Student's Journal of Health Research Africa
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Advancements in technology for the diagnosis and treatment of gastric cancer: A narrative review.: Gastric Cancer
No full textGastric cancer is a major global health concern, ranking as the fifth most commonly diagnosed cancer and a leading cause of mortality, often detected at advanced stages. It's a multifactorial disease influenced by genetics, H. pylori infection, environmental factors, and diet, predominantly affecting older men. Approximately 90% are adenocarcinomas, characterized by specific molecular biomarkers. Diagnosis primarily relies on EGD with biopsy. Historically, treatment involved surgery and chemotherapy, but the field is rapidly evolving towards targeted and immunotherapies. Crucially, the CRISPR-Cas9 gene editing system has emerged as a promising tool with the potential to precisely modify genes involved in gastric carcinogenesis, offering novel therapeutic avenues.
This narrative review highlights that gastric cancer remains a major global health challenge, driven by multifactorial risk factors including H. pylori infection, dietary habits, and genetic predispositions, often presenting with non-specific symptoms that lead to late diagnosis. While diagnostic tools have advanced from EGD to AI-assisted endoscopy, and TNM staging has been refined, molecular heterogeneity necessitates the integration of biomarkers for personalized approaches. Therapeutically, management has evolved significantly, encompassing perioperative chemotherapy and surgical techniques (from endoscopic resections to D2 lymphadenectomy), increasingly integrating targeted therapies (like HER2 inhibitors) and immunotherapies for advanced disease. Crucially, emerging CRISPR-Cas9 gene editing technology shows immense promise for future therapeutic interventions, aiming to address genetic drivers of carcinogenesis and further revolutionize patient outcomes.
Hence, gastric cancer remains a significant global health challenge, with its complex nature (risk factors, symptoms, and diagnosis) necessitating a continuous evolution in its management. Advancements in diagnostic tools, refined staging, and the integration of molecular insights are driving personalized treatments, while CRISPR-Cas9 gene editing holds transformative potential for future therapies
Factors Associated with Utilisation of Post natal Care Services in Lwengo Sub- County, Lwengo District, Uganda: A Cross Sectional Study.
Get PDFIntroduction: Postnatal care is the support provided to mothers and their newborns from the time of birth up to six weeks afterward. This period is crucial because many mothers and babies die during these weeks. Despite being a vital part of mothers' and children's health, postnatal care (PNC) continues to be one of the most neglected aspects of reproductive health programs.
Objective: The main objective of the study was to examine the factors associated with utilization of post-natal care services from 2002 to 2025 in Lwengo sub-county, Lwengo District.
Methods: The study was conducted in Lwengo Sub–County. A total of 370 mothers participated in this research. Quantitative data were gathered through questionnaires with 250 mothers, while qualitative data were obtained via semi-structured interviews and focus group discussions with 120 mothers and healthcare workers, using Simple Random Sampling. Quantitative data was analysed by logistic regression, and qualitative data by content from descriptions by participants.
Results: Mothers who did not know the PNC services they were supposed to receive after birth were 59% less likely to attend compared to mothers who know the services offered after delivery. Mothers who had no check-ups at a health facility while pregnant were 65% less likely to attend the PNC services compared to those who had check-ups during pregnancy.
The qualitative analysis of interviews reported the major obstacles to uptake for the PNC services by mothers from the key informant interviews included la ack of knowledge about PNC services, a lack of designated rooms purposely for postnatal services, behaviour of some midwives towards the mothers.
Conclusion: 57.6% of participants used PNC services. Key determinants included awareness of PNC, proximity to health facilities, and facility readiness.
Recommendations: Deploying more midwives, improving facility infrastructure, and enhancing community education on PNC by the Government of Uganda
Morphometric evaluation of the body and odontoid process of the axis vertebra and its clinical significance. A cross-sectional anatomical study.
Get PDFIntroduction:
The axis, which is the second cervical vertebra, serves as a pivot, allowing the atlas to rotate and support the head. Despite its small size, this area can lead to significant complications because of the intricate anatomy of the cranio-cervical junction. The axis vertebra is distinct because it features a dens or odontoid process. Fractures of the dens in the axis account for 7–27% of all cervical spine fractures. Surgical procedures in the craniovertebral region carry a high risk, as vertebral artery injury is common. Therefore, a comprehensive understanding of the anatomy of the body and the odontoid process of the axis vertebra is essential.
Materials and methods:
A cross-sectional study was carried out using fifty-two intact dry human axis vertebrae of unspecified sex. Measurements of the body and odontoid process of these vertebrae were obtained with a digital vernier caliper, which has an accuracy of up to 0.01mm. Statistical analysis was performed using IBM SPSS Version 21.
