Student's Journal of Health Research Africa
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Bacteriological and mycological profile of non-tuberculous lower respiratory tract infections in patients attending a tertiary care centre in eastern Bihar: A prospective observational study.
Get PDFIntroduction
Acute lower respiratory tract infection (LRTI) is a common clinical illness encountered both in community and hospital settings. Worldwide, lower respiratory tract infections are the leading cause of death. Apart from tuberculosis, pneumonia, bronchitis, and bronchiolitis are the important LRTIs. This prospective hospital-based study was undertaken to identify the microbiological profile and antibiogram of LRTI patients attending our institution.
Aim
To determine the bacteriological and mycological profile of suspected cases of LRTI attending a tertiary care center in Eastern Bihar
Materials and methods
This study was carried out over a period of 3 years. A total of 2107 sputum samples were received in the Microbiology laboratory in Katihar Medical College, Katihar, from July 2022 to June 2025. After doing Bartlett scoring, 1665 samples were processed and included in the study. Identification and antibiotic susceptibility testing of isolates were done using automated methods (VITEK 2) for bacteria and yeasts. LPCB preparation was used for the identification of molds.
Results
Out of the 1665 sputum samples processed, 487 showed the growth of pathogenic organisms. 290 bacterial species, 148 yeasts, and 32 molds were isolated. 17 samples showed mixed growth. The male-to-female ratio was 1.4:1. The Maximum patients (43.15%) were aged 61–80 years, followed by 41–60 years (29.46%). The majority were inpatients from the Department of General Medicine (62.65%).
Conclusion
Gram-negative bacilli were identified as the leading cause of LRTI, followed by yeasts and molds. Many of the isolates were found to be multidrug resistant (MDR).
Recommendation
The increasing rate of isolation of yeasts and molds and the rising incidence of antibiotic resistance a matter of grave concern for one and all. Strict implementation of antimicrobial stewardship is the need of the hour
Clinicoradiological profile and its association with severity of pulmonary hypertension in post-tuberculosis sequelae: a cross-sectional study.
Get PDFBackgroundPulmonary tuberculosis (PTB) remains a major global health challenge. Even after microbiological cure, many patients develop sequelae involving parenchyma, airways, and vasculature, predisposing them to pulmonary hypertension (PH). Evaluating the relationship between clinicoradiological changes and PH severity is essential for improved management.
ObjectivesTo assess the clinicoradiological profile of post-PTB sequelae and its association with the severity of PH using spirometry, high-resolution computed tomography (HRCT), and echocardiography.
MethodsThis hospital-based cross-sectional study included 100 patients with PH previously treated for PTB at a tertiary care center. Clinical symptoms, signs, radiological patterns, spirometry, and echocardiographic findings were recorded. HRCT was used to calculate the Total Lung Score (TLS). PH severity was determined by right ventricular systolic pressure (RVSP) on 2D echocardiography. Statistical associations between TLS, spirometry indices, and PH severity were tested using chi-square and ANOVA, with p<0.05 considered significant.
ResultsThe cohort comprised 66 males and 34 females with a mean age of 46.6 ± 10.5 years. Dyspnea (97%) and cough (79%) were the predominant symptoms. Radiological sequelae included mixed fibrosis with bronchiectasis (30%), fibro-cavitary lesions (27%), and fibrosis (23%). HRCT showed cardiomegaly in 42% and pulmonary artery dilatation in 25–31%. All patients had abnormal spirometry: mixed pattern (49%), obstructive (29%), and restrictive (22%). FEV1 impairment was moderate in 28%, moderately severe in 26%, and severe in 22%. Echocardiography revealed mild PH in 52%, moderate in 30%, and severe in 18%. TLS correlated significantly with PH severity (p<0.001). Mean FEV1% and FVC% predicted decreased with higher TLS categories (p=0.03 and p=0.002).
ConclusionPost-PTB sequelae frequently lead to mixed ventilatory impairment and pulmonary hypertension, with the extent of radiological involvement strongly predicting PH severity.
