Annals of Medicine and Medical Sciences is a peer-reviewed medical journal that publishes original research articles, review articles, case reports, and short communications in the fields of medicine and medical sciences. The journal aims to provide a platform for researchers and healthcare professionals to share their latest findings and developments with the international medical community. The journal covers a wide range of topics, including but not limited to, clinical medicine, surgery, pediatrics, obstetrics and gynecology, neurology, oncology, and epidemiology. The journal is particularly interested in publishing research that has a strong emphasis on evidence-based medicine, and that is of interest to clinicians and researchers alike. The journal is committed to maintaining high standards of scientific integrity and ethical principles. All submitted manuscripts are subject to a rigorous peer-review process to ensure that only high-quality, scientifically valid research is published. The journal also follows strict guidelines for the protection of human subjects, ensuring that all research involving human subjects is conducted in accordance with international ethical standards. Annals of Medicine and Medical Sciences is an open-access journal, making its articles freely available to the public. This allows the journal to reach a wider audience and ensure that important research findings are widely disseminated. In conclusion, Annals of Medicine and Medical Sciences is a valuable resource for anyone working in the fields of medicine and medical sciences, providing a platform for the exchange of knowledge and the dissemination of cutting-edge research.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Knowledge, Attitude, Healthcare-Seeking Behaviour, and Barriers Related to Reproductive Tract Infections/Sexually Transmitted Infections among Married Women Residing in Urban Slums of Central India: A Cross-Sectional Study
Context: Reproductive tract infections (RTIs) are common health problems among women of reproductive age and contribute significantly to morbidity, particularly in low- and middle-income countries. Aim: To assess knowledge, attitude, healthcare-seeking behaviour, and perceived barriers related to reproductive tract infections and sexually transmitted infections among married women. Settings and Design: A cross-sectional study was carried out in urban field practice area of a tertiary care centre in Central India. Methods and Material: A total of 317 married women were interviewed using a pretested questionnaire. Data were analysed using descriptive statistics, and associations were assessed using the Chi-square test. Results: Most participants were aware of reproductive tract infections and sexually transmitted infections; however, only 39.8% knew the modes of transmission and 32.5% were aware of preventive measures. Nearly 96% believed that increased awareness could reduce disease prevalence. Only 33.4% sought treatment for genital symptoms. Major barriers to healthcare seeking were lack of time (35.5%) and cultural stigma (28.4%). Education and socioeconomic status were significantly associated with knowledge levels (p<0.05). Conclusions: Strengthening health education, particularly regarding menstruation and menstrual hygiene, is essential to improve awareness, promote timely healthcare seeking, and reduce disease burden.
Reproductive tract infections Healthcare-seeking behaviour Knowledge and attitude Urban slums
Copyright (c) 2026 Dr. Aishwarya Kumar, Dr. Uday Narlawar https://creativecommons.org/licenses/by/4.0/
Student’s Perspective on ‘E-learning’ as a Tool for Medical Education: A KAP Study
Background: The COVID-19 pandemic catalyzed widespread adoption of e-learning in medical education, yet its sustained acceptability and integration as a core pedagogical tool remain insufficiently explored in resource-constrained government medical colleges of South India. Methods: A cross-sectional questionnaire-based study was conducted from January to March 2024 among undergraduate MBBS students at Government Medical College, Pudukkottai, Tamil Nadu. Using convenience sampling, 512 of approximately 600 eligible students (response rate 85.3%) completed a pretested self-administered questionnaire assessing knowledge (7 items), attitude (12 items), and practice (11 items) regarding e-learning. Data were analysed using IBM SPSS version 25.0; descriptive statistics and chi-square tests were applied. Results: Students exhibited high confidence in basic digital skills (online search 61.5%, emails 58.6% very confident) but low confidence in advanced tasks (statistics 16.2%, blog creation 6.1%). Two-thirds (67.6%) supported e-learning as a supplement to regular classes, whereas only 17.9% favoured replacing all lectures. Concerns about increased screen time and health issues were endorsed by 66.4%. Daily social networking was nearly universal (63.1%), while specialized academic uses remained limited. Senior students showed significantly higher confidence in online medical platforms (χ² = 26.81, P < 0.001), and students acknowledging health risks paradoxically spent more time on social networking (χ² = 16.26, P = 0.0003). Conclusion: Undergraduate medical students are digitally proficient and strongly favour blended learning models. A balanced digital ecosystem is essential to enhance learning without compromising student well-being. Institutions should prioritise structured hybrid frameworks, advanced informatics training, and digital-wellness interventions to optimise benefits while addressing screen-time related morbidity.
Copyright (c) 2026 Dr. Muthamizhveena R, Dr. Muthukumar Rajamohan, Dr. Peter R https://creativecommons.org/licenses/by/4.0/
Real-World Toxicity Profile, Treatment Compliance, and Dose Intensity of CAPOX Chemotherapy in Gastric and Rectal Cancers: A Prospective Observational Study
Background: Capecitabine–oxaliplatin (CAPOX) is a commonly used chemotherapy regimen in gastric and colorectal malignancies. Although its efficacy has been well established in randomized trials, real-world evidence regarding toxicity patterns, treatment compliance, and dose intensity remains limited. Objectives: To evaluate the toxicity profile of CAPOX chemotherapy, assess treatment compliance and dose modifications, and identify early clinical predictors of significant adverse events in patients with gastric and rectal cancers. Methods: This prospective observational study included 60 patients with histologically confirmed gastric (n = 35) or rectal cancer (n = 25) treated with CAPOX chemotherapy. Treatment-related toxicities were graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Treatment compliance, dose delays, reductions, and relative dose intensity were systematically recorded. Results: The median age was 54 years, with male predominance. Overall, 46 patients (76.7%) completed all planned cycles of CAPOX, with higher completion rates observed in rectal cancer compared with gastric cancer (84% vs 71%). The most frequent toxicities were peripheral neuropathy (45%), nausea/vomiting (38.3%), diarrhea (30%), hand–foot syndrome (26.7%), and anemia (41.7%). Grade ≥2 peripheral neuropathy occurred in 18.3% of patients and correlated with cumulative oxaliplatin exposure. Early Grade 1 neuropathy within the first two cycles independently predicted subsequent dose reduction. Relative dose intensity ≥85% was maintained in 68% of patients, particularly among those receiving early, individualized dose adjustments. Conclusion: CAPOX chemotherapy demonstrates acceptable tolerability and good compliance in routine clinical practice. Early low-grade neuropathy, baseline nutritional status, and symptom clustering may serve as clinically useful markers for anticipating cumulative toxicity and optimizing individualized treatment delivery.