Results:
The body of the axis vertebra measured as follows: mean length of the body, 14.93±1.11 mm; vertebral body superior width, 15.79±1.76 mm; vertebral body inferior width, 16.22±1.31 mm; vertebral body anterior height, 18.69±2.17 mm; and vertebral body posterior height, 15.96±1.89 mm. The odontoid process of the axis vertebra measured as follows: odontoid process height, 17.60±1.94 mm; odontoid process anteroposterior diameter, 10.61±0.85 mm; maximum transverse diameter of the odontoid process, 9.78±0.93 mm; minimum transverse diameter of the odontoid process, 8.53±0.82 mm; atlanto-odontoid facet height, 9.67±1.43 mm; and atlanto-odontoid facet width, 7.86±0.90.
Conclusion:
These measurements are essential for the safe and effective application of modern orthopedic techniques. This data helps surgeons in reducing complications such as vertebral artery injury and other vital structures during surgical procedures in the cranio-vertebral region.
Recommendations:
Future studies should include larger, diverse samples with radiologic correlation
Antibacterial profiles of bacterial isolates from maternity ward hospital beds at Bubulo health centre IV, A cross- sectional study.
Get PDFBackground:
Healthcare-associated infections (HAIs) remain a major challenge in maternity wards, particularly in low-resource settings like Uganda. This study investigated the antibacterial profiles of bacterial isolates from maternity ward bed surfaces at Bubulo Health Centre IV, Manafwa District, to address knowledge gaps and inform infection control practices.
Methodology:
A cross-sectional, laboratory-based analytical study was conducted over three months, during which 60 swab samples were collected from high-touch points on maternity beds, including mattress covers, bed rails, and headboards. Samples were cultured on selective media, and bacterial isolates were identified through Gram staining and biochemical tests. Antibacterial susceptibility testing was performed using the Kirby-Bauer disk diffusion method in accordance with CLSI guidelines.
Results:
The study identified five bacterial species: Staphylococcus aureus (33.3%), Escherichia coli (20%), Enterococcus spp. (16.7%), Klebsiella pneumoniae (15%), and Proteus spp. (15%). Gram-positive and Gram-negative bacteria were equally represented (50% each). Antibacterial susceptibility testing revealed that Gram-positive isolates were highly sensitive to Vancomycin (100%) and Gentamicin (80–90%), with 25% of S. aureus isolates resistant to Oxacillin, suggesting possible MRSA strains. Gram-negative isolates showed high sensitivity to Ciprofloxacin (88–83%) and Ceftriaxone (77–75%), but moderate to high resistance to Ampicillin (33–66%) and Co-trimoxazole (33%). These findings indicate the presence of multidrug-resistant organisms on maternity bed surfaces, highlighting the risk of nosocomial infections.
Conclusion:
Maternity bed surfaces at Bubulo Health Centre IV are contaminated with clinically significant bacteria, including multidrug-resistant strains. The study underscores the urgent need for stringent IPC practices, routine environmental surveillance, rational antibiotic use, and targeted cleaning and disinfection strategies to safeguard maternal and neonatal health.
Recommendation:
Strengthen national infection prevention guidelines, ensure strict cleaning and disinfecting practices in health facilities, provide regular staff training and supplies, and promote public awareness on personal and environmental hygien
Intimate partner violence, associated factors, and psycho-social support networks among pregnant women attending selected health facilities in Isingiro District, Ankole Sub-region, Uganda. A cross-sectional study
Get PDFBackground
Intimate partner violence (IPV) during pregnancy is a major public health concern with serious consequences for maternal and child health. This study assessed the prevalence, associated factors, and psychosocial support systems for pregnant women experiencing IPV in Isingiro District, Uganda.
Methods
A mixed-methods cross-sectional design was employed at Rwekubo and Kabuyanda Health Centre IVs, involving 371 participants selected through proportionate stratified sampling. Quantitative data were collected using researcher-administered questionnaires and analyzed with STATA 18, while qualitative data from in-depth interviews with IPV survivors were thematically analyzed using NVivo 15.
Results
The study enrolled pregnant women aged 20-46 and above, and a high IPV prevalence of 36.5%, higher at Rwekubo (39.2%) than Kabuyanda (32.6%) was found. Predictors included partner substance use (OR = 0.05, p < 0.001), unemployment (OR = 5.07, p = 0.001), and low income, while women earning above UGX 100,000 were less likely to experience IPV. Primary education increased IPV risk (OR = 2.80, p = 0.025). Cultural norms (OR = 27.49, p < 0.001) and limited service awareness (OR = 2.99, p = 0.020) were also significant. Though 56.6% of women reported access to legal protection, it was not statistically protective (OR = 0.72, p = 0.240). Qualitative findings highlighted normalization of marital sexual abuse, stigma, and weak enforcement of services, though peer networks provided emotional support.
