African Health Sciences

Editor’s choice: AHS reaches leaps and bounds

James K Tumwine — 2025-05-09

Nil.

Antimicrobial susceptibility pattern of pathogens isolated from surgical wound infections in tertiary care hospitals of Pakistan

Rashid Iqbal — 2025-05-09

Background: Antimicrobial susceptibility testing for post-surgical site infections is crucial amid rising cases and antibiotic resistance.
Objective: This study aimed to evaluate demographic factors, the occurrence of surgical wound site infections, pathogens associated with these infections, and antimicrobial susceptibility of the isolated pathogens.
Subjects and Methods: A cross-sectional study including 384 patients suffering from post-surgical site infections was conducted in tertiary care hospitals in Pakistan over six months.
Results: The study participants’ ages ranged from 7 to 74 years old, with a mean age (±SD) of 30.4 (±9.5) years, and 44.8% of them were female. Among 384 study subjects, bacterial pathogens were isolated from 295 (76.80%). The frequency of gram-negative was 58.75%, whereas the frequency of gram-negative was 41.25%. Methicillin-resistant Staphylococcus aureus (MRSA), (19%), Staphylococcus aureus (Staph aureus) (18.0%), and Escherichia coli (E. coli) (18.0%) were the most common organisms isolated from wound infections. A significant association was present between occupation and culture sensitivity with a p-value of 0.01. Most of the culture-positive population had appendectomy site infection (92.90%). MRSA had the highest sensitivity to vancomycin (89.8%) and the highest resistance to gentamicin (85.7%). Staph. aureus was most sensitive to imipenem (80%) and most resistant to gentamicin (68.4%). E. coli was most sensitive to imipenem (100%) and most resistant to ceftazidime (90%).
Conclusion: This study has provided a thorough description of the prevalence of gram-positive and gram-negative bacteria, as well as their relationships to wound type and demographic parameters.

Keywords: Antibiotics; gram-positive; gram-negative; sensitive; resistant.

Patterns of bacterial pathogens and their antimicrobial susceptibility from blood culture specimens in Wad Medani, Sudan: a four-year laboratory-based, cross-sectional study

Yousif B Hamadalneel — 2025-05-09

Background: Antibiotic-resistant bacterial bloodstream infections are rapidly emerging, which makes successful treatment challenging. Therefore, this study aimed to determine the patterns of bacterial pathogens and their antimicrobial susceptibility from blood culture samples.
Methods: This was a cross-sectional study. All clinical samples were collected from patients at Wad Medani and investigated at the Pathology Center for Diagnosis and Research, Faculty of Medicine, University of Gazira, Sudan, from the 1st of January, 2020, to the 15th of October, 2023.
Results: Overall, 577 blood samples were cultured. Among these samples, 86 (14.9%) exhibited bacterial growth. S. aureus (40.7%) and E. coli (40.7%) were the most frequently isolated bacteria. The most sensitive drugs to S. aureus were vancomycin 100% (13/13) and linezolid 86.7% (13/15), whereas the most sensitive drugs to E. coli were norfloxacin 88.9% (8/9), imipenem 85.7% (6/7), and levofloxacin 84% (21/25). The rate of bacterial growth has steadily increased over time, from 5% in 2020 to 24.9% in 2023.
Conclusions: This study revealed a modest rate of 14.9% of bloodstream infections, which has steadily increased over the years. The most frequently isolated bacteria were S. aureus and E. coli. Vancomycin was the most susceptible drug to isolated bacteria.

Keywords: Patterns; bacterial pathogens; antimicrobial susceptibility; blood culture; specimens; Wad Medani; Sudan.

Surgical site infections following emergency abdominal surgery: a prospective cohort study

Mert Adali — 2025-05-09

Background: Surgical site infection (SSI) is of major concern in surgical patients due to increased morbidity and mortality, prolonged hospital stay, increased need for intensive care, increased costs and hospital readmissions. The main objective of this study was to define the incidence and risk factors associated with SSI in patients undergoing emergency abdominal surgery.
Methods: This is a prospective cohort study. Patients over the age of 18 who underwent emergency abdominal surgery were included in this study. [ma1]Patients under 18 years of age, who underwent elective surgery and who underwent procedures outside the abdomen were excluded from the study. Wound assessments were performed according to ASEPSIS score.
Results: A total of 130 patients were included in the study. The incidence of SSI was found to be 10.0%. The prevalence of SSI was 27.5% (8/29) in patients operated for intestinal obstruction and 4.9% (5/101) in other patients (p=0.001). [ma2]Predictors[ma3] of SSI were open surgical approach, contaminated/dirty wound group, intestinal obstruction, colorectal surgery, increasing incision length[ma4] and age.
Conclusion: This study identified several independent risk factors for SSI after emergency abdominal surgery that need to be addressed.

Keywords: Abdominal surgery; ASEPSIS; Emergency surgery; Surgical site infection.

Abscess of the ligamentum teres hepatis and Arantius’ ligament: a case report

Xiaopeng Suo — 2025-05-09

Simultaneous abscesses of the ligamentum teres hepatis and Arantius’ ligament are an extremely rare entity. The ligamentum teres hepatis (LTH) and the Arantius ligament are formed by the regression of the umbilical vein and venous ducts during embryonic period and are normally atretic in adulthood, which may recanalize in the case of portal hypertension. Even if the ligament is recanalized, in most cases only blood flows through it. It is very rare for abscesses to occur in these ligaments. Here we present a case with simultaneous LTH abscess and Arantius ligament abscess, a condition that has never been reported before. A 72-year-old female patient complained of epigastric discomfort and was diagnosed with an intra-abdominal tubular mass, which was confirmed to be the thickened LTH and Arantius ligament during operation. Postoperative specimens showed pus in the ducts and histopathological examination confirmed that the mass was the inflamed ligament. The patient's symptoms disappeared after the operation and there was no recurrence after 19 months of follow-up. Postoperative case data and related literature were reviewed. We here described in detail the characteristics and possible etiology of the disease.

Keywords: Ligamentum teres hepatis; Arantius’ ligament; Abscess; Case report.

Possible link between Toxoplasma gondii and neurodegenerative diseases

Rugıyya Samadzade — 2025-05-09

Background: Toxoplasma gondii is one of the most common causes of zoonotic parasitic diseases in the world. Neurodegenerative diseases (Parkinson's, Alzheimer's, Multiple Sclerosis) are relatively common and create significant social and health problems. As a result of the studies, it has been hypothesized that the neuro-inflammation caused by Toxoplasma gondii may be responsible for the development of various neurodegenerative diseases.
Objective: Serum samples of 300 patients with neurodegenerative diseases and 100 healthy volunteers were evaluated for the presence of Toxoplasma gondii IgG and IgM antibodies by Electrochemiluminescence method. A sociodemographic questionnaire was applied to the patients. Results were evaluated statistically.
Results: Toxoplasma gondii IgG positivity was detected in 172 (57.3%) of 300 serum samples taken from the patient groups. Seropositivity was found in 42 (24.4%) patients with multiple sclerosis, 60 (34.9%) patients with Parkinson's disease and 70 (40.7%) patients with Alzheimer's disease. In the control group IgG was positive in 36 (36 %) subjects but IgM antibody positivity was not detected.
Conclusions: According to the study results, there was a statistically significant relationship between the presence of Toxoplasma gondii seropositivity and Parkinson's and Alzheimer's diseases, but there was no a statistically significant relationship in multiple sclerosis patients.
Keywords: Alzheimer's disease; Electrochemiluminescence; Multiple Sclerosis; Parkinson’s disease; Toxoplasma gondii.

Seroprevalence and associated risk factors of Toxoplasma gondii among pregnant women in Ain Defla, northwest Algeria

Asma Dahmani — 2025-05-09

Background: Toxoplasma gondii (T. gondii) is a serious public health issue, but limited data has been published to date on the seroprevalence of T. gondii infection in Algeria.
Objectives: The aim of this study was to determine the seroprevalence and associated risk factors of T.gondii infection among pregnant women in Ain Defla, northwest Algeria.
Methods: Blood samples were collected from 300 pregnant women. Serum samples were analyzed to detect T. gondii antibodies (immunoglobulin M and immunoglobulin G) via the enzyme-linked immunosorbent assay (ELISA) technique. Risk factors associated with T.gondii infection was assessed through structured questionnaire.
Results: The overall seroprevalence of T.gondii infection was 32.03%. Seropositivity for IgG only was 22.78%, IgM only was 2.14% and cooccurrence of IgG/IgM was 7.12%. Pregnant women who lived in rural areas (OR= 1.739 ; 95%CI: 1.009–2.997; P=0.045),eat raw vegetables (OR=2.659; 95%CI: 1.575–4.488; P<0.0001), who drunk tap water (OR=3.806 ; 95%CI: 2.248–6.442; P<0.0001),were in contact with soil (OR= 2.836; 95%CI: 1.620– 4.967; P<0.0001) and have not meals at home (OR=3.221 ; 95%CI: 1.864 – 5.565 ; P<0.0001) were significantly at risk of infection with T. gondii.
Conclusion: Our findings emphasize the need for higher awareness of T. gondii infection in Algeria. Public education and serological screening programm should be recommended.

Keywords: T.gondii infection; Pregnancy; Seroprevalence; Antibodies; Risk Factors.

