Student's Journal of Health Research Africa
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Talocalcaneal coalition in dry bones: An observational descriptive morphological study.
Get PDFBackground:Tarsal coalition is an abnormal union between two or more tarsal bones and may be fibrous, cartilaginous, or osseous. Among its variants, talocalcaneal coalition (TCC) is one of the most common and is clinically significant because progressive ossification can restrict subtalar joint mobility and alter foot biomechanics, often becoming symptomatic after skeletal maturity.
Aim:To determine the occurrence, type, and morphological characteristics of talocalcaneal coalition in dry human tali and calcanei.
Materials and Methods:
This observational descriptive study examined 150 dry calcanei and 150 dry tali obtained from the Department of Anatomy, Coimbatore Medical College. Intact bones from both sides were included irrespective of age and sex, while damaged or eroded specimens were excluded. Each specimen was evaluated by visual inspection and morphometric assessment for evidence of talocalcaneal fusion, facet involvement, bony bridges, traction spurs, and obliteration of the subtalar joint space.
Results:Talocalcaneal coalition was identified in two talus–calcaneum pairs, one right and one left, representing 1.33% of the examined dry bone sample. Both were osseous coalitions. The left-sided specimen showed complete synostosis predominantly involving the middle subtalar facet with extension into the anterior facet, resulting in obliteration of the subtalar joint space and associated traction spur formation. The right-sided specimen demonstrated complete medial fusion at the middle facet with incomplete lateral osseous bridging and a small residual unfused gap, along with traction spurs and an indistinct middle facet.
Conclusion:Osseous talocalcaneal coalition was uncommon in this dry bone series but consistently involved the middle subtalar facet with possible anterior facet extension. Such coalitions are clinically relevant, as they may contribute to rigid flatfoot, restricted subtalar movements, recurrent ankle sprains, and peroneal muscle spasm.
Recommendations:Routine emphasis on subtalar facet morphology should be incorporated into anatomical teaching and radiological training
Evaluation of anthropometric indices for obesity prediction and classification in indian adults: A cross-sectional comparative analysis of waist-to-height ratio, body roundness index, and traditional measures.
Get PDFBackgroundObesity is a major public health challenge worldwide and is strongly associated with cardiovascular diseases, type 2 diabetes mellitus, and metabolic syndrome. Although Body Mass Index (BMI) is widely used for obesity classification, it has limitations in reflecting body fat distribution, particularly central adiposity.
Objective
To evaluate the effectiveness of selected anthropometric indices in predicting obesity among Indian adults and to determine optimal cutoff values for obesity classification.
Methods
A cross-sectional study was conducted among 241 adults (133 females and 108 males) at Coimbatore Medical College, Coimbatore, Tamil Nadu, India. Standard anthropometric measurements were obtained, and derived indices, including WHtR, BRI, WHR, and A Body Shape Index (ABSI) were calculated. Pearson correlation analysis assessed relationships between indices, independent t-tests evaluated gender differences, and Receiver Operating Characteristic (ROC) curve analysis determined predictive accuracy and optimal cutoff values.
Results
WHtR and BRI demonstrated the highest predictive accuracy for obesity classification, each with an AUC of 0.88. BRI showed the highest sensitivity (91%) with 78% specificity, followed by WHtR (sensitivity 87%, specificity 78%). Optimal cutoff values were identified as WHtR ≥ 0.55 and BRI ≥ 4.21. Hip circumference also showed strong predictive performance (AUC 0.89; cutoff 108 cm). Waist circumference exhibited high specificity (92%) with an optimal cutoff of 97 cm but moderate sensitivity (65%). WHR and ABSI were the weakest predictors. Combining indices, particularly waist circumference with BRI, improved classification accuracy (AUC 0.90).
Conclusion
WHtR and BRI are superior to BMI for obesity classification in Indian adults, offering better reflection of central adiposity and improved risk stratification.
Recommendation
Waist-to-Height Ratio and Body Roundness Index should be incorporated into routine clinical and community-based obesity screening programs to facilitate early detection and timely intervention
Lichen planopilaris with drug-induced lichen planus: A Case Report
Get PDFBackground:
Lichenoid drug eruption is a known adverse reaction to several medications, including anti-tubercular therapy, and may clinically resemble idiopathic lichen planus. Lichen planopilaris is a scarring inflammatory disorder of hair follicles that can result in permanent alopecia. The coexistence of these two conditions is rare and presents diagnostic and management challenges.
