Nigerian Medical Journal

The immunological and virological correlates of Cervical Precancerous Lesions among HIV-Infected Women on ART in Faith Alive Hospital, Jos, Nigeria

Fri, 19 Sep 2025 00:00:00 +0000

Background: Immuno-suppression in women living with HIV (WLHIV) increases the persistence of high-risk human papillomavirus (HPV) and reduces the ability to clear cervical precancerous lesions; as such, WLHIV are more predisposed to cervical cancer. Widespread use of antiretroviral therapy (ART) among WLHIV enhances immune reconstitution, controlling HIV replication and reversing the weakened immune system. This impedes HPV persistence and the development of precancerous lesions. The immune status of WLHIV is related to their CD4 count and viral load. These factors are impacted by the duration of effective ART. This study aimedto determine the association between cervical precancerous lesions with viral load, CD4 count, and duration on ART among WLHIV.

Methodology: A retrospective study on 1113 WLHIV aged 16 -55 years screened for cervical cancer using visual inspection with acetic acid (VIA) and visual inspection with Lugol’s iodine (VILI) within a 16-month period in Faith Alive Hospital, Jos, Nigeria. Sociodemographic characteristics of study participants, CD4 count, viral load, duration on ART, and screening results were documented. The data were analysed using IBM-SPSS 26, and logistic regression was performed to determine factors associated with pre-cancerous lesions.

Results: The prevalence of cervical precancerous lesions was 9.1%, the prevalence of suspected cancer was 1.6% and the mean age of clients with pre-cancerous lesions was 41.32±9.89 years. Unsuppressed baseline viral load (≥1000 copies/ml) and <6 months of exposure to ART were found to be strongly associated with cervical precancerous lesions.

Conclusion: This study demonstrated a higher burden of cervical precancerous lesions in viral unsuppressed women on ART initiation and in women with <6 months of exposure to antiretroviral therapy. Early commencement and prolonged use of ART on WLHIV to ensure early and sustained viral suppression to reduce the risk of cervical cancer is recommended.

Psychosocial Impact and Coping Strategies by Mentor Mothers Engaged in Prevention of Mother-to-Child Transmission of HIV Services in Taraba State, Nigeria: A Qualitative Study

Fri, 19 Sep 2025 00:00:00 +0000

Background: Mentor mothers (MMs) are women living with HIV who provide peer education, advice, support, and mentorship for HIV-positive women undergoing Prevention of Mother-to-Child Transmission of HIV (PMTCT) during pregnancy and after delivery. This study aimed to explore their experiences and the impact of the work on their psychosocial well-being, as well as the strategies they adopt to cope with the same.

Methodology: We conducted a qualitative study using in-depth interviews among 16 MMs in Taraba State, Nigeria, between September and November 2022.All interviews were recorded using a voice recorder. The collected data were transcribed and translated into English for analysis. Thematic analysis was applied to analyse the data.

Results: The key themes identified from MMs’ account of their lived experiences as mothers living with HIV and providing support to other HIV positive (+) women were their fears and distress at diagnosis, disclosure challenges, stigma, and discrimination, the place of good counselling in helping newly diagnosed to accept and adhere to treatment, the ill-feelings evoked from repeated telling of their own stories to new clients, some negative impact on their psychosocial wellbeing, and various strategies to cope with the demands of the program.

Conclusion: The study concluded that there was no serious negative impact on the psychosocial well-being of the MMs from their work. They adopt various strategies, such as religious activities and relaxation with family and friends, to keep this intact. This program should therefore be scaled up with holistic support for the health and well-being of the MMs themselves.

Clinical Challenges with Neovascular Glaucoma-Patient Tailored Strategies and Outcomes

Aparna Rao, Tapas Ranjan Padhi, Sanjib Khan M — Fri, 19 Sep 2025 00:00:00 +0000

Background: To report the outcomes of patient-tailored concurrent combined surgery for retinal ischemia and intraocular pressure (IOP) control in neovascular glaucoma (NVG) with or without cataract.

Methodology: Ninety-seven (97) eyes with NVG seen between January 2022-September 2023 at a tertiary eye care centre, 6 eyes (4 proliferative diabetic retinopathy and 2 retinal vein occlusion) that underwent concurrent retinal and glaucoma procedures with or without cataract surgery, were recruited. Outcomes after surgery were based on the World Glaucoma Association guidelines on the reporting of glaucoma surgical trials that comprise functional and surgical parameters.

Results: The IOP reduced by>50% from baseline in all 6 eyes, with one eye developing shallow AC by overstraining and 3 eyes developing transient self-resolving hyphema. Two eyes received additional bevacizumab (n=1) or ranibizumab (n=1) injections for persistent DME at 4 and 5 months after surgery. The final IOP was reduced in all eyes at the final follow-up of 6±1.2 months, with one eye requiring 2 medications for IOP control.

Conclusion: The outcomes after concurrent retinal and glaucoma filtering surgery in NVG may provide favourable outcomes comparable to the traditional stepwise approach to management provided these are offered on a case-case basis.

Cervicovaginal fetal Fibronectin in Predicting Success of Induced Labour among Nulliparous Women

Fri, 19 Sep 2025 00:00:00 +0000

Background: Induction of labour is a routine and common obstetric intervention which aims at achieving successful vaginal delivery. Over the years, attempts have been made to find a pre-induction test that can predict the success of induced labour, which may also serve as a selection criterion for determining which women should undergo labour induction. The study aims to determine whether the presence of fetal fibronectin in the cervicovaginal secretion can predict the success of induced labour.

Methodology: This was a cohort study involving 137 nulliparous women at term undergoing induction of labour. The presence of fetal fibronectin in the cervicovaginal secretion was determined using a fetal fibronectin rapid immunoassay kit. Induction of labour was done using misoprostol.

Results: Data obtained were analysed using statistical product and service solutions (IBM-SPSS) version 20.0. Data obtained were tested for normality of distribution and compared by Chi square, Students’ t-test, or Mann-Whitney U as appropriate. A p-value of less than 0.05 was regarded as significant. The rate of vaginal delivery was not significantly different between fetal fibronectin positive and negative women (65% vs. 66.7%, p value—0.839). Women who were positive for fibronectin had a significantly shorter mean duration of induction (22.8+6.1 hours versus 30.1 + 11.1 hours, P value of 0.015), had higher bishop’s scores, and required fewer doses of misoprostol. Regression analysis did not find fetal fibronectin to be predictive of vaginal delivery.

Conclusion: The Presence of fetal fibronectin was not predictive of successful labour induction. Its presence may possibly be associated with a relatively shorter duration of induction.

Determinants of Discharge Against Medical Advice Among Paediatric Patients in a Tertiary Hospital in Nigeria: A Retrospective Observational Study

Fri, 19 Sep 2025 00:00:00 +0000

Background: Discharge Against Medical Advice (DAMA) among children represents a significant public health issue in low- and middle-income countries. DAMA occurs when a patient leaves the hospital contrary to the physician’s recommendation. This action can hinder effective healthcare delivery and may lead to increased rates of morbidity and mortality. The aim of this study was to assess the prevalence and underlying reasons for DAMA among paediatric patients at a tertiary healthcare facility in Nigeria.

Methodology: A descriptive retrospective study was carried out from October 1, 2020, to September 30, 2022, at the Department of Pediatrics, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Data such as age, gender, diagnosis, duration of hospital stay, insurance status, and the highest educational attainment and occupation of both parents were retrieved from the admission record book. These data were analyzed using proportions and Pearson’s chi-square (χ²) test. A p-value of less than 0.05 was considered statistically significant.

Results: The prevalence of DAMA was 3.4%, with 30 cases recorded out of 875 admissions. A higher proportion of those discharged were females (18 out of 30; 60.0%), and the majority (27 out of 30; 90.0%) belonged to the lower socioeconomic class. Sepsis, malignancy, malaria, and sickle cell anaemia collectively accounted for 80.2% of the diagnoses. The most common reason for DAMA was financial constraint, cited in 15 out of 30 cases (50.0%). Notably, none of the patients had health insurance.

Conclusion: Financial constraints were identified as a leading cause of paediatric DAMA in our environment. Given that none of the affected patients were enrolled in any health insurance scheme, there is a need to raise public awareness about the benefits of health insurance.

Awareness and Determinants of Analgesic Abuse Among Undergraduate Students of University of Port Harcourt, Rivers State, Nigeria: A Descriptive Cross-sectional Study

Fri, 19 Sep 2025 00:00:00 +0000

Background: Rising incidents of deaths due to analgesic abuse are public health concerns globally. A good level of awareness and understanding of the determinants of analgesic abuse can reduce mortalities associated with the condition. This study assessed the awareness and determinants of analgesic abuse among undergraduate students of the University of Port Harcourt.

Methodology: A descriptive cross-sectional study design with multi-stage sampling was employed. An online self-administered questionnaire was used to collect information from 362 undergraduate students at the University of Port Harcourt. The data was analyzed using IBM Statistical Product and Service Solutions (SPSS) version 27. Data were summarized using means, frequency, proportions, Chi-square, and regression analysis; a p-value of <0.05 was considered significant.

Results: The awareness of risks associated with analgesic abuse was low in 47.4% and high in 10.9% of the respondents. Pharmacy students and females had higher levels of awareness. Peer pressure, availability of analgesics on campus/local stores, offer of analgesics by peer(s), and knowledge of someone who has experienced the adverse effects of analgesic abuse were significant determinants; however, only availability of analgesics on campus/local stores and offer of analgesics by peer were significant determinants of analgesic abuse from the bivariate logistic regression.

