bluuebunny/crossref_metadata_2025 huggingface dataset:
Reproductive health challenges of an African school girl: a case report on non-bulging imperforate hymen with haematocolpometra during Covid-19 pandemic
Authors: Bvumbi Raymond , Chibuoke Ngene Nnabuike
Published: October 2023

Background: Several schoolgirls attain reproductive age with undiagnosed gynaecological problems which pose challenges in their livelihood. These conditions include precocious puberty, congenital reproductive tract abnormalities, and delayed sexual development. Many children with these conditions face additional challenges including physical pain, psychological trauma and delayed diagnosis.

Methods: A 14-year-old girl presented with acute on chronic pelvic pain and haematocolpometra due to imperforate hymen during COVID-19 pandemic. She has not undergone cultural virginity test in her community. The hymenal membrane was unusually non-bulging despite the haematocolpometra. A partial hymenotomy with a narrow margin of excision was performed.

Results: The hymenal orifice later obliterated and resulted in a repeat partial hymenectomy where a wide surgical margin of the hymen was excised.

Conclusions: A wide rather than narrow partial hymenectomy prevents obliteration of the hymenal orifice after surgery for imperforate hymen. There is a need for timely interventions such as counselling and community awareness that prevent undue consequences of an imperforate hymen and its treatment including pain and possible inability to pass cultural virginity test in some African communities.

Keywords: African schoolgirl; cryptomenorrhea; haematocolpometra; hydrometrocolpos; impact of COVID-19; non-bulging imperforate hymen.
Neonatal factors associated with immediate low Apgar score in newborn babies in an intermediate hospital in Namibia: a case control study
Authors: Lungameni Justina , Maano Nghitanwa Emma , Uusiku Laura
Published: October 2023

Introduction: Apgar score is conducted to a baby immediately after birth checking how the baby tolerated the birth processand outside the uterus.

Objectives: To describe the neonatal factors associated with immediate low Apgar score and analysing the associations amongfactors associated with low Apgar score in new-born babies.

Methods: A quantitative, case-control, descriptive research design was used. Study population were all maternal records ofdeliveries conducted between 01 January 2019 and 31 December 2019. Simple random sampling was used to select the samplesize for 194 cases and 194 controls using a 1:1 case-control ratio. Records indicating low Apgar scores were the cases while normalApgar scores were the controls. A total of 388 maternal files were reviewed. Data were collected using a document reviewchecklist and analysed using SPSS version 26.

Results: The study found that, neonatal factors associated with immediate low Apgar score are; gestational age, foetal presentation,cord prolapse, cord around the neck and the importance of cardiotocography interpretation as they had a P-value > 0.005.

Conclusion: Gestational age, birth weight, foetal presentation, cord around the neck and lack of cardiotocography assessmentwere found to be associated with immediate low Apgar score.

Keywords: Neonatal; factors; immediate low Apgar score; newborn; babies.
Prevalence and factors associated with low birth weight among newborns in South Sudan
Authors: Lat Chol , Murila Florence , Wamalwa Dalton
Published: October 2023

Background: WHO estimates that that 13% of babies are delivered low birth weight in Sub-Saharan Africa. Infants with LBWhave a twenty times greater risk of dying than infants weighing more than 2500 grams. The neonatal mortality rates in SouthSudan is 40 per 1000 live births. LBW significantly contributes to neonatal mortality rates.

Objectives: The study aimed at determining the prevalence and factors associated with LBW among newborns.

Methods: This was a cross-sectional descriptive study conducted at three hospitals. Completed data on all live births was collectedusing a structured questionnaire. Univariate and multivariate logistic regression analysis was applied for factors associated withLBW. Adjusted odds ratio with 95% confidence interval was applied and a P value < 0.05 was considered statistically significant.

Results: We retrieved records of 11845 birth cohorts. The prevalence of LBW among newborns was 11.4%. The prevalenceof LBW at Aweil, Juba and Bor was 13.3%, 9.8% and 8.8% respectively. Maternal age less than 20 years and 35 years and above,multigravidity, GA < 37 weeks, male sex and multiple pregnancy were significantly associated with LBW.

Conclusion: The prevalence of LBW in infants was 11.4%. Associated factors were, maternal age, GA < 37 weeks, multigravidity,male sex and multiple pregnancy.

Keywords: Low birth weight; improve birth outcomes; multivariate logistic regression analysis.
Spatio-temporal modelling of under-five mortality in Lesotho using demographic and health survey data
Authors: Mxolisi Zondi Mthobisi , G Mwambi Henry , Fanta Melesse Sileshi
Published: October 2023

Background: Lesotho is in the Sustainable Development Goal (SDG) region which aims to reduce the under-five mortality (U5M) to the average of 25 deaths per 1000 live births by the end of 2030 under the sustainable development goals (SDGs) initiative by the United Nations

Methodology: This paper makes use of the Lesotho Demographic and Health Survey (LDHS dataset, which focuses on female reproductive ages 15-49 and male reproductive ages 15-54 The spatio-temporal models were used in this study to investigate how the proposed covariates change over time.

Results: The results showed that children who were breastfed had a lower odd of death compared to children who were not breastfed, children from more educated mothers had significantly lower odds of U5M compared to those from less educated mothers. Having a larger number of children under the age of five also contributed significantly to an increased risk of U5M. The likelihood of U5M increased with age.

Conclusion: The study recommends that mothers of under-five children be educated about breastfeeding and encouraged to use contraception in order to postpone birth and reduce parity. Rural development should be prioritized through improved primary health care; and public health services should be made more accessible to rural residents.

