Student's Journal of Health Research Africa
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A RETROSPECTIVE COHORT STUDY EXAMINING THE RELATIONSHIP BETWEEN 30-DAY MORTALITY AND HIGH-SENSITIVITY TROPONIN T LEVELS BEFORE AND AFTER CARDIAC SURGERY.
No full textBackground:
Elevated troponin levels have been linked to adverse outcomes in cardiac surgery patients, but the specific impact of high-sensitivity troponin T (hs-TnT) measured before and after surgery on short-term mortality remains unclear. This study analyses a retrospective cohort to determine the reliability of hs-TnT readings as early mortality prognostic markers and their potential to improve perioperative treatment.
Methods:
In this retrospective cohort analysis, we examined 200 heart surgery patients at the Indira Gandhi Institute of Medical Sciences, Patna, over 24 months (January 2023 – January 2025). After controlling for age, gender, operation type, and comorbidities, we investigated preoperative and postoperative hs-TnT levels and 30-day mortality.
Results:
This retrospective study of 200 cardiac surgery patients (mean age 63 years) demonstrated that elevated postoperative hs-TnT levels above 150 ng/L were associated with a significantly higher risk of 30-day mortality, with an odds ratio of 4.5 (p < 0.001). Preoperative hs-TnT levels did not show a significant correlation with mortality. When adjusted for confounding factors, the highest quartile of postoperative hs-TnT levels was linked to a 4-fold increased mortality risk (adjusted OR = 4.0, p = 0.003). These findings suggest that monitoring hs-TnT levels post-surgery could be critical for predicting early mortality in cardiac surgery patients.
Conclusion:
Elevated postoperative hs-TnT levels are a strong predictor of 30-day mortality in cardiac surgery patients. Monitoring hs-TnT levels could be essential for identifying at-risk patients and enhancing postoperative care.
Recommendation:
Postoperative hs-TnT levels should be routinely monitored to predict 30-day mortality risk in cardiac surgery patients
A study on the impact of smartphone use on haematological and cardiovascular parameters in the adult population: A cross-sectional study.
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The increasing use of mobile phones has raised concerns about their potential health effects, particularly on cardiovascular, inflammatory, and hematological parameters. This study investigates the impact of mobile phone usage on WBC count and blood pressure among adults.
Methods
This study was conducted at IGIMS, Patna, to assess the effects of mobile phone radiation on cardiovascular, inflammatory, and hematological parameters. Blood pressure was measured using a mercury sphygmomanometer, and the WBC count was analyzed using the hemocytometer method. Data on mobile phone usage were obtained from call logs, and statistical analysis was performed using SPSS with a significance level of p<0.05.
Results
The study included mostly males (86%) aged 21-25 years (76%). Blood pressure analysis revealed that 47% had systolic BP >120 mmHg, and 51% had diastolic BP >80 mmHg. No significant correlation was found between mobile phone usage and blood pressure or leukocyte count (p > 0.05). Overall, mobile phone use showed minimal impact on cardiovascular and hematological parameters, including total leukocyte count and CRP levels, in young adults at IGIMS, Patna.
Conclusion
Prolonged mobile phone use showed a non-significant trend toward higher blood pressure, but no direct impact on leukocyte count. Further studies with larger samples are needed to explore potential health effects.
Recommendation
Future studies should involve a larger and more diverse population to enhance the validity of the findings. Long-term monitoring of mobile phone usage and its health effects should also be explored
BURN INJURY TREATMENT OUTCOMES RELATED TO SEVERITY AND FIRST AID RESPONSE.
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Burn injuries are a significant global health issue, with high morbidity and mortality, particularly in low- and middle-income countries. Early first aid intervention and severity assessment play a crucial role in determining treatment outcomes and recovery. This study aims to evaluate burn injury treatment outcomes about severity and the effectiveness of first aid interventions.
Methods
This hospital-based, prospective observational study was conducted at the Rajendra Institute of Medical Sciences (RIMS), Ranchi, from November 2021 to October 2022, involving a minimum of 100 patients with acute burn injuries. Data were collected on patient demographics, burn severity (TBSA), clinical parameters, and treatment outcomes. Laboratory investigations and monitoring were performed to assess prognosis and the impact of first aid response on recovery.
Results
The socio-demographic data revealed that the majority of patients were young adults, with an average age of 34.3 ± 13.1 years, and a higher proportion of male patients (70%) compared to females (30%). Among the 66 burn survivors, complications were strongly linked to initial treatment. Patients receiving professional medical care had the best outcomes, with 57.69% experiencing no complications and only 7.69% developing severe complications. Patients with first-aid-only injuries had higher complication rates, with 50% developing mild complications and 25% experiencing severe complications. All survivors in the no-treatment group (100%) had severe complications, emphasizing the critical role of professional medical intervention (p < 0.001).
