Nigerian Medical Journal

Metachronous Testicular Loss Following Testicular Torsion; A Pathology requiring a time dependent intervention: A Case Report and Review of the Literature

Ehiremhen Ozah, Joseph Osaigbovo Obasuyi — Tue, 11 Nov 2025 00:00:00 +0000

Bilateral metachronous testicular torsion is rare, few cases are reported in the literature. A high clinical index of suspicion is required to avoid a delay in diagnosis and intervention on the part of the managing physician and if necessary to avoid delayed referral. It is also important to educate patients on the possibility of this condition and the need for timeous presentation at the hospital to avoid testicular loss. We present a case of a 24-year-old who presented 48 hours after sudden onset of left testicular pains after an initial delay of 24 hours at a private hospital, where he had analgesics and antibiotics. He previously had right orchidectomy 10 years ago for right testicular torsion and left orchidopexy, after an initial delay in presentation. Examination findings revealed an oedematous left hemiscrotum, tender with hard, indurated knotted mass and absent testis in right hemiscrotum. He immediately had scrotal exploration with findings of a gangrenous left testis with 540 degrees anticlockwise twist, he subsequently had orchidectomy. Post-operative recovery was uneventful. Hormonal parameters revealed hypergonadotrpic hypogonadism, 2weeks after surgery, he was placed on testosterone replacement therapy and counselled for immediate sperm banking. Bilateral testicular torsion is rare, it is important to emphasize to the patients that it can occur, despite orchidopexy, therefore the need to present early to avoid testicular loss and the challenges of hypogonadism and infertility. In the literature it is documented that use of non-absorbable sutures and more than two-point fixation may reduce risk of recurrent testicular torsion.

A Diagnostic Conundrum: Amelanotic Vulvar Malignant Melanoma in a Postmenopausal Patient

Vaishali Bhankhodia, Gyanendra Singh, Tarang Patel, Parth Goswami — Tue, 11 Nov 2025 00:00:00 +0000

Amelanotic vulvar malignant melanoma is an exceedingly rare and aggressive malignancy, accounting for only 2% of vulvar melanomas and presenting unique diagnostic challenges due to its lack of pigmentation. This report discusses the case of a 57-year-old postmenopausal woman who presented with a 2x2 cm greyish-white growth on the labia majora, accompanied by itching and burning for three months. Clinical examinations and routine investigations were inconclusive, necessitating a biopsy for definitive diagnosis. Histopathological analysis revealed nests of atypical cells exhibiting high-grade features, including a high nuclear-to-cytoplasmic ratio, vesicular chromatin, prominent eosinophilic nucleoli, and mitotic activity. The absence of melanin pigment complicated the diagnosis, requiring immunohistochemical confirmation with markers such as S100, Melan-A, and HMB45. Differential diagnoses, including poorly differentiated squamous cell carcinoma, neuroendocrine tumor, and adenocarcinoma, were meticulously excluded through morphological and immunohistochemical evaluation. This case underscores the critical importance of histopathological examination and immunohistochemistry in accurately diagnosing vulvar lesions, particularly in amelanotic variants, where clinical presentation can mimic other malignancies. Given the high metastatic potential and poor prognosis of vulvar melanoma, early recognition, accurate diagnosis, and prompt surgical intervention, including wide local excision and lymphatic dissection, are essential. This case highlights the need for heightened clinical suspicion and a multidisciplinary approach in managing rare vulvar malignancies to optimize patient outcomes.

Statin-Induced Toxic Myopathy Masquerading as Recurrent Falls and De-Conditioning in an Older Adult

Emediong Santhus Asuka, Jesse Odion — Tue, 11 Nov 2025 00:00:00 +0000

Statins, widely prescribed for their efficacy in reducing low-density lipoprotein cholesterol (LDL-C) and preventing atherosclerotic cardiovascular disease, are generally well tolerated. However, muscle-related adverse effects, particularly statin-associated myopathy, can significantly impact patient function and adherence. This case report describes an 83-year-old man who developed progressive proximal muscle weakness, fatigue, and recurrent falls following initiation of high-dose atorvastatin after a ST-elevation myocardial infarction. Clinical and laboratory evaluation, along with the temporal association and improvement after drug withdrawal, supported a diagnosis of self-limited toxic statin myopathy. Extensive differential diagnosis excluded other neuromuscular, endocrine, and vascular causes. Prompt discontinuation of atorvastatin, supportive care, and physiotherapy led to marked functional recovery. This case highlights the spectrum of statin-induced muscle toxicity, emphasises diagnostic vigilance in older adults, and underscores the importance of personalised therapy and early intervention to mitigate adverse outcomes.

A complex presentation of complicated secondary syphilis with ulcerated lesion progression

Eman A. Ibrahim, Haidar Abbas, Emmanuel O. Oisakede, Natalie Walker — Tue, 11 Nov 2025 00:00:00 +0000

Secondary syphilis is commonly associated with well-known cutaneous and mucosal manifestations, including maculopapular rashes and condylomata lata. However, clinical presentation can vary significantly, often resembling other dermatological or infectious conditions, which can lead to diagnostic delays and challenges, particularly in immunocompetent individuals. We report the case of a 26-year-old heterosexual Asian man working as a baggage handler at a busy international airport, who presented with a rapidly progressive, painful rash. Initially treated with flucloxacillin, his condition worsened, spreading to his face, trunk, and mucous membranes, accompanied by fever, tachycardia, and difficulty swallowing. Physical examination revealed widespread umbilicated vesicles, haemorrhagic blisters on his right lower leg, and ulcers in the oral cavity. Despite negative results for common viral infections (HSV, VZV, HIV) and autoimmune disorders, serological testing for syphilis revealed a positive rapid plasma regain test, confirmed by a positive treponemal antibody EIA test and subsequent clinical improvement with appropriate antibiotic therapy. Following the diagnosis of secondary syphilis, the patient was treated with benzathine penicillin and supportive care. He experienced a mild Jarisch-Herxheimer reaction, which resolved with monitoring. A subsequent infection of a fungating lesion (bacteria superimposition) on the right shin was managed with amoxicillin/clavulanic acid. By the patient’s follow-up visit, the skin lesions had markedly improved, and he was discharged with ongoing care and penicillin treatment. This case highlights the importance of considering syphilis in the differential diagnosis of atypical cutaneous and mucosal lesions, especially when presenting with systemic symptoms. The diagnosis of secondary syphilis can be challenging due to its diverse clinical manifestations, which may mimic other infectious or autoimmune conditions. A careful diagnostic approach, including serological and polymerase chain reaction testing, is essential for accurate diagnosis and effective treatment. This case also emphasizes the need for timely public health intervention and education in high-risk populations.

Point-of-Care Ultrasound in Paediatric Cardiac Tamponade: A Case Report of Rapid Diagnosis and Guided Pericardiocentesis in a Resource-Limited Setting.

Tue, 11 Nov 2025 00:00:00 +0000

The case report demonstrates the utility of point-of-care ultrasound (POCUS) for both diagnosis and ultrasound-guided intervention in managing cardiac tamponade in a paediatric patient. A 10-year-old child presented with a six-week history of cough, weight loss, and a two-week history of respiratory difficulty, orthopnoea, and generalized body swelling, starting in the legs. He had progressive easy fatigability over the last three months. An external chest X-ray indicated a globular heart, suggestive of pericardial effusion to rule out cardiomyopathy. Cardiac POCUS revealed a massive pericardial effusion with tamponade physiology. Immediate ultrasound-guided pericardiocentesis was performed, draining 800 ml of purulent fluid, followed by an additional 200 ml with an underwater seal setup. Post-procedure, serial POCUS examinations were conducted to monitor for adequate drainage and to detect any possible re-accumulation of pericardial fluid. The symptoms resolved, and a 2-week follow-up showed sustained improvement. This case underscores the vital role of POCUS in both the prompt diagnosis and safe, accurate ultrasound-guided pericardiocentesis in emergent cardiac care for paediatric patients.

Rare Presentations of Embryonal Rhabdomyosarcoma in the Middle Ear of a 3-Year-Old Boy and Girl.

