expression; Besides, the suppression of one of them could inhibited another and collagen I/III expression.

Conclusions: CTGF and VEGF-A increase in late IVDD. Prevent NP fibrosis by suppressing their interaction.

Keywords: Connective tissue growth factor; vascular endothelial growth factor -A; intervertebral disc; nucleus pulposus; fibrosis.

Network-based pharmacology to predict the mechanism of qianghuo erhuang decoction in the treatment of rheumatoid arthritis

Xuemeng Chen, Qinghua Zou, Bing Zhong, Yong Wang — Sat, 11 Jan 2025 00:00:00 +0000

Background: To investigate the mechanisms of Qianghuo Erhuang Decoction (QED) in the treatment of rheumatoid arthritis (RA), we performed compounds, targets prediction and network analysis using a network pharmacology method.

Methodology: We collected active ingredients and targets of QED according to the database of Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP) and selected therapeutic targets on RA. "drug-ingredient-target" network was made for the intersecting genes. The STRING database was used for constructing a protein-protein interaction network (PPI) for the intersection genes, and R version 4.1.2 software was used for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis.

Results: We found that there were 141 main active ingredients in QED, of which the main core active ingredients were: β-sitosterol, stigmasterol, baicalein, wogonin, kaempferol, etc., involving 166 RA genes. GO enrichment analysis results showed that QED involved 2229 biological processes, 78 cell components and 212 molecular functions. QED might interfere and treat RA through lipid and atherosclerosis, cancer pathways, PI3K-Akt, AGE-RAGE, IL-17, TNF, as well as HIF-1 signaling pathways.

Conclusion: QED may treat RA by regulating inflammation-related signaling pathways, angiogenesis signaling pathways, and reducing the expression of inflammatory factors.

Keywords: Computer communication networks; Rheumatoid arthritis; Target.

Effects of general anesthesia combined with ultrasound-guided lumbosacral plexus block on hemodynamics and postoperative rehabilitation in geriatric patients with total hip arthroplasty

Yanan Cui, Qin Fan, Na Wu, Baichun Xing — Sat, 11 Jan 2025 00:00:00 +0000

Background: The incidence of fractures increases with age, and it is estimated that the incidence in women is higher than that in men.

Objective: To investigate the influence of general anesthesia & ultrasound-guided lumbosacral plexus block in elderly patients with total hip arthroplasty (THA).

Methods: Eighty-one geriatric sufferers who were sent to our hospital from July 2019 to January 2021 and underwent THA surgery in the Department of Orthopedics were divided into Grades I to III according to American Society of Anesthesiologists (ASA). Forty-one patients were ascribed to a combination group (using general anesthesia combined with guided lumbosacral plexus block), and forty to a general anesthesia group (with general anesthesia) by a random number table to compare the differences in mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2), intraoperative general anesthesia dosage, incidence of postoperative delirium (POD), serum inflammation and oxidative stress indexes between them.

Results: Prior to anesthesia induction, MAP, HR, and SpO2 between them had significant differences (P>0.05); at skin-incision-time and implantation of the prosthesis, the MAP value of the experimental group was higher than that of the general anesthesia group, 30 minutes after surgery, the SpO2 was higher than the general anesthesia group, and had significant differences (P<0.05); prior to the surgery, had significant differences in measured values such as Cor, blood glucose, IL-6, CRP, MDA and SOD between the two groups (P>0.05); 2 hours after that, the values of Cor, CRP, and MDA in experimental group were lower than the general anesthesia group, and that of IL-6 and SOD were higher than those in the general anesthesia group, and had significant differences (P<0.05); the dosage of propofol, remifentanil, sufentanil in experimental group were lower than the general
anesthesia group, while postoperative extubation time in experimental group was earlier than general anesthesia group, and had significant differences (P<0.05); the incidence of POD in experimental group was lower than the general anesthesia group at 1d, 2d, and 3d after surgery, and had significant differences (P<0.05); the incidence of adverse reactions of anesthesia in experimental group was lower than the general anesthesia group with 9.76 % to 27.50 % , and had significant differences (P<0.05).

Conclusion: General anesthesia & ultrasound-guided lumbosacral plexus block in THA patients is more conducive to the patients’ hemodynamic stability, reducing inflammatory stress response, the dosage of anesthetic drugs, and the incidence of POD,
compared with general anesthesia alone.

Keywords: Geriatric; total hip arthroplasty; general anesthesia; ultrasound guidance; lumbosacral plexus block.

