Annals of African Medicine最新文献

{"title":"Evaluation of Microbiological and Neuroimaging Diagnostic Modalities in Tuberculous Meningitis in Children: A Prospective Observational Study from Rural India.","authors":"Ganesh Kumar Verma, Muniba Alim, Ramesh Chand, Vinay Verma, Himanshu Gupta","doi":"10.4103/aam.aam_438_25","DOIUrl":"10.4103/aam.aam_438_25","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous meningitis (TBM) remains a leading cause of morbidity and mortality in children, particularly in endemic regions. Early diagnosis is crucial for optimal outcomes, yet remains challenging due to nonspecific clinical presentations and limited diagnostic sensitivity.</p><p><strong>Objective: </strong>To evaluate the diagnostic utility of various microbiological and neuroimaging modalities in clinically suspected cases of pediatric TBM and classify cases according to the established diagnostic criteria.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted at the department of pediatrics of a rural tertiary care center in North India. Fifty children aged 6 months-15 years with suspected TBM were enrolled. All participants underwent comprehensive clinical evaluation, cerebrospinal fluid (CSF) analysis including cartridge-based nucleic acid amplification test (CBNAAT), adenosine deaminase (ADA) estimation, contrast-enhanced computed tomography imaging, and chest radiography. Cases were classified using the Marais diagnostic scoring system.</p><p><strong>Results: </strong>The study population had a median age of 3.2 years with female predominance (58%). All patients presented with fever, while vomiting (92%), irritability (82%), altered sensorium (78%), and seizures (72%) were other common manifestations. 68% of patients presented in advanced British Medical Research Council (BMRC) stages (II-III). CSF analysis revealed lymphocytic predominance in 52% and elevated protein (40-500 mg/dL) in 94% of cases. CBNAAT was positive in 18% of patients, with rifampicin resistance detected in 11% of positive cases. Elevated CSF-ADA (>10 U/L) was found in 42% of all cases and 89% of definite TBM cases. Neuroimaging abnormalities were present in 90% of patients, with hydrocephalus being the most common finding (50%), followed by basal exudates and meningeal enhancement (38%). Mortality was significantly associated with advanced BMRC staging, with 100% fatality in Stage III patients.</p><p><strong>Conclusion: </strong>Neuroimaging demonstrated the highest sensitivity for TBM diagnosis in children. While CBNAAT provided definitive diagnosis with high specificity, its sensitivity remained limited. A multimodal diagnostic approach incorporating clinical assessment and CSF analysis including ADA, CBNAAT, and neuroimaging is essential for optimal diagnostic accuracy in pediatric TBM.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1619-1624"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145601826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on Branching Pattern of Middle Cerebral Artery and its Variations: A Systematic Review and Meta-analysis.","authors":"Debajani Deka, Malamoni Dutta, Rashmi Rekha Bordoloi, Hrishikesh Talukdar","doi":"10.4103/aam.aam_318_25","DOIUrl":"10.4103/aam.aam_318_25","url":null,"abstract":"<p><strong>Abstract: </strong>Middle cerebral artery (MCA) anatomy is essential to prevent catastrophe during intravascular procedures such as thrombolysis and cerebral angiography and neurosurgical practices, example - stent insertion, bypass grafting, etc. Eighty percent of blood supply to the brain is through MCA. The motor and sensory homunculus of brain representing arm and face receive blood supply from MCA. MCA consists of four segments. M1 is between the origin of MCA and the genu of insula (sphenoidal); M2 runs from limen insula to insula's circular sulcu (insular) s; M3 from circular sulcus to Sylvian fissure surface (opercular). Cortical branches of MCA territory can be divided into 13 areas orbitofrontal, prefrontal, precentral, central, postcentral, anterior parietal, posterior parietal, angular, temporo-occipital, posterior temporal, middle temporal, anterior temporal, and temporopolar arteries. MCA with bifurcated termination is seen in 64.70%. Bilateral bifurcation of MCA is present in 50%. Unilateral bifurcation of MCA