Conclusion: The result showed that the majority of the respondents had low levels of awareness of risks associated with analgesic abuse, with females and pharmacy students showing higher levels of awareness. Peer pressure, availability of analgesics on campus/local stores, offer of analgesics by peers, and knowledge of someone who has experienced the adverse effects of analgesic abuse were significant determinants of analgesic abuse. Comprehensive educational/awareness programmes that cut across all departments and genders addressing analgesic abuse and policies to regulate the availability of analgesics on campus should be established in the institution.

Epidemiology and Pattern of Mental Health (Psychiatric) Disorders in Sierra Leone: A Retrospective Cross-Sectional Study of 4020 Cases.

Fri, 19 Sep 2025 00:00:00 +0000

Background: The organization of mental health services and management of mental health disorders are driven by the availability of information on patterns and prevalence of such conditions. To the best of our knowledge, no study has presented the pattern of mental illness in Sierra Leone disaggregated by ICD (International Classification of Diseases) categorization. This study aims to establish the socio-demographic profile and ICD11 diagnostic categorization of mental health patients in Sierra Leone.

Methodology: All patients registered at SLPTH Kissy from 1st January 2021 to 31st July 2023 were eligible for the study. Data were retrospectively collected from the digital register of patients. Abstracted variables included patients’ age, sex, marital status, district of residence, and diagnosis. Each of the diagnoses was further classified into one of the broad ICD-11 mental health diagnostic categories. Statistical analysis was done in Microsoft Excel and SPSS software.

Result: There were 4020 individual patients, translating to an average of 130 new registrations monthly. The age range of patients was 4 to 96 years, with a median (IQR) age of 30(23 -40) years. About 87% of all patients were below 50 years of age. Of the 4020 patients, 2591 (64.5%) were males while 1429(35.5%) were females (P<.001). Disorders due to substance abuse accounted for 38.9% of all presentations, followed by schizophrenic and mood disorders at 25.1% and 19.0% respectively. Disorders of substance use, and Schizophrenia/primary psychotic disorders were significantly more prevalent in males, while Mood disorders were significantly more prevalent in females.

Conclusion: Mental Health disorders in Sierra Leone showed comparable socio-demographic patterns with findings in regional studies. There are significant gender differences in the frequency of some ICD categories of mental disorders. Substance use is a foremost cause of severe mental illness; thus, campaign of demand reduction will improve the mental health situation of the country.

Pre-cancerous cervical lesions among women in Bauchi: A cross-sectional study

Fri, 19 Sep 2025 00:00:00 +0000

Background: Cervical cancer is an important contributor to morbidity and mortality in low Human Development Index (HDI) countries where organized cervical cancer screening is often lacking. There is a paucity of data on the prevalence of cervical precancerous lesions in Bauchi, Nigeria.

Methodology: This cross-sectional study was carried out in selected hospitals in the 3 senatorial zones of Bauchi State. Sociodemographic and reproductive data were collected using a data collection tool, and cervical smears were collected and stained using a manual liquid-based cytology (LBC) method.

Results: Out of 458 women who underwent screening, 410 (89.5%) of the participants had a negative smear. Low-grade squamous intraepithelial lesions (LSIL) and Atypical squamous cells of undetermined significance (ASC-US) were the most common diagnostic categories of abnormal smears, together accounting for 78.9% of abnormal pap smear results. The chances of developing cervical precancerous lesions were higher in women <35 years (p<0.05). There was no statistically significant association between precancerous lesions and age at sexual debut or marital status (p>0.05).

Conclusion: There is a need to implement organized state-wide screening programmes within the state to improve detection rates of cervical pre-cancerous lesions and eventually a reduction in cervical cancer mortality and morbidity statistics in the country.

Quality of Life among Women Living with Gynecological Malignancies in Zaria, Nigeria

Fri, 19 Sep 2025 00:00:00 +0000

Background: Cancer can have an impact on Quality of Life (QoL), which can be influenced by an individual's culture and value system.

Methodology: The study was a cross-sectional descriptive study involving all women with gynecological malignancies accessing care at Ahmadu Bello University Teaching Hospital, Zaria.

The sample size constituted all women diagnosed with any gynecological malignancy who accessed care in Ahmadu Bello University Teaching Hospital within six months from the start of data collection. This period was from October 1^st, 2023, to March 31^st, 2024. A total of 176 cases were identified. The WHOQOL BREF was used to assess QoL. Scores greater than one standard deviation above the mean were considered good, scores less than one standard deviation below the mean were regarded as poor, while scores that fell between them were deemed fair.

Results: The mean age of respondents was 49.4 ± SD15.0 years. The mean overall quality of life and overall health were 3.18 ± SD 1.1 and 3.10 ± SD 1.1, respectively. The overall quality of life was poor in 19 (26%) of respondents, and only 7 (9.6%) of respondents had a good quality of life. The majority had a fair overall QoL. The overall QoL was significantly affected by the stage of disease (p=0.04) and treatment status (p=0.02).

Conclusions: QoL concerns need to be addressed while offering care for women with gynecological malignancies.

Embracing Computer Vision for Diagnostic Maxillofacial Imaging — An Artificial Intelligence Machine Learning (AIML)Pilot Project

Kesiena Seun Yarhere, Oladimeji Adeniyi Akadiri — Fri, 19 Sep 2025 00:00:00 +0000

Background: Artificial intelligence (AI) is rapidly transforming healthcare, particularly in diagnostic medical imaging. For Nigerian Oral and Maxillofacial surgeons, embracing AI technologies is essential to improve diagnostic accuracy and maintain global relevance. This study aimed to demonstrate the potential of machine learning (ML) tools in enhancing diagnostic precision in maxillofacial radiology.

Methodology: A supervised learning model was developed using Google’s Teachable Machine, a no-code ML platform based on computer vision. Radiological images of histologically confirmed lesions were retrieved. Two projects were conducted: Project 1 trained the model to distinguish between malignant and benign bony jaw lesions using 46 radiographs (panoramic and sectional CT images). Project 2 trained the model to differentiate between craniofacial fibrous dysplasia and ossifying fibroma, using 40 radiographs. Each model was tested on five new images. The output probabilities were analyzed, and standard performance metrics—accuracy, precision, recall (sensitivity), and F1-score—were computed. Additionally, ROC-AUC (Receiver Operating Characteristic – Area Under the Curve) curves were generated using Python code on Google Colaboratory IDE.

Results: In Project 1, the model yielded predictive probabilities ranging from 89% to 100% for distinguishing malignant from benign lesions. In Project 2, it produced 71% to 100% probabilities for classifying fibrous dysplasia versus ossifying fibroma. Applying a 70% probability threshold for positive prediction, both models achieved perfect scores (1.0) across all performance metrics, including AUC = 1.00.

Conclusion: AI-driven computer vision models show strong potential for improving diagnostic workflows in maxillofacial imaging. Their application can support more efficient clinical decision-making. However, the use of small test samples may have resulted in overfitting. Future studies with larger datasets and increased AI literacy among clinicians are essential for real-world implementation in resource-limited settings.

Serum Vitamin A Levels and Xerophthalmia among Children with Protein Energy Malnutrition in Zaria, Northwest Nigeria

Fri, 19 Sep 2025 00:00:00 +0000

Background: Protein-energy malnutrition (PEM) is one of the major risk factors for vitamin A deficiency (VAD), which may be complicated by xerophthalmia. There have been several interventions employed to tackle VAD in our environment. However, there are limited recent local studies assessing the interplay between VAD and the burden of xerophthalmia in under-five children with PEM. The study aims to determine the association between serum vitamin A levels and xerophthalmia among under-five children with PEM.

Methodology: This was a prospective cross-sectional study conducted among 200 children between the ages of 6 to 59 months newly diagnosed with protein-energy malnutrition at the study centre. Data was collected using a structured proforma, which included sociodemographic variables and ocular examination findings. Blood samples were collected to analyse serum vitamin A levels using an ELISA kit (Aviva systems®).

Results: There were 153 (76.5%) children with PEM who had low serum vitamin A levels. Xerophthalmia was found in 12 (6%) children. Xerophthalmia was only seen in those with low serum vitamin A and was statistically significantly higher in children with very low levels of vitamin A (1.5% vs 12.9%, p = 0.002). Blinding forms of xerophthalmia were seen in 3 (1.5%) of the children.

Conclusion: The prevalence of vitamin A deficiency and xerophthalmia is still considerably high and of public health significance among children with PEM in our environment.

Clinical Characteristics and Outcome of Children with Non-Traumatic Coma: Experience from a Tertiary Hospital in Rivers State, Nigeria.

Nneka Gabriel-Job, Kininyiruchi Nelson Wobo — Fri, 19 Sep 2025 00:00:00 +0000

Background: Non-traumatic coma (NTC) is a common neurological emergency associated with high morbidity and mortality. This study investigates the clinical features and outcomes in children at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State.

Methodology: A prospective study was conducted from 2021-2023 involving 406 patients who presented with NTC in the children's emergency ward and were consecutively recruited into the study. Consent was obtained from parents/caregivers. Data on age, sex, and clinical history were collected. The aetiology of NTC was determined based on history, clinical examination, and laboratory investigations. The degree of encephalopathy was assessed at presentation using Glasgow's coma score. All patients were followed up until discharge to evaluate the outcome.

Result: A total of 5120 patients aged 1 month to less than 18 years were admitted, with 406 cases of NTC, indicating a prevalence (406/5120) of 7.9%. Of the 406 patients, 194 (47.8%) were males. Their ages ranged from 3 months to 17 years (mean age, 6.13±5.10 years). The prevalence of NTC was higher among under five years old. Fever (76.1%), convulsions (63.8%), and vomiting (53.2%) were the common complaints presented. Two hundred and forty-one (59.4%) patients presented with mild encephalopathy. The primary causes of NTC were CNS infection in 280 (69.0%), metabolic or toxic causes in 44 (10.8%), and epileptic causes in 27 (6.6%). Seventy-one (17.5%) patients died, while 319 (78.6%) were discharged. Among those discharged, 10.0% had mild disability, 3.4% severe disability, and 1.3% remained in a permanent vegetative state. The outcomes were influenced by sex, level of encephalopathy at presentation, age, and the need for ICU care.

