Student's Journal of Health Research Africa
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A cross-sectional comparative study of the monocyte to high-density lipoprotein cholesterol ratio in normal individuals, type 2 diabetes mellitus, and diabetic nephropathy.
Get PDFBackground
Chronic low-grade inflammation plays a pivotal role in the progression of diabetes mellitus and its complications, particularly diabetic nephropathy. The Monocyte to HDL Cholesterol Ratio (MHR) has emerged as a novel inflammatory marker linked with cardiovascular and metabolic disorders. However, its clinical relevance across the spectrum of diabetes and nephropathy remains underexplored.
Objective: To compare the MHR among healthy individuals, patients with type 2 diabetes mellitus, and those with diabetic nephropathy, and to evaluate its correlation with renal function markers.
Methods
A cross-sectional comparative study was conducted among 100 participants divided into three groups: healthy controls (n = 30), diabetes mellitus without complications (n = 35), and diabetic nephropathy (n = 35). Monocyte count, HDL cholesterol levels, and renal function tests (serum creatinine, eGFR) were measured. MHR was calculated as the ratio of absolute monocyte count to HDL cholesterol. Statistical analysis was done using ANOVA and Pearson’s correlation.
Results
The mean age of participants was 52.9 ± 7.7 years, with no statistically significant age difference among groups. Gender distribution was approximately balanced (55% male, 45% female).MHR values showed a progressive increase from healthy individuals (8.45 ± 1.56) to diabetic patients (13.27 ± 2.31), and were highest in diabetic nephropathy patients (18.65 ± 3.02) (p < 0.001). MHR was positively correlated with serum creatinine (r = 0.52, p < 0.01) and negatively with eGFR (r = -0.47, p < 0.01). Significant intergroup differences were observed across all parameters.
Conclusion
The study highlights that MHR significantly increases with disease progression from diabetes to diabetic nephropathy and correlates with declining renal function. MHR may serve as a simple, cost-effective inflammatory biomarker for early risk stratification in diabetic patients.
Recommendations
Routine inclusion of MHR in diabetic monitoring protocols may improve early detection of nephropathy and guide timely interventions in high-risk individuals
Impact of lifestyle modifications on blood pressure control in hypertensive patients: A Prospective cohort observational study.
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Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality worldwide. While pharmacological treatment is widely prescribed, lifestyle modification is a cornerstone of non-pharmacologic management. This study aimed to evaluate the impact of structured lifestyle changes on blood pressure control among hypertensive patients.
Objectives: To assess the effectiveness of dietary, behavioral, and physical activity-based lifestyle modifications on systolic and diastolic blood pressure control over six months.
Methods
This prospective observational study was conducted on 100 adult hypertensive patients over six months. Baseline demographics, co-morbidities, and blood pressure readings were recorded. Patients received counseling on lifestyle modifications, including DASH diet adherence, salt restriction, physical activity, smoking cessation, weight management, and alcohol moderation. Follow-up measurements of blood pressure and lifestyle adherence were recorded and analyzed using appropriate statistical methods.
Results
The mean age of participants was 52.4 ± 10.8 years, with 56% males. At baseline, the mean systolic and diastolic blood pressures were 148.6 ± 9.5 mmHg and 92.4 ± 6.3 mmHg, respectively. After six months, significant reductions were observed in systolic (134.2 ± 8.6 mmHg) and diastolic (84.1 ± 5.4 mmHg) blood pressure (p < 0.001). Among patients with high adherence to lifestyle changes (≥4 factors), 86% achieved blood pressure control, compared to only 25% in the low adherence group. Lifestyle adherence was strongly associated with better blood pressure outcomes.
Conclusion
Lifestyle modifications significantly improve blood pressure control in hypertensive patients, particularly when multiple changes are adopted consistently. These non-pharmacologic strategies should be integrated into routine hypertension management.
Recommendations
Primary care settings must prioritize lifestyle counseling and follow-up reinforcement to improve adherence and long-term hypertension control
Epidemiological Trends and Multidrug-Resistant Tuberculosis Burden in Vikarabad District: A Cross-Sectional Observational Study.
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Multidrug-resistant tuberculosis (MDR-TB) remains a public health concern, particularly in resource-constrained settings. Limited data exist on the regional burden and epidemiological patterns of MDR-TB in Vikarabad district, Telangana, India. This study was conducted to evaluate the clinical characteristics, prevalence of drug resistance, and treatment outcomes among patients diagnosed with tuberculosis.
Methods:
A cross-sectional observational study was conducted from October 2023 to January 2025 across DOTS centers in Vikarabad district. A total of 300 bacteriologically confirmed TB patients were enrolled. Demographic and clinical data were collected using structured case records. Drug susceptibility testing (DST) for rifampicin and isoniazid was performed using GeneXpert and line probe assays. Treatment outcomes were evaluated per national TB program guidelines.