is present in 25.45% on the left side and in 24.54% on the right side. MCA with trifurcated termination is seen in 12.35%. Bilateral trifurcation is present in 14.28%. Unilateral trifurcation is seen in 28.57% on the left side and 57.14% on the right side. Quadrifurcated type of termination is seen in 2.35%, four on the right side and four on the left side. Different sites of accessory MCA are at the level of proximal A1, at the level of middle A1, at the level of distal A1, at the level of Anterior communicating artery (AComA) at the level of A2. M1 segment (sphenoidal) of MCA is either straight or curved, where it is more curved than straight. The volume of this segment is more on the left side in males as compared to females. Average length of M1 segment is 17.30 ± 0.07 mm. Length is more on the left side as compared to the right side; it is more on nonaneurysmal side as compared to aneurysmal side. Again, the average diameter of M1 segment of MCA is 2.37 ± 0.33 mm, which is more on the left side and in male populations, diameter is more on aneurysmal side as compared to nonaneurysmal side. Diameter of M2 segment is more on left side (0.8-2.6 mm), and it is also more in case of females as compared to males. The M3 segment has been found to be more on the left side (1.5 mm as compared to right side1.4 mm. MCA fenestration is the name given to a fusion defect in the main trunk of the MCA after its origin, such that it emerges as a single trunk, branches, and then re-fuses. CRD number-420251052884.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1355-1363"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Resistin and High-sensitivity C-reactive Protein as Independent Predictors of Vascular Complications in Type 2 Diabetes Mellitus: A Cross-sectional Observational Study at a Tertiary Care Center.","authors":"B J Subhashchandra, M C Prasad, Bhaskar Prakash Gowd, Baiju Sam Jacob","doi":"10.4103/aam.aam_428_25","DOIUrl":"10.4103/aam.aam_428_25","url":null,"abstract":"<p><strong>Background: </strong>Serum resistin has been implicated in atherosclerosis and vascular smooth muscle dysfunction through inflammatory pathways, making it a potential biomarker for cardiovascular risk. Comparative data in diabetic patients with acute vascular events are limited. This study evaluates serum resistin and high-sensitivity C-reactive protein (hs-CRP) levels in type 2 diabetes mellitus (T2DM) with acute myocardial infarction (AMI) or acute ischemic stroke (AIS) to explore their association with vascular complications.</p><p><strong>Materials and methods: </strong>A cross-sectional, hospital-based study was conducted among T2DM patients presenting with AMI or AIS. Serum resistin, hs-CRP, glycated hemoglobin (HbA1c), lipid profile, and body mass index (BMI) were evaluated, and their associations with vascular events were statistically analyzed, considering P < 0.05 as statistically significant.</p><p><strong>Results: </strong>The mean serum resistin was significantly higher in the diabetes mellitus (DM) with AMI group (23.21 ± 5.65 ng/ml; P < 0.001) compared to controls (13.30 ± 2.94 ng/ml) but not in the DM with AIS group (19.90 ± 5.46 ng/ml; P = 0.215). hs-CRP was significantly elevated in both DM with AMI and AIS groups (3.43 ± 0.70 mg/l and 3.43 ± 1.01 mg/l, respectively) compared to controls (2.43 ± 0.62 mg/l; both P < 0.001). Positive correlations were observed between these biomarkers and conventional risk factors, including HbA1c, BMI, and low-density lipoprotein cholesterol.</p><p><strong>Conclusion: </strong>Elevated serum resistin (notably in AMI) and hs-CRP (in both AMI and AIS) in T2DM patients highlight a strong association between inflammation and acute vascular events. These biomarkers may serve as accessible tools for early risk stratification and targeted preventive strategies in high-risk diabetic populations.