Annals of African Medicine最新文献

{"title":"Cardiac Rhythm Disorders in Patients with Obstructive Sleep Apnea.","authors":"Lavalik Boppana, Sujata Khatal","doi":"10.4103/aam.aam_535_25","DOIUrl":"https://doi.org/10.4103/aam.aam_535_25","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a prevalent but often underdiagnosed sleep disorder associated with intermittent hypoxia and fragmented sleep. It has been increasingly implicated in the pathogenesis of cardiac rhythm disorders (CRDs), including atrial fibrillation (AF), bradyarrhythmia's, and ventricular arrhythmias. Despite substantial global evidence, limited Indian data exist regarding the burden and characteristics of CRDs among OSA patients.</p><p><strong>Objective: </strong>The objective is to determine the prevalence and types of CRD in patients diagnosed with OSA and explore their correlation with OSA severity and clinical-demographic factors.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted at a tertiary care center in Pune over 1½. Fifty adult patients diagnosed with OSA by polysomnography (PSG) (apnea-hypopnea index [AHI] ≥5) underwent 24-h Holter monitoring to assess cardiac rhythm abnormalities. Data on demographic profile, comorbidities, STOP-BANG and Epworth Sleepiness Scale scores, and PSG parameters were collected and analyzed.</p><p><strong>Results: </strong>The mean age was 61.2 ± 11.5 years, and 64% were male. Obesity was present in 72% of participants. Severe OSA was seen in 56%, moderate in 28%, and mild in 16%. Sinus tachycardia (24%) and AF (12%) were the most common, followed by sinus bradycardia (10%) and premature ventricular contractions (8%). CRDs were significantly associated with OSA severity (P < 0.001), high STOP-BANG and ESS scores, and systemic hypertension.</p><p><strong>Conclusion: </strong>Nearly half of the OSA patients exhibited cardiac rhythm abnormalities, with higher OSA severity correlating with increased arrhythmias. Early cardiac evaluation in OSA patients may aid in mitigating cardiovascular risk.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832796","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":"Critical Comment on Knowledge, Awareness, and Practice of Disposal of Unused Medicines among Medical Undergraduates: A Cross-sectional Study.","authors":"Radha Saini","doi":"10.4103/aam.aam_680_25","DOIUrl":"https://doi.org/10.4103/aam.aam_680_25","url":null,"abstract":"","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832810","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":"Study on Screen Time and Its Association with Academic Performance in Children of Age Group 8-15 Years.","authors":"Jeffy John, Deepa T Unnikrishnan, Menon Narayanankutty Sunilkumar","doi":"10.4103/aam.aam_723_25","DOIUrl":"https://doi.org/10.4103/aam.aam_723_25","url":null,"abstract":"<p><strong>Background: </strong>Media use among children is widespread, and its impact on various aspects of life is increasingly recognized. The growing availability of information technology gadgets has led to a notable rise in screen exposure among the young population. Despite this, limited research exists on the influence of screen time on academic performance, particularly in developing countries. The present study aimed to investigate the relationship between screen time and academic performance among children aged 8-15 years, specifically assessing the association between total screen exposure and scholastic achievement in this age group.</p><p><strong>Methods: </strong>This cross-sectional observational study was conducted among 400 students aged 8-15 years, randomly selected from two public and two private schools. Data on academic performance were obtained from teachers and verified through school records, while information on screen exposure was collected using a structured questionnaire. Statistical analysis was performed using SPSS software, employing Spearman's correlation coefficient and Kruskal-Wallis tests to determine the relationship between screen exposure and academic performance.</p><p><strong>Results: </strong>The mean total screen time among participants was 147.8 min/day, with television accounting for the maximum share (67.5 min). A statistically significant association was observed between television screen time and academic performance ( P = 0.013).</p><p><strong>Conclusion: </strong>Screen exposure among children in the 8-15-year age group exceeded the American Academy of Pediatrics' recommendations. Increased television viewing was significantly associated with poorer academic performance, highlighting the need for awareness and regulation of children's screen use.