RecommendationsRoutine follow-up with HRCT, spirometry, and echocardiography should be integrated into post-PTB care to allow early detection and intervention
A CASE CONTROL STUDY TO COMPARE THE EFFICACY OF PRE-OPERATIVE INTRAVENOUS TRANEXAMIC ACID IN THE CONTROL OF INTRAOPERATIVE TONSILLECTOMY BLEEDING.
Get PDFINTRODUCTION
Tonsillectomy is one of the most performed surgeries all over the world. Modern methodologies, use of bipolar scissor dissection, bipolar radio frequency ablation, harmonic scalpel, micro-debrider endoscopic tonsillectomy, laser tonsillectomy, and the like, have revolutionized the tonsillectomy procedure. To compare the efficacy of preoperative intravenous Tranexamic acid in the control of intraoperative tonsillectomy bleeding.
MATERIALS AND METHODS:
This prospective clinical study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Adichunchanagiri Institute of Medical Sciences, B. G. Nagara, Mandya District. The study period was from November 2016 to May 2018. A sample size of a minimum of 107 patients who satisfied the inclusion criteria was included in the study. Dissection tonsillectomy was done in all cases. In the study group, pre-operative intravenous Tranexamic acid will be given in the dosage of 10mg/kg/body weight.
RESULTS:
The most common age group in the study and control group was 11-20 years. In the study group, 30 females (56.6%) and 23 males (43.4%), and in the control group, 33 females (61.1%) and 21 males (38.9%). The grading was done according to Brodsky's grading scale; in the study group, maximum cases (39.6%) had grade 3 tonsillar hypertrophy, and in the control group, maximum cases (31.5%) had grade 2 and grade 3, respectively. Mean intraoperative blood loss was 135.96 ml in the study group and 159.81 ml in the control group. P value was calculated to be <0.001, thus statistically proving significance.
CONCLUSION:
In this study, we have proved the efficacy of pre-operative intravenous use of Tranexamic acid in the control of intra-operative tonsillectomy bleeding with no recorded side effects. No side effects of tranexamic acid were noted during the study. So, it is a safe drug to be used
Incidence and predictors of difficult airway in elective surgical patients: A hospital-based observational study.
Get PDFBackground:
Difficult airway remains a major challenge in anesthetic practice and is associated with increased perioperative morbidity when not anticipated. Despite routine preoperative evaluation, unexpected airway difficulty continues to occur in elective surgical patients, highlighting the need to identify reliable predictive parameters.
Objectives:
To determine the proportion of difficult airways among elective surgical patients and to assess the predictive value of commonly used preoperative airway assessment parameters.
Materials and Methods:
This hospital-based observational study included 80 adult patients undergoing elective surgery under general anesthesia with endotracheal intubation. Preoperative airway assessment included Mallampati classification, thyromental distance, inter-incisor distance, cervical spine mobility, and neck circumference. Laryngoscopy was performed using a Macintosh blade. Difficult laryngoscopy was defined as Cormack–Lehane grade III or IV, while difficult intubation was defined by more than two attempts, prolonged intubation time, or need for advanced adjuncts. Data were analyzed using descriptive statistics and multivariate logistic regression.
Results:
The proportion of patients with a difficult airway was 13.8%. Difficult laryngoscopy occurred in 12.5% and difficult intubation in 8.8% of cases. Higher Mallampati grades (III–IV), reduced thyromental distance (<6.5 cm), restricted mouth opening, limited cervical mobility, and increased neck circumference (>40 cm) were significantly associated with a difficult airway. Multivariate analysis identified reduced thyromental distance (Adjusted OR 4.2) and Mallampati Class III–IV (Adjusted OR 3.6) as the strongest independent predictors. Mild desaturation occurred exclusively in the difficult airway group.