Factors influencing the development of osteoporosis in elderly patients with rheumatoid arthritis

Yanru Yang, Ying Chen, Li Zhang, Xiaofeng Yang, Jingquan Qiao — Sat, 11 Jan 2025 00:00:00 +0000

Background: To explore the influencing factors of osteoporosis (OP) in elderly patients with rheumatoid arthritis (RA).

Methodology: A total of 145 elderly patients with RA were divided into comorbidity group (with OP) of 79 patients and RA group (without OP) of 66 patients. Demographic data and laboratory parameters were collected from patients. Demographic characteristics and laboratory parameters were compared between the two groups. Multiple influencing factors of OP in RA patients were analysed.

Results: There were significant differences in age, BMI, primary disease duration, history of glucocorticoids (GC) administration, disease activity score in 28 joints (DAS-28), and Sharp score data between the two groups. There were significant differences in rheumatoid factor (RF), interleukin-27 (IL-27), procollagen I N-Terminal Propeptide (PINP), nuclear receptor of activator factor-κB ligand (RANKL), and 25-hydroxyvitamin D [25-hydroxyvitamin D, 25 (OH) D] data between the two groups (P < 0.05). Logistic analysis showed that age, primary disease duration, GC history, DAS-28, Sharp score, RANKL and 25 (OH) D were independent factors for OP in RA patients.

Conclusion: The risk of OP in elderly RA patients is mainly related to age, primary disease duration, GC history, DAS-28, Sharp score, RANKL, and 25 (OH) D levels, and risk factors should be actively prevented.

Keywords: Elderly; rheumatoid arthritis; osteoporosis; influencing factors.

Effects of febuxostat in different doses on uric acid, inflammatory factors of serum and knee articular cavity, endothelin-1, and oxidative stress in patients with a gout-a comparative study

Ning Tie, Lijie Bai, Hongbin Li, Dafu Man, Lei Wang, Xinlu Zhou, Yong Wang — Sat, 11 Jan 2025 00:00:00 +0000

Objective: The present comparative study aimed to investigate the effects of different doses of febuxostat on uric acid, inflammatory factors of serum, knee articular cavity, endothelin-1, and oxidative stress in patients with gout.

Methods: 80 cases with hyperuricemia admitted to our hospital (January 2018- March 2020) were randomly distributed into two groups. The control group was administered 40 mg of febuxostat tablets daily., whereas the treatment group was administered febuxostat tablets 80 mg daily. Data were collected from two groups of patients, including uric acid level, TNF-α levels of serum and knee articular cavity, vascular endothelial function, and complications 1 month after the intervention.

Results: After data intervention, the levels of uric acid, TNF-α levels of serum, and knee articular cavity, NO, and SOD were signifi cantly different between the treatment group and the control group (each p< 0.05). There were no signifi cant differences in abdominal pain and diarrhea, liver damage, kidney damage, acute gout, and pruritus between the two groups (p >0.05). The duration of activity disorder, pain duration, and swelling in the treatment group were signifi cantly shorter than those in the control group (p< 0.05). The uric acid level was positively correlated with serum TNF-α level (p < 0.05), and negatively correlated with NO and SOD levels (p < 0.05).

Conclusion: For hyperuricemia-induced gout patients, taking a large dose of 80 mg febuxostat daily can signifi cantly reduce the uric acid level and inflammatory response, improve vascular endothelial function, enhance antioxidant ability, and improve the clinical symptoms of patients without increasing the adverse reactions to medication.

Keywords: Febuxostat; hyperuricemia; gout; blood uric acid; serum inflammatory factors; inflammatory factors of knee articular cavity; endothelin 1; oxidative stress response.

Research progress on the role of ginsenoside Rd in central nervous system diseases

Xiaoyu Ma, Juejin Wang — Sat, 11 Jan 2025 00:00:00 +0000

Ginsenoside Rd (GSRd) is one of the rare saponin monomers extracted from ginseng. Most importantly, GSRd could effectively cross the intact blood-brain barrier (BBB). Studies have shown that it plays an important role in the treatment of neurological diseases such as ischemic stroke (IS), spinal cord injury (SCI), Alzheimer's disease (AD) and Parkinson's disease (PD). The results of these studies are of great significance for the clinical application of GSRd in the treatment in neurological diseases. This article reviewed the protective effects of GSRd in central nervous system diseases and analysed the related mechanism.