Case presentation:
A 25-year-old female receiving first-line anti-tubercular therapy for pulmonary tuberculosis developed progressive scarring alopecia of the scalp along with pruritic violaceous papules over the neck, trunk, and axillae. Dermoscopy and histopathological examination confirmed a lichenoid drug eruption with coexisting lichen planopilaris. Given the near completion of tuberculosis treatment, anti-tubercular drugs were continued, and the patient was managed with topical corticosteroids, emollients, and oral antihistamines, with planned initiation of hydroxychloroquine after therapy completion.
Conclusions:
Early identification of drug-induced lichenoid reactions is crucial to prevent irreversible scarring. A conservative, multidisciplinary approach can allow continuation of essential anti-tubercular therapy while effectively managing cutaneous manifestations
OPTIMIZING AND STRENGTHENING PHARMACOVIGILANCE TO ENSURE DRUG SAFETY IN PATIENTS’ CARE AT BAPTIST HOSPITAL MUTENGENE.
Get PDFIn effective drug regulation systems, clinical practice, and public health programs, pharmacovigilance practice is of utmost importance (WHO, 2004). WHO defines Pharmacovigilance (PV) as “the science and activities related to the detection, assessment, understanding, and prevention of adverse drug effects or any other possible drug-related problems” (Beri et al., 2019; Hadi et al., 2017). Pharmacovigilance ensures the safety and efficacy of drugs throughout their life cycle.
Following the evidence-based needs assessment (EBNA) of October 2022, high incidences of medication errors and adverse drug reactions were identified as the major concerns of pharmacovigilance in BHM, but recording was not done. Thus, a need for pharmacovigilance.
This project aims to prevent or reduce the harm caused to patients by medication errors and ADRs by improving the knowledge of healthcare workers and the provision of a policy to enforce the practice of pharmacovigilance. Factors influencing the management of change are explored. They are divided into patient-related factors and health system-related factors. The change management models used to implement the change project are Lewin’s change theory, the I provisional change model, and the ADKAR Model. Influential persons were contacted and departments that use drugs for patient care were selected, and the change project was implemented. An evaluation of the level of implementation was done.
The results of the evaluation were different for different PV activities in the different departments. There was a positive change in some activities; meanwhile, there was no improvement in some activities. Successful implementation of this project will go a long way to reduce or prevent some drug-related problems that cause treatment failure, harm, long hospitalization, increased cost of care, and death
HIV Related stigma and discrimination interventions among adolescents and young people 15-24 years living with HIV in Busia HCIV.
Get PDFIntroduction
The UNAIDS global estimates show that about 4400 new HIV infections occur among people aged between 15 and 24 years, of whom almost 43% are among young women.
Goal
To reduce all forms of HIV related stigma and discrimination among adolescents and young people (15-24 years) living with and affected by HIV in Busia HCIV by 70% in 12 months
Project design
The project was based on an evidence-based needs assessment that utilized the key informant approach and a root cause analysis that identified the need for a change in reducing HIV stigma and discrimination among adolescents and young people living with and affected by HIV/AIDs in Busia HCIV ART clinic. The intervention approach was based on the ADKAR theory of change, John Kotter’s 8-step theory of change, incorporating the theory of reasoned action, the health belief model, adult learning theory, and the social cognitive theory. The project also examined the influence of leadership, power, culture, and policies on the change process.
Project outcomes
The project is still ongoing; however, the mid-evaluation that was done quarterly showed improving retention and disclosure of HIV status among adolescents and young people. There was also significant evidence of reduced stigma and discrimination at the facility and in the community, as seen by the social support provided by family members, and the high self-esteem and confidence among adolescents and young people, leading to improved quality of care.
Recommendation
Sensitization campaigns should be beefed up among Health workers, community leaders, and other stakeholders to address potential causes and sources of stigma among people living with and affected by HIV
Assessing knowledge and awareness about syphilis among undergraduate students in the faculty of engineering at Mangosuthu University of Technology (MUT).
Get PDFBackground
Syphilis is a genital ulcerative condition caused by the bacterium called Treponema pallidum. It can cause multiple organ and system failure, which can lead to death if left untreated. The main risk factors of syphilis transmission are inconsistent condom use, having several sex partners, and sharing needles during injection of medication. Syphilis is emerging as a public health problem in sexually transmitted Infections, and research has shown a rise in infections among adults at KwaZulu-Natal universities.
