Student's Journal of Health Research Africa
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THE CLINICAL RELEVANCE OF INTERLEUKIN 6 & hs-CRP IN CARDIOVASCULAR DISEASES: A CASE STUDY.
Get PDFBackground
Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide, necessitating the identification of reliable biomarkers for early detection and risk assessment. Among these, high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) have emerged as crucial inflammatory mediators linked to the pathogenesis and development of CVD. Pro-inflammatory cytokine IL-6 is essential in endothelial dysfunction, atherosclerosis, and plaque instability, while hs-CRP serves as a systemic marker of inflammation, correlating with vascular injury and adverse cardiac events.n. This study aims to assess the association of baseline IL-6, hs-CRP, and LDL-C levels with cardiovascular events over one year in patients undergoing intensive cardiovascular treatment.
Methods
This research consisted of 100 patients with cardiovascular disease (CVD) and 100 healthy controls. After obtaining consent, demographic data, medication history, and cardiovascular risk factors were recorded. Clinical parameters, including age, sex, height, body weight, and blood pressure, were also recorded. Patients with liver diseases, renal dysfunctions, thyroid disorders, HIV, and acute inflammatory conditions were excluded. Blood samples were obtained for biochemical examination after a 12-hour fast. IL-6 levels were quantified using an ELISA kit (Ray Biotech, Inc.), Serum hs-CRP was measured using photometric analysis (autoimmune), and lipid profiles were assessed using enzymatic and colorimetric techniques.
Results
Patients with CVD showed significantly raised levels of total cholesterol, LDL, VLDL, triglycerides, hs-CRP, and IL-6 (p<0.0001), while HDL levels were lower. Increased BMI, waist circumference, and blood pressure were also noted. These results reinforce the link between dyslipidemia, inflammation, and CVD, emphasizing their importance in disease progression and risk evaluation.
Conclusion
Elevated hs-CRP and IL-6 levels may help in the prediction of cardiovascular risks and further improve the stratification in suspected coronary artery disease (CAD) cases. Managing risk factors in high-risk patients and further research on IL-6’s causal role are essential
A STUDY OF LIVER FUNCTION TESTS DERANGEMENTS IN LEPTOSPIROSIS IN A TERTIARY HEALTH CARE CENTER IN ODISHA: A COHORT STUDY.
Get PDFBackground
A zoonotic illness that is found throughout the world is leptospirosis. For growth, leptospires need specific media and circumstances. Positive cultural shifts might occur over weeks or months. Clinical, diagnostic, and epidemiologic objectives are best served by classifications based on serologic distinctions.
Objectives
This study aims to determine the distribution of leptospirosis patients by identifying the correlation between clinical factors at admission and six weeks later in leptospirosis patients.
Materials and Methods
The study was observational and prospective. The study was conducted in Burla, Sambalpur, Odisha, India, at the Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR). The research was conducted between February 2024 and January 2025. One hundred patients in all were enrolled in the trial.
Results
A total of 100 IgM lepto-antibody-positive patients were enrolled and completed the 6-week follow-up. The mean age was 42.3 ± 13.8 years, with 61% males and 39% females. Fever and myalgia were present in all patients, with other common symptoms including headache (75%) and icterus (68%). Liver function parameters such as AST, ALT, bilirubin, ALP, total protein, and albumin showed significant improvement after 6 weeks (p < 0.001). These results indicate notable hepatic recovery in leptospirosis patients.
Conclusion
The study came to the conclusion that elevated levels of bilirubin and transaminases were the primary way that the liver was involved in leptospirosis. Patients' bilirubin, AST, and ALT levels were much lower at 6 weeks than they were at admission.
Recommendation
Early diagnosis and regular monitoring of liver function are essential for effective management of leptospirosis. Public health strategies should focus on awareness and timely intervention to prevent hepatic complications
Predictive utility of inotropic scores in pediatric septic shock: A prospective observational cross-sectional study from a tertiary PICU in India.