Keywords: Spatio-temporal modelling; under-five mortality; Integrated Laplace nested approximation; Lesotho demographic and health survey data.
Comparison of iron isomaltoside ferumoxytol with iron sucrose for iron deficiency anemia: a meta-analysis of randomized controlled trials
Authors: Shi Lunbo , Zhao Yan , Rao Aihua
Published: October 2023

Introduction: The efficacy of iron isomaltoside ferumoxytol versus iron sucrose to treat iron deficiency anemia remains controversial. We conduct this meta-analysis to explore the influence of iron isomaltoside ferumoxytol versus iron sucrose on iron deficiency anemia.

Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2021 for randomized controlled trials (RCTs) assessing the effect of iron isomaltoside ferumoxytol versus iron sucrose on iron deficiency anemia. Meta-analysis was performed using the random-effect model.

Results: Four RCTs involving 3892 patients were included in the meta-analysis. Overall, compared with iron sucrose for iron deficiency anemia, iron isomaltoside showed similar change of Hb (SMD=0.14; 95% CI=-0.07 to 0.35; P=0.18), Hb responder (SMD=1.41; 95% CI=0.71 to 2.81; P=0.33), serum ferritin (SMD=15.13; 95% CI=-23.45 to 53.71; P=0.44), and transferrin saturation (SMD=1.20; 95% CI=-1.08 to 3.47; P=0.30). However, iron isomaltoside further improved serum-ferritin at week 2 than iron sucrose (SMD=204.79; 95% CI=38.23 to 371.35; P=0.02).

Conclusions: Iron isomaltoside ferumoxytol showed comparable efficacy to iron sucrose for the treatment of iron deficiency anemia.

Keywords: Iron isomaltoside ferumoxytol; iron sucrose; iron deficiency anemia; randomized controlled trials.
Preliminary efficacy, feasibility and safety of intra-umbilical oxytocin to reduce the time to placental delivery at caesarean section: an exploratory randomized trial
Authors: Middleton Katrin , Mbengo Fungai , Redford Mavundla Thandisizwe , Justus Hofmeyr George
Published: October 2023

Background: Delayed placental separation either after vaginal birth or caesarean birth is an important cause of postpartum haemorrhage, among other causes such as uterine atony. Intra-umbilical oxytocin has been shown to reduce the time to placental delivery after vaginal birth. However, the efficacy of intra-umbilical oxytocin to reduce the time to placental delivery following caesarean section birth is not known.

Objectives: To explore the preliminary efficacy, feasibility and safety of intra-umbilical oxytocin to reduce the time to placental delivery at caesarean section.

Methods: A double-blind, placebo-controlled, exploratory randomized clinical trial was conducted at a tertiary hospital in the Eastern Cape Province, South Africa. A total of 66 women undergoing elective caesarean section were enrolled in the study and randomized into oxytocin group (n = 33) receiving an intra-umbilical infusion of 20 units of oxytocin in 30ml saline, and placebo group (n = 33) receiving an intra-umbilical infusion of 30ml saline. Data were analysed using Epi Info and RevMan software. Preliminary efficacy was assessed by examining the time elapsed from birth of the baby to complete delivery of the placenta; blood loss more than 500 ml; the need for manual removal of the placenta; and the completeness of the placenta. Feasibility was determined by observing the successful insertion of the catheter and injection of the solution. Safety was evaluated by investigating adverse effects of the procedure.

Results: Four women (12%) in the placebo group had a delayed placental delivery compared to one (3%) in the oxytocin group. The mean time from birth to placental delivery was 159 (SD 61) seconds in the placebo group and 143 (SD 45) seconds in the oxytocin group. There was no statistically significant difference between the two groups. Feasibility of the procedure was confirmed by successful insertion of the catheter and injection of the majority of the solution in all 66 cases. No adverse effects of the procedure were identified.

Conclusion: Administration of intra-umbilical oxytocin is feasible, safe and has potential to reduce the time of placental delivery at caesarean section. Further studies involving larger sample sizes are justified.

Keywords: Caesarean section; intra-umbilical oxytocin; postpartum haemorrhage.
Malignancy-related mir-210, mir-373 and let-7 levels are affected in iron deficiency anemia
Authors: Sak Ruveyda , Ozbalci Demircan , Guchan Alanoglu Emine , Hekimler Ozturk Kuyas
Published: October 2023

Background: Hypoxia is the hallmark of iron deficiency anemia (IDA) and in hypoxic environment, significant changes are observed in malignancy-related microRNAs (miRNA). Our aim is to examine whether there is any difference in the levels of miR-210, miR-373 and let-7, which are directly related to malignancies in patients with IDA.

Methods: Thirty-five female patients with IDA between the ages of 18-65 and 10 healthy controls were included in the study. Patients who received oral iron therapy, who had inflammatory disease, and who were pregnant were excluded from the study. Student t Test was used for comparing variables with normal distribution in two independent groups, and Mann-Whitney U Test was used for variables without normal distribution. Comparison of categorical data was made using the chi-square test.

Results: The mean hemoglobin and ferritin level were 10,78±0,93 and 6.28±5,76 respectively. Plasma miR-210 expression were found as -7.27±2.23 and -6.15±0,88 in IDA and control group respectively (p = 0.022). Plasma miRNA-373 were -7.36±2,58 and -6,96±1,93 and let-7 expression were 2.14±2,15 and 3,57±2,21 in IDA and control group. (p = 0.65 and p = 0.20, respectively).

