Nigerian Postgraduate Medical Journal最新文献

{"title":"Barriers to the Nursing Process in Iraqi Nursing Education and Practice: Cross-sectional Study.","authors":"Mohammed Abdul Kareem Mustafa, Ayad Majid Mousa, Haider Mohammed Majeed","doi":"10.4103/npmj.npmj_442_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_442_25","url":null,"abstract":"<p><strong>Background: </strong>The nursing process is an essential component of nursing practice and education, functioning as a systematic, evidence-based approach to patient care.</p><p><strong>Objectives: </strong>the main objective is to identify and compare the specific barriers faced by faculty, nursing students and nursing managers in implementing the nursing process.</p><p><strong>Materials and methods: </strong>This study employed a descriptive and cross-sectional design to investigate the perceived barriers to the implementation of the nursing process amongst nursing faculty members, undergraduate nursing students and nurses. The study was conducted across a range of governmental and educational institutions located in nine Iraqi provinces. A structured questionnaire was used as the primary data collection tool. It consisted of two parts: (1) demographic information and (2) 15 items assessing perceived barriers to implementing the nursing process using a five-point Likert scale. The data were analysed using the SPSS version 29.</p><p><strong>Results: </strong>the results show that the overall effect level of barriers as perceived by different roles as follows, majority (70%) rated the barriers as having a moderate effect, about 27%-29% considered the effect high, while only a few saw it as low.</p><p><strong>Conclusions: </strong>This study concluded that reveal that the most significant obstacles to implementing the nursing process stem from institutional and administrative short comings, such as inadequate managerial support, lack of standardised documentation systems and unclear policies. Healthcare institutions should establish clear policies, provide adequate staffing and implement standardised tools to facilitate the use of the nursing process.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"474-484"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Digital Therapeutics and Artificial Intelligence in Chronic Disease Management: A Narrative Review.","authors":"Sahil Harihar Shendre, Harshal Mendhe, Sonali Borkar, Nancy Nair","doi":"10.4103/npmj.npmj_142_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_142_25","url":null,"abstract":"<p><strong>Abstract: </strong>We conducted research showing that chronic disease management continued to challenge healthcare systems, payers, and patients. At the same time, digital therapeutics emerged as a promising and potentially transformative approach. They supported better management of long-term conditions, improved patient outcomes, and helped streamline healthcare delivery. We carried out a comprehensive literature search to identify both original reports and reviewed publications. The search covered multiple databases, including Google Scholar and PubMed, and we also gathered relevant information from credible online sources such as the World Health Organization and India's National Crime Records Bureau. Using these findings, the narrative explained how digital therapeutics reshaped chronic disease management by highlighting key benefits, the technologies that enabled these solutions, and the expected impacts on both clinical and economic outcomes. We also discussed the obstacles the sector encountered as it developed, and we considered the future prospects of digital therapeutics in chronic care. In conclusion, digital therapeutics offered personalised care, improved patient engagement and adherence, provided real-time monitoring and feedback, enhanced accessibility and convenience, and were cost-effective in managing chronic disease; however, challenges such as cybersecurity concerns, reliability of data, the digital divide, and a lack of extensive clinical validation needed to be addressed for widespread adoption. While the evidence to date suggested clear clinical and economic promise, realizing that promise required coordinated action stronger clinical trials to build robust evidence, clear regulatory pathways to ensure safety and efficacy, investment in secure interoperable infrastructure, and targeted efforts to close the digital divide so vulnerable populations were not left behind; policymakers, clinicians, payers, and technology developers had to collaborate to translate innovation into equitable, scalable care improvements.