Keywords: Ginsenoside Rd; Stroke; Spinal cord injury; Alzheimer's disease; Parkinson’s disease.

System-level barriers account for non-compliance to physiotherapy among persons with Parkinson’s disease at the Korle Bu Teaching Hospital, Ghana: an explanatory mixed-method study

Sat, 11 Jan 2025 00:00:00 +0000

Background: Despite the increasing importance of physiotherapy and robust evidence, there is still limited studies assessing compliance rates and barriers to physiotherapy appointments for Persons with Parkinson disease (PwPD) especially in low-resource settings such as Ghana.

Objective: To assess compliance rates and identify barriers to adhering to physiotherapy appointments among PwPD receiving physiotherapy management at a tertiary hospital in Ghana.

Methods: A sequential explanatory mixed method design was used. The quantitative part involved a retrospective survey of health records of PwPD who reported at the Korle-Bu teaching hospital physiotherapy PD-clinic from 2013-2021. The qualitative part involved semi-structured telephone interviews among defaulters from the year with highest clinic attendance. Quantitative data was descriptively analyzed. For the qualitative data, a deductive qualitative content analysis of the transcribed audiotaped interviews was conducted.

Results: Eighty-six PD records (56 males) were included. Overall mean (SD) age was 67(±11) and ranged from 38-90 years. The year 2014 recorded the highest number of attendees (n=20/86; 23%). Overall, 88% of the participants had stopped physiotherapy. Six PwPD participated in the interviews. System-level barriers were mainly recorded as the reasons for patients defaulting physiotherapy.

Conclusion: The majority of PwPD had stopped physiotherapy and system-level barriers were the key reasons.

Keyword: Parkinson's disease; physiotherapy; patient compliance.

Barriers to uptake of refractive error services in a rural community in Enugu, south-East, Nigeria

Nkiru Zuada Nwachukwu, Daniel Chukwu Nwachukwu, Boniface Ikenna Eze — Sat, 11 Jan 2025 00:00:00 +0000

Background: Uncorrected refractive error remains a leading cause of visual impairment. The utilization of refractive error care services in many Nigerian communities is poor in spite of its availability.

Objective: To determine the barriers to uptake of refractive errors care services in a rural community in Enugu State, Nigeria.

Methods: A descriptive, cross-sectional, population-based survey with mixed method was adopted. The study instruments were a pre-tested, researcher-administered questionnaire and focus group discussion (FGD). Quantitative data were subjected to descriptive and comparative statistics and FGD was analyzed using ATLAS.ti. P value <0.05 was considered significant.

Results: A total of 522 adults comprising 307(58.8%) males and 215(41.2%) females aged 43 ± 31.6 years participated in the study. Lack of felt need 235(45.02%), affordability 200(38.31%), stigmatization 184(35.25%) and distance to health care facility 88(16.86%) were the major factors that hindered the uptake of refractive errors care services in Amorji community. Age significantly associated with lack of felt need (P=0.001) and affordability (P=0.001). Educational status significantly associated with stigmatization (P=0.002) and lack of felt need (P=0.021). Results from FGDs were in agreement with those obtained from the questionnaire-based part of the study.

Conclusion: The major factors that militated against the uptake of refractive care services in the community were lack of felt need, affordability, stigmatization and distance from health care facility. Good health education, planning and implementation of eye care services programmes may improve the uptake of refractive care services in such rural community.

Keywords: Refractive errors; barriers; rural community; black population.

Meta analysis of clinical efficacy of acupoint application in the treatment of irritable bowel syndrome

Sat, 11 Jan 2025 00:00:00 +0000

Purpose: The clinical efficacy of acupoint application in the treatment of irritable bowel syndrome (IBS) was evaluated by Meta-analysis.

Method: Computer searched Chinese and English databases for the randomized controlled trials (RCTs) and quasi-randomized controlled trials (CCTs) of TCM external therapy, acupoint application, TCM external application, navel sticking and their combination therapy in the treatment of IBS. The search period is from the establishment of the database to December 2022. The literature was screened independently by 2 researchers according to the standard of nano-ranking, and the data of the other 5 researchers were proofread, screened and extracted. After that, the bias risk of the included study was evaluated, and the data were analysed by RevMan 5.4. software.