Conclusions: Plasma miR-210 expression was significantly up-regulated and miR-373 and let-7 expression was down-regulated, though insignificantly, in IDA group.

Keywords: miRNA; iron deficiency anemia; malignancy.
Assessment of the relationship between miR-499C/T (rs3746444) polymorphism and lung carcinoma in Iranian population; a case-control study
Authors: Torabi Mehdi , Khafaei Mostafa , Jahanbin Behnaz , Sadeghi Morteza
Published: October 2023

Introduction: Lung carcinoma is characterized by uncontrollable division of respiratory system cells with detrimental and lethalconsequences on human health. Critical roles of microRNAs (miR) are scientifically approved in biological and pathologicalpathways, such as the role of miR-499 (rs3746444) in lung carcinomas. Thus, in this case-control investigation, we aimed toassess the probable relationship between miR-499C/T variant and the occurrence of lung carcinoma in Iranian population forthe first time.

Methods: Genotype of miR-499 polymorphism was described by the Polymerase Chain Reaction-Restriction Fragment LengthPolymorphism (PCR-RFLP) assay in patients and healthy individuals. Following definite diagnosis of lung carcinoma, the bloodsamples were collected, and the DNA extraction was performed by Salting-Out method. Finally, data were analysed by SPSS (v.20) and the significant level was considered p-value<0.05.

Results: Statistically, the frequency of combined genotypes of CC+CT were 83.33% and 35% and TT+CT were 100% and 92%in case and control individuals, respectively. Also, individuals with genotypes of TC (OR: 3.08, CI95%: 3.03-3.17, p<0.0001),TC+CC (OR: 0.10, CI95%: 0.05-0.23, p<0.0001), CC (OR: 0, CI95%: 0.00-0.60, p=0.0214), and TC (OR: 0.07, CI95%: 0.03-0.15, p<0.0001) represented statistically significant (p<0.05) differences lung carcinoma than those with TT, TT, TT+TC, andTT+CC genotypes, respectively. The frequency of miR-499C (78.5%) and miR-499T (21.5%) alleles were also statistically significantly(p<0.05) difference associated with lung carcinoma in patients than controls.

Conclusion: In this study, a possible relationship among miR-499C/T polymorphism and lung carcinoma was detected in Iranianpopulation. Since this study was conducted for the first time, thus other supplementary assessments are needed for definiteconclusion.

Keywords: Lung, neoplasm; carcinoma; rs3746444; miR-499C/T; miR-499A/G; RFLP-PCR; Polymorphism; Iran.
Physical inactivity and barriers to physical activity among Type-2 diabetics in Kumasi, Ghana
Authors: Kumah Taylor Linda , Adjatey Nyakotey David , Kwarteng Alexander
Published: October 2023

Background: Although the benefits of physical activity (PA) in diabetes management are well documented, there insufficientdata on physical activity levels and barriers to physical activity among Type-2 diabetics in Ghana. This study assessed physicalactivity and barriers to physical activity among Type-2 diabetics at Manhyia Hospital in Kumasi, Ghana.

Methods: The study recruited 97 participants (32% men, 68% women). Physical activity was assessed using the Global physicalactivity questionnaire and barriers to PA were assessed using the Barriers to being active Quiz. Anthropometry and sociodemographicdata were also collected.

Results: Prevalence of overweight/ obesity was 63.9%. About 60% of participants were inactive. Social influence (60.8%)was the most prevalent PA barrier followed by lack of energy (59.8%) and lack of willpower (58.8%). Majority of participants(57.7%) reported at least 4 barriers to being active. There was a significant negative correlation between age and number of PAbarriers (r = -0.214, p = 0.035). A significantly higher proportion of employed participants were active compared to the unemployed/retired participants (p = 0.035).

Conclusion: This population of Type-2 diabetics needs urgent lifestyle interventions to improve physical activity and weight,considering that the main physical activity barriers were personal motivation related.

Keywords: Physical activity barriers; Type 2 diabetics; Ghana; physical activity.
Influence of feedforward control-based health education intervention on compliance, visual function and self-perceived burden among patients with diabetic retinopathy
Authors: Wang Jia , Tang Huanyu
Published: October 2023

Objective: To assess the influence of feedforward control-based health education intervention on the compliance, visual functionand self-perceived burden (SPB) among patients with diabetic retinopathy (DR).

Methods: Eighty-six DR patients were divided into feedforward control and control groups (n=43). The control group wasgiven routine nursing intervention, based on which the feedforward control group received feedforward control-based healtheducation intervention. The health behavior indices were compared after intervention. The correlations of QOL score with SPBscore and health behavior indices were analysed using Pearson’s and Spearman’s coefficients.

Results: After intervention, the total QOL score and scores of symptoms and visual function, physical function, social activity,and mentality and psychology were significantly improved compared with those before intervention, which were significantlyhigher in the feedforward control group (P<0.05). SPB score was significantly lower in the two groups after intervention thanthat before intervention, particularly in the feedforward control group (P<0.05). The QOL score of DR patients was significantlynegatively correlated with SPB score but positively correlated with health behavior indices (P<0.05).

Conclusion: The feedforward control-based health education intervention mode is beneficial for guiding DR patients to promotevisual function recovery and to reduce SPB.

Keywords: Correlation; diabetic retinopathy; feedforward control; health education; self-perceived burden; visual function.
Assessment of gender differences in some inflammatory cytokines of tuberculosis patients before and during treatment
Authors: Okeke Chizoba , Okonkwo Robert , Ibeh Nancy , Chukwuma Oluchukwu , Okeke Chisom
Published: October 2023

Background: Gender variation is a feature of many physiological parameters including inflammatory cytokines. Inflammation is an obvious feature of Tuberculosis (TB) infection with changes in pro and anti-inflammatory cytokines.