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"433-438"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and Validation of an Osteoporosis Risk Prediction Model for Elderly Population based on National Health and Nutrition Examination Survey Data.","authors":"Yonghui Lao, Zhengui Liang, He Ling, Wencai Li, Rongbin Lu","doi":"10.4103/npmj.npmj_441_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_441_25","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is a systemic bone disease characterized by low bone mass and destruction of bone microstructure, which is prone to fractures. It is more common in the elderly. Against the context of global population aging, osteoporotic fractures have become a major public health burden.</p><p><strong>Objective: </strong>To construct and validate a nomogram model for predicting osteoporosis risk in elderly individuals aged ≥60 years based on National Health and Nutrition Examination Survey (NHANES) data.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 3,422 participants aged ≥60 years from the NHANES database (2017-March 2020). Osteoporosis was defined as a dual-energy X-ray absorptiometry (DXA) T-score ≤ -2.5. Demographic characteristics, biochemical indicators, anthropometric measurements, and inflammation-related indices were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of osteoporosis. The dataset was randomly divided into a training set (70%) and a validation set (30%). A nomogram model was then developed and validated using area under the curve (AUC), calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>The results showed that female gender (5.92[3.21,10.91], P < 0.001), age (1.06[1.03,1.09], P < 0.001), height (0.94[0.91,0.96], P < 0.001), BMI(0.97[0.95,1], P = 0.038), drinking history (1.78[1.02,3.12], P = 0.043), history of kidney disease (1.96[1.06,3.62], P = 0.033), previous hypercholesterolemia (1.47[1.03,2.09], P = 0.036), and difficulty falling asleep (1.6 [1.12,2.28], P = 0.010) were independent predictors of osteoporosis in the elderly. The nomogram demonstrated its good discrimination ability with AUC values of 0.806 in the training set and 0.793 in the validation set. Calibration curves showed good agreement between predicted and observed outcomes, and DCA confirmed clinical applicability.</p><p><strong>Conclusion: </strong>This study developed a clinically applicable prediction model to identify elderly individuals at high risk of osteoporosis, aiding early intervention and reducing adverse outcomes.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"485-495"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Primary Healthcare Services by University Students in Marrakech-Safi Region, Morocco: Cross-sectional Study.","authors":"Fatima Ezzahra Khachay, Ouassim Mansoury, Nadia Nouari, Hajar Ouahid, Majda Sebbani, Mohamed Amine, Latifa Adarmouch","doi":"10.4103/npmj.npmj_537_25","DOIUrl":"10.4103/npmj.npmj_537_25","url":null,"abstract":"<p><strong>Background: </strong>The health status of students affects their learning, quality of life and relationships during their academic and personal life. Access to and use of youth-friendly health services by young people is an important issue that should be taken into account by health authorities when providing services to this group.</p><p><strong>Objective: </strong>The objective is to describe the use of primary healthcare (PHC) services by the student population in the Marrakech-Safi region.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted among students enrolled at public universities in the Marrakech-Safi region, Morocco, during the academic year 2023-2024. A self-administered questionnaire was completed by 605 participants. Studied variables included socio-demographic data, student knowledge and use of PHC services.</p><p><strong>Results: </strong>Among the participants, 73.1% were female and the average age of the sample was 22.03 ± 4.7 years old. A proportion of 64.8% [95% confidence interval (60.8%, 68.6%)] of the respondents had used PHC facilities in the past 12 months, with an average of 2.1 ± 1.9 visits, 31% of them were from rural areas. The use of PHC facilities was significantly associated with monthly family income ( P = 0.014) and income-generating activity ( P = 0.033).</p><p><strong>Conclusion: </strong>Improving living conditions broadly, especially the socio-economic conditions of young students, may be a sustainable approach to remedy obstacles linked to access to care, and in particular the use of PHC facilities.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"515-520"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Medical Laboratories in Public Health Surveillance.","authors":"Yugeshwari R Tiwade, Obaid Noman","doi":"10.4103/npmj.npmj_91_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_91_25","url":null,"abstract":"<p><strong>Abstract: </strong>Medical laboratories play a critical role in public health surveillance by providing accurate and timely data for detecting, monitoring and responding to public health threats. This short communication highlights the importance of medical laboratories in disease detection, outbreak management and the continuous monitoring of endemic and emerging health threats. It also discusses the challenges laboratories face in this role and suggests strategies for enhancing their contribution to public health surveillance.