Results:
The mean age of participants was 38.4 ± 14.7 years, with 66% being male and 59% residing in rural areas. Pulmonary TB accounted for 81% of cases. Of the total sample, 24% were previously treated TB cases. Rifampicin resistance was detected in 6% of participants; MDR-TB was confirmed in 4%. Notably, 13.9% of previously treated cases were MDR-TB, compared to 0.9% in new cases. Treatment success was achieved in 80% of patients overall, but only 58.3% among MDR-TB cases. Drug-sensitive TB patients had a significantly higher success rate of 82.2%.
Conclusion:
MDR-TB remains a considerable burden in Vikarabad, particularly among previously treated TB cases. Targeted DST, robust follow-up, and community-based adherence strategies are essential to improve outcomes and reduce transmission.
Recommendations:
Enhance early DST access, strengthen treatment adherence monitoring, integrate TB counseling at primary care, and ensure continuous drug supply and follow-up systems to effectively manage MDR-TB in high-risk rural populations
A Prospective study comparing the frequency of hyponatremia in survivors and deaths after ST elevation myocardial infarction- A cohort study.
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With differing results both in the hospital and subsequently, STEMI remains a serious health issue. At the community level, effective interventions are required to stop its progression. One of the major issues with CVDs in India is hypertensive heart disease. In order to address this substantial burden, it is necessary to comprehend the intricate dynamics that underlie the connections between the biological and social determinants.
Objectives- To compare the incidence of hyponatremia among survivors and deaths after ST elevation MI, the current study was conducted.
Materials and methods
It was a prospective, observational study. The study was carried out at the Department of Emergency and Cardiology, Kerala Institute of Medical Sciences (KIMS), Trivandrum, Kerala, India. The study was conducted for 18 months, that is, from November 2018 to February 2020. In all, 100 patients were enrolled in the study.
Results
34% of the patients were between the ages of 51 and 60, and 38% were between the ages of 61 and 70. The bulk of the patients were in this age range. With 80% of the patients being men and only 20% being women, there was a pronounced male predominance. The most common comorbidities were diabetes mellitus (57%) and hypertension (61%), indicating their close correlation with STEMI.
Conclusion
According to the study's findings, patients with STEMI who had hyponatremia had a considerably higher in-hospital death rate. According to the study's findings, serum sodium levels in STEMI patients should be regularly checked since they can be a straightforward and affordable prognostic indicator.
Recommendation
Regular monitoring of serum sodium levels is recommended in STEMI patients to identify and manage the risk of in-hospital mortality
Diagnostic patterns of haemoglobinopathies: A prospective observational study using high-performance liquid chromatography in a remote tertiary care center of Telangana.
Get PDFBackgroundHaemoglobinopathies, including sickle cell disorders and thalassemias, are significant genetic conditions that alter hemoglobin structure and function. High-performance liquid chromatography is a sensitive and reliable tool for identifying hemoglobin variants. This study aimed to analyze the diagnostic patterns of haemoglobinopathies using HPLC in a tertiary care center serving the tribal population of Telangana.
MethodsA prospective observational study was conducted over 18 months (June 2023 to December 2024) involving 182 patients attending a tertiary care hospital. Hemoglobin variants—Hb A0, Hb A2, Hb F, and Sickle Cell Window—were analyzed using HPLC. Red cell distribution width (RDW-CV) was assessed to evaluate erythrocyte size variability. Diagnostic classification was based on HPLC parameters, including specific thresholds for sickle cell disease, trait, and beta-thalassemia.
ResultsAmong the 182 cases, 6 (3.3%) were diagnosed with sickle cell disease (S-window >40%), 62 (34.1%) with sickle cell trait (S-window <40%), and 9 (4.9%) with probable sickle cell beta-thalassemia trait (S-window <40% and Hb A2 between 3.5–4.5%). The remaining 105 cases (57.7%) were unclassified on HPLC alone but showed features suggestive of iron deficiency anemia, anemia of chronic disease, or borderline hemoglobinopathy patterns. Mean values observed were: Hb A0 = 71.77%, Hb A2 = 2.81%, Hb F = 2.11%, and Sickle Cell Window = 36.58%. RDW-CV was highest in sickle cell disease cases (mean 17.27%) compared to the trait (15.35%).
ConclusionThis study demonstrates a high burden of sickle cell disorders among the tribal population in Telangana. HPLC proves to be a valuable diagnostic modality, but further molecular testing is essential for accurate classification, particularly in compound and borderline cases. Early identification, genetic counseling, and targeted screening are vital for managing haemoglobinopathies in high-risk regions.