Result: (1) A total of 1842 patients, were included in 25 randomized controlled trials, including the acupoint application treatment group (n=928) and conventional therapy control group (n = 914).
(2) The quality of the literature method shows that there are 5 high-quality literatures with a score of 4-7, 20 low-quality literatures with a score of 1-3 and few high-quality literatures;
(3) In terms of effectiveness, compared with the western medicine control group, the total odds ratio OR [95 % CI] of the total effective rate of the acupoint application treatment group was 4.77 [3.68, 6.20], and the difference was statistically significant (P < 0.05). Shenque, Zhongwan, Pishu and Zusanli are the most commonly used.
(4) In terms of literature bias, 2 studies used envelopes to hide, which belonged to "low risk"; 9 studies were blindly implemented and evaluated as "unclear"; and 6 studies were rated as "high risk" because cases fell off but were not reported. The funnel plot shows that the study is scatter symmetrical, the probability of publication bias is small, and the conclusion is reliable.

Conclusion: Acupoint application can improve the effective clinical rate of IBS with fewer adverse reactions, better patient compliance and fewer adverse reactions, but it still needs to be confirmed by high-quality multicenter, large sample randomized controlled trials.

Keywords: Acupoint application; irritable bowel syndrome; diarrhea type; constipation type; mixed-type.

Male adolescents’ (Aged 15-24 years) smoking habit and its determinant: analysis of Indonesia demographic and health survey data, 2017

Diana Rohmandani Putri, Erni Astutik, Putri Bungsu Machmud, Tika Dwi Tama — Sat, 11 Jan 2025 00:00:00 +0000

Objectives: The aim of the study was to examine the factors influencing cigarette consumption among male adolescents aged 15-24 years in Indonesia.

Methods: This study used the Indonesia Demographics and Health Survey 2017, which included 8,488 male adolescents aged 15-24 years. The survey used multi-stage cluster sampling. Data were analyzed by using multivariable logistic regression adjusted for covariates and a complex survey design.

Results: There is 70.4% of male adolescents who smoke any tobacco products daily or occasionally. The male adolescents who aged 20-24 years (p<0.001; AOR=2.26, 95%Cl=1.96-2.59), had low education level (p<0.001; AOR=5.90, 95%Cl=3.91-8.92), start smoking at 18-24 years (p-value<0.001; AOR=3.09, 95%Cl=2.25-4.23), had been influenced by friend/someone to smoke (p<0.001; AOR=5.60, 95%Cl=4.77-6.58), used the internet at least once a week (p<0.001; AOR=1.28, 95%Cl=1.11-1.49), did not read newspaper/magazine (p<0.001; AOR=1.55, 95%Cl=1.28-1.87) had a higher odds of current smoking.

Conclusions: Factors of smoking tobacco, such as age, age at first smoking, low education, the influence of smoking, and access to information on the internet and newspapers/magazines, had a significant impact on the current tobacco of male adolescents. Our findings support the enforcement of health warnings and laws related to tobacco restrictions for adolescents.

Keywords: Tobacco use; male adolescents; smoking.

Occupational exposure to pesticides and health symptoms among farmers in Palestine

Iyad Ali — Sat, 11 Jan 2025 00:00:00 +0000

Background: This study aimed to examine the usage patterns of commonly used pesticides and categorize the health problems associated with long-term exposure.

Methods: Data for this cross-sectional study was collected between February 2020 and October 2022. Participants from various agricultural regions were recruited through social media surveys.

Results: This study included 1105 farmers from diverse agricultural areas, and found that the participants' level of education was a significant factor in determining the number of reported symptoms. Significant correlations were also found between the number of symptoms and the frequency and duration of pesticide spraying, as well as the use of personal protective equipment. A small percentage of participants reported no symptoms and were excluded from the analysis. Negative associations were observed between the number of symptoms and age group, high school education, frequency of pesticide use per week, involvement in other work, and source of information. Positive associations were found between the number of symptoms and spraying period and perception of pesticide toxicity.

Conclusion: Farmers exposed to pesticides experienced various symptoms and illnesses, including cardiovascular, dermatological, neurological, and hematological symptoms. The number of reported symptoms decreased significantly with higher education levels and the use of personal protective measures.

Keywords: Pesticides; farmers; toxicity; symptoms; Palestine.

Nursing for conical telescopic crown prosthodontics in treating periodontitis accompanied by dentition defects

Lina Hu, Miao Liang, Feng Zhu, Rongrong Nie — Sat, 11 Jan 2025 00:00:00 +0000

Objective: We aimed to investigate the nursing technique and outcomes of conical telescopic crown prosthodontics for patients with periodontitis accompanied by dental defects.

