Annals of African Medicine最新文献

{"title":"Impact of Vitamin C Supplementation in Reducing Oxidative Stress in Preterm Neonates: A Randomized Open-label Study.","authors":"Mysore Prashanth Sri Hira, Raghavendra H Gobbur, Shrishail Gidaganti","doi":"10.4103/aam.aam_653_26","DOIUrl":"https://doi.org/10.4103/aam.aam_653_26","url":null,"abstract":"<p><strong>Context: </strong>Preterm birth remains the leading cause of neonatal mortality worldwide and contributes substantially to neonatal deaths in India. Ascorbic acid (Asc.A) (Vitamin C) is an important antioxidant involved in immune function and protection against oxidative stress. Vitamin C concentration declines rapidly after birth in preterm neonates. Evidence supporting the role of Vitamin C supplementation in reducing respiratory morbidity (oxidative stress) in preterm neonates, in developing countries is limited.</p><p><strong>Aims: </strong>The study aimed to investigate the impact of Asc.A on reducing the oxidative stress in preterm neonates by assessing Asc.A levels and corresponding change in malondialdehyde (MDA) levels.</p><p><strong>Settings and design: </strong>A randomized, open-label, interventional study in a Level III-A neonatal intensive tertiary care unit.</p><p><strong>Materials and methods: </strong>One hundred and thirty preterms with gestational ages <37 weeks and birthweight <2.5 kg were equally allocated to case and control groups. The case group received Asc.A supplementation of 40 mg/kg/day till discharge day. Asc.A and MDA levels were measured on day 2 of life and at discharge.</p><p><strong>Statistical analysis used: </strong>Statistical analysis was performed using the SPSS software (version 20).</p><p><strong>Results: </strong>At discharge, case group demonstrated significant increase in Asc.A levels (+1.22 mg/dL; P < 0.0001), while control group showed reduction (-0.98 mg/dL; P < 0.0001). MDA levels showed a substantial reduction in the supplementation group (-4.34 μmol/L; P < 0.0001) evidence of reduced oxidative stress compared with controls (-1.55 μmol/L; P < 0.0001). Improvement in Asc.A levels correlated positively with reduction in MDA.</p><p><strong>Conclusions: </strong>Asc.A supplementation in preterm neonates was associated with significant reduction in oxidative stress. Given its safety, affordability, and biological efficacy, Asc.A/Vitamin-C supplementation may serve as a valuable adjunct to standard neonatal care, with potential relevance to national initiatives such as the National Newborn Action Plan.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219837","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":"Impact of Triple Assessment on Surgical Decision-making in Thyroid Nodule Management.","authors":"Megh Rajgor, M B Bagwan","doi":"10.4103/aam.aam_760_26","DOIUrl":"https://doi.org/10.4103/aam.aam_760_26","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate preoperative assessment of thyroid nodules is crucial for distinguishing malignant from benign lesions and making optimal decisions. Triple assessment using clinical examination, ultrasonography (USG), and fine needle aspiration cytology (FNAC) has been increasingly used to improve diagnostic accuracy.</p><p><strong>Aim: </strong>The aim of the study was to evaluate the efficacy of triple assessment in the detection and treatment of thyroid nodules by correlating ultrasonographic findings, clinical evaluation, and FNAC results with histopathological diagnosis.</p><p><strong>Methods: </strong>This study was a prospective observational study of 56 patients with thyroid nodules undergoing surgical management. Data were collected prospectively using structured case record forms. Baseline information, physical examination findings, USG features, FNAC records, operative details, and histopathological reports were documented. Data were analyzed using descriptive statistics. Frequency and percentage were used to present categorical variables. The diagnostic accuracy of clinical examination, USG, FNAC, and triple assessment was evaluated by estimating specificity, sensitivity, negative predictive value (NPV), positive predictive value, and diagnostic accuracy.</p><p><strong>Results: </strong>A higher proportion of participants were female (85.7%) and were in the 41-60 years old age group. Histopathology confirmed benign lesions in 57.14% and malignant lesions in 42.86% of cases. Triple assessment achieved the most effective diagnostic accuracy, showing a sensitivity of 100%, a specificity of 87.50%, with a NPV of 100% and an overall diagnostic accuracy of 97.86%.</p><p><strong>Conclusion: </strong>Triple assessment is a dependable and useful modality for assessing thyroid nodules. Combined use of clinical examination, USG, and FNAC reduces false-negative results and supports appropriate clinical decision-making.