Recommendations
Implement universal newborn screening, strengthen genetic counseling services, enhance molecular diagnostics, and promote community awareness for effective haemoglobinopathy management
Pattern and Prevalence of Poisoning Cases Reported to a Tertiary Care Hospital: A Retrospective Cross-Sectional Study.
Get PDFBackgroundPoisoning remains a significant public health issue in developing countries, contributing to substantial morbidity and mortality. Identifying patterns and prevalent substances involved is essential for guiding preventive measures and clinical management.
ObjectiveTo analyze the demographic profile, type, intent, clinical presentation, and outcomes of poisoning cases reported to a tertiary care hospital.
MethodsThis retrospective cross-sectional observational study included 100 patients admitted with acute poisoning over a 12-month period. Data were collected from hospital records, including demographic details, type and intent of poisoning, presenting symptoms, time to hospital presentation, interventions, and outcomes. Descriptive statistics were used for data analysis.
ResultsMost poisoning cases occurred in individuals aged 21–30 years (42%), followed by the 11–20 age group (28%). Males (58%) were more commonly affected than females (42%) (Table 1). The most frequent agents were organophosphorus compounds (35%), followed by non-OP pesticides (15%) and drug overdoses (14%) (Table 2). Suicidal intent was predominant (66%), while accidental ingestion accounted for 28% of cases (Table 3). Vomiting (72%) was the most common presenting symptom, with altered sensorium (34%) and respiratory distress (20%) also observed (Table 4). The majority of patients presented within 2–6 hours (44%) (Table 5). Gastric lavage was performed in 82% of cases; specific antidotes were administered in 38%. ICU admission was needed in 27% and 12% required ventilatory support. Complete recovery was observed in 85% of patients, with a mortality rate of 7% (Table 6).
ConclusionPoisoning primarily affects young adults, with a high rate of suicidal intent and organophosphorus compound involvement. Early recognition, timely intervention, and psychiatric counseling are critical to improving outcomes.
Recommendations
Enhance public awareness, regulate toxic substances, strengthen rural healthcare, and integrate psychiatric support to prevent and manage poisoning case
A comparative cross-sectional study on early childhood development through anthropometric measurements among urban and rural Anganwadi children.
Get PDFBackgroundEarly childhood is a crucial period for cognitive, physical, and emotional development. Nutritional status during this phase plays a significant role in shaping a child’s growth and development.
Objectives
To assess early childhood development through anthropometric measurements among Anganwadi children in urban and rural areas, and to compare the nutritional status between the two groups.
Methods
A comparative cross-sectional study was conducted from 25th November 2023 to 25th January 2024 among 254 children under five years attending Anganwadi centres, 129 from rural areas and 125 from urban areas. Anthropometric parameters such as weight, height, Body Mass Index (BMI), Mid-Upper Arm Circumference (MUAC), and head circumference were recorded. Developmental milestones were also assessed. The data were analysed using WHO growth standards, and Chi-square tests were applied for statistical significance.
Results
The study revealed that 77.5% of rural and 68.0% of urban children had normal weight-for-age, though the difference was not statistically significant (p = 0.233). Stunting was present in 37.2% of rural and 37.6% of urban children (p = 0.204). BMI analysis showed that 94.6% of rural and 87.2% of urban children were within the normal range (p = 0.118). Developmental delays were observed in 2.4% of rural and 8.0% of urban children. MUAC was normal in 99.2% of children across both groups (p = 0.982). No significant differences were found in head circumference (p = 0.926) or weight-for-height (p = 0.328) between the groups.
Conclusion
Children with lower anthropometric measurements were more likely to exhibit developmental delays. Rural Anganwadi children were relatively better nourished compared to urban children. Early detection of malnutrition through growth monitoring is vital for ensuring proper childhood development.
Recommendations
Regular anthropometric monitoring, nutrition education for caregivers, and strengthening Anganwadi services are essential to identify at-risk children early and implement timely interventions
Impact of maternal obesity on maternal and neonatal outcomes: A case-control study at a tertiary care centre in South Bihar.
Get PDFBackgroundMaternal obesity has emerged as a significant public health concern, particularly in low- and middle-income countries, due to its association with increased maternal and neonatal complications. Both prepregnancy Body Mass Index (BMI) and gestational weight gain (GWG) are linked to adverse pregnancy outcomes.
Aim: To evaluate the impact of prepregnancy Body Mass Index (BMI) and gestational weight gain (GWG) on maternal and neonatal outcomes among term pregnancies.
MethodsThis case-control observational study was conducted at the Department of Obstetrics and Gynaecology, Narayan Medical College, Sasaram, Bihar, from Dec 2022 to Dec 2023. A total of 400 singleton pregnant women attending their first antenatal visit before 16 weeks of gestation were enrolled and categorized into two groups: BMI <25 kg/m² (n=200) and BMI ≥25 kg/m² (n=200). Participants were followed through pregnancy, labor, and postpartum. Statistical analysis was conducted using SPSS version 26.0.
