West African journal of medicine最新文献

{"title":"Artificial Intelligence in Medical Practice: Time to Join the Global Participants' Train.","authors":"A G Akanbi, O O Akanbi, A A Adejumo, O S Ilori, V O Oyedepo, I Aina, A A Olalere","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The application of artificial intelligence (AI) in medical practice is attracting attention in various aspects of disease management. Currently, many doctors lack a basic understanding of this data-driven innovation and are unaware of its potential applications in the field of medicine. This review thus aims to provide an introductory insight into AI, the basic concepts of AI and how it is applicable to medical practice.</p><p><strong>Methods: </strong>We reviewed the concept of AI by elucidating its fundamental principles and applications in medical practice. Literature searches were conducted on AI using PubMed, Scopus, Google Scholar, and MEDLINE. The search keywords included artificial intelligence, machine learning, AI algorithm, medical application of AI, and the future of AI in medical practice.</p><p><strong>Results: </strong>Ninety-four articles were initially reviewed, but only 71 met the inclusion criteria. The application of AI in medicine is growing across various aspects of disease management for cancerous and non-cancerous conditions. It has been used for complex procedures, such as robot-assisted surgery, in managing medical information and data, in predictive and precision medicine, and in clinical research.</p><p><strong>Conclusion: </strong>AI is rapidly transforming the future of human endeavours, and the healthcare community is no exception, with its potential to revolutionise medicine. Incorporating AI into healthcare should be considered a necessity, not just an option. We cannot afford to be passive observers, waiting for others to take the lead.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 6","pages":"482-493"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551008","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":"Serial C-reactive Protein and Blood Culture in the Diagnosis of Neonatal Sepsis among Babies with Risk Factors for Sepsis at Uniosun Teaching Hospital, Osogbo, Nigeria.","authors":"A O Omoboyeje, O J Adebami, O A Oyedeji, A Ademisoye, V O Kayode","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Neonatal sepsis (NNS) contributes significantly to morbidity and mortality among newborns, especially in developing countries. Early identification of risk factors is crucial for prompt diagnosis and treatment. This study aimed to investigate utility of serial C-reactive protein (CRP) and blood culture in the diagnosis of neonatal sepsis (NNS) among babies with risk factors for sepsis.</p><p><strong>Methodology: </strong>All consecutive term babies with maternal and/or neonatal risk factors for sepsis with or without initial symptoms were studied. Blood culture was done for all the participants. The CRP I was done at admission, CRP II at 48 hours and CRP III at 72 hours (a total of 3 samples). The value of CRP ≥10mg/l was considered abnormal.</p><p><strong>Results: </strong>Of 106 participants, 35 (33%) had positive blood cultures, with Staphylococcus aureus being the prevalent organism. The sensitivity of CRP at the cut off ≥10mg/l was 60%, 69.7%, and 66.7% for CRP I, CRP II and CRP III, with negative predictive value (NPV) of 73.6%,72.2% and 73.8%, respectively. Abnormal temperature, respiratory distress and convulsion at presentation were significantly associated with positive blood culture (p= 0.002, 0.014 and 0.009, respectively). Logistic regression identified abnormal temperature and delivery outside the hospital facility as being significantly related to elevated CRP values (p= 0.027, 0.016).</p><p><strong>Conclusion: </strong>These findings highlight the importance of utilization of serial CRP tests in the early detection of sepsis in neonates with risk factors.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 6","pages":"423-429"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551097","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":"Prevalence, Mortality Rate and Risk Factors of Obstetrics-Related Venous Thromboembolism in Africa: A Systematic Review.","authors":"T U Nwagha, C P Ojukwu, M Nweke, U I Nwagha","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Obstetric-related venous thromboembolism (VTE) is common in Africa. However, management has remained suboptimal. Evaluating its epidemiology will aid policy decisions.</p><p><strong>Aim: </strong>To evaluate the prevalence, mortality rate and risk factors of obstetrics-related venous thromboembolism in Africa.</p><p><strong>Search strategy: </strong>We searched four databases namely MEDLINE, PubMed, CINAHL, and Academic Search Complete.</p><p><strong>Data collection and selection: </strong>We undertook independent screening to identify relevant articles. Only peer-reviewed articles written and published in English were included.