Methods: One hundred patients with chronic periodontitis and dental problems from January 2018 to August 2020 were enrolled. They were randomly assigned to an observation group (n=50) and a control group (n=50). The control group received traditional nursing, whereas the observation group received comprehensive nursing. Comparisons were made between the indices related to chewing function and periodontal condition, inflammatory factors, quality-of-life score, and nursing satisfaction rate.

Results: The masticatory efficiency and absorbance were greater in the observation group than in the control group following nursing (P<0.05). The observation group had lower levels of plaque index, debris index, sulcus bleeding index, and periodontal probing depth, as well as levels of C-reactive protein, tumor necrosis factor-alpha, and interleukin-6 (P<0.05). The quality-of-life score of the observation group was significantly higher than that of the control group (P<0.05). The nursing satisfaction rate of the observation group was significantly higher than that of the control group (P<0.05).

Conclusion: Comprehensive nursing for conical telescopic crown prosthodontics can improve the chewing function and periodontal conditions of patients with periodontitis accompanied by dentition defects.

Keywords: Dentition; defect; nursing; periodontitis; prosthodontics.

The practice and effect of multi-disciplinary cooperative mobile devices in improving the satisfaction of inpatients on drug education

Shuangai Zhu, Chen Huang, Xiaoyun Hu, Yulan Xu, Lili Cheng, Hongying Pan — Sat, 11 Jan 2025 00:00:00 +0000

Objective: To explore the effect of multi-disciplinary cooperative mobile device-assisted drug education on the satisfaction of inpatients drug education.

Methods: Mobile nursing vehicle, IPAD, and mobile phone were used to scan QR code to play drug propaganda videos and distribute drug propaganda materials. Doctors, nurses and pharmacists cooperated to complete drug education for inpatients.
The satisfaction on drug education of inpatients was collected through a third-party satisfaction survey.

Results: Before implementation, the four satisfactions of communicating about the drug, understanding the purpose of the drug, informing the role of the drug and informing the side effect of the drug were 83.9%, 80.4%, 83.8% and 83.9%, respectively, and after the implementation increased to 88.2%, 86.4%, 89.6% and 87.3% (P<0.05). The effective rate of drug education among inpatients increased from 95% before the implementation to 99.4%, and the medication compliance of inpatients increased from 93.1% before the implementation to 98.75%.

Conclusion: Multi-subject cooperative mobile device-assisted drug education can improve the satisfaction of inpatients drug education, the efficiency of drug education and drug compliance.

Keywords: Multidisciplinary collaboration; mobile devices; drug education; patient satisfaction.

Alleviation of nephropathy during aging as complications of diabetic by natural products

Rami M Mosaoa, Taha A Kumosani, Soonham S Yaghmoor, Said S Moselhy — Sat, 11 Jan 2025 00:00:00 +0000

Background: The most complications of chronic diseases as diabetic during aging is micro and microvascular disorders. Consumption of functional foods is very important in protection from these complications. We studied the impact of dipeptide anserine in combination with vitamin E in prevention diabetic nephropathy in diabetic rats.

Methods: The study included 60 male albino rats sorted into five groups: GP (I): control and the other rat groups were induced diabetic by a single dose of streptozocine i.p, at dose of (55 mg/kg/b.w).GP II was considered as diabetic untreated. The other diabetic groups were treated with anserine (1mg/kg b.w, i.p), α-tocopherol (50, 00 IU/kg b.w) or combined. After 12 weeks ,fasting serum was subjected for assay of glucose, glycated hemoglobin (HA1c), advanced glycated end products (AGEs), oxidative stress markers( MDA, SOD) and inflammatory markers (TNF-α and IL-6).

Results: Data obtained revealed that, diabetic rats treated with anserine or α-tocopherol or combination improve abnormalities, glucose, HA1c, antioxidant enzymes, inflammatory mediators and AGEs versus untreated diabetic.

Conclusion: Dietary supplement of natural products as anserine and α-tocopherol protect against micro and microvascular system, which is suggestive as alternative or complementary therapeutic agents for diabetic complications as neuropathy, nephropathy, and CVD.

Keywords: Aging; Diabetic nephropathy; AGEs; Inflammation; anserine;Vitamin E; rat.