Objective: To compare the levels of inflammatory cytokines between male and female TB patients before treatment, after 2-months and after 6-months anti-tuberculosis treatment.

Materials and methods: A total of 35 males and 25 females TB subjects were enlisted before initiation of therapy and followed up after 2-months and 6 months treatment and samples collected and analysed. Tumour necrosis factor-alpha (TNF-α), Interleukin 10 (IL-10, Interleukin -6 (IL-6), Interleukin-2 (IL-2), transforming growth factor-beta (TGF-β) were assayed by ELISA method.

Results: Before treatment, the median level of IL-6 (pg/ml) was significantly higher in males compared to female TB patients (P=0.046). While after 2-months treatment, TNF-α (pg/ml) and IL-10 (pg/ml) was significantly higher in males compared with females (P=0.008 and 0.045 respectively). Conversely, the median IL-6 (pg/ml) was significantly higher in female TB patients compared to the males (P=0.042). No significant differences were observed after 6-months treatment.

Conclusion: Gender differences exist in IL-6 before treatment and in IL-6, TNF-α and IL-10 at two months treatment. Thus, TB treatment contributes differentially to levels of inflammatory cytokines in male and female TB patients.

Keywords: Tuberculosis; anti-tuberculosis drugs; cytokines; inflammation.
Neutralising antibodies against SARS-CoV-2 give important information on Covid-19 epidemic evolution in Rabat, Morocco, March 2020-February 2021
Authors: Touil Nadia , Drissi Touzani Charifa , Benaissa El Mostafa , Kasouati Jalal , Rhazzar Zineb , El Annaz Hicham , El Mrimar Nadia , Neffah Lamiae , Abi Rachid , Rida Tagajdid Rida Tagajdid , El Kochri Safae , Ducatez Mariette , Akhouad Youssouf , Reggad Ahmed , El Kassimi Zouhour , Zrara Abdelhamid , Bssaibis Fatna , El Fahime ElMostapha , Lahlou Amine Idriss , Belmekki Abdelkader , Singh Malik Yashpal , Elouennass Mostafa , Ennibi Khalid
Published: October 2023

Background: The SARS-CoV-2 is an extremely contagious and acute viral disease mainly affecting humans.

Objective: To estimate seroprevalence of SARS-CoV-2 neutralizing antibodies (NAbs) for illegible armed force individuals living in Rabat, Morocco

Method: A convenience sample (N = 2662) was conducted from May 2020 to February 2021. We used the standard neutralization assay to quantify the NAbs titers. A serum was positive when the titer was 1:4. High positive NAbs titers were defined when ≥ 1:32.

Results: Demographic and socioeconomic status did not affect seroprevalence data. An overall seroprevalence of 24,9% was found. Sera from blood donors, young recruits and auto-immune population had lower NAbs titers. However, titers were above 1:16 in 9% of the population with high risk of SARS-CoV-2 exposure. Seropositivity increased over time with values reaching peaks after the epidemic waves (2.4% in May 2020; 16.2% in August 2020; 22.7% in December 2020 and 37% in February 2021).

Conclusion: And increase of NAbs was observed over time and correlated with the post-epidemic waves of COVID-19 in Morocco.

Keywords: SARS-CoV-2; Serum neutralizing assay; Seroprevalence; Rabat; Morocco.
Covid-19 and non-communicable diseases (NCDs) in Africa: a narrative review
Authors: Azeez Olanrewaju Yusuff , Abimbola Oladunni Amos , Bitrus David Kenneth , Olalekan Babatunde Yusuf , Abdulmumin Damilola Ibrahim , Adedeji Oluwakorede , Chidozie Ahamefula Colette
Published: October 2023

Coronavirus disease 2019 popularly known as COVID-19 is the current pandemic ravaging the world. It has disrupted so many aspects of humans’ life including the healthcare systems of all countries. While governments have instituted preventive measures such as social distancing, self-isolation and lockdown in a bid to control the spread of the virus, the absence of vaccine can lead to poor management of key risk factors (including unhealthy diets and physical inactivity) associated with NCDs and limited access to preventive health services can further contribute to development and progression of NCDs. This study provides a review of available evidences from PubMed, google scholar, online databases, and papers from other sources on the impact of COVID-19 pandemic on NCDs in Africa and emphasizes lessons from past pandemics that can be adopted to reduce the burden of the disease.

Keywords: COVID-19; Pandemics; Africa; Non-Communicable Diseases.
Decision to delivery interval, maternal and fetal outcomes in emergency caesarean sections in a tertiary teaching hospital, Dar es salaam, Tanzania
Authors: Wangwe Peter , Kibwana Mfaume , August Furaha , I Kikula Aman
Published: October 2023

Background: Emergency caesarean section (CS) answers the question on how soon the procedure should be performed. Maternal and fetal outcomes deteriorate when decision to delivery interval (DDI) exceeds 75 min. This study aimed at determining the DDI, Maternal and fetal outcomes in CS categories at Muhimbili National Hospital (MNH).

Methodology: A descriptive cross-sectional study involving 427 emergency CS at MNH was conducted from September to November, 2017. Data was extracted and analysed using SPSS version 23.0 where frequency, means, chi-square test and DDI were calculated to determine its association with categories of CS.

