Annals of African Medicine最新文献

{"title":"A Cross-sectional Analysis of Serum Irisin Levels in Individuals with Thyroid Dysfunction Compared to the Control Population.","authors":"Ishika Chaudhary, Sanjana Jayaraj Mangala, Tharuni Latha Arigela, Manjunath Paidakula Ramakrishna, Manvitha Thalamati, Krishnamurthy Ugraiah, Noynika Shukla, Deepak Bhat Seetharama, Vagisha Gupta","doi":"10.4103/aam.aam_219_25","DOIUrl":"https://doi.org/10.4103/aam.aam_219_25","url":null,"abstract":"<p><strong>Background: </strong>Irisin is an adipo-myokine that is released by proteolytic cleavage of the membrane protein, fibronectin type III domain-containing protein 5. Irisin is responsible for the process of browning of white adipose tissue and is known to impact thermogenesis. Owing to the similarities in action between irisin and thyroid hormones, identifying these mutual influences in the body seems to be imperative.</p><p><strong>Aim: </strong>This study aimed at investigating the association between serum irisin levels and thyroid dysfunction.</p><p><strong>Methodology: </strong>This cross-sectional study was conducted in the Department of Endocrinology, Ramaiah Medical College and Hospital, Bengaluru, India, from January 1, 2025, to May 1, 2025, among individuals greater than 18 years old with new-onset hypothyroidism or hyperthyroidism and euthyroid age- and sex-matched control population who consented to the study. Serum irisin levels were assayed and compared between groups (hypothyroid, hyperthyroid, and control). Statistical analysis was performed using SPSS version 22 and Microsoft Excel (2016). An independent t-test was used as a significant test to identify the mean difference between two quantitative variables. Categorical data were represented in frequencies and proportions. Continuous data were expressed as mean and standard deviation. Correlations were performed with the Pearson Correlation coefficient. P <0.05 was considered statistically significant.</p><p><strong>Results: </strong>The study included 23 euthyroid controls and 48 individuals with thyroid dysfunction (28 hyperthyroid; 20 hypothyroid). A significant difference was noted in serum irisin levels between controls and individuals with thyroid dysfunction (P = 0.03). Further analysis depicted hypothyroid individuals showing a strong positive correlation between irisin and thyroid-stimulating hormone levels (r = 0.382, P = 0.04).</p><p><strong>Conclusion: </strong>This study highlights the positive correlation of irisin levels in hypothyroid individuals, speculating on the possibility of irisin's role in physiological adaptations in individuals with hypothyroidism.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111806","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":"Computed Tomography Angiographic Diagnosis of Dieulafoy's Lesion - A Rare Nonvariceal Cause of Gastrointestinal Bleeding.","authors":"Sanjay M Khaladkar, Amanya Shukla, Abhijeet Karad, Neeha Amit Jhala","doi":"10.4103/aam.aam_303_25","DOIUrl":"https://doi.org/10.4103/aam.aam_303_25","url":null,"abstract":"<p><strong>Abstract: </strong>Dieulafoy's lesion is a rare but potentially life-threatening cause of gastrointestinal (GI) bleeding, with its rarity possibly attributing to unawareness and underdiagnosis. Due to its subtle presentation and the potential for massive bleeding, Dieulafoy's lesion often poses a diagnostic challenge. This report presents the case of a 68-year-old patient with upper GI bleeding, where computed tomography (CT) angiography confirmed a Dieulafoy's lesion which was successfully treated with endoscopic hemoclip application. The aim of this article is to increase awareness about Dieulafoy's lesion and to stress the importance of CT angiography in cases where Dieulafoy's lesion might be missed during endoscopy.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068926","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":"Smart Hospital Infrastructure: Enhancing Parking Management and Ambulance Accessibility in Urban Healthcare Systems.","authors":"Ketki Bharat Tendolkar, Raman Kalia, Gopal Singh Charan","doi":"10.4103/aam.aam_293_25","DOIUrl":"https://doi.org/10.4103/aam.aam_293_25","url":null,"abstract":"<p><strong>Abstract: </strong>Hospitals face significant challenges in parking management and assessing ambulances due to fast-growing urbanization, high population density, and traffic load in metro cities. The healthcare delivery system is impacted by inappropriate parking facilities, which leads to delays for patients, visitors, and emergency responders. In the same way, inadequate route optimization and traffic jams affect