Asmau Usman, Lawal Shuaibu, Abubakar Dahiru, Shuaibu Adam — Tue, 11 Nov 2025 00:00:00 +0000

Embryonal rhabdomyosarcoma is a distinct subtype of rhabdomyosarcoma commonly seen in children less than 5 years of age, but it can appear at any age. It’s frequently seen at the head and neck region, but rare sites include the ear. It often presents with facial nerve palsy. We present two extraordinary cases of embryonal rhabdomyosarcoma of the middle ear in a 3-year-old boy and girl.

Increased thromboembolic risk in non-neoplastic pancreatic diseases: A review focusing on acute pancreatitis

Tue, 11 Nov 2025 00:00:00 +0000

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cause of preventable morbidity and mortality in hospitalized patients. While VTE is well-established in pancreatic malignancy, its association with non-neoplastic pancreatic conditions, particularly acute pancreatitis (AP), is less clearly defined and frequently underrecognized in clinical practice. This narrative review aims to explore and synthesize existing literature on the thromboembolic complications associated with AP, highlighting the underlying pathophysiological mechanisms, clinical implications, and current gaps in prophylactic and therapeutic strategies. We reviewed published studies from major databases up to June 2025, focusing on epidemiological trends, pathological mechanisms related to inflammation-induced thrombosis, and clinical outcomes in patients with AP complicated by VTE. The review discusses pathogenesis, epidemiology, clinical features and diagnostic challenges due to symptom overlap, current pharmacologic and non-pharmacologic management strategies, and the limited but growing real-world evidence on anticoagulation in this setting.

Current Concepts in the Management of Achilles Tendon Injuries

Tamunokuro Ezekiel Diamond, Mike Tochi Achor — Tue, 11 Nov 2025 00:00:00 +0000

Achilles tendon injuries are commonly encountered in orthopaedic practice. The Achilles tendon is prone to rupture, and this negatively imparts ambulation. The diagnosis is clinical. Treatment options have evolved from conservative to surgeries, however there is no consensus on the most superior option of treatment. This narrative review aims to highlight the evolution in clinical diagnosis and treatment of Achilles tendon ruptures and discuss the current evidence in the treatment with emphasis on outcome measures of each treatment modality. Relevant studies on Achilles tendon ruptures with emphasis on treatment options, their strengths and weaknesses were reviewed. The treatment of Achilles tendon rupture has evolved from conservative options to surgeries. The surgical options include open repair, percutaneous repair, endoscopic repair, and ultrasound-guided repair. However, there is still no consensus on the most superior option for treating Achilles tendon injuries. Each method has its pros and cons. Conservative treatment has the appeal of the absence of scars, low cost and shorter duration of hospital stay. However, ankle stiffness, and late return to work are important drawbacks. Open surgery has the advantage of early return to function and low re-intervention rates. Surgical scars, likelihood of infection and cost are major disadvantages. Appropriate patient selection guided by the severity of the injury, the age of the patient, pre-injury status, work demand for the patient, experience of the surgeon, available resources, local soft tissue condition, and the patient’s preferences are key to successful outcome.

Discovery of New Bat Coronavirus (HKU5-CoV-2): Can it be Another Public Health Threat?

Tue, 11 Nov 2025 00:00:00 +0000

The deadly COVID-19 outbreak which started in Wuhan city of China in December 2019, created a dangerous Public Health Disaster the world has ever witnessed. Bats have been widely recognised as natural reservoir hosts of several zoonotic diseases, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) caused by coronaviruses. A new bat coronavirus similar to the virus resembling COVID-19, has been discovered recently by researchers at the Wuhan Institute of Virology in China. The new virus named as ‘HKU5-CoV-2, carries the risk of animal-to-human transmission. This paper shares the most recent information on the virus and views of other eminent scientists regarding its potential to start another pandemic.

Assessment of Peripheral Arterial Disease among Type 2 Diabetes Patients in Calabar, Nigeria

Ofem Egbe Enang, Aburu Ndim Araga, Henry Ohem Okpa, Okon Ekwere Essien — Tue, 11 Nov 2025 00:00:00 +0000

Background: Peripheral Arterial Disease (PAD) is a significant complication among patients with Type 2 Diabetes Mellitus (T2DM), characterized by atherosclerosis that leads to reduced blood flow to the extremities. This article assesses the traditional risk factors for PAD and the predictive value of the new inflammatory biomarkers like fibrinogen and C-reactive protein (CRP), and the implications of PAD in T2DM patients, drawing from recent studies and findings. The presence of PAD in T2DM patients poses serious health risks, including increased risk of foot ulcers, limb amputation, and cardiovascular events, necessitating comprehensive cardiovascular risk management. The study aims to assess the effectiveness of various diagnostic tests for PAD, particularly the Ankle-Brachial Index (ABI), in detecting PAD and stratifying cardiovascular risk in T2DM patients.

Methodology: The study population comprises the recruitment of 112 Type 2 DM patients and an equal number and sex matched healthy participants as controls from three centres in Calabar, making a total of 224 participants. Socio-demographic information was collected. After physical examination and anthropometric measurements, the ABI was performed using a Doppler ultrasound device. Descriptive statistics were used to summarize clinical and demographic characteristics, and comparative analysis was done using chi-square for categorical variables and t-test for continuous variables. Logistic regression was used for independent risk factors associated with PAD.

Results: The median ages for the Type 2 DM patients and the controls were 58 years (IQR 10) and 58 years (IQR 11), respectively. The prevalence of PAD using ABI<0.9 in this study was 37.5% in people living with type 2 diabetes and 14.3% in controls. The prevalence of PAD for Type 2 DM patients and controls using symptoms of palpation of pedal pulsations and intermittent claudication was 17.0% vs 3.6% and 11.6% vs 2.7% respectively. There was a statistically significant relationship between advanced age, hypertension, duration of diabetes, glycaemic control, fibrinogen, as well as CRP, and PAD among people living with Type 2 diabetes. After multiple regression analysis, the predictors of PAD in this study were age, duration of Diabetes, and elevated serum CRP. There was no correlation between smoking, obesity, and lipid profiles with PAD.

Conclusion: There is a high prevalence of peripheral artery disease among people with T2DM in Calabar. The use of ABI is of great value in the detection of PAD, as evidenced by a more objective assessment of PAD compared to intermittent claudication and reduced/absent pedal pulses. Routine screening of PLWDM for PAD using ABI would enhance early diagnosis and intervention.

Evaluation of the Prevalence and Factors Affecting the Mental Health of Undergraduate Medical Students in a Nigerian University: A Cross-Sectional Study.

Tue, 11 Nov 2025 00:00:00 +0000

Background: Medical education is known to be demanding and stressful, often leading to mental health challenges such as stress, anxiety, and depression among students. Understanding the prevalence and factors contributing to these issues is crucial for effective intervention and support.

Methodology: A descriptive cross-sectional study was conducted among 400 medical students at the College of Health and Medical Sciences at Babcock University. Data was collected using a standardised questionnaire comprising sections on sociodemographic characteristics, depression (PHQ-9), anxiety (GAD-7), stress (PSQ), and health-seeking behaviour. Statistical analysis was performed using SPSS version 22, with descriptive statistics and chi-square tests applied. The value for p was <0.05, which is statistically significant.

Results: The prevalence of depression was 53.5% with 186(45.3%) having mild depression, more than half of the respondents had minimal anxiety, 202(50.5%), and a high level of stress, 214(53.5%), respectively. Factors affecting mental health included lack of institutional support 170 (42.5%), poor awareness of available services 125 (31.3%), and poor utilization of mental health services 310, (77.5%). Age was found to be statistically significant (x2=15.792, P=0.015) in terms of anxiety level. Additionally, significant associations were observed between stress and depression (x2=37.497, P<0.001), as well as between stress and anxiety (x2=44.286, P<0.001).

Conclusion: This study shows that the levels of depression, anxiety, and stress are moderately high among the medical students, underscoring the urgent need for intervention and support mechanisms. Enhancing institutional support, integrating mental health education into the curriculum, and conducting regular screenings will go a long way in creating a supportive environment conducive to the mental well-being and academic success of its medical students.

