Student's Journal of Health Research Africa
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Mortality predictors and early outcomes in very low birth weight infants: A retrospective cross-sectional study.
Get PDFBackground:
Very low birth weight (VLBW) infants, defined as those weighing under 1500 g, are highly vulnerable to morbidity and mortality, particularly in low-resource settings. Despite advances in neonatal care, outcomes remain inconsistent, with respiratory distress syndrome (RDS), sepsis, and prematurity as major contributors to mortality.
Aim:
To evaluate short-term outcomes and identify mortality predictors among VLBW infants admitted to the NICU of Katihar Medical College, Bihar.
Methods:
This retrospective descriptive cross-sectional study was conducted over one year (November 2023–October 2024) and included 60 VLBW infants. Data on demographic characteristics, perinatal factors, complications, and outcomes were collected from hospital records and analyzed using SPSS version 23.0. The Chi-square and t-tests were used for univariate analysis, and logistic regression identified independent predictors of mortality.
Results:
The mean birth weight and gestational age were 1225 ± 180 g and 30.8 ± 2.4 weeks, respectively. Survival was achieved in 42 infants (70%), while 18 (30%) died during NICU stay. Mortality was higher among infants with birth weight <1000 g (66.7%), gestational age <32 weeks (38.9%), RDS (47.4%), and sepsis (54.5%) (p<0.05). Logistic regression identified birth weight <1000 g (OR 4.3; p=0.007), RDS (OR 3.9; p=0.012), and sepsis (OR 3.1; p=0.031) as independent mortality predictors.
Conclusion:
Extremely low birth weight, respiratory distress syndrome, and sepsis are key determinants of mortality among VLBW infants. Early recognition and targeted management of these risk factors, along with strengthened neonatal intensive care services, are essential to improve survival outcomes.
Recommendations:
Early identification of risk factors, timely surfactant therapy, strict infection control, and improved NICU infrastructure can help reduce mortality in VLBW infants
Secretory carcinoma in labial minor salivary gland of pediatric patients. A systematic Review.
Get PDFBackground:
Secretory carcinoma (SC), formerly referred to as mammary analogue secretory carcinoma (MASC), is a rare malignant salivary gland neoplasm most frequently identified in the parotid gland but also reported in minor salivary glands. It is strongly associated with the ETV6:NTRK3 fusion, which has therapeutic implications due to the advent of TRK inhibitors. Pediatric SC is exceedingly rare, with even fewer cases reported in the labial minor salivary glands, making systematic analysis crucial.
Objective:
To synthesize available evidence on pediatric SC of the labial minor salivary glands, focusing on presentation, diagnosis, management, and outcomes.
Methods:
Electronic databases (PubMed, Scopus, Google Scholar) were searched until 2025. Studies were included if they described SC of the labial minor salivary glands in patients aged ≤18 years with histopathologic and immunohistochemical confirmation. Two case reports met the inclusion criteria.
Results:
Both patients presented with upper lip masses. A 9-year-old girl had a well-circumscribed, 2 cm lesion confirmed as SC (CK7+, mammaglobin+, S100+); managed by excision with margin extension, she remained disease-free at 36 months. A 17-year-old male had a high-grade SC of the philtrum with nodal metastasis, treated by wide excision, bilateral selective neck dissection, and adjuvant chemoradiotherapy; he remained disease-free at 6 months. Both tumors displayed classical SC morphology, though molecular fusion testing was not universally performed.
Conclusions:
Pediatric labial SC is exceptionally rare but clinically significant. It should be considered in the differential diagnosis of circumscribed pediatric lip nodules. Management is primarily surgical, with aggressive multimodal therapy indicated for high-risk disease. Awareness is vital to avoid misdiagnosis as acinic cell carcinoma and to facilitate timely recognition of ETV6-NTRK3 fusions, which may enable targeted therapies
A prospective clinical study on the efficacy of preoperative intravenous tranexamic acid in reducing operative time and blood loss during tonsillectomy.
Get PDFBackground:
Tranexamic acid is widely used in surgical practice to stabilise clot formation by inhibiting fibrinolysis. This study measured the effect of preoperative intravenous tranexamic acid on operative time and intraoperative blood loss during tonsillectomy.
Aim:
To determine whether preoperative intravenous tranexamic acid reduces intraoperative blood loss and shortens operative time during tonsillectomy.