Copyright (c) 2026 Dr Zahoor Ahmad Paul, Dr Tavseef Ahmad Tali, Dr Shumail Bashir, Dr Toufeeq Ahmed Teli https://creativecommons.org/licenses/by/4.0/
Attitudes Toward Artificial Intelligence Among Technical and Non-Technical Employees: A GAAIS-Based Comparative Study
Background: The rapid integration of AI into workplaces highlights the need to understand employee attitudes influencing acceptance and use, yet multidimensional comparisons between technical and non-technical employees remain limited. Aim: To compare attitudes toward AI between technical and non-technical employees using the General Attitudes Toward Artificial Intelligence Scale (GAAIS), assessing both positive evaluations (e.g., usefulness, innovation) and negative concerns (e.g., errors, loss of control). Methodology: A cross-sectional study of 85 employees (technical = 58; non-technical = 27) using workplace AI assessed attitudes via the GAAIS and demographics; group differences were analyzed using Welch’s t-tests with Hedges’ g effect sizes visualized in forest plots. Results: Technical employees showed moderate Positive (3.65 ± 0.26) and lower Negative (2.99 ± 0.39) scores. Thirteen items differed significantly between groups, with non-technical employees exhibiting higher Positive and Negative subscale scores, reflecting greater attitudinal polarization and longer organizational AI exposures. Conclusion: Technical employees exhibited more stable, experience-based attitudes toward AI, balancing perceived benefits with lower levels of concern. These findings highlight their potential role as key stakeholders in responsible and sustainable organizational AI implementation.
General Attitudes Toward Artificial Intelligence Scale (GAAIS).
Artificial Intelligence, General Attitudes Toward Artificial Intelligence Scale (GAAIS)
Copyright (c) 2026 Varma PSK, Anshu Pinnama Raju, Ashwin Kandula, Partha Bhattacharya, Maha Lakshmi Keerthana Kalidindi, Attili Venkata Satya Suresh, Natukula Kirmani https://creativecommons.org/licenses/by/4.0/
Dyslipidemia: Prevalence and Associated Risk Factors among undergraduate Students of Wellspring University, Benin City, Edo State, Nigeria
Background: Dyslipidemia, characterized by abnormal blood lipid levels, is a major risk factor for cardiovascular disease, contributing to an estimated 4.2 million deaths and disabilities globally. This study aimed to assess the prevalence and factors associated with dyslipidemia among undergraduate students of Wellspring University, Benin City, Edo State, Nigeria. Methods: A cross-sectional study was conducted among 107 undergraduates (aged 16–40 years; mean age 20.33 ± 4.14 years) at Wellspring University using purposive sampling. Sociodemographic data were collected via self-administered questionnaires. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) were analyzed using a Spectrumlab MF-21D spectrophotometer. Data were analyzed with IBM-SPSS version 23.0 at p < 0.05 significance level. Results: Of the participants, 80 (74.8%) were females, and the overall prevalence of dyslipidemia was 59.8%. Prevalence of abnormal TC, HDL-C, and LDL-C were 9.3%, 52.3%, and 14.9%, respectively. There were significant associations between age and TC; access to affordable healthy food and HDL; hours of weekly physical activities and LDL (P < 0.05) respectively. Conclusion: Dyslipidemia prevalence was high among subjects. Age, physical activities and healthy food intake significantly influenced dyslipidemia. Promoting physical exercise, and healthy food consumption including fruit and vegetable may reduce dyslipidemia risk.
Cholesterol, Dyslipidemia, HDL, LDL, Lipid Profile, Triglycerides
Copyright (c) 2026 John E. Moyegbone, Mary K. Ayanlere, Edafe O. Emurotu, Eghonghon E. Oronsaye, Prisca Onyema, Onyekach C. Madubuattah, Jennifer A. Ebeigbe, Ezekiel U. Nwose https://creativecommons.org/licenses/by/4.0/
Comparative Evaluation of Tzanakis and Alvarado Scoring Systems in the Diagnosis of Acute Appendicitis: A Prospective Observational Study
Background: Acute appendicitis remains the most common surgical emergency, yet its diagnosis can be challenging due to atypical presentations. The Alvarado and Tzanakis scoring systems are commonly employed tools for preoperative diagnosis, but their relative diagnostic accuracy remains under debate. Objectives: This study aimed to compare the diagnostic efficacy of the Tzanakis score versus the Alvarado score in patients with suspected acute appendicitis and to validate these scores against histopathological findings. Methods: A prospective observational study was conducted from August 2023 to December 2024 at the Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research. Ninety adult patients with clinical suspicion of acute appendicitis who underwent laparoscopic appendicectomy were included. Alvarado and Tzanakis scores were calculated preoperatively, and results were correlated with postoperative histopathology. Results: Of the 90 patients, histopathology confirmed acute appendicitis in 95.5%. Tzanakis score ≥8 had a sensitivity of 87.21% and specificity of 75%, outperforming the Alvarado score ≥7, which had a sensitivity of 76.74% and specificity of 50%. Tzanakis score also demonstrated higher predictive accuracy in identifying true positive cases. Conclusion: Both scoring systems are useful in diagnosing acute appendicitis; however, the Tzanakis score demonstrated superior diagnostic performance. Incorporation of Tzanakis scoring into routine practice may improve diagnostic accuracy and reduce negative appendectomy rates, especially in resource-constrained settings.
Acute appendicitis, Tzanakis score, Alvarado score, Appendicitis diagnosis, Clinical scoring systems
Copyright (c) 2025 Monisha P, Kodali Adiseshu, Kishor RJ, Mohanapriya T https://creativecommons.org/licenses/by/4.0/
Complications and Comorbidities in Hospitalized Children with Severe Acute Malnutrition
Background: Severe Acute Malnutrition (SAM) remains a major cause of childhood morbidity and mortality in low- and middle-income countries, including India. Hospitalized children with SAM often present with multiple comorbidities and life-threatening complications, which significantly influence outcomes. Objectives: To evaluate the incidence, clinical profile, comorbidities, complications, and early outcomes among hospitalized children with Severe Acute Malnutrition. Methods: A hospital-based observational analytical study was conducted over one year at the Nutrition Rehabilitation Centre (NRC), Civil Hospital, Ahmedabad. Children aged 6–59 months fulfilling WHO criteria for SAM were enrolled. Sociodemographic details, feeding practices, anthropometry, clinical features, laboratory parameters, comorbidities, complications, duration of hospital stay, and outcomes were recorded and analyzed. Results: Out of 7,566 children screened, 211 (2.79%) were diagnosed with SAM. The majority were below two years of age (65%) and belonged to lower socioeconomic strata (55.92%). Inadequate exclusive breastfeeding was observed in 56.4% of children. Wasting and stunting were present in 70.14% and 49.28% respectively, with all children having MUAC <11.5 cm. Common comorbidities included nutritional anemia (73.93%), gastroenteritis (45.49%), pneumonia (29.85%), and septicemia (32.22%). Frequent complications were dehydration (48.34%), respiratory distress (39.81%), hypothermia (30.80%), and septic shock (18.95%). The mortality rate was 9.48%. Conclusion: Severe Acute Malnutrition continues to impose a substantial clinical burden among hospitalized children. Early identification, optimal feeding practices, timely management of infections, and comprehensive inpatient care are essential to reduce morbidity and mortality.
Severe acute malnutrition, comorbidities, complications, pediatric malnutrition, NRC.