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1595-1601"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Critical Peripheral Arterial Blood Flow of the Lower Limbs of Patients with Diabetic Foot Ulcers.","authors":"Efe Uwadiae","doi":"10.4103/aam.aam_222_25","DOIUrl":"10.4103/aam.aam_222_25","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetics have a 15% lifetime risk of developing foot ulcers. Ankle-brachial index (ABI) is a noninvasive vascular screening test to identify large-vessel peripheral arterial disease and can be measured using the hand Doppler. As a component of a multimodal approach to vascular assessment, the pocket Doppler has been used routinely by foot surgeons. It also has results comparable to those measured in vascular laboratories and is thus important in patients with diabetic foot ulcers (DFUs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims and objectives: &lt;/strong&gt;The study aimed to evaluate the critical peripheral arterial blood flow of the lower limb of patients with DFUs while determining the effect of ankle-brachial pressure index on DFU grade.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;This was a case-control study of 49 diabetic patients with features of DFUs presenting at UBTH over a period of 1 year between March 2016 and February 2017. Forty-nine diabetic patients without ulcers were used as controls. Sociodemographic characteristics (age, gender, weight, height, educational level, occupation, religion, address, smoking status, and alcohol intake) and clinical history (age at initial diagnosis of DM, duration of DM, current medical therapy, and history of hypertension) were recorded using guided questionnaires. The color of the foot lesion, the peripheral pulses, the sensation, the ulcer grading, and the findings of the foot on radiographs, as outlined in the Diabetic Foot Severity Score (DFSS) were assessed. Data were analyzed using the Statistical Package for the Social Sciences version 20.0 software. Chi-squared test of association was used to test for statistical association between Ankle-Brachial Pressure Index grading variable and DFU status. A scatter plot was drawn to determine the linear relationship between DFSS and the Ankle-Brachial Pressure Index. The level of significance was set at P &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The DFSS ranged from 7 to 20 with a mean of 11.9. The mean Ankle-Brachial Pressure Index for diabetics without foot ulcers was 1.169 ± 0.225. The mean ABI for diabetics with foot ulcers was 0.944 ± 0.238. There was a statistically significant difference between the mean Ankle-Brachial Pressure Index for diabetics with and without foot ulcers ( t = 4.807, P &lt; 0.0001). A receiver operating characteristic curve was drawn to analyze the accuracy of Ankle-Brachial Pressure (AB) Index in diagnosing diabetics with foot ulcer. At a cutoff value of 1.135, the Ankle-Brachial Pressure Index produced a sensitivity of 75.5% and a specificity of 63.3%. A Spearman's correlation between DFSS and the Ankle-Brachial Pressure Index showed a moderate, positive correlation between DFSS and the Ankle-Brachial Pressure Index.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1538-1550"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital Agenesis of the Obturator Foramen in an Asian Population and Its Clinical Significance.","authors":"Kosuri Kalyan Chakravarthi, Thapasya Reddy Gaddam","doi":"10.4103/aam.aam_763_25","DOIUrl":"10.4103/aam.aam_763_25","url":null,"abstract":"<p><strong>Background: </strong>The obturator foramen, an ovoid opening in the hip bone formed by the ischium and pubis, allows passage of the obturator artery, vein, and nerve through the obturator canal. Mostly covered by the obturator membrane, its congenital agenesis or partial underdevelopment is extremely rare and scarcely documented, yet it carries significant implications for pelvic surgery, orthopedic, vascular procedures, and radiological interpretation.</p><p><strong>Objective: </strong>This study aimed to determine the prevalence, morphological characteristics, and clinical relevance of congenital agenesis of the obturator foramen in an Asian population.</p><p><strong>Materials and methods: </strong>The study was conducted between 2019 and 2025 in the department of Anatomy on 228 dried human hip bones belonging to 114 pelvises, irrespective of age and sex. All hip bones were examined macroscopically for evidence of congenital agenesis complete or incomplete of the obturator foramen. Thickness measurements of the abnormal bony plate replacing the foramen were recorded using digital callipers. High-resolution photographs were taken for documentation.