Student's Journal of Health Research Africa
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Factors Contributing to Puerperal Sepsis among Postnatal Mothers at Entebbe Regional Referral hospital, Wakiso District. A Cross Sectional Study.
No full textIntroduction
In Uganda, puerperal sepsis presents a substantial risk to maternal health and deaths due to puerperal sepsis in the national referral hospital account for 12.7 % of the maternal mortality rate annually. The purpose of this study was to determine the factors contributing to puerperal sepsis among postnatal mothers at Entebbe Regional Referral Hospital.
Methodology
The researcher employed a descriptive cross-sectional design, utilizing quantitative methods of data collection from a sample of 30 respondents selected through simple random sampling. The data was analyzed using Microsoft Office programs and presented in the form of tables, graphs, and pie charts.
Results
The results, regarding maternal factors; 19 (63.3%) had received blood transfusion, 16 (53.3%) did not go to the facility with everything needed to use during child birth, 24(80%) had infections such as urinary infections during pregnancy and 14(46.7%) bathed twice in a day. Concerning the health facility factors; 21(70%) were examined more than 4 times by a health work to show progress of labour, 19(63.3%) were not monitored regularly during the whole process of pregnancy, 22(73.3%) did not get adequate health education concerning hygiene needed during pregnancy and 24(80%) mentioned that the available space at the facility is small to accommodate everyone.
Conclusion
In Conclusion, the factors identified were; being transfused with blood, lack of birth preparedness, infections during pregnancy, long duration of labour, and inadequate hygienic practices, multiple vaginal examination, lack of regular monitoring during pregnancy, lack of adequate health education and inadequate space at the hospital.
Recommendations
The health workers should develop comprehensive health education programs for pregnant women and their families, focusing on hygiene practices, early detection of infections, and the importance of prenatal care
Correlation between serum vitamin D, prolactin levels, and clinical depression at a tertiary care centre: A cross-sectional study.
Full text linkBackground
Depression is a highly prevalent psychiatric disorder with complex etiopathogenesis involving neuroendocrine and biochemical factors. Emerging evidence suggests that serum vitamin D deficiency and hyperprolactinemia may play contributory roles in the development and severity of depressive symptoms.
Objective: To evaluate the correlation between serum vitamin D and prolactin levels with the severity of clinical depression in patients attending a tertiary care center.
Methods
A cross-sectional observational study was conducted involving 120 adult patients diagnosed with clinical depression based on DSM-5 criteria. The severity of depression was assessed using the Hamilton Depression Rating Scale (HAM-D). Serum 25-hydroxy vitamin D [25(OH)D] and prolactin levels were measured using chemiluminescent immunoassay (CLIA). Vitamin D status was classified as deficient (<20 ng/mL), insufficient (20–30 ng/mL), and sufficient (>30 ng/mL). Pearson correlation, ANOVA, and independent t-tests were applied for statistical analysis.
Results
The mean age of participants was 36.4 ± 10.2 years, with 60.8% being female. Mean serum vitamin D and prolactin levels were 17.8 ± 6.9 ng/mL and 24.6 ± 9.1 ng/mL, respectively. Vitamin D deficiency was present in 70% of patients and associated with higher HAM-D scores (22.1 ± 5.4; p < 0.01). A moderate negative correlation was observed between vitamin D levels and HAM-D scores (r = -0.54, p < 0.01), while prolactin levels showed a weak positive correlation with HAM-D scores (r = 0.28, p = 0.03).
Conclusion
Vitamin D deficiency and elevated prolactin levels are significantly associated with increased severity of clinical depression. Routine assessment of these biomarkers may aid in the comprehensive evaluation and management of depressive disorders.
Recommendations
Routine screening of serum vitamin D and prolactin levels should be considered in depressive patients to guide individualized treatment strategies and improve overall management of clinical depression
Suspected drug-induced hypersensitivity reaction (DRESS Syndrome) following sitagliptin addition in a diabetic patient on glimepiride and metformin: A case report.
Full text linkBackground
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a rare, potentially life-threatening drug-induced hypersensitivity reaction characterized by skin eruptions, eosinophilia, and multi-organ involvement. While rare with antidiabetic drugs, sitagliptin has been implicated in a few reported cases.
Objective : To report and analyze a suspected case of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome associated with sitagliptin initiation in a type 2 diabetic patient previously controlled on glimepiride and metformin, and to emphasize the importance of early recognition, appropriate management, and pharmacovigilance in rare but serious drug-induced hypersensitivity reactions.
Case Presentation
We present a case of suspected DRESS syndrome in a 52-year-old male with type 2 diabetes mellitus, who developed facial and limb swelling, skin hyperpigmentation, and systemic laboratory abnormalities five days after sitagliptin initiation.