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832841","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":"Clinical Predictors and Histopathological Spectrum of Nondiabetic Kidney Disease in Type 2 Diabetes.","authors":"Rohit Ghai, Monica Bhagat, H P S Dhooria","doi":"10.4103/aam.aam_53_26","DOIUrl":"https://doi.org/10.4103/aam.aam_53_26","url":null,"abstract":"<p><strong>Introduction: </strong>When a patient's presentation raises suspicions for conditions other than diabetic kidney disease (DKD), such as sudden onset proteinuria <5 years after the onset of type 2 diabetes, proteinuria without retinopathy or neuropathy, acute kidney injury, active urinary sediment, or hematuria, clinically indicated kidney biopsies are typically carried out. Consequently, a high incidence of non-DKD (NDKD) in clinical biopsies from diabetes individuals is not unexpected. The purpose of the study is to investigate the clinical predictors, prevalence and histopathological spectrum of NDKD in patients with type 2 diabetes mellitus.</p><p><strong>Materials and methods: </strong>Dayanand Medical College and Hospital in Ludhiana conducted this cross-sectional observational study. After taking informed consent, 43 patients with diabetes who were suspected of having NDRD had kidney biopsies based on either or both of the following criteria: (1) Hematuria (red blood cell [RBC] casts, RBC >5/hpf). (2) Unexpected elevations in serum creatinine of more than 2 mg/dL. (3) Nephrotic syndrome with sudden onset. (4) Renal failure without diabetic retinopathy (DR). (5) DM duration <5 years. (6) Nephrotic range massive proteinuria with normal renal function. (7) Normal or negligible proteinuria along with severe renal insufficiency (serum creatinine >2 mg/dL) (<500 mg/dL).</p><p><strong>Results: </strong>(1) Of the 43 patients, 24 (56.0%) had pure NDKD. Four patients (9.3%) had mixed renal disease, while 15 patients (35%) had DKD. (2) The most prevalent NDKD was acute interstitial nephritis (AIN) (12%), which was followed by immunoglobulin A (IgA) nephropathy, localized proliferative glomerulonephritis and crescentic glomerulonephritis (7.0% each). The most prevalent pathology observed in mixed renal disease was DN with AIN. (3) The duration of hypertension was 4.98 ± 2.86 years in the group without DKD and 8.07 ± 4.65 years in the group with DKD, both of which were statistically significant. (4) Compared to the DKD group, more patients in the NDKD group had shorter DM duration (<5 years). A greater proportion of individuals in the DKD group had DM for more than 10 years. (5) Compared to the NDKD group, there were more NPDR patients in the DKD group.</p><p><strong>Conclusion: </strong>Since several diseases, including MN, IgA nephropathy and AIN, are frequently treatable or even curable, our study demonstrated the need for early suspicion and diagnosis of NDKD.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832812","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":"Novel Heterozygous Variant in a Child with Axonal Charcot-Marie-Tooth disease.","authors":"Sangeeta Gupta, Charushila Atul Rukadikar","doi":"10.4103/aam.aam_241_26","DOIUrl":"https://doi.org/10.4103/aam.aam_241_26","url":null,"abstract":"<p><strong>Abstract: </strong>Charcot-Marie-Tooth (CMT) disease comprises a genetically diverse range of disorders affecting the peripheral nervous system. We report an axonal CMT (CMT 2) case from India with a novel heterozygous variant of uncertain significance detected in the ganglioside-induced differentiation-associated protein 1 (GDAP1) gene. A 12-year-old male patient presented with severe distal lower limb weakness (bilateral foot drop) progressing proximally. Bilateral pes-cavus, high-steppage gait, reduced power in bilateral lower limbs, bilaterally absent ankle jerks, and no cerebellar or pyramidal signs/vocal cord paresis were salient clinical findings that suggested the clinical diagnosis of Hereditary motor and sensory neuropathy (HMSN)/CMT disease. Neurophysiological tests revealed axonal CMT. Genetic studies showed a novel heterozygous missense variant classified as a variant of uncertain significance in the GDAP1 gene. Although the causative role of the variant remained unclear, mutation in the GDAP1 gene, clinical features, and characteristic electrophysiological findings exhibiting axonal CMT supported the subtype diagnosis as probable CMT type 2K in the patient. The present report emphasizes the significance of clinical and neurophysiological findings in CMT when analyzing sequencing data in the era of next-generation sequencing, particularly when variant of uncertain significance are found.