Student's Journal of Health Research Africa
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Association between maternal vitamin D levels and the risk of gestational diabetes mellitus: A case-control study.
Get PDFBackgroundVitamin D deficiency has emerged as a potential risk factor for gestational diabetes mellitus (GDM), supported by evidence of its role in insulin sensitivity and glucose metabolism.
Objectives: To compare serum 25-hydroxyvitamin D [25(OH)D] levels between pregnant women with and without GDM, and to assess the association between vitamin D status and glycemic control.
MethodsA hospital-based case-control observational study was conducted in the Department of Obstetrics and Gynaecology, Narayan Medical College, Sasaram, from December 2023 to December 2024. The study included 200 third-trimester pregnant women—100 with GDM (Group A) and 100 with normal glucose tolerance (Group B). Demographic, lifestyle, and biochemical data were collected. Serum 25(OH)D and HbA1c levels were measured using chemiluminescence immunoassay. Statistical analysis included t-tests and chi-square tests, with p<0.05 considered significant.
ResultsMean serum vitamin D levels were significantly lower in the GDM group (10.15 ± 5.85 ng/mL) than in controls (19.22 ± 7.34 ng/mL; p<0.001). Vitamin D deficiency was more prevalent among GDM cases (90.0%) compared to controls (60.0%; p<0.001). HbA1c and fasting blood glucose levels were significantly higher in GDM patients (p<0.001). An inverse correlation was observed between serum vitamin D and HbA1c. No significant differences were noted in maternal age, diet, or family history of diabetes (p= 0.21, 0.63, 0.60), whereas prior GDM and low sunlight exposure were significantly associated with GDM ( p<0.01)
ConclusionLow maternal serum vitamin D levels are significantly associated with GDM and poor glycemic control, indicating a potential role in its pathogenesis.
RecommendationsRoutine screening of serum 25(OH)D levels during antenatal care is advised, particularly for women at high risk of GDM. Vitamin D supplementation under medical supervision may help reduce GDM risk and improve glycemic outcomes
Factors influencing the occurrence of urinary tract infections in girls aged 14-19 years attending Wera seed secondary school, Wera sub county Amuria district. A cross-sectional study.
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Urinary Tract Infections are more common in females due to their shorter urethra, which allows easier entry of bacteria into the urinary system. This study was to assess factors influencing the occurrence of urinary tract infections among girls aged 14 to 19 years attending Wera Seed Secondary School in Wera Sub-County, Amuria District.
Methods
A descriptive Cross-sectional study design employing a quantitative research method was used to obtain data from a sample size of 40 girls aged 14 to 19 years in a duration of four days, sampled using a simple random sampling technique. A structured questionnaire was used, the data collected was analyzed, and findings were entered into Microsoft Excel 2013, then presented in tables and pie-charts.
Results
Among the 40 participants sampled, more than half (57.5%) of the respondents were aged 14–15 years, and 62.5% lived in rural areas. On adolescent-related factors, most (77%) always delayed urination due to embarrassment, more than half (55%) used homemade hygiene products, nearly half (45%) wore tight clothes, and most (70%) reported that their parents were not involved in guiding them on proper hygiene practices. Concerning School-related factors, almost all (92.5%) delayed urination due to school rules or activities, and (73%) sometimes had access to clean and private toilets at school.
Conclusion
The study found that the majority of the girls frequently delayed urination due to embarrassment and used homemade hygiene products.
Recommendation
There is a need to deploy health workers to regularly sensitize students on proper hygiene and the dangers of reusing sanitary materials or delaying urination
Factors influencing the utilization of guidance and counseling services among health training students at Mildmay Uganda School of Nursing and Midwifery. A cross-sectional study.
Get PDFBackground:
In Uganda, 41% of health training students do not access structured counseling services during their study period. The purpose of the study was to assess the factors influencing the utilization of Guidance and Counseling Services among health training students at Mildmay, Uganda.
Methods.
A descriptive cross-sectional study design was used, employing quantitative methods of data collection, conducted in Mildmay Uganda School of Nursing and Midwifery. In 6 days, 90 students were selected using simple Stratified random sampling. A structured questionnaire was used to collect data, and it involved closed-ended questions. The data collected was analyzed manually, and after the findings were entered into a Microsoft Excel 2013, which was then presented in the form of tables, pie-charts, and graphs.
Results.
The majority (61%) were females, and 89% were single. 56% felt uncomfortable seeking them, 51% lacked peer support, and 56% were hindered by school work. Institutionally, 73% noted a shortage of counselors, 67% said the school did not actively promote counseling, 42% indicated inflexible counseling schedules, 46% acknowledged supportive leadership, and 100% stated that counseling was weakly integrated into academic programs.