Conclusion: NTC is common in children, CNS infections, particularly cerebral malaria and meningitis, were the predominant causes. Implementing measures to prevent these infections is important in our setting, where resources are limited for adequate management.

Sociodemographic Factors Associated with Malaria Infection among Under-Five Children in Nigeria

Fri, 19 Sep 2025 00:00:00 +0000

Background: Malaria is a significant source of mortality and morbidity, particularly among children under the age of five. Meanwhile, the multi-causation theory in public health views disease and health development as underpinned by several variables, including social and demographic factors. Therefore, this study investigates the sociodemographic factors associated with malaria among under-five children in Nigeria.

Methodology: This study used secondary cross-sectional data collected from the 2018 Nigeria Demographic and Health Survey (NDHS). The sample for this study was 10,352 children. The response variable was malaria rapid diagnostic tests (RDTs) results, while the independent variables considered were children's age, residential area, zone, mosquito net ownership, gender, mother’s level of education, and wealth status. Analysis was done using bivariate analysis and binomial logistic regression at a 0.05 significance level and 95% confidence interval.

Results: Children's age was statistically significant with malaria (χ2 = 166.200, p = 0.000). Malaria had a statistically significant relationship with mother’s level of education (χ2 = 762.530, p = 0.000). The relationship between malaria and wealth index was statistically significant (χ2 = 1020.442, p = 0.000). The result shows that children living in rural areas were more prone to have malaria infection than children living in urban areas (OR = 1.633, p = 0.000).

Conclusion: Children's age, wealth index, mother’s level of education and place of residence are key predictors and factors associated with malaria infection among under-five children in Nigeria. Therefore, broad-based programmes and interventions should be increased to tackle malaria incidence and prevalence.

Exploring diversity in Non-Alcoholic Fatty Liver Disease (NAFLD) among lean, overweight, and obese patients: A Multicenter study from India

Fri, 19 Sep 2025 00:00:00 +0000

Background: One common chronic liver illness is non-alcoholic fatty liver disease (NAFLD) affecting individuals across various body weights. Traditionally associated with obesity, NAFLD is now increasingly observed in overweight and lean individuals as well. This research investigates the clinical, metabolic, dietary pattern, and socio-demographic differences of NAFLD in lean, overweight, and obese individuals across various centers in two Indian states.

Methodology: Conducted as a cross-sectional observational study with 154 NAFLD patients aged 18-65 years across four centers [Odisha (OD) -3; Uttar Pradesh (UP) -1], the research utilized a self-administered questionnaire to gather socio-economic, biochemical, and clinical data. Data analysis involved Chi-square tests at a 0.05 significance level. Trail Registration: CTRI/2024/04/065699.

Result: The majority of NAFLD cases were found in obese patients (37.01% in Odisha and 35.06% in UP). Overweight NAFLD was more common in UP (10.39%), while lean NAFLD was more prevalent in Odisha (7.14%). Obesity was significantly associated with diabetes in both states (p=0.020). Constipation was notable in overweight and obese groups (p=0.001 and p=0.027), and bloating was more frequent in overweight individuals (p=0.064). Loss of appetite was significant among lean NAFLD patients. Biochemical parameters and food consumption across ten food groups showed no significant variation.

Conclusion: Overall, NAFLD was more common among obese patients, highlighting the need for tailored dietary interventions based on body type.

Clinico-hematological Portrait of Bone Marrow Infections: Unusual Visitors Unveiled

Fri, 19 Sep 2025 00:00:00 +0000

Background: Bone marrow examination is a crucial diagnostic tool for both hematological and non-hematological disorders, ranging from benign to malignant ones. It is a relatively simple and easy procedure for evaluating pyrexia of unknown origin, as it often leads to an etiological diagnosis. The study aims to evaluate the clinico-hematological profile in various infections infiltrating bone marrow and study the spectrum of morphologic alterations in bone marrow aspirate in various infections.

Methodology: This retrospective observational study was conducted at a tertiary care center in Bihar, India, over a 4.5-year period (June 2019–December 2023). All patients referred to the haematology section for bone marrow aspiration and/or biopsy based on strong clinical and morphological suspicion of infection were included. Cases with inadequate marrow samples or lacking corroborative infection evidence were excluded.

Results: The study included a total of 52casesdemonstratingthe presence of bone marrow infections. Out of 52 cases, bone marrow aspirations were done in all cases, whereas bone marrow biopsy was done in 23(44.2%) cases only. There were 39 (75%) cases of adults and 13 (25%) of children; and the mean age of presentation was 35.3 years (range, 1-72 years).

On clinical examination, anemia was the most common symptom (82.6%), followed by splenomegaly (78.8%). On bone marrow examination, an increase in plasma cells was the most striking finding, accounting for 67.3% (n=35), followed by erythroid hyperplasia and an increased number of macrophages showing features of hemophagocytosis in 50% and 32.6% of cases, respectively. A total of 41 cases showed the presence of Leishmania Donovani (LD) bodies. Granulomas were seen in 09 cases (17.3%), out of which 05(9.6%) cases showed AFB positivity.

Conclusion: Bone marrow examination plays a pivotal role in diagnosing various infectious diseases, particularly in patients presenting with pyrexia of unknown origin, cytopenias, or unexplained hematological abnormalities. Morphological analysis, along with specialized staining techniques, allows the identification of a broad spectrum of infectious agents, spanning from parasites and bacteria to fungi.

Screening for Psychological distress and their Determinants among Clinical nurses in Tertiary Care Teaching Institution, India: A cross-sectional Survey

Fri, 19 Sep 2025 00:00:00 +0000

Background: Nurses are continually subjected to physical and mental stress because of their employment. Estimating the prevalence of and its association with psychological distress among nurses is critical for developing health promotion initiatives. We conducted this study to investigate the incidence of psychological distress and related characteristics among nurses working in a teaching institute in Jharkhand.

Methodology: We conducted cross-sectional research involving 452 clinical nurses between December 2024 and February 2025. We examined psychological distress using a self-administered general health questionnaire-12 (GHQ-12). Participants with a GHQ-12 score > three were classified as having psychological distress. The chi-squared test and multiple logistic regression analysis were performed to identify the components related to psychological distress.

Results: More than one-fourth of nurses, 25.2% (95% CI: 21.3 - 29.5), had psychological distress. Psychological distress was significantly higher among age group of 26-30 years ( aPR=3.1, 95% Cl: 1.3 -7.3) those who were not doing any physical activity (aPR=2.2, 95% Cl: 1.3 -3.6), those with poor sleep quality (aPR=2.0, 95% Cl: 1.0 -3.), and those having online screen time >3 hours (aPR=3.1, 95% Cl: 1.3 -7.3).

Conclusion: We report a high prevalence of psychological distress among nurses, especially among the age group of 26-30 years, those having poor sleep quality, and those not doing physical activity and having online screen time of more than 3 hours. We highlight that reducing workplace stress and improving sleep hygiene can be vital in improving mental health status.

Magnetic Resonance Neuroimaging Findings in High-altitude Cerebral Edema (HACE) and Probable Correlation with its Temporal Evolution and Pathogenesis.

Fri, 19 Sep 2025 00:00:00 +0000

Background: High-altitude illness (HAI) is a spectrum continuum ranging from innocuous high-altitude headache (HAH) to severe, potentially fatal high-altitude cerebral edema (HACE) with acute mountain sickness (AMS) and high-altitude pulmonary edema (HAPE) in the middle of the gamut. MRI brain findings in such patients have prognostic implications, especially the diffusion and susceptibility-weighted imaging.

Methodology: Twenty-one devotees visiting a high-altitude cave temple, in whom there was a clinical suspicion of high-altitude cerebral edema after the ascent, were included in this study. All the patients met the criteria for diagnosis of acute mountain sickness (AMS) as well as HACE. MRI brain was done in all 21 patients with special emphasis on diffusion and susceptibility-weighted imaging.

Results: Diffusion restriction with T2/FLAIR hyperintensity was present in the splenium of the corpus callosum in all 21 patients. Other sites involved were centrum semiovale and deep white matter (90.5%), middle cerebellar peduncles (66.7%), and posterior limb of the internal capsule (57%). SWI revealed multiple tiny cerebral microbleeds in splenium, deep white matter, and middle cerebellar peduncles.

Conclusion: This study suggests the evolution of diffusion restriction, T2/FLAIR hyperintensity, and cerebral microbleedsin the splenium of the corpus callosum and white matter in HACE corresponds well with the temporal evolution of cytotoxic, ionic,and vasogenic cerebral edema underpinning the role of brain water dyshomeostasis central to the pathogenesis of HACE.

Knowledge and Uptake of Seasonal Malaria Chemoprevention among Caregivers of Under-five Children in a Tertiary Hospital in Kaduna State, North-western Nigeria

Fri, 19 Sep 2025 00:00:00 +0000

Background: Malaria is a life-threatening parasitic infection primarily found in the tropics, and seasonal malaria chemoprevention (SMC) is one of the strategies used to protect children. Despite years of implementation, gaps remained in terms of knowledge and uptake among caregivers. This study aimed to assess the knowledge and uptake of SMC among caregivers of children at a tertiary hospital in Kaduna State, North-western Nigeria.

Methodology: Using a cross-sectional study, 234 caregivers of under-five children were selected from immunization and paediatric clinics through systematic sampling. An interviewer-administered questionnaire was used to collect data on sociodemographic characteristics, knowledge and uptake of SMC during the preceding SMC campaign. Data was analysed using IBM SPSS Statistics, and a chi-square test was used to check for associations between relevant variables. A p-value <0.05 was considered statistically significant.