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832838","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":"Erratum: A Comparative Study of Open versus Laparoscopic Sublay Repair for Ventral Hernia.","authors":"","doi":"10.4103/aam.aam_323_26","DOIUrl":"10.4103/aam.aam_323_26","url":null,"abstract":"","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"741"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508863","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":"Diagnostic Accuracy of Anorectal Manometry in Identifying Dyssynergic Defecation among Chronic Constipation Patients.","authors":"Anuradha Dnyanmote, Veerla Siddharth, Amol Dahale, Dakshayani Satish Nirhale, Kishor Jeughale, Parin Nilesh Patel","doi":"10.4103/aam.aam_205_25","DOIUrl":"10.4103/aam.aam_205_25","url":null,"abstract":"<p><strong>Background: </strong>Dyssynergic defecation (DD) is a common yet underdiagnosed subtype of chronic constipation, often refractory to conventional treatment. Anorectal manometry (ARM) is a valuable physiological tool for identifying neuromuscular abnormalities contributing to DD.</p><p><strong>Objective: </strong>This study aimed to assess the diagnostic accuracy of ARM in detecting DD among patients with chronic constipation.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted at Dr. D. Y. Patil Medical College, Pune, between January 2023 and February 2025, involving 102 patients with chronic constipation unresponsive to laxatives and lifestyle changes. Patients underwent high-resolution ARM and balloon expulsion test (BET). Dyssynergic patterns were classified using Rao's criteria. Data were analyzed using SPSS v26.0.</p><p><strong>Results: </strong>Among the participants (mean age 45.53 ± 13.3 years), 75.5% were diagnosed with DD via ARM. The most prevalent manometric subtype was Type IV (28.4%), followed by Type I (21.6%). ARM demonstrated high diagnostic accuracy with a sensitivity of 97.4%, specificity of 88.5%, and overall accuracy of 95.1% when compared with BET.</p><p><strong>Conclusion: </strong>ARM is a reliable diagnostic modality for evaluating functional defecatory disorders. Incorporating ARM into routine evaluation of chronic constipation, especially when empirical therapies fail, can significantly enhance diagnostic precision and guide targeted interventions such as biofeedback therapy.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"596-600"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145443747","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":"Clinical Study of Gastrointestinal Symptoms in Patients with Diabetes Mellitus.","authors":"Sreevidya Yekkaluru, Manasi Harale, Sandesh Raut, Tushar Pancholi","doi":"10.4103/aam.aam_123_25","DOIUrl":"10.4103/aam.aam_123_25","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus (DM) is a chronic metabolic disorder associated with numerous complications affecting multiple organ systems. Among these, gastrointestinal (GI) symptoms are commonly observed but often underdiagnosed and undertreated. Understanding the prevalence and patterns of these symptoms in diabetic individuals is crucial for optimizing clinical management.</p><p><strong>Aim: </strong>In this study, the frequency of GI symptoms in individuals with DM was assessed, and their relationship to antidiabetic drugs, the length of diabetes, and glycemia control was investigated.</p><p><strong>Materials and methods: </strong>A cross-sectional, observational study was conducted on 200 diabetic patients at a tertiary care hospital. Detailed medical histories were recorded, and participants underwent laboratory investigations, including HbA1c levels. Statistical analyses were performed to determine associations between GI symptoms and various clinical parameters.</p><p><strong>Results: </strong>Among the 200 participants, 67.5% reported at least one GI symptom. The most common symptoms were fecal incontinence (37%), nausea and vomiting (34.5%), abdominal bloating (33.5%), and constipation (32.5%). Poor glycemic control (HbA1c ≥9.0%) was significantly associated with increased prevalence of GI symptoms ( P < 0.01). Biguanides (metformin) were the most frequently prescribed antidiabetic drug (93%), but no significant association was found between specific oral hypoglycemia agents and GI symptoms.