Efficacy and Safety of Steroids in Acute Heart Failure: A Systematic Review and Meta-analysis

Tue, 11 Nov 2025 00:00:00 +0000

Background: Persistent congestion in acute heart failure (AHF) is associated with worse clinical outcomes. The use of steroids may provide therapeutic benefits by alleviating congestion, overcoming diuretic resistance, and mitigating the harmful effects of neurohormonal activation. This approach could potentially improve hemodynamic status and support better management of AHF, ultimately leading to enhanced patient recovery and reduced complications.

Objective: To evaluate the efficacy and safety of steroids in acute heart failure (AHF) as compared to the standard of care (SOC).

Search strategy: We used PubMed, Scopus, Google Scholar, and a manual search to identify Randomized controlled trials published up to October 15, 2024.The protocol was registered in PROSPERO (CRD42024601261)

Selection Criteria: All full-text randomized control trials (RCTs) that investigated steroids in heart failure were included. Results were pooled, where appropriate, using a random-effects model.

Results: Three RCTs with 563 participants [282 Steroid, 281 (SOC)] were identified. No statistically significant difference is seen in mortality as well as NT-proBNP levels between the steroid plus SOC and control group (RR=0.59, 95% CI=0.06–6.13, p=0.66, (I²=51%, p=0.15) and (MD=0.14, 95% CI=−0.62 to 0.90, p=0.71, I²=91%, p<0.0006), respectively.

Conclusion: Steroids have no significant effect on all-cause mortality or NT-proBNP levels in patients with AHF.

Assessment of the Secondary Metabolites of the Aerial Extract of Ocimum Tenuiflorum for Anti-Diabetic Potential

Tue, 11 Nov 2025 00:00:00 +0000

Background: Ocimum tenuiflorumis an important plant in Africa with diverse medicinal properties. This study investigates the anti-diabetic effects of Ocimum tenuiflorum methanol-ethyl acetate (2:1) extract (OTE) on alloxan-induced diabetic rats.

Methodology: Thirty rats (90-100g) acclimatized for one week were grouped into 5 (n=6). Group 1 (Normal control) received distilled water. The other groups were administered a single dose of 100 mg/kg alloxan intraperitoneally and treated as follows: Group 2 (olive oil), Groups 3 and 4 (200mg/kg and 400mg/kg OTE, respectively), and Group 5 received 5mg/kg glibenclamide. After twenty-one days of treatment, the rats were fasted overnight and sacrificed. Blood and liver samples were collected for analysis. Blood glucose status was measured using a glucometer. Serum insulin concentration was measured using an Enzyme-linked immunosorbent assay. Antioxidant assays were assessed via spectrophotometry. P<0.05 was considered statistically significant.

Results: Blood glucose level increased while insulin concentration reduced in diabetic controls relative to normal rats. Conversely, a dose-dependent reduction was observed in the glucose level, while insulin concentration returned to near normal with increasing doses of OTE compared to the normal control. It was observed that GSH level, CAT, and GST activities decreased significantly in diabetic control relative to normal control. Meanwhile, treatment with doses of OTE caused a dose-related increase in these antioxidant parameters, significantly compared to the normal control. MDA showed a significant increase in the untreated group relative to the normal control. However, MDA concentration declined drastically (P<0.01) in a dose-dependent manner upon treatment with OTE relative to normal rats.

Conclusion: It could be inferred from the results above that OTE may exhibit its anti-diabetic potential via enhancing the synthesis of insulin and scavenging of free radicals. This study showed that the extract can be used in the treatment of diabetes and can be formulated into a novel drug or supplement.

Establishing a Consensus Algorithm for H. Pylori Screening, Diagnosis, Initial Management, and Referral Protocols for Primary Care Physicians.

Sarah Abere, Ozuomba Sixtus, Ngozi Koko-James — Tue, 11 Nov 2025 00:00:00 +0000

Background: Helicobacter pylori (H. pylori) infection is a significant public health concern, contributing to various gastrointestinal disorders, including peptic ulcers and gastric cancer. The infection is highly prevalent in Africa, but still diagnostic and treatment challenges persist in primary care settings. Effective treatment regimens are therefore crucial for eradicating this infection and preventing complications. This study aimed to develop a consensus-based algorithm for H. pylori management optimized for Primary care settings utilizing data from primary care physicians, patient screening, and treatments.

Methodology: A cross-sectional study was conducted among forty-four primary care physicians involved in diagnosing and treating H. pylori infection. They were provided with a data Collection Form (DCF) and an H. pylori rapid antibody test kit. All the questionnaire responses and the result of rapid antibody test were recorded and analyzed. A panel of experts involving senior family medicine doctors, and a gastroenterologist via a modified Delphi process of discussions on the DCF responses, and test results from the 44 physicians arrived at a consensus-based treatment algorithm developed to guide clinical decision-making for H. pylori management.

Results: This study comprised 245 patients with a female preponderance and mean age of 35.0±11.5 years. The most common symptoms from the DCF were epigastric pain, nausea/vomiting and bloating in 74.5%, 52.7% and 35% respectively while the mean duration of symptoms was 3weeks. Constipation and irritability were the least common symptoms with heartburn reported less frequently in the H. Pylori positive cases. 79.9% of the 245 patients were H. Pylori treatment naïve with a higher likelihood (57.1%) of having a positive antibody test. It was recommended that both treatment experienced and naïve patients with epigastric or abdominal pain, nausea vomiting and/or bloating with symptom duration > 2weeks be tested and eradicated while those with alarm symptoms be referred to the specialist.

Conclusion: The proposed algorithm provides a comprehensive guide for Physicians at the primary and secondary care level in selecting the most effective treatment regimen for H. pylori infection. H. Pylori antibody testing is a primary screening tool for patients with persistent symptoms or those lasting greater than 2weeks and where positive confirmatory test is recommended.

Outcome of intra-operative Purulent Peritoneal Fluid Aspirate Culture Results during Appendicectomy in Patients’ Management

Tue, 11 Nov 2025 00:00:00 +0000

Background: Intra-operative purulent peritoneal fluid aspirate for microscopy, culture, and sensitivity during appendicectomy is practiced by some surgeons to help in the post-operative management of patients if the patients get unwell, requiring a change of the prescribed pre-operative antibiotics. This study aimed to evaluate if there are benefits from purulent peritoneal fluid aspirate culture results during appendicectomy.

Methodology: This was a retrospective review of medical records and operation notes of all the patients who had an appendicectomy with purulent peritoneal fluid that was aspirated for microscopy culture and sensitivity in the last 3 years (May 2019 to April 2022).

Results: A total of 73 patients had purulent peritoneal fluid culture results and received perioperative intravenous antibiotics. There were 52 (71%) bacteriological positive culture results from the purulent peritoneal fluid aspirates and 21 (29%) negative peritoneal pus culture results. The most common antibiotics administered were a combination of co-amoxiclav and metronidazole 45 (61.6%). One-quarter of the preoperative antibiotics were changed due to the positive microbiology culture results from the peritoneal pus aspirates. The main reasons for the change in antibiotics were intra-abdominal collections and wound infection in 21 (28.8%) of the patients, and Streptoccocus anginosus was the most common organism isolated. A re-operation and/or ultrasound-guided drainage of intra-abdominal collections were avoided in 13 out of 17 patients due to the change of the pre-operative antibiotics following the results from the purulent peritoneal fluid.

Conclusion: The intra-operative purulent peritoneal fluid culture results during appendicectomy contributed positively towards the post-operative management of patients.

Descriptive study of free Emergency Trauma Services and Outcomes in a Tertiary Teaching Hospital, North-Western Nigeria

Tue, 11 Nov 2025 00:00:00 +0000

Background: Waiting time at a trauma centre (TC) before injured patients receive treatment is critical to treatment outcomes. The study aims to find the impact of the government’s free emergency services on the waiting time before treatment is initiated.