Get PDFBackgroundSeptic shock remains a leading cause of morbidity and mortality in children, particularly in resource-limited settings. Early recognition of high-risk patients is essential to improve outcomes. The Inotropic Score (IS) and Vasoactive-Inotropic Score (VIS) quantify cardiovascular support and reflect illness severity. This study aimed to evaluate the usefulness of the Wernovsky Inotropic Score (WIS) and VIS in predicting mortality among children with septic shock admitted to a tertiary care PICU.
Objectives: To assess the predictive accuracy of the Wernovsky Inotropic Score (WIS) and Vasoactive-Inotropic Score (VIS) for in-hospital mortality in pediatric septic shock.
Methodology
This prospective, longitudinal study was conducted over 18 months (September 2022–March 2024) in the PICU of a tertiary care teaching hospital. Children aged 1 month to 18 years admitted with septic shock requiring vasoactive therapy were included. Patients who had received inotropes for more than 6 hours before admission or had ≥2 organ dysfunctions were excluded. The Inotropic Score (IS) was calculated as [IS = Dobutamine + Dopamine + 100 × Epinephrine (μg/kg/min)] at 24 and 48 hours. Data were analysed using appropriate statistical tests, and ROC curves were plotted to determine predictive accuracy.
ResultsAmong 21 patients, 13 (61.9%) died. Mean VIS and WIS were significantly higher in nonsurvivors (VIS: 53.55 ± 16.71 vs 29.04 ± 13.11, p = 0.002; WIS: 39.80 ± 14.78 vs 20.72 ± 12.57, p = 0.006). ROC analysis showed strong predictive performance (VIS AUC = 0.837; WIS AUC = 0.865).
ConclusionBoth WIS and VIS are reliable predictors of mortality in pediatric septic shock. VIS demonstrated higher sensitivity, while WIS showed better specificity, aiding early prognostication and management of critically ill children.
Recommendations
WIS and VIS can be used to help predict mortality among children with septic shock
Comparative evaluation of propofol and etomidate for laryngeal mask airway insertion and hemodynamic stability: A randomized controlled trial.
Get PDFBackground
The laryngeal mask airway (LMA) is widely used in modern anesthesia practice, and successful insertion requires adequate suppression of airway reflexes with minimal hemodynamic disturbances. Propofol is considered the standard induction agent but is associated with hypotension, whereas Etomidate offers cardiovascular stability, though insertion conditions may be suboptimal.
Aim: To compare the ease of LMA insertion and hemodynamic responses following induction with intravenous Propofol and Etomidate.
Methods
This prospective randomized double-blind study included 62 ASA I–II patients aged 18–50 years, undergoing elective surgeries at CARE Hospitals, Visakhapatnam. Participants were randomly assigned to receive either Propofol (2 mg/kg; n=31) or Etomidate (0.3 mg/kg; n=31) for induction. Ease of LMA insertion was evaluated using predefined parameters (mouth opening, gagging, coughing, head/limb movements, and laryngospasm). Hemodynamic variables (heart rate, systolic and diastolic blood pressure) were recorded at baseline and 30 seconds post-induction.
Results
The mean age was 32.1 ± 8.0 years; both groups were comparable in gender (Propofol 58% male vs. Etomidate 55% male), weight (61.2 ± 9.6 kg vs. 60.4 ± 8.8 kg), and ASA status (Grade I: 67.7%, Grade II: 32.3%). Propofol achieved better insertion conditions with higher adequate mouth opening (93.5% vs. 71.0%, p=0.02), absence of gagging (90.3% vs. 61.3%, p=0.01), and first-attempt success (93.5% vs. 74.2%, p=0.04). However, Propofol caused significant post-induction hypotension (SBP 124 → 98 mmHg; p<0.001), while Etomidate maintained stable hemodynamics.
Conclusion
Propofol provides better ease of LMA insertion with higher first-attempt success but is associated with significant hypotension. Etomidate, although hemodynamically stable, offers less favorable insertion conditions. The choice between the agents should therefore balance airway insertion ease against cardiovascular safety.