Results: All the respondents were females, 226 (95.4%) were married, 175 (73.8%) were Hausa and 98 (41.4%) were unemployed. Up to 182 (76.8%) had heard of SMC, 156 (65.8%) knew it as a drug for prevention, 128 (54.0%) correctly identified it as a rainy season activity, and overall, 128 (54.0%) had good knowledge of SMC. A total of 137 (58.4%) had taken at least one dose of SMC during the last campaign, but only 65 (27.2%) received all four doses. Of the 100 (41.6%) who missed SMC, reasons included not knowing about SMC (54.0%) and the child being absent (20.0%) during distribution. Factors associated with SMC uptake included education, occupation, ethnicity, religion and knowledge on SMC (p< 0.05).

Conclusion: Despite good awareness, gaps in knowledge persist with many unable to identify the purpose, duration or eligibility for SMC. Uptake of SMC was moderate, with only a third receiving full coverage. Health authorities should intensify efforts towards community enlightenment and adaptive programming to bridge the identified gaps.

Prevalence of Migraine and Association between Migraine Headache and Refractive Errors among Adolescents in Secondary Schools in Ibadan, Nigeria

Sewuese Bitto, Olufunmilola A. Ogun — Fri, 19 Sep 2025 00:00:00 +0000

Background: Migraine is frequently overlooked and underdiagnosed among school-aged children and adolescents, despite its potential to cause significant morbidity, negatively affect quality of life, and lead to school absenteeism. Its sporadic nature and low fatality often result in an underestimated public health burden. While migraine and headache associated with refractive errors are reported globally among adolescents, data from African settings remain limited. This study aimed to determine the prevalence of migraine headache and its association with refractive errors (type and severity) among secondary school students.

Methodology: This cross-sectional, descriptive, multi-school study involved secondary school students selected via multistage sampling with probability proportional to size. Eligible students underwent visual acuity testing, ocular examination, and refraction. Migraine was assessed using criteria from the International Classification for Headache Disorders and an interviewer-administered semi-structured questionnaire.

Results: A total of 775 students from 6 schools participated, including 352 (45.4%) males and 423 (54.6%) females, with a mean age of 14.5 ± 1.85 years. The prevalence of migraine headache was 18.3%, with gender-specific rates of 10.2% in males and 25.1% in females. There was a significant association between migraine and both the type and severity of refractive error. Students with mild refractive error had 3.42 times higher odds of migraine (95% CI, 1.74–6.75) than those with moderate error. Astigmatism was associated with 1.53 times, increased odds, of migraine (95% CI, 0.98–2.40) compared to myopia.

Conclusion: Migraine is common and underdiagnosed among secondary school students and is significantly associated with refractive errors. Periodic school eye screenings that assess both refractive errors and migraine headaches, with appropriate referral pathways, are recommended.

Gestational Weight Gain and Associated Factors in a Tertiary Hospital in Southwest Nigeria: A Cohort Study

Fri, 19 Sep 2025 00:00:00 +0000

Background: Gestational weight gain (GWG) is an important determinant of maternal and foetal wellbeing. Evidence suggests that there is heterogeneity in GWG across countries and regions based on the influence of several factors. This study was designed to investigate GWG, associated factors, and pregnancy outcome among women who gave birth at Babcock University Teaching Hospital, Nigeria.

Methodology: A prospective cohort study carried out on 220 pregnant women who registered for antenatal care before gestational age of 13 weeks and recruited between June 2022 and May 2024. GWG was categorized into adequate, inadequate or excessive according to the United States Institute of Medicine (IOM) guidelines. Logistic regression analysis was used to investigate predictors of GWG, while Relative Risk was reported for pregnancy outcomes.

Results: Adequate GWG, inadequate GWG and Excessive GWG were achieved by 29.1%, 40.5% and 30.5% of the women, respectively. The median (95% CI) GWG in all study participants was 9.8 (8.8-10.3) Kg. Older maternal age [OR 2.5(1.3-5.0); P=0.013], multiparity [OR 8.2(1.3-51.8); P=0.025] and middle/upper socioeconomic class [OR 14.6(2.1-99.2); P=0.006] predicted increased likelihood of inadequate GWG while being overweight [OR 0.2(0.1-0.4); P<0.001] and obese [OR 0.06(0.02-0.20); P<0.001] were associated with reduced likelihood of inadequate GWG. None of the variables studied predicted excessive GWG. In terms of pregnancy outcome, women with inadequate GWG had a 30% reduced risk of caesarean delivery compared to those with adequate GWG [RR 0.7(0.6-0.9); P= 0.036]. The mean birth weight of babies born to women with inadequate GWG was significantly lower than that of babies born to women with adequate GWG (T-test = 2.998; P=0.003).

Conclusion: A substantial proportion of study participants had suboptimal GWG (inadequate and excessive), with only a third meeting the IOM recommendations. There is a need for targeted counselling for older, multiparous, and upper socioeconomic class women on adequate GWG.

Knowledge, Attitudes and Practices Regarding the use of Traditional and Complementary Medical Practices by Patients with Ischemic Heart Disease in Oman

Ahmed Al-Maskari, Qasim Al-Maamari, Hassan Al-Riyami, Sunil K. Nadar — Fri, 19 Sep 2025 00:00:00 +0000

Background: The use of traditional and complementary medicine is increasing worldwide. This study aims to assess the knowledge, attitudes and practices regarding the use of traditional medicine (TM) by patients with ischemic heart disease (IHD) in Oman.

Methodology: This was a cross-sectional study based on a previously validated questionnaire conducted among patients attending a Cardiology outpatients’ clinic.

Results: There were 103(mean age 45.1+13.4 years; 85 or 82.5% male) responses to the questionnaire of which 70(67.9%) had previously used at least one form of TM. Those who had used TM were older (48.1+13.4yrs vs 41.2+10.9 years; p=0.01). However, there was no difference between the gender, educational status or occupation between the two groups. Cupping was the most common (58 out of 70 or 82.8%) followed by herbal medications (52 or 74.2%) and branding (47 or 67.1%), TM was used mainly for non-cardiac indications such as headache (47 or 67.1%), back pain (42 or 60%), abdominal pain (41 or 58.5%) and only 30 (42.8%) using it for chest pains. Majority of those who had used (65 out of 70 or 92.8%) said that they felt it was effective and 58 (82.8%) said that they would try it again. However, only 21.4% said that they would recommend it to others.

Conclusion: Our study demonstrates that there is widespread use of TM practices among patients with IHD in Oman and their use should be monitored due to the potential for interactions with regular medications and side effects.

Clinico-demographic Profile of Patients with Early Primary Open Angle Glaucoma at a Tertiary Private Eye Hospital in Lagos, Nigeria

Victor Chukwuebuka Umeh, Godswill Inye Nathaniel, Adunola Ogunro — Fri, 19 Sep 2025 00:00:00 +0000

Background: This study aimed to characterize the clinical and sociodemographic profiles of Nigerian patients with early-stage primary open-angle glaucoma (POAG), with the goal of highlighting the significance of timely diagnosis in enhancing glaucoma treatment outcomes.

Methodology: This cross-sectional study involved participants aged ≥ 40 years with early POAG. The participants underwent a slit-lamp examination of the anterior and posterior segments. The examination included gonioscopy, after which only eyes with open angles were selected. A central visual field test was conducted, and one eye of each participant who met the criteria for early POAG was selected for optical coherence tomography/angiography test (OCT/A). The relevant data were analyzed using the Statistical Package for Social Sciences (SPSS) version 26, with statistical significance set at p<0.05, with a 95% confidence interval.

Results: There were 90 participants with a mean age of 54.5 ± 10.1 years, comprising 54 males (60%). All participants had a best-corrected visual acuity (BCVA) of at least LogMAR 0.48, and the mean central visual field (CVF) MD was -3.50 ± 1.0 dB. The mean retinal nerve fiber layer (RNFL) thickness was 97.79 ± 17.33. The mean peripapillary vessel density (VD) was 50.21 ± 4.54%. Nearly half (47.8%) of the participants had other systemic medical conditions, primarily hypertension or hyperlipidemia.

Conclusion: Patients with early POAG were asymptomatic and had good visual acuity and minimal RNFL thickness reduction. This highlights the importance of routine hospital screening of people 40 years and older to aid early diagnosis of POAG.

Association of Depression with Phenomenology and Insight Among Patients with Obsessive-Compulsive Disorder

Vasu Mishra, Navratan Suthar, Mukesh Kumar Swami — Fri, 19 Sep 2025 00:00:00 +0000

Background: The phenomenology of obsessive-compulsive disorder (OCD) is influenced by culture; its understanding can enhance case identification. Insight levels and depressive symptoms may vary with OCD phenomenology, affecting management and outcomes. This study assessed the association of depression with phenomenology and insight among patients with OCD and predictors of comorbid depression severity.

Methodology: This observational study enrolled 146 participants after receiving ethical approval and consent. Obsession and compulsion were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS). Insight and depression were assessed with the Over Valued Ideas Scale (OVIS) and the Hamilton Depression Rating Scale (HDRS). Linear regression was employed to identify predictors of the severity of depression.

Results: The sample consisted of 68.5% males, with a mean age of 31.5 years. The mean duration of OCD was 63 months. Contamination was the most common obsession; while washing or cleaning was the most frequent compulsion. Aggressive, sexual, and religious obsessions were more prevalent in males. Notably, 73.2% of patients experienced depression. Those with depression exhibited longer and more severe OCD. The severity of depression had a significant positive correlation with the duration of OCD, the YBOCS score, and the OVIS score. Female gender and higher OVIS scores were significant predictors of the severity of depression, with gender being the most important predictor.