Results: The mean DDI for category one, two and three CS were 126.73, 133.57 and 160.08 min respectively. Only two (0.5%) and 54 (12.6%) of category one and two emergency CS met the recommended DDI of 30 and 75 min respectively. Maternal and fetal adverse outcome were increasing with increase in DDI. There was no significant association between DDI and adverse maternal outcome (OR: 1.2; 95% CI 0.49-2.83) and fetal outcome (OR: 1.7; 95% CI 0.91-3.38).

Conclusion: The proportions of adverse maternal and fetal outcome were high when DDI was ≥ 75 min. Improving triage of the patients according to their urgency is crucial in reducing prolonged DDI.

Keywords: Caesarean section category; maternal and fetal outcome; decision to delivery interval.
Correlations of intestinal microorganisms with liver and immune functions of patients with human immunodeficiency virus and hepatitis B virus coinfection
Authors: Deng Yong , Yang Ke , Zhou Guoqiang , Wang Ning , Liu Chun , Chen Zhong
Published: October 2023

Objective: Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection has threatened the survival ofHIV-infected people. To explore the correlations of intestinal microorganisms with liver and immune functions of patients withHIV/HBV coinfection.

Methods: Eighty-six patients positive for HIV antibody and HBV surface antigen diagnosed from January 2018 to June 2020were selected as HIV/HBV coinfection group. Another 86 patients positive for HBV surface antigen and 86 healthy people wereselected as HBV infection and control groups, respectively. The correlations of intestinal flora with liver function, inflammatoryindices and immune cells were explored through Pearson’s analysis.

Results: Compared with control group, the proportions and numbers of T lymphocytes (CD3+), helper T lymphocytes (CD4+),cytotoxic T lymphocytes (CD8+), CD4+/CD8+ and natural killer (NK) cells decreased in HIV/HBV coinfection group (P<0.05).IL-2, IL-6, IL-17, ALT, AST, GGT, DBiL and TDBi levels were correlated negatively with Bifidobacterium, Lactobacillus and Bacteroidesnumbers, but positively with Enterobacter and Enterococcus numbers (P<0.05). IL-10 level and proportions of CD3+, CD4+,CD8+, CD4+/CD8+ and NK cells were correlated positively with Bifidobacterium, Lactobacillus and Bacteroides numbers, but negativelywith Enterobacter and Enterococcus numbers (P<0.05).

Conclusion: HIV aggravates the liver damage and immuno-inflammatory response in HBV patients.

Keywords: Intestinal flora; liver function; inflammatory factor; immune; human immunodeficiency virus; hepatitis B virus.
Relationship between antimicrobial resistance and virulence factors in uropathogenic Escherichia coli isolates from Ramadi, Iraq: phenotype and genotype identification
Authors: Dhahir Abed Ahmed , Y Mutter Thamer
Published: October 2023

Background: Uropathogenic Escherichia coli (UPEC) is the most predominant pathogen that causes severe urinary tract infections (UTIs). Their therapeutic options are limited due to the rising of antibiotic resistance.

Objective: The aim of the study was to evaluate the level of antibiotic resistance profile, redundancy of virulence genes, and their correlation.

Methods: 41 UPEC isolates were collected from patients diagnosed with UTI, identified by the standard microbiological analysis, and tested for susceptibility to 12 antibiotic agents using the Kirby-Bauer method. The ability of UPEC isolates to produce biofilm, hemolyze and cause clumping of blood was determined. Virulence genes were detected by PCR analysis.

Results: The percentage of UPEC isolates was higher in females (78.1%) than in males (21.9%). UPEC isolates showed a high degree of resistance towards Ceftriaxone (90.2%), Cefepime (90.2%), Ciprofloxacin (82.9%), Levofloxacin (82.9%), and Trimethoprim-Sulfamethoxazole (80.4%). Biofilm formation (87.8%) and hemagglutinin activity (80.4%) were the most predominant virulence markers expressed in UPEC and showed a high degree of correlation with the antibiotic resistance profile. PCR analysis showed that fimH (85.3%) was the most prevalent gene detected in UPEC isolates, followed by aac3-II (80.4%) among the five genes tested, blaTEM, aac3-II, sul2, hlyA, and fimH. The correlation between antibiotic resistant patterns and the presence aac3-II gene was significantly high. The resistance to the sulfonamides’ combined antibiotic was highly correlated with the presence of sulf2 gene.

Conclusion: Antimicrobial resistance was significantly linked to phenotypic and genotypic virulence factors. These results will aid in elucidating the pathogenicity of UTIs and guiding treatment decisions.

Keywords: UPEC resistance profile; virulence factor; Biofilm formation; hemagglutinin; hemolysin.
Values of serum neutrophil gelatinase-associated lipocalin and cystatin C after percutaneous coronary intervention for early diagnosis of contrast-induced nephropathy
Authors: Luo Ping , Ao Wei , Xiang Dikai , Wang Jian , Liu Jia
Published: October 2023

Objective: Serum creatinine (SCr) is not a sensitive and reliable index for the early diagnosis of acute kidney injury caused bycontrast-induced nephropathy (CIN). The aim of this study was to explore the values of serum neutrophil gelatinase-associatedlipocalin (NGAL) and cystatin C (Cys-C) after percutaneous coronary intervention (PCI) for the early diagnosis of CIN.

Methods: Three hundred patients receiving PCI from January 2018 to December 2020 were assigned to a CIN group (n=25)and a non-CIN group (n=275), respectively. SCr, Cys-C and NGAL levels were measured, and their sensitivities for early CINdiagnosis were evaluated by the area under the receiver operating characteristic curve (AUC) values.