Recommendations
Propofol is preferred for healthy patients; Etomidate is recommended in cardiovascularly vulnerable individuals to balance airway management and hemodynamic stability
Efficacy of Epley’s Maneuver versus Vestibular Sedatives in the Management of Benign Paroxysmal Positional Vertigo: A Prospective Analytical Study.
Get PDFBackground:Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder presenting with brief episodes of vertigo triggered by head movements. While vestibular sedatives are frequently used, canalith repositioning maneuvers such as Epley’s are considered more effective. This study compared the efficacy of Epley’s maneuver with vestibular sedatives in a tertiary care setting.
Methods:
A prospective analytical study was conducted at a government ENT hospital in Telangana over 24 months. Seventy-two patients aged 20–59 years with a positive Dix–Hallpike test were randomized equally into two groups: Group A (vestibular sedatives) and Group B (Epley’s maneuver). Patients were assessed at the 2nd week, 1st month, and 2nd month using the Dix–Hallpike test and Visual Analogue Scale. Outcomes were analyzed using SPSS version 23.0, with p <0.05 considered significant.
Results:
The mean age was 38.7 years, with nearly equal gender distribution. Symptomatic relief was significantly higher in Group B compared to Group A at all follow-up points: 66.7% vs. 6.7% at 2 weeks, 83.3% vs. 13.3% at 1 month, and 93.3% vs. 16.7% at 2 months (all p <0.001). Outcomes at 2 months showed 94% complete relief with Epley’s maneuver versus 16% with sedatives. Adverse events occurred only in the sedative group (hearing loss 6.6%, tinnitus 10%), while no complications were reported with Epley’s maneuver.
Conclusion:
Epley’s maneuver demonstrated superior efficacy and safety compared to vestibular sedatives in the management of BPPV, providing rapid and sustained symptom resolution.
Recommendations:
Epley’s maneuver should be considered as the first-line therapy for BPPV in clinical practice. Training primary care physicians and ENT practitioners in performing this simple, cost-effective maneuver can reduce reliance on sedatives, minimize side effects, and improve patient outcomes
Association of sun exposure, hormonal factors, and cosmetic use with melasma: An observational study in urban Indian women.
Get PDFBackground:Melasma is a common acquired hypermelanosis characterized by irregular brown macules, predominantly affecting women with darker skin types.
Objectives:
To evaluate the association of sun exposure, hormonal factors, and cosmetic use with the clinical patterns and severity of melasma among urban Indian women.
Methods:
A cross-sectional observational study was conducted among 100 women clinically diagnosed with melasma attending a tertiary dermatology outpatient clinic in urban India. Data on demographic profile, duration of sun exposure, hormonal history (pregnancy, oral contraceptive use), and cosmetic usage were collected using a structured questionnaire. Clinical evaluation included pattern classification and severity assessment using the Modified Melasma Area and Severity Index (mMASI). Statistical significance of associations was analyzed using the chi-square test, with p < 0.05 considered significant.
Results:
The mean age of participants was 34.8 ± 6.7 years, with the majority in the 30–40-year group (58%). The malar pattern (52%) was most frequent, followed by centrofacial (38%) and mandibular (10%) types. Moderate-to-severe melasma was noted in 54% of women. Significant associations were found with sun exposure >2 hours/day (p < 0.01), hormonal influences including pregnancy and OCP use (p = 0.02), and regular cosmetic use (p = 0.03). Family history of melasma was observed in 34% of participants, predominantly among those with Fitzpatrick skin type IV.
Conclusion:
Melasma among Indian women shows a clear association with prolonged sun exposure, hormonal influences, and regular cosmetic use. The predominance of malar and centrofacial patterns, particularly in women with Fitzpatrick skin type IV, highlights the combined impact of environmental triggers and genetic predisposition.