Methods:
A prospective controlled clinical study was conducted in the Department of Otorhinolaryngology, Adichunchanagiri Institute of Medical Sciences, Mandya district. Participants were aged 4 to 50 years and met the inclusion criteria for tonsillectomy. A total of 107 patients were analysed, with 53 receiving tranexamic acid and 54 serving as controls. Blood loss was measured using pre- and postoperative weight assessments of surgical materials. Operative time was recorded from incision to completion of haemostasis. Data were analysed using t-test, chi-square, mean, and standard deviation.
Results: The study group comprised 53 participants (all age groups and both sexes), and the control group comprised 54 participants. Mean operative time was 58.2 minutes (SD 9.94) in the tranexamic acid group and 63.7 minutes (SD 15) in the control group (P = 0.028). In the study group, the entire cohort achieved haemostasis within 80 minutes, whereas 13 percent of the control group exceeded 80 minutes.
Conclusion:
Preoperative intravenous tranexamic acid reduced operative time and improved haemostasis during tonsillectomy in this cohort. The findings support its use as an adjunct for intraoperative bleeding control.
Recommendation:
Routine use of tranexamic acid can be considered in suitable tonsillectomy candidates to optimise operative efficiency and reduce blood loss
Factors associated with adherence to anti-retroviral therapy among adult males living with hiv in Lira Regional Referral Hospital, Lira City, Northern Uganda. A cross-sectional study.
Get PDFBackground
The use of anti-retroviral therapy (ART) in the management and prevention of HIV/AIDS. This study aims to assess the level of adherence and factors associated with adherence to ART among Adult males living with HIV in Lira Regional Referral Hospital.
Methodology
A cross-sectional study that assessed self-reported treatment adherence among adult males living with HIV who are accessing drugs for the treatment from LRH. Random sampling was employed to select 380 participants, and data were collected using a questionnaire and entered into SPSS software for analysis.
Results
341 respondents were included, 58.7% aged between 18 and 30 years, 24% were in the range of 31-45 years, 17.0% between 46 and 60 years, and a mere 0.3% aged 61years and above. Non-adherence to ART was perceived to result from individual factors such as forgetfulness, alcohol abuse, disclosure, knowledge about HIV and its treatment, among others, and health system-related factors such as distance to the health facility, waiting time at the facility, relationship with the healthcare provider, and privacy, among others. Most respondents (49.9%) take one pill daily, with 31.7% taking two pills, 18.2% taking more than two, and 0.3% not taking any pills. Weekly adherence data showed that 39.0% never miss a dose, while others miss one (23.5%), two (20.5%), or more than two doses (17.0%) per week. This results in 43.1% of respondents having good weekly adherence and 56.9% having poor adherence. Monthly adherence reveals that 37.5% never miss a dose, but 4.1% miss one dose, 15.5% miss two doses, and 42.8% miss more than two doses, leading to 46.9% good adherence and 53.1% poor adherence monthly.
Conclusion
Non-adherence to ART was attributed to 48 various factors, such as alcohol consumption, forgetfulness, and stigma.
Recommendation
Healthcare providers should minimize waiting times in healthcare facilities to improve adherence
Epidemiological Profile and Prevalence of Hyponatremia in Pulmonary Tuberculosis: A Cross-Sectional Study from Rajasthan, India”: prevalance of hyponatremia in TB
No full textBackground:
Hyponatremia is one of the most common electrolyte disturbances seen in hospitalized pulmonary tuberculosis (PTB) patients and may reflect disease severity. Indian data are limited, particularly from high-burden states such as Rajasthan.
Objectives:
To determine the prevalence and severity of hyponatremia in newly diagnosed sputum smear–positive pulmonary tuberculosis patients and to describe their demographic and clinical profile.
Methods:
This descriptive cross-sectional study was conducted in the Department of Respiratory Medicine, Institute of Respiratory Diseases, S.M.S. Medical College, Jaipur, Rajasthan. A total of 140 newly diagnosed sputum smear–positive PTB patients were included over one year. Serum sodium levels were measured at diagnosis and categorized as mild (130–134 mmol/L), moderate (125–129 mmol/L), and severe (<125 mmol/L). Sociodemographic and clinical parameters were recorded and analyzed.