ResultsObesity was more prevalent among women aged ≥30 years and those from lower socioeconomic classes. Women with BMI ≥25 kg/m² had significantly higher incidences of gestational hypertension (31.3% vs. 6.3%), gestational diabetes mellitus (22.9% vs. 4.5%), preeclampsia/eclampsia (7.8% vs. 1.1%), prolonged labor (9.6% vs. 2.3%), and emergency cesarean delivery (53.0% vs. 11.4%) compared to women with BMI <25 kg/m² (p<0.01 for all). No significant differences were noted in fetal growth restriction, gestational age at delivery, congenital anomalies, or newborn birth weight.
ConclusionMaternal obesity is significantly associated with increased risks of hypertensive disorders, gestational diabetes, labor complications, and cesarean deliveries.
RecommendationEarly BMI screening, preconception counseling, and tailored antenatal care strategies are essential for mitigating obesity-related pregnancy complications in resource-constrained settings
Utilization of postnatal care services among mothers aged 15-24 years at Kisenyi Health Centre IV, Kampala City- a cross-sectional study.
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Postnatal care (PNC) is a critical component of maternal and newborn health, particularly during the first six weeks after delivery when the risk of complications is highest. Despite its importance, the utilization of PNC services remains low among young mothers in Uganda. This study aimed to assess the utilization of postnatal care services and associated factors among mothers aged 15–24 years who attended Kisenyi Health Centre IV in Kampala City.
Methodology
A descriptive cross-sectional study was conducted using a structured, self-administered questionnaire. A total of 42 mothers aged 15–24 years were selected through convenience sampling. Data were collected on participants' background characteristics, knowledge, behaviors, and experiences with postnatal care services. Descriptive statistics were used to analyze the data, and results were presented in frequencies, percentages, and tables.
Results
The majority of respondents (52.4%) were aged 15–19 years, and 33.3% had attained secondary education. Most participants (66.7%) resided in urban areas, and 54.8% were unemployed. While 97.6% reported that PNC services were available at the facility, only 23.8% had a birth plan, and 31.0% rated their knowledge of PNC as poor. Health workers were the primary source of PNC information (50.0%), and 42.9% of respondents visited the clinic three times or more. Factors such as distance to the facility, perceived quality of care, provider attitudes, and affordability influenced utilization.
Conclusion
Despite the high availability of PNC services at Kisenyi HC IV, limited knowledge, lack of birth preparedness, and mixed perceptions of care quality still hindered their utilization by young mothers.
Recommendations
Health education during antenatal care, promoting respectful and youth-friendly services, should be enhanced. Increase community outreach to improve awareness and accessibility of PNC among adolescents and young mothers
Knowledge, attitude, and perception of women towards medical versus surgical management of abnormal uterine bleeding: A cross-sectional descriptive study.
Get PDFBackground: Abnormal uterine bleeding (AUB) significantly affects the quality of life in reproductive-age women. Despite the availability of both medical and surgical treatments, decision-making is often influenced by inadequate awareness and socio-cultural perceptions.
Objectives: To assess the knowledge, attitudes, and perceptions of women diagnosed with AUB regarding its medical and surgical management, and to evaluate their treatment preferences, concerns, and adherence.
Methods: A cross-sectional descriptive study was conducted at the gynecology outpatient department of KIMS & RF, Amalapuram, Andhra Pradesh, from November 2024 to February 2025. A total of 136 women with diagnosed AUB were enrolled. Data were collected using a structured and validated questionnaire covering sociodemographic characteristics, awareness levels, treatment attitudes, and decision-making behavior. Statistical analysis was performed using SPSS, with significance assessed via chi-square tests.
Results: Of the 136 participants, the majority (66.2%) were aged 31–50 years and predominantly married (77.2%). Awareness of AUB was high (94.1%), but only 66.2% were aware of both medical and surgical options. While 89.7% had a favorable view of surgical management, 66.2% preferred medical treatment, and 29.4% chose a combination approach. Treatment refusal was reported by 29.4%, primarily due to fear of surgery. Education was significantly associated with treatment preference (p = 0.044), and diagnosis with AUB was significantly associated with adherence (p < 0.001). Occupation influenced refusal of recommended management (p = 0.0165).
Conclusion: Despite high awareness of AUB, significant gaps exist in understanding treatment modalities. Cultural fears and misconceptions continue to influence patient decisions. Patient-specific counseling is imperative to improve informed decision-making and treatment compliance.
Recommendations: Integrate routine counseling addressing both treatment options, dispel misconceptions, enhance shared decision-making, and prioritize health education interventions during gynecological consultations for AUB