European Journal of Medical and Health Research
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The Teleological Fallacy in Microbiome-Cancer Research
No full textThe discovery of tumor-associated microbes like Fusobacterium nucleatum has led to striking descriptions of bacteria "exploiting" tumors or "evolving to promote cancer" a language that smuggles in teleological assumptions about purpose in evolution. This paper interrogated such narratives through Gould and Lewontin's critique of adaptationism and Dennett's concept of the intentional stance, asking whether microbiologists risk conflating selected effects with goal-directed behavior. Through discourse analysis of 20 key oncology papers (2015-2024) and two case studies (F. nucleatum's immune- suppressing Fap2 protein and colibactin-producing E. coli), the study found that 65% of studies employ teleological language without evidence of bacterial intent. These metaphors as a finding, while heuristically useful, may obscure the complex evolutionary pressures shaping microbial traits in tumors. The paper recommended replacing purpose-laden terms like "oncobiont" with mechanistic descriptions ("trait X enhances persistence in niche Y") and designing experiments that distinguish true adaptation from exaptation in tumor microbiomes
Morbus Bowen in the Os Pubis Region: Dermatosurgery as Treatment Choice
No full textMorbus Bowen also known as squamous cell carcinoma in situ, is a disease which is characterised by abnormal squamous cells within the epidermis whilst the basement membrane stays intact. Higher prevalence is shown in older age groups and individuals with higher sun exposure. If left untreated the disease could progress into invasive squamous cell carcinoma, which could lead to local tissue destruction and perineural invasion. We report a case of a 53-year-old male presenting with a reddish plaque in the right inguinal area. Routine investigation determined the patient to have Bowen’s disease. Dermatosurgical management was deemed the best option with the benefits greatly outweighing the risks in comparison to other therapies. Surgical intervention proved to be successful showing no complications. This case highlights the efficacy of dermatosurgical management for perigenital Bowen’s disease and underscores the importance of early diagnosis and individualized treatment planning
Early vs. Delayed Cholecystectomy in Acute Biliary Pancreatitis: Impact on Recurrent Attacks
No full textBackground: Acute biliary pancreatitis (ABP), traditionally regarded as a condition predominantly affecting adults, is increasingly recognized in pediatric and adolescent populations, particularly in low- and middle-income countries undergoing epidemiologic transitions in biliary disease. Gallstone- induced obstruction of the common bile duct or pancreatic duct remains the principal etiology. Delayed definitive surgical management specifically cholecystectomy is associated with high recurrence rates. However, the optimal timing of cholecystectomy remains contentious, especially within resource-constrained health systems such as Iraq’s, where structural limitations including restricted surgical capacity, fragmented referral pathways, and limited caregiver health literacy frequently delay intervention beyond evidence-based recommendations. Objective: This study aimed to compare the incidence of recurrent pancreatitis and other biliary-related complications between pediatric and adolescent patients (aged 6–18 years) with mild-to-moderate ABP who underwent early (≤72 hours from symptom onset or diagnosis) versus delayed (>6 weeks) cholecystectomy. Additionally, we assessed system-level factors contributing to surgical delays and their impact on healthcare utilization. Methods: A prospective cohort study was conducted at Al- Zahra Teaching Hospital from January 2021 to September 2024. Patients diagnosed with mild-to-moderate ABP according to the Revised Atlanta Classification were enrolled and stratified into two groups: Group E (early cholecystectomy within 72 hours; n = 58) and Group D (delayed cholecystectomy beyond 6 weeks; n = 54). The primary outcome was 90-day readmission due to recurrent pancreatitis. Secondary outcomes included cumulative hospital length of stay (initial admission plus readmissions), 30- and 90-day all-cause readmission rates, intraoperative and postoperative complications (classified per Clavien-Dindo), and health system-related causes of surgical delay. Results: Of 112 eligible patients, Group E demonstrated a significantly lower recurrence rate of pancreatitis (2 patients, 3.4%) compared to Group D (13 patients, 24.1%; p < 0.001). Although the median initial hospital stay was slightly longer in Group E (4.2 vs. 3.1 days; p = 0.012), the total cumulative hospitalization including readmissions was markedly reduced (1.1 vs. 5.8 days; p = 0.001). No statistically significant difference was observed in surgical complication rates (5.2% vs. 3.7%; p = 0.71). System-level barriers including weekday-only operating room availability, absence of surgical teams on weekends, and delayed referrals from primary care accounted for 74% of all delayed procedures. Conclusion: Early cholecystectomy within 72 hours of ABP diagnosis in pediatric and adolescent patients is associated with a substantial reduction in pancreatitis recurrence and overall healthcare utilization, despite a modest increase in initial hospital stay. These findings underscore the urgent need to strengthen surgical capacity at secondary-level hospitals in Iraq to ensure timely definitive care. Aligning such system improvements with Sustainable Development Goal 3 (Good Health and Well-being) offers a strategic framework to reduce preventable morbidity and promote equitable access to essential surgical services in resource- limited settings
