Student's Journal of Health Research Africa
Not a member yet
1618 research outputs found
Sort by
Comparison of Sequential Organ Failure Assessment (SOFA) Score and SOFA Score with pH in Outcome Prediction among ICU Patients: A Prospective Observational Study.
Get PDFBackground:
The SOFA score is commonly employed in ICUs to assess disease severity and forecast patient outcomes. Nevertheless, it does not include all physiologic variables that may influence prognosis. Arterial blood pH, a reflection of global metabolic and respiratory balance, could provide added predictive value.
Objective:
To determine whether combining arterial pH with the SOFA score improves the prediction of in-hospital mortality in ICU patients.
Methods:
Between July 2024 and June 2025, this prospective observational study was carried out at the intensive care unit of Paras HMRI Hospital in Patna. In the first 24 hours, we enrolled 275 consecutive adults who had arterial blood gas analysis and full SOFA data. Two models were compared: SOFA alone and SOFA plus pH. Model performance was evaluated by clinical utility, calibration, and discrimination.
Results:
In-hospital mortality occurred in 24.0% (66/275) of patients. The AUC for SOFA + pH was 0.82 (95% CI 0.77–0.87), a statistically significant improvement (p=0.030) compared to 0.78 (95% CI 0.72–0.83) for SOFA alone. Calibration metrics were more favourable with SOFA + pH (slope 1.02 vs 0.94). The Brier score also improved (0.138 vs 0.145). Decision curve analysis demonstrated superior net benefit for SOFA + pH at threshold probabilities between 10–40%.
Conclusion:
Incorporating arterial pH into SOFA enhances the accuracy of mortality prediction. This adjustment requires no additional cost or technology and may support better risk stratification in daily ICU practice.
Recommendations:Integrating arterial pH into routine SOFA scoring is recommended for early risk stratification and improved mortality prediction among ICU patients. This approach can be easily adopted in all critical care units without additional cos
A prospective observational study on the correlation between hormonal profiles and acne severity in women with adult-onset acne.
Get PDFBackground:Adult-onset acne (AOA) is increasingly prevalent among women and is often refractory to conventional therapy. Hormonal fluctuations, hyperandrogenemia, and metabolic disturbances are recognized contributors, yet the correlation between hormonal profiles and acne severity remains under-defined in Indian women. To evaluate the relationship between serum hormonal parameters and the severity of acne in women presenting with adult-onset acne.
Methods:
A prospective observational study was conducted among 100 women aged 18–40 years with clinically diagnosed AOA attending a tertiary dermatology OPD. Detailed clinical assessment, menstrual and family history, and Global Acne Grading System (GAGS) scoring were performed. Fasting serum levels of total and free testosterone, DHEA-S, SHBG, LH, FSH, prolactin, TSH, 17-hydroxyprogesterone, and fasting insulin (HOMA-IR) were estimated. Correlations between hormonal parameters and acne severity were analyzed using Spearman’s rank test and multivariate logistic regression.
Results:
The mean age of participants was 26.8 ± 4.9 years. Menstrual irregularity and PCOS were observed in 38% and 41% respectively. Based on GAGS, 28% had mild, 46% moderate, and 26% severe acne. Elevated free testosterone (34%), total testosterone (29%), and reduced SHBG (26%) were the most frequent hormonal abnormalities. Acne severity correlated positively with free testosterone (ρ = 0.41, p < 0.001), total testosterone (ρ = 0.32, p = 0.002), DHEA-S (ρ = 0.29, p = 0.004), and LH/FSH ratio (ρ = 0.24, p = 0.016), while SHBG showed an inverse correlation (ρ = −0.33, p = 0.001). PCOS and insulin resistance significantly amplified the severity.
Conclusion:
Hormonal imbalance, particularly elevated free testosterone and low SHBG, plays a crucial role in the pathogenesis and severity of AOA. Recognition of underlying endocrine dysfunction is essential for comprehensive management.
Recommendations:
Routine hormonal evaluation should be incorporated in women presenting with persistent or severe AOA to guide individualized hormonal or metabolic therapy, ensuring optimal and sustained outcomes
PD-L1 upregulation and tumour progression in conjunction with lncRNA UCA1 about oral squamous cell carcinoma. A systematic review.
Get PDFBackground:
Oral squamous cell carcinoma (OSCC) remains a lethal malignancy with a poor prognosis, particularly in advanced stages. The tumour microenvironment (TME), rich in cancer-associated fibroblasts (CAFs) and immune checkpoint molecules like PD-L1, is critical in OSCC progression. This review investigates the specific role of long non-coding RNA UCA1 in orchestrating PD-L1 upregulation and tumour progression within the OSCC TME.