Investigation of Blastocystis spp. in patients with inflammatory bowel disease by direct microscopy and molecular methods

Şentürkoğlu Feride — 2025-05-09

Background: Blastocystis spp. is a single-celled, eukaryotic protozoan parasite that lives in the intestinal tract of human and animal hosts.
Objectives: The aim of this study is to investigate the relationship between Inflammatory Bowel Diseases and Blastocystis spp.
Methods: Crohn's disease (n:25), Ulcerative Colitis patients (n:30) and healthy individuals (n:30) included into the study. Stool samples were investigated by direct microscopic examination and real time PCR method.
Results: Blastocystis spp. was detected in five (16.6%) of Ulcerative Colitis , one (4%) of Crohn's disease, and one (3.3%) of the healthy control group by direct microscopy. Blastocystis spp. DNA was detected in seven (23.3%) of Ulcerative Colitis, one (4%) of Crohn's disease and one (3.3%) of the healthy control group by real time PCR method.
Conclusions: The prevalence of Blastocystis spp. was found to be higher in Ulcerative Colitis patients (23.3%) than in Crohn's disease (4%) and healthy controls (3.3%). According to these results, it has been shown that there may be a possible relationship between Ulcerative Colitis and Blastocystis spp.

Keywords: Blastocystis spp; Crohn's Disease; Ulcerative Colitis.

Associated factors of Nigerian Nurses' Emotion regulation, perceived stress, and coping mechanism during COVID-19 Pandamic: a cross-sectional study

Blessing Agbonselohbor — 2025-05-09

Background: Nursing, marked by its demanding nature, often exposes professionals to elevated stress levels and emotional hurdles. Recognizing the determinants shaping nurses' stress, emotional regulation, and coping mechanisms is imperative for fostering their welfare and maintaining superior patient care standards.
Objective: This study aimed to explore the correlation between socio-demographic and workrelated factors and nurses' perceived stress, emotional regulation, and coping mechanisms.
Methods: A cross-sectional study encompassing 200 nurses in Nigeria was conducted. Participants completed questionnaires evaluating socio-demographic details, the Perceived Stress Scale (PSS), Emotion Regulation Questionnaire (ERQ), and Coping Mechanism Scale. Statistical analyses, comprising t-tests and ANOVA, were employed to scrutinize variable associations.
Results: Participants exhibited a mean score of 27.1 (±3.7) (out of 40) on the PSS, indicating heightened stress levels. Notably, cognitive reappraisal scored 32.2 (±5.2) (out of 42) on the ERQ, while expressive suppression scored 23.4 (±3.8) (out of 28), with a total ERQ score averaging 55.5 (±9.8) (out of 70), indicating moderate emotion regulation. Furthermore, participants scored 78.1 (±10.7) (out of 112) on the Coping Mechanism Scale, suggesting frequent utilization of coping strategies. While gender, age, religion, and employment status showed no significant correlations with stress levels, factors such as educational attainment, number of children, years of experience, department worked in, job position, and work environment satisfaction displayed noteworthy relationships. Various socio-demographic and work-related factors, including the number of children, years of experience, department worked in, and job position, demonstrated significant relationships with nurses' emotional experiences and coping strategies.
Conclusion: The study underscores the intricate interplay between socio-demographic and work-related factors in shaping nurses' stress, emotional regulation, and coping mechanisms. Interventions tailored to address these factors and cultivate supportive work environments are vital for safeguarding nurses' well-being and upholding exceptional patient care standards.

Differentiated service delivery strategies to optimize modern contraceptive uptake among adolescents with HIV in Northern Uganda

Harriet Ajilong — 2025-05-09

Background: In sub-Saharan Africa, contraceptive use among adolescents in 2014 ranged from 21–42% with an unmet need of 53–64%. Therefore, client-centered strategies like the differentiated service delivery (DSD) model should be explored to improve contraceptive use among adolescents in northern Uganda.
Methods: An exploratory mixed-methods study was conducted in HIV positive adolescents 12-19 years at Gulu hospital. Structured questionnaires were used to obtain information on contraceptive use, and the most convenient mode of delivery. Selected key informants identified specific delivery strategies potentially associated with higher contraceptive uptake.
Results: Of the 193 respondents who participated in the study, 108(56%) were females with a mean age of 15 years. Approximately 20% of the respondents were sexually active. Ever use of modern contraceptives was low at 16% because only a small percentage (approximately 20%) were sexually active. Most participants, 54/193 (40%) preferred accessing contraceptives from the adolescent clinic from health workers and peer supporters. Factors associated with increased contraceptive use were tertiary levl education and employment. From qualitative analysis participants recommended separation of adolescent services, peer support and community outreaches to improve uptake.
Conclusion: The contraceptive prevalence rate among HIV-positive adolescents is still low. Contraceptive use is higher among the educated or employed. Services should be provided at adolescent-friendly clinics by trained health workers and peers during school holidays.

Keywords: Modern contraceptive methods, HIV-positive adolescents, Differentiated Service Delivery Strategies.

Kidney Disease in HIV Infected Children on HAART in Nigeria

Marcia M Ihekaike — 2025-05-09

Background: In Nigeria, HIV/AIDS contributes to leading causes of morbidity and mortality and children living with HIV on HAART tend to live longer therefore, they are more likely to develop kidney diseases.
Objective: This study aimed to evaluate the prevalence of kidney diseases in HIV-infected children and identify potential risk factors with a specific focus on antiretroviral regimens.
Methods: A cross-sectional study conducted in a cohort of 121 consecutive children with HIV/AIDS on HAART. Serum creatinine level was determined and the estimated GFR was calculated using modified Schwartz formula. Kidney disease was defined as eGFR <90 mL/min/1.73 m2 and or dipstick proteinuria ≥1+.
Results: This study included 65 (53.7%) females and 56 (46.3%) males with mean age of 10.8 ± 4.3 years. The children were all on antiretroviral medication. Proteinuria was observed in 7 (5.8%) of the participants, 6 (5.0%) had mild reduction of eGFR, and 1 (0.8%) each had moderately and severely reduced eGFR. A statistically significant association was observed between renal disease and high viral load, as well as the use of an abacavir or tenofovir-based regimen.
Conclusion: These findings emphasize the importance of regular kidney function monitoring and tailored antiretroviral therapy selection in the management of HIV-infected children.

Keywords: HIV; kidney disease; HAART; Nigeria.

High seropositivity of Mumps Virus IgG antibodies in unvaccinated population of Mwanza, Tanzania: a community-based study

Mariam M Mirambo — 2025-05-09

Background: Mumps virus (MuV) infection has been associated with significant morbidities across the globe. Despite being endemic in most of low- and middle-income countries including Tanzania, it has not been included in routine immunization in many sub-Saharan countries. This study reports MuV IgG seropositivity in different communities of Mwanza, the information that might be useful in devising evidence-based control measures.
Methodology: A laboratory based cross-sectional study was conducted from July to August 2022, involving 276 archived plasma collected from Misungwi, Ukerewe and Magu districts. Socio-demographic information and other relevant information were extracted from database. Indirect Enzyme-Linked Immunosorbent Assay (ELISA) was used to detect MuV IgG antibodies. IBM SPSS version 23 was used for data analysis.
Results: The median age of the participants was 36(Interquartile range (IQR):26-42) years. The overall seropositivity of MuV IgG antibodies was found to be 262 out of 276 (94.93%, (95% Cl:91.59-96.98), highest among age group between 15-24. None of the factors was found to be associated with MuVIgG seropositivity in Mwanza.
Conclusion: MuV IgG seropositivity is alarmingly high in Mwanza suggesting the virus is endemic and might be associated with morbidities. This calls for the need to scale up the serological studies so as to provide evidence for intervention.

Keywords: Mumps; Unvaccinated population; Mwanza; Tanzania.

Prevalence and correlates of Hepatitis B and C infections in Sickle cell anaemic (SCA) children compared to Controls in a Tertiary Hospital, Abakaliki, Southeast, Nigeria

Samuel Amechi Nwukor — 2025-05-09

Background: Practices among sickle cell anaemic (SCA) children may increase their risk of infection with blood-borne viruses. The study aimed to determine the prevalence and correlates of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among children with SCA compared to controls.
Methods: A hospital-based cross-sectional study that involved 200 children with SCA and 200 non-SCA children (controls). Information was obtained using an interviewer-administered questionnaire. Screening for hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus (anti-HCV) was done using Smartcare® rapid diagnostic tests (RDT) kits for HBV and HCV. Data was analyzed using the Statistical Package for Social Science (SPSS) version 22. P<0.05 was considered statistically significant.
Results: Five (2.5%) and 21 (10.5%) of the SCA children recruited into the study were positive for HBsAg and anti-HCV respectively, compared to 2(1.0%) and 13 (6.5%) observed in controls. The Logistic regression analysis revealed that female gender (AOR=3.39, 95%CI=1.20-9.57, p=0.016), age (AOR=0.88, 95%CI=0.79-0.99, p=0.033), and multiple ear piercings (AOR=1.93, 95%CI=1.17-21.59, p=0.021) were correlates of HCV infection among study participants.
Conclusion: A high prevalence rate of HCV infection was observed among children with SCA and was significantly associated with a modifiable variable.