Copyright (c) 2025 Dr. Dhara Gosai, Dr. Gargi H. Pathak, Dr. Achalkumar V. Raval https://creativecommons.org/licenses/by/4.0/
The Study of Cord Blood Albumin as a Risk Predictor of Neonatal Hyperbilirubinemia
Objective: To study correlation between umbilical cord blood albumin (CBA) and neonatal hyperbilirubinemia. Methods: From January 2023 to December 2023, a prospective observational study was conducted on 150 neonates, clinically stable babies delivered either vaginally or by caesarean section with birth weight ≥2 kg. At birth, CBA was analysed and neonate was followed up till 72 hours of birth for hyperbilirubinemia. Detailed analysis was done to correlate CBA with significant hyperbilirubinemia requiring treatment according to >35 weeks charts (AAP guidelines 2022). The statistical analysis used were Microsoft Excel and SPSS software. A p-value of less than 0.05 was considered statistically significant. Result: On the basis of CBA obtained, all the neonates were classified into 3 groups, 1st of 2-2.5g/dl, 2nd of 2.51 – 3g/dl and 3rd of >3g/dl. Significant hyperbilirubinemia (requiring phototherapy) was observed in 45 (30%) neonates and 105 neonates (70%) had no hyperbilirubinemia. The association between CBA levels and neonatal hyperbilirubinemia had strong statistically significant relationship (p<0.05). Conclusion: It was concluded that, CBA level of 2.15mg/dl belonging to group 1 had the highest sensitivity (95%) and specificity (100%) to predict appearance of significant neonatal hyperbilirubinemia and was statistically significant (p value<0.05).
Hyperbilirubinemia, Cord Blood, Albumin, Phototherapy
Copyright (c) 2025 Dr. Asmita Tripathy, Dr. Dhara Gosai, Dr. Gargi H. Pathak https://creativecommons.org/licenses/by/4.0/
Unraveling the Burden of Chemotherapy-Induced Peripheral Neuropathy: A Prospective Clinical Insight from 50 Cancer Patients
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting toxicity of neurotoxic chemotherapy that significantly impairs quality of life (QoL) and functional status. Despite its clinical relevance, data on real-world incidence, severity, and early recovery patterns remain limited. Objective: To prospectively evaluate the clinical spectrum, risk factors, treatment impact, and short-term reversibility of CIPN in cancer patients receiving neurotoxic chemotherapy. Methods: This 18-month prospective observational study enrolled 50 adult cancer patients undergoing treatment with known neurotoxic agents, including paclitaxel, oxaliplatin, docetaxel, cisplatin/carboplatin, and bortezomib. CIPN was assessed using NCI-CTCAE v5.0, and functional impact was measured via FACT/GOG-Ntx. Patients were evaluated at baseline, during chemotherapy, at treatment completion, and three months post-therapy. Associations between severe CIPN (Grade ≥2) and risk factors such as cumulative dose, age, and diabetes were analyzed. Results: The cohort had a mean age of 54.3 years (range 28–72), with 60% female. Sensory neuropathy occurred in all patients (100%), most commonly presenting as tingling (80%), numbness (72%), and burning pain (44%). CIPN severity was Grade 1 in 44%, Grade 2 in 30%, Grade 3 in 20%, and Grade 4 in 6% of patients. Severe neuropathy was significantly associated with cumulative paclitaxel dose >600 mg/m², oxaliplatin >780 mg/m², and presence of diabetes (p<0.05). CIPN led to treatment modifications in 38% of patients, including dose reductions, delays, or permanent discontinuation. Quality-of-life scores declined by a mean of 19 points (p<0.01). At three months post-treatment, 30% of patients had complete resolution, 50% showed partial improvement, and 20% had persistent neuropathy. Conclusion: CIPN is highly prevalent, predominantly sensory, and significantly impacts QoL and treatment continuity. Higher cumulative doses and diabetes increase the risk of severe neuropathy. Although most patients demonstrated partial recovery by three months, persistent symptoms in 20% highlight the potential for chronic CIPN. Early detection, risk-based monitoring, and timely dose adjustments are essential to mitigate neurotoxicity and optimize patient outcomes.
Chemotherapy-induced peripheral neuropathy
Copyright (c) 2025 Dr Zahoor Ahmad Paul, Dr Tavseef Ahmad Tali, Dr Mustafa Bashir, Dr Peerzada Ajaz Ahmad Shah, Dr Toufeeq Ahmed Teli https://creativecommons.org/licenses/by/4.0/
Study the Comparison of Cartilage Tympanoplasty vs Temporalis Fascia Graft Techniques at a Tertiary Care Centre
Background: The study compares the post-operative restoration of hearing in patients undergoing Tympanoplasty for chronic otitis media, specifically between the use of Cartilage Graft and Temporalis Fascia Graft. Key objectives include assessing the success rate, post-operative failure, and hearing status after surgery with both graft techniques. Methods: A prospective study, to examine chronic otitis media, including various perforations and trauma. Patients excluded from the study included those with acute otitis media, otosclerosis, congenital hearing disorder, sensorineural hearing loss, active intracranial complications, diabetes mellitus, HIV, TB, radical mastoidectomy, and only hearing ear. Results: Total of 60 patients underwent tympanoplasty using either temporalis fascia or cartilage island. Both groups had similar age and gender distributions, with mean durations of graft uptake at 7.88±6.34 months for temporalis fascia and 9.68±5.80 months for cartilage island. Trauma was the cause in 16.67% of the temporalis fascia cases and 13.13% in the cartilage island cases. Graft uptake rates were 83.33% for temporalis fascia and 90.0% for cartilage island, showing no significant differences, with medialization in 16.67% of patients and no complications reported. Conclusions: The study indicated that cartilage island groups had higher uptake rates, while the temporalis fascia group did not experience significant pain. Additional research is necessary to assess long-term effects.
Copyright (c) 2025 Dr Vivek Singh, Dr Krishna Kumar Chaubey, Dr Onkar Vedak https://creativecommons.org/licenses/by/4.0/
Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) Test of Gambir Extract (Uncaria gambir Roxb.) and NaOCl Against Candida albicans as Root Canal Irrigation Material
Background: Root canal treatment failure that causes re-infection can occur due to various causes, one of which is by Candida albicans fungus in the root canal. Gambir extract is a natural ingredient that can be developed as a root canal irrigation solution, this plant has many benefits and contents, such as catechin and flavonoid compounds as antibacterial and antifungal. Purpose: This study aims to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of gambir extract (Uncaria gambir Roxb.) and NaOCl on the growth of Candida albicans as a root canal irrigation material. Methods: The type of experimental laboratory research on the extraction of gambir plants (Uncaria gambir Roxb.) using the maceration method, fractionation to separate active compounds in gambir (Uncaria gambir Roxb.), then the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) test of gambir extract and 5% NaOCl using the broth microdilution method on 96 well plates observed with a microplate reader and the minimum bactericidal concentration (MBC) test using the spread method on agar calculated using a colony counter. Results: MIC of gambir extract (Uncaria gambir Roxb.) is 10% and MBC is 40% and MIC of NaOCl is 0,010% and MBC is 0,020%. Conclusion: Gambir extract (Uncaria gambir Roxb.) and NaOCl have effective minimum inhibitory concentration and minimum bactericidal concentration eagainst Candida albicans.
Candida albicans, Minimum Bactericidal Concentration, Minimum Inhibitory concentration, NaOCl; Uncaria gambir Roxb.