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219839","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":"Perinatal Outcome of Sickle-cell Disease in Pregnancy: A Retrospective Cross-sectional Study.","authors":"Vinita Singh, Nutan Sinha, Priyanka Mondal, Gurugubelli Lavanya, Anamika Dewraja","doi":"10.4103/aam.aam_524_26","DOIUrl":"https://doi.org/10.4103/aam.aam_524_26","url":null,"abstract":"<p><strong>Background: </strong>Sickle-cell disease (SCD) poses significant maternal and neonatal risks during pregnancy. Assessing the perinatal outcomes in pregnant women with homozygous SCD (HbSS) to optimize management strategies is the goal of this study.</p><p><strong>Materials and methods: </strong>A retrospective cross-sectional study was conducted at the Department of Obstetrics and Gynecology, AIIMS Raipur, Chhattisgarh, over 18 months (September 1, 2021, to February 28, 2023). All pregnant women in the third trimester with HbSS admitted to the antenatal care ward were included. Patients with chronic hypertension, diabetes, renal diseases, thalassemia syndromes, or compound sickle-cell syndromes were excluded. Data on maternal and neonatal outcomes were analyzed.</p><p><strong>Results: </strong>The mean hemoglobin at admission was 7.98 + 2.19 g/dL. 65.9% of women required antenatal transfusions. 38.2% of women developed sickle-cell crisis. 23.5% of women required intensive care unit admission in the antenatal and postnatal period. Notable was the mortality of 5.8% of women, which occurred in the postnatal period. 61.8% of women underwent cesarean section, with fetal distress as the most common indication. The mean birth weight was found to be 2.51 ± 0.47 kg. However, there was no neonatal mortality.</p><p><strong>Conclusion: </strong>Optimizing perinatal care requires an understanding of the maternal and neonatal problems linked to SCD during pregnancy. This study emphasizes how crucial multidisciplinary management is to reducing unfavorable results.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219843","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":"Platelet Indices as Biomarkers of Disease Severity and Morbidity in Hospitalized Dengue Patients.","authors":"Upendra Prasad Sahu, Praveen Kumar Singh, Neha Rani, Ankita Raj, Rahul Mukherjee, Shrasta Soumya, Ankita Dinkar","doi":"10.4103/aam.aam_591_26","DOIUrl":"https://doi.org/10.4103/aam.aam_591_26","url":null,"abstract":"<p><strong>Background: </strong>Dengue fever is a rapidly expanding mosquito-borne illness with significant morbidity in children. While thrombocytopenia is a key feature, platelet count alone poorly predicts disease severity. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) may provide better insight into disease progression and complications.</p><p><strong>Materials and methods: </strong>This hospital-based cross-sectional observational study was conducted in the Department of Pediatrics, at a tertiary care hospital over 18 months. A total of 120 children aged 1-16 years with confirmed dengue infection (NS1 antigen or immunoglobulin M positive) were enrolled. Platelet indices were recorded at admission. Patients were classified according to the World Health Organization 2009 dengue severity criteria. Associations between platelet indices and disease severity, hepatic dysfunction, and renal dysfunction were analyzed using appropriate statistical tests.</p><p><strong>Results: </strong>Among 120 patients, 35% had dengue without warning signs, 48.3% had warning signs, and 16.7% had severe dengue. MPV and PCT decreased, while PDW increased significantly with disease severity (P < 0.001). Hepatic (31.7%) and renal (9.2%) dysfunction were associated with lower MPV and PCT and higher PDW (P < 0.001). PDW showed a strong positive correlation with severity (r = 0.71), whereas MPV and PCT showed negative correlations.</p><p><strong>Conclusion: </strong>Platelet indices, particularly PDW and PCT, are simple, readily available, and reliable markers for predicting disease severity and organ dysfunction in pediatric dengue. Their routine use may aid early risk stratification, timely intervention, and improved clinical decision-making, especially in resource-limited settings where advanced biomarkers may not be accessible.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219619","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":"Comparison of Outcomes between Teacher-Led Large Group Teaching and Scenario-based Team Learning in Physiology among Phase I MBBS.","authors":"Havilah Twinkle Reddipogu, Ananthakrishnan Nilakantan, Laxmi Chettangada Cariappa","doi":"10.4103/aam.aam_469_26","DOIUrl":"https://doi.org/10.4103/aam.aam_469_26","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In Indian medical colleges, physiology is taught largely using a conventional lecture-based format with its focus on factual information and memorization instead of understanding and application, leading to passive learning. Team-based learning (TBL) is a highly structured form of active-learning strategy designed to integrate engagement, accountability, and application of knowledge to promote learning in large classes. Despite being well-established globally, evidence from Indian medical colleges remains sparse.