Conclusion.
Despite high awareness of guidance and counseling services, their utilization among health training students was limited due to personal discomfort, lack of peer support, institutional constraints, and inadequate promotion and accessibility.
Recommendation.
The institution should strengthen the promotion, accessibility, and confidentiality of guidance and counseling services to enhance their utilization by students
Leadership, conflict, and pedagogy: Examining the role of management in mitigating academic disagreements that affect learning – A qualitative case study design.
Get PDFBackgroundConflict among academic staff is an inevitable part of university life, often arising from competing priorities, power dynamics, and differing pedagogical philosophies. When unresolved, such conflicts can negatively affect collaboration, morale, and ultimately the student learning experience. Leadership and departmental management play a crucial role in either exacerbating or resolving these tensions. This study explores how university leadership intervenes in academic disputes and assesses the impact of these conflicts on teaching and learning within a South African university department.
MethodsA qualitative case study design was employed. Data were collected through in-depth, semi-structured interviews with 12 academic staff members and 3 faculty managers at a mid-sized South African university. Participants were selected using purposive sampling based on their involvement in or exposure to departmental conflicts. Thematic analysis was conducted following Braun and Clarke’s framework to identify patterns related to leadership, conflict management, and pedagogical disruption.
ResultsThree dominant themes emerged: (1) Leadership Silence and Avoidance, where managers failed to address conflicts early, allowing them to escalate; (2) Pedagogical Disruption, where conflicts led to breakdowns in team teaching and inconsistent student engagement; and (3) Restorative Leadership Practices, where inclusive dialogue, mediation, and clear role boundaries helped restore collaboration. Staff widely agreed that unresolved conflicts affected curriculum coherence, delayed marking, and confused students about academic expectations. Managers who engaged proactively in transparent conflict resolution were credited with improving departmental cohesion and restoring trust.
ConclusionLeadership plays a decisive role in managing academic disagreements. Silence or inaction reinforces division, while proactive, inclusive leadership promotes a healthier departmental culture and supports student learning.
RecommendationsUniversities should train academic managers in conflict resolution and implement early-intervention frameworks. Clear communication protocols, mediation practices, and regular reflection spaces should be institutionalized to foster an environment where disagreement does not compromise pedagogy
Factors contributing to the prevalence of sexually transmitted diseases among youth in Nansana Town Council, Wakiso District. A cross-sectional study.
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In Uganda, STDs remain a pressing public health issue among the youth, with an estimated prevalence of 49% among youth. This study aimed to assess the factors contributing to the prevalence of sexually transmitted diseases (STDs) among youths in Nansana Town Council, Wakiso District.
Methods
A descriptive cross-sectional study design was employed, utilizing quantitative methods for data collection. Over 8 days, 72 youth were selected using a simple random sampling method. A structured questionnaire was used to collect data, and it involved closed-ended questions. The data collected was analyzed manually, and after the findings were entered into a Microsoft Excel 2013, that was then presented in the form of tables, pie charts, and graphs.
Results
Out of the 72 participants sampled, more than half (52.8%) were aged between 24 and 29 years, and half (50%) had attained secondary level education. Individual factors, more than half (51.4%) had two sexual partners, more than half (54.2%) never used condoms during sexual activity, and nearly half (48.6%) engaged in sexual activity after alcohol use a few times. Concerning Health facility factors, more than half (59.7%) disagreed that health workers are always present, more than half (59.7%) strongly disagreed that recommended drugs were readily available, and most (66.7%) disagreed that health facilities are close to their homes. About social and cultural factors, half (50%) stated that their partners encouraged sexual behavior, and 77.8% indicated that talking about sex and STDs was considered taboo.
Conclusion
The prevalence of STDs was attributed to multiple sexual partners, occasional sex under the influence of alcohol, and low condom use.
Recommendation
There is a need to enhance public health education through continuous community sensitization campaigns on the importance of consistent condom use, STD testing, and the risks associated with multiple sexual partners and alcohol-influenced sexual activity
Monitoring the technique of instillation of topical drops in the eye by the healthcare personnel in the Department of Ophthalmology of a tertiary care hospital: A cross-sectional study.
Get PDFBackgroundCorrect instillation of eye drops is critical for achieving the desired therapeutic effects in ophthalmic care. The patient should also be informed about the technique for instilling drops in the eyes to achieve optimal results.