Recommendations:
Dermatologists should incorporate counseling on UV protection, screening for hormonal triggers, and guidance on safe cosmetic practices into routine management protocols for melasma. Longitudinal studies are recommended to assess the long-term impact of behavioral modification and hormonal regulation on melasma recurrence.
Spectrum of endometrial pathologies in abnormal uterine bleeding: A retrospective descriptive study.
Get PDFBackground
Abnormal uterine bleeding (AUB) is one of the most frequent gynecological complaints affecting women of all reproductive and perimenopausal ages. Histopathological evaluation of the endometrium remains the cornerstone for identifying the underlying causes, which may range from benign hormonal imbalance to premalignant or malignant lesions.
Objectives
To describe the histopathological spectrum of endometrial lesions in women presenting with abnormal uterine bleeding (AUB) over two years
Methods
This retrospective study included 50 cases of AUB evaluated over two years. Endometrial biopsy and curettage specimens were reviewed, and histopathological patterns were categorized as functional, structural, inflammatory, or neoplastic. Clinical data such as age, menopausal status, and bleeding pattern were retrieved from medical records and analyzed descriptively.
Results
The mean age of participants was 42.3 ± 8.1 years, with the highest incidence (46%) in the 41–50-year age group. Menorrhagia (46%) was the most common clinical presentation. Histopathological examination revealed proliferative endometrium (20%), secretory endometrium (16%), endometrial hyperplasia (16%), and disordered proliferative pattern (12%) as the major findings. Structural lesions included endometrial polyps (8%) and carcinoma (4%), while atrophic and inflammatory changes accounted for 6% each. Hyperplasia was most frequent in the perimenopausal group, whereas carcinoma was confined to postmenopausal women.
Conclusion
The predominance of functional and hyperplastic endometrial patterns in AUB underscores the hormonal etiology of bleeding in most women, particularly during the perimenopausal transition. Routine histopathological evaluation of endometrial samples is essential to detect precancerous and malignant conditions early.
Recommendations
All women with persistent or recurrent AUB—especially those aged ≥40 years or postmenopausal should undergo endometrial sampling for definitive diagnosis. Integrating histopathological assessment with hormonal evaluation and imaging improves diagnostic accuracy and guides targeted management.
Cost analysis in the clinical chemistry laboratory in the era of automation: A prospective observational study.
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By standardizing the entire testing procedure and minimizing repetitive operations that could result in human mistakes, laboratory automation systems were created to enhance laboratory performance. To deliver high-quality services at a reasonable cost in the modern day, clinical laboratory administration surely depends on sound financial management.
Objectives
By comparing important metrics like turnaround time, test volume, labor cost, reagent waste, and maintenance expenses before and after automation, the study aims to assess how laboratory automation affects operational efficiency and cost parameters in a clinical chemistry laboratory.
Materials and Methods
It was a prospective, observational study. The study was carried out at the Patna Medical College and Hospital (PMCH), Patna, Bihar, India. The study was conducted for 12 months, i.e., from August 2024 to July 2025. In all, 150 patients were enrolled in the study. Participants had to be at least eighteen years old, have clinical specimens processed by PMCH's clinical chemistry laboratory throughout the study period, and have given their informed consent for participation and the use of anonymised data.
Results
The mean age of participants was 45.8 ± 13.4 years (pre-automation) and 46.5 ± 12.7 years (post-automation). Males constituted 56.0% of the pre-automation group and 53.3% of the post-automation group. Average tests per patient increased from 6.6 to 8.5 following automation. Monthly labor cost decreased from ₹4,00,000 to ₹2,60,000, and reagent wastage declined from 18% to 7%.
Conclusion
Automation significantly improved operational efficiency, reduced labor costs, increased test throughput, and minimized reagent waste.
Recommendation
Adoption of laboratory automation is recommended for tertiary-care laboratories to improve cost-effectiveness and workflow efficiency
Dual-energy CT quantitative parameters can improve the performance of differential diagnostics between Ameloblastomas and Odontogenic Keratocysts with solid components – A systematic review.