</p><p><strong>Results: </strong>Overall, congenital agenesis complete, incomplete, or mixed was observed in 15 of 114 pelvises (13.2%). Unilateral complete agenesis of the obturator foramen and canal was identified in 3 right-sided (2.6%) and 4 left-sided (3.5%) hip bones, with an average bony plate thickness of 2.1 mm. Unilateral complete agenesis of the obturator foramen with a narrowed bony obturator canal occurred in 3 right-sided (2.6%) and 3 left-sided (2.6%) hip bones, demonstrating an average thickness of 2.2 mm. One pelvis (0.9%) exhibited mixed agenesis complete on the right and incomplete on the left, with an average thickness of 2.0 mm. In addition, one hip bones (0.9%) demonstrated bilateral complete agenesis of the obturator foramen and canal, showing a markedly increased average thickness of 1.9 mm. The thinnest bony plate recorded in the present study measured 0.5 mm.</p><p><strong>Conclusion: </strong>Congenital agenesis of the obturator foramen is an exceptionally rare anatomical variant in the studied Asian population. Awareness of this anomaly is clinically important, as it can alter pelvic biomechanics, obscure radiological interpretation, and affect the surgical approach to the obturator region. Detailed anatomical knowledge may help prevent intraoperative complications and improve diagnostic accuracy.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1417-1422"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Outcomes of Anterior Cruciate Ligament Reconstruction with or without the use of Antibiotic Solution in Graft Preparation: A Randomized Control Trial.","authors":"Kumar Gourab, Sudha Rani, Govind Kumar Gupta, Abhishek Guria, Saumya Kullu, Nisha Pandey, Zikra Ain","doi":"10.4103/aam.aam_270_25","DOIUrl":"10.4103/aam.aam_270_25","url":null,"abstract":"<p><strong>Background: </strong>Reconstruction of ligament injuries, particularly the anterior cruciate ligament, is a widely accepted approach for restoring knee function in anterior cruciate ligament (ACL) deficiency; however, postoperative infections remain a serious complication. Presoaking grafts in antibiotic solutions offers protective benefits against infection by providing local antibiotic prophylaxis without affecting graft integrity. No high-quality RCTs in India have evaluated this infection prevention method.</p><p><strong>Methodology: </strong>In this prospective RCT at a tertiary center, 76 patients with complete ACL tears were allocated to presoaking of ACL grafts in either vancomycin solution (500 mg/100 mL saline for 10-15 min) in the experimental group or presoaking of ACL grafts in normal saline in the control group before implantation. A simple randomization technique using sealed opaque envelopes ensured unbiased allocation. The primary outcome was postoperative infection measured via C-reactive protein levels postoperatively to monitor the inflammatory response. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) and Lysholm Knee score at 6 months.</p><p><strong>Results: </strong>This study aims to evaluate the effectiveness of vancomycin presoaking of ACL grafts in reducing postoperative infection rates in patients undergoing ACLR. The vancomycin presoaked ACL grafts group ( n = 38) had 0% infection versus 5.26% in the saline presoaked ACL grafts group ( n = 38) ( P = 0.152). No graft failures occurred in both groups. Mean IKDC scores were 87.02 ± 6.75 in the vancomycin presoaked grafts group versus 87.19 ± 6.24 in the saline presoaked grafts group ( P = 0.838), and mean Lysholm scores were 83.68 ± 7.66 in the vancomycin presoaked grafts group versus 86.47 ± 6.38 in the saline presoaked grafts group ( P > 0.05), respectively.</p><p><strong>Conclusions: </strong>Vancomycin presoaking of ACL grafts is safe and shows a trend towards lower infection risk without adverse effects on graft performance or recovery.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1551-1555"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Violent Video Games on Heart Rate Variability with Different Durations among Nonhabitual Young Adults: A Quasi-experimental Study.","authors":"Himani Jain, Saira Bano, Anuradha Rajeev Joshi, Srishti Jain","doi":"10.4103/aam.aam_712_25","DOIUrl":"10.4103/aam.aam_712_25","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effect of playing violent video games on the heart rate variability (HRV) with different durations in nonhabituated young adults.