Aim: To assess the technique of instillation of topical drops by the healthcare personnel in the department of Ophthalmology of a tertiary care hospital
MethodThis is a hospital-based, cross-sectional, observational study conducted over 6 months involving 180 healthcare personnel, including junior residents, medical interns, optometry interns, and nursing students. A self-structured checklist was used to assess the protocol followed while using eye drops, and the observation was recorded. The ophthalmic personnel were then taught to rectify the lacunae, and the assessment was repeated.
ResultsAmong 180 ophthalmic personnel observed, only 56 subjects adhered to the correct instillation technique at first assessment. This number improved to 141 after proper training. Among junior residents (n=15), correct technique improved from 9 at presentation to 15 post-training, with a statistically significant p-value of 0.02. MBBS interns (n=140) demonstrated a marked improvement from 38 to 106, yielding a highly significant p-value of 1.14 × 10⁻¹⁵. Optometrist interns (n=15) also showed significant improvement, with correct technique increasing from 6 students to 12 students (p=0.034). Although nursing staff (n=10) improved from 3 to 8 following training, the p-value of 0.059.
Conclusion
This study revealed the significance of monitoring the technique of instillation of drops among ophthalmic personnel. Proper audit and counselling help in inculcating the correct practice among healthcare personnel and patients.
Recommendations
This study highlights the need for ongoing monitoring and training of the healthcare team, ensuring strict adherence to standard guidelines for the instillation of topical eyedrops
Effectiveness and safety of add-on antidiabetic therapies to metformin in type 2 diabetes mellitus patients of south odisha population: A prospective observational cohort study.
Get PDFBackground
Type 2 Diabetes Mellitus (T2DM) is a growing public health concern in India, particularly in resource-limited regions like South Odisha. While metformin remains the first-line therapy, combination regimens are often required for sustained glycemic control. However, real-world comparative data on the effectiveness and safety of such add-on therapies remain limited.
Objective
To assess the effectiveness and safety of various oral antidiabetic add-on regimens to metformin in T2DM patients attending a tertiary care center in South Odisha.
Methods
This prospective observational cohort study followed 289 patients (of 323 enrolled) over 9 months at MKCG Medical College, Berhampur. Patients were assessed at baseline, 3, 6, and 9 months for glycemic parameters, renal and lipid profiles, adverse drug reactions (ADRs), and health-related quality of life (HRQoL) using the WHO-5 Wellbeing Index.Statistical analysis was performed using SPSS v22.0 with significance set at p<0.05.
Results
The mean age of participants was 48.8 ± 15.5 years; 51% were male. Most were overweight or obese (66.7%) and 61.6% lived in rural areas. All add-on regimens showed significant reductions in FPG, PPPG, and HbA1c compared to metformin monotherapy (p < 0.05). DPP-4 inhibitor–based regimens (teneligliptin/vildagliptin) produced the greatest improvements in glycemic and lipid parameters (↓ triglycerides, LDL, VLDL; ↑ HDL). Renal and electrolyte values remained stable across groups. ADRs were reported in 157 patients, with hypoglycemia (19.7%) being most frequent, mainly linked to glimepiride. HRQoL scores improved significantly across all add-on groups compared to metformin alone.
Conclusion
Combination therapies, especially those including DPP-4 inhibitors, offer superior glycemic and lipid control with acceptable safety and improved quality of life in South Odisha T2DM patients.
Recommendations
Clinicians should consider DPP-4 inhibitor-based combinations for optimal outcomes in T2DM management. Further multicentre, randomized controlled trials with longer follow-up and inclusion of newer agents are recommended to strengthen the evidence base
Prevalence and associated factors of underweight among children aged 06-59 months living in the slum areas of Mbarara city, Uganda: A cross-sectional study.
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Undernutrition among children aged 6-59 months remains a public health concern posing a major challenge in achieving Sustainable Development Goal 2.2. Despite considerable efforts to quantify the burden of stunting and wasting, little attention has been paid to underweight. Moreover, children living in slum areas and poor households are significantly affected by underweight. This study aimed to determine the prevalence of underweight and associated factors among children aged 6-59 months living within the slum areas of Mbarara city.
Methods
This was a cross-sectional study done within the slum areas of Mbarara city among children aged 6-59 months and their caregivers. Proportionate probability sampling and simple random sampling were used to select 532 households with potential participants within the slum areas. Interviews were done using a researcher-administered questionnaire, and anthropometric measurements of children were taken using a digital weighing scale. Data was analyzed using Stata version 17. Associated factors were determined using a modified Poisson regression model.