Methodology: This was a retrospective study of the admitted emergency patients at the Trauma Centre, of Usmanu Dan fodio University Teaching Hospital (UDUTH), Sokoto, Nigeria, from November 2024 to March 2025. Patients’ presentation time was classified as less than 6 hours or more than 6 hours before admission and waiting time as less than 15 minutes or greater than 15 minutes. The outcome was either satisfactory or unsatisfactory. Chi-Square was used to analyse categorical data. The level of significance was set at P<0.05.

Results: There were 366 patients included in the study. The average waiting time before intervention (in minutes) was 10.5±0.242. Most patients (42/11.5%) had a waiting time of 7 minutes. The male-to-female ratio was 2.1 to 1. The mean age of patients was 35.87±17.20. Cases seen were fractures & dislocations (122/33.3%), gunshot wounds (62/16.9%), head injuries (43/11.7%), burns (38/10.4%), spinal cord injuries (33/9.0%), abdominal injuries (26/7.1%), urologic injuries (21/5.7%) and others (21/5.7%) include chest injuries, soft tissues, limbs gangrene etc. There were 252 (58.9%) patients who presented less than 6 hours post-injury, while 114 (31.1%) presented after 6 hours. Patients who started receiving treatment on admission <16 minutes were 298 (81.4%), and those at >15 minutes were 68 (18.6%). Associating injury duration (<6 hours vs. >6 hours) and treatment outcomes, p-value=0.0001, OR=4.90, 95% CI=2.39-10.04. At the same time, associating waiting time before treatment and treatment outcomes, the p-value=0.0001, OR=5.29, 95% CI=10.77. Following the paired sample t-test of the 2 groups between the median (10.0), the p-value was 0.0001.

Conclusion: There was an improvement in the waiting time for the initiation of treatment. This was largely influenced by the presence of free ambulance services, available free medications and surgical interventions.

Knowledge and Attitude of Pregnant Women on ABO and Rhesus Blood Grouping Towards Preventing Neonatal Hemolytic Disease at Rasheed Shekoni Federal University Teaching Hospital, Dutse, Jigawa State, Nigeria

Abdul’aziz Sulaiman, Mas’ud Abdullahi — Tue, 11 Nov 2025 00:00:00 +0000

Background: Hemolytic Disease of the Fetus and Newborn (HDFN) is a significant neonatal condition resulting from ABO and Rhesus (Rh) blood group incompatibility between mother and fetus. Adequate knowledge and positive attitudes among pregnant women toward blood grouping can help prevent complications. This study assessed the Knowledge and Attitude of Pregnant Women on ABO and Rhesus Grouping towards Preventing Neonatal Hemolytic Disease at Rasheed Shekoni Federal University Teaching Hospital, Dutse, Jigawa state.

Methodology: A descriptive cross-sectional study was conducted among 316 pregnant women receiving antenatal care at the hospital. A structured questionnaire was used to collect data on socio-demographic characteristics, knowledge of ABO and Rh blood grouping, and attitude toward their importance in preventing HDFN. Data were analyzed using descriptive and inferential statistics.

Results: The majorities of respondents (46.2%) were aged 26–30 years and most had at least a secondary education (57.2%). Awareness of ABO and Rh blood groups was high, with 70.3% of respondents knowing their blood group and Rh status. However, only 16.5% demonstrated good knowledge of HDFN, while 33.2% had poor knowledge. Awareness of preventive measures, including the anti-D immunoglobulin, was low (17.4%). Despite knowledge gaps, attitudes were positive, with 87.7% recognizing the importance of blood grouping in pregnancy, and 98.4% supporting public health campaigns on the topic. Age (p = 0.001), educational level (p = 0.001), occupation (p = 0.001), family income (p = 0.001) and number of pregnancies (p = 0.003) were significantly associated with knowledge levels. Attitude was also significantly associated with age (p = 0.003), educational level (p = 0.003) and family income (p = 0.024).

Conclusion: While awareness of blood grouping was high, knowledge of HDFN and its preventive measures remained limited. Strengthening antenatal education and implementing targeted awareness programs are essential to improve understanding and ensure the effective prevention of HDFN.

Serum Galectin-3 as a Prognostic Biomarker in Acute Ischemic Stroke: A Comparative Cross-Sectional Study

Tue, 11 Nov 2025 00:00:00 +0000

Background: Stroke is a major cause of morbidity and mortality globally, with a particularly high burden in low- and middle-income countries such as Nigeria. Early identification of biomarkers, such as serum Galectin-3, which plays a role in inflammation and tissue remodeling, may improve diagnostic accuracy and patient outcomes in acute ischemic stroke. This study aimed to compare serum Galectin-3 levels between patients with acute ischemic stroke and age- and sex-matched stroke-free controls.

Methodology: A prospective comparative cross-sectional study was conducted at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 100 first-ever acute ischemic stroke patients and 100 apparently healthy controls were recruited. Serum Galectin-3 levels were measured using an enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed to compare Galectin-3 levels between groups using the Statistical Package for the Social Sciences (SPSS), version 24.0.

Results: The median serum Galectin-3 level was significantly higher in stroke patients compared to controls [60 (55.00–63.00) vs 56 (49.00–62.00), p = 0.003]. The two groups were comparable in age and sex distribution, but hypertension and diabetes were significantly more prevalent among stroke patients. Elevated serum Galectin-3 levels were positively associated with stroke diagnosis.

Conclusion: Serum Galectin-3 is significantly elevated in acute ischemic stroke patients compared to stroke-free individuals. Galectin-3 could serve as an important biomarker for acute ischemic stroke, aiding in timely diagnosis and management.

Treatment Outcome of Patellar Fractures Across Two Tertiary Centers: A Five-Year Retrospective Study

Tamunokuro Ezekiel Diamond, Mike Tochi Achor — Tue, 11 Nov 2025 00:00:00 +0000

Background: Fractures of the patella, though not so common, are prone to complications. Injuries to the patella often disrupts the extensor mechanism of the knee and increases the likelihood of patella-femoral joint incongruence. The aim of this study was to determine the outcome of treatment of patella fracture in two tertiary health institutions in South-south Nigeria.

Methodology: A retrospective descriptive study was conducted among patients who had patella fractures over a five-year period, using hospital records. The data obtained were analyzed and formed into tables, charts and figures.

Results: Thirty-nine patients were recruited into the study. Patella fractures were most predominant in the age bracket 31-40 years (30.8%), while the least was noted in the age group 61-70 years (5.1%). Road traffic accidents were the most common etiological factor (53.8%). Majority of the patients had transverse fractures (61.5%), while severely committed fractures constituted the least (2.6%). Four patients (10.3%) had open fractures. Majority of the patients had surgical treatment with tension band wiring (25 patients). The outcomes were good within the period of follow-up.

Conclusion: The result showed that patella fractures are common in young population. Patients receive optimum care with good outcome in the two centers involved in this study.

The Cost of Care of Childhood Epilepsy in Southern Nigeria: Experience from a Tertiary Hospital in Port Harcourt

Kininyiruchi Nelson Wobo, Nneka Gabriel-Job — Tue, 11 Nov 2025 00:00:00 +0000

Background: The financial burden of caring for a child living with epilepsy and its effect on the family's financial status and quality of life are understudied. This study aimed to determine the cost of care for children with Epilepsy in Port Harcourt.

Methodology: A purposive sampling method was employed. Participants were 37 children with epilepsy and their parents/caregivers. An interviewer-administered semi-structured questionnaire was used to obtain information on the socio-demographic, estimates of the financial costs of epilepsy care, the effect of caregiving on caregiver productivity and income.

Results: The average monthly income per family is $332.80 ± $116.82. The majority, 32(86.5%), financed epilepsy care via out-of-pocket payments. The average cost of epilepsy care is $66 per month ($792 per annum), accounting for 20% of the average family income. There was a negative correlation between hours spent on caregiving and household income (rho =-0.288; p-value = 0.084). Over two-thirds (67.6%) of the caregivers consider their overall well-being negatively affected by having a child with epilepsy.