Keywords: Case-controls; Correlates; Hepatitis B virus; Hepatitis C virus; Prevalence; Sickle cell anaemia.

Establishment and validation of a predictive model for severe pneumonia in children

Wenhua Ye — 2025-05-09

Background: This study aimed to develop a model for the early identification of severe pneumonia in children by comparing common laboratory indicators between children with ordinary pneumonia and severe pneumonia.
Methodology: Children aged 1 month to 14 years, diagnosed with pneumonia and admitted to our hospital between January 2017 and June 2022, were included in the study. Participants were divided into two groups based on the severity of their pneumonia. Data, including demographic information, medical history, clinical symptoms, laboratory indicators, and treatment outcomes, were collected from the hospital's medical records system.
Results: The single-factor analysis revealed significant differences (P < 0.05) between the two groups in various parameters, including age, length of hospital stay, repeated hospitalization within 90 days, invasive ventilation, Intensive Care Unit (ICU) stay time, birth history, temperature, respiratory rate, blood pressure, procalcitonin, and C-reactive protein. Binary logistic regression analysis indicated that high body temperature and high respiratory rate were independent risk factors for severe pneumonia (P < 0.05).
Conclusion: A predictive model for severe pneumonia in children can identify the risk of progression to severe disease, enabling prompt treatment and improving patient prognosis. This reduces the burden on families and social security.

Keywords: Predictive model; severe pneumonia; children.

Diagnostic reference levels in Africa: a protocol for systematic review and meta-analysis

Ademola Joseph Adekanmi — 2025-05-09

Background: Despite its wide acceptance and recommendation as an essential tool for radiation exposure optimization and the increasing influx of high-technology imaging facilities, there is still a paucity of available data on the Diagnostic reference level (DRL) of ionizing radiation radiological examinations and its use in many African countries.
Objectives: This review aims to evaluate published work on DRLs in Africa and to establish the status of DRL in common radiological examinations in Africa.
Methods: The electronic databases, namely; Embase, PubMed, Scopus, Google Scholar, CINAHL, AJOL, and Web of Science, will be searched using a developed search strategy to include only published articles and survey studies retrieved in English from 1996 to December 2022. Information to be extracted will include the World Bank income level, World Bank geographical region, country of origin, research sponsorship, year of publication, age group of the patients, imaging modality, local/regional/ national DRL, type of examination, study design, type of DRL quantity, and whether DRLs were established as the 75th percentile or mean of the median or mean of DRL quantity measured. Descriptive statistics will be formulated and a narrative synthesis of the information from selected studies measured. If required, we will include a subgroup analysis based on the income level of the countries, geographical regions, and year of publication.
Results: This study will provide information on the status of diagnostic reference levels of common radiological examinations in Africa.
Conclusion: The result of this study will be useful in healthcare policymaking and by the end-users of medical radiation facilities, thereby ensuring the optimization of radiation exposure in patients undergoing medical ionizing-radiation imaging.

Keywords: Diagnostic reference levels; Medical exposure; Radiation Dose.

MicroRNA-9-5p regulates apoptosis of human osteoarthritis chondrocytes through suppressing TnC

Xinming Yi — 2025-05-09

Background: Osteoarthritis (OA) is one of the most common degenerative diseases, with obesity being one of the main contributing factors. MicroRNAs (miRNAs) have been shown to regulate gene expression and improve OA, making them a promising target for future treatment strategies.
Methodology: We measured the expression levels of miR-9-5p and Tenascin C (TnC) using quantitative Real-time PCR. We examined the effect of miR-9-5p overexpression/silencing on chondrocytes using Western blot analysis to assess protein levels and quantitative Real-time PCR analysis to assess gene expression of TnC, Bax, and Bcl-2. We also performed a dual luciferase reporter gene assay to investigate the correlation between miR-9-5p and TnC targeting regulation.
Results: We validated successful overexpression/inhibition of miR-9-5p compared to negative control (NC) using quantitative Real-time PCR. We found that the expression of TnC and Bax protein was significantly decreased in the mimic+Model group compared to the model group, while Bcl-2 protein was significantly increased in the mimic+Model group. In contrast, we observed the opposite effect in the inhibitor+Model group. Moreover, our results suggested that upregulation of miR-9-5p decreased the expression of inflammatory factors.
Conclusion: miR-9-5p inhibits chondrocyte apoptosis by targeting TnC, offering a therapy target for OA treatment.Our study indicates that miR-9-5p plays an important role in the regulation of OA chondrocytes and can inhibit cell apoptosis by negatively targeting TnC, providing a promising therapy target for the treatment of OA.

Keywords: microRNA-9-5p; apoptosis; osteoarthritis; TnC.

Inhibition of Nuclear factor kappa B ameliorates bone destruction and osteoclastogenesis in collagen-induced arthritis mice

Jiangtao Guo — 2025-05-09

Background: We aimed to investigate the effect of interleukin-1β (IL-1β)/nuclear factor κB (NF-κB) pathway on osteoclastogenesis and inflammatory bone destruction in a mouse model of collagen-induced arthritis (CIA).
Methodology: DBA/1 mice were divided into CIA group, NF-κB inhibitor group and control group. The degree of paw edema was measured and the score of paw arthritis was assessed. mRNA levels of IL-1β, matrix metalloproteinase-1 (MMP-1), tumour necrosis factor-α (TNF-α) levels, anti-tartrate acid phosphatase (TRAP), matrix metalloproteinase-9 (MMP-9), tissue proteinase K (CtsK) and integrin β3 (β3-Integrin) in the joints of mice were determined.
Results: The paw edema score at 18-30 d and the paw arthritis score at 12-30 d in CIA group were higher than those in control group, and the paw edema score and paw arthritis score at 24-30 d in NF-kB inhibitor group were lower than those in CIA group. mRNA levels of IL-1β, MMP-1, TNF-α in serum and TRAP, MMP-9, CtsK and β3-Integrin in joint tissues in CIA mice were higher than in controls. NF-κB inhibitor treatment significantly decreased the above mRNA levels both in serum and joint tissues.
Conclusion: NF-κB pathway inhibition can ameliorate bone destruction in the foot joints of CIA mice, which may be related to the reduction of inflammatory bone destruction and osteoclastogenesis.

Keywords: Collagen induced arthritis; osteoclasts; bone destruction; inflammatory response; interleukin-1β; nuclear factor κB

Mild hypothermia (35°C) reduces myocardial ischemia-reperfusion injury and attenuates hypoxia induced apoptosis of H9C2 cardiomyocytes by changing the phosphorylation level of Connexin43 (Cx43) protein

Yuanming Lu — 2025-05-09

Background: The purpose of this study was to investigate the effect of connexin 43 (Cx43) on myocardial cell apoptosis under mild hypothermia and its potential for treating ischemia reperfusion injury.
Methodology: In vivo experiments were conducted on rats, using an ischemia-reperfusion model, small animal ultrasound imaging system, and relevant biochemical assays to measure myocardial function, infarction area, and tissue damage. In vitro experiments were performed on H9C2 cells using an oxygen-glucose deprivation and recovery model, and various assays were used to assess cell viability, apoptosis, and biochemical changes.
Results: Mild hypothermia (35°C) was found to reduce ischemia-reperfusion injury, enhance myocardial function, decrease infarction area, and increase the expression of phosphorylated Cx43 and protein kinase C in myocardial tissue. In vitro, mild hypothermia enhanced cell viability, decreased gap junction permeability, downregulated pro-apoptotic factors, and upregulated anti-apoptotic factors, while also increasing the levels of calcium and superoxide dismutase and decreasing the level of malondialdehyde.
Conclusions: Mild hypothermia can protect against myocardial ischemia-reperfusion injury by regulating the level of phosphorylated Cx43 protein, which reduces myocardial cell apoptosis and enhances cardiac function. This study highlights the potential therapeutic benefits of mild hypothermia in treating ischemia-reperfusion injury.

Keywords: Mild hypothermia; Cx43; ischemia reperfusion; hypoxia; apoptosis.

Assessment of the complaints and the hospital application of patients with acute coronary syndrome, and the patient’s knowledge and behaviors regarding the management of cardiovascular risk factors

Busra Zehra Buyukkilic — 2025-05-09

Background: This research was carried out to determine the complaints and duration of hospital admission of patients with acute coronary syndrome (ACS) and to evaluate their healthy lifestyle behaviors related to the management of cardiovascular risk factors.
Methodology: This is a descriptive cross-sectional study. The study sample consisted of 202 patients diagnosed with ACS from September 2022 to August 2023. Data were collected using the Hospital Admission and Symptom Assessment Survey, Cardiovascular Disease Risk Factor Diagnostic Survey, Healthy Lifestyle Behaviors Scale II (HPLP II), and Cardiovascular Disease Risk Factors-Knowledge Level (CARRF-KL) scale.
Results: The median duration of decision-making for admission to the hospital was 40 minutes, and the mean duration until arrival at the hospital was 17.35 ± 9.76 minutes. There was no statistically significant difference between the duration of admission decisions according to the association of cardiac complaints with heart disease (p > 0.05). The CARRF-KL total scale mean score was calculated to be 19.98 ± 4.41, and the HPLP II total scale mean score was 107.69 ± 18.09. A positive and statistically significant correlation was found between CARRF-KL total scale and HPLP II total scale scores (r = 0.49, p < 0.05).
Conclusion: Although the duration of admission to the hospital for individuals diagnosed with ACS was within the period recommended by the guidelines, it is noteworthy that they did not associate their complaints with heart defects in their decisions to be admitted to the hospital.