Results
The prevalence of underweight was 8.3%.
Child’s age 12-23 months (APR=2.6; 95% CI: 1.2-5.6) and multiple pregnancy (APR=2.7; 95% CI: 1.4-5) were independently associated with underweight. Children aged 12-23 months were 2.6 times more likely to be underweight than those aged 6-11 months. Additionally, children born to multiple pregnancies were 2.7 times more likely to be underweight than those from singleton pregnancies.
Conclusions
Underweight among children living within the slum areas of Mbarara city is still a public health problem, with about 1 in 10 children underweight. Child’s age 12-23 months and multiple pregnancy were the associated factors.
Recommendation
The study recommends health education for child caregivers on optimal child feeding practices, particularly for children aged 12-23 months and those born to multiple pregnancies
The neurological and epigenetic basis of psychosomatic pain: A narrative review.
Get PDFPsychosomatic disorders, which were once dismissed as "all in the mind," are now understood through an integrated biopsychosocial models that bridge the gap between psychological stress and physiological dysfunction of the body. This narrative review synthesizes current research to unravel the mechanisms of underlying psychosomatic pain and its neurological implications. Epidemiological data highlight the widespread prevalence of these disorders globally, particularly in adolescents and high-risk adult populations, which are the ones with significant comorbidities like depression, anxiety, and chronic pain syndromes like fibromyalgia.
The core of this paradigm shift lies in the emergence and integration of epigenetics, which demonstrates how chronic stress and trauma can induce stable, long-term changes in gene expression without altering the DNA sequence. Specifically, epigenetic modifications, such as DNA methylation of genes like FKBP5, NR3C1, and BDNF, are shown to dysregulate the hypothalamic-pituitary-adrenal (HPA) axis, heighten inflammatory responses, and impair neuroplasticity, thereby embedding psychological distress into a physical, somatic reality.
Neurological investigations, particularly using functional neuroimaging, reveal that these disorders are not fabricated but are rooted in aberrant neural circuitry. Conditions like functional neurological disorder (FND) are characterized by disrupted connectivity between emotion-processing centers (e.g., the amygdala) and sensorimotor pathways, leading to involuntary physical symptoms. The clinical features of these disorders are multifaceted, marked by a heightened focus on bodily sensations, negative healthcare experiences, and significant functional impairment.
Evolving beyond traditional methods, psychosomatic disorder treatment is now integrative and personalized. New approaches combine CBT with novel therapies like non-invasive brain stimulation, neurofeedback, and pharmacogenomics.
 
A CROSS-SECTIONAL STUDY ON PATIENTS AND HEALTH FACILITY CHALLENGES FACED BY FRONTLINE NURSE MANAGERS DURING THE COVID-19 PANDEMIC AT KAWEMPE NATIONAL REFERRAL HOSPITAL, KAMPALA DISTRICT.
Get PDFBackground.
Healthcare workers' health, well-being, and safety are paramount to a functioning healthcare system and to ensuring patient safety. Consequently, it is necessary to mitigate risks on multiple levels. This study determined the challenges faced by frontline nurse managers during the COVID-19 pandemic at Kawempe National Referral Hospital, Kampala District.
Methodology.
A descriptive cross-sectional study design and quantitative data collection method was used, 30 respondents were selected using convenience sampling procedure. Data was collected using questionnaires. Data was analyzed using excel data base and the results were presented inform of figures and tables.
Results
20 (66.7%) of the respondents were Midwives, and 18 (60%) of the respondents had 5 years or more of experience. 21 (70%) reported poor health-seeking behavior of patients due to fear of COVID-19 infection from hospitals, 30 (100%) reported patients’ failure to adhere to recommendations, and 30 (100%) reported lack of appreciation from patients and community members. Facility-related challenges included; 30 (100%) of participants reported, increased exposure to highly contagious, life-threatening infections, 18 (60%) reported a lack of support, supervision, and monitoring, 30 (100%) reported a lack of resources such as oxygen, 30 (100%) reported lack of equipment such as beds to handle the number of patients and 25 (83.3%) reported excessive job demands as well as heavy workload.
Conclusion.
The established patients and health facility-related challenges included; poor health-seeking behavior of patients due to fear of covid 19 infection from hospitals, lack of appreciation from patients and community members, increased exposure to highly contagious, life-threatening infections, and lack of support, supervision, and monitoring.
Recommendations.
The administration of Kawempe National Referral Hospital should endeavor to provide all the required resources, such as beds, PPE, and equipment, to ensure the provision of high-quality, efficient services