Aim and Objective: This research aimed to assess the knowledge and awareness of syphilis among undergraduate students in the Faculty of Engineering at MUT, and the objective was to evaluate the incidence of syphilis infection among male and female students in the Faculty.
Methodology
This study was conducted at MUT, targeting a population of 210 undergraduate students in the Faculty of Engineering. The data was collected by use of an online survey using Google Forms, and responses were imported to an Excel spreadsheet.
Research findings
The results showed 44% of the study participants had basic awareness of syphilis infection, 40% had advanced knowledge, and 16% had no understanding of syphilis. Females were shown to have higher levels of awareness and knowledge about syphilis infection (55% vs. 45% for males). 85% of the study participants had never been exposed to syphilis, 11% had been previously infected, and 4% had no known exposure.
Conclusion
Most MUT engineering undergraduate students know of the existence of syphilis infection; however, there is still a need to do more awareness campaigns.
Recommendations
Health Education Programs and Modules: Incorporating sexual health education, including information on syphilis and STIs, into academic curricula or general university modules makes health education programs compulsory
Factors post abortion care utilization and associated factors among women of reproductive age in Lira City. A cross-sectional study.
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Background
PAC is an effective intervention for decreasing maternal mortality and morbidity owing to abortion. PAC Services are services offered by the healthcare professionals to women who have had an abortion to prevent complications related to Abortion. This study aimed to assess the factors influencing PAC service utilization among women of reproductive age in Lira City.
Methods
This was a quantitative cross-sectional study done among women of reproductive age in Lira City. A total of 335 women were recruited by multistage sampling. The data was collected using a pre-tested structured questionnaire. Ethical approval was obtained. Data was analyzed using SPSS version 23.
Results
The mean age of study participants was 26.09. (87%) Of the participants were Christians 54.3% (182) had heard about PAC, and the majority, 55.5% (186), had some knowledge about PAC. Most participants (63.9%) stay 1-5km away from the health facility. Stigma was the most common (59.1%) challenge women who had an abortion faced in the community. 26.6% of the participants said health providers of abortion services are kind. Only marital status remained statistically significant at multivariate analysis, P-value (0.009 OR 4.907[0.870-8.266]. Age, religion, and income level are significant in determining whether one will have an abortion or not at p-values of 0.004, 0.009, and 0.029, respectively.
Conclusion
Education level, marital status, and knowledge increased utilization of PAC services, while factors like stigma and restrictive abortion laws decreased utilization of services.
Recommendations
The restrictive abortion laws, which allow abortion only if the life of the mother and/or the fetus is in danger, should be adjusted to include adolescents and young women who are not ready for childbearing
The emerging trends in antimicrobial susceptibility pattern of Pseudomonas species: A hospital-based cross-sectional study at a tertiary care hospital of South Bihar.
Get PDFBackground
Infections caused by Pseudomonas spp. are becoming more common in immunocompromised patients, particularly in hospital settings. The most well-known member of this family is Pseudomonas aeruginosa, a serious pathogen. To develop antibiograms, this study examined the distribution and susceptibility patterns of Pseudomonas species isolated from various specimens as part of a surveillance program.
Objectives: This study aimed to determine the prevalence and analyze the antibiogram of Pseudomonas species at a tertiary care hospital in South Bihar.
Methods
A hospital-based, retrospective, cross-sectional study was conducted at a tertiary care hospital in South Bihar from February 2024 to January 2025. A total of 68 isolates of Pseudomonas species were isolated from 1862 various clinical specimens. For the isolation of the organisms, Blood Agar and MacConkey Agar plates were used. The oxidase test, catalase test, and gram staining were used to characterize phenotypes. The Clinical and Laboratory Standards Institute (CLSI), M100, 2024 recommendations were followed during the antibiotic susceptibility testing of anti-pseudomonal medications.
Results
Among the 68 isolates of Pseudomonas species that were isolated, the study found that pus was the most common specimen (46.8%), followed by urine specimens (18.75%). All the isolates were found sensitive to Colistin (100%), whereas Imipenem (76.6%) and Piperacillin-tazobactam (69.5%) were found sensitive in the majority of the isolates, followed by Amikacin (61.3%). Less than half of the isolates were found sensitive to Ciprofloxacin, Levofloxacin, and Gentamycin. Aztreonam had the lowest sensitivity (15%).
Conclusions
The study reveals a rising trend of multidrug resistance among Pseudomonas species, with limited susceptibility to commonly used antibiotics.