Conclusion
Early professional medical care significantly improves survival and reduces long-term complications in burn patients. Delayed or inadequate treatment leads to higher mortality and severe complications, highlighting the need for timely medical intervention.
Recommendation
It is recommended that timely and professional medical care be prioritized for burn patients to improve survival rates and minimize long-term complications
ASSESSMENT OF SELF-DIRECTED LEARNING ABILITIES AMONG FIRST-YEAR UNDERGRADUATE MEDICAL STUDENTS USING THE SDLI TOOL: A CROSS-SECTIONAL STUDY IN GUNTUR, ANDHRA PRADESH, INDIA.
Get PDFBackground
Self-Directed Learning (SDL) is a cornerstone of Competency-Based Medical Education (CBME), essential for fostering lifelong learning among future medical professionals. The National Medical Commission (NMC) mandates the integration of SDL in the undergraduate curriculum. However, limited studies in India have assessed SDL abilities using standardized tools.
Objective
To assess the Self-Directed Learning abilities among first-year undergraduate medical students using the validated Self-Directed Learning Instrument (SDLI).
Methods
A cross-sectional study was conducted among first-year MBBS students at Guntur Medical College, Andhra Pradesh. Data collection was conducted in December 2024. A total of 250 students were invited to participate, and 141 students completed the SDLI, yielding a response rate of 56.4%. The SDLI consists of 20 items categorized into four domains: Learning Motivation, Planning and Implementation, Self-Monitoring, and Interpersonal Communication. Each item was rated on a five-point Likert scale. Descriptive statistics were used to analyze the data, and domain-wise mean scores were calculated.
Results
Among the 141 participants, 51.1% were male, and 48.9% were female, with a mean age of 18.5 ± 0.52 years. The highest mean domain score was observed in Learning Motivation (25.56/30), followed by Planning and Implementation (22.63/30), Self-Monitoring (15.67/20), and Interpersonal Communication (11.44/15). The overall mean SDLI score was 75.29 out of a maximum of 95, indicating a moderate to high level of self-directed learning ability among the cohort.
Conclusion
The findings suggest that most first-year medical students possess a favorable level of self-directed learning ability, particularly in motivation and planning. However, relatively lower scores in interpersonal communication indicate a potential area for targeted educational interventions.
Recommendations
The faculty should enhance SDL training by incorporating collaborative learning activities, mentorship programs, and workshops on communication skills. Emphasis on interpersonal communication can complement students’ motivation and planning abilities, fostering well-rounded, self-directed learners aligned with CBME goals
A COMPARATIVE ANALYSIS OF PAP SMEAR AND COLPOSCOPIC FINDINGS IN INDIVIDUALS PRESENTING WITH VAGINAL DISCHARGE AT A TERTIARY CARE OUTPATIENT DEPARTMENT: A CROSS-SECTIONAL STUDY.
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Cervical cancer is a predominant cause of cancer-related mortality in women globally. Screening techniques, such as Pap smear and colposcopy, are essential for detecting precancerous lesions, facilitating prompt intervention, and alleviating the disease burden.
Methods
This cross-sectional study was conducted in the Obstetrics and Gynaecology Department, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, over one year. A total of 250 women aged 35–55 years underwent Pap smear, colposcopy, and biopsy for cervical lesion assessment.
Results
Among the participants, 34.0% had high-grade squamous intraepithelial lesions (HSIL), 22.4% had low-grade squamous intraepithelial lesions (LSIL), and 21.2% showed inflammatory changes on Pap smear. Colposcopy revealed CIN I in 48.0% of cases, CIN II–III in 36.4%, and CIN III in 15.6%. Histopathological confirmation showed 83.2% had precancerous lesions, with 7.2% diagnosed with squamous cell carcinoma and 1.2% with adenocarcinoma. Among the total study population (n = 250), 83.2% (208 patients) had abnormal findings suggestive of precancerous or cancerous cervical lesions, while 16.8% (42 patients) showed normal or non-precancerous findings. This corresponds to a prevalence of abnormal cervical pathology of 83.2% in the present study cohort. The study demonstrated that combining Pap smear screening with colposcopic evaluation and targeted biopsy significantly improved early detection of precancerous cervical lesions. This integrated diagnostic approach enabled timely intervention, reducing the risk of progression to invasive cancer.
Conclusion
The study highlights the high prevalence of precancerous cervical lesions, emphasizing the necessity of early screening. Colposcopy demonstrated higher diagnostic accuracy than Pap smear, reinforcing its role in early cervical cancer detection.