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"533-534"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopaedic Implant Surgery or Trauma as a Trigger for Necrobiosis Lipoidica: A Manifestation of an Immunocompromised Cutaneous District?","authors":"Praneet Awake, Laxman Salwe, Atul Dongre","doi":"10.4103/npmj.npmj_104_26","DOIUrl":"10.4103/npmj.npmj_104_26","url":null,"abstract":"<p><strong>Abstract: </strong>Necrobiosis lipoidica (NL) is a rare chronic granulomatous skin disorder most commonly associated with diabetes mellitus, typically presenting in middle-aged women. We report an unusual case of NL in a young, non-diabetic male following orthopedic surgery involving a metallic implant. The patient developed characteristic well demarcated, atrophic, violaceous-brown plaques with violaceous borders localized over shin area of his left lower leg. Histopathological examination confirmed the diagnosis of NL, showing palisading granulomas with necrobiosis and lipid-laden macrophages. Notably, there was no history of diabetes, hypothyroidism, glucose intolerance, or autoimmune disease. This case highlights a rare presentation of NL potentially triggered by local immune dysregulation by trauma, surgery and the presence of a metallic implant. The report underscores the importance of considering NL in the differential diagnosis of persistent postsurgical cutaneous lesions, even in non-diabetic individuals, and raises questions about trauma, implant-related immune dysregulation, or microvascular changes as possible pathophysiological mechanisms.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"546-549"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Isolated Hydrosalpinx Torsion in a Young Female: Diagnostic and Surgical Challenges.","authors":"Manali Bhure, Shubhada Jajoo, Suhas Jajoo","doi":"10.4103/npmj.npmj_198_25","DOIUrl":"10.4103/npmj.npmj_198_25","url":null,"abstract":"<p><strong>Abstract: </strong>Isolated torsion of a hydrosalpinx is an exceptionally rare gynaecological emergency that often presents with vague and non-specific symptoms, leading to delays in diagnosis. Hydrosalpinx is a known predisposing factor for tubal torsion, yet isolated involvement without ovarian pathology is uncommon. We report the case of a 22-year-old woman presenting with acute right lower abdominal pain and vomiting, in whom ultrasonography demonstrated a cystic adnexal lesion distinct from the ovary. Laparoscopic evaluation confirmed isolated torsion of the right hydrosalpinx with necrosis, necessitating salpingectomy. Early laparoscopic intervention enabled prompt recovery and preservation of ovarian function. This case highlights the importance of maintaining a high index of suspicion for isolated tubal torsion in reproductive-aged women presenting with acute pelvic pain.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"543-545"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Binswanger's Disease: A Diagnostic Challenge in a Middle-aged Male.","authors":"Mohd Faizan Khan, Priyanka Negandhi, Salman Khan, Sourya Acharya, Nikhil Reddy","doi":"10.4103/npmj.npmj_272_25","DOIUrl":"10.4103/npmj.npmj_272_25","url":null,"abstract":"<p><strong>Abstract: </strong>Binswanger's disease, a rare form of subcortical vascular dementia, presents with a progressive decline in cognitive and motor functions due to chronic small vessel ischemic changes in the brain. Its clinical presentation often overlaps with other neurological conditions, particularly Wernicke's encephalopathy, leading to potential diagnostic delays. We report the case of a 45-year-old male who presented with altered mental status, gait abnormalities, memory impairment and ocular pain. Given his significant history of alcohol consumption, an imperial diagnosis of Wernicke's encephalopathy was made, and treatment was commenced with thiamine supplementation. However, the persistence of behavioural changes, right-sided pyramidal signs, extrapyramidal features and cognitive deficits prompted further evaluation. The clinical findings, combined with the patient's history of hypertension, diabetes and prior stroke, led to the diagnosis of Binswanger's disease. This case highlights the importance of considering vascular dementia in differential diagnoses of subacute encephalopathy and emphasises early recognition to initiate appropriate management.