Results: The NGAL and Cys-C levels of the CIN group began to rise 6 and 12 h after operation, respectively (P<0.05). TheCIN group had higher NGAL and Cys-C levels than those of the non-CIN group 12, 24 and 48 h after operation (P<0.05). TheAUC values of NGAL, Cys-C and SCr 24 h after operation were 0.885, 0.874 and 0.856, respectively.

Conclusion: The serum NGAL and Cys-C levels of patients after PCI reflect the early changes of renal function, which arevaluable for early CIN diagnosis.

Keywords: Contrast; cystatin C; nephropathy; neutrophil gelatinase-associated lipocalin; percutaneous coronary intervention.
Perception and level of satisfaction with the quality of antenatal care services among pregnant women attending antenatal clinic at plateau state specialist hospital, Jos, Nigeria
Authors: Titilayo Olaoye , Oyewole Oyerinde , Chidera Aguiyi , Omosuzi Mercy
Published: October 2023

Objective: This study evaluated pregnant women’s perception and level of satisfaction with quality of antenatal care receivedat Plateau State Specialist Hospital.

Materials and Methods: The study employed a hospital-based cross-sectional design. Convenience sampling was used toselect two hundred and thirty-eight (238) women attending antenatal clinic at the Plateau State Specialist Hospital. A validatedsemi-structured interviewer-administered questionnaire with a Cronbach’s Alpha score of 0.83 was used for data collection. Respondent’s perception was measured on a 36-point rating scale and the level of satisfaction on a 9-point rating scale. Data wassubjected to descriptive analysis and Pearson’s correlation was used to test for hypothesis.

Results: The mean age was 28.79 years. Most of the respondents were married (81.9%), twenty-eight percent of the respondentshad two children. The respondent’s perception of quality of antenatal care shows a mean score of 25.0± 4.61 whichindicates that the respondents had positive perception of the quality of antenatal care (69.4%). Also, the respondent’s level ofsatisfaction with the quality of antenatal care received shows a mean score of 6.50 ± 1.8 indicating that they were very satisfied(72.2%) with quality of antenatal care. There was a significant relationship between the respondent’s perception of the qualityof antenatal care and level of satisfaction of the quality of antenatal care service (r= 0.43; p< 0.003).

Conclusion: The respondents had positive perception and are satisfied with the quality of antenatal care services received. APeriodic patient satisfaction survey should be established as part of the antenatal evaluation to provide feedback for continuousquality improvement.

Keywords: Antenatal care; perception; level of satisfaction; Plateau.
The balance between CD4+ T helper 17 and T-cell immunoglobulin and mucin domain 3 is involved in the pathogenesis and development of atrial fibrillation
Authors: Dai Wenjing , Zhang Jun , Wang Yang , Zhou Jingqun , Dai Qiuting , Lv Jianfeng
Published: October 2023

Background: To investigate the expression of Th17, T lymphocyte immunoglobulin mucin 3 (TIM-3+) cells and their relatedcytokines in atrial fibrillation (AF) and their clinical significance.

Methodology: A total of 90 patients with AF were divided into paroxysmal group (n=45) and chronic group (n=45), and 45healthy volunteers were selected as the control group. The proportion of Th17 cells and Tim-3 + cells in the peripheral bloodwere detected. The concentrations of related cytokines in peripheral blood serum were determined. The correlation betweenTh17 / Tim-3+ cells and related cytokines was analysed.

Results: Compared with the control group, the proportion of Th17 cells and the concentration of related cytokines (IL-17, IL-6and Matrix metalloproteinase (MMP9)) in peripheral blood of patients with paroxysmal and chronic AF increased significantly,while the proportion of tim3 + cells and the concentration of related cytokines decreased significantly. Compared with theparoxysmal group, the proportion of Th17 cells and the concentration of related cytokines in the peripheral blood of patientsin the chronic group increased significantly, while the proportion of tim3 + cells and the concentration of related cytokinesdecreased significantly.

Conclusion: Th17 / Tim-3 + cell balance is involved in AF, and can be used as a target for AF treatment.

Keywords: Atrial fibrillation; Th17 cells; Tim-3; Cytokines; IL-17; Gal-9.
Outcome of preventive nursing intervention, prophylactic anticoagulation and the use of the Caprini score on venous thromboembolism after varicose vein surgery
Authors: Zheng Ting , Zheng Xiaofei
Published: October 2023

Objective: This research was devoted to estimate the outcome of preventive nursing intervention on venous thromboembolism (VTE) after varicose vein surgery in lower extremities.

Methods: A total of 516 subjects with varicose veins of lower extremities (from January 2020 to January 2022) treated in our hospital were separated into observation subgroup (n = 258) and control subgroup (n = 258) at random. The conventional nursing intervention was applied in the control subgroup, preventive nursing intervention, prophylactic anticoagulation and the use of Caprini score was applied in the observation subgroup. The levels of blood indexes [hemoglobin (Hb), platelet (PLT) and D-dimer (D-D)] were compared between the two subgroups before operation and 7 days postoperative, the occurrence of subcutaneous congestion, lower limb swelling and pain, VTE and nursing satisfaction of the subject 4 (four) weeks after discharge.

Results: After intervention, the levels of PLT and D-D in the observation subgroup were notably lower than those in the control subgroup. Four weeks after discharge, the incidence of subcutaneous congestion, lower limb swelling and pain, there had no notable difference in two subgroups Versus the control subgroup, VTE in the observation subgroup was notably lower and nursing satisfaction was higher.