Conclusion: Depression is quite common among patients with OCD, particularly those experiencing longer and more severe illnesses. Being female and having lower insight significantly predict the severity of depression.

Profile of Triple Negative Breast Cancer: A Retrospective Review

Fri, 19 Sep 2025 00:00:00 +0000

Background: Triple-Negative Breast Cancer (TNBC) is a particularly aggressive tumor. Major responses to chemotherapy in TNBC do not necessarily correlate with better survival, indicating a need for further research into treatment strategies and underlying molecular mechanisms. This study is aimed at assessing the profile of Triple Negative Breast Cancer.

Methodology: This study retrospectively evaluated the profile of TNBC patients at Lagos State University Teaching Hospital, Ikeja. Sociodemographic data, tumour grade, and type of chemotherapy administered were abstracted from the hospital’s cancer register. Statistical analyses were conducted using SPSS version 27.0, with associations between sociodemographic characteristics, tumour grade, and type of therapy established using chi-square tests. Key relationships were considered statistically significant at p-values ≤ 0.05.

Results: A total of three hundred and thirty (330) patients were recruited. The mean age of presentation was 49.96 ± 11.39 years, with the minimum and maximum ages of 22 and 80 years, respectively. The most represented age group was between 41-50 years, constituting about a third of all the patients. About three quarters of the tumours were moderately differentiated. Correlating tumour grade with the age of the patients was statistically significant, p value =0.05

Conclusions: Triple-negative breast Cancers remain a moderately differentiated tumour and are seen predominantly in the middle-aged group.

Histopathological and Immunohistochemical Patterns of Malignant Peripheral Nerve Sheath Tumours in a Tertiary Institution of Northern Nigeria

Zainab Ali Adamu, Mikhail Olayinka Buhari, Abdullahi Mohammed — Fri, 19 Sep 2025 00:00:00 +0000

Background: Malignant peripheral nerve sheath tumours (MPNSTs)are uncommon, aggressive sarcomas arising from a peripheral nerve or extra neural soft tissue and show evidence of nerve sheath differentiation. These tumours exhibit variability in grade and can either occur as familial or sporadic tumours. Immunohistochemistry is a paramount tool in the evaluation of these tumours. This study aimed at analyzing the histopathological and immunohistochemical patterns of these tumours and determining the frequency, demographic and anatomical site distribution.

Methodology: This was a 10-year retrospective hospital-based study. Formalin fixed paraffin embedded tissue blocks were sectioned and the slides werereviewed and interpreted. Morphological features were noted and immunohistochemical analysis was performed using four primary antibodies. Descriptive statistical analysis was used to collate and analyse data, and statistical test was used where necessary. The results were presented on statistical charts and tables.

Results: In this series, 20 cases of MPNSTs were seen with a male predilection. The 3^rd and 4^th decades were the most frequent decades of occurrence, and most tumours occurred in the gluteal region (eight cases) constituting 40% of all anatomical site’s distribution. Borderline/intermediate grade tumours (Grade 2) were the most frequent grade. S100 (25%) and SOX10 (35%) showed low positive immunoexpression. Most of the tumours had low proliferative index or labelling hot spots with Ki67 antibody.

Conclusion: Malignant peripheral nerve sheath tumours are uncommon and tend to be sporadic in our region. Most of these tumours are borderline/intermediate grade tumours (Grade 2) showing low immunoexpression to antibodies employed with varying intensities.

Effectiveness of Rectal Versus Oral Diclofenac for Perineal Pain Relief following Episiotomy Repair at a Tertiary Hospital in Port Harcourt, Nigeria: A randomized controlled study

Fri, 19 Sep 2025 00:00:00 +0000

Background: Perineal pain following episiotomy repair is a common complaint after vaginal delivery and may be severe, requiring the use of strong analgesics. Diclofenac is a non-steroidal anti-inflammatory drug commonly used for pain relief. This study aimed to compare the effectiveness of rectal versus oral Diclofenac in the management of pain post-episiotomy repair.

Methodology: A prospective double-blind randomized controlled study was carried out involving 132 booked mothers who had episiotomy repair after vaginal delivery at a tertiary hospital in Port Harcourt, Nigeria. They were randomized into two groups and received either rectal diclofenac 100mg and oral placebo 12 hourly (Group A), or oral diclofenac 100mg and rectal placebo 12 hourly (Group B), for 48 hours following the repair. Perineal pain was measured using Visual Analogue Scale (VAS). Both groups were monitored for 48 hours (pain relief assessed at 6, 12, 18, 24, 36 and 48) and the analgesic effectiveness compared. The data obtained was analysed using IBM SPSS version 24. The recruitment spanned from 1st September 2023 to 30th January 2024.

Results: Both groups were similar in their baseline socio-demographic characteristics. The overall mean pain score was significantly lower in the rectal diclofenac group than the oral diclofenac group (4.14±0.42 vs. 4.30±0.44, t=2.01, p=0.048). Majority of the participants in the rectal route expressed more satisfaction (66.7% vs. 37.1%, χ2=23.08, p<0.01). The mean time interval (hours) between drug administration and the first urine void was similar in both groups (3.19±3.13 vs. 3.29±3.11, t=0.29, p=0.74), and there was no difference in the requirement for additional analgesia (12.1% vs. 9.1%, χ2=0.32, p=0.57).

Conclusion: Diclofenac suppository was more effective in management of perineal pain following episiotomy repair and the participants in the rectal route group expressed more satisfaction than their counterparts who received the oral drug.

A Composite Risk Scoring Model for Predicting Adverse Perinatal Outcomes in Patients with Pre-Eclampsia- A Pilot Study

Fri, 19 Sep 2025 00:00:00 +0000

Background: Accurate early identification of pregnancies at high risk for adverse fetal outcomes (small-for-gestational-age [SGA], preterm birth, stillbirth) enables targeted interventions. The study aims to pilot the development and internal validation of a point-based Fetal Risk Score (rFRS₅) incorporating ten routine maternal parameters, and to compare its performance against a simpler four-item score (FRS red).

Methodology: In this single-centre, retrospective cohort study of 118 pregnant women, we assigned points based on clinically meaningful ranges for age, parity, BMI, blood pressure, 24-hour proteinuria, haemoglobin, platelets, ALT, AST, and LDH. We computed rFRS₅ (0–19 points) and FRS_red (0–6 points). Discrimination was assessed using the ROC AUC (5-fold cross-validation), and calibration was evaluated using the Brier score and calibration curves. Optimal thresholds were determined by sensitivity/specificity trade-offs. Variables for score development were selected a priori based on clinical relevance and published evidence. Internal validation was performed using five-fold cross-validation and calibration methods.

Results: rFRS₅ achieved ROC AUC 0.80 and Brier score 0.219; FRS red achieved ROC AUC 0.82 and Brier score 0.220. For rule-out (sensitivity 100 %), rFRS₅ < 2 and FRS red < 2 both provided NPV 100 %. For rule-in, FRS red ≥ 6 yielded specificity 94 % and PPV 50 %, outperforming rFRS₅ (specificity 68 %, PPV 40 %).

Conclusion: In this pilot study, both scores effectively stratify fetal risk, with the simpler FRS red offering superior rule-in performance in resource-limited settings. Larger, prospective studies are warranted to confirm these findings.

NGAL Superiority to Creatinine in the Diagnosis of Renal Injury in a Pediatric Tertiary Hospital Setting

John U Ohiri, Owamagbe Emmanuel Mustapha, Evelyn Ada Idam — Fri, 19 Sep 2025 00:00:00 +0000

Background: Acute kidney injury (AKI) is related with higher death rates, longer hospital admissions, and an increased chance of developing chronic kidney disease (CKD). Serum creatinine, a conventional biomarker for AKI diagnosis, has limitations since it rises slowly after renal injury and is dependent on muscle mass and hydration state. Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a promising early biomarker, appearing in urine and plasma within two hours of kidney injury. This study investigates the diagnostic accuracy of NGAL against serum creatinine in diagnosing AKI in pediatric patients. The aim of this study is to assess the sensitivity and specificity of NGAL in diagnosing AKI in pediatric patients compared to serum creatinine. By assessing the reliability of NGAL, the study aims to enhance early detection and management techniques for AKI in children.

Methodology: A cross-sectional analytic study was carried out over a 12-month period at a tertiary hospital's pediatric nephrology department. The study included 200 children aged 1 month to 18 years who had been admitted with symptoms that put them at risk for AKI, such as sepsis, dehydration, and nephrotoxic medication exposure. Blood samples were taken at admission and 24 hours later to determine serum creatinine and NGAL levels. An enzymatic colorimetric technique was used to determine serum creatinine, and an enzyme-linked immunosorbent assay (ELISA) was used to detect NGAL. Data was analyzed with SPSS software, and diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis.

Results: NGAL revealed superior diagnostic accuracy, with an area under the curve (AUC) of 0.94 against 0.72 for creatinine. NGAL demonstrated greater sensitivity (92% vs. 68%) and specificity (88% vs. 62%), especially in infants. The ROC curve demonstrated NGAL's excellent diagnostic performance in all pediatric age groups. Conclusion: This study shows that NGAL is a more reliable early biomarker for AKI in pediatric patients than serum creatinine. Its implementation in clinical practice could lead to early diagnosis and treatments, lowering the risk of severe kidney injury and improving pediatric patient outcomes.

Evaluation of Orthodontic Patients’ Pain Experience, Perception and Management of Pain from Orthodontics Centres in Lagos, Nigeria

Onyinye Dorothy Umeh, Sylvia Simon Etim — Fri, 19 Sep 2025 00:00:00 +0000

Background: Pain has been reported as a common unpleasant experience or complication following orthodontic treatment. Despite this, the routine management of the pain remains controversial and inconsistent. This study aimed to evaluate the orthodontic patients’ pain experience following orthodontic appliance installation, orthodontic pain assessment, the pain management protocol received, and the perceived possible effect of orthodontic pain on daily activities.