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The aim of our study is to compare the students' academic performance and perception between teacher-led large-group teaching (TLGT) and scenario-based team learning (SBTL) in selected topics of Physiology among Phase-I MBBS students with regards to conceptual clarity, knowledge retention, teamwork, motivation, communication and readiness for examination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology: &lt;/strong&gt;A mixed-methods approach was adapted, where 167 Phase-I MBBS students participated in both lecture-based classes and team-based learning sessions. Learning outcomes were measured by pretest and posttest scores, a 20-item questionnaire (represented with a Likert scale of 1 = strongly disagree, 5 = strongly agree) and focus-group discussions (FGDs) of students and faculty. Quantitative data were analyzed with descriptive statistics and paired t-tests, and qualitative data were interpreted by Braun and Clarke's six-phase thematic analysis framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Substantial improvements were seen in academic performance (knowledge acquisition) on postintervention analysis (pretest = 9.8 ± 2.4; posttest = 15.6 ± 3.1; P &lt; 0.001; Cohen's d = 1.02), suggesting a highly significant increase in the mean academic scores for SBTL as against lectures. Quantitative analysis of the Likert scale perception study showed that there was a general preference for SBTL (mean = 3.96) over lecture sessions (mean = 3.83) by students. The perception scores of students showed a strongly agree opinion for TBL improving understanding of subject concepts (4.35 ± 0.71), retention (4.22 ± 0.76), teamwork (4.31 ± 0.72), communication (4.18 ± 0.79), and motivation (4.27 ± 0.78). Thematic analysis revealed the major advantages of SBTL as active engagement/involvement, working as a team, correlating clinically, and retention is better, whereas challenges include time constraint, unequal participation and the need for training facilitators to implement TBL better. Student and faculty FGDs reinforced these findings: students reported enhanced participation, peer learning, and motivation, while faculty emphasized improved engagement but raised concerns about preparation time and curricular scheduling. The overall results comply with the international literature and systematic reviews supporting the role of team-based learning as a pedagogical tool to promote self-directed learning, collaboration and use of phys","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163986","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 S-technique: A Novel Dense Polytetrafluoroethylene-assisted Surgical Technique for Peri-implant Keratinized Mucosa Preservation - A Case Review.","authors":"Sunil Kumar Nettemu, Sowmya Nettem, Vijayendranath Nayak, Karthik Kannaiyan, V V Bharathwaj","doi":"10.4103/aam.aam_796_26","DOIUrl":"https://doi.org/10.4103/aam.aam_796_26","url":null,"abstract":"<p><strong>Abstract: </strong>Immediate implant placement following tooth extraction often leads to peri-implant defects that require guided bone regeneration (GBR) to achieve complete bone fill and stable osseointegration. Conventional GBR techniques typically rely on primary flap closure, coronal advancement, and additional soft-tissue grafting, which increase surgical complexity and patient morbidity. The S-Technique was introduced to enable simultaneous hard and soft-tissue regeneration under open-healing conditions while preserving the mucogingival junction. A patient presented with a grossly decayed, painful, vertically fractured, nonrestorable maxillary right second premolar (tooth 15). After atraumatic extraction and immediate implant placement, a peri-implant gap defect with limited soft-tissue availability was noted. GBR was performed using particulate xenograft and a resorbable collagen membrane. A dense polytetrafluoroethylene membrane was then placed according to the S-technique protocol, allowing secondary epithelialization without primary closure. Healing progressed uneventfully. At 4 months, clinical assessment showed complete coverage of the peri-implant site, an adequate band of keratinized mucosa, improved soft-tissue contour, a favorable emergence profile, and stable peri-implant architecture. Prosthetic rehabilitation resulted in satisfactory esthetic and functional outcomes with maintained bone support. This case demonstrates the S-Technique as a minimally invasive dual-layer membrane approach for simultaneous hard and soft-tissue regeneration around immediate implants. By eliminating the need for primary closure and autogenous soft-tissue grafting, it offers a predictable alternative for managing peri-implant defects in sites with limited soft-tissue availability, while promoting keratinized mucosa formation and stable peri-implant tissue integration.