Keywords: Acute coronary syndrome; hospital admission; cardiovascular risk factors; knowledge; behaviors.

The efficacy and safety of transcatheter aortic valve replacement in elderly patients with aortic stenosis

Jinghui An — 2025-05-09

Background: Transcatheter aortic valve replacement (TAVR) is a promising treatment for aortic stenosis (AS). However, few clinical studies have concentrated on the application of TAVR in elderly AS patients. This study aimed to explore the efficacy and safety of TAVR in elderly patients with AS.
Methods: Clinical and imaging data of 143 AS patients undergoing Transcatheter aortic valve replacement were retrospectively analyzed. These patients were divided into non-elderly group (< 65 years old) and elderly group (65 years old), and the baseline characteristics and clinical outcomes were compared between the two groups.
Results: The baseline characteristics showed no significant difference between the two groups. After surgery, echocardiography revealed that the forward flow velocity of aortic valve was higher in the non-elderly group than that in the elderly group (234.2 49.8 cm/s vs. 209.957.7 cm/s, P=0.022), while there was no significant difference in other indicators. The operation time (197.463.5 min vs. 194.267.8 min, P=0.811), length of hospital stay (14.07.3 days vs.14.27.6 days, P=0.874), incidence of perioperative complications (2.2% vs. 4.1%, P=1.000), and mortality rate (0.0% vs. 1.0%, P=1.000) sho wed no significant differences between the two groups.
Conclusion: Transcatheter aortic valve replacement is an effective and safe therapeutic approach for elderly patients with aortic stenosis.

Keywords: Valvular heart disease, Aortic stenosis; Elderly patients; Transcatheter aortic valve replacement, Echocardiography.

Value of cerebrovascular hemodynamics and thromboelasto¬gram-related parameters in evaluating the effect of Naomai Jiejing Decoction on the rehabilitation of patients with aneurysmal subarachnoid hemorrhage

Xuetao Wang — 2025-05-09

Background: To explore the value of cerebrovascular hemodynamic and thromboelastogram-related parameters in evaluating the effect of Naomai Jiejing Decoction (NJD) on the rehabilitation of patients with Aneurysmal subarachnoid hemorrhage (aSAH).
Methodology: This article is observational studies.This study compared cerebrovascular hemodynamics, thromboelastogram results, and rehabilitation outcomes between a research group (treated with Naomai Jiejing Decoction) and a control group (not treated with Naomai Jiejing Decoction) of 160 patients with Aneurysmal subarachnoid hemorrhage. Logistic regression analysis explored associations between poor rehabilitation outcomes and hemodynamic/ thromboelastogram-related parameters in the research group.
Results: At 12 months after operation, the measured hemodynamics values were lower in research group than those in control group, and the differences were statistically significant (P<0.05). Patients with good rehabilitation outcomes had lower measured hemodynamics values than those with poor rehabilitation outcomes. The results of Logistic regression analysis showed that the high values in hemodynamics and thromboelastogram examinations were risk factors for poor rehabilitation outcomes in research group (P<0.05).
Conclusion: Monitoring cerebrovascular hemodynamic and thromboelastogram-related parameters in patients with Aneurysmal subarachnoid hemorrhage receiving Naomai Jiejing Decoction treatment can offer valuable prognostic and therapeutic insights, with improvements correlating to better rehabilitation outcomes, underscoring their significance in assessing intervention effectiveness.

Keywords: Aneurysmal subarachnoid hemorrhage; cerebrovascular hemodynamics; thromboelastogram; Naomai Jiejing Decoction; rehabilitation outcome; clinical efficacy.

Anti-oxidative enzymes, cardiovascular disease risk factors, and adipokines in Nigerian women on oral and implant contraceptives

Bassey Iya — 2025-05-09

Background: Increased use of oral contraceptives and implants has necessitated the need to examine biochemical changes associated with their use.
Objectives: This study assessed insulin resistance, lipid profile, superoxide dismutase, glutathione peroxidase, adiponectin and leptin levels in women using oral and implant contraceptives in Calabar.
Methods: Ninety women aged 18-45years were recruited for this case-control study. Thirty of them women were on oral contraceptives, 30 on implants and the remaining 30 were controls. Total cholesterol (TC), VLDL-cholesterol (VLDL-C), HDL-cholesterol (HDL-C), triglycerides, glucose, insulin, superoxide dismutase, glutathione peroxidase, adiponectin and leptin were analyzed by standard methods. Body mass index (BMI), Insulin resistance (HOMA-IR),
Atherogenic index of plasma (AIP) and LDL-cholesterol (LDL-C) were calculated. Data was analyzed by Multivariate Analysis of Variance, Bonferrori Post Hoc test and Pearson’s correlation. Significance was set at <0.05.
Results: The oral contraceptive users had significantly higher BMI (p=0.003), TC (p=0.004), HDL-C (p=0.000), Insulin (p=0.019), Leptin (p=0.000) and Adiponectin (p=0.049) than controls. Implant users had a significantly higher (p=0.000) BMI, TC, HDL-C LDL-C, Insulin, HOMA-IR, FPG (p=0.018) and Leptin (p=0.022) with significantly lower TG (p=0.003), VLDL-C (p=0.000) and AIP (p=0.003) compared to controls. There was a significant positive correlation between the duration of contraceptive use with LDL-C in implant users (r=0.366, p=0.046).
Conclusions: Oral contraceptive use may be associated with weight gain while implant use may lead to derangement in carbohydrate, lipid metabolism and weight gain. This suggests the need for appropriate client profiling before recommending a contraceptive method, especially for those with pre-existing conditions.

Keywords: Oral contraceptives; contraceptive implants; oxidative stress markers; lipid profile; adiponectin; leptin; black women.

Effect of IIFAR information nursing model and comprehensive rehabilitation training on negative emotions and rehabilitation outcomes in elderly hemiplegic stroke patients

Yinli Duo — 2025-05-09

Background: We aimed to investigate the effects of the IIFAR (initial check, information exchange, final accuracy check, reaction) nursing model and comprehensive rehabilitation training on negative emotions and rehabilitation outcomes in elderly stroke patients with hemiplegia.
Methodology: Forty elderly stroke patients with hemiplegia were divided into two groups: the control group received comprehensive rehabilitation training intervention, while the observation group received IIFAR information nursing model intervention. Both groups were assessed for disease uncertainty, negative emotions, mindfulness level, balance, and limb movement ability before and after the intervention.
Results: After the intervention, both groups experienced a significant decrease in the complexity, ambiguity, lack of information, unpredictability, State Anxiety Inventory, Trait Anxiety Inventory, and total score of the State-Trait Anxiety Inventory scale. However, the observation group had lower scores than the control group. Furthermore, after the intervention, both groups saw a significant increase in scores, but the observation group had higher scores than the control group. Lastly, after the intervention, the observation group had significantly higher scores than the control group.
Conclusion: The use of the IIFAR information nursing model combined with comprehensive rehabilitation training can improve the disease uncertainty and negative emotions of elderly stroke patients with hemiplegia, and enhance their mindfulness level and balance movement ability.

Keywords: IIFAR information nursing; comprehensive rehabilitation training; elderly; stroke with hemiplegia; negative emotions.

Effects of ultrasound-guided nerve block combined with PCIA analgesia on postoperative pain, inflammatory response, hospital stay, and adverse reactions in breast cancer surgery

Xiaojuan Zhou — 2025-05-09

Background: This study aimed to evaluate the effects of ultrasound-guided combined nerve block with patient-controlled intravenous analgesia (PCIA) on postoperative pain, inflammatory response, hospital stay, and adverse reactions in breast cancer surgery.
Methodology: A total of 100 patients undergoing radical mastectomy for breast cancer were randomly assigned to two groups. The combined group received ultrasound-guided thoracic nerve block with PCIA, while the PCIA group received PCIA alone. Visual Analogue Scale (VAS) scores for pain were assessed postoperatively at intervals, and levels of inflammatory response markers (IL-6, TNF-α, hs-CRP) were compared before and after surgery. Analgesic efficacy, sufentanil dosage, hospitalization conditions, and safety profiles were recorded.
Results: The combined group exhibited significantly lower VAS scores for resting and active pain at various postoperative time points compared to the PCIA group. Inflammatory markers at 48h post-surgery were notably lower in the combined group. Sufentanil consumption, analgesia pump use, rescue analgesia rate, and duration of effective pain relief were all improved in the combined group (P<0.05).
Conclusions: Ultrasound-guided nerve block combined with PCIA effectively reduced analgesia pump usage, alleviated postoperative pain, and suppressed inflammatory marker expression. However, it showed minimal impact on hospital stay and adverse reactions, making it a promising strategy for postoperative pain management in breast cancer surgery.

Keywords: Ultrasound-guided; thoracic nerve block; patient-controlled intravenous analgesia; breast cancer; inflammatory factors; adverse reactions.