Copyright (c) 2025 Sari Dewiyani, Bani Imran, R Risky Nurainunisah, Gading Prameswari https://creativecommons.org/licenses/by/4.0/
Microbial Informatics in Association with Disease Biology: A Multi-Omics Approach on Computational Microbiology Applications
Background: Bioinformatics is a scientific sub-discipline that covers the area of biology at multi-disciplinary levels of microbiology, immunology, molecular biology, biochemistry, genetics, proteomics etc. This is a technical analysis of computational biology that collect and convert raw data into storage to analyse and disseminate this biological information such as, De-oxy-ribonucleic Acid, protein, amino acid sequences, alpha-fold 3-Dimensional structure, taxonomic hierarchy, polypeptides, messenger Ribonucleic Acid, chemical origin into annotated databases. Aim: Bioinformatics tools and programs are used to interpret and develop biological raw data and efficiently manage through accession database to create statistical approaches for evaluating relationships between large datasets. Scope: The advancement of genome sequencing technologies and metagenomic analysis have well developed microbial informatics applications to study microorganisms and their functionality based on microbial interactions in natural and artificial environments. This large amount of microbial information has been structured, indexed and correlated with existing experimental evidences. The bioinformatics solutions of overwhelming research parameters are cross-connected with information science and microbiology in relevance. In the recent scenario, artificial intelligence techniques, aggregated statistical analysis methods and large-scale data input system have provided microbiology to evolve with data science. Key Insights: ‘‘Clinical Microbiology Informatics’’ deals with detection, identification and confirmation of antimicrobial susceptibility testing and communicates with clinicians about the importance of clinically relevant microbes. Clinical microorganisms in pathogenic diseases provide insights into genetic and molecular mechanisms of pathogen through bioinformatics analysis. Microbial bioinformatics applications are used for pathogen identification, characterization, mutation, detection of virulence factors, microbial engineering, vaccine targets, drug and vaccine combinations, disease regulation, host-immune evasion and diagnostic approaches. Future Perspective: This study highlights the critical significance of computational microbiology in comprehending microbial pathogens and their interactions with hosts by examining the nexus between microbial informatics and disease biology. Researchers can examine microbial populations, analyze genomic data, and pinpoint virulence factors linked to a range of illnesses by utilizing cutting-edge bioinformatics methods. We go on recent applications that improve our comprehension of microbial dynamics in illness contexts, including metagenomics, machine learning, and network analysis. The analysis highlights the potential of microbial informatics to guide treatment plans, enhance diagnostic techniques, and support vaccine research, all of which will ultimately lead to improvements in public health.
Copyright (c) 2025 Debaleena Samanta, MSc, Malavika Bhattacharya, PhD https://creativecommons.org/licenses/by/4.0/
Recovered from Disinfectants Often Used in Khartoum Tertiary Care Hospitals, Pseudomonas aeruginosa Isolates are able to Produce β-lactamase Resistance Enzymes
Background and study aim: Disinfectants play a crucial role in infection control in hospitals, but some bacteria can resist these disinfectants or contaminate them. This study aims to investigate the potential disinfectant contamination in Sudanese hospitals by Pseudomonas aeruginosa (P. aeruginosa). Methods: The study period for this cross-sectional investigation was between November 2020 and October 2021. The actual collection of disinfectant samples was over a three-week period within that timeframe. Analysis was conducted on 44 disinfectant samples from nine hospitals in Khartoum state. The 44 disinfectant samples collected encompassed 9 distinct types of disinfectants commonly used in hospital settings. The presence of P. aeruginosa was determined using a combination of microbiological methods and genotypic techniques based on Polymerase Chain Reaction (PCR). The antibiotic susceptibility of bacterial isolates was assessed using the disc diffusion method. Additionally, PCR was used to identify a number of ß-lactamase genes. Results: Among 44 disinfectant samples, 7 samples (15.9%) tested positive for P. aeruginosa contamination. Contamination was most frequently observed in chloroxylenol-based disinfectants (5/9), followed by sodium hypochlorite (1/6) and chlorhexidine gluconate–cetrimide formulations (1/1). P. aeruginosa showed resistance to both the cephalosporin and penicillin groups of antibiotics, and all isolates tested positive for the blaTEM-1 resistance gene. Conclusions: Significant contamination with P. aeruginosa was found in the disinfectant samples examined, posing a risk to hospital patients.
Copyright (c) 2025 Lubaba S. Eisa, MSc, Rehab Ahmed, PhD https://creativecommons.org/licenses/by/4.0/
A Prospective Study of Abdominal Wound Dehiscence in a Tertiary Care Hospital
Background: Abdominal wound dehiscence is defined as the postoperative separation of layers of a wound, with or without eventration. AWD is one of the most feared postoperative complications for surgeons and is of great concern because of the risk of burst abdomen, the need for immediate intervention, and the possibility of repeat dehiscence, surgical site infection, and mortality. Objective: To estimate the burden of cases of abdominal wound dehiscence in elective and emergency operations, and to identify the aetiology and risk factors responsible for it. Design: A Prospective study was conducted, where the data was collected over a period of one year, from 1st June 2023 to 31st May 2024, in patients attending Government Medical College Jammu, who developed wound dehiscence after undergoing laparotomy for management of abdominal diseases. Subjects/Patients: The patients who had undergone laparotomy and developed wound dehiscence. Methods: A prospective observational study was carried out over a period of one year, from June 1, 2023, to May 31, 2024, in patients attending Government Medical College Jammu who developed wound dehiscence after laparotomy. Inclusion criteria included Patients of age > 14 years and of either sex who underwent either emergency or elective abdominal operations and developed wound dehiscence. Exclusion criteria: All patients with incisional hernia and patients with wound dehiscence on sites other than the abdomen. Results: Laparotomy wound dehiscence was more common in 46-55 years age group with a male-to-female ratio of 2.3:1 the incidence was higher in Emergency surgeries and those performed during night. Dirty wounds and Midline laparotomy had higher risk. Layered closure, of the abdomen, showed a higher rate of dehiscence compared to mass closure. Incidence was higher in BMI greater than 25, with haemoglobin levels below 10 g%, Albumin <3.5gm/dl, Proteins <6gm/dl. Average hospital stay was 22 days and mortality rate in our study was 8%. Conclusion: Keeping in view the morbidity, increased hospital stays, medical expenses, time lost to work, disabilities with future incisional hernia formation and mortality associated with abdominal wall dehiscence, the risk factors should be identified, preoperative optimisation should be done, corrective measures should be taken while closing abdomen and standard protocols should be followed to prevent wound dehiscence.