Methodology:
This systematic review followed PRISMA guidelines. A comprehensive search of five electronic databases (PubMed, Scopus, Web of Science, Embase, and Lilacs) was conducted from 2020 to 2024. The search strategy used Boolean operators with terms related to "Oral cancer," "long non-coding RNA," "UCA1," "cancer-associated fibroblasts," and "PD-L1." Four original research articles meeting the inclusion criteria were selected for final analysis.
Results:
The included studies demonstrate that LncRNA UCA1 influences OSCC prognosis through genetic variants. Furthermore, CAFs, whose prevalence increases with tumour grade, contribute to an immunosuppressive TME. Key mechanisms identified include CAF-derived extracellular vesicles promoting epithelial-mesenchymal transition and collagen crosslinking, and stromal enzymes like NNMT regulating angiogenesis. Crucially, these CAF-driven processes are implicated in the upregulation of PD-L1, facilitating immune evasion.
Conclusion:
LncRNA UCA1 and CAFs are pivotal in driving OSCC progression and immune evasion via PD-L1 upregulation. Their interplay creates a pro-tumorigenic and immunosuppressive niche that supports disease advancement and resistance.
Recommendation:
Future research should prioritize elucidating the precise molecular cascade linking UCA1, CAF activation, and PD-L1 expression. Targeting this axis holds significant promise for developing novel diagnostic biomarkers and combination immunotherapies for OSCC
Quantitative diagnosis of salivary gland tumors with contrast-enhanced ultrasound. A systematic review.
Get PDFSalivary gland tumors pose diagnostic challenges, with fine-needle aspiration cytology showing limitations in accuracy. Contrast-enhanced ultrasound (CEUS) has emerged as a promising alternative for preoperative differentiation. This systematic review aims to evaluate the diagnostic value of CEUS in distinguishing between benign and malignant salivary gland tumors. Electronic databases (PubMed, Embase, Scopus, Web of Science, Lilacs) were searched up to October 2024. Inclusion criteria comprised original studies (2020–2024) evaluating CEUS for salivary gland lesions. Exclusion criteria included non-English articles, reviews, and irrelevant studies. The STROBE checklist was used for quality assessment. Data were synthesized narratively. Eight studies were included. CEUS demonstrated high diagnostic value, with features such as blurring enhancement margins and increased lesion size aiding malignancy risk assessment. It effectively differentiated pleomorphic adenomas from Warthin tumors and benign from malignant lesions. CEUS is a valuable, non-invasive tool for the quantitative diagnosis of salivary gland tumors, enhancing preoperative planning and differential diagnosis
Effect of pain assessment scale integration and nurse training on knowledge, attitudes, and practices in postoperative pain management at a low-resource facility quantitative quasi-cross-sectional study.
Get PDFBackground
Post-operative pain remains one of the greatest concerns for patients following surgery. Failure to promptly assess and manage pain may result in postoperative complications like hypertension, depression, and overall poor health outcomes.
Objective
To describe the effect of integrating the pain assessment scale on the nurse’s knowledge, attitude, and practice toward post-operative pain management in the surgical ward in a low-resource facility.
Method
This was a quasi-experimental study using pre- and post-intervention evaluation carried out from June to November 2022. The nurses included were educated on post-operative pain management using a numeric pain assessment scale during a CME. They completed a pre- and post-test to assess their knowledge and attitude towards post-operative pain management. Data was analyzed using SPSS version 20. A student paired t-test was performed to assess for change in knowledge, attitude, and practice.
Results
The researcher surveyed 60 participants, and the majority (70%) were aged between 24 and 33 years. In the pretest and posttest, the mean total knowledge scores about post-operative pain treatment were (M= 62.83, SD= 9.583, t = -59, P=0.01), pretest attitude (M = 60.72, SD=7.095) and the posttest (M=71.65.SD= 7.688, t =-7.479, dt= 59, p=.000). Majority of respondents had their post-operative practices (POP) management practices improved (87%) and were able to use the PQRST to evaluate POP, more than seventy-three percent (73.3%) used the PAS to manage POP and 75% of the respondents gave POP patients direct nursing care.
Conclusion
The results revealed a great improvement, which was statistically significant in the nurses’ knowledge, attitude, and practice towards post-operative pain management.
Recommendations
Create educational initiatives that emphasize pain evaluation and management, put in place standardized instruments for pain assessment, and create quality improvement initiatives in addition to procedures for efficient pain management and documentation
Prevalence of Polycystic Ovary Syndrome (PCOS) in Adolescent Girls and Young Women: A Cross-Sectional Questionnaire-Based Study.
Get PDFBackground:
Polycystic Ovary Syndrome (PCOS) is a common endocrine and metabolic disorder affecting adolescent girls and young women, with significant reproductive and long-term health consequences. Early diagnosis and awareness are crucial for effective management and prevention of complications.