</p><p><strong>Conclusion: </strong>GI symptoms are highly prevalent in diabetic patients, with poor glycemic control playing a major role in their occurrence. Routine screening for GI symptoms should be incorporated into diabetes management to improve quality of life and treatment adherence.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"579-583"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939548","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":"Swiss Cheese Configuration of Incisional Hernia following Trauma: Role of Open Sublay Mesh Repair.","authors":"Immadi Saikumar, Vinayak Kshirsagar, Vedanth Tirmanwar","doi":"10.4103/aam.aam_269_25","DOIUrl":"10.4103/aam.aam_269_25","url":null,"abstract":"<p><strong>Abstract: </strong>Incisional hernia is a frequent postoperative complication following laparotomy, often associated with significant morbidity and recurrence. We present the case of a 47-year-old male with a history of blunt abdominal trauma and prior exploratory laparotomy, who presented with multiple anterior abdominal wall defects. Clinical examination and imaging confirmed a \"Swiss cheese\" configuration of incisional hernias. Elective open sublay mesh repair using the Rives-Stoppa technique was performed. The postoperative period was uneventful. This case highlights the importance of meticulous imaging and tailored surgical planning in complex hernias.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"728-731"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022767","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":"Comparative Study of Dermatotraction and Split Skin Grafting in Infected Ulcers at Tertiary Care Hospital in Mangalore.","authors":"G M Govardhan, Madhava Shenoy, Sunil Kumar Math, V F Ahris","doi":"10.4103/aam.aam_149_25","DOIUrl":"10.4103/aam.aam_149_25","url":null,"abstract":"<p><strong>Background: </strong>Ulcers with skin loss causes lot of complications leading to delay in wound healing, prolonged hospital stay and complications like wound infections, need for prolong hospital stay, need for multiple surgery. Split skin grafting technique comprises of harvesting the skin graft from the healthy skin areas and is used to cover the exposed ulcers. With time newer techniques to treat ulcers were developed out of which one of the method is called as Dermatotraction. This technique utilizes the skin characteristics of stress relaxation (creep) and delayed primary closure is used. The procedure involves the approximation of the skin edges using the method of shoelace technique and a gradual skin traction is applied for a period, and when the two ends approximate secondary suturing is done.</p><p><strong>Aims: </strong>To assess the outcomes of Dematotraction vs Split skin grafting in infected ulcers in a Tertiary Care Hospital in Mangalore.</p><p><strong>Objectives: </strong>a) To Determine the clinical outcomes of the dermatotraction on complex wounds of varying size and shape, b) To analyze the outcomes of dermatotraction by comparing to Split Skin Grafting.</p><p><strong>Material and methods: </strong>This study was done in Department of General Surgery. Prior to the study approval from the ethical committee was obtained and the study was done on the patients as per listed in the inclusion criteria. A total 52 cases were performed 26 cases in dematotraction group 26 cases in Split Skin Grafting group.</p><p><strong>Results: </strong>The dermatotraction group was done in the 26 patients of which 18 patients was treated with the technique of primary closure and 6 patients had to undergo dermatotraction followed by secondary suturing, 2 patients had infection required further treatment. The split skin grafting 22 cases had uptake and 4 cases had graft rejection of which16 cases had complete uptake with 6 cases had partial uptake and 4 cases had complete rejection of the graft. Of the 26 cases in split skin grafting 4 patients also had donor site infection. Dermatotraction group had good cosmetic appearance with intact tactile sensations compared to the split skin grafting.</p><p><strong>Conclusion: </strong>Split skin grafting has been a conventional method of treatment for peripheral limb ulcers. In this study we have found dermatotraction can be a cost effective, feasible procedure in selected patients with better outcomes and the quality of life. Further studies are warranted to establish dermatotraction to be considered as a standard of treatment for peripheral limb ulcers.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"640-644"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699480","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}