Conclusion:
Focused preoperative assessment using Mallampati grading and thyromental distance, supported by complementary airway parameters, can facilitate early identification of high-risk patients and improve perioperative airway safety.
Recommendations:
Standardized airway assessment and readiness with basic airway adjuncts should be ensured for high-risk patients
Usefulness of trappin-2 level in cervicovaginal secretion in predicting spontaneous preterm birth in asymptomatic high-risk women: A prospective case–control study at a tertiary care centre.
Get PDFBackground:
Spontaneous preterm birth (SPTB) remains a major contributor to neonatal morbidity and mortality, especially in developing countries. Identifying reliable early biomarkers in asymptomatic high-risk women could improve risk stratification and perinatal outcomes. Trappin-2, an antiprotease and innate immune modulator, plays a critical role in mucosal defense and inflammation within the cervicovaginal environment.
Objectives:
To assess cervicovaginal fluid (CVF) Trappin-2 levels in predicting spontaneous preterm birth in asymptomatic high-risk pregnant women and across two mid-trimester sampling windows.
Methods:
This prospective case–control study included 100 pregnant women (50 preterm and 50 term) enrolled between 14 and 20 weeks of gestation and followed through delivery. Cervicovaginal secretions were collected twice, at 14–20 and 22–28 weeks, respectively, using sterile dacron swabs. Trappin-2 concentrations were quantified using an ELISA assay, and the sensitivity, specificity, and predictive value were evaluated.
Results:
The majority of participants were aged 20–30 years (66%), and 70% had regular antenatal care visits. Mean CVF Trappin‑2 levels were significantly higher in women who delivered preterm compared with term controls at both visits (14–20 weeks: 6124 ± 1102 pg/ml vs 3100 ± 1529 pg/ml; 22–28 weeks: 7915 ± 2112 pg/ml vs 4100 ± 1602 pg/ml; p < 0.001). Sensitivity and specificity at the second visit were 76.4% and 66.2%, respectively, with a high negative predictive value (>90%).
Conclusion:
Cervicovaginal Trappin-2 can be used as a promising early biomarker for identifying women at risk of spontaneous preterm birth. Its reproducible mid-trimester elevation and high negative predictive value support its integration into antenatal screening to guide timely interventions and improve neonatal outcomes.
Recommendation:
Routine mid-trimester screening of cervicovaginal Trappin-2 levels in asymptomatic high-risk pregnant women is recommended to aid early risk stratification. Integration of this biomarker into antenatal care may facilitate timely preventive interventions and improve perinatal outcomes
PREVALENCE AND FACTORS ASSOCIATED WITH UNSUPPRESSED VIRAL LOADS AMONG ADOLESCENTS ON ART ATTENDING ART CLINIC AT BUSEMBATIA HEALTH CENTER III, BUGWERI DISTRICT, UGANDA. A CROSS-SECTIONAL STUDY.
Get PDFBackground
Adolescents living with HIV are put on ART to improve their quality of life. The emerging failure to have their viral load suppressed is increasing. However, risk factors for failure of viral load suppression in a rural ART clinic are not well documented. This study sought to find out the prevalence and factors associated with unsuppressed viral loads among HIV/AIDS-positive adolescents in the ART clinic of Busembatia Health Centre III.
Methodology.
A descriptive cross-sectional study was used for HIV positive adolescents attending ART Clinic at Busembatia Health Centre III, Bugweri District. A Kish and Leslie statistical formula was used to obtain the sample size and a random sampling technique was used among 92 adolescents. Data about the adolescents was both extracted from the Client forms and also obtained through questionnaires.
Results.
51(55.44%) of the participants were female,50(54.35%) of the adolescents were aged 12-13 years and the majority of them were single 89(96.74%). 21% of the participants had unsuppressed viral loads. The established patient-related factors were; Substance abuse 16(84.21%), Sexual behaviors 10(52.63%), Knowledge about HIV 16(84.21%) and clinical-related factors were poor adherence 4(21.05%), Multimorbidity and opportunistic infections 6(31.58%), poor nutritional status 6(31.58%), 12(63.15%) were in WHO clinical stage and 4 (21.05%) of the unsuppressed adolescent had their regimen changed.