Copyright (c) 2025 Vikrant Singh, Sanjay Sharma, Raja Langer, Priya Manhas, Vanita Gupta, Riya Singh Chandail https://creativecommons.org/licenses/by/4.0/
Feeding Methods and Nutritional Status in Infants Under Six Months in the Wum Urban Community, North West Region- Cameroon
Background: Nutritional status and feeding practices are crucial for infant growth and development. It is worthy of note that various factors influence feeding practices and nutritional status. The purpose of this study was to analyze the feeding habits and nutritional condition of infants under six months old in the Wum Urban community. Methods: A total of 150 mothers and infants were recruited in this study. A community based analytic cross sectional study was conducted from April to June 2024 in the Wum Urban community. A Multistage sampling technique was used to select participants for this study. Mothers of children under six months were given questionnaires to evaluate their feeding methods; interviews were held, and the anthropometric measures of the children were obtained. Chi square test and cluster analysis were conducted. Results: Infants under six months old were studied. The majority of mothers (46%), were between the ages of 26 and 35, and had secondary education. Mothers were more of housewives (32%), and more of them identified as Christians (67.3%). Most infants (56.7%) were female, and 28% of them ranged in age from 10 to 15 weeks. The prevalence of exclusive breastfeeding, mixed feeding, and weaning were 39.3%, 42.0%, and 18.7%, respectively. A significant number of infants (14.0%) were underweighted. (8.0%) were overweight, 13.3% were stunted, 3.3% had microcephaly and 6.0% had severe microcephaly. Infant feeding practices were found to be correlated with a wide range of factors including socio demographic, economic, maternal and obstetric factors. However, there was no correlation found between mother exclusive breastfeeding knowledge and infant feeding. Based on weight categories, cluster analysis shows that while the majority of infants who were mixed-fed were overweight, those who were exclusively breastfed had normal healthy weights, for their age. Conclusion: Wum urban community all mothers breastfed their babies, but mixed feeding was more prevalent than exclusive breastfeeding. A significant proportion of newborns were stunted, had both microcephaly and severe microcephaly, and were both overweight and underweight. There are many factors that affect infant feeding, and there is a significant relationship between infant feeding methods and nutritional status.
Key words: Feeding methods, Nutritional status, Infants, associated factors, Wum community.
Copyright (c) 2025 Andong Karen Unyo, Dr Mary Chia Garba, Dr Njiandock Fomenky Cecilia https://creativecommons.org/licenses/by/4.0/
Adult Ileocolic Intussusception Due to Submucosal Lipoma in Distal Ileum: A Case Report
Intussusception in adults usually occurs secondary to a lead point which can be both benign and malignant in nature. Diagnosis of adult intussusception is rare and challenging due to its presentation with nonspecific symptoms. If not identified and treated promptly, it might lead to permanent bowel obstruction, compression of the blood supply, intestinal necrosis, bowel perforation, peritonitis, and sepsis. We report a case of a 55-year-old man with intussusception with a submucosal lipoma as the lead point. The patient presented at the emergency department with severe abdominal pain around the umbilicus with abdominal distention during the physical exam. Other complaints included vomiting, persistent nausea, and loose stools. A Computer Topography (CT) scan and exploratory laparotomy indicated ileocolic intussusception-related small bowel obstruction. Resection of the terminal ileum, caecum, and ascending colon followed by anastomosis of the remnant portion of the ileum and transverse colon done using Vertex linear cutter staplers (Healthium Medtech, India). The post operative period and follow up was uneventful. Due to its unique presentation, a diligent approach from clinicians is required when a patient presents with bowel obstruction symptoms with an unclear etiology. Although abdominal CT scan has high diagnostic value, it has low specificity in differentiating malignant, benign, or idiopathic lead points making surgical examination inevitable in most cases. This case study seeks to deepen our comprehension of adult intussusception while highlighting the need for a diligent approach to its management. We have also examined the literature to highlight key aspects of adult intussusception, challenges associated with its diagnosis, and potential management strategies.
Copyright (c) 2026 Dr. Yaswanth Karri, Dr. Rama Chandra Mohan, Dr. Soumya Upadhyaya, Dr. Pallela Anudeep Kumar Reddy, Dr. Sandhya Rani Bonthu https://creativecommons.org/licenses/by/4.0/
Comparative Impact of Medical, Surgical, and Expectant Management of Tubal Ectopic Pregnancy on Subsequent Fertility: A Network Meta Analysis
Background: Ectopic pregnancy (EP) is a primary cause of maternal health issues and fatalities during the first trimester. With advancements in treatments such as methotrexate (MTX), salpingectomy, salpingostomy, and expectant management, the focus in clinical practice has shifted to enhancing future fertility outcomes and minimizing the risk of recurrence. Aim and Objective: This study sought to address the question: “How do medical, surgical, and expectant management strategies for tubal EP compare in terms of future fertility and recurrence rates?” Methods: An extensive search was conducted in PubMed, Embase, Cochrane Library, and Web of Science up to 2025. The studies considered were randomized controlled trials (RCTs) and cohort studies that compared MTX, salpingectomy, salpingostomy, or expectant management, and reported on intrauterine pregnancy (IUP), live birth, or recurrent EP. Data were analyzed using arm-level event rates, and a network meta-analysis was performed to facilitate both direct and indirect comparisons. Results: Ten studies (comprising two RCTs and eight cohort studies with follow-up periods ranging from 12 to 80 months) met the inclusion criteria. Fertility outcomes were generally similar across the different strategies. MTX demonstrated the highest absolute success rate (72.4%), while expectant management achieved the highest SUCRA ranking (100%) and showed the most consistent results. Salpingostomy was ranked lowest and was associated with a higher risk of recurrence (up to 14.3%). Conclusion: All major strategies maintain fertility potential, but salpingostomy is linked to a higher risk of recurrence. Expectant management shows promise for stable patients; further large RCTs are necessary to refine criteria for patient selection.
Copyright (c) 2025 Rajeshwari Balu Chettiar, Rajathi Sampath, Jothikala Chellamuthu, Swathi N, Jamila Hameed https://creativecommons.org/licenses/by/4.0/
Global Patterns of Inappropriate Pediatric Outpatient Antibiotic Prescribing: A Systematic Review and Meta-analysis Across Diverse Healthcare Settings
Background: Inappropriately prescribed antibiotics in pediatric outpatient care remain one of the most significant global drivers of antimicrobial resistance. Diagnostic uncertainty, excessive treatment duration, and reliance on broad-spectrum agents continue to compromise the quality of prescribing notwithstanding various stewardship initiatives. Aim and Objective: This systematic review and meta-analysis were done to assess the magnitude of inappropriate pediatric outpatient antibiotic prescribing across diverse global healthcare settings. Research Question: What is the overall proportion of inappropriate or guideline-discordant antibiotic prescriptions in pediatric outpatient care, and how consistent are these findings across international studies? Methods: Four databases were searched following PRISMA-2020 guidelines from 2018 to 2025. Of the results, ten studies met the inclusion criteria for qualitative synthesis, and eight provided extractable data for meta-analysis. A random-effects model synthesized proportions of non-optimal prescribing (p). Heterogeneity, funnel asymmetry, and meta-regression diagnostics were conducted in RStudio. Results: In the eight quantitative studies, the proportion of inappropriate or guideline-discordant antibiotic prescribing ranged from 0.210 to 0.848 (n = 14,393,085). The overall pooled meta-analytic estimate was greater than 0.60, showing that more than 60% of pediatric outpatient prescriptions were non-optimal globally. Significant heterogeneity (high I²), asymmetry in the funnel plot, and Egger's test supported variability influenced by study size and setting characteristics. Conclusion: Suboptimal antibiotic prescribing is common worldwide in pediatric outpatient care, driven by excessively long duration, overuse of broad-spectrum agents, and unnecessary treatment of viral illnesses. Strengthened, context-specific stewardship efforts are urgently needed.