Management and Outcome
Sitagliptin was discontinued, and supportive care was initiated. Laboratory abnormalities included leukocytosis, eosinophilia (10%, AEC 1,480 /µL), elevated liver enzymes, and mild renal dysfunction. Symptoms resolved within two weeks following drug withdrawal.
Conclusion
This case highlights the need for vigilance in recognizing drug-induced hypersensitivity reactions in diabetic patients, even with relatively safe agents like sitagliptin.
Recommendation
Sitagliptin should be used cautiously after assessing hypersensitivity risk. Monitor for early DRESS signs (rash, facial swelling, eosinophilia) within 2–4 weeks. Educate patients, perform baseline and follow-up labs. Stop the drug at first suspicion; avoid rechallenge and other DPP-4 inhibitors. Report to pharmacovigilance. Skin biopsy and viral tests may aid diagnosis. Further research is needed
The diagnostic accuracy of injury severity score and revised trauma score to predict mortality and hospital stay in polytrauma patients: A prospective cohort study.
Full text linkBackground
Trauma continues to be a significant global health concern, ranking as one of the leading causes of death and long-term disability worldwide. Each year, nearly 5 million individuals succumb to trauma-related injuries stemming from incidents such as road traffic accidents (RTAs), falls from height, violence, warfare, fires, and occupational hazards. Polytrauma is a leading cause of emergency admissions and mortality worldwide. Accurate trauma scoring systems like the Injury Severity Score (ISS) and Revised Trauma Score (RTS) help predict outcomes.
Objectives- This study compares ISS and RTS in assessing mortality and hospital stay in polytrauma patients.
Methods
A prospective observational, cohort study was conducted from March 2023 to February 2025 at KIMS, Bhubaneswar, including 147 patients aged 18–60 with injuries to two or more body regions. ISS and RTS were calculated, and patients were grouped accordingly. Outcomes such as mortality and hospital stay were recorded. Statistical analysis was done using SPSS and GraphPad Prism with a significance level of p ≤ 0.05.
Results
Most patients were males (85.7%) aged 21–30 years, with road traffic accidents being the main cause (85.7%). Mean ISS was 25.07, and RTS was 10.59. Higher ISS and lower RTS were significantly associated with mortality (p < 0.0001). Age was also a significant predictor (p = 0.0053), while hospital stay did not differ significantly.
Conclusion
This prospective observational study highlights the clinical utility of the RTS and ISS as effective tools for predicting mortality and assessing injury severity among polytrauma patients.
Recommendations
It has been recommended that patients with RTS < 10 or ISS ≥ 20 should trigger senior review, expedited imaging, and ICU preparedness. Older patients, particularly those above 50 years, warrant heightened monitoring
Hiv/aids treatment adherence among adolescents attending Mildmay Hospital, Uganda, Wakiso District. A cross-sectional study.
Full text linkBackground
Globally, over 39 million people were living with HIV in 2023, with adolescents accounting for a significant portion of new infections and deaths. In Uganda, the non-adherence rate to ART among adolescents is 48.7% attributed to stigma and medication side effects. The purpose of the study was to assess factors affecting adherence to HIV/AIDS treatment among adolescents attending Mildmay Hospital, Uganda, Wakiso District.
Methods
A descriptive cross-sectional study design was used, employing quantitative methods of data collection, conducted in Mildmay Hospital, Uganda, Wakiso District. The data collected was analysed manually, and after the findings were entered into a Microsoft Excel 2013, which was then presented in the form of tables, pie-charts, and graphs.
Results
out of 52 respondents, results showed that 100% of the respondents reported taking their medication daily, yet 73% experienced stigma, 77% had difficulty swallowing tablets, and 33% failed to return for refills. Socio-demographic data indicated that 36% were aged 19 years and above, 40% were in secondary school, and 58% were currently attending school. Regarding hospital-related factors, 52% reported unfair treatment by health workers, 58% lived over 10 km from the facility, 42% missed treatment due to stockouts, and 69% faced long waiting times. Drug-related factors included 46% having difficulties swallowing drugs, 43% experiencing side effects, 79% citing the long duration of treatment as a challenge, and 62% expressing doubts about medication effectiveness.
Conclusion
Adherence to HIV/AIDS treatment among adolescents was influenced by stigma, difficulty swallowing medication, long treatment duration, negative experiences with health workers, and long distances to health facilities.
Recommendation
Adolescent-friendly services, improved drug availability, supportive healthcare interactions, community sensitisation, and enhanced access to nearby treatment facilities are recommended to improve adherence to HIV/AIDS treatment
Functional outcomes of displaced midshaft clavicle fractures treated with precontoured locking compression plates. A prospective observational study.