Impact of Video Assisted Teaching on Knowledge Regarding Infection Control among 2nd Year GNM Students in Smt. Nagarathnamma College of Nursing, Bangalore
No full textInfection control addresses the spread of infections within healthcare settings, including between patients, from patients to staff, from staff to patients, and between staff. Preventive measures include hand washing, cleaning, disinfecting, sterilizing and vaccinating. Infection control is the discipline concerned with preventing nosocomial or healthcare-associated infections. It is a practical subdiscipline of epidemiology and is vital, although often not supported or recognized as part of healthcare. Hospital-acquired infection (HAI) is a major global safety concern for patients and healthcare professionals alike. Many factors stimulate infection among hospitalized patients, including decreased resistance. The increasing variety of medical procedures and invasive techniques creates potential sources of infection, and drug-resistant bacteria are transmitted among the hospital population where poor infection control practices may facilitate this
A Study to Assess the Effectiveness of a Structured Teaching Program on Prevention of Needle Stick Injuries among Nursing Students
No full textNeedle stick injuries are a major occupational hazard among nursing
students, predisposing them to serious blood-borne infections such as HIV, hepatitis B, and hepatitis C. This study was conducted to evaluate the effectiveness of a Structured Teaching Program (STP) on knowledge regarding prevention of needle stick injuries among nursing students. A quasi-experimental one-group pre-test post-test design was adopted. The study was carried out at a selected college of nursing in Bengaluru with a sample of 40 first-year nursing students, selected through purposive sampling. A structured knowledge questionnaire consisting of 40 multiple- choice questions was used to assess knowledge, and its validity was established by subject experts. A pre-test was conducted, followed by the STP intervention, and a post-test was administered after 7 days. Pre-test findings revealed that 55% of students had inadequate knowledge, 40% had moderate knowledge, and only 5% had high knowledge (mean score: 19.35 ± 4.8; 54.2%). Post-test results demonstrated a significant improvement, with 75% of students achieving high knowledge and 25% moderate knowledge (mean score: 32 ± 2.7; 80%). The paired t-test value (t = 32.04, p < 0.0001) confirmed a statistically significant improvement in knowledge after the intervention. Chi-square test revealed no significant association between knowledge scores and selected demographic variables. The study concludes that the STP was highly effective in improving nursing students’ knowledge regarding prevention of needle stick injuries and highlights the importance of incorporating structured health education into nursing curricula
A Study to Access the Level of Homesickness among the 1st Year GNM Nursing Students at Smt. Nagarathnamma School of Nursing in Bangalore, Karnataka
No full textHomesickness is a common psychological challenge among students transitioning to hostel life, with potential consequences on emotional well- being and academic engagement. First-year General Nursing and Midwifery (GNM) students are particularly vulnerable due to simultaneous adjustment to academic and clinical demands. This descriptive cross-sectional study assessed the prevalence, contributing factors, and coping strategies of homesickness among first-year GNM students in selected nursing colleges of Bangalore. Findings revealed that 55% of respondents were aged 18–25, with 58.3% reporting frequent loneliness, 50% missing family and friends, 58.4% experiencing difficulty adjusting to the new environment, and 40% feeling disconnected from family support. Coping strategies included regular communication with family and friends (96.7%) and seeking counseling support (61.7%), while fewer relied on social events (30%) or hobbies (15%). Academic impact was reflected in 68.3% experiencing poor concentration, 65% feeling overwhelmed, and 56.7% missing classes. The study highlights the need for institutional counseling and peer-support initiatives
A Study to Assess the Effectiveness of Structured Teaching Program on Knowledge Regarding Social Anxiety Disorder among Adolescents in Selected High School in Udupi
No full textA research study was conducted to evaluate the effectiveness of structured