Conclusion.
Prevalence of unsuppressed viral loads was high and the factors associated with viral load unsuppression are numerous, unique and thus require unique interventions.
Recommendation.
The ART clinic personnel and Implementing partners should engage the adolescents on ART, parents/guardians, and teachers in identifying their problems and the challenges and try to find and or address these problems
The Effectiveness of Post-operative Analgesia in Caesarean Section Patients at King Dinuzulu Hospital Complex: A Prospective Qualitative Descriptive analytical study at a District level Hospital in South Africa.
Get PDFBackground:
Post-operative pain management in caesarean section (C-section) patients is crucial for optimal recovery. However, pain control in district-level hospitals, such as King Dinuzulu Hospital Complex in KwaZulu-Natal, often faces challenges due to resource limitations and variability in clinical practices. The study aimed to assess post-operative pain management following spinal anaesthesia in women receiving a caesarean section. The main objective was to assess a patient's pain level at specified time intervals post-operatively – therefore evaluating the adequacy of the post-operative analgesia prescribed and administered in decreasing a patient’s pain level.
Methods:
This prospective qualitative descriptive analytical study included 157 women undergoing elective C-sections under spinal anesthesia. Pain management effectiveness was assessed using patient questionnaires and visual analogue scales (VAS) at multiple time points post-operation.
Results:
The participants ranged in age from 18 to 44 years with a mean age of 30.5 years (SD = 5.54) and most of the participants were African (96.1%). The study revealed significant variability in analgesic prescriptions and administration, with many patients experiencing suboptimal pain relief. Despite a standard protocol, 29.9% of patients reported increased pain 24 hours post-surgery, highlighting inconsistencies in pain management practices.
Conclusion:
The findings underscore the need for standardized pain management protocols and improved training for healthcare providers to enhance patient outcomes.
Recommendations
The Authors recommend that healthcare workers should be trained on the latest postoperative analgesia guidelines for women coming for caesarean section. Pain should be regularly assessed in the postnatal ward and analgesia administered timeously
KNOWLEDGE AND ATTITUDE OF HYPERTENSIVE PATIENTS TOWARDS DIETARY MANAGEMENT AT ENTEBBE REGIONAL REFERRAL HOSPITAL IN WAKISO DISTRICT. A CROSS-SECTIONAL STUDY.
Get PDFBackground.
Hypertension is one of the most crucial health problems and chronic diseases in developed and underdeveloped countries, which is further expanded due to ignorance and lack of knowledge. The study assessed the knowledge and attitude of hypertensive patients towards dietary management at Entebbe Regional Referral Hospital in the Wakiso district.
Methodology.
A cross-sectional study design was used, employing a quantitative approach to collect data using a semi-structured questionnaire from 36 participants. The information was manually tallied; thereafter, Microsoft Word and Excel programs were employed, followed by presentation in the form of frequency tables, graphs, and figures like pie charts and bar graphs.
Results.
Most respondents were in the age range of above 50 years (47.2%), (44.4%) had attained secondary education, (61.1%) had good knowledge, 20 (55.6%) of the respondents were not familiar with salt content in common foods, 32 (88.9%) knew the foodstuffs restricted in hypertension, (47.2%) knew that reducing salt intake can help manage hypertension, (94.4%) agreed that consuming a diet rich in fruits vegetables whole grains and proteins positively impact blood pressure. 30(83.3%) participants had a positive attitude towards adding fruits and vegetables to their diet, and 21 (58.3%) respondents strongly agreed that physical exercises have an impact on blood pressure.
Conclusion.
The majority of the participants had good knowledge regarding the relevant dietary approaches needed to stop hypertension. A significant number of the respondents had a positive attitude toward the dietary modifications for proper hypertension control.
Recommendations.