Full text linkBackground:Displaced midshaft clavicle fractures are common injuries in active adults. Although conservative treatment has been the traditional approach, surgical fixation using precontoured locking compression plates (LCPs) offers potential benefits of anatomical reduction, stable fixation, and early rehabilitation. This study evaluated functional outcomes, union rates, and complications following open reduction and internal fixation with precontoured LCPs.
Methods:
A prospective observational study was conducted on 30 patients aged >18 years with displaced midshaft clavicle fractures (Allman Group I) treated at a tertiary care center between April 2018 and September 2019. Open fractures, proximal or distal third fractures, pathological fractures, neurovascular injury, and nonunion cases were excluded. All patients underwent open reduction and internal fixation with precontoured LCPs. Functional outcomes were assessed using the Constant–Murley score at a minimum of 6 months follow-up. Radiological union was confirmed by callus formation and the absence of a fracture line. Data were analyzed descriptively.
Results:
The mean age was 37.4 years; males comprised 73.3% of cases (male: female ratio 2.75:1). Road traffic accidents were the predominant cause (70%), and the right clavicle was more frequently involved (60%). The mean union time was 10.33 ± 1.2 weeks, with 90% achieving full shoulder range of motion by 6 months. Constant–Murley scores showed 73.3% excellent, 20.0% good, 3.3% fair, and 3.3% poor outcomes. Good-to-excellent results were achieved in 93.3% of cases. No nonunions or implant failures occurred; minor complications were limited to transient stiffness in 10% of patients.
Conclusion:
Precontoured LCP fixation for displaced midshaft clavicle fractures provides high union rates, excellent functional outcomes, and minimal complications. Early mobilization and rigid fixation contribute to favorable results.
Recommendations:
Precontoured LCP fixation should be considered in active adults with displaced midshaft clavicle fractures to optimize recovery and reduce disability
Evaluating gastrointestinal side effects and discontinuation rates of semaglutide in routine clinical practice: A prospective observational study.
Full text linkBackground:Semaglutide, a GLP-1 receptor agonist, has demonstrated significant efficacy in glycemic control and weight reduction in Type 2 Diabetes Mellitus (T2DM). However, gastrointestinal (GI) side effects remain a common barrier to long-term adherence in real-world clinical practice. This study aimed to evaluate the prevalence, severity, and impact of gastrointestinal (GI) adverse events on discontinuation rates among patients initiated on semaglutide therapy.
Methods:
A prospective observational study was conducted on 100 adult T2DM patients prescribed semaglutide in a routine outpatient setting. Data on demographics, GI side effects (nausea, vomiting, diarrhea, constipation), severity grading (mild, moderate, severe), dose adjustments, and discontinuation rates were collected over a 12-week follow-up period. Descriptive statistics were applied to analyze frequency distributions.
Results:
The mean age of participants was 54.6 ± 10.8 years, with 52% being male. GI side effects were reported in 43% of patients. Nausea (28%) was the most common symptom, followed by vomiting (12%), diarrhea (10%), and constipation (6%). Multiple GI symptoms occurred in 14% of patients. Among affected individuals, 58.1% experienced mild symptoms, 27.9% required dose reduction for moderate symptoms, while 14% discontinued due to severe intolerance. The overall discontinuation rate was 9%, with GI side effects accounting for 6% of treatment cessations. Dose reductions were performed in 18% of patients, with 66.7% of them successfully continuing therapy post-titration.
Conclusion:
Gastrointestinal side effects are common but generally mild to moderate with semaglutide therapy. Proactive management, including gradual dose escalation and patient education, can mitigate side effects and improve adherence. Despite initial intolerance, most patients can continue therapy with appropriate interventions.
Recommendations:
Routine counseling, slow titration schedules, and early side-effect management strategies are crucial to optimize semaglutide adherence in clinical practice
Clinical and electrophysiological profiles of patients with diabetic peripheral neuropathy: A cross-sectional study of 50 patients.
Full text linkBackground:
Diabetic peripheral neuropathy (DPN) is a prevalent complication of type 2 diabetes mellitus, often presenting with sensory and motor deficits. This study aimed to characterize the clinical and electrophysiological profiles of patients with DPN and explore correlations between symptom severity and nerve conduction parameters.
Methods:
A cross-sectional study was conducted at the Neurology Outpatient Department of a tertiary care centre of Eastern India. Fifty patients with type 2 diabetes and clinical signs of peripheral neuropathy were enrolled. The Neuropathy Disability Score (NDS) was used for clinical grading. Nerve conduction studies (NCS) of the peroneal, tibial, and sural nerves were performed.