</p><p><strong>Data analysis: </strong>We fitted a random-effect model to estimate the pooled prevalence and mortality rates, with I2 computed to estimate the degree of heterogeneity.</p><p><strong>Result: </strong>Prevalence of obstetrics-related VTE varied between 2 (per 100,000 deliveries) in 2000 and 248 (per 100,000 births) in 2020. The pooled prevalence was 17 per 100,000 births (95% CI 6-480/100,000 births). Two most important risk factors were immobilization/prolonged travel (OR=2.5 [95% CI 1.4 - 4.5] to 18 (95% CI 2.3-137) and oral contraceptive (OR=15.9, [95% CI 1.9-133.1]). VTE-related maternal mortality ranged from 33 to 286 per 100,000 live births.</p><p><strong>Conclusion: </strong>Moving from 2000 to 2020, there is an increasing trend in the prevalence of obstetrics-related VTE and associated maternal mortality in Africa. The strength of risk factors of obstetrics-related VTE in Africa may not follow a global risk stratification pattern.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 6","pages":"506-516"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551051","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":"Serum Glial Fibrillary Acidic Protein (GFAP) as an Index of Severity and Predictor of Functional Outcome in Acute Stroke.","authors":"A A Sanusi, M B Fawale, A O Idowu, A F Ogunmodede, U C Eke, A A Adebowale, M A Komolafe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Serum biomarkers, such as glial fibrillary acidic protein (GFAP), have been proposed to accurately assess stroke severity and prognosis. However, there is limited published data on their potential role in resource-limited settings where the stroke burden is highest.</p><p><strong>Objective: </strong>The study aims to determine the predictive value of the serum level of GFAP in assessing the severity and functional outcome of acute stroke.</p><p><strong>Method: </strong>This prospective cohort study recruited forty consecutively presenting stroke subjects each for both ischaemic stroke and intracerebral haemorrhage at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife with forty apparently healthy controls. Serum concentrations of GFAP were measured using Enzyme-Linked Immunoassays, and the data were analyzed using Statistical Package for the Social Sciences software with significance at p<0.05.</p><p><strong>Result: </strong>The median serum GFAP levels among apparently healthy controls, ischaemic stroke group and the ICH group at admission were 18.04 pg/ml, 24.10 pg/ml, and 33.33 pg/ml respectively. At admission, there was a significant difference in the median serum GFAP level in the ICH and apparently healthy control group as well as in the ischaemic stroke group and apparently healthy control group (p = 0.001). The study found no significant correlation between admission NIHSS and serum GFAP levels in both the ischaemic stroke group and the ICH group. In the ICH group, there was an inverse correlation between median serum GFAP level at day 7 and Barthel index at day 7 (p = 0.021) and day 30 (p = 0.001), but a positive correlation with modified Rankin score at day 30 (p = 0.001).</p><p><strong>Conclusion: </strong>The study found that routine screening for serum GFAP level at admission in ischaemic stroke and ICH does not predict acute stroke severity and does not correlate with functional outcomes. However, Serum GFAP level at day 7 correlated with 30-day functional outcomes for ICH and its usefulness may be explored further in larger studies.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 6","pages":"466-473"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551065","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 Relationship Between Nonalcoholic Fatty Liver Disease and Hepatitis B: Ameliorating or Aggravating? A Systematic Review.","authors":"S Abere, B Oyan, U F Okeke","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background/purpose: </strong>Chronic Hepatitis B is a global health challenge which has persisted despite universal vaccination against Hepatitis B. The relationship between hepatitis B virus infection and Non-alcoholic Fatty disease (NAFLD) remains unclear thus, a review was carried out to elucidate the nature of the relationship existing between them and the risk factors for this interrelation.</p><p><strong>Data source and selection: </strong>The accepted guideline for a systematic review was followed. English language-based studies on hepatitis B and NAFLD in adult populations between 2010 -2021 were sourced from CINHAL, PubMed, Medline, Scopus, google scholar and ScienceDirect database.</p><p><strong>Data extraction: </strong>Following the PICO format, studies which met the inclusion criteria were identified and selected on a Prisma chart. They were further assessed using the modified Newcastle-Ottawa score for the assessment of non-randomized studies.