Diagnostic value of the cardiophrenic lymph nodes in gastric peritoneum metastases

Xiaolong Gu — 2025-05-09

Background: The presence of cardiophrenic lymph nodes (CPLN) was potentially associated with peritoneal involvement in patients with abdominal malignancies. In this study, gastric cancer patients were investigated for the relationship between CPLN and peritoneum metastases.
Methodology: Peritoneal exploration was performed on 516 gastric cancer patients between 2017 and 2019, including 134 (26%) with peritoneal metastases (PM). An univariate and multivariate analysis of preoperative computed tomography (CT) scans was conducted to assess the association between CPLN and confirmed PM.
Results: Among the factors associated with CPLN in the univariate analysis, PM accounted for the strongest association (P < 0.001). In the multivariate analysis, PM was the only independent factor associated with CPLN (odds ratio [OR], 7.8; 95% confidence interval [CI], 4.6 ~ 13.0; P < 0.001). CPLN was significantly more common in the 38 patients with classic signs of PM compared to the 96 patients without visible signs of PM (36/38 [95%] versus 76/96 [79%]). CT scan sensitivity rose from 28% (38/134 patients) to 85% (114/134 patients) with CPLN detection added to other diagnostic signs of PM.
Conclusion: Detecting CPLN on CT was a valuable tool for diagnosing peritoneal metastases of gastric cancer.

Keywords: Cardiophrenic lymph nodes; Gastric cancer; Peritoneum metastases; Exact diagnosis.

Sequential dilatation of two balloons and double D-J stents for therapy of ureteroenteral anastomotic stricture in patients following radical cystectomy and Bricker urinary diversion

Ning Liu — 2025-05-09

Background: To determine the safety and efficacy of successive retrograde dilatation of two balloons and a double D-J stent for the treatment of ureteroenteral anastomotic strictures in patients who had undergone radical cystectomy and Bricker urinary diversion.
Methodology: A total of 25 patients with ureteroenteral anastomotic stricture following radical cystectomy and Bricker urinary diversion were treated with sequential dilatation of two balloons (F18 and F24), while the remaining other 32 patients were only dilated once. All patients were treated with ureteroscope or flexible ureteroscope-guided retrograde implantation of twin D-J stents (F5).
Results: Sequential dilation required significantly longer hospital stay and surgery time than single dilation. When sequential dilatation was compared to single dilatation, both the length of stay and the time it took to do the operation were clearly longer. After a follow-up of 6 to 24 months, the success rate of sequential dilatation was 61.5%, in comparison to 58.847.1% for single dilatation (P=0.83<0.05). All patients did not appear to have serious complications, such as hemorrhage, intestinal injury, or egression of the stent. No serious complications occurred in all patients, such as hemorrhage, intestinal injury, or egression of the stent.
Conclusion: Sequential retrograde dilatation with two balloons and double D-J stents is thought to be safe and effective for uretero-intestinal anastomotic strictures in patients having with brick ureteral diversions, and it is associated with fewer sequelae. It is worthwhile for clinical purposes.

Keywords: Bricker; Ureteroenteric anastomosis; Stricture; Dilatation.

Pattern of gastrointestinal malignancies in a suburban centre in Southern Nigeria

Esteem Tagar — 2025-05-09

Background: Recent studies in sub–Saharan Africa have suggested an increasing incidence of gastrointestinal malignancies which consequently poses significant public health burden in terms of morbidity and mortality.
Objective: This study was carried out to assess the distribution, clinical presentation, and histopathological characteristics of gastrointestinal malignancies in a tertiary health centre in Southern Nigeria.
Methods: A retrospective review of all patients with histologic diagnosis of gastrointestinal malignancy in a tertiary health institution in Southern Nigeria between January 2013 and December 2022.
Results: A total of 104 patients were included in the study. There were 64 males and 40 females with a male to female ratio of 1.6:1 and the peak age group was 41-50 years. The commonest sites affected were the colon and rectum (63.5%), followed by the stomach (22.1%). Adenocarcinoma was the predominant type of gastrointestinal malignancy, comprising 87.5% of the cases with most of them well differentiated. Others included sarcoma (6.7%), squamous cell carcinoma (1.9%), neuroendocrine tumour (1.9%), lymphoma (1%), and plasmacytoma (1%).
Conclusion: Colon and rectal cancers were the predominant gastrointestinal malignancies with a male preponderance, and individuals between 41-50 years, who constitute the bulk of the country’s workforce, were more affected. It is imperative to develop strategies aimed at reducing the incidence and fatality.

Keywords: Gastrointestinal malignancies; colon; rectum; cancers; adenocarcinoma.

Effect of nursing procedure-oriented comprehensive nursing on negative emotion and self-care ability of renal transplant recipients after operation

Yan Wang — 2025-05-09

Background: To explore the effect of nursing process-oriented comprehensive nursing on postoperative negative emotions and self-protection ability of kidney transplant recipients.
Methodology: A total of 80 patients after kidney transplantation were selected from June 2020 to May 2022 in our hospital as the research object, and were divided into control group (40 cases) and observation group (40 cases) by taking the time of carrying out nursing program-oriented comprehensive nursing in our hospital (June 2021 to May 2021, routine nursing). The emotional state [Hamilton Anxiety and Depression Scale (HAMA), (HAMD)], self-care ability and nursing satisfaction were compared between the two groups.
Results: After intervention, the emotional state HAMA and HAMD scores in the observation group were lower than those in the control group, and knowledge level, self-concept, self-responsibility, self-care score and total satisfaction rate were higher than those in the control group, with statistical significance (P<0.05).
Conclusion: Nursing procedure-oriented comprehensive nursing care can help renal transplant recipients relieve negative emotions quickly, increase patients' postoperative self-care ability, and increase patient satisfaction with nursing care, all of which have great significance and are well worth promoting.

Keywords: Kidney transplantation; Nursing program orientation; Comprehensive nursing; Negative emotion; Self-protection ability; Nursing effect.

Burden and distribution of chronic kidney disease in sub-saharan africa: a systematic review with meta-analysis

Martins Nweke — 2025-05-09

Background: Chronic kidney disease (CKD) is fast becoming a leading non-communicable disease in sub-Saharan Africa. Efforts directed at mitigating CKD will thrive on precise and accurate estimation of CKD burden, which often varies widely owing to study characteristics like methods of estimating Glomerular Filtration Rate (GFR) and study population.
Objective: To determine the burden of CKD and distribution of this burden in sub-Saharan Africa based on study characteristics.
Methods: Involved systematic review of articles peer-reviewed literature published in English. Review was conducted consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources for review include MEDLINE, PubMed, CINAHL, Academic Search Complete, African wide information and articles that reported prevalence of chronic kidney disease in sub-Saharan Africa. Bias risk assessment was conducted using mixed-method appraisal tool. Random-effect model of meta-analysis was employed to quantify effects of variation study characteristics on burden of chronic kidney disease in sub-Saharan Africa.
Result: Showed statistically significant difference in CKD prevalence by study population (F=2.547, p=.019) and epidemiological significance difference in GFR estimate method with Schwartz approach (35%).
Conclusion: CKD remains a public health issue in sub-Saharan Africa and the distribution varies widely according to region, study population and method of estimating GFR.

Keywords: Chronic kidney disease; sub-saharan africa; systematic review; meta-analysis.

Renal profile and the associated outcome of patients with acute kidney injury undergoing dialysis in Renal Unit at a Tertiary Healthcare Facility in Western Kenya

Rodgers Norman Demba — 2025-05-09

Background: Acute Kidney Injury (AKI) is characterized by sudden decline or loss of kidney function.
Objective: This study aimed to determine the renal profile and the outcome of AKI patients undergoing dialysis.
Methods: Retrospective cohort study was conducted from January 2015 to December 2021.
Results: Of the 69 AKI patients enrolled in this study, 33 (47.8%) were men, and 36 (52.2%) were women. Majority (55.56%; 10) of the AKI patients died within one month of diagnosis, 44.44% (8) died after one month. Independent predictors of survival were creatinine level (adjusted hazard ratio= 20.54, 95% CI: 0.15, 2862.17; P = 0.23), urea level (adjusted hazard ratio= 0.56, 95% CI: 0.05, 6.78; P = 0.65), phosphate level (adjusted hazard ratio= 5.94, 95% CI: 0.51, 69.57; P = 0.16), calcium level (adjusted hazard ratio= 0.31, 95% CI: 0.04, 2.67; P = 0.29), sodium level (adjusted hazard ratio= 0.53, 95% CI: 0.27, 10.21; P = 0.67), potassium level (adjusted hazard ratio= 5.3, 95% CI: 0.38, 73.56; P = 0.21), chloride level (adjusted hazard ratio= 0.23, 95% CI: 0.03, 1.66; P = 0.15).
Conclusion: AKI patients had a mortality rate of 26% after initiation of dialysis.

Keywords: Renal Profile; Acute Kidney Injury; Dialysis and mortality.