teaching programme on knowledge regarding social anxiety disorder among adolescents, with the objectives to To assess the knowledge regarding social anxiety disorder among adolescents in selected high school. To evaluate the effectiveness of structured teaching program regarding social anxiety disorder among adolescents by comparing with pre-test and post-test knowledge score. To determine the association between pre-test knowledge score of adolescents regarding social anxiety disorder and selected demographic variables. The study was carried out at selected high school in Udupi using a pre-experimental one group pre-test post-test design. A total of 60 students were selected through convenient sampling technique. Data was collected using a self-structured questionnaire focusing on social anxiety disorder. The result indicated that the mean percentage of post-test knowledge score (69.3%) was higher than the mean percentage of pre-test knowledge score (40.33%). The calculated ‘t’ value showed a significant difference between mean pre and post-test knowledge scores.Calculated χ 2 values are showed significantly associated between the respondents age group(χ2=6.46),gender(χ2= 5.19), place of residence (χ2= 4.80), previous knowledge (χ2 =5.83), source of information on social anxiety disorder(χ2 =7.44) and pre-test knowledge score of the study participants. The study concludes that there was a deficit in knowledge of adolescents before administration of STP. The results indicated that the STP is effectiveness in increasing the knowledge of adolescents on social anxiety disorder
Giant Uterine Fibroid Expelled Through the Cervix: A Case Report and Review of the Literature
No full textBackground: Giant uterine fibroids expelled through the cervix are rare. They usually measure less than 3–4 cm and may cause dyspareunia, menorrhagia, and sometimes infection. They are prone to necrosis or superinfection, and management is essentially surgical. Case Presentation: We report the case of a 45-year-old nulliparous single woman who presented with a large mass expelled through the cervix and exteriorized through the vulva, soft in consistency, bleeding on contact and friction, measuring 35 × 12 cm. She reported pelvic pain and heaviness evolving for one year. MRI suggested a cervical myoma. Vaginal myomectomy was performed. Histology confirmed a leiomyoma. Postoperative course was uneventful. Conclusion: Giant cervical leiomyomas are rare but may present with significant clinical symptoms. MRI plays a crucial role in diagnosis. Surgical removal remains the treatment of choice with good prognosis
Urinary Bladder Echinococcosis Causing Cystitis, Hydatiduria and Bilateral Hydroureteropnephrosis: A Rare Case Report
No full textHydatid disease or cystic echinococcosis is a parasitic zoonosis, caused by larval stages of Echinococcusgranulosus. Hydatid cysts usually affect liver followed by lungs and less commonly spleen, kidney, heart and other otherorgans. Hydatid cysts of urinary bladder is very rare with only few case reports published till now. In a systematic review of literature by Hasan et al., only 7 cases were found of urinary bladder hydatid cyst [1]. We are reporting a case of 65-year-old male, diagnosed to have urinary bladder hydatid cyst by radiological imaging and urine investigations
Immunohistochemical Expression of CDx2, CK20, Ck7 in Carcinoma of Ampulla of Vater: Clinicopathological Study
No full textCarcinoma of the ampulla of Vater (AoV) is an uncommon malignancy characterized by variable clinical behavior and distinct histological subtypes. Differentiating intestinal from pancreatobiliary types is clinically important, but histomorphology alone may be insufficient. Immunohistochemical (IHC) profiling with markers such as cytokeratin 7 (CK7), cytokeratin 20 (CK20), and caudal-type homeobox 2 (CDX2) provides valuable diagnostic and prognostic information. Aim: To assess the immunohistochemical expression of CK7, CK20, and CDX2 in carcinoma of the ampulla of Vater, and to correlate these findings with clinicopathological parameters, including age, histological subtype, tumor grade, and stage. Methods: This retrospective study reviewed 180 histologically confirmed cases of AoV carcinoma diagnosed at the Gastroenterology Teaching Hospital, Medical City, Baghdad, from January 2023 to December 2024. Hematoxylin and eosin slides were re- evaluated for histological classification, and IHC staining for CK7, CK20, and CDX2 was performed on paraffin-embedded tissue blocks. Staining intensity was scored semi-quantitatively (0–3). Results: CK7 was positive in 83.3% of cases and showed significant correlation with older age, male gender, pancreatobiliary subtype, and advanced stage (p < 0.001). CK20 was expressed in 38.9% of cases, predominantly in intestinal and mixed subtypes, and was associated with lower tumor grade and female gender (p < 0.05). CDX2 positivity (38.9%) was significantly linked to intestinal and mixed subtypes, well/moderately differentiated tumors, and older age (p < 0.05). Conclusion: The combined evaluation of CK7, CK20, and CDX2 enhances diagnostic accuracy in AoV carcinoma, distinguishes histological subtypes, and provides prognostic insight, supporting their role in clinical decision- making