</p><p><strong>Methods: </strong>The present study was a quasi-experimental study, conducted in the department of physiology at an institute after obtaining the ethics approval. A total of 166 healthy participants (males and females aged 18-24 years; 83 in each group) were enrolled in the study and were divided into two groups based on their habit of playing video games. The participants who played violent video games were included in the study group, and participants who played nonviolent video games were included in the control group. HRV (time domain and frequency domain) parameters were measured before the game play, 15 min of game play, and after 30 min of game play.</p><p><strong>Results: </strong>The results of our study showed that participants who played nonviolent video games led to increased increased standard deviation of normal to normal intervals (SDNN), root mean square of successive differences (RMSSD), and total power, indicating parasympathetic dominance. Conversely, participants who played violent video games showed decreased SDNN, pNN50%, and RMSSD, reflecting decreased parasympathetic activity and increased low frequency (LF), reflecting sympathetic dominance, suggesting immediate postgame play sympathetic dominance. Minimal changes were observed in the high-frequency percentage in violent video games. A statistically significant difference was also observed in the LF/high frequency ratio, indicating sympathetic activation in the study group. Blood pressure and pulse rate before and after the game play were also significantly increased in the study group.</p><p><strong>Conclusion: </strong>Our research findings implicate an upsurge in sympathetic activity and decreased parasympathetic activity in individuals playing violent video games. Monitoring HRV offers insights into cardiovascular fitness and well-being. The study underscores the demerits of playing violent video games on a daily basis.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1497-1503"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147961924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Renal Doppler and Shearwave Elastography in Diabetic Nephropathy.","authors":"Kunal Verma, G Yuvabalakumaran, Pugazhendhi Sambath, Mansha Dua","doi":"10.4103/aam.aam_877_25","DOIUrl":"10.4103/aam.aam_877_25","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy is a leading cause of chronic kidney disease and end-stage renal failure worldwide. Early detection of renal microvascular and parenchymal changes is crucial for timely intervention and risk stratification.</p><p><strong>Objectives: </strong>The objective is to evaluate the diagnostic utility of renal Doppler ultrasonography and shearwave elastography (SWE) in detecting and staging diabetic nephropathy, and to assess their correlation with biochemical markers of renal function.</p><p><strong>Materials and methods: </strong>This prospective cross-sectional study included adult patients with type 2 diabetes mellitus, categorized based on albuminuria stages. Renal resistive index and pulsatility index were measured using Doppler ultrasound, while renal cortical stiffness was quantified using point SWE. Findings were correlated with estimated glomerular filtration rate (eGFR), serum creatinine, and urinary albumin-creatinine ratio.</p><p><strong>Results: </strong>Increased renal cortical stiffness and elevated Doppler indices were observed in patients with microalbuminuria and overt nephropathy compared to normoalbuminuric diabetics. SWE showed a strong inverse correlation with eGFR and a positive correlation with urinary albumin levels. Combined use of Doppler and elastography improved early detection of subclinical nephropathy with high diagnostic sensitivity.</p><p><strong>Conclusion: </strong>Renal Doppler and SWE are valuable non-invasive tools for early identification and functional assessment of diabetic nephropathy. Their integration into routine screening may enhance early detection, staging, and monitoring of renal involvement in diabetic patients.