</p><p><strong>Result: </strong>11 out of 12,380 studies obtained from multiple databases were included in the review comprising of 128,566 controls and 5177 cases. The relationship between exposure to hepatitis B infection and NAFLD outcome was aggravating, ameliorating and non-existent in six, four and one study respectively. Risk factors for NAFLD identified include metabolic factors such as increased body mass index, hyperglycaemia, raised triglycerides, metabolic syndrome, hyperuricemia and the presence of hepatitis B HBx protein.</p><p><strong>Conclusion: </strong>NAFLD is most likely to occur in HBV patients in the presence of host metabolic factors.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 6","pages":"494-505"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551073","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":"Pattern of Morbidities, Mortality and Healthcare Financing of Hospitalised Medical Patients (MOHOPA): The Study Protocol.","authors":"K M Karaye, E M Umuerri, I Onwuekwe, A M Daiyab, R N Sani, C Anjorin, H O Iheonye, Z G Habib, A Onunu, A G Habib, A Ogunniyi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>MOHOPA (Pattern of Morbidities, Mortality and Healthcare Financing of Hospitalised Medical Patients) Study aimed to determine the pattern of morbidities among patients admitted to the medical wards of 7 Teaching and Specialised Hospitals across Nigeria, the short-term outcomes of admissions and their determinants, challenges of managing the patients, and the pattern of healthcare financing for their care. The primary study outcomes were all-cause mortality (in-hospital and at 12 weeks post-discharge), duration of hospitalisation and rehospitalisation rate. 705 patients were recruited consecutively between May 2023 and March 2024, from Aminu Kano Teaching Hospital, University of Maiduguri Teaching Hospital, Federal Medical Centre Lokoja, University College Hospital, Ibadan, University of Nigeria, Ituku-Ozalla Campus, Enugu, Delta State University Teaching Hospital, Oghara, and University of Abuja Teaching Hospital. Each patient was followed up for 12 weeks or until his/her demise or referral to another facility. We hereby present the detailed study protocol. MOTS-CLÉS: Morbidités, Mortalités, Financement des Soins de Santé, Hospitalisation, MOHOPA.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 6","pages":"430-442"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551062","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":"Payment Methods and Coping Strategies for Health Care Costs by Patients with Chronic Diseases in a Low-Middle Income Country.","authors":"U I Mariere, D S Ogaji, O O Obikeze, A D Adesina, S Babatunde","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic diseases contribute the highest to disease burden and deaths worldwide and require long-term access to health care. This study identified the payment methods and coping strategies for healthcare costs by patients with chronic diseases using public health facilities in Yenagoa, Bayelsa State, Nigeria.</p><p><strong>Methods: </strong>Three hundred and thirty-nine (339) adult patients, being managed for chronic conditions (Hypertension, Diabetes mellitus, Tuberculosis & HIV), were randomly selected from three specialist hospitals that are the major providers of specialized care for patients with chronic diseases in the State. Data on sociodemographic characteristics, morbidity patterns, household financing and coping with health expenditure were collected. Chi-squared test was used to identify significant associations. A p-value 0.05 was considered significant.</p><p><strong>Results: </strong>Majority were females 211(62%) and about a third were not working 113(33.3%). To pay for their chronic disease healthcare expenses, 268 (79.1%) paid out-of-pocket while 71 (20.9%) used social health insurance. Among the 120 (35.4%) patients who subscribed to a health insurance program, about 2 in 5 still paid out-of-pocket. Missing a clinic visit 145(42.8%) was the common coping strategy followed by patients having to forfeit necessities 113(33.3%) to cope with their healthcare costs. The type of chronic disease was statistically associated with payment methods adopted by patients (p<0.01).</p><p><strong>Conclusions: </strong>Most patients with chronic diseases rely on out-of-pocket payments for healthcare expenditures including patients with health insurance coverage. This has necessitated households to adopt coping strategies, found to be economically distressing, to source funds for healthcare needs. Targeted programmes are needed for patients with chronic diseases to enhance financial risk protection.