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"539-542"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the Association of Cognitive Impairment among Type 2 Diabetes Mellitus Patients: A Cross-sectional Study.","authors":"Mariha Jabeen, Fathima Zuhara Banu, Abhishek Sherigar, M Radhakishan, L Ananthesh, Anjusha Alex, Chethan Subramanya, Uday Venkat Mateti","doi":"10.4103/npmj.npmj_11_26","DOIUrl":"10.4103/npmj.npmj_11_26","url":null,"abstract":"<p><strong>Background: </strong>Patients with diabetes are increasingly susceptible to complications, one of the most overlooked being cognitive impairment. As the majority of people with diabetes remain undiagnosed for cognitive disorders and with the rising incidence of diabetes, early identification is essential.</p><p><strong>Aim: </strong>The aim of this study was to determine the prevalence and predictors of cognitive impairment among type 2 diabetes mellitus patients.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted among 138 participants at a tertiary care teaching hospital. All the patients who were aged 18 years or above and who were on antidiabetic medications were included. Patients with a known history of dementia and those on Vitamin B12 supplementation were excluded. The Montreal Cognitive Assessment scale was used to assess cognitive impairment. Predictors of cognitive impairment were identified using multiple linear regression analysis. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The mean age of participants was found to be 58.4 ± 10.6 years. The cognitive impairment was found among 130 (94.2%) diabetes patients. More than half of the participants, 73 (52.9%), had mild cognitive impairment and 44 (31.9%) had moderate impairment, whereas 13 (9.4%) were found to have severe cognitive impairment. Among the predictors, females had significantly lower cognitive scores than males (β = -2.76, P = 0.005), and participants with only primary education scored significantly lower than graduates (β = -3.94, P < 0.001).</p><p><strong>Conclusion: </strong>A high prevalence of cognitive impairment was found among diabetic patients. Hence, there is a need for healthcare policymakers to integrate cognitive screening into routine diabetes care to ensure early detection and improve patient outcomes.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"504-510"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Effects of Metabolic Factors on Pancreatic Ductal Adenocarcinoma Risk: A Mendelian Randomization Study.","authors":"Jielin Zhou, Yaoyao Yu, Tianyi Xia, Chao Chen","doi":"10.4103/NPMJ.NPMJ_618_25","DOIUrl":"https://doi.org/10.4103/NPMJ.NPMJ_618_25","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological studies focusing on pancreatic ductal adenocarcinoma (PDAC) have consistently reported robust positive associations between metabolic factors and PDAC. In the realm of evaluating the causal implications of these factors on PDAC, Mendelian randomisation (MR) demonstrates distinct advantages over traditional observational research approaches. Therefore, an MR study was meticulously designed and executed to elucidate the causal relationship between obesity-related metabolic factors and PDAC.</p><p><strong>Aims: </strong>This study aimed to explore the relationship between PDAC and obesity-related metabolic factors.</p><p><strong>Materials and methods: </strong>We identified instrumental variants corresponding to 30 exposures. These exposures could be classified into four distinct groups, namely traits related to glucose metabolism-related traits, lipid metabolism-related traits, body fat distribution and body mass index (BMI)-related traits. Summary-level data for PDAC were obtained from FinnGen consortia. MR analysis was conducted using three methods including inverse-variance weighted, weighted median and MR-Egger. Heterogeneity and horizontal pleiotropy were assessed to ensure result reliability.</p><p><strong>Results: </strong>Our research findings demonstrated significant causal relationships among body fat distribution, BMI-related traits and PDAC. Specifically, parameters such as arm predicted mass, leg predicted mass, leg fat mass, trunk predicted mass, waist circumference, whole body fat mass, BMI, weight and basal metabolic rate exhibit positive associations with PDAC. Conversely, other risk factors, including the waist-to-hip ratio (WHR) and WHR adjusted for BMI, present negative associations.</p><p><strong>Conclusions: </strong>This study provided evidence that some obesity-related metabolic factors were correlated with PDAC. Specifically, significant correlations were observed between PDAC and certain body fat distribution as well as BMI-related traits.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"451-459"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}