Copyright (c) 2025 Sakthivel S, Preyeamvadha R, Akshai B, Jamila Hameed https://creativecommons.org/licenses/by/4.0/
Global Childhood Obesity and Metabolic Syndrome: Prevalence, Risk Factors, and Meta-Analytic Evidence
Background: Childhood obesity and metabolic syndrome are fast becoming major health challenges worldwide, although the estimates of prevalence rates vary largely due to the varying definitions, populations, and methodologies. Synthesizing contemporary evidence is essential for understanding the true magnitude and epidemiological pattern of these conditions. Aim and Objective: The objective was to answer the research question: "What is the pooled prevalence of childhood obesity and metabolic syndrome globally between 2021 and 2025, and what epidemiological patterns, risk factors, and clinical implications emerge from the recent evidence?" Methods: A systematic search of PubMed, Scopus, Embase, and Web of Science was conducted from 2021 to 2025 using predefined keywords. Ten studies entered qualitative synthesis, while five with extractable proportions entered meta-analysis. Data extraction was performed using Microsoft Excel (version 16), while statistical analyses were carried out in RStudio, including random-effects pooling, funnel plot asymmetry tests, and linear regression. Quality assessment was done using the AMSTAR-2, NOS, and JBI tools. Results: The pooled prevalence from five studies was 9.2% (95% CI 7.1–11.3) with extreme heterogeneity (I² ≈ 99.99%, p < 0.001). Funnel plot asymmetry tests, including Egger's test (p > 0.05), indicated no significant publication bias. Epidemiological patterns from the studies showed rising obesity trends and a MetS prevalence of 3–5%, consistent with associations to lifestyle-linked risk factors. Conclusion: Childhood obesity is still a significant and growing global burden, while MetS affects a smaller but clinically important subset. Heterogeneity emphasizes the need for standardized definitions and stratified risk assessment. Integrated preventive strategies and enhanced surveillance systems are urgently needed.
Copyright (c) 2025 Sakthivel S, Preyeamvadha R, Jamila Hameed https://creativecommons.org/licenses/by/4.0/
Artificial Intelligence and Mobile Technologies in Clinical Trial Operations and Recruitment in Cancer Research: A Four-Year Retrospective Analysis of Adult Oncology Trials
Patient recruitment and retention remain persistent challenges in oncology clinical trials, often leading to delays, increased costs and compromised data validity. Traditional recruitment strategies frequently fail to identify suitable participants efficiently which may result in under-enrollment and high dropout rates that limit the generalizability of trial outcomes. This paper examines how the use of artificial intelligence (AI) and mobile technologies affect patient recruitment and retention in oncology clinical trials. Employing a retrospective analysis of adult oncology trials conducted in the United States between 2017 and 2021, the study utilizes data from adult clinical trial registries to evaluate recruitment patterns and outcomes. Findings demonstrate that AI and mobile health (mHealth) tools can significantly streamline recruitment processes, reduce participant attrition and enhance overall trial efficiency. Integrating these technologies into clinical research operations may aid oncology trials to achieve more reliable data, accelerate therapeutic discoveries and ultimately contribute to improved cancer care outcomes. The study concludes that the integration of AI and mobile health technologies will not only improve operational efficiency but also help address disparities in participation, particularly among underrepresented groups. Therefore, this study recommends that clinical trial administrators should adopt AI and mobile health (mHealth) tools for patient matching, recruitment optimization and retention tracking.
Copyright (c) 2025 Ome Valentina Akpughe, Timothy Olorundare https://creativecommons.org/licenses/by/4.0/
The First Hour Advantage: Impact of Breast Crawl on Maternal and Neonatal Wellbeing
Background: One of nature's simplest and most powerful mechanisms to start breastfeeding is the "breast crawl"; a newborn's reflexive movement onto the breast after being placed skin-to-skin on the mother's abdomen. Although its physiological benefits are very well known, "breast crawling" is underused in many delivery settings worldwide. Aim and Objective: To evaluate the effect of breast-crawl practice on early maternal and neonatal outcomes and answer the following research question: "Does facilitating breast crawl immediately after birth improve maternal recovery and neonatal adaptation compared with routine care?" Materials and methods: It is a retrospective comparative study conducted in Karuna Medical College, Kerala, from January to June 2025, involving 100 mother–infant dyads: 50 in the breast-crawl group and 50 controls. Maternal and neonatal parameters were analyzed by using R Studio, with Shapiro–Wilk, Mann–Whitney U, Kruskal–Wallis, χ², Fisher’s Exact, and logistic-regression tests. Results: Practice of breast-crawl significantly improved birth weight (2.83 ± 0.33 kg vs 2.41 ± 0.42 kg), reduced duration of third stage of labor (10.3 vs 12.3 min) and blood loss (222 vs 282 mL), and improved early initiation of breastfeeding (84 % vs 20 %, p < 0.001). Logistic regression showed that breast crawl was an independent predictor of early breastfeeding. Conclusion: Breast crawl is an inexpensive, evidence-based practice that hastens maternal recovery and enhances neonatal adaptation. Integration of this practice into the standard obstetric regimen has the potential to significantly raise the quality of post-partum care.
Copyright (c) 2025 Mamta Gopaldas Parmar, Asha G, Nadira Banu, Nadha Rahim, Jamila Hameed https://creativecommons.org/licenses/by/4.0/
Early Second Trimester Serum Lipid Profile as a Predictor of Gestational Hypertension and Preeclampsia: A Prospective Hospital-Based Study
Objective: To evaluate the association between early second-trimester serum lipid concentrations and the subsequent risk of developing gestational hypertension and preeclampsia. Design: A prospective hospital-based observational study. Subjects/Patients: A total of 100 antenatal women (both primigravidae and multigravidae) with singleton pregnancies between 14 and 20 weeks of gestation who had no preexisting medical illnesses, with normal baseline blood pressure, were enrolled. Methods: Serum lipid profiles of participants were measured, and participants were followed until delivery. Based on blood pressure and proteinuria, participants were classified as normotensive, having gestational hypertension, or preeclampsia. Data were statistically analysed. Results: Among the participants, 82% antenatal women remained normotensive (Group A), 7% developed gestational hypertension (Group B), and 11% developed preeclampsia (Group C). Higher serum lipid profiles were seen in women who subsequently developed hypertensive disorders compared to normotensive women (p < 0.05). Elevated lipid levels were more pronounced in preeclamptic women, indicating an atherogenic trend with increasing disease severity. Conclusion: Overall, the study demonstrated that the association of altered lipid profiles during the early second trimester resulted in increased risk of gestational hypertension and preeclampsia. Prompt recognition of lipid screening is recommended for identifying high-risk pregnancies and enabling timely preventive interventions.