Advancements and controversies in vascular malformation management: A Systematic review.
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Congenital vascular malformations encompass a wide spectrum of anomalies, ranging from isolated capillary, venous, lymphatic, and arteriovenous malformations to complex mixed forms. These anomalies may occur as solitary lesions with minimal impact or as part of syndromic conditions, such as Klippel-Trenaunay Syndrome and Parkes-Weber Syndrome, which are associated with significant morbidity due to limb overgrowth and tissue abnormalities. Additionally, the PIK3CA-related overgrowth spectrum (PROS) represents a distinct subset driven by somatic PIK3CA mutations, which complicates diagnosis and management.
Objective: This study aims to systematically review the classification, pathogenesis, genetic factors, diagnostic approaches, and treatment modalities for vascular malformations and associated syndromes.
Methods
In order to perform a systematic review, peer-reviewed publications, clinical recommendations, and expert consensus statements on vascular malformations were found using PubMed, Scopus, Web of Science, and Google Scholar. Studies published within the last two decades were prioritized, with an emphasis on recent advancements.
Results
Genetic insights have redefined vascular malformation classification, with PIK3CA, TEK (TIE2), and RASA1 mutations playing a crucial role in pathogenesis. Advanced imaging techniques, including MRI and digital subtraction angiography (DSA), remain the gold standard for precise diagnosis, while genetic testing enhances diagnostic accuracy and guides personalized treatment. Conventional therapies such as sclerotherapy and embolization demonstrate 70–85% success rates; however, targeted molecular therapies, including Sirolimus and Alpelisib, have shown superior outcomes in PIK3CA-related cases.
Conclusion
The evolving landscape of vascular malformation management highlights the shift toward precision medicine, integrating advanced imaging, genetic diagnostics, and molecular-targeted therapies.
Recommendations
Encouraging international collaborations among researchers, clinicians, and geneticists can accelerate advancements in vascular malformation research. Quality-of-life assessments should be incorporated into research to evaluate the long-term psychological and functional impacts of various treatments
School-related factors contributing to school dropout among adolescent girls aged 10-19 years in koboko town council, koboko district, uganda. A cross sectional study.
Get PDFBackground:
In most of those societies, the average rural parent would rather invest in the education of the son rather than the daughter. The study aims to determine the school-related factors contributing to school dropout among adolescent girls aged 10-19 years in Koboko town council, Koboko district, Uganda.
Methodology
The study design was cross-sectional and descriptive, and quantitative data collection techniques were used; respondents were selected using cluster sampling. Data was analyzed using SPSS version 20 and was presented in tables and transferred to Microsoft Excel 2016 for the presentation of graphs.
Results
96 (26.2%) of the girls were housewives, and 222 (61.8%) of the girls did not have children. Most, 96(75.2%), had had female teachers but dropped out of school. The majority, 72(56.7%), showed they had never received support, encouragement, and motivation from teachers, but dropped out of school. The majority, 108(58.4%), who had received corporal punishment at school, sometimes dropped out of school. The majority of 130(69.5%) Schools did not have all the required resources, and the girls dropped out of school. The majority, 82(43.9%), had a distance of more than 3 km and dropped out of school. 71(39.7%) had a distance of 2-3 km from school and remained in school, followed by 69 (38.5%) who had a distance of less than 1 km and remained in school.
Conclusion.
School -related factors contributing to school dropout among adolescent girls aged 10-19 years were motivation by teachers, punishments in schools, availability of resources, and distance of schools from homes.
Recommendations.
The Koboko local government, through the District Education Officer, should do regular support supervision of the schools. To ensure schools maintain the standards and girls remain at school
Sonographic measurement of inferior vena cava diameter in assessment of volume status in pediatric shock: A prospective observational study.
Get PDFBackgroundAccurate assessment of intravascular volume status in pediatric shock remains a clinical challenge, often relying on subjective and invasive methods. Bedside ultrasonography of the inferior vena cava (IVC) has emerged as a promising, non-invasive modality to estimate volume status. This study aimed to evaluate the IVC diameter and IVC-to-aortic (IVC/Ao) ratio as objective indicators of hypovolemia in children using ultrasound.
Objectives: To obtain and analyze data on IVC diameter and IVC/Ao ratio measured by sonography for assessing intravascular volume status in infants and children with clinical shock compared to euvolemic controls.
MethodsIn this prospective observational study, 60 children aged 1 month to 18 years admitted with clinical shock were compared with 60 age-matched euvolemic controls. Sociodemographic characteristics, including age and sex, were recorded. Maximum sagittal IVC diameter, transverse aortic diameter, and IVC/Ao ratio were measured using bedside ultrasound.