Methods:
A questionnaire-based cross-sectional study was conducted over six months (January–June 2024) among 300 females aged 13–30 years attending a tertiary care hospital in Visakhapatnam, Andhra Pradesh. Data on sociodemographic characteristics, clinical features, lifestyle factors, and knowledge, attitude, and practices (KAP) related to PCOS were collected using a pre-validated questionnaire. Diagnosis was based on the Rotterdam criteria. Statistical analysis was performed using the chi-square test.
Results:
The mean age of participants was 23.5 years, with the majority belonging to the 21–25-year age group. PCOS was diagnosed in 76.7% of participants. Awareness regarding PCOS was high, with 89.7% recognizing it as a common disorder. Positive attitudes were observed, as 79.2% believed that PCOS is increasing rapidly, and 71.0% agreed that early diagnosis and lifestyle modification can improve outcomes. However, preventive practices were inconsistent, with 28.8% reporting no regular physical activity and a substantial proportion exhibiting sedentary behaviour. Lifestyle factors were identified as the most common perceived cause of PCOS by 52.6% of participants.
Conclusion:
The study demonstrates a high prevalence of PCOS among adolescent girls and young women with good awareness and positive attitudes toward early diagnosis and lifestyle modification. However, gaps in preventive practices highlight the need for structured educational and lifestyle-based intervention programs.
Recommendation:
Structured awareness programs focusing on early screening, lifestyle modification, and adolescent counselling should be implemented at institutional and community levels to reduce long-term complications of PCOS
Histopathological Patterns and Molecular Alterations in Surface Epithelial Ovarian Tumors: A Retrospective Study from a Tertiary Care Centre in India
No full textBackground
Surface epithelial ovarian tumors constitute the largest category of ovarian neoplasms and show considerable variation in morphology and biological behavior. Recent insights into molecular alterations have improved classification and prognostic stratification.
Objective
To analyze histopathological patterns and correlate them with immunohistochemical markers and molecular alterations in surface epithelial ovarian tumors diagnosed over a five-year period.
Methods
A retrospective study was conducted in the Department of Pathology, Nalanda Medical College and Hospital, Patna, India. All histologically confirmed surface epithelial ovarian tumors from January 2020 to December 2023 were reviewed. Hematoxylin – Eosin stained slides were assessed for tumor subtype, architectural pattern, grade, and associated features. Immunohistochemistry (IHC) included WT1, p53, PAX8, ER/PR, β-catenin, HNF1β, Napsin A, CK7, CK20, and CDX2 panels as indicated. In malignant tumors where tissue was adequate, targeted gene panel testing was performed for TP53, BRCA1/2, KRAS, BRAF, PIK3CA, ARID1A, and CTNNB1.
Results
A total of 180 cases were analyzed: benign (32.8%), borderline (14.4%), and malignant (52.8%). Among malignant tumors, high-grade serous carcinoma (HGSC) was most frequent (61.2%), followed by endometrioid carcinoma (16.5%), clear cell carcinoma (12.1%), and mucinous carcinoma (8.7%). TP53 mutation was detected in 92% of HGSC, with aberrant p53 IHC pattern showing 89% concordance. BRCA1/2 mutations were observed in 18% of HGSC. KRAS mutations were prevalent in mucinous tumors (48%) and low-grade serous tumors (33%). ARID1A loss and PIK3CA mutations were noted in 39% and 28% of endometrioid/clear cell tumors respectively. CTNNB1 nuclear expression was characteristic of endometrioid carcinoma (22%).
Conclusion
Distinct histomorphologic patterns of surface epithelial ovarian tumors closely correlate with specific molecular alterations. Incorporating focused IHC and targeted mutational analysis improves diagnostic precision and guides personalized therapy pathways such as PARP inhibition in BRCA-mutated HGSC and MAPK-pathway inhibition in KRAS/BRAF-driven tumors.
Keywords
Ovarian carcinoma, Histopathology, Immunohistochemistry, TP53, BRCA, KRAS, ARID1
G protein activation subunit genes in ovarian hemangioma. A systematic review
Get PDFBackground
Heterotrimeric G-proteins transmit signals from G-protein-coupled receptors (GPCRs) to the cell interior, modulating physiological activities based on specific tissue targets. While the fundamental schemes of G-protein regulation and signaling are well-documented, their specific role in rare neoplasms like ovarian hemangiomas remains an emerging area of study. Ovarian hemangiomas are uncommon; most are characterized by isolated reports of peculiar clinical manifestations or morphologic features. To fully characterize the clinicopathologic correlations of ovarian hemangiomas and assess the importance of hormone receptors in their pathogenesis, researchers are increasingly investigating the G protein-activating subunit gene, particularly mutations in GNAQ. In other vascular tumors, somatic mutations in these G-protein subunits trigger constitutive activation of downstream pathways, such as MAPK/ERK, driving endothelial proliferation. Understanding these molecular drivers is essential for distinguishing these benign vascular lesions from malignant ovarian cancers and for developing targeted diagnostic markers that bridge the gap between heterotrimeric G-protein signaling and rare gynecological pathology.