Conclusion: The cost of care of childhood epilepsy in southern Nigeria is high and takes up a significant proportion of household income. Concerted efforts need to be made to encourage subscription to health insurance to alleviate the financial burdens on families.

Epidemiological Profile of Haemoglobinopathies in Different Districts of West Bengal: A Retrospective Study

Oindrila Dhar, Abhishek Sharma, Somdatta Bhaumik, Anjan Kumar Das — Tue, 11 Nov 2025 00:00:00 +0000

Background: Haemoglobinopathies are autosomal recessive inherited disorders affecting haemoglobin structure or production. Over 1,000 haemoglobin variants have been identified, with carriers often asymptomatic or exhibiting mild anaemia. When both parents are carriers, there is a 25% risk per pregnancy of having a child with a severe form of the disease. Our study aims to (i) describe the epidemiological profile of different haemoglobinopathies, (ii) evaluate the variety of haemoglobinopathies and carriers, and(iii) estimate the prevalence of haemoglobinopathies and carriers.

Methodology: This retrospective cross-sectional study included 5,000 cases obtained from multiple screening camps organized by Ma Sarada Charitable Dispensary & Pathology Centre. All available high-performance liquid chromatography (HPLC) reports with corresponding patient clinical histories and complete blood count results were reviewed. Patients with a history of blood transfusion were excluded from the study to prevent alteration of hemoglobin profiles. Data was extracted and analysed to determine the prevalence and types of haemoglobinopathies in the study population.

Result: Beta thalassemia carrier is the most common haemoglobinopathy (6.36%) detected in West Bengal, followed by HbE carrier. HbE disease, Hb E beta thalassemia, Hb S carrier, Hb S disease, and HPHF trait are the other haemoglobinopathies, also found in this study. Most of the patients are male (11.27%). Among the districts, Beta thalassemia carrier is mostly found in North 24 Parganas, and Hb E carrier is mostly found in South 24 Parganas. Other haemoglobinopathies are also mostly found in North 24 Parganas.

Conclusion: This study highlights a significant prevalence of beta thalassemia and other hemoglobinopathies in the screened population, underscoring the urgent need for widespread screening programs to identify asymptomatic carriers. Early detection through high-performance liquid chromatography (HPLC) can facilitate timely genetic counseling and intervention, thereby helping to prevent disease transmission. Although HPLC interpretation demands specialized training, it remains a reliable and practical screening tool when performed promptly after blood collection to minimize diagnostic errors.

Prevalence of Adverse Drug Reactions among People Living with HIV in Lagos State University Teaching Hospital, Lagos, Nigeria

Tue, 11 Nov 2025 00:00:00 +0000

Background: Human Immunodeficiency Virus (HIV) remains a major public health concern in Nigeria, which has been rated as having a high HIV burden globally. Antiretroviral therapy (ART) has significantly improved life expectancy and reduced HIV-related morbidity and mortality. However, ART is associated with adverse drug reactions (ADRs), which can lead to treatment failure, regimen changes, and non-adherence, ultimately affecting patient outcomes.

Methodology: This was a retrospective cohort study of newly initiated people living with HIV (PLHIV) accessing care at the Lagos State University Teaching Hospital (LASUTH), Ikeja. All newly initiated HIV patients receiving antiretroviral therapy (ART) at LASUTH between March 2023 and March 2025 were included. Data collected during the study period were abstracted, and individuals who experienced an adverse drug reaction (ADR) were recorded. Data was analysed using the Statistical Package for the Social Sciences (SPSS) version 27.0. Statistical significance was established at p ≤ 0.5.

Results: Overall, 533 newly initiated into treatment in the study period. Out of the newly initiated (533), a total of 65 reported adverse reactions to the drugs of treatment, which constituted 12.1% prevalence of ADR in the newly initiated. The mean age of all participants was 40.50 ± 11.76 years. All the newly initiated (100%) were on Tenofovir, Lamivudine, and Dolutegravir (TLD) combination. Pruritus is the commonest symptom in both females and males.

Conclusion: The ADR prevalence among the newly enrolled PLHIV is 12% and pruritus is the commonest ADR seen among the newly enrolled.

Immediate, 6-hours and 24-hours urethral catheter removal on urinary morbidity following elective caesarean delivery under spinal anaesthesia: A randomized comparative study.

Tue, 11 Nov 2025 00:00:00 +0000

Background: Urethral catheterization is a common practice during caesarean delivery. Prolonged use may lead to urinary tract infection, the duration of catheterization being critical to its development. The optimal time for its removal after caesarean delivery remains undecided. This study compared the effect of immediate, 6-hours and 24-hours removal post-elective caesarean delivery on significant bacteriuria, re-catheterisation, interval to first micturition and maternal discomfort.

Methodology: The study was conducted at a tertiary hospital in Port Harcourt, Nigeria. A total of 150 women who had elective caesarean delivery were randomised into 3 groups using computer-generated random sequence numbers. Group A – had the urethral catheter removed immediately, Group B – after 6 hours, and Group C – after 24 hours post-operation. The women were assessed for significant bacteriuria and need for re-catheterisation as the primary outcomes; interval to first micturition and maternal discomfort as the secondary outcomes. Data was analysed using IBM SPSS version 23.

Results: Overall incidence of significant bacteriuria was 12%. The difference in incidence was 0(0%), 6(12%), and 12(24%) for the Immediate, 6-hours and 24-hours groups respectively,(p<0.001).Urinary retention requiring re-catheterization was also significant, highest in the Immediate group 8(14%), 2(4%) in the 6-hours group and none in the 24-hours group. The mean interval to first micturition was highest in the 6-hour group, least in the 24-hour group and intermediate in the Immediate group (9.52±6.26, 5.16±3.80, and 6.92±3.36, respectively<0.001). Most participants had mild discomfort, and the difference between groups was insignificant (p=0.445).

Conclusion: Immediate catheter removal had a lower risk of significant bacteriuria but increased urinary retention, while the 24-hour removal had reduced urinary retention but was fraught with significant bacteriuria. The 6-hour removal had a modest risk for both significant bacteriuria and urinary retention. The 6-hours removal offers a balance and should be a safer option.

Evaluating the Knowledge and Awareness of Professional Indemnity Insurance among Medical Doctors in Nigeria

Tue, 11 Nov 2025 00:00:00 +0000

Background: Professional Indemnity Insurance (PII) is an important cover for health professionals against the risks of legal and financial consequences of medical malpractice lawsuits. Nigerian medical doctors are still not adequately informed about it. This cross-sectional study evaluated PII knowledge and awareness among 300 registered physicians across different settings in Nigeria, including urban tertiary hospitals, rural clinics, and private practice.

Methodology: A self-validated questionnaire collected socio-demographic data, medical specialties, and the extent of PII knowle1dge. Descriptive and inferential statistics were used to analyse the data. Outcomes revealed that merely 32% of participants possessed sufficient knowledge about the purpose and scope of PII. Knowledge was significantly correlated with years of experience (p=0.03), with senior physicians exhibiting higher awareness, as well as practice setting (p=0.04), with doctors working in urban tertiary institutions performing better than those practising in rural clinics.

Results: In particular, 45% of urban tertiary hospital physicians expressed familiarity with PII, compared with 22% of rural clinic physicians, presumably due to greater access to professional resources. These disparities indicate a large gap in PII awareness, particularly in the countryside.

Conclusions: To address this, the integration of medico-legal modules into medical training, as implemented in South Africa, would enhance knowledge among newly qualified doctors. Targeted education interventions, such as workshops and continuing medical education courses in diverse practice settings, would be required to bridge the gap. This would empower Nigerian doctors with the knowledge needed to access PII and hence better protect themselves and patients.

Association of Anaemia and Depression: A Systematic Review and Meta-analysis

Bhupesh Gupta, Ramita Goel, Vimal Satodiya, Kirtika Gupta, Anshu Mittal — Tue, 11 Nov 2025 00:00:00 +0000

Background: This research aims to find out the prevalence of depression in all types of anaemia patients of all age groups and genders by conducting a comprehensive meta-analysis of observational epidemiological studies.