Methodology: This was a 12-month cross-sectional study involving orthodontic patients. A structured questionnaire was used for data collection via Google Forms. Three different sections evaluated participants’ sociodemographic variables, the patient’s pain experience and management of that pain, orthodontic pain perception, possible effects of orthodontic pain and the need for development of a standardized pain management protocol. Statistical analysis was performed using SPSS Version 26, IBM Corp, with significance set at P-value < 0.05.

Results: A total of 347 orthodontic patients were recruited into the study. Approximately 90% of orthodontic patients experienced pain following orthodontic appliance installation (5.59 ± 2.78), with pain medication prescribed after the onset of pain (25.9%). Pain was mostly described as distressing (47.6%) and lasting for 1 to 6 days (75.8%). There was no significant age or gender variation in pain experience. Paracetamol was the most prescribed pain control option (69%). Difficulty with feeding and brushing was the most affected daily activity. Respondents agreed on the need for a standardised pain control protocol (72.9%).

Conclusion: Orthodontic pain is an established complication following orthodontic treatment, with variation in treatment duration and intensity. It can adversely affect patients’ ability to carry out daily activities, consequently affecting treatment outcomes. Efforts should therefore be made to develop a pain management protocol for holistic patient care.

Assessing Thyroid Function (FT4, FT3, and TSH) in Pediatric Renal Patients: A Focus on Sex and Age Subgroups

John U. Ohiri, Emmanuel Mustapha Owamagbe — Fri, 19 Sep 2025 00:00:00 +0000

Background: Thyroid dysfunction is a common complication but is lessdiagnosed most times with pediatric chronic kidney disease (CKD), where impaired renal function disrupts thyroid hormone metabolism. This study is aimed at assessing thyroid function specifically FT4, FT3, and TSH in pediatric CKD patients, while exploring variations by age and sex.

Methodology: In a cross-sectional design, 150 children within the ages of 1–18 years with CKD stages 2–5 or on renal replacement therapy were examined using standardized immunoassays and eGFR determined via the Schwartz formula.

Results: The results showed a 25% prevalence of hypothyroidism, with females exhibiting higher dysfunction rates than males. With age, FT4 and FT3 levels increased from infancy to adolescence, while TSH decreased, reflecting a maturing hypothalamic-pituitary-thyroid axis. Significantly, strong positive correlations were observed between eGFR and both FT3 (r = 0.78) and FT4 (r = 0.76), whereas TSH showed no notable relationship with kidney function.

Conclusion: These findings suggest that thyroid dysfunction in pediatric CKD is primarily caused by decreasing FT3 and FT4 levels. Early, tailored thyroid screening is recommended to improve growth, neurodevelopment, and overall outcomes in this vulnerable population.

NMA/AGSM/2025/PUBH/003-Hyper-Reactio Luteinalis Associated with Abruptio Placentae Hyper-Reactio Luteinalis Associated with Abruptio Placentae

Abubakar Nasiru, Ekele Ojogbane Innocent, Abubakar Sirajo, Umar Mohammed — Fri, 19 Sep 2025 00:00:00 +0000

Hyper-reactio luteinalis is a rare non-neoplastic tumor-like ovarian lesion associated with pregnancy where there are elevated levels of beta human chorionic gonadotropin characterized by benign enlargement of bilateral ovaries, being incidentally discovered at the time of cesarean section. The condition is rare in normal pregnancy. Abruptio placenta It is defined as premature separation of a normally situated placenta before the delivery of the fetus. It is as an important cause of antepartum hemorrhage (APH). We report a rare case of 28years old G7P1+5 0A with hyper-reactio luteinalis associated with abruptio placentae in a spontaneously conceived singleton pregnancy.

NMA/AGSM/2025/PUBH/006- Diverticular Disease of the Jejunum.

Fri, 19 Sep 2025 00:00:00 +0000

Small intestinal diverticulosis refers to the clinical entity characterized by the presence of multiple bulging in any portion of the gastrointestinal tract. The most common site for the formation of diverticula is the large intestine. Small intestine diverticular disease is much less common than colonic diverticular disease. Major complications include diverticulitis, gastrointestinal bleeding, intestinal obstruction, intestinal perforation, localized abscess, malabsorption, anemia, volvulus and bacterial overgrowth. We present the clinical case of a 50-year-old male patient with clinical diagnosis of rupture viscus on account of typhoid ileitis, intraoperative finding of diverticular disease of the small intestine (Jejunum), with associated complication of perforation.

NMA/AGSM/2025/PUBH/001-Ovarian collision tumour: Serous Cystadenoma and adipocyte rich mature cystic teratoma.

Fri, 19 Sep 2025 00:00:00 +0000

Collision tumour refers to the simultaneous coexistence of two distinct tumors in the same tissue or organ without any transition zone or mixing interface. Collision tumors have been described in various body organs. However, their occurrence in ovary is rare. and mature cystic teratoma with prominent adipocytic proliferation is also an exceedingly uncommon finding. Mature cystic teratoma is the most common component of collision combinations.

We present a case of a 20-year-old P₀⁺⁰ who presented with complaints of a 2-year history of abdominal swelling that was initially small but gradually increased to present size. Her medical history was non-contributory. The Ultrasonography findings revealed: Huge intra-abdominal cystic mass with differentials of Pancreatic Pseudocyst, Mesenteric and Simple Ovarian cysts. Physical examination and vital sign were within normal limit. Abdomen was distended with abdomino-pelvic swelling of about 32 weeks size. The ovarian specimen measuring 22× 12×12 cm with a weight of 4100g, and a bi-loculated solid and cystic area filled with 3000mls amber colour fluid was found. The solid area showed tufts of hair and yellowish materials. Histological sections revealed fibro collagenous cyst wall lined by Tubal type of epithelium and areas showing keratinized squamous epithelium with skin adnexa and predominantly adipose tissue. A diagnosis of collision tumour comprising of mature cystic teratoma with prominent adipocytic tissue and serous cystadenoma was made.

Collision tumours present a complex clinical scenario that demands extensive tissue sampling of cystic ovarian masses for a comprehensive diagnosis, so as not to miss any component which might have a bearing on prognosis of the patient.

NMA/AGSM/2025/PUBH/004- Gonadal and Extra Gonadal Teratoma

Dahiru Abubakar, Amadi M. Saleh, Adam Shuaibu, Umar Mohammed — Fri, 19 Sep 2025 00:00:00 +0000

Background: Teratomas are germ cell tumours that generally arise in the gonads, can present at any age, although several cases are reported in the extra gonadal sites. They originate from totipotent germ cells and consist of well-differentiated tissue from at least one of the three germ cell layers i.e. ectoderm, mesoderm & endoderm and occur most frequently in the ovary or testis (gonadal), gonadal teratomas are well described, however, the extragonadal variants are underrepresented in the literature. Extragonadal teratomas are rare and believed to originate along the migration route of germ cells during embryogenesis.

Objective: To determine the frequency and histopathological classification of Gonadal and Extra-gonadal teratoma in Federal Teaching Hospital katsina and compare it with other centers.

Method: This is a retrospective study in which surgical biopsy specimen seen over 5 years period were reviewed with respect to age, sex, site and histopathological characteristics.

Result: A total case of 51 teratomas were diagnosed within the period. Which constitute 43 (84%) gonadal and 8 (16%) Extra-gonadal. Extra-gonadal 8 (16%) occur in male while Gonadal 43(84%) in females. The histological types are mature teratomas 48(94%), monodermal 2(4%) and immature teratoma 1(2%). Extra-gonadal (sacrococcygeal region) is common in first decade 8 (16%), while Gonadal in the 3^rd decade of life 13(27%) with mature cystic teratoma as the common histological type 45(94%) respectively.

Conclusion: Gonadal and Mature cystic teratomas were common in our environment, although cases are seen in the extra gonadal sites and affect children and women in the first and third decades of life.

NMA/AGSM/2025/PUBH/002 - Ectopic pregnancy in Federal Teaching Hospital Katsina. North-western Nigeria.

Adam Shuaibu, Tajuddeen A, Dahiru Abubakar, Aisha AbdulRahman, Mohammed Umar — Fri, 19 Sep 2025 00:00:00 +0000

Background: Ectopic pregnancy (EP) is a significant cause of maternal morbidity and mortality; it is a major gynaecological emergency that requires prompt diagnosis and treatment. occurring when a fertilized ovum implants outside the uterine cavity. It accounts for approximately 1-2% of all pregnancies. A rising incidence has been observed worldwide in the last two decades and this has been attributed to an increase in the incidence of sexually transmitted diseases, the use of contraceptives and assisted reproductive technologies. This study aimed to determine the prevalence, mode of presentation and forms of ectopic pregnancy in Federal Teaching Hospital Katsina.

Methodology: This is a retrospective study in which surgical biopsy specimens seen over 5-year period (2020-2024) were reviewed with respect to age, site and Mode of presentations.

Results: A total of 56 cases of ectopic pregnancy were histologically diagnosed during the period under review (2020-2024), within age range of 20-39 years, with peak incidence in the 3^rddecade of life 31(53.4%). The most common site of involvement was the fallopian tube 55(98.2%), an infrequent site was the cervix uteri 1(1.8%). The side of involvement in Fallopian tube were 29(53.0%) on left side, 25(45.0%) right side, while in 1(2.0%) site was not specified. The triad of amenorrhoea, abdominal pain and vaginal bleeding was the most common mode of presentation (100%).