Effect of modified Shenqi pill combined with conventional western medicine on diabetic nephropathy and its influence on netrin-1 level and renal function

Xiaoli Zhang — 2025-05-09

Background: Our aim in this study was to investigate the efficacy of modified Shenqi pills combined with conventional western medicine in patients with diabetic nephropathy.
Methodology: 150 patients with diabetic nephropathy were divided into a western medicine group (50 cases, conventional western medicine), a traditional Chinese medicine group (50 cases, modified Shenqi pills), and an observation group (50 cases, modified Shenqi pills combined with conventional western medicine). The values of netrin-1, 24-hour urinary protein, blood urea nitrogen (BUN), creatinine (Scr), symptom score, and clinical efficacy were compared among three groups before and after treatment.
Results: The netrin-1, 24h urine protein, BUN and Scr values, the total score of main symptoms, and total score of secondary symptoms in the observation group were lower than those in the traditional Chinese medicine group and western medicine group at 3 months after treatment, and the difference was statistically significant. The total effective rate in the observation group (100.00%) was significantly higher than that in the traditional Chinese medicine group (86.00%) and western medicine group (78.00%), and the difference was statistically significant.
Conclusion: Combination of modified Shenqi Pills with conventional western medicine can achieve a more satisfactory effect in diabetic nephropathy, by reducing Netrin-1, promoting renal function recovery, eliminating edema and decreasing blood pressure.

Keywords: Diabetic nephropathy; modified Shenqi pill; western medicine; combined therapy; nerve guidance factor-1; renal function.

Prevalence and factors associated with inadequate intake of fruits and vegetables in a population from Northern Angola

Humberto Morais — 2025-05-09

Background: The World Health Organization recommends a minimum intake of 400 g or five servings of Fruits and Vegetables (FVs) per day for the prevention of chronic diseases.
Objective: The present study aims to describe the prevalence and factors associated with inadequate FVs intake in a sample of Angolan adults who participated in the CardioBengo study.
Methods: It is a subset analysis of CardioBengo, a community-based cross-sectional observational study conducted in the Dande Municipality, Bengo Province, Angola.
Results: The sample included 2161 individuals aged 18 to 84, with 64.1% being women. 57.2% of participants was below high school, and only 3.1% attended higher education. 61.7% were married, 48.3% had a monthly income below 150 USD. The prevalence of insufficient FVs consumption in the sample was 86.2%. It was observed that female gender, low education level, and the age group of 20-29 years were associated with inadequate FVs intake (p = 0.010, p = 0.001, and p = 0.006, respectively).
Conclusion: There was no association between FVs consumption and cardiovascular risk factors. A prevalence of FVs consumption well below current recommendations was identified. The identified risk factors can serve as a strategy to increase FVs consumption in this population.

Keywords: Fruits and vegetables; non-communicable chronic diseases; sociodemographic factors; Angola.

Inflammatory cytokines and quality of life response to weight reduction in obese patients with bronchial asthma

Shehab M Abd E-Kader — 2025-05-09

Background: Globally, about 20% of the population are affected with asthma. However, public health is adversely affected with asthma and obesity.
Objective: The target of the present study was to measure influence of weight loss on quality of life and Inflammatory cytokines of obese asthmatic patients.
Material and Methods: Eighty obese asthmatic patients; the mean of their age was 42.71 ± 6.35 year and body mass index (BMI) was 32.85 ± 3.16 Kg/m². Participants equally assigned in group (A) received weight reducing program, where group (B) received no therapeutic intervention.
Results: The Health-related quality of life (SF-36 HRQL) subscale scores, interleukin-10 (IL-10) and Asthma Control Test (ACT) improved significantly, where, the mean values of BMI, TNF-α and IL-6 were significantly reduced in group (A). While group (B) had no significant changes in their parameters. In addition, the differences between both groups were not significant at the end of the study.
Conclusion: Inflammatory cytokines and quality of life parameters improved with lifestyle modification among obese asthmatic patients.

Bronchial Asthma; Cytokines; Obesity; Quality of Life; Weight Reduction.

Correlation between retention and masticatory ability of magnetic attachment overdenture in elderly patients

Junmei Han — 2025-05-09

Background: To explore the correlation between restoration and retention of magnetic attachment overdenture and masticatory ability in elderly patients.
Methods: 200 elderly patients with most defects of dentition undergoing denture repair were selected, and with magnetic attachment retention repair in group A (n=70), with Taiji buckle attachment denture retention repair in group B (n=65), with removable partial denture repair in group C (n=65) .The masticatory ability, abutment related indexes and the incidence of denture repair related complications in the three groups were compared, and the masticatory efficiency of patients with different magnetic attachment retention and repair effects before and after treatment was compared.
Results: The bite force, retention and masticatory efficiency of group A were higher than group B and C (P<0.05). After treatment, gingival index, bleeding index and mobility in group A were higher than group B and C, plaque index in group B were higher than group A and C (P<0.05). The masticatory efficiency of patients with good retention and repair effect of magnetic attachment before and after treatment of patients with general effect were better than patients with poor effect and there was a positive correlation (r=0.320, 0.398, P<0.05).
Conclusions: Magnetic attachment overdenture is effective and safe in most elderly patients with dentition defects.

Keywords: Dentition defect; Denture restoration; Magnetic attachment retention repair; Denture retention and restoration with pole buckle attachment; Removable partial denture repair.

Phosphodiesterase 4 inhibitor combined with secukinumab relieves clinical symptoms in patients with psoriasis via regulating p38MAPK activation and the immune response inflammation

Qian Zhang — 2025-05-09

Background: The purpose of the present study was to explore the effect of phosphodiesterase 4 (PDE-4) inhibitor combined with secukinumab monoclonal antibody on the activation level of p38 mitogen-activated protein kinases (p38MAPK) in psoriatic leukocytes.
Methodology: The clinical data of 60 patients with psoriasis were retrospectively analyzed, and they were divided into a control group (secukinumab monotherapy, 30 cases) and a study group (PDE-4 inhibitory therapy). Agent combined with secukinumab treatment(30 cases), all were treated for 3 months. The Psoriasis Area and Severity Index (PASI), clinical symptom score, serum inflammatory factors, p38MAPK gene expression in lesion tissue, and clinical outcome were compared between the two groups.
Results: After treatment, the PSAI score (t=5.051) and symptom score (t=14.102) of the study group were lower than those of the control group, and the relative expression of interleukin-6 (IL-6) (t=7.514) and p38MAPK (t=4.219), the relative expression of interleukin-17 (IL-17) (t=2.579) was lower than that of the control group. The total effective rate in the study group (83.33% vs. 60.00%) was higher than that in the control group.
Conclusion: Secukinumab along with phosphodiesterase 4 inhibitors reduces p38MAPK activation, and improves immune response, inflammation, and clinical symptoms in patients with psoriasis.

Keywords: Psoriasis; phosphodiesterase 4 inhibitor; secukinumab secukinumab; p38 MAPK.

Cytokine and immune cell interaction in immune-inflammatory response during crisis event in sickle cell disease

Suprava Patel — 2025-05-09

Background: The present study focused on evaluating serum cytokines in SCD cases and understanding these mediators' interplay with immune cells and their impact on disease severity score(DSscore).
Methods: The study population of eighty-eight participants comprised twenty-one SCD cases with DSscore>5, thirty-seven SCD cases with DSscore≤5, and thirty control group. Blood samples were analyzed for T cell markers by flowcytometry and serum IL10, TNFα, IFNγ, and glutathione.
Results: Serum IFNγ and IL10 levels were significantly higher in cases than control(p<0.05). The median(IQR) TNFα, 100.51(66.8) was higher in cases DSscore>5 than those with DSscore≤5(p=0.04). Both cases showed a significant rise in IFNγ compared to the control group(p<0.05). Similarly, median(IQR) IL10, 7.9(13.3) was elevated in cases DSscore>5(p=0.001) than control group. IL10 recorded a significant linear relationship with Tc-exhausted (CD8+CD279+) cells(r= 0.327,p=0.012) and Th-exhausted (CD4+CD279+) cells(r=0.265,p=0.045). A linear association(r=0.292,p=0.026) was observed between IFNγ and Tc Naive/Effector cell ratio (CD8+NECR). Similarly, TNFα was positively associated with the total T cell Naive/Effector cell ratio (TNECR) (r=0.307,p=0.019). Serum glutathione levels correlatedh exhausted (CD4+CD279+) cell (r=0.393,p=0.002) and IL10 (r=0.589,p<0.001). Conclusion: Cytokine profiling in SCD patients might provide insight into the underlying clinical course and vulnerability toward crisis events.

Keywords: TNFα; IFNγ; IL10.

Association between frailty status and health literacy in the elderly

Jingli Kou — 2025-05-09

Background: To analyze the association between frailty status and health literacy in the elderly, and identify the influencing factors of health literacy the elderly. Provide a basis for enhancing the health literacy of elderly patients.
Methodology: Relevant data, including general information, frailty status and health literacy level, were collected using the convenience sampling method from 185 elderly people attending inpatient or outpatient clinics in a Grade-III Class-A hospital in Beijing.
Results: Among the elderly people, the prevalence of frailty was 23.2%, and the overall health literacy was at a high level, with a rate of health literacy possession of 84.9%. Results of analysis of variance and trend test revealed a linear relationship between frailty status and health literacy, i.e., health literacy level of the elderly became lower as the degree of frailty increased. It was found by multivariate linear regression analysis that the educational level, frailty status, daily activity and type of medical insurance were independent influencing factors for of health literacy (P<0.05).
Conclusion: The health literacy level varies among the elderly with different frailty status, . Health literacy and frailty has s dose-response relationship.and t Frailty is an independent influencing factor of health literacy. Targeted education can be given based on different characteristics of the elderly to raise their health literacy level.