Methodology: The relevant peer-reviewed literature describing primary data analysis was thoroughly evaluated using the PRISMA checklist as a reference. We searched databases, including PubMed, Scopus, Embase, and Google Scholar, to identify research publications published between 2003 and 2024. R software version 4.3.0 was utilised to perform the meta-analysis, and the JBI score was employed for quality appraisal. Heterogeneity was assessed using the Q and I2 statistics. To pool estimates, a random-effects model was employed. Publication bias was assessed using a funnel plot and Egger's regression test.

Results: After combining the results of the papers, the prevalence of depression was estimated at 36 % (CI = 95: 28–45 %) based on a random effects model. Sub-group analysis showed that the prevalence of depression was higher in patients with sickle cell anaemia (42%) followed by Thalassemia (35%) and Iron deficiency anaemia (20%). Sub-group analysis also found a higher prevalence (almost double) of depression in anaemic patients of Asia (40%) and the African continent (37%,) which is almost double as compared to America (28%) and Europe (20%). The declining trend of meta-regression analysis demonstrates that depression prevalence is higher among young anaemia patients (Children and adolescents) as compared to older ones.

Conclusion: Routine screening for depression may be required during regular follow-ups of anaemic patients, especially in resource-limited settings.

A Comparative Study of Clinical and Electroencephalographic Findings of the Children with Epilepsy with or without Cerebral palsy in a Tertiary Health Facility in Nigeria

Tue, 11 Nov 2025 00:00:00 +0000

Background: Epilepsy, whether occurring alone or with cerebral palsy (CP), is among the most common neurological disorders seen in paediatric neurology clinics in Nigeria. Management requires accurate diagnosis and classification, which becomes more challenging when epilepsy coexists with CP. Electroencephalography (EEG) is a valuable tool for confirming and characterising epileptic activity. This study aimed to compare the clinical and EEG characteristics of children with CP and epilepsy (Group 1) and those with epilepsy without CP (Group 2) in a Nigerian tertiary institution.

Methodology: This prospective, cross-sectional, comparative study was conducted from March 2022 to February 2023. A total of 121 children with epilepsy and CP (Group 1) and 124 with epilepsy only (Group 2), aged 6 months to 15 years, were consecutively recruited. Clinical profiles and EEG findings were compared. Data were analysed with SPSS version 25.0, with p < 0.05 considered significant.

Results: The median age at epilepsy onset was 12 months (IQR: 9.5) in Group 1 and 49 months (IQR: 58.7) in Group 2, showing a significant difference (p < 0.001). Uncontrolled epilepsy was more common in Group 1, occurring in 50 of 72 (69.4%) on antiepileptic drugs, compared to 12 of 69 (17.4%) in Group 2 (p < 0.001). Generalized-onset epilepsy was most frequent in both groups (59.5% vs. 54.8%, p = 0.844). West and Lennox–Gastaut syndromes appeared only in Group 1, while Doose syndrome occurred only in Group 2.

Conclusion: A disparity was observed between clinical and electroencephalographic (EEG) classifications, particularly among children with epilepsy and cerebral palsy. EEG evaluation is therefore recommended as an essential component of epilepsy management in this population.

Comparison of Blood Glucose Levels in Caesarean and Vaginally Delivered Newborns at Lagos University Teaching Hospital, Nigeria

Tue, 11 Nov 2025 00:00:00 +0000

Background: Normal blood glucose supply and metabolism are of utmost importance for growth and normal brain development in the foetus and newborn. Disorders in glucose supply or metabolism can result in hypoglycaemia or hyperglycaemia. Considering the increasing trend of caesarean section (CS) worldwide, including Nigeria, it is important to determine the incidence and type of dysglycaemia in neonates delivered by CS. The study objective was to compare the blood glucose (BG) levels of newborns delivered by CS with those by vaginal delivery (VD).

Methodology: This was a prospective observational study of 164 neonates, of which 85 were delivered through CS and 79 through VD. A pretested questionnaire was used to obtain information on sociodemographic variables, gestational age, feeding time of the new-born and maternal fasting time, while BG was determined using Accu-chek Multiclix. Every tenth sample was also tested in the laboratory for quality control.

Results: The mean (SD) cord blood glucose level was lower in the CS (68.7(10.1) mg/dl) than VD neonates (80.9(11.5) mg/dl, p = <0.001). The mean (SD) blood glucose level at 2 hours of life was also lower in CS (62.5(10.0) mg/dl) than VD neonates (71.2(10.9) mg/dl, p = <0.001). Factors that were significantly associated with cord BG levels were gestational age, maternal fasting time and mode of delivery. At two hours of life, cord blood, neonatal feeding time, gestational age and birth weight were significantly associated with neonatal BG levels.

Conclusion: Cord and neonatal BG were significantly lower in neonates who were delivered via CS compared to those delivered vaginally.

Glycemic control among People living with HIV and diabetes in Eastern Uganda: A cross-sectional study

David Okia — Tue, 11 Nov 2025 00:00:00 +0000

Background: Poor glycemic control remains a significant Public Health problem among people living with HIV(PLWH) and diabetes in Africa and Uganda specifically. Dual diagnosis of HIV and diabetes is associated with high costs of management and poor prognosis. This study aimed to determine the baseline glycemic control of PLWH and diabetes and associated factors in Eastern Uganda.

Methodology: This study employed quantitative methods along with a cross-sectional analytical study design. A total of 257 participants (ten didn’t participate) from Mbale and Soroti Regional Referral Hospitals participated in this study from May 1 to July 30th, 2024. The sample size was determined using the modified Cochrane formula, and participants were selected using simple random sampling. An electronic questionnaire was used to collect socio-demographic and clinical data. An automated Finecare HbA1c analyser was used to determine the HbA1c levels of participants. The data was analysed using Stata version 15. Multivariable logistic regression analyses were conducted to identify associated factors. At p<0.05, statistical significance was established.

Results: The median age was 51(44, 60). The female participants comprised 152 (59.1%), and 52 (20.2%) of the total participants had a tertiary education. More than half, 136 (52.9%), had HbA1c above 7%. The age group above 50 years, having more than three children, and tertiary education were positively associated; however, only the tertiary level of education was statistically significant after adjusting for confounders, aPOR 3.9(95% CI:1.1-14.2), p=0.037.

Conclusion: The prevalence of poor glycemic control among people living with HIV and diabetes at Mbale and Soroti Hospitals in Uganda is high at 52.90%. The age group above 50 years, having children and tertiary education were positively associated with poor glycemic control. Routine HbA1c testing and immediate evidence-based management by health workers are encouraged among clients over 50, those with children, and those with tertiary education.

Assessment of Uptake of Cervical Pre-Cancer Screening among Women of Reproductive Age in Ogun State, Nigeria.

Tue, 11 Nov 2025 00:00:00 +0000

Background: Cervical cancer is the second most common cancer in women in Nigeria and is largely preventable. However, in Nigeria, the absence of universal screening means individual awareness and knowledge significantly impact screening uptake. Previous studies have reported mixed results regarding awareness and screening rates.

The study assessed cervical screening uptake rate among women of reproductive age.

Methodology: It was a descriptive cross-sectional study among women of reproductive age across the three senatorial districts in Ogun State, Nigeria, using interviewer-administered questionnaires following ethical approval. Data analysis was performed using IBM SPSS version 25. The outcome variables included the level of awareness and knowledge of cervical cancer and its pre-malignant screening, as well as the level of uptake of cervical cancer.

Results: A total of 1310 women were interviewed, with 1233 responses analyzed. The mean age of the respondents was 32.33 ± 6.25 years. Of the respondents, 592 (48.0%) were aware of cervical cancer, 281 (22.8%) were aware of cervical screening, and 141 (11.4%) had good knowledge of cervical cancer. Eighty (6.49%) participants had been screened at least once, and only nine had been screened at least twice. The majority of the women, despite the poor awareness and knowledge levels, were willing to be screened in the future. There was a statistically significant association between cervical cancer awareness and uptake of screening (X² = 9.282, df =1, P-value = 0.002).