Results:
The prevalence of hyponatremia (<135 mmol/L) was 45%. Severe hyponatremia was seen in 10%, moderate in 14%, and mild in 21% of patients. Most participants were aged 41–60 years (53.6%), male (80.7%), and from rural areas (90%). A statistically significant association was observed between serum sodium and age group (p = 0.00001), gender (p = 3.35×10⁻⁵), BMI (p = 6.22×10⁻⁴), occupation (p = 2.36×10⁻⁴), chest X-ray findings (p = 6.12×10⁻⁴), and sputum AFB grading (p = 0.02).
Conclusion:
Hyponatremia is highly prevalent in PTB patients, particularly among females, underweight individuals, and those with advanced radiological and bacteriological disease. Routine sodium monitoring is recommended for early detection and manage
Can initial apparent diffusion coefficient and tumour volume predict future metastases in treatment-naive patients with laryngeal squamous cell carcinoma. A systematic review.
Get PDFBackground: Laryngeal squamous cell carcinoma (LSCC) represents a significant portion of head and neck malignancies and is associated with a high risk of regional and distant metastasis. Traditional prognostic indicators such as TNM staging and histopathological grading often fail to capture underlying tumour biology. Quantitative MRI parameters, particularly the apparent diffusion coefficient (ADC) and tumour volume (TV), have emerged as non-invasive biomarkers capable of reflecting tumour aggressiveness and potentially predicting metastatic behaviour.
Aim: To evaluate whether pretreatment ADC and tumour volume derived from MRI can reliably predict future metastases in treatment-naïve patients with LSCC.
Methods: This systematic review followed PRISMA 2020 guidelines. A comprehensive search of major biomedical databases identified observational human studies assessing the relationship between MRI-based ADC or tumour volume and metastatic outcomes in treatment-naïve LSCC. Eligible studies included adults with pretreatment MRI and quantifiable imaging parameters. Due to methodological heterogeneity, findings were synthesized qualitatively. Five studies met the inclusion criteria.
Results & Discussion: Across the five reviewed studies, lower pretreatment ADC values consistently correlated with higher tumour cellularity, increased biological aggressiveness, and greater likelihood of metastasis. Larger tumour volumes were also strongly associated with increased disease burden and higher metastatic risk. Studies that combined ADC and TV demonstrated the highest predictive accuracy, highlighting the complementary value of integrating microstructural (ADC) and morphological (TV) tumour characteristics.
Conclusion: Pretreatment ADC and tumour volume show strong potential as non-invasive MRI-based biomarkers for predicting metastasis in LSCC. Their combined assessment may improve early risk stratification, guide treatment planning, and optimize follow-up. Standardized imaging protocols and prospective multicentre studies are required to validate these findings.
Level of Evidence: Level III (Systematic review of observational prognostic studies)
Effectiveness of intermittent fasting for weight loss in obese individuals: A randomized controlled trial.
Get PDFBackground:Obesity remains a major public health concern globally, with lifestyle modification forming the cornerstone of management. This randomized clinical trial evaluated the impact of intermittent fasting on weight reduction and metabolic parameters in obese individuals.
Methods:Sixty obese adults were randomly assigned to either an Intermittent Fasting (IF) group (n=30) or a Standard Calorie Restriction (SCR) group (n=30) for eight weeks. The IF group followed a 16:8 fasting schedule, while the SCR group reduced daily caloric intake by approximately 20%. Anthropometric measurements (weight, BMI, waist circumference, body fat percentage) and biochemical parameters (fasting glucose and lipid profile) were recorded at baseline and at the end of the study. Adherence and tolerability were monitored throughout the trial. Statistical comparison between groups was performed, and significance was set at p < 0.05.
Results:Baseline characteristics were similar across groups (Table 1). The IF group achieved greater weight loss (−4.1 ± 2.1 kg) compared to the SCR group (−2.7 ± 1.9 kg), with statistically significant differences (p=0.012). Reductions in BMI, waist circumference, and body fat percentage were also more pronounced in the IF group (Table 2). Improvements in fasting glucose (−7.2 ± 9.1 mg/dL vs. −3.1 ± 8.7 mg/dL; p=0.041) and triglyceride levels (p=0.048) were observed with IF, while changes in total cholesterol and LDL-C were modest in both groups (Table 3). Adherence was satisfactory, and no serious adverse events occurred (Table 4).
Conclusion:Intermittent fasting demonstrated superior benefits in weight reduction and selected metabolic markers compared to standard calorie restriction over eight weeks. It was well-tolerated and feasible for regular clinical practice.