The Ministry of Health and other responsible bodies should strive to increase the awareness and knowledge of hypertensive patients about the importance of consultation and seeking medical services
Antibacterial activity of aqueous extract of Sutherlandia frutescens against Shigella flexneri
Get PDFBackground: Shigella flexneri is a highly infectious bacterium responsible for gastrointestinal infections and has developed alarming levels of antibiotic resistance over the years. It particularly poses a threat in developing countries. Traditional medicinal plants offer potential alternatives to conventional antimicrobial therapies.
Aim: To investigate the antibacterial activity of the aqueous extract of Sutherlandia frutescens against Shigella flexneri.
Setting: This laboratory-based study was conducted in a controlled environment at the Mangosuthu University of Technology, Department of Biomedical Sciences, Kwa- Zulu Natal, South Africa.
Methods: Aqueous extract of Sutherlandia frutescens was prepared using standard methods. The extract was assessed using the Kirby-Bauer Antimicrobial Sensitivity, Minimum Inhibitory Concentration (MIC) and the Minimum Bactericidal Concentration (MBC) assays.
Results: Sutherlandia frutescens aqueous extract demonstrated statistically significant antimicrobial activity against Shigella flexneri with p-values less than 0.05. The aqueous extract showed moderate activity with a high MIC (1.56 mg/ml) and equivalent MBC (1.56 mg/ml) values suggesting balanced bacteriostatic and bactericidal activity.
Conclusion: The findings of the study show that S. frutescens exhibits promising antimicrobial activity against Shigella flexneri, supporting its potential as a natural antimicrobial agent for treating gastrointestinal infections.
Keywords: Aqueous extract, Sutherlandia frutescens, Antimicrobial, Shigella flexneri, Minimum Inhibitory Concentration
Altered gut microbiota and inflammatory markers in depression: A cross-sectional study.
Get PDFBackground:Depression is a multifactorial mental health disorder influenced by psychological, biological, and environmental factors. Emerging evidence highlights the role of the gut–brain axis, particularly gut microbiota and inflammatory responses, in the pathophysiology of depression.
Aim:
To investigate alterations in gut microbiota composition and their association with systemic inflammatory markers in individuals diagnosed with depression.
Methods:
A cross-sectional observational study was conducted over one year, involving 100 participants 50 with clinically diagnosed depression and 50 healthy controls. Stool and blood samples were collected to analyze gut microbiota via 16S rRNA sequencing and inflammatory markers (CRP, IL-6, TNF-α) via ELISA. Data were analyzed using SPSS version 23.0.
Results:
Participant characteristics included religion and educational status, with 68% of participants identifying as Hindu, 22% as Muslim, and 10% as others; 54% had completed secondary education, while 46% had higher education. Depressed individuals showed significantly elevated levels of CRP (6.2 ± 2.1 mg/L), IL-6 (11.4 ± 3.8 pg/mL), and TNF-α (19.7 ± 6.5 pg/mL) compared to controls (p < 0.001). Gut microbiota analysis revealed a reduction in beneficial bacteria (Lactobacillus and Bifidobacterium) and an increase in Proteobacteria and Firmicutes/Bacteroidetes ratio in the depression group. Significant negative correlations were observed between beneficial bacteria and inflammatory markers (Lactobacillus vs. CRP (r = –0.52, p < 0.001) and Bifidobacterium vs. TNF-α (r = –0.44, p = 0.004)), indicating a potential link between microbial dysbiosis and systemic inflammation in depression.
Conclusion:
The findings suggest that depression is associated with gut microbiota imbalance and elevated inflammatory markers. Dysbiosis may contribute to systemic inflammation reinforcing the role of the gut–brain–immune axis in depression's pathogenesis.
Recommendations:
Future longitudinal studies should explore microbiome-based therapeutic interventions, such as probiotics or dietary modulation, as adjunctive treatments for depression. Incorporating gut health screening in mental health assessments may enhance holistic management