Conclusion
This study provides critical insights into the high prevalence. It demonstrates that IPV in these settings is shaped by a combination of socioeconomic vulnerabilities, partner-related risk factors, especially substance abuse, and entrenched patriarchal norms that normalize violence, particularly sexual and emotional abuse within marriage.
Recommendation
The study recommends routine IPV screening during ANC, awareness creation, and survivor-centered interventions tailored to rural sociocultural contexts
Assessment of aflatoxin contamination in peanuts of selected markets in Kampala. A cross-sectional study.
Get PDFBackground
Aflatoxin is a mycotoxin that is frequently known to contaminate peanuts. Aflatoxins are secondary toxic metabolites primarily produced by A.flavus and A. parasiticus. This study was hence aimed at evaluating the level of aflatoxin contamination in peanuts from selected markets in Kampala.
Methodology
Twelve (12) samples were collected by a simple random technique from Nakawa, Banda, Kireka, and Bweyogerere markets. The samples were collected from different sales points, and three samples were collected per market. These samples were prepared and extracted using a suitable solvent to achieve an effective extract. The solvent used was 70% methanol. Thin layers plated were activated, spotted, and developed under a chloroform/acetone mobile phase system. The plates were analyzed for aflatoxin using a thin-layer chromatography mobile phone-based technique.
Results
The results obtained from the analysis of samples collected from the selected markets of Kampala show that five out of the twelve samples had bright spots when viewed under UV light. For the Nakawa market, sample N1 had 0 (Ppb), N2 had 0 (Ppb), and N3 (88Ppb). Banda market, B1 had 0(Ppb), B2 had 0(Ppb), B3 had 0(Ppb). Kireka market, K1 had 101(Ppb), K2 had 101.5(Ppb), and K3 had 88(Ppb). Bweyogerere market, BW1 had 0(Ppb), BW2 had 0(Ppb), and BW3 had 81(Ppb). 42% of the total samples were contaminated with aflatoxins, and these were found to be above the permissible levels by UNBS.
Conclusion
The level of contamination of 42% of the total samples was highly above the permissible levels as stipulated by UNBS and FDA.
Recommendation
Therefore, peanuts sold in the different Markets need to be continually evaluated to ensure food safety and public health concerns
Clinicopathological characterization of gall bladder neuroendocrine neoplasm. A case series.
Get PDFBackground
Gallbladder neuroendocrine neoplasms (GB-NENs) are rare, aggressive tumors with limited data on their clinicopathological characteristics. This study aims to evaluate the clinical presentation, radiological features, histopathology, and immunohistochemical (IHC) profile of GB-NENs to enhance diagnostic and therapeutic strategies.
Methods
A retrospective case series of 15 patients diagnosed with GB-NENs at Homi Bhabha Cancer Hospital and Research Centre over one year was analyzed. Clinical symptoms, radiological findings, tumor markers, histopathology, and IHC markers were reviewed.
Results
Most patients were female (80%), with a mean age of 56.7 years. Abdominal pain (100%) was the most common symptom, while hepatic invasion (53.3%) was frequently observed on imaging. Histopathology revealed small cell neuroendocrine carcinoma (66.6%), neuroendocrine tumor grade 3 (20%), and mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) (13.3%). IHC positivity for PanCK, INSM1, and chromogranin confirmed neuroendocrine differentiation.
ConclusionGB-NENs exhibit aggressive behavior with poor prognosis, emphasizing the need for early diagnosis and standardized treatment approaches. Further studies focusing on molecular profiling and targeted therapies are essential for improving patient outcomes.
RecommendationGiven the rarity and diagnostic complexity of GB-NENs, clinicians should maintain a high index of suspicion in gallbladder masses with atypical imaging or histological features. Routine inclusion of neuroendocrine markers such as INSM1 and chromogranin in gallbladder biopsy evaluations can improve diagnostic accuracy. Multicenter collaborations, molecular characterization, and standardized therapeutic protocols are strongly recommended to enhance patient outcomes and guide future clinical practice
Comparative analysis assessing the effectiveness and efficiency of paper-based Vs digital approaches in Kadoma cholera case area targeted interventions between june to august 2024. A cross-sectional study.
Get PDFStudy Aim
To assess the effectiveness and efficiency of paper-based vs digital approaches in the Kadoma cholera case area, targeted interventions between June to August 2024.
Methodology
A field trial was employed to compare paper-based and digital data collection methods during Case Area Targeted Interventions (CATIs) within the context of the cholera outbreak. Twenty CATI team members were randomly assigned to two groups using a random number generation process.