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1423-1428"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study of Acute Kidney Injury in Stroke Patients and Its Relationship to Short-term Outcome.","authors":"Munna Lal Patel, Amit Kumar Singh, Achintya Sachan, Rekha Sachan, Virendra Atam","doi":"10.4103/aam.aam_539_25","DOIUrl":"10.4103/aam.aam_539_25","url":null,"abstract":"<p><strong>Background: </strong>Acute stroke patients often develop AKI. AKI is associated with poor clinical outcomes, but stroke incidence and outcomes data are scarce.</p><p><strong>Aim: </strong>The aim is to examine the prevalence of AKI in acute stroke patients, risk factors, and clinical outcomes of patients with and without AKI.</p><p><strong>Methods: </strong>This prospective observational study was carried out at a tertiary care center. The study examined 139 patients with acute ischemic stroke and intracerebral bleeding. AKI was defined as per the Kidney Disease: Improving Global Outcomes guidelines. The study measured acute stroke patients, AKI prevalence, cause of death, hospital stay duration, dialysis need, and outcome of ischemic versus hemorrhagic stroke outcomes. AKI and hospital mortality were outcomes in a multivariate logistic regression model with gender, age, ventilatory requirement, hospital stay duration, and NIHS scale at admission as covariates.</p><p><strong>Results: </strong>Out of 112 ischemic strokes, with 6 deaths (5.35%) and 27 intracranial hemorrhages (ICH) with 10 deaths (8.92%). The average age was 54 years, 68.34% were male, and AKI complicated 74.3% of ischemic stroke and 25.6% of ICH hospitalizations. In multivariate analysis, AKI and hospital mortality are the outcomes. Covariates include age, gender, ventilatory requirement, duration of hospital stay, and National Institute of Health Stroke Scales Score at admission. AKI was associated with hospital mortality from ischemic stroke (odds ratio (OR): 25.25, 95% confidence interval (CI): 4.4-225.21) and hemorrhagic stroke (OR: 5.20, 95% CI: 1.32-22.34).</p><p><strong>Conclusions: </strong>AKI complicates stroke and increases hospital mortality, requiring further research on a large scale to understand the causal relationship and whether preventing AKI could reduce mortality.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"25 6","pages":"1723-1729"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of Pain on Propofol Injection: A Comparison of Pretreatment with 5-Hydroxytryptamine 3 Antagonists Granisetron, Ondansetron, and Ramosetron.","authors":"Srishti Kindo, Nitesh Sinha, Dipali Singh, Subodh Kumar, Shio Priye, Khushboo Saran, Jay Prakash","doi":"10.4103/aam.aam_360_25","DOIUrl":"10.4103/aam.aam_360_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Propofol is commonly used for the induction and maintenance of anesthesia. However, approximately 28%-90% of patients experience pain during injection. In this study, we compared the effectiveness of ondansetron, ramosetron, and granisetron, the three common 5-hydroxytryptamine 3 receptor antagonists in reducing the incidence and severity of propofol-induced pain (PIP).</p><p><strong>Methods: </strong>This study included 120 adult patients (18-65 years old) scheduled for elective laparoscopic cholecystectomy under general anesthesia. Patients were randomly assigned to four groups ( n = 30 for each group). Granisetron (2 mg) was administered to Group G, ramosetron (0.3 mg) to Group R, ondansetron (4 mg) to Group O, and normal saline to Group N. Venous circulation was occluded by a rubber tourniquet to retain the drug in the vein and prevent its spread in circulation. Pain was assessed at 0, 5, 10, 15, and 20 s using a four-point verbal rating scale (VRS). The Kruskal-Wallis, Chi-square, Friedman tests, and generalized estimating equations were used to analyze the data.</p><p><strong>Results: </strong>Groups O, R, and G demonstrated significantly reduced pain compared to group N at all-time points ( P < 0.001). Granisetron (Group G) was the most effective, with a mean VRS of 0.00 at 20 s. PIP incidence was 100% in Group N, compared to 80%, 70%, and 26.7% in Groups O, R, and G, respectively (χ² =40.443, P < 0.001).</p><p><strong>Conclusion: </strong>Granisetron is the most effective in reducing PIP, though ondansetron and ramosetron also offer significant pain relief.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1664-1669"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}