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Technical constraints and a laborious workflow have likely led to underutilization of dual-energy CT. Clinical radiologists need a better understanding of the benefits of its benefits over single-energy CT. The fundamental idea of DECT involves acquiring data at two different X-ray energy levels to differentiate materials. Various acquisition techniques are available, including dual-tube systems, fast voltage switching, dual-layer detectors, split-filter techniques, and sequential scanning, each with its own pros and cons for clinical application. Up to 20% of cystic jaw lesions are OKCs, which are epithelial-lined cysts that are frequently linked to a nevoid basal cell carcinoma syndrome. Ameloblastomas (AMs) and odontogenic keratocysts (OKCs) are common, benign jaw lesions often discovered accidentally during routine radiographic examinations. Although benign, they can cause significant pain and tissue damage. Diagnosis typically involves clinical exams, radiography (such as panoramic X-rays, CT scans, or CBCT), and a subsequent biopsy. A key challenge is that AMs and OKCs look identical on conventional imaging, making primary differentiation by a radiologist difficult and highlighting a potential area where advanced techniques like DECT could offer improved diagnostic capabilities.
Material and Methods
Major databases such as Medline were explored through a detailed literature search, resulting in a systematic review pertaining to Dual-energy CT quantitative parameters that can improve the performance of differential diagnosis between ameloblastomas and odontogenic keratocysts with solid components.
Results
Ten original research scientific articles, dated between 2020 and 2024, about the mentioned topic were highlighted.
Conclusions
The ability to distinguish ameloblastomas from OKCs with solid components is much enhanced when DECT quantitative parameters are combined with traditional imaging features, providing a possible image-based diagnostic tool for clinical diagnosis. Detailed information regarding the DECT quantitative parameters can improve the performance of differential diagnosis between AMs and OKC, as discussed in this systematic review.
Prevalence and factors influencing the development of hypertension among people living with HIV and AIDS attending TASO at Mulago Hospital. A Cross-sectional study.
Get PDFBackground: Hypertension has devastated the lives of many people living with HIV/AIDS (PLWHIV) globally, yet its prevalence in Uganda is not known. This study aimed to determine the prevalence and factors influencing hypertension among PLWHIV and AIDS at TASO Mulago.
Methodology:
A cross-sectional design was employed with qualitative and quantitative approaches on 80 randomly sampled participants. Qualitative data was collected through interviews. Blood pressure measured by a sphygmomanometer, Height, and weight data by anthropometry were used to compute the body mass index (BMI). Descriptive statistics were run to report frequencies, means, and standard deviations for continuous variables, chi-square tests, and binary logistic regressions with adjusted odds ratios (AORs). Statistical significance was considered for p-values < 0.05. Ethical clearance obtained from Mild May Uganda Research Ethics Committee and study authorization from TASO.
Results:
In a sample of 80 PLWHIV attending TASO Mulago, the majority were females, 56(70.0%), while 50 (30%) were males. The majority 45.0% were married, 10(12.5%) single, 16(20.0%) divorced and 18(22.5%) widowed. The prevalence of hypertension was 37.5% (95% CI [27.5, 48.8]). In multivariable analysis, having secondary or higher education was independently associated with lower odds of hypertension (AOR = 0.27, 95% CI [0.08, 0.94], p = .040), whereas an undetectable viral load was associated with higher odds of hypertension (AOR = 2.83, 95% CI [1.00, 7.99], p = .049). Age ≥45 years, male sex, marital status, employment, socioeconomic status, ART regimen, and over-nutrition were not significantly associated with hypertension in the adjusted model.
Conclusion:
Hypertension is a prevalent comorbidity among PLWHIV at TASO Mulago, highlighting the dual burden of HIV and cardiovascular disease.
Recommendation:
Integration of HIV care through routine hypertension screening, nutritional counseling, adherence support, and targeted lifestyle interventions, to reduce cardiovascular complications and improve long-term health outcomes for PLWHIV in Uganda