Conclusion: Ectopic pregnancy is common in this environment and is still a major health problem among women of reproductive age group, while the left fallopian tube side and triad of amenorrhoea, abdominal pain and vaginal bleeding was the most common mode of presentations

NMA/AGSM/2023/PUBH/ - Frequency and Histological Classification of Neoplastic Ovarian Lesions Seen in a Tertiary Health Centre in North-Western Nigeria

Fri, 19 Sep 2025 00:00:00 +0000

Background: Ovarian cancer was the seventh most common cancer worldwide in women and is the second most common malignancy after breast cancer over the age of 40years, particularly in developed countries also the fifth leading cause of cancer-related death in women, and it affects mainly the economically viable age groups. The study aims to determine the frequency and histopathological classification of neoplastic ovarian lesions in a tertiary institution in Northwestern Nigeria and compare it with other centers.

Methodology: This is a retrospective study in which surgical biopsy specimens seen over 9 years period were reviewed with respect to age and histopathological characteristics.

Results: A total of 120 neoplastic ovarian lesions were histologically diagnosed during the period under review which constitute 7.0 % of all the gynaecological spacemen received. 49 (40.8 %) cases were epithelial, and 71 (59.2 %) cases were non epithelia. Majority of both the epithelial and non-epithelial lesion 13(26.53 %) and 20 (28.16%) cases respectively, occurred in women in the age bracket of 30-39 years. Out of 49 epithelial lesions, malignant and benign lesions account for 26(53.06%) and 23(46.93%) respectively while the most common histological types were serous tumour 33 (67.34 %), mucinous 12(24.48%), others 4 (8.16%). Of the 71 (59.2%) Non epithelial cases malignant account for 12(16.90%) while Benign 59(83.09%). The most common histological types where germ cell tumours 52 (73.23%), sex cord stromal tumours 15(21.12 %) while others 4 (5.61%).

Conclusion: Ovarian non-epithelial tumours are common in our environment and benign germ cell tumours being the most common type as well as serous malignant epithelial tumours. Economically viable age groups are mainly affected by the tumours. Therefore, early diagnosis and adequate management are necessary in reducing both morbidity and mortality associated with this condition.

NMA/AGSM/2023/PUBH/ - Amoebic Perforation of the Bowel: A Case Report

Fri, 19 Sep 2025 00:00:00 +0000

Amoebiasis is the third leading cause of death worldwide after Malaria and schistosomiasis and it still posed a major public health concern in developing countries. Entamoeba histolytica is a single-celled extracellular parasitic protozoan that causes amoebiasis which have two main clinical forms of extra intestinal and intestinal presentation, and with rare invasive disease affecting the intestine that may lead to perforation. We present a case of 13yrs old male patient who presented to the accident and emergency of our hospital with features of acute abdomen an assessment of Generalized peritonitis secondary to typhoid ileal perforation was made. Despites critical care and adequate surgery regrettably the patient died 12^th days post operative, the resected bowel was sent for histopathological analysis. A histological diagnosis of Entamoeba histolytica was made. Bowel perforation due to Entamoeba histolytica was therefore entertained as the final diagnosis. We present this rare case in our environment. High index of suspicion for intestinal amoebiasis second to typhoid ileitis should be top on the differential diagnosis list in our environment

NMA/AGSM/2023/PUBH/ - Inflammatory Cloacogenic Polyp Masquerading as Haemorrhoid.

Umar Mohammed, Haruna S. Muhammad, Adoke U. Kasimu, M. T. Aliyu, O Moses — Fri, 19 Sep 2025 00:00:00 +0000

The inflammatory cloacogenic polyp (myoglandular polyp, proctitis cystic profunda) is a rare lesion arising in the region of anorectal transitional zone, which is generally the result of mucosal prolapse due to recurrent mucosal injury. Common in middle-aged and older patients and essentially in patients presenting with hemorrhoids. Common clinical feature includes constipation, Bleeding, tenesmus and mucoid stools. Differential diagnosis of the lesions is prolapsing hemorrhoid, other polyps such as juvenile or adenomatous polyps or even carcinoma. We present a 23year old male patient who presented with 3 weeks history of tenesmus, protrusion and bleeding per anus. All other laboratory investigation parameters done were within normal limits. The resected protruded anal mass was sent for histopathological analysis. A histological diagnosis of inflammatory cloacogenic polyp was made and therefore entertained as the final diagnosis. We present this rare case in our environment. Appropriate diagnosis is needed for proper management of this rare disease entity in our environment.

NMA/AGSM/2023/PUBH/ - Colonic Intramural Haematoma Mimicking Strangulated Hernia

Umar Mohammed, Haruna S. Muhammad, Adoke U. Kasimu, M. T. Aliyu, O. Moses — Fri, 19 Sep 2025 00:00:00 +0000

Colonic intramural hematomas are a rarely encountered clinical entity, but important because of their inclination to cause hemorrhage. The aetiologies may include abdominal trauma, anticoagulant therapy, or bleeding diathesis such as hemophilia or leukemia. It rarely occurs as an iatrogenic consequence or a complication of vaginal delivery. The severity of clinical symptoms varies, and include abdominal pain, bowel obstruction, lower gastrointestinal bleeding and haemorrhagic shock amongst others. 25-year-old male patient presented to our A & E department with 1 day history of groin pain and swelling. Clinical assessment of strangulated inguinoscrotal hernia was made All other laboratory investigation para meters done where within normal limit. The patient was operated on, and the resected bowel was sent for histopathological analysis. A histological diagnosis of intramural hematoma was made, therefore entertained as the final diagnosis. We present this rare case which mimics strangulated hernia in our environment. Without the submission of surgical resected tissue, it is very difficult for the surgeon and pathologist to diagnose this rare disease entity.

Paraneoplastic Anti-NMDA Receptor Encephalitis in a Nigerian Female Teenager: A Case Report

Fri, 19 Sep 2025 00:00:00 +0000

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is characterized by neuropsychiatric symptoms, seizures, dysautonomia, and movement disorders. Initially identified as a paraneoplastic syndrome predominantly in young women with ovarian teratomas, it has become clear that not all affected individuals have tumors, and symptoms can occur across genders. With the availability of the NMDAR antibody assay, cases have also been identified in patients presenting with early psychosis, epilepsy, and classic limbic encephalitis. This emerging understanding enables earlier diagnosis, even in resource-limited settings, facilitating a multidisciplinary management approach that combines immunotherapies and tumor removal when indicated. This case highlights the importance of recognizing anti-NMDAR encephalitis in an 18-year-old female, emphasizing the need for prompt intervention to improve recovery outcomes.

Metastatic Pulmonary Calcification with the Coexistence of known Esophageal Carcinoma: Case Report and Literature Review

Khurram Khaliq Bhinder, Sana Sayeed, Aroosa Kanwal, Nasir Khan — Fri, 19 Sep 2025 00:00:00 +0000

Metastatic pulmonary calcification, also called MPC, is a metabolic abnormality resulting in pulmonary calcium deposition. Our patient is a known biopsy-proven SCC of the mid-esophagus with extensive widespread alveolar calcifications on a background of renal and ureteric stones. It is important to note that, although the disease is known as metastatic, it is a rather benign lung illness with an excellent long-term prognosis. To our knowledge, this kind of cohabitation has never been documented before.

Giant incisional hernia with a protruding pregnant uterus and overlying thinned-out ulcerated skin: A case report and review of literature

Fri, 19 Sep 2025 00:00:00 +0000

Incisional hernias are part of the workload of the General Surgeon, for which there are known risk factors, and surgical repair can be challenging. The aim of this study was to report an unusual presentation of a giant incisional hernia with a protruding pregnant uterus and thinned-out ulcerated skin, seen at the Rivers State University Teaching Hospital in Port Harcourt in the year 2024.A 38-year-old female, Gravida 2 Para1, who presented with protrusion of the lower abdomen, pain, and bleeding from a sore at the lower abdomen. She had a previous Caesarean section complicated by wound sepsis and prolonged hospital stay. Significant examination findings included enlarged (gravid) pendulous abdomen, a broad sub-umbilical mid-line scar, an overlying area of shallow ulcer (10cm by 6cm), surrounding hyperpigmented skin, and tenderness at the sub-umbilical area. There was a protruding mass that measured 20cm by 14cm at presentation, which increased in size, extending to the mid-thigh at the time of surgery. She had multi-specialty care that ended with an elective repeat Caesarean section, hernia repair, abdominoplasty, and the outcome of care was satisfactory. A complicated giant incisional hernia is reported in a patient with gestational diabetes mellitus. A successful outcome was guaranteed by prolonged admission and multidisciplinary care.

Tuberous sclerosis with recurrent seizure, dermatological lesions, renal cysts, and hypothyroidism in a female patient in Awka, Nigeria

Fri, 19 Sep 2025 00:00:00 +0000

The incidence of tuberous sclerosis seems to be rising in Nigeria. Tuberous sclerosis with cerebral, renal, thyroid, and dermatological manifestations have not been completely identified. This case report documents a rare case of tuberous sclerosis with cerebral and dermatological lesions, renal cysts, and hypothyroid state. A 28-year-old female patient who presented in our clinic with a history of recurrent seizures for 19 years, a shagreen patch on the right lumbar area, scarring alopecia, and puckering facial angiofibroma. No member of her family had a similar illness. Computerized tomography scan showed multiple echoic cysts in the two kidneys. Her thyroid function tests revealed a hypothyroid state. Brain computerized tomography showed subependymal calcified nodules of the lateral ventricles and prominence of the cerebral sulci, more at the vertex. Electroencephalogram findings were normal. She was placed on oral Carbamazepine 400mg BD and has remained seizure-free for two years. Tuberous sclerosis with concomitant renal, cerebral, and dermatological lesions and hypothyroidism, though rare, was presented. The patient had tuberous sclerosis with renal cysts, subependymal nodules, and prominence of the cerebral sulci, with recurrent seizures, ash leaf/shagreen patches, scarring scalp alopecia, and a hypothyroid state.