Conclusion: Preventive nursing intervention can reduce the level of PLT and D-D, restrain in the incidence of VTE and improve the nursing satisfaction of subjects with varicose veins of lower extremities after varicose vein surgery of lower limb.

Keywords: Varicose vein surgery; nursing intervention; Caprini score.
Lipid and nutritional profiles of Caribbean patients with chronic kidney disease
Authors: Idris Saleh
Published: October 2023

Aim: Chronic kidney disease (CKD) is marked by the deterioration of kidney function and derangement in lipid metabolism.Thus, we aim at evaluating the lipid and nutritional parameters of Caribbean patients with CKD.

Methods: The study recruited 88 CKD patients and 105 apparently healthy subjects. Blood glucose, urea, creatinine, albumin,uric acid, total cholesterol, triglycerides, HDL-cholesterol, VLDL, and LDL were measured in duplicate on the Vitros 4600Multi-Channel Chemistry Auto-Analyzer (Johnson & Johnson Ortho-Clinical Diagnostics Inc., Rochester NY, USA) in our laboratory.The Statistical Package for the Social Sciences (SPSS, version 20) was used for statistical analysis.

Results: Mean levels of diastolic blood pressure (p < 0.05), age, and systolic blood pressure between the patients and thehealthy controls (p < 0.001) were different. In addition, mean levels of BUN (p < 0.05), serum creatinine, and uric acid werehigher and eGFR lower in the patients compared with the healthy controls (p < 0.001). The mean levels of albumin, glucose,triglycerides, HDL-cholesterol, and VLDL (p < 0.001) also differed between patients and healthy controls. Negative correlationbetween eGFR and triglycerides and a positive correlation between eGFR and total cholesterol, HDL-c and LDL were observed.The prevalence of hypoalbuminemia, hypercholesterolemia and underweight were 27.27%, 57.95% and 4.55% respectively inpatients, compared with 10.48%, 44.74% and 2.86% respectively in healthy controls.

Conclusion: Dyslipidemia is common in CKD patients and is therefore, imperative that, routine lipid profile analysis be detailedin order to check any trend towards the development of CVD.

Keywords: Cardiovascular diseases; chronic kidney disease; dyslipidemia; estimated glomerular filtration rate; kidney; malnutrition;parameter; risk factor.
Factors associated with poor asthma symptom control in adult Angolan regularly seen at an outpatient respiratory clinic
Authors: L T Arrais Margarete , J P Maricoto Tiago , M Lulua Ofélia , G S Quifica Francisca , M R Gama Jorge , D Brito Miguel , Taborda-Barata Luis
Published: October 2023

Background: Asthma is one of the most common chronic respiratory diseases and one of the most frequent causes of hospitalcare.

Objectives: To describe the clinical characteristics of asthma and factors associated with its control.

Methods: A cross-sectional study was conducted at the Military Hospital in Luanda, from April 2018 to March 2019. Data collectionwas performed using questionnaires on asthma symptoms and treatment, socio-demographic and environmental questions,and a Global Initiative for Asthma (GINA) questionnaire to assess the level of asthma control. Ordinal logistic regressionanalyses were performed. We estimated odds ratios, for higher categories of asthma control. P<0.05 was considered significant.

Results: The sample consisted of 305 asthmatics ≥18-years-old, 56% women, with a mean age of 41.3 years. About 28% ofpatients had controlled asthma, 36% partially controlled and 35% uncontrolled. Poor asthma control was associated with frequentuse of short-acting beta-2 agonists [OR 5.70 (95%CI 2.37;13.7)], oral corticosteroids [OR 3.68 (95%CI 2.24;6.04)], andincorrect inhaler technique [OR 4.08 (95%CI 1.25;13.3)].

Conclusions: A significant number of adults living in Luanda have uncontrolled asthma due to the under-use of inhaled corticosteroidtherapy. It is necessary to develop strategic management and prevention plans to improve Angolan asthmatics' medicalcare.

Keywords: Asthma; Angola; symptom control; inhalers.
Spectrum of substance use precipitating rehabilitative services among adult patients in the university of Port Harcourt teaching hospital
Authors: Ugochukwu Okeafor Chukwuma , Esu Irene
Published: October 2023

Background: World Health Organization ranks substance abuse as one of the top twenty health risk factors. It poses a seriouspublic health crisis with a significant burden for affected individuals, families and health systems. This study aimed to identifythe spectrum and pattern of substance use among patients receiving rehabilitative services.

Methods: The study was a cross-sectional design involving 190 patients receiving rehabilitative care for substance use in theUniversity of Port Harcourt Teaching Hospital. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), avalidated and reliable tool was employed to obtain data on substance use. Statistical analyses were performed at P<0.05.

Results: The male to female ratio was 4:1. A higher proportion of the patients were within 18-35years category (81.6%; n=155).The commonly used substances were alcohol (90.5%; n=172), cannabis/marijuana (43.7%; n=83), prescription opioids (28.9%;n=55). cigarette (25.8%; n=49), and street opioids (15.8%; n=30). The prevalence of poly substance use was 68.4%(n=130).Age(p=0.033) and sex (being male) (p=0.002) were predictors for number of substances used.

Conclusion: Almost all the patients receiving drug rehabilitative service used alcohol, and approximately 7 in 10 used more thanone substance. The need to inculcate harm reduction in the management protocol is therefore paramount.

Keywords: Substance use; alcohol; cannabis; substance use; rehabilitative care.
Service delivery inaccessibility as a predictor of teenage pregnancy in South Africa
Authors: Sibusiso Mkwanazi
Published: October 2023

Background: With the onset of the South African democracy in 1994 it was hoped that many social inequalities would beaddressed urgently. However, studies have shown that service delivery inaccessibility remains a challenge and investigating thesocial implications of such injustices remains important.