Results:
Sensory symptoms were predominant (84%), with sensorimotor involvement in 16%. Patients with higher NDS scores showed significantly reduced sural SNAP and peroneal CMAP amplitudes. A strong inverse correlation was observed between NDS and sural SNAP amplitude (r = –0.68, p < 0.001) and peroneal conduction velocity (r = –0.55, p = 0.002). Sural nerve abnormalities were present in 90% of patients.
Conclusion:
Electrophysiological parameters, particularly sural SNAP amplitude, correlate strongly with clinical severity in DPN. Combined use of NDS and NCS enhances early detection and stratification of neuropathy severity.
Recommendations
Adopt Combined Screening Protocols: Integrate NDS scoring with targeted NCS, especially sural SNAP amplitude, as a routine diagnostic approach in diabetic clinics. This dual assessment can improve early detection and stratification of DPN severity
Medication compliance among individuals with hypertension and type 2 diabetes mellitus in urban slums of amalapuram: Findings from a cross-sectional study.
Full text linkBackground: Medication adherence is essential for effective management of chronic conditions such as hypertension and type 2 diabetes mellitus. In urban slum populations, adherence is often hindered by socioeconomic limitations, low health literacy, and lack of awareness, contributing to poor clinical outcomes.
Objective: This study aimed to evaluate the prevalence of medication adherence among individuals with hypertension and type 2 diabetes mellitus, identify associated sociodemographic and clinical factors, and explore barriers to adherence.
Methods: A descriptive cross-sectional study was carried out in the urban slums of Amalapuram from January 2025 to June 2025. A total of 100 adult patients with both hypertension and type 2 diabetes were enrolled. Data regarding sociodemographic characteristics, clinical history, and treatment practices were collected using a pretested structured questionnaire. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used to assess adherence levels. Descriptive statistics were applied to determine prevalence, while associations with influencing factors were explored.
Results: The mean age of participants was 54.2 ± 9.6 years, with females accounting for 56%. Most patients (71%) belonged to the lower socioeconomic class. The average duration of hypertension and diabetes was 7.3 ± 3.8 years and 6.1 ± 3.2 years, respectively. Adherence assessment revealed that 28% had high adherence, while 36% each showed medium and low adherence. Younger age (<50 years), female gender, higher education, shorter disease duration, and middle socioeconomic status were positively associated with better adherence. The main reasons for poor compliance were forgetfulness (44%), discontinuation after symptomatic relief (28%), financial constraints (15%), and adverse drug reactions (8%).
Conclusion: Medication adherence among patients with coexisting hypertension and diabetes in Amalapuram urban slums was suboptimal, with nearly three-fourths demonstrating medium or low compliance.
Recommendations: Regular patient counseling, routine adherence assessment, and ensuring affordable access to medicines are essential to improve compliance and reduce long-term complications
Association of dietary patterns with acne vulgaris severity among adolescents: A cross-sectional study.
Full text linkBackground:Acne vulgaris is a prevalent dermatological disorder among adolescents, influenced not only by genetic and hormonal factors but also by lifestyle and dietary habits. Identifying modifiable risk factors, particularly dietary patterns, is essential to reducing disease burden and improving quality of life.
Objectives:
To assess the association between dietary patterns and the severity of acne vulgaris among adolescents.
Methods:
A cross-sectional study was conducted among 100 adolescents aged 13–19 years. Data regarding demographic characteristics, dietary patterns, and specific food consumption were collected using a pretested questionnaire. Acne severity was graded using the Global Acne Grading System (GAGS). Dietary intake was classified into traditional, mixed, and Western patterns. Statistical analysis was performed using the chi-square test, with p < 0.05 considered significant.
Results:
The study population comprised 42% males and 58% females, with a mean age of 16.2 ± 2.1 years. Acne severity was mild in 34%, moderate in 46%, and severe in 20% of participants. The Western dietary pattern was reported in 41% of adolescents and showed the highest prevalence of moderate (58.5%) and severe acne (29.3%). In contrast, the traditional dietary pattern was associated with a lower prevalence of severe acne (13.6%) (p = 0.002). Frequent intake of dairy products (>4 times/week) and sugary beverages (>3 times/week) significantly increased acne severity (p = 0.03 and p = 0.01, respectively). Conversely, higher consumption of fruits and vegetables (>5 servings/day) was associated with reduced severity (p = 0.04).
Conclusion:
Westernized dietary habits, particularly high consumption of dairy and sugary drinks, are significantly associated with greater acne severity among adolescents, while fruit- and vegetable-rich diets appear protective.
Recommendations:
Adolescents should be encouraged to adopt balanced dietary habits emphasizing fruits, vegetables, and whole foods while limiting high-glycemic, dairy, and processed foods