Material and Methods
Major databases such as Medline were explored through a detailed literature search, resulting in a systematic review pertaining to G protein activation subunit genes in ovarian hemangioma.
Results
Eight original research scientific articles, dated between 2020 and 2024, about the mentioned topic were highlighted.
Conclusions
Ovarian hemangiomas are extremely uncommon tumors that can occur at any age and are discovered by accident after surgery or autopsy. The purpose of this article is to highlight that these neoplasms should be considered in the differential diagnosis of a hemorrhagic ovarian lesion, even though they are extremely uncommon in the ovary. Receptor-G protein interactions have been the subject of extensive research for over 40 years, yielding significant insights into one of the most fundamental systems in human physiology
The correlation between academic staff depression and student course evaluation scores: A cross-sectional quantitative study.
Get PDFBackgroundMental health in academia has become an increasing concern due to its impact on teaching quality and student learning. Depression among lecturers can reduce motivation, attendance, and classroom engagement, potentially influencing how students perceive teaching effectiveness. This study examines the relationship between depressive symptoms among academic staff and student course evaluation outcomes at a South African public university.
MethodsA cross-sectional quantitative study was conducted with 30 academic staff across four faculties: Humanities, Science, Engineering, and Management Sciences. Depression levels were assessed using the Beck Depression Inventory-II (BDI-II), and corresponding course evaluation scores were obtained from the university’s evaluation system. Statistical analyses included Pearson’s correlation and faculty-based subgroup comparisons to determine the relationship between depression and teaching evaluations.
ResultsA moderate negative correlation was observed between BDI-II scores and student course evaluations (r = -0.41, p < 0.01), indicating that lecturers with higher depressive symptoms received lower evaluation scores. Faculty-level analysis showed that Humanities staff had the highest mean BDI-II score (23.6 ± 8.4), followed by Science (19.2 ± 6.7), Engineering (17.8 ± 7.1), and Management Sciences (16.4 ± 5.9). The mean course evaluation score declined from 82.4% among staff with minimal depression to 67.1% among those with moderate to severe symptoms, a 15.3% difference. The relationship was strongest in first-year courses, where lecturer-student interaction is most intensive.
ConclusionDepressive symptoms among academic staff are significantly associated with lower student evaluation scores, suggesting that mental health challenges can indirectly affect perceptions of teaching performance.
RecommendationsUniversities should integrate mental health support into academic development programmes and avoid relying solely on student evaluations for performance assessment. Early intervention, counselling access, and workload adjustments are crucial to fostering lecturer well-being and sustaining teaching excellence
Nurses' knowledge, practices, and attitudes of intravenous fluid therapy at a healthcare facility in the Volta Region of Ghana: A cross-sectional study.
Get PDFBackground:
Intravenous infusion therapy is essential to clinical care but poses risks, including phlebitis, fluid overload, and infections when inadequately managed. Nurses play a crucial role in ensuring safe and effective Intravenous administration. This study assessed nurses' knowledge, practices, and attitudes regarding intravenous infusion therapy at a healthcare facility in the Volta Region of Ghana.
Methods:
A quantitative exploratory-descriptive cross-sectional survey was conducted using convenience sampling to recruit 269 registered nurses through a self-reporting questionnaire. Descriptive statistics and chi-square tests analysed relationships between knowledge, practices, and attitudes.
Results:
Overall knowledge levels were satisfactory; 96.7% identified correct IV insertion sites, 81.4% correctly calculated infusion rates, and 85.5% confirmed drug compatibility. However, gaps existed in recognising air embolism symptoms (43.1%). Practice analysis revealed 81.8% of nurses assess IV sites regularly and 75.1% recognise phlebitis symptoms, yet nearly half (49.1%) do not practice correct peripheral IV dressing change frequency. Additionally, 29.7% provided incorrect responses regarding medication administration through active IV lines. Significant associations were found between self-reported IV competence and phlebitis management knowledge (χ² = 17.342, df = 4, p = 0.002) and between formal IV training and infusion rate adjustment knowledge (χ² = 6.478, df = 1, p = 0.011).
Conclusion:
Nurses demonstrated satisfactory knowledge, practices, and positive attitudes toward IV therapy. Knowledge deficits in key safety areas underscore the need for targeted training and institutional support.
Recommendation:
Healthcare facilities should implement structured in-service training programs that target specific knowledge gaps, particularly in recognising air embolism and preventing phlebitis. Developing and disseminating standardised institutional protocols and national guidelines is essential for enhancing Intravenous infusion practice consistency and safety.