The effectiveness of a breastfeeding educational program on knowledge of antenatal women: A quasi-experimental study

Sat, 11 Jan 2025 00:00:00 +0000

Background: Prenatal knowledge about breastfeeding is an important modulator of feeding practices.

Objectives: This study aimed to evaluate effectiveness of a structured breastfeeding educational program on breastfeeding knowledge of antenatal women and identify factors that predict breastfeeding knowledge.

Methods: A quasi-experimental pre-test post-test study was conducted between June and July 2022. Using convenience sampling,150 antenatal women from a tertiary care hospital in Riyadh, Saudi Arabia, were included. Personal and obstetrical information were collected using a demographic questionnaire. On Day one, the pre-test Breastfeeding Knowledge Questionnaire was administered, followed by the structured educational intervention. On Day 10, the post-test was conducted through telephonic interviews, using the same questionnaire. Descriptive statistics, paired t test and regression analysis were computed.

Results: The mean post-test knowledge (24.97, SD=1.69) was significantly higher than the mean pre-test knowledge (20.26, SD=3.02), indicating that breastfeeding education was effective in improving the overall (p<0.001) and domain-wise knowledge: initiation and colostrum, exclusive breastfeeding, practices and techniques, nutritional aspects, and breastfeeding problems (p<0.001). High monthly income (OR=2.017; 95% CI=1.053–3.864; p=0.034), multigravidity (OR=3.117; 95% CI=1.489–6.525; p=0.003) and large family size (OR=2.889; 95% CI=1.479–5.643; p=0.002) were significant predictors of pre-test breastfeeding knowledge.

Conclusion: The educational intervention was effective in improving breastfeeding knowledge in antenatal women. The findings can have significant implications for healthcare professionals seeking to enhance the delivery of breastfeeding information in clinical settings, particularly during the antenatal period.

Keywords: Breastfeeding; educational intervention; knowledge; antenatal women; quasi-experimental study.

Malnutrition and associated factors among children of adolescent mothers attending a tertiary hospital in Uganda

Geraldine Basanyukira, Violet Okaba, Elizabeth Kiboneka, Sarah Kiguli — Sat, 11 Jan 2025 00:00:00 +0000

Background: Children bearing children” emphasizes vulnerability of both parties involved. Children of adolescent mothers are prone to poor health outcomes, undernutrition inclusive.

Objective: To assess the nutrition status and factors associated with under nutrition among children aged one to twenty-four months, of adolescent mothers(COAM) attending Mulago Hospital.

Methodology: A cross-sectional study conducted at pediatric department of Mulago Hospital. COAM were recruited consecutively following consent. Mother-baby pair underwent history, physical exam, anthropometry and HIV testing. Data was extracted by a standardized questionnaire, entered into Epidata 3.1 and analyzed with SPSS Version19.

Results: The prevalence of stunting, wasting and underweight was 32%, 31% and 27% respectively. Age above twelve months[OR 4.2CI 95 %( 2.12 -8.32)p<0.001], partner lack of financial support[OR2.093CI 95%(1.1- 3.97)p<0.024], chronic illness[OR 3.901CI 95%(2.21-6.87)p<0.001], low birth weight[OR3.537CI 95%(1.5- 8.1)p<0.003], rural residence[OR 2.65CI95%(1.23-5.07)p 0.013] were associated with stunting. Factors associated with wasting: partner lack of financial support[OR 2.0CI 95%(1.06- 3.78)p 0.032], prematurity[OR 2.115CI 95%(1.02-4.35)p0.042], employed mother[OR 2.174CI 95%(1.18- 3.97),p 0.012] and inadequate antenatal care visits[OR1.83CI 95%(0.97-5.55)p 0.031].

Conclusion: The high burden of under nutrition among COAM is of concern to parents, community and policy makers. Therefore, delaying teenage pregnancies, education on proper nutrition practices will reduce on the high burden.

Keywords: Malnutrition; teenage mothers; children of teenage mothers; Uganda; nutrition status.

Predictors of stunting among children aged 6-59 months in Kitui County, Kenya

Morris K Chui, Justus O Osero, Judy W Mugo — Sat, 11 Jan 2025 00:00:00 +0000

Background: Stunting in children below the age of five is a significant public health problem in Kenya. Stunting has transitory and lifelong effects on people and communities, including high risk of morbidity and death, lowered mental and physical growth, and decreased productivity.

Objective: To investigate the predictors of stunting in children aged 6 to 59 months in Kitui County, Kenya.