ResultsThe mean age of participants was comparable; the male-to-female ratio was 0.6:1 in the shock group and 1:1.2 in controls. The mean IVC diameter was significantly lower in the shock group (0.99±0.45 cm) than in controls (1.46±0.52 cm; p<0.001), indicating intravascular hypovolemia. The IVC/Ao ratio was also reduced in shock cases (0.65±0.10) compared to controls (0.98±0.09; p<0.001). No significant difference was observed in aortic diameters.
ConclusionUltrasound-derived measurements of IVC diameter and IVC/Ao ratio are reliable non-invasive indicators of hypovolemia in pediatric shock.
RecommendationsBedside ultrasound should be integrated into the routine evaluation of children with suspected shock to improve early detection and guide fluid management
A Prospective Cross-Sectional Study of the Spectrum of Gallbladder Masses on Computed Tomography, Confirmed by Histopathological Examination at a Tertiary Care Centre in Eastern India.
Get PDFIntroduction:Gallbladder carcinoma is the most common malignancy of the biliary tract and is often diagnosed at an advanced stage due to non-specific clinical symptoms. Early and accurate imaging is crucial for timely diagnosis and appropriate surgical planning. This study aimed to evaluate the structural and enhancement characteristics of gallbladder masses using Multi-Detector Computed Tomography (MDCT) and to correlate the imaging findings with histopathological results.
Methodology:
A prospective cross-sectional diagnostic study was conducted in the Department of Radio-diagnosis at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna. A total of 200 patients with clinically or sonographically suspected gallbladder cancer were enrolled between July 2021 and June 2022. All patients underwent contrast-enhanced MDCT using a Toshiba Aquilion 128-slice scanner. Imaging findings—including tumor morphology, local invasion, lymph node involvement, vascular encasement, and resectability—were recorded.
Results:
The mean age of the study population was 54.16 years, with a female predominance (70%). Common CT findings included focal irregular wall thickening (33.5%), sessile intraluminal polyps (27.5%), and masses replacing the gallbladder fossa (24.5%). Liver invasion was observed in 81% of cases, and lymph node metastases in 44.5%. Only 28% of patients had resectable disease at diagnosis. Histopathology revealed that moderately differentiated adenocarcinoma was the most frequent type (51.5%). MDCT demonstrated a sensitivity of 100%, specificity of 73.08%, and diagnostic accuracy of 96.5%.
Conclusion:
MDCT is a highly sensitive imaging modality for evaluating suspected gallbladder malignancies. It plays a critical role in tumor staging, assessing local extension, and determining operability. However, due to late-stage presentation, the majority of cases remain unresectable at the time of diagnosis.
Recommendation:
In endemic regions for gallbladder cancer, early screening through ultrasound followed by contrast-enhanced CT imaging is recommended to facilitate earlier detection and improve surgical outcomes
The prevalence of multidrug-resistant Mycobacterium tuberculosis in patients diagnosed with pulmonary TB at Ngwelezana Hospital. A quantitative cross-sectional retrospective.
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Multidrug-resistant tuberculosis (MDR-TB), which is TB resistant to critical anti-TB drugs such as isoniazid and rifampicin, presents a major challenge to tuberculosis treatment, leading to significant public health concerns. The study objective is to evaluate the patterns of antibiotic drug resistance of MTB in patients taking treatment for TB and determine the demographic profile of patients in whom drug-resistant TB is the most prevalent.
Aim
This research aims to determine the prevalence of drug resistance in patients with Mycobacterium tuberculosis using retrospective data.
Methodology
This study aimed to evaluate the prevalence of multidrug-resistant tuberculosis by analyzing retrospective data from the National Health Laboratory Services for patients diagnosed at Ngwelezana Hospital, KwaZulu-Natal. A sample of 695 participants was included in the study, with 267 (38.4%) males and 428 (61.6%) females. Among these participant’s demographic characteristics of patients tested for TB were evaluated, and an analysis was done to explore the rifampicin susceptibility.
Findings
The study correlation analysis revealed a weak but statistically significant positive correlation between age and gender (ρ = 0.077, p = 0.022). Rifampicin resistance was detected in 5.3% of the tested participants, while 94.7% were found to be sensitive to the drug. The relatively low prevalence of rifampicin resistance is a positive finding, suggesting that first-line TB treatment with rifampicin remains largely effective in this population. However, the presence of any resistance is still a cause for concern, as rifampicin-resistant TB can lead to more complex and expensive treatment regimens, with higher morbidity and mortality rates.
Conclusion
The study's findings indicate the low prevalence of rifampicin resistance, but continuous monitoring is necessary to prevent the spread of resistant strains. Future research should include exploring track changes in rifampicin resistance over time and investigating potential contributors to its resistance