Conclusion: Awareness, knowledge, and screening uptake remain low among women in Ogun State. However, awareness of cervical cancer positively influences screening participation. Therefore, extensive awareness campaigns are recommended to improve screening rates and reduce cervical cancer prevalence.

Disparities Impacts Psychiatry Competency Assessments among Students in a Nigerian Medical School

Tue, 11 Nov 2025 00:00:00 +0000

Background: Assessments in medical education must reliably evaluate competencies while addressing potential gender disparities. This study examines the reliability of psychiatry competency assessments among final-year medical students at the University of Ilorin, Nigeria, and explores gender differences in performance. The aim was to evaluate the internal consistency of formative (progressive assessment) and summative (final MBBS) examinations, analyse correlations between assessment components, and compare gender-based performance.

Methodology: A retrospective analysis of all 137 (77 male, 60 female) final year medical students’ psychiatry competence assessments was conducted. Reliability was measured using Cronbach’s alpha, correlations between exam components were assessed via Pearson’s correlation, and gender differences were analysed using t-tests and Cohen’s d.

Results: The combined assessments showed high reliability (α = 0.857), though lower for females (α = 0.553 vs. males: α = 0.618). Progressive assessment correlated moderately with theory components (Multiple Choice Questions: r = 0.507) but weakly with clinical tools (picture test: r = 0.158). Females outperformed males in both theory (mean difference: +1.71, p = 0.001) and clinical exams (mean difference: +1.08, p = 0.019), with moderate effect sizes (Cohen’s d = 0.63 and 0.42, respectively).

Conclusion: While the assessment system demonstrates strong overall reliability, gendered disparities suggest a need for more equitable evaluation methods. Females consistently outperformed males, but lower reliability in their combined scores calls for refined formative tools. Integrating more multimodal assessments may enhance fairness and validity.

‘Publish or Perish!’: perception and self-appraisal of Indian physicians on academic publications: A cross-sectional study

Santanu Nath, Shiv Kumar Mudgal, Venkata Lakshmi Narasimha, Saurabh Varshney — Tue, 11 Nov 2025 00:00:00 +0000

Background: Research and academic publications are crucial for Indian physicians' professional growth, evidence generation, and academic advancement. It often contributes to the "publish or perish" culture. This study aims to assess Indian physicians' perceptions and self-appraisal on academic publications, for those practicing evidence-based medicine (EBM).

Methodology: A cross-sectional online survey with proper consent was conducted over two months, targeting Indian physicians practicing EBM to evaluate their views on research and publications.

Results: A total of 320 physicians participated (mean age 41.15 ± 8.94 years; 68.8% male). Most held post-graduate degrees (73.4%) and worked in government-run institutions (56.6%). A large proportion (88.7%) had prior publications, with a preference for PubMed/Medline-indexed journals (40.0%). Sixty-five percent balanced clinical and academic roles. Physicians were motivated by career advancement (31.6%) and professional recognition (34.7%). Behavioral patterns showed "addiction-like" tendencies, with many frequently checking publication metrics and tracking manuscript progress. Physicians with post-graduate qualifications, particularly in medicine, were more engaged in these behaviors. Those in central government teaching institutions showed even greater engagement.

Conclusion: This study reveals the complex dynamics of academic publishing among Indian physicians, highlighting the pressures of the "publish or perish" culture. Institutions should focus on fostering quality over quantity in publishing, providing mentorship, and promoting ethical practices to mitigate these pressures.

Comparative evaluation of intracanal medicaments on sealing ability of MTA and Hydroxyapatite apical plug in simulated immature teeth – An in vitro study.

Tue, 11 Nov 2025 00:00:00 +0000

Background: Immature teeth must be managed by apexification as there is no definite apical stop. Use of intracanal medicaments prior to apexification affect the sealing ability of apical plug. Present study was done to compare the effect of various intracanal medicaments: Metapex, Chlorhexidine digluconate, Curcuma longa, and Triple antibiotic paste (TAP) on the sealing ability of MTA and Hydroxyapatite as an apical plug.

Methodology: 130 single-rooted teeth were divided into two experimental groups (n=60 each) [Group I: MTA; Group II: Hydroxyapatite], and two control groups (n=5 each) [Group IIIA: MTA; Group IIIB: Hydroxyapatite] based on the apical plug used. Experimental groups were subdivided, based on intracanal medicaments [Group IA and IIA – Metapex; Group IB and IIB - 2% Chlorhexidine digluconate, Group IC and IIC - Curcuma longa, Group ID and IID - TAP]. After biomechanical preparation, simulation of immature apex was done using peeso-reamer. Intracanal medicaments were placed, and study samples were incubated for 7 days. Then all medicaments were removed using H-files, followed by retrograde apical placement, obturation, and restoration. Samples were subjected to dye penetration test, followed by clearing procedure. Apical microleakage was assessed using stereomicroscope at 40X. Data collected was subjected to statistical analysis using SPSS version 20.0 (p=0.05).

Results: Apical dye penetration was minimum in control group, followed by Group IB (0.17±.46) < IIB (0.53±.57) < IIC (0.90±.96) < IID (0.93±.59) < IC (1.83±.83) < ID (1.91±.81) < IIA (2.13±.81) < IA (2.31±.73).Intragroup comparison for apical microleakage was statistically significant (p<0.001), whereas intergroup comparisons were statistically significant except for group IA v/s IIA, IB v/s IIB, IC v/s IIA, ID v/s IIA.

Conclusion: Hydroxyapatite showed better sealing ability than MTA with all intracanal medicaments. Sealing ability was minimal with Metapex, followed by Turmeric, TAP, and 2% Chlorhexidine.

Hematological Profile and Blood-Borne Virus Prevalence in Pregnant Women at a Tertiary Military Hospital, Lagos, Nigeria.

Tue, 11 Nov 2025 00:00:00 +0000

Background: Maternal haematological status and concurrent blood-borne viral infections play a crucial role in determining pregnancy outcomes. This study assessed haematological profiles and the prevalence of blood-borne viruses among pregnant women attending a tertiary military hospital over a four-year period.

Methodology: A retrospective cohort analysis was conducted using clinical records of 499 pregnant women who attended antenatal care at the 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Data on demographics, complete blood count, and serology for blood-borne viruses were extracted into a structured proforma. It was analysed using statistical package of social sciences (SPSS) version 29. Descriptive statistics were presented using tables and charts. Associations were tested, with statistical significance set at p<0.05.

Results: Participants had a mean age of 36 ± 2.3 years. Blood group O was most common 245(49.7%), with the least being AB blood group which accounted for 48(9.6%). Haematocrit was lowest in the third trimester (31.21 ± 4.1%, p<0.001), while 1^st and 2^nd trimester haematocrits were 33.49±3.4 and 31.73±3.1 respectively. Anaemia was significantly associated with primiparity (p=0.04), HIV infection (p=0.03), and the Hb AS genotype (p=0.01). HIV prevalence was 30 (6.0%) higher than that of hepatitis B 27(5.4%) and Hepatitis C 7(1.4%).

Conclusion: HIV prevalence (6.0%) was higher than hepatitis B and C, and primiparous women showed significant anaemia with low haematocrit values. These findings call for targeted nutritional support and strengthened antenatal screening for blood-borne viruses to improve maternal and fetal outcomes.

Digital Technology-Enhanced Remote Health Services: Antenatal Clients’ Perception, Acceptance and Readiness at a Nigerian Tertiary Hospital.

Tue, 11 Nov 2025 00:00:00 +0000

Background: Digital technology offers promising solutions for monitoring pregnant women but client’s readiness for its adoption in Nigeria remains underexplored. This study assessed antenatal clients’ perceptions and readiness for digital health adoption.

Methodology: This cross-sectional survey involved 228 antenatal clients recruited through systematic sampling. Participants completed the 16-item Technology Readiness Index (TRI 2.0) and supplementary perception scales on 5-point response scales. Respondents were categorised as explorers, pioneers, skeptics, paranoids, or laggards based on their TRI scores. The range of Cronbach’s alpha for scales was: 0.80–0.92. Data were analysed using SPSS version 29, applying descriptive and generalised linear regression analyses, with statistical significance set at p ≤ 0.05.