Keywords: Elderly; frailty; health literacy.

Attitudes of secondary school adolescents towards premarital sexual activity and associated factors in Fako, Cameroon

Rita Muso Fubam — 2025-05-09

Background: Adolescents continue to engage in risky sexual behaviours. These behaviours can be influenced by their attitude regarding premarital sexual activity.
Aim: This paper aimed to assess attitude of secondary school adolescents towards premarital sexual activity and the associated factors in Fako, Cameroon.
Method: A cross-sectional study was conducted among 1180 adolescents in secondary schools in Fako, Cameroon. A questionnaire was administered to assess their knowledge and attitudes regarding sexual and reproductive health. Descriptive analysis and inferential statistics were used to identify factors associated with their attitude toward premarital sexual activities. p value < 0.05 with 95% confidence interval indicated statistical significance.
Results: More than half (54.6%) of the adolescent students had more liberal attitudes regarding premarital sexual activity. Being male (AOR= 1.931, 95% CI= 1.400, 2.663), discussing sexuality-related information with family (AOR=1.423, 95% CI=1.034-1.958), and using the internet to obtain sexuality-related information (AOR= 1.397, 95% CI: 1.023-1.397) were associated with more liberal attitudes towards premarital sexual activities. Younger adolescents had less liberal attitudes (AOR=0.541, 95% CI= 0.361-0.810).
Conclusion: More liberal attitudes towards premarital sexual activity was reported among adolescents hence stakeholders concerned with adolescent reproductive and sexual health should design strategies, including internet-based interventions that address any negative attitudes about sexuality among adolescents.

Keywords: Adolescents; attitude; Cameroon; sexual behaviour; reproductive health.

Perceptions about reduced antenatal care contacts to a minimum of eight and its associated factors among pregnant women in Bayelsa State, Nigeria

Olakunle I Makinde — 2025-05-09

Background: Scheduling antenatal care (ANC) contacts in line with WHO-recommended minimum of eight can reduce costs for pregnant women and health systems without compromising quality of care.
Objectives: Assess how pregnant women perceive reduced frequency of scheduled ANC contacts from a minimum of twelve to eight and associated factors.
Methods: Cross-sectional survey of 363 pregnant women receiving ANC in Nigeria. Multivariate logistic regression was conducted using IBM SPSS Statistics version 25; Chicago, IL.
Results: Mean age of respondents was 30.5 ± 5.2 years. Majority had previous ANC experience in at least 1 previous pregnancy (61.7%), were satisfied (79.6%) with the ANC received, and had a negative perception (63.9%; 95%CI: 59.3% - 68.0%) of reduced frequency of scheduled ANC contacts. Satisfaction with ANC received, low social class, and living far from the hospital were the predictors of negative perception.
Conclusion: Women who were satisfied with the traditional model of ANC received, tend to perceive a reduction in the frequency of scheduled ANC contacts negatively. Low social class and living far from the hospital were other predictors of negative perception. Therefore, the characteristics and community features of the population being served should underlie the decision on the frequency of scheduled ANC contacts.

Keywords: Antenatal care contacts; Perception; Minimum of eight contacts.

Relationship between sleep disorders and depression in perimenopausal women in the United States: a cross-sectional survey based on NHANES 2009-2014

Le Zhang — 2025-05-09

Background: Many studies have found that depression and sleep disorders in perimenopausal women often appear as comorbidities, but its relevance has not been further verified. To clarify the relationship between the two can provide guidance for future clinical research.
Methodology: A cross-sectional research was carried out among 1400 women aged 45-55 years who participated in the 2009-2014 national health and Nutrition Examination Survey (NHANES). We estimated unadjusted and adjusted logistic regression models to analyze the relationship between sleep disturbances and other related factors with depression.
Results: 18.1% of the 1440 participants had depressive symptoms in the past two weeks. 11.2% had sleep disorder. Compared with women without sleep disorder (14.70%), depression was more common in perimenopausal women who had sleep disorder (44.72%), In the logistic regression model, menopausal women with sleep disturbance suffer from depression were four times more than that without sleep disturbance (odds ratio, 3.798; 95%CI, 2.611-5.525); The difference remained significant after adjusted the effects of covariates (adjusted odds ratio, 3.687; 95% CI, 2.533-5.367).
Conclusion: Sleep disorders strongly link to depression in menopausal women. Early intervention for sleep issues may reduce depression risk in this group.

Keywords: Sleep disorders; depression; perimenopausal women; NHANES.

A clinical and biochemical study to estimate the salivary alpha-amylase level in post-menopausal women with psychosomatic disorders

Kumuda Rao — 2025-05-09

Background: The salivary alpha-amylase (sAA) is a key player in the oral cavity’s starch digestion process. Only in the last decade has this enzyme come under greater scrutiny as a Sympathetic Nervous System (SNS) stress marker. Acute stress has been demonstrated to cause a rise in sAA, which is associated with norepinephrine levels in the blood. As an analogous marker of Sympathoadrenal Medullary System (SAM) activity reflecting the changes during acute psychosocial stress, very few studies have directly demonstrated the sensitivity of salivary alpha-amylase levels to changes in catecholamine levels in the blood.
Methods: Extraoral and intraoral examination was conducted on 100 post-menopausal women to check for psychosomatic disorders/lesions. The ‘Spit Technique’ was used to collect Unstimulated saliva from individuals who had clinically identified Psychosomatic disorders or lesions. The ELISA technique was utilized to estimate salivary Alpha-Amylase.
Results: The outcomes were statistically significant since they demonstrated that postmenopausal women with clinically confirmed Psychosomatic disorders/lesions had greater levels of salivary Alpha-Amylase.
Conclusion: The findings of this study suggest that all post-menopausal women should undergo periodic examination for acute stress. When accompanied with the clinical presence of psychosomatic disorder/lesions, salivary estimation of alpha-amylase may be utilized as a diagnostic tool for women enduring postmenopausal psychological anguish.

Keywords: Salivary Alpha-Amylase; Post-menopausal women; Psychosomatic disorder.

Contraceptive prevalence and types used among female secondary students in public schools in Obio Akpor, Rivers State Nigeria

Kelechi Favour Andrew — 2025-05-09

Background: Correct and consistent contraceptive use among adolescents reduces the incidence of sexually transmitted infections and unplanned pregnancies.
Objective: The purpose of this study was to determine the prevalence of contraceptive use and ascertain the types of contraceptives used by female secondary school students in Obio Akpor Local Government Area.
Methods: The study used a cross-sectional design and a multistage random sampling method to recruit students who were sampled using a pre-tested semi-structured interviewer-assisted questionnaire, and the data collected was analyzed using Statistical Package for Social Science (SPSS) Version 20.0.
Results: Three hundred and twelve participants were recruited for this study. The rate of contraceptives ever used by respondents was 35%; 34% had used them at their last sexual activity, while only 20% were consistently using contraceptives. Older students between the ages of 16 and 18 years used more contraceptives than the younger students (13 and 15 years), with a probability (p-value) of 0.100. Contraceptives used by respondents include condoms, post-coital pills, and withdrawal methods (88%), 24%, 8.82%, and 2.94%, respectively.
Conclusion: This study revealed that the contraceptive prevalence among students was poor, and there is a serious need to increase adolescents’ access to reproductive health services and information.

Keywords: Contraceptive use; prevalence; female students.

Uterine artery chemoembolization compared with uterine artery embolization combined with prior to hysteroscopy and curettage in the treatment of cesarean scar pregnancy

Liangping Wang — 2025-05-09

Background: To compare evaluate the clinical effectiveness and safetyefficacy of uterine artery chemoembolization (UACE) and versus uterine artery embolization (UAE) prior to combined with hysteroscopy and curettage in the treatment of cesarean scar pregnancy (CSP)
Methodsology: A totalThe clinical data of 84 patients with CSP who underwent UACE or U AE combined with hysteroscopy and-guied uterine curettage were enrolled in the retrospective cohort study from August 2016 to April 2021 were retrospectively collected. They were divided into UACE group (n = 39) and UAE group (n = 45) according to different surgical methods. The clinical characteristicsgeneral data, operattreatment success rate,ion, postoperative outcomeconditions, and re-pregnancyproductive outcomes of the two groups were observed and compared and analyzed between the two groups.
Results: The overall success rate of 84 patients was 96.43%, the complication rate was 19.05%, and the serious complication rate was 1.19%. There was no significant difference between the two groups in the success rate of operation, complication rate, serious complication rate, UAE operativeon time, hysteroscopic operation time, intraoperative bleeding volume, duration of postoperative hospital stay, β-human chorionic gonadotropin (β-hCG) reductiondecrease on postoperative day 1, and re-pregnancyproductive outcome (P > 0.05). The time of menstruation recoveryto resumption of menses was shorter in the UACE group than in the UAE group (P < 0.05).
Conclusion: UACE was as effective and safe as UAE in the treatment of CSPor UAE combined with hysteroscopy is safe and effective in the treatment of CSP, and the time of menstruation recovery was shorter. UACE reduced the time to resumption of menses compared with UAE, with a similar both of which had similar re-pregnancyproductive outcomes.

Keywords: Uterine artery embolization; Chemoembolization; Methotrexate; Hysteroscopic surgery; Cesarean scar pregnancy.