Recommendation
Regular antimicrobial surveillance and strict antibiotic stewardship programs are recommended to effectively manage and control multidrug-resistant Pseudomonas infections
Community-acquired versus hospital-acquired methicillin-resistant Staphylococcus aureus in postoperative orthopaedic infections: A prospective observational study.
Get PDFBackground: Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant cause of postoperative orthopaedic infections worldwide. Differentiating community-acquired MRSA (CA-MRSA) from hospital-acquired MRSA (HA-MRSA) is critical for effective treatment, infection control, and public health planning.
Objective: This study aimed to compare the prevalence, clinical profiles, antibiotic susceptibility patterns, and outcomes of CA-MRSA and HA-MRSA infections in postoperative orthopaedic surgical site infections (SSIs).
Methods: A prospective observational study was conducted over 18 months in a tertiary care teaching hospital. Patients developing SSIs within 30 days after orthopaedic surgery were included. Wound swabs and pus samples were processed for culture and sensitivity testing. MRSA was identified by cefoxitin disc diffusion and mecA gene PCR. Cases were classified as CA-MRSA or HA-MRSA per CDC criteria. Clinical data, risk factors, antibiotic susceptibility, and outcomes were analysed.
Results: Among 146 SSI cases, MRSA was isolated in 57 (39.0%), with 24 (42.1%) CA-MRSA and 33 (57.9%) HA-MRSA. HA-MRSA cases had higher rates of prior hospitalization (78.8% vs. 20.8%, p<0.001), previous antibiotic use (66.7% vs. 25.0%, p=0.002), and comorbidities. CA-MRSA isolates were more susceptible to clindamycin (87.5%) and trimethoprim-sulfamethoxazole (79.2%) compared to HA-MRSA (51.5% and 36.4%). All isolates were uniformly sensitive to vancomycin and linezolid. HA-MRSA infections were linked to longer wound healing and hospital stays (p=0.01).
Conclusion: Both CA-MRSA and HA-MRSA contribute considerably to postoperative orthopaedic infections. HA-MRSA is more common and associated with worse clinical outcomes. Variations in susceptibility patterns highlight the importance of targeted empirical therapy and strict infection control measures.
Recommendations: Implement routine MRSA typing, reinforce antibiotic stewardship, enhance preoperative screening, and strengthen hospital hygiene practices to reduce MRSA burden and improve patient outcomes
A Prospective interventional study on the therapeutic potential of human placental extract in dermatological conditions.
Get PDFBackground
Placental extract is known for its regenerative, anti-inflammatory, and antioxidant properties. It is increasingly used in dermatology for conditions such as melasma, alopecia, and chronic ulcers.
Objective: To evaluate the clinical efficacy and safety of topical and intradermal human placental extract (HPE) in selected dermatological conditions.
Methods
A prospective interventional study was conducted at a tertiary care dermatology outpatient clinic over 6 months (August 2023 to February 2024). Fifty patients were enrolled and grouped according to diagnosis: melasma (n=20), chronic non-healing ulcers (n=15), and alopecia areata (n=15). Topical application or intradermal injection of placental extract was administered over 6 weeks. Clinical improvement was assessed using the MASI (score melasma), ulcer area measurement, and SALT score (alopecia) at baseline, 3 weeks, and 6 weeks.
Results
In the present study, age (mean±SD): B 47.3±8.4 > A 34.1±6.2 > C 29.8±5.6; females: A 90%, B 60%, C 40%. Significant improvement was observed in all groups. In melasma, the mean MASI score decreased from 12.6 ± 2.3 to 6.4 ± 1.9 (p < 0.01); in chronic ulcers, the mean area reduced by 68.2% (p < 0.01); and in alopecia areata, the SALT score improved from 35.2 ± 8.1 to 22.5 ± 6.7 (p < 0.05). No major adverse effects were reported.
Conclusion
Human placental extract is effective and safe in the management of melasma, chronic ulcers, and alopecia areata. Further large-scale trials are recommended.
Recommendations
Use HPE adjunctively (melasma: weekly intradermal ×6; ulcers: daily topical; alopecia: intralesional q2w ×3 with standard co-therapies), standardize monitoring (photos, MASI/SALT/ulcer area at 0/3/6 weeks), enforce safety/asepsis with AE logs, implement SOPs/registry, and conduct ≥6–12-month RCTs (dose–response, subgroups/biomarkers, cost-effectiveness, PROs)