Results: The response rate was 100% and most participants were aged 25–34 (43.9%), married (51.8%), and held tertiary education (38.6%). Ownership of digital devices was smartwatches (6.1%), smartphones (25.9%), and computers (26.3%). Clients prioritised e-prescription (3.09±1.11) and access to personal health information (3.08±1.13) as top benefits of remote services. TRI Scores were overall TRI (3.00±0.31), optimism (3.12), innovativeness (3.22), discomfort (3.12), and insecurity (3.19). Majority (90.4%) were classified as skeptics. Unemployed clients showed lower acceptance of devices for remote maternal monitoring (B = -0.13, 95% CI: -0.24, -0.01, p = 0.033).

Conclusion: Despite the global momentum toward digital maternal health solutions, antenatal clients in Nigeria demonstrate low digital engagement and are predominantly skeptics. Targeted interventions including digital literacy campaigns, improved trust through data privacy protections, and broader infrastructural investments are critical for promoting equitable adoption of remote digital maternal health solutions.

Factors Leading to Delay in Surgical Treatment of Paediatric Congenital Heart Diseases in Rural Western India – A Hospital-Based Study.

Tue, 11 Nov 2025 00:00:00 +0000

Background: Congenital heart diseases (CHD) account for 28% of birth defects in India. Treatment options and long-term outcomes have significantly improved over the past six decades. However, there is a notable delay in diagnosing CHD and initiating treatment for diagnosed patients. This study seeks to identify factors influencing the treatment timing of CHDs in paediatric patients residing in rural areas of India.

Methodology: Cross-sectional survey. The study uses descriptive statistics and chi-square tests for comparing categorical data between groups to identify factors contributing to delays.

Results: A total of 115 patients were enrolled. Ventricular septal defect was the most prevalent diagnosis (40 patients), followed by Tetralogy of Fallot (23 patients). 47 % of patients experienced delayed diagnosis, while 69% experienced delayed treatment. Notably, the severity of delayed treatment was more pronounced in acyanotic heart diseases compared to cyanotic heart diseases. Financial constraints were cited as the primary reason for delayed treatment in 27.8% of cases, while social factors were the most common reason for delayed treatment despite diagnosis in the remaining 72.2%.

Conclusion: Despite substantial government financial support for treatment and diagnosis, further delays in treatment remain significant. Social factors, other than economic factors, appear to be the primary contributors to these delays. Sample size and in-hospital study limitations are acknowledged.

Misconceptions about Ebola Virus Disease among Residents of Calabar, Cross River State, Nigeria: A Mixed-Method Approach.

Tue, 11 Nov 2025 00:00:00 +0000

Background: The Ebola Virus Disease (EVD) has a high risk of death killing an average of about 50% of those infected. Several outbreaks have occurred intermittently since the disease was first described. The 2014 outbreak was the largest and most complex in recorded history. Rumours were rife especially through social media that a salt ritual amongst other unverified claims could prevent or cure EVD. This study aimed to determine the knowledge, perception and practices to prevent EVD in Calabar and to highlight the role of social media in health seeking behaviours.

Methodology: This was a mixed method study, a combination of cross-sectional design and Focused Group Discussion conducted between November 2016 and June 2017.

Results: Ninety-three percent (93%) of the respondents had heard about EVD with the radio (82%) being the dominant source of information. Virus as the causative agent and contact with body fluids as the most common mode of transmission were correctly identified by 72%. Fever ranked as the most common symptom by 75% and washing of hands (60%) was perceived as the most common way to prevent EVD. Sixty-three percent (63%) responded that salt is used to cure EVD,57% participated in the salt ritual and 85% of those who partook in the salt ritual later realized it did not cure or prevent EVD.

Conclusion: People should be encouraged to seek health related information from the appropriate sources. Effective and sustained communication strategies are advocated to mitigate rumour mongering and misinformation to curb unhealthy practices.

What is the relationship between the Number of Significant rib fractures and Haemothorax in adults with blunt chest trauma?

Kelechi E. Okonta — Tue, 11 Nov 2025 00:00:00 +0000

Background: The study aimed to determine the correlation between the number of significant rib fractures in patients with blunt chest trauma (BCT) and the amount of haemothorax as recorded by Closed Thoracostomy Tube Drainage (CTTD).

Methodology: This was a cross-sectional study of all patients with significant rib fractures following BCT over a period of two years. “Significant rib fractures” was defined as the fracture of 3 or more ribs with 50% or more displacement of each fractured rib edge. Patients with massive haemothorax, patients with severe neurological, or patients who required emergency thoracotomy were excluded. The diagnosis of rib fracture was made by standard chest radiograph or Chest Tomography Scan. Descriptive analyses were reported as mean and standard deviation (SD) for the variables. Pearson correlation test was conducted to test the relationship between the numbers of fractured ribs with the amount of haemothorax as recorded by CTTD with P-value significant at<0.001.

Result: Sixteen patients who met the criteria were analysed with a mean age of 46.5years+(SD16.47), the mean number of fractured ribs was 4.5+1.37, the mean amount of drained blood was 605.3ml+(SD244.3) and the mean amount of drained blood per the number of each fractured rib was 134.5ml+54.29. The Pearson Correlation test was strongly positive at,r=0.80 with (P < 0.001).

Conclusion: In any patient with BCT, and with fractured of 3 or more ribs, there may be the need to institute a CTTD irrespective of whether the chest radiograph or chest computerized scan shows immediate evidence of significant haemothorax.

Socio-economic Characteristics of Orthodontic Patients in Lagos, Nigeria: A Cross-sectional Study

Sylvia Simon Etim, Oyninye Dorathy Umeh — Tue, 11 Nov 2025 00:00:00 +0000

Background: Orthodontic treatment for malocclusion is one of the costly dental treatments globally, leading to the general belief that it is mostly accessible to individuals in the high socioeconomic category (SEC) in Nigeria. This study aims to assess the socio-economic characteristics of Nigerian orthodontic patients.

Methodology: This was a descriptive cross-sectional study, conducted in Lagos State, Nigeria, from March to August2025. The study sites were Lagos University Teaching Hospital and Hilton Dental Services, a major private orthodontic clinic in Lagos. Data was collected using a 15-item structured interviewer questionnaire, analyzed with SPSS version 26 statistical software using descriptive (frequency and percentage) and inferential (Fisher’s exact test) statistics. The level of significance was set at p < 0.05.

Result: A total of 309 respondents participated; 220 females and 89 males, with a mean age of 24.8 ± 10 years. Most, 217 (70.2%), were at the tertiary education level. The majority (197, 63.8%) fell into the high SE category, and rented apartments were the most common type of housing. Respondents from the high SEC agreed that SE status serves as a barrier to accessing orthodontic treatment. However, it was not a factor in choosing the treatment facility. Out-of-pocket payment was the most common method used for paying for orthodontic treatment.

Conclusion: Socioeconomic status has a significant impact on access to orthodontic treatment, and most orthodontic patients belong to the higher socioeconomic category. Recommendation is the main reason for choosing a treatment facility.

Heart-Brain Interactions in Depression: Insights from HRV and Neurocognitive Correlates

Nesrin Ardahanlı , Ertaç Sertaç Örsel , İsa Ardahanlı — Tue, 11 Nov 2025 00:00:00 +0000

This commentary addresses the recent study by Sharma et al., which investigates the relationship between depression severity, cognitive function, and heart rate variability (HRV) in patients with Major Depressive Disorder (MDD). The authors are commended for their integrative approach combining psychometric, neurophysiological, and autonomic markers. While the study provides valuable insights into the multidimensional nature of MDD, including the inverse associations between HAM-D scores and cognitive/HRV parameters, several methodological considerations—such as the cross-sectional design, limited generalizability, and underexplored confounding variables—are discussed. Emphasis is placed on the need for longitudinal and inclusive models that better reflect the complex heart–brain interactions in depressive illness.