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 6","pages":"457-465"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551049","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":"Renal Replacement Therapy and Kidney Transplantation: Addressing Gaps in Access and Outcomes.","authors":"G E Erhabor","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 5","pages":"337-338"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233596","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":"Correlates of Histologic Activity and Chronicity Indices in Adult Patients with Glomerulonephritides: A Nigerian Picture.","authors":"T A Bamikefa, A Adelakun, A Adefidipe, B Omosule, R Ezeugonwa, B Omotoso, M O Hassan, O O Okunola, A A Sanusi, F A Arogundade","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Globally, glomerulonephritis with its diverse clinical manifestations and histologic attributes still maintains a dominant position among the myriads of aetiological culprits associated with the pathophysiologic course of chronic kidney disease. This study distinctively correlated the graded and scored histologic features observed in the glomerulus and tubulo-interstitium with clinical and biochemical features.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study of 70 adult patients who presented consecutively with features of glomerulonephritis was carried out. Renal biopsies were undertaken after renal function assessment. Light microscopy and immunoperoxidase staining utilising IgA, IgM, IgG and C3 antibodies were carried out on the biopsied renal tissues. The degree of glomerular, tubular, interstitial and vascular affectation were graded and scored. Total activity and chronicity indices were collated and their association/correlation with clinical parameters assessed.</p><p><strong>Results: </strong>Male gender predominated (67.2%) with an overall mean age of 28.4 ±10.3 years. Statistically significant correlations were found between interstitial oedema with serum creatinine (r=0.35, p=0.003) and GFR (r=-0.38, p=0.004); interstitial infiltrate with serum creatinine (r=0.52, p<0.0002) and GFR (r=-0.70, p=0.002); total activity index with serum creatinine (r=0.60, p=0.0001) and GFR (r= -0.48, p = 0.004). Statistically significant correlations were also seen between total chronicity indices with serum creatinine (r=0.62, p=0.001) and GFR (r= -0.58, p<0.001).</p><p><strong>Conclusion: </strong>Both activity and chronicity indices significantly influenced renal function. The higher they are, the lower the GFR and vice versa. These further buttress the need for aggressive management protocol for GN patients with higher indices to slow down renal function decline.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 5","pages":"339-345"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233583","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":"Utility of Cardiac Troponin I as a Marker of Severity in Non-Ischaemic Heart Failure.","authors":"A Udosen, V O Ansa, I O Umoh, T Shogade, B Effiong, B Akpu, E Epoke, E Udoh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Biomarkers are crucial for assessing the severity of heart failure (HF) and monitoring its treatment. Cardiac troponin I (cTnI) has traditionally been used as a marker for myocardial injury but its role in non-ischemic heart failure (NIHF) remains unclear.</p><p><strong>Objectives: </strong>This study was aimed at determining the relationship between cTnI and left ventricular function and geometry in NIHF patients.</p><p><strong>Methods: </strong>This was a cross-sectional comparative study that recruited 60 NIHF patients and 60 controls from the cardiology unit in a tertiary hospital. All participants had cTnI assay and transthoracic echocardiography done to assess left ventricular function and geometry. Data was analysed using Statistical Package for Social Sciences (SPSS) version 23. The level of statistical significance was fixed at p value < 0.05.</p><p><strong>Results: </strong>The mean age of patients with NIHF was 50.0±12.6 years versus 50.3±12.0 years for controls (p=0.456). The mean serum cTnI level was 358.52±56.60ng/L in NIHF patients versus 218.54±36.01ng/L in the controls (p <0.001). Serum cTnI had a moderate negative correlation with ejection fraction (EF) in NIHF patients (R= -0.70, R2 = 0.492); and a positive correlation with left ventricular mass index (LVMI) (R= 0.12, R2 = 0.015). Mean cTnI levels increased with worsening grade of diastolic dysfunction in NIHF patients. Higher levels of serum cTnI was associated with worse New York Heart Association (NYHA) class of HF (p <0.001).</p><p><strong>Conclusion: </strong>Elevated serum cTnI level was associated with worsening clinical and echocardiographic indices of left ventricular function in NIHF patients suggesting that it is an important surrogate marker for worsening HF.</p>","PeriodicalId":23680,"journal":{"name":"West African journal of medicine","volume":"42 5","pages":"387-393"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233616","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}