Results
The data reveal a fairly balanced gender distribution among the 20 implementors: 11 males and 9 females. The collection process uses paper-based and digital methods. There were 140 (98%) completed interviews using the paper-based method and 142 (100%) using the digital method. The number of completed interviews using the two approaches does not differ significantly (p-value < 0.05). The paper-based mean is 12 minutes (SD =2.89, CI 11.53 -12.47), the digital mean is 9 minutes (SD =2.85, CI 9.53 - 10.47), and the t-test for the mean difference is 7.502. The p-value was 0.0001. The digital method demonstrated slightly higher completion rates (100%) compared to the paper-based method (98%).
Conclusion
The study demonstrates that digital methods outperform paper-based approaches in terms of efficiency, resulting in considerable time savings during data collection. While both methods achieved high completion rates, the digital approach allows for faster data capture and swifter public health responses, which are crucial during outbreaks.
Recommendations
Kadoma City Council should prioritize the adoption of digital methods for time-sensitive situations, particularly during outbreak investigations where a swift response is crucial
PREMOLAR EXTRACTION'S IMPACT ON MANDIBULAR ROTATION
Get PDFBackground
In orthodontics, premolar extraction is a frequent therapeutic method. Premolar extraction is justified by the need to make room for crowded teeth to be realigned and, more specifically, for a camouflage treatment of class II malocclusion. It is normal procedure to extract all first premolars as part of fixed orthodontic treatment in order to create room for proclination correction or crowding relief. The goal of orthodontic mechanics should be to prevent posterior teeth from extruding and to intrude of anterior teeth.
Objectives- This study compared the mandibular rotation changes of subjects who had all of their first premolars extracted after receiving fixed orthodontic treatment.
Materials and Methods
The samples were chosen only after the course of treatment was finished because the study was retrospective in nature. Based on patient information from Department of Dentistry,Jawaharlal Nehru Medical College and Hospital (JNMCH), Bhagalpur, Bihar, India.Two years' worth of data, from January 2023 to January 2025, have been collected. Twenty participants' data were collected.
Results
A p-value of 0.02 indicated that the ratio between pre- and post-treatment was statistically significant. On the days of SN-Go-GN, Frankfort-mandibular plane angle (FMA), anterior facial height (AFH), and posterior facial height (PFH), no discernible variations were found between them, respectively.
Conclusion
The study found that there was no discernible change in the FMA or SN-GoGn angle between the pre- and post-tests. There were a few differences in anterior and posterior facial height before and after therapy. Jaraback's ratio did not significantly change before or after treatment. To maintain the vertical dimension stable, it might be proposed that the proper mechanics, as per growing rotation, must be adhered to.
Recommendations
To see changes before and after therapy, more research with a bigger sample size that is split according to growth pattern is required
DRUG UTILISATION, ADVERSE DRUG REACTION PROFILE AND TREATMENT OUTCOME OF PNEUMONIA IN UNDER-FIVE CHILDREN IN A TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY.
Get PDFBackgrounds
Childhood pneumonia is a leading cause of morbidity and mortality among children under 5 years old worldwide. Despite global efforts to prevent and manage this condition, the improper and irrational use of antimicrobials is one of the greatest hinderance to achieving the target.
Objectives: The study aimed to evaluate the drug utilization pattern, treatment outcome, and monitoring of frequency and severity of Adverse Drug Reactions (ADRs) with its causality assessment among under-five pneumonia cases.
Methods
This observational cross-sectional study was conducted on 118 diagnosed cases of pneumonia aged 2 months to 5 years. Data were collected from treatment records and parents' responses and analyzed using Microsoft Excel 2016 and SPSS version 22.0.
Results
Among 118 under-five pneumonia cases, 88.1% recovered and 11.9% required ICU care. Most were male (75.4%), aged 2–12 months (60.2%), and from rural areas (73%). Complications were linked to female gender and parental smoking. Adverse outcomes were associated with fever, cough, delayed treatment, prolonged hospitalization, and multiple antibiotic use. Prescription analysis (536 cases) showed polypharmacy (mean 4.52 drugs), universal antibiotic, and injection use, with 85.92% prescribed by generic name and 88.93% from the essential drug list. Of 50 ADRs, diarrhea (58%) from ceftriaxone was most common.
Interpretation: Female gender and parental smoking were associated with higher ICU admissions, highlighting the need for targeted clinical strategies in managing pediatric pneumonia.
Conclusion
The study concluded that prompt and appropriate treatment is pivotal for resolving pneumonia in children and reducing morbidity and mortality. Monitoring prescriptions and drug utilization studies helps in detecting and reducing irrational prescribing while offering feedback to prescribers.
Recommendation
Raising awareness among healthcare providers and caregivers, regularly educating on proper antibiotic use, implementing prescribing guidelines, and involving patients in ADR reporting can enhance treatment outcomes and minimize adverse drug reactions in under-five pneumonia cases