ambulance response times. The hospital infrastructure can be improved through innovative architectural and technological approaches, such as smart parking systems, green hospital designs, and intelligent ambulance routing. Automated parking systems and artificial intelligence-powered smart parking systems may improve space utilization while reducing congestion. The strategies are designed to make green parking areas and healing gardens, which help create an eco-friendly environment for patients and their relatives. Similarly, radio frequency identification and Internet of Things technology may improve emergency response efficiency in real-time ambulance traffic control systems. This dual smart infrastructure significantly increases accessibility for urban planning. Adopting these technologies allows hospitals to assure continuous patient flow, reduce emergency service delays, and build a more efficient and environmentally responsible healthcare system. This review highlights the need for interdisciplinary collaboration between urban planners, hospital administrators, and technology experts to optimize hospital architecture, ultimately improving patient care and emergency response in congested metropolitan areas.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068983","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 Synergistic Effects of Trunk Rehabilitation Exercise and Transcranial Direct Current Stimulation on Brain-derived Neurotrophic Factor Levels in Stroke Recovery.","authors":"Abdulkareem Muhammad Umar, Mohd Ariff Sharifudin, Naresh Bhaskar Raj, Aisha Ahmad Ahmad","doi":"10.4103/aam.aam_230_25","DOIUrl":"https://doi.org/10.4103/aam.aam_230_25","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke is a prevalent neurological disorder resulting from cerebral ischemia or hemorrhagic injury. Its pathomechanism varies based on etiology and location, leading to complications such as speech loss, impaired motor function, and cognitive decline. This study examines the innovative roles of trunk rehabilitation exercise (TRE), transcranial direct current stimulation (tDCS), and their combination on serum levels of brain-derived neurotrophic factor (BDNF) in patients with stroke.</p><p><strong>Materials and methods: </strong>A total of 69 stroke survivors were randomized into three intervention groups (IGs): TRE + control intervention (CI) (IG-I, n = 17), tDCS + CI (IG-II, n = 17), combined TRE + tDCS + CI (IG-III, n = 17), and a control group (n = 18). The demographic analysis indicated a predominance of males aged 45-65 years. Serum BDNF levels were measured using an ELISA kit (SL0371Hu). Statistical analyses included factorial analysis of variance to assess the effects of the interventions on serum BDNF levels, with post hoc Tukey's tests to identify differences between the groups.</p><p><strong>Results: </strong>The analysis revealed a statistically significant difference in serum BDNF levels among the groups (F = 9.530, P = 0.001). The combined IG exhibited the highest mean posttest serum BDNF concentration (181.80 pg/mL), indicating that the combination of TRE and tDCS is more effective than either individual intervention.</p><p><strong>Conclusions: </strong>These findings highlight the potential of combined rehabilitation strategies to enhance neuroplasticity and recovery in stroke survivors, suggesting that integrating TRE and tDCS may offer improved therapeutic outcomes.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068930","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":"Unraveling the Causes of Perianal Itching: Magnetic Resonance Imaging as a Diagnostic Tool for Perianal Fistulas and Its Mimics.","authors":"Sanket Vinubhai Davra, Anurag Kumar, Anushka Jain, Yawar Ali Khan","doi":"10.4103/aam.aam_258_25","DOIUrl":"https://doi.org/10.4103/aam.aam_258_25","url":null,"abstract":"<p><strong>Background: </strong>Perianal itching is a common complaint associated with a variety of anorectal conditions such as fistulas, abscesses, hemorrhoids and pilonidal disease. Accurate diagnosis is essential for effective treatment and magnetic resonance imaging (MRI) plays a pivotal role due to its excellent soft-tissue resolution and multiplanar imaging.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the diagnostic utility of MRI in patients with perianal itching, focusing on the identification and classification of perianal fistulas and their mimics, using St. James and Parks classification systems.