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163900","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":"Conus Medullaris Syndrome Following Traumatic Thoracolumbar Burst Fractures: Clinical Presentation, Surgical Management, and Early Outcomes in Three Cases.","authors":"R Ajay, B Vijay Anand, C Rishab, Dhanush Delish, R Rohit Raj","doi":"10.4103/aam.aam_1198_26","DOIUrl":"https://doi.org/10.4103/aam.aam_1198_26","url":null,"abstract":"<p><strong>Abstract: </strong>Burst fractures of the thoracolumbar spine can carry a neurological deficit, particularly where the conus medullaris is injured. Conus medullaris syndrome (CMS) typically disturbs bladder, bowel, and sexual function while sparing much of the leg power, and its earliest signs are easily missed. We report three patients in whom a traumatic thoracolumbar burst fracture produced features of CMS and describe their operative management. A 57-year-old man with an L1 burst fracture and intact leg power presented with bowel and bladder incontinence and underwent posterior stabilization (D11-L3), regaining continence early. A 25-year-old man with an L1 burst fracture and sacral involvement after a fall from height had impaired voiding and defecation with blunted S3-S5 sensation and was treated with L1 decompression with stabilization (D12-L2). A 62-year-old woman with a 2-month-old D12 nonunion, paraparesis, and multilevel disc protrusion underwent D10-L2 transforaminal lumbar interbody fusion. All three patients demonstrated neurological improvement after surgical decompression and stabilization. Early recovery of bladder function occurred in one patient, while the remaining two experienced symptomatic improvement with ongoing rehabilitation. Thoracolumbar burst fractures involving the T12-L2 region may compress the conus medullaris, resulting in a spectrum of neurological deficits ranging from isolated sphincter dysfunction to mixed upper and lower motor neuron signs. Early recognition requires careful neurological examination, particularly assessment of sacral sensation and sphincter function, and early magnetic resonance imaging and prompt posterior decompression with fixation favor recovery, though return of bladder and sphincter function stays unpredictable.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164605","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":"Oxytocin versus Carbetocin: Preventing Postpartum Hemorrhage in Elective C-section.","authors":"Megha Singh, Sauda Alam, Sumesh T Rao, T Megha","doi":"10.4103/aam.aam_522_26","DOIUrl":"https://doi.org/10.4103/aam.aam_522_26","url":null,"abstract":"<p><strong>Background: </strong>Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide, particularly following cesarean delivery (CD). Uterotonics are routinely administered to prevent uterine atony and reduce PPH risk. This study aimed to compare the efficacy and safety of intramuscular carbetocin versus intravenous oxytocin in preventing PPH during elective CD under spinal anesthesia.</p><p><strong>Methods: </strong>This comparative observational study was conducted at a tertiary care hospital in India. Sixty pregnant women undergoing elective CD under spinal anesthesia were divided into two groups: Group C received intramuscular carbetocin 100 μg, and Group O received intravenous oxytocin infusion 20 IU. Primary outcome was changes in hemodynamic parameters, including heart rate, blood pressure (BP), and mean arterial pressure (MAP); secondary outcomes included uterine tone scores, need for additional uterotonics, and requirement for vasoactive agents.</p><p><strong>Results: </strong>Hemodynamic parameters, including MAP and diastolic BP remained more stable in the carbetocin group. Carbetocin demonstrated better uterine tone at 2, 5, and 10 min postdelivery (P < 0.001). The need for additional uterotonics was significantly lower in the carbetocin group (10% vs. 40%, P = 0.007), and only 3.3% required vasoactive agents compared to 53.3% in the oxytocin group (P < 0.001).</p><p><strong>Conclusion: </strong>Carbetocin was associated with improved uterine tone, reduced need for additional uterotonics, and better cardiovascular stability compared to oxytocin. These findings suggest that intramuscular carbetocin may be a more effective and safer alternative to intravenous oxytocin for PPH prevention in elective CD.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164978","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":"Cone-