Copyright (c) 2025 Nithya M.P. https://creativecommons.org/licenses/by/4.0/
A Comparative Evaluation of Hyperbaric Ropivacaine Versus Hyperbaric Bupivacaine for Lower Limb Surgeries
Background: Anesthesiologists frequently utilize various local anesthetics for intrathecal administration, including isobaric or hyperbaric formulations of ropivacaine, levobupivacaine, and bupivacaine solutions. Among these, hyperbaric local anesthetics like ropivacaine, levobupivacaine, and bupivacaine solutions are particularly prevalent. Aim of this study to compare the clinical efficacy and safety of hyperbaric 0.75% ropivacaine and hyperbaric 0.5% bupivacaine under spinal anaesthesia for lower limb surgeries, focusing on sensory and motor block characteristics. Methods: A randomized double-blind, prospective study, total 130 patients aged 18-50 undergoing lower limb surgeries. The study excluded patients with unwillingness, psychiatric diseases, emergency surgeries, drug abuse history, medical complications, coagulation disorders, local infections, spinal deformities, heart block or dysrrhythmia, sensory block not achieved till T10 level, and motor block less than 3(BS-3). Patients in the study were categorized into two groups: one receiving 0.75% ropivacaine and the other receiving 0.5% bupivacaine for spinal anaesthesia. The main objective was to investigate the effects of ropivacaine on spinal anaesthesia outcomes. Results: Total of 130 patients were analyzed, comparing the demographics and clinical parameters between two groups, R and B. The mean age of participants was 40.36±9.76 years, with average weight and height at 66.94±15.53 kg and 164.22±14.79 cm, respectively. Both groups had similar mean surgical durations, 120.74 minutes for group R and 121.01 minutes for group B. While group B exhibited shorter sensory and motor blockade durations, group R showed longer times. Bromage scores were found to be comparable between the two groups. Conclusion: The study compared ropivacaine and bupivacaine in spinal anesthesia duration, finding no significant difference. Bupivacaine had longer sensory blocking and motor blockage time, while ropivacaine had superior hemodynamic stability.
Ropivacaine, Hyperbaric Bupivacaine, Lower Limb Surgery, Spinal Anesthesia
Copyright (c) 2025 Dr Satyendra Singh Yadav, Dr Pallavee Priyadarshini https://creativecommons.org/licenses/by/4.0/
Assessment of Knowledge, Attitude and Practice Pertaining to Fever in Children Among Parents Attending Under Five Clinic at a Tertiary Care Hospital in Bangalore - A Cross-Sectional Study
Objectives: 1. To assess the knowledge and attitude among parents regarding fever in under five years children. 2. To assess the practice among parents in managing fever in under five years children. 3. To correlate the demographic attributes with the knowledge, attitude and practices among parents regarding fever in under five years children. Methodology: This is a cross-sectional study conducted among 300 parents of children aged < 5 years between April 2023 and May 2024 using a pre-validated questionnaire. Data were analysed using descriptive statistics. Chi square test was used to test the association of knowledge, attitude and practices with categorical demographical data. A p - value of <0.05 was considered statistically significant. Results: 53% and 47% of children were males and females respectively. Among the 300 parents interviewed, 61% correctly identified the temperature defined as fever and 57% knew the correct site for measuring temperature. Encouragingly, 70% were aware that paracetamol is the drug of choice, while 50.3% were unaware that all types of fever do not require antibiotics and 47% were unaware that fever can be a beneficial symptom indicating an underlying cause. Tepid sponging (33%) and cold water sponging (30%) were the most common home remedies used to reduce fever. Conclusion: This study highlighted that majority of parents had better knowledge regarding basic concepts of fever and adhered to appropriate practices related to management of childhood fever. However, their understanding of the appropriate use of antibiotics was inadequate. Therefore, there is a need for targeted educational programs, aimed at improving parent’s knowledge and promoting evidence-based practices in the management of childhood fever.
Children, Fever management, Knowledge, Parents
Copyright (c) 2025 Dr Usha B K, Dr Vishnu K, Shriya Sanjeev https://creativecommons.org/licenses/by/4.0/
An Assessment of Booking Status on Pregnancy Outcome Among Women in Geidam Local Government Area, Yobe State, Nigeria
Introduction: Antenatal care (ANC) refers to the care a pregnant woman receives during her pregnancy through consultations with trained healthcare workers such as midwives, nurses, and sometimes doctors specializing in maternal health. Globally, approximately 800 women die daily from pregnancy- or childbirth-related complications, with Yobe State being among the regions with the worst health indices in Nigeria, particularly concerning maternal health. The maternal mortality rate in this region is unacceptably high, exceeding 1000 deaths per 100,000 live births. Factors contributing to this include poor ANC services, socio-cultural norms, and lack of access to healthcare facilities. This study aims to assess the influence of antenatal care on pregnancy status and outcomes among women in Geidam LGA, Yobe State, Nigeria. Methodology: A facility-based cross-sectional descriptive study was conducted among 400 women. Participants were selected using a systematic sampling technique. Data were collected using a pre-tested, interviewer-administered questionnaire and analysed using Epi-info at a 5% α level of significance. Results: The age range of 25–29 years constituted 28% of the participants, 46.5% were grand multipara and 32.2% had three ANC visits. The study revealed that 63.8% of respondents attended ANC, with 85% attending due to the desire for better outcomes. Among those who did not attend ANC (36.2%), the reasons were not due to lack of knowledge but factors such as cost, distance, ineffectiveness, unavailability, and refusal of husband consent. Factors influencing ANC attendance included age, educational status, parity, residence, cost of services, ineffectiveness, unavailability, and husband refusal. The sisterhood method estimated maternal mortality at 6030/100,000 live births, which is significantly higher than similar studies in other developing countries. Conclusion: The study found that perinatal mortality was higher among un booked pregnancies, and pregnancy complications such as eclampsia, postpartum haemorrhage, and anemia were more prevalent among un booked women. There are needs to promote female education, subsidizing ANC services, improving infrastructure, encouraging male involvement in ANC, and establishing more antenatal clinics in the rural areas.
Copyright (c) 2025 Usman Abba, Abubakar Musa https://creativecommons.org/licenses/by/4.0/
Patterns of Anaesthesia in Orthopaedic and Trauma Surgery in Secondary Health Care Centre in South-Western Nigeria: A Retrospective Audit
Background: Anaesthesia practice patterns in secondary care orthopaedic surgery in Nigeria remain understudied despite the critical role these facilities play in healthcare delivery. Understanding the relationship between anaesthetic technique selection, surgical duration, and postoperative outcomes is crucial for optimizing patient care and resource allocation in resource-limited settings. Objective: To analyse anaesthesia utilization patterns, examine correlations between anaesthetic techniques and surgical outcomes, and evaluate safety profiles in orthopaedic and trauma surgery at a Nigerian secondary healthcare centre. Methods: A retrospective descriptive study was conducted at Adeoyo State Hospital, Ibadan, over a 36-month period from January 2022 to December, 2024. Data from 62 consecutive orthopaedic surgical cases were analysed, including patient demographics, surgical procedures, anaesthesia types, surgical duration, hospital stay, and complications. Correlation analysis was performed to examine relationships between anaesthetic techniques and key outcomes using SPSS version 21. Results: Spinal anaesthesia was the predominant technique used in 45 cases (73.4%), followed by general anaesthesia in 10 cases (16.1%) and regional blocks in 5 cases (8.1%). Mean surgical duration was 3.2±1.4 hours across all cases, with no significant correlation between anaesthesia type and surgical duration (r=0.23, p=0.07). Mean hospital stay was 12.8±6.7 days, with anaesthesia technique showing no independent influence on length of stay (adjusted p=0.82). Blood transfusion was required in 26 cases (41.9%). No major anaesthesia-related complications were recorded, with an overall surgical complication rate of 6.5%. Conclusion: Spinal anaesthesia dominates orthopaedic anaesthesia practice in Nigerian secondary care settings while demonstrating versatility across surgical complexities and durations. The lack of correlation between neuraxial anaesthesia and prolonged surgical times or delayed recovery challenges conventional duration limitations, supporting the effectiveness of context-adapted anaesthetic protocols in resource-limited settings.