</p><p><strong>Materials and methods: </strong>This prospective observational study was conducted in the department of radiodiagnosis over 6 months (December 2023-May 2024) and included 59 patients aged ≥ 18 years with perianal itching. MRI (1.5T) pelvis scans were obtained using T1, T2, short tau inversion recovery, diffusion-weighted imaging, apparent diffusion coefficient and postcontrast sequences. Fistulas were classified using the St. James and Parks systems. Chi-square test assessed the correlation between the classifications.</p><p><strong>Results: </strong>Among 59 cases, perianal fistula was most common (57.6%), followed by abscess (33.9%), pilonidal sinus (5.1%) and hemorrhoids (3.4%). The mean age was 45.8 ± 10.6 years with male predominance. Grade 2 fistulas ( 47.06%) and intersphincteric type (64.70%) were most frequent. A strong correlation (P < 0.001) was observed between St. James and Parks classifications. Common complications included abscesses (70.6%) and horseshoe tracts (14.7%). MRI findings showed high concordance with clinical and surgical data.</p><p><strong>Conclusion: </strong>MRI is a sensitive, noninvasive tool for evaluating perianal itching. It effectively characterizes underlying pathology, guides treatment planning, shows strong classification correlation and enhancing clinical decision-making.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068900","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":"An Emerging Autoimmune Neuroinflammatory Disease: Myelin Oligodendrocyte Glycoprotein Antibody Disease.","authors":"Satbir Kaur Malik, Atharvan Sharma Mangalapalli, Hemanjali Avuthu","doi":"10.4103/aam.aam_343_25","DOIUrl":"https://doi.org/10.4103/aam.aam_343_25","url":null,"abstract":"<p><strong>Abstract: </strong>Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a discrete autoimmune, neuroinflammatory demyelinating disease with a broad clinical spectrum caused by antibodies against MOG proteins on myelin and oligodendrocytes. It is now recognized as a separate disease from multiple sclerosis and neuromyelitis optica spectrum disorder (AQP4-IgG + NMOSD). A 40-year-old female presented with a history of fever, acute onset visual impairment and painful extra ocular movements of left eye, ataxia, giddiness, bitemporal headache, and urinary retention. Cerebrospinal fluid evaluation showed lymphocytic pleiocytosis, serum anti-MOG antibodies were positive (1:100), and magnetic resonance imaging (MRI) showed multiple lesions involving the diencephalon, brainstem and periventricular white matter and conus medullaris. The patient was started on a 5 day pulse dose of injection METHYLPREDNISOLONE 1 g followed by a gradually tapering dose of oral prednisolone for 1 month. Patient recovered completely with no residual disease and was followed up for 1 year. Repeat serum MOG antibodies were negative and MRI showed complete resolution of both brain and spinal lesions. MOGAD is an emerging autoimmune neuroinflammatory disease that is not only distinct in its presentation, but also in response to disease modifying therapies with a better prognosis and lower morbidity than the other demyelinating diseases. A high suspicion for its clinical phenotypes and radiological peculiarities must be held for avoiding misdiagnosis and for early management.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068942","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":"Remarkable Remission of Alopecia Totalis with Tofacitinib and Excimer.","authors":"Shubham Deokar, Anushka Agarwal, Kalyan Dalave, Namratha Puttur","doi":"10.4103/aam.aam_274_25","DOIUrl":"https://doi.org/10.4103/aam.aam_274_25","url":null,"abstract":"","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068928","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":"Asymptomatic Complete Heart Block in an Adult with Down's Syndrome and Structurally Normal Heart: A Rare Association.","authors":"Sangram Mangudkar, Nallani Chakravarthi Sai Sirisha, Vijayashree Gokhale, Divam Prakash Singh","doi":"10.4103/aam.aam_234_25","DOIUrl":"https://doi.org/10.4103/aam.aam_234_25","url":null,"abstract":"<p><strong>Abstract: </strong>Down's syndrome (DS) is caused by an extra copy of the chromosome 21. Patients with DS have short stature, intellectual impairment, and characteristic physical features. Cardiovascular disease is the leading cause of morbidity and mortality in patients with DS. An estimated 40%-60% of DS patients have congenital heart disease (CHD). Cardiac conduction disturbances in association with CHD have been described in patients with DS. However, isolated cardiac conduction defect is exceptionally rare in DS, and we report an unusual case of asymptomatic complete heart block in an adult case of DS with structurally normal heart and review the literature about the conduction disturbances in DS.