Methods: This was a cross-sectional analytical survey that used multistage cluster sampling. Data were gathered through questionnaires, interviews with key informants and discussions with focus groups. Anthropometric measurements were taken to assess the rate of stunting.

Results: The stunting rate was 26.6%. The independent predictors of stunting included birth weight < 2500 grams (AOR = 2.302; 95% CI: 1.027-6.150; p: 0.043), having secondary education (AOR = 5.404; 95% CI: 1.607-18.173; p: 0.006), mother’s MUAC < 23 cm (AOR = 2.845; 95% CI: 1.125-7.192; p:0.012), and having no access to a latrine/toilet (AOR = 0.008; 95% CI: 0.009-0.561; p: 0.013).

Conclusions: Stunting was high and was influenced by sociodemographic factors, and the household environment.

Keywords: Stunting; predictors; children.

Practices of lactating mothers regarding exclusive breastfeeding in Outapi district, Omusati region: a qualitative study

Veremunde Nikanor, Emma Maano Nghitanwa, Monika Nakweenda — Sat, 11 Jan 2025 00:00:00 +0000

Introduction: Breastfeeding exclusively for the first six months of a child's life is beneficial to the child's health and development.

Objectives: The study objectives were to determine and describe the practices of lactating mothers regarding exclusive breastfeeding and to determine the association between the overall level of practice and demographic characteristics.

Methods: The study employed a quantitative approach which utilised a descriptive- analytic design. The study population was all women in Outapi district breastfeeding babies aged 0 to 6 months. Data was collected from three clinic selected though cluster sampling and 200 participants were sampled through simple random sampling participated in the study. Data were collected in April 2022 using a questionnaire. Data was analysed using a Software Package for Social Science (SPSS VERSION 25.0). Frequency distribution tables and descriptive statistics were generated to summarise data and bivariate analysis was performed to determine the association between sociodemographic characteristics and the level of breastfeeding practices.

Results: The study found that, most 121 (60.5%) participants have poor practice on exclusive breastfeeding. Furthermore, the study found an association between the level of practice and babies’ age.

Conclusion: Poor practices regarding exclusive breastfeeding may negatively affect babies’ health. Therefore there is a need for reinforcement on the practice as well as health education on the benefits of exclusive breastfeeding. It is recommended that the Ministry of Health and Social Services in Namibia formulate a policy to enforce exclusive breastfeeding among women.

Keywords: Exclusive breastfeeding; practices; lactating mothers.

Prevalence of hearing loss among primary school children in Ethiopia

Sat, 11 Jan 2025 00:00:00 +0000

Objective: The objective of this study was to determine the prevalence of hearing loss in children attending primary schools in urban and rural Ethiopia.

Methods: A cross-sectional study was performed to determine the prevalence of hearing loss in children aged 7 to 14 years. A total of 384 children had complete examinations and were included in the study.

Results: The prevalence of hearing loss of all types in the urban school was 6.2% using a cut-off of 40 dB Fletcher index (500–2000 Hz). The prevalence increased to 10.2 % in the same population if a cut-off of 25 dB HL FI was used. In the rural school with a cut-off of 30 dB HL the hearing prevalence was 5.9%. The proportion of conductive hearing loss was lower in the urban school and constituted 16% of all hearing losses. We estimated the proportion of conductive hearing loss in the rural school to be at least 50% . In the urban school the prevalence of sensorineural hearing loss was 5.8% while it was much lower at 1.3% and exclusively unilateral in the rural school. The degree of hearing loss according to WHO criteria was calculated only for the urban population. A prevalence of bilateral severe hearing loss (≥61 dB HL) of 0.5% and of moderate hearing loss ( > 41 dB and ≤60dB HL) of 1% was found using WHO criteria.
The prevalence of chronic suppurative otitis media and of dry perforations were similar between schools (2.5 to 2.7%). Otitis media was rare in this study likely due to seasonal influences and exclusion of very young children. These results are compared to similar school studies in Sub-Saharan Africa.

Conclusions: The prevalence of hearing loss in these two Ethiopian cohorts (rural and urban) is in agreement with the data published by WHO for Sub-Saharan Africa. While some of the variation between urban and rural populations may have been real, some of the discrepancy may have resulted from differences in acoustic testing environments. We describe these challenges in hopes of improving universal screening procedures.

Keywords: Hearing loss; primary children; Ethiopia.