Bilateral Optic Disc Coloboma with Coexisting Unilateral Retinochoroidal Coloboma in an Adolescent from Northwestern Nigeria: A Case Report

Fri, 19 Sep 2025 00:00:00 +0000

Optic disc coloboma is a rare congenital anomaly of the optic nerve. We report a case of bilateral optic disc coloboma with coexisting unilateral retino choroidal coloboma in an adolescent from Northwestern Nigeria, who presented with complaints of difficulty seeing distant objects for 3 months, associated with ocular pains, tearing, and headache while reading. She had never worn spectacles. No previous history of systemic illnesses or trauma. Developmental milestones were optimal for age. Ocular examination revealed a best corrected visual acuity of 6/5 and 6/6 in the right and left eyes respectively. Dilated fundoscopy revealed an enlarged bilateral optic disc with a white bowl-shaped excavation, absent inferior neuro retinal rim, thin superior rim, and an area of well-defined oval retino choroidal defect, located inferior and slightly temporal to the right optic disc. No syndromic features or any ocular complications associated with optic disc and retino choroidal colobomas were seen.

Adult intussusception: A case report and review of literature of a patient seen at university of Abuja teaching hospital, Gwagwalada, Abuja, Nigeria

Fri, 19 Sep 2025 00:00:00 +0000

Intussusception is a recognized cause of bowel obstruction and is significantly more common in paediatric patients. Adult intussusception is rare and usually results from a predisposing factor in most patients. These factors may include benign lesions, malignant lesions, or bowel wall abnormalities such as inflammatory bowel disease. We report on a case of a patient who presented with recurrent colicky central abdominal pain, anorexia, vomiting with occasional constipation and diarrhoea for six months. She was assessed and investigated with abdominal USS and Computer Tomography (CT) Scan, which showed features of intussusception, with telescoping of the jejunum with proximal bowel distension suggesting bowel obstruction. The patient underwent emergency laparotomy and surgical resection, and histopathology confirmed the lead point as intraluminal lipoma.

We present a case of jejuno-jejunal intussusception in an adult, which is not commonly seen. The history of recurrent colicky abdominal pain and CT abdomen, together with an abdominal ultrasound scan (USS), was important in establishing a preoperative diagnosis, and histology confirmed lipoma as a lead point. Despite the conservative approach described in the literature, surgery continues to be the only option in patients who are unstable with persistent colicky abdominal pain, vomiting, abdominal distension, and constipation; Surgery is advocated for all adult patients. Adult intussusception is not a common condition and can be difficult to diagnose, posing a diagnostic conundrum. Patients with intussusception may report a relatively long period of recurrent colicky abdominal pain that might worsen acutely following complete obstruction. Abdominal CT scan is a very useful investigation in the preoperative diagnosis of intussusception, with histopathological confirmation of lipoma as a lead point.

Acute Shoulder Injury Following Tdap Vaccination: A Case Report on SIRVA and the Importance of Proper Injection Technique

Fri, 19 Sep 2025 00:00:00 +0000

Shoulder Injury Related to Vaccine Administration (SIRVA) is a preventable iatrogenic condition caused by improper injection technique into the deltoid region. It can result in significant pain, inflammation, and impaired function. We report a case of a healthy adult female who developed acute shoulder pain and fatigue within hours of receiving an intramuscular tetanus toxoid vaccine. With no prior history of shoulder pathology, clinical evaluation supported a diagnosis of SIRVA. Conservative treatment with NSAIDs and physical therapy led to partial symptom relief, though some pain persisted a month later. This case highlights the importance of correct vaccination techniques and early recognition of SIRVA to mitigate its impact.

Meckel Gruber Syndrome in a Nigerian child: A Case Report and Review of the Literature.

Wasinda Solomon Bulus, Fatima Joy Baba, Innocent Adoyi Agaba, Nasiru Raheem — Fri, 19 Sep 2025 00:00:00 +0000

Meckel-Gruber Syndrome (MGS) is a rare and lethal autosomal recessive disorder characterized by a triad of occipital encephalocele, polycystic kidneys, and polydactyly. The worldwide incidence varies from 1 in 13,250 to 1 in 140,000 live births, with a 25% reoccurrence rate. Prenatally, diagnosis can be made by ultrasonography for fetal anomalies at 11 to 14 weeks of pregnancy, which can guide management decisions. We report a female baby with the characteristic features of this syndrome, which was confirmed by autopsy findings.

Dermatofibrosarcoma Protuberans Presenting as a Breast Mass: a Case Report

Fri, 19 Sep 2025 00:00:00 +0000

Dermatofibrosarcoma protuberans is a rare tumor that accounts for a negligible percentage (approximately 0.1%) of all malignancies. It usually occurs on the trunk and upper and lower limbs. Its occurrence in the breast is uncommon.

A 46-year-old Nigerian woman presented with a left breast mass of 3 years duration without clinical and radiological evidence of metastasis. Initial histological diagnosis revealed a malignant phyllodes tumour. However, immunohistochemistry showed a diagnosis of dermatofibrosarcoma protuberans. She subsequently had a wide local excision with axillary clearance and has shown no clinical and/or radiological signs of recurrence of the lesion one year following surgical removal.

This case helps reiterate the need for immunohistochemistry and not only histology of all malignant breast tumours, irrespective of the nature of the presentation, mode of occurrence, and initial diagnosis. Dermatofibrosarcoma protuberans, however rare, should be considered an important diagnosis of breast malignancies. Indeed, considering the high rate of misdiagnosis of dermatofibrosarcoma protuberans, early histopathological evaluation of breast lesions is of utmost importance. Our case also demonstrates that a wide local excision that is readily available in resource-poor settings remains an extremely important option in the absence of the preferable and technical Mohs micrographic surgery (MMS).

Opioids in Cancer Pain Management: A Double-Edged Sword of Relief and Risk

Fri, 19 Sep 2025 00:00:00 +0000

Opioids are indispensable for managing cancer-related pain but carry risks such as immunosuppression, increased susceptibility to infections, and potential tumour progression. Balancing effective pain relief with these risks remains a critical challenge. This review examines the dual role of opioids in cancer pain management, highlighting their benefits, risks, and ethical implications while exploring strategies to mitigate adverse effects. Through a comprehensive literature review, we analysed mechanisms of opioid-induced immunosuppression, infection risks, tumour progression, and ethical prescribing practices. Additionally, strategies such as multimodal analgesia, opioid rotation, and personalised medicine were evaluated. Findings indicate that while opioids effectively alleviate cancer pain, they may suppress immune function, elevate infection risks, and potentially promote tumour progression. Mitigation strategies, including multimodal approaches, immunomodulatory interventions, and adherence to ethical principles (beneficence, non-maleficence, autonomy, and justice), are essential for safe opioid use. In conclusion, opioids remain vital for cancer pain management but require judicious application to minimise risks. Future research should prioritise non-opioid alternatives and immunomodulatory therapies to enhance patient outcomes.

Robotic Surgery in Africa: History, Contemporary, and Thereafter.

Fri, 19 Sep 2025 00:00:00 +0000

Background: Since its introduction in the late 1980s, robotic surgery has become a less invasive procedure, offering advantages such as increased dexterity, mobility, 3D visualization, and reduced fatigue for surgeons. Although the procedure is still not widely used in Africa, it is fast growing and can potentially minimize surgical inequities in low- and middle-income nations. This narrative review aims to explore the advantages of robotic surgery, its history in Africa, the current level of application of this surgical technique in the continent, the limitations, and how the healthcare system in the region stands to benefit from its use in the future.

Methodology: In this narrative review, extensive literature research was conducted using the Google search engine and databases: ‘Google Scholar’, ‘Cochrane Library’, ‘PubMed’, ‘ScienceDirect’, and African Journals Online (AJOL), spanning 6 months. The search phrases used included: robotic surgery, robotic surgery in Africa, history of robotic surgery in Africa, robotic surgery in low- and middle-income countries, potential advantages of robotic surgery, robotic surgery limitations, benefits of robotic surgery, demerits of robotic surgery, artificial Intelligence in surgical care, and the future of robotic surgery.

A total of 405 articles were found. An advanced search that limited the search to titles revealed only 20 results. Two discussed the possibility of embracing robotic surgery in low- and middle-income countries, one talked about the potential benefits, challenges, and scope of robotic surgery in the future. Also, one talked about the origin of robotic surgery, one delved into artificial Intelligence and its role in surgical care, then discussed the roles of robotic surgery in surgical care, and the rest discussed the few recorded applications of robotic surgery in surgical care in Africa.

Results: Even though the concept of robotics in surgery dates back more than fifty years, its practical application began in the late 1980s. Its enormous potential notwithstanding, the application of robotic surgery on the African continent is still highly underwhelming.

Admittedly the utilization of robotic surgery in Africa faces many challenges such as the high cost of its acquisition, maintenance, and training needed to use the machine, the upskilling of surgeons to specialize in robotic surgery in each field of expertise, the need to alter the size and layout of pre-existing operating rooms to accommodate the components of the robots and to also increase patient load for the use of the robot to make it effective for the cost price, it can potentially reduce cost of healthcare, nosocomial infections, antibiotics abuse and surgical inequalities in the Mother Continent.

Conclusion: Our research showed that robotic surgery, despite offering multiple benefits and having the capability to lessen surgical inequalities in resource-poor nations, is still underutilized in the African continent. The study also showed that even though the utilization of robotic surgery faces challenges in middle and low-income parts of the world, like Africa, due to high costs, limited facilities, patient burden, and the need for specialized training. It, however, holds enormous potential in the continent, such as reductions of infections, antibiotic resistance, and hospital stays, and even possibly reduce the costs of healthcare.