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068964","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":"Antineutrophilic Cytoplasmic Antibodies Negative Vasculitic Neuropathy.","authors":"Prateek Harsh, Shalesh Rohatgi, Prajwal Rao, Satish Nirhale, Pravin Naphade, Srivatsav Addepalli","doi":"10.4103/aam.aam_181_25","DOIUrl":"https://doi.org/10.4103/aam.aam_181_25","url":null,"abstract":"<p><strong>Abstract: </strong>Antineutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAA) is a systemic disorder involving small vessels. Neuropathy may be associated with the involvement of other organs such as the kidneys, lungs, and heart. ANCA is detected in only 80%-90% of cases; hence, high degree of clinical suspicion is required. We report a case of 49-year-old male patient who had a known case of type-2 Diabetes mellitus and chronic kidney disease on regular peritoneal dialysis. He developed progressive tingling and burning paresthesia and weakness in all four limbs. Examination revealed quadriparesis, hypotonia, areflexia, and sensory loss in the glove and stocking pattern. The nerve conduction study was suggestive of severe generalized axonal sensorimotor neuropathy. He had rapidly progressive breathlessness. High-resolution computed tomography of the chest revealed bilateral ground-glass opacities with interstitial thickening suggestive of interstitial lung disease. He was treated with biweekly hemodialysis. He suffered a cardiac arrest due to an acute myocardial infarction and was successfully revived. Given multisystem involvement, the possibility of small vessel vasculitis was kept. Antinuclear antibodies and ANCA were negative. Sural nerve biopsy was reported as an inflammatory axonopathy, probably vasculitic. The patient was treated as a case of seronegative ANCA with six cycles of injection cyclophosphamide followed by immunosuppression with injection rituximab. He made a steady neurological recovery over 2 years with improved muscle power to grade 3 in both lower limbs and grade 4 in both upper limbs. ANCA may be negative in 10%-20% of cases. AAA should be strongly suspected in the presence of axonal neuropathy with evidence of multisystem involvement. A nerve biopsy can clinch the diagnosis.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068977","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":"Evaluation of the Quality of Life of Women with Breast Cancer in Morocco.","authors":"Hanane Lemmih, Badre Bakzaza, Saad Rachiq, Sidi Mohammed Raoui","doi":"10.4103/aam.aam_292_25","DOIUrl":"https://doi.org/10.4103/aam.aam_292_25","url":null,"abstract":"<p><strong>Introduction: </strong>The quality of life (QoL) of Moroccan woman with breast cancer (BC) continues to be influenced by various simultaneous factors that affect their psychological, physical, cognitive, and social well-being throughout the course of treatment. Studying these factors is essential, as it allows for the identification of patients at risk and the development of appropriate interventions to promote their QoL. This study aims to assess the QoL in Moroccan women with BC and explore its relationship with sociodemographic and clinical characteristics.</p><p><strong>Materials and methods: </strong>The study involved a sample of 265 BC patients who were being followed at the Regional Oncology Center in Meknes, Morocco. The evaluation was conducted using the WHOQOL-BREF questionnaire.</p><p><strong>Results: </strong>The participants reported a reduced QoL and overall health status. The mean scores for the physical, environmental, social, and psychological dimensions were 43.13, 42.69, 46.85, and 45.19, respectively. The results identified several predictors of overall QoL, including education level, income, age, tumor size at diagnosis, presence of metastases, type of treatment, and cancer stage. In contrast, no significant association was found with the number of children, menopausal status, presence of comorbidities, hormone receptor status, geographic origin, disease duration, affected breast, or use of complementary medicine.</p><p><strong>Conclusion: </strong>The QoL of Moroccan BC patients undergoing treatment is negatively impacted. These findings underscore the need for future healthcare policies to incorporate strategies aimed at improving patients' QoL - primarily through holistic approaches that include psychological and social support, therapeutic patient education, and the prevention or management of treatment-related complications.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068945","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}