Copyright (c) 2025 O K Adebayo, O Koleosho-Ademua, J O Morhason-bello, A Allen-Taylor https://creativecommons.org/licenses/by/4.0/
To Comparative Study of Continuous Intermittent Crossed Versus Continuous Suturing Techniques for Linea Alba Closure in Midline Exploratory Laparotomy at a Tertiary Care Centre
Objective: This study evaluates intraoperative closure parameters and short-term postoperative outcomes comparing continuous intermittent crossed suturing to continuous suturing techniques for linea alba closure in midline exploratory laparotomy. Methods: This prospective randomized study total 60 patients undergoing midline exploratory laparotomy, divided into two equal groups: Group A underwent linea alba closure using continuous intermittent crossing suturing, while Group B received continuous suturing. Key metrics documented included baseline demographics, intraoperative closure duration, suture lengths, suture-to-wound length (S/W) ratio, and postoperative wound complications such as infection and dehiscence. Results: Total 60 patients 30 in each group. Male predominance in both groups, with females making up 30% in Group A and 33.33% in Group B, while males constituted 70% and 66.67%, respectively. The study compared two groups, Group A and Group B, with mean ages of 35.45± 13.54 years and 37.63± 16.77 years, respectively (p = 0.688). Group A had a slightly longer closure time averaging 24.88 ± 4.52 seconds compared to 22.38± 6.52 seconds in Group B (p = 0.68). Other parameters, including suture length, wound length, and the suture-to-wound ratio, showed no significant differences between the groups (p>0.05). Additionally, wound infection occurred in 16.67% of patients in both groups, while wound dehiscence was noted in 6.67% of patients in each cohort. Conclusion: Both wound closure methods assessed yielded similar short-term results. Continuous suturing led to slightly faster closure times, while continuous intermittent crossing suturing is also a viable choice, notably in high-risk cases. Further studies are needed to evaluate the rates of incisional hernias.
Midline laparotomy, Linea alba, intermittent crossed suturing, continuous suturing, wound dehiscence
Copyright (c) 2025 Amit Kumar, Brijesh Kumar Shukla, Rajdeep Singh https://creativecommons.org/licenses/by/4.0/
To Study the Prevalence and Association of Thyroid Disorders in Patients with Type 2 Diabetes Mellitus
Background: Thyroid dysfunction is a significant comorbidity in type 2 diabetes mellitus, disrupting the metabolic balance and increasing the disease burden. The objective of the study was to assess the prevalence and association of thyroid disorders in patients with type 2 diabetes mellitus. Materials and Methods: A case control study was conducted among 100 patients with type 2 diabetes mellitus and 100 controls attending the outpatient department (OPD) and wards of Department of Endocrinology, Index Medical College, Hospital and Research Center, Indore, Madhya Pradesh. The study was done over a period of 21 months from July 2023 to March 2025. The study was done after obtaining ethical approval from the Institutional Ethics Committee. Results: The mean age of the participants in the diabetic group was 52.14 ± 17.86 years and the control group was 52.07 ± 17.62 years. The gender distribution in the study population had 51% females. Subclinical hypothyroidism was the most common thyroid dysfunction found in type 2 diabetes mellitus patients. The prevalence of thyroid dysfunction in the study was 28% in patients with type 2 diabetes mellitus. Thyroid dysfunction is more prevalent in individuals with type 2 diabetes mellitus compared to non-diabetics. Conclusion: The study highlights the importance of thyroid screening and awareness among individuals with type 2 diabetes mellitus. It also underlines the need for holistic evaluation strategies that goes beyond glycaemic indices to ensure comprehensive metabolic care. The healthcare providers should foster strategies to ensure detection of thyroid dysfunction among diabetic individuals and optimize management so as to potentially improve outcomes for those individuals at risk.
Copyright (c) 2025 Deepak Dhakal, Medo M. Kuotsu, Ajay Gupta, Abhyudaya Verma, Divyansh Malik https://creativecommons.org/licenses/by/4.0/
Urinary and Fecal Incontinence after COVID 19 in a Young Male: Case Report
Background: Coronavirus Disease 2019 (COVID-19) infection by inflammation and demyelination in the pudendal nerve causes urinary and bowel incontinence. The aim of the present study is to report urinary and fecal incontinence in a 29-year-old male patient during and after COVID 19. Case presentation: A 29-year-old male patient with a history of Covid 19 was admitted to the Therapy Unit Intensive ICU, required mechanical ventilation for nine days, had pulmonary embolism, 75% pulmonary involvement, renal failure and left with urinary and fecal incontinence. He did not have deep vein thrombosis but complained of pain and swelling in his legs. Conclusion: The hypothesis is injury to the pudendal nerve and the management was expectant, which improved over the days.
Maria de Fatima Guerreiro Godoy, OT, PhD
Copyright (c) 2025 Jose Maria Pereira de Godoy, MD, PhD, Maria de Fatima Guerreiro Godoy, OT, PhD, Henrique Jose Pereira de Godoy, MD https://creativecommons.org/licenses/by/4.0/
Efficacy of Atomized Versus Transtracheal Lignocaine (4%) for Awake Flexible Endoscopic Intubation Prospective Randomized Clinical Study
Background: Achieving adequate airway anesthesia is essential for patient comfort and safety during awake flexible endoscopic intubation. Atomized and transtracheal lignocaine represent two widely used techniques with differing invasiveness and efficacy. Objective: To compare the efficacy, patient comfort, and hemodynamic stability between atomized and transtracheal administration of 4% lignocaine in patients with anticipated difficult airway. Material and Methods: Sixty ASA II–III patients were randomly divided into two groups. Group A received atomized 4% lignocaine via mucosal atomization device, while Group T received 4% lignocaine through transtracheal injection. Parameters recorded included cough and gag reflex, comfort score, time to intubation, and hemodynamic changes. Results: The transtracheal group demonstrated significantly lower cough and gag scores, higher patient comfort, and shorter intubation times, with comparable hemodynamic stability across groups. Conclusions: Transtracheal lignocaine provides superior airway anesthesia and patient comfort compared with atomized application, though atomization remains a valuable non-invasive option.
Copyright (c) 2025 Dr. Lalenkawli Fanai, Dr. Yogita Y. Parmar, Dr. Azarabegum A Patel, Dr. Nootan Maru https://creativecommons.org/licenses/by/4.0/