Clinical analysis of dexmedetomidine-esketamine combined with intranasal administration before laparoscopic high ligation of hernia sac in infants and young children

Cuicui Shi — 2025-05-09

Background: Studying To investigate the clinical values of dexmedetomidine and esketamine combined with intranasal infusion before laparoscopic high ligation of hernia sacs in infants and young children.
Methodology: In our hospital, 90Ninety children aged 8-14 years underwent surgical high ligation of the hernia sac between March 2021 and March 2022 were included. During March 2021 to March 2022, 90 children aged 8-14 underwent surgical high ligation of hernia sacs at our hospital. The study and control groups were divided. Each group had 45 cases. A routine fast was given to all the children before anesthesia, and they received midazolam for the contrast set and dexmedetomidine combined with esketamine for the examination set. The onset time, recovery time, sedation time and other indicators were analyzed.
Results: The onset time of sedation in the study group was significantly lower than that in the control group, and the sedation time was significantly higher than that in the control group(P<0.05). The Ramsay score of the study group was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). After sedation, the Montreal cognitive assessment (MoCA) scores of the study group was significantly lower than the control group (P<0.05). After sedation, the Ramsay score and MoCA score were significantly positively correlated (P<0.05).
Conclusion: The use of Dexmedetomidine combined with esketamine nasal drops in infants and young children undergoing laparoscopic high ligation of hernia sac is an effective and safe sedation technique. It not only improves sedation but also reduces the incidence of adverse reactions. Furthermore, it does not impair the cognitive function of children.The combination of dexmedetomidine with esketamine intranasal instillation can improve sedation, reduce adverse reactions, and will not harm them. Clinical efficacy, safety, and cognitive function are high in children.

Keywords: Dexmedetomidine; esketamine; intranasal sedation; infants and young children; high ligation of laparoscopic hernia sac.

Influencing factors of neural tube malformation: a systematic review and meta-analysis

Xiangling Wu — 2025-05-09

Background: Neural tube malformation is a common congenital malformation and its influencing factors were still unclear. This paper aims to explore the main influencing factors of neural tube malformation, and provide reference for the primary prevention of neural tube malformation.
Methodology: Case-control literatures on the influencing factors of neural tube malformation from 1990 to 2021 were searched from Chinese and English websites. The quality of the included literatures was evaluated according to Newcastle-Ottawa Scale (NOS) scale and data were extracted. Meta-analysis was performed on the data using funnel plot and Egger’s est evaluated publication bias, and sensitivity analysis was performed by eliminating individual studies one by one.
Results: A total of 49 case-control studies were included. Meta-analysis showed that the main influencing factors of neural tube malformation were folic acid (odds ratio (OR)OR=0.31, 95%CI: 0.20-0.47), fever (OR=3.02, 95%CI: 2.38-3.83), obesity (OR=1.76, 95%CI: 1.39-2.21), passive smoking (OR=1.91, 95%CI: 1.52-2.40). Antiepileptic drugs (OR=6.10, 95%CI: 2.58-14.43); Heavy metals (Zinc: OR=2.37, 95%CI: 1.06-5.30, mercury: OR= 4.61, 95%CI: 2.85-7.47).
Conclusion: Prenatal supplementation with folic acid and zinc has been shown to reduce the risks of neural tube defects. It is recommended that women of childbearing age take folic acid and zinc supplements before and during pregnancy. Other factors such as fever, obesity, passive smoking, antiepileptic drugs, and mercury exposure have been associated with an increased incidence of neural tube abnormalities.Neurological tube abnormalities can be reduced by folic acid and zinc, which act as protective factors. The incidence of neural tube abnormalities is increased by fever, obesity, passive smoking, antiepileptic drugs, and mercury.

Keywords: Neural tube malformation; influencing factors; meta-analysis.

Analysis of the use and advantages of depth of anaesthesia monitoring in children undergoing tonsillar adenoid surgery

Tingting Sun — 2025-05-09

Background: To investigate the application and analysis of the advantages of depth of anesthesia monitoring in children undergoing tonsillar adenoid surgery.
Methodology: Eighty tonsillar adenoid surgery patients were divided into a control group and an observation group. Observation group was given dexmedetomidine. Saline was given to the control group. Hemodynamics, perioperative indicators, stress reaction indicators, and adverse reactions were compared.
Results: At t0, no statistically significant differences were found between the two groups for mean arterial pressure (MAP) (t =0.3789) or heart rater (HR) (t =0.0130). On t1, t2, t3 and t4, the mean arterial pressure (MAP) (tt1=4.5321, tt2=2.5818, tt3=5.0025, tt4=3.2068) and heart rater (HR) (tt1=6.64299, tt2=29.4580, tt3=15.5095, tt4=10.1461) were lower compared to the control group (P<0.05). Extubation time (t=49.9687) and respiratory recovery time (t=16.4542) of children in the observation group were shorter than those of the control group (t=20.1926), a statistical difference was found between the groups (P<0.05). Observation group adverse events were 0.44% lower than control group (x2=5.1647, P<0.05).
Conclusion: During tonsillar adenoid surgery, dexmedetomidine hydrochloride was used to anesthetize children. The dosage of anesthetic drugs was adjusted according to the depth of anesthesia monitored. Despite its small effect on hemodynamic indexes, it delayed extubation, reduced organism stress, and facilitated respiratory management.

Keywords: Tonsil; Adenoid; Surgery; Anesthesia; Depth; Dexmedetomidine; Hemodynamics.

Prevalence of anxiety symptoms, depression and temporomandibular dysfunction in prisoners and workers from a Brazilian prison: an observational study

José Carlos de Oliveira Gomes Filho — 2025-05-09

Background: Temporomandibular Disorder (TMD) is a condition in which there are several psychosomatic and/or psychosocial aspects. Imprisonment situations may be an example of a triggering factor for stress and TMD symptoms, especially if taken into account that the incarcerated population is bigger than the general population.
Objective: The present study aims to investigate the prevalence of symptoms of anxiety, depression and temporomandibular disorder (TMD) in prisoners and employees of a closed male penitentiary in Brazil.
Methods: A total of 140 prisoners and 50 employees were part of the study. This is a cross-sectional study with a quantitative approach, where the symptom questionnaire for Temporomandibular Disorders (DC/TMD) and the Hospital Anxiety and Depression Scale (HAD) were applied.
Results: The anxiety and depression levels found in prisoners were 64.86% and 48.64%, respectively. There was a higher statistical significance in the reported symptoms of headache in employees with anxiety when compared to those without anxiety (p= 0.03). Regarding depression, it was observed that it influenced the symptoms of jaw opening and locking, both in employees (p=0.09) and inmates (p=0.01).
Conclusion: A high prevalence of TMD symptoms, anxiety, and depression were identified in both prisoners and employees, especially the prisoners.

Keywords: Temporomandibular dysfunction; Depression; Anxiety; Prisoners.

Surgical outcomes research in LMICs: a narrative review

Taylor Jaraczewski — 2025-05-09

Background: Surgical outcomes research is sparse in low- and middle-income countries (LMICs). This is due to poor funding, lack of human resources, and inadequate infrastructure. However, a growing number of collaborative small collection of large multinational and multicentered studies have been successfully performed. These studies have overcome regulatory and logistical hurdles and have shown that collecting such data in the LMIC setting is possible.underscore the drive and capabilities of LMIC researchers.
Methods: A review of the literature using PubMed was performed for multicenter and multinational studies on surgical outcomes in LMICs.
Results: All studies collected a diverse array of postoperative outcomes including complications and mortality. Multiple studies performed adjusted analyses to allow for identification of independent risk factors of surgical outcomes. Each study reinforced that outcomes in LMICs are markedly worse than in HICs.
Conclusion: These studies showed that outcomes research is feasible and needed in LMICs. In this review we summarize each of these impactful studies and present strengths, weaknesses, commonalities and gaps that remain.

Keywords: Surgical outcomes; research; LMICs.

The value and safety of percutaneous vertebroplasty (PVP) for spinal compression fractures with the aid of G-arm fluoroscopy

Guangman Tang — 2025-05-09

Background: This study investigated the clinical value and safety of G-arm fluoroscopy-assisted percutaneous vertebroplasty in treating spinal compression fractures with vertebral posterior wall destruction.
Methods: 68 patients were divided into a study group (37 patients) and a control group (31 patients). The study group was treated with percutaneous vertebroplasty assisted by G-arm machine, and the control group was treated with percutaneous vertebroplasty assisted by C-arm machine.
Results: At 5 days after operation, there was significant difference between the two groups, and the control group was smaller than the study group. Oswestry disability index (ODI) ODI and Visual analogue scale (VAS) scores of the two groups were significantly lower than those before operation, and ODI and VAS scores of the control group were significantly lower than those of the study group at 5 days after operation. In the control group, bone cement spread to bilateral upper and lower endplates in 21 segments, and bone cement injection volume, which was significantly higher than that in the study group. The operation time of the control group was longer than that of the study group, the above differences were statistically significant (P<0.05).
Conclusion: G-arm fluoroscopy-assisted percutaneous vertebroplasty can effectively relieve pain symptoms, improve postoperative function, and result in minimal surgical trauma with faster recovery.

Keywords: G-arm fluoroscopy; Vertebroplasty; Posterior wall of vertebral body; Vertebral compression fractures; Clinical Application.