Objective: This study determined to establish the association between service delivery inaccessibility and adolescent pregnancyin South Africa.

Methods: Using data from 2019 and 2021 general household surveys, 7 737 teenage females were included. The study applieddescriptive statistics, chi-squared testing as well as multilevel binary logistic regression.

Results: Random-intercept multilevel binary logistic regression revealed that the risk of adolescent pregnancy independently increased as the level of service inaccessibility increased at household level (no services: OR=1.73, 1 service: OR=1.40, 2 services:OR=1.28) and community level (medium: OR=1.22, high: OR=1.38) at a P-value of 0.05.

Conclusion: Findings highlight the need to guarantee universal service delivery urgently not only for development, but also toprevent adolescent pregnancy. Furthermore, the findings present evidence of structural factors driving adolescent pregnancy inSouth Africa, which renders continued cycles of poverty, injustice and early pregnancy amongst the majority of Blacks.

Keywords: Teenage pregnancy; service inaccessibility; multilevel modelling; South Africa; structural inequality; teenagers.
Reducing the risk of nuclear war- the role of healthcare professionals
Authors: Abbasi Kamran , Ali Parveen , Barbour Virginia , Bibbins-Domingo Kirsteen , Rikkert Marcel G.M. Olde , Haines Andy , Helfland Ira , Horton Ricard , Mash Robert , Mitra Arun , Monteiro Carlos , Naumova Elena N. , Rubin Eric J. , Ruff Tilman , Sahni Peush , Tumwine James , Yonga Paul , Zielinki Chris
Published: October 2023

No Abstract
Protective effect of Rosemarinus officinalis on gentamicin-induced acute kidney injury in adult male albino rats
Authors: Waswa Kennedy Wanyonyi , Marera Domnic , Korir Scolastica , Masoni Isaac
Published: October 2023

Background: Gentamicin (GN) drug is one of the first-line drugs for managing severe gramnegative bacteria. Its association with acute kidney injury (AKI) has restricted its use due to oxidation damage to kidney architectural structures. Rosmarinus Officinalis (rosemary) is anatural antioxidant available and affordable in many developing countries. Antioxidants can be used to prevent oxidation that causes AKI  in GN use. This study was undertaken to evaluate the protective gross morphological effect of Rosmarinus Officinalis (RO) on Gentamicin- induced acute Kidney injury in male albino rats’ species of Rattus norvegicus.

Methodology: The study was done in Kenya at Maseno  University. A posttest true experimental design was used, and a sample size of 25 Albino rats was calculated using a resource-modified  equation. Rats were randomly sampled into 5 groups, each with 5 albino rats. The negative control group received a standard rat diet  plus water, the positive control received GN100,mg/kg/bwt/i.p, low-dose RO, medium-dose RO, and high-dose RO groups received  100,150 and 200 mg/kg/bwt of RO orally, respectively, and were co-administered with GN 100mg/kg/bwt/i.p. At the end of day seven, they were humanely sacrificed, and gross morphometric were taken.

Results: It was observed that the mean weight of the rat, weight,  and volume of the kidney increased significantly (p= 0.001) in high-dose RO group as compared to the positive control. The mean length  and thickness in high-dose RO group increased significantly (p=0.0001) as compared to the positive control.

Conclusion: This present  study shows that co-administration of a high dose of RO has a protective effect on gross morphology against Gentamicin-induced AKI  among male albino rats.
Determinants of cadaver acquisition at Human Anatomy Learning Institutions in Kenya
Authors: Siwa Benard , Adero Walter , Oyieko Willis , Marera Domnic , Ongeti Kevin
Published: October 2023

Background: Human anatomy instruction in Kenya is based on dissection of cadavers during practical sessions. Institutions get these  cadavers using procedures available to them. However, the processes used are not standardized, and several problems are likely to  develop during the cadaver acquisition process. Several factors appear to have an impact on the source, availability, and cadaver  collection techniques. Some of the issues affecting cadaver acquisition may not be sufficiently addressed by current anatomy practice  guidelines. This study evaluated the determinants of cadaver acquisition at human anatomy learning institutions in Kenya.

Methodology:  Anatomists and anatomy laboratory personnel handling cadavers in Kenya were interviewed for the study. A cross-sectional study design  was used, as well as a purposive sampling strategy. The self-administered surveys were completed by 68 study participants. The data was  tallied, loaded into SPSS version 26 for analysis, then plotted into graphs and tables for interpretation.

Results: Cadavers were mostly  acquired from unclaimed bodies (100%). In most situations (80.9%), anatomy laboratory technicians oversee cadaver collection. A  cadaver acquisition delay of more than two weeks was reported by 80.88% of respondents. According to 44.12% of respondents, the  biggest reason for cadaver collecting delays was the need for financial compensation. Most cadavers (98.5%) are obtained through  lobbying at the source. According to 92.6% of responders, defaced or damaged cadavers are mostly rejected. According to 94.2% of  respondents, the Kenya Anatomy Act has no instructions on how to obtain cadavers.

Conclusion: The efficiency of cadaver acquisition is  affected by several factors that affect both the procedure and the people in charge of procuring the cadavers. Institutions in Kenya lack a comprehensive cadaver acquisition policy that describes the procedure and personnel in charge of procuring cadavers. There is no  specified documented protocol or guideline for cadaver acquisition in the Kenya anatomy act.