Recommendations:Intermittent fasting may be considered a structured dietary intervention for weight management in obese adults. Long-term studies are recommended to assess sustained outcomes and adherence patterns
A CONTRIBUTION OF FINANCIAL LITERACY ON FINANCIAL MANAGEMENT AMONG PERSONS WITH DISABILITY: FINANCIAL MANAGEMENT AMONG PERSONS WITH DISABILITY
No full textPersons with Disabilities (PwDs) face significant challenges in financial management, including low revenue generation, poor cost control techniques, and limited profitability and sustainability of their projects. These challenges are often linked to a lack of financial literacy, which hampers effective operational strategies. This study aimed to address the gap in empirical evidence by examining the contribution of financial literacy to the financial management of PwDs, focusing on VSLA group beneficiaries in Magale Sub-county, Namisindwa district. Specifically, it explored the impact of budgeting literacy, savings literacy, and debt management literacy on financial management.
Using a Convergent Parallel design, the study combined quantitative and qualitative methods to collect data from 127 respondents, including VSLA beneficiaries, project management committees, and district officials. Stratified random sampling and purposive sampling techniques were employed. Data analysis involved descriptive statistics and Pearson Correlation coefficients.
Findings revealed a strong positive relationship between financial literacy components—budgeting, saving, and debt management—and improved financial management among PwDs and their caretakers. The study concluded that enhancing these aspects significantly improves financial outcomes. It recommended strengthening financial literacy training and ensuring the sustainability of models like VSLA through increased funding and technical support. Further research was suggested to develop frameworks for model sustainability
MEDICAL SOLID WASTE MANAGEMENT IN KAKE INTEGRATED HEALTH CENTRE II.
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Medical solid waste management is a critical aspect of healthcare delivery that requires urgent attention worldwide. The generation of medical waste poses significant risks to human health and the environment. This review examines the types of medical solid waste generated in healthcare facilities, the challenges associated with its management, and the importance of proper waste disposal practices.
Results.
The findings highlight the lack of knowledge and inadequate equipment among healthcare personnel, leading to poor waste management practices. Insufficient training contributes to the improper treatment and disposal of medical waste, resulting in environmental contamination and the spread of diseases. Financial considerations and institutional factors, including the availability of guidelines and policies, also impact waste management systems. Developing countries face greater challenges in managing medical waste due to limited resources and knowledge.
Conclusion.
The review emphasizes the need for comprehensive training programs, allocation of sufficient funds, and the implementation of effective policies to improve waste management practices. Furthermore, the review underscores the importance of raising awareness, providing education, and establishing proper waste management systems to minimize the health and environmental risks associated with medical solid waste.
Recommendation.
Urgent interventions are necessary to mitigate the risks and promote sustainable waste management practices in healthcare facilities
A MIXED COHORT STUDY ON DIETARY ADHERENCE, INFECTION PREVENTION, AND GLYCEMIC CONTROL AMONG DIABETIC PATIENTS IN SOUTH KIVU, EASTERN DEMOCRATIC REPUBLIC OF THE CONGO.
Get PDFBackground
Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body does not use it effectively. A well-adapted diet is essential to stabilize blood glucose levels and prevent complications such as hyperglycaemia and infections. However, adherence to this diet is often compromised by socio-economic factors, limiting access to balanced nutrition and healthcare. This study aims to evaluate the impact of dietary adherence on diabetes management, focusing on infection prevention and glycaemic control.
Materials and Method
A longitudinal study (2020-2024) in South Kivu (Bukavu, Mwenga, Walungu) followed diabetic patients. After informed consent, data was collected through medical records and structured interviews using standardized forms. Statistical analyses, including chi-square tests and logistic regressions, were performed using Jamovi software.
Results
Among 1520 patients, 59.3% of those with stable blood glucose levels adhered to the diet, with an infection rate of 56.8%, compared to 81.9% for non-adherent patients. Among patients with unstable blood glucose levels, 16.5% adhered to the diet, with an infection rate of 27.2%, compared to 98.1% among non-adherent patients. Non-adherence was associated with a higher risk of infection (OR = 7.84), hyperglycaemia (OR: 4.6), hospitalisation (OR = 2.03), and comorbidities (OR = 4.8).
Conclusion
Dietary adherence plays a crucial role in diabetes management by reducing infections and improving glycaemic control.
Recommendations
However, socioeconomic constraints have a significant impact on adherence. Strengthening nutrition education and improving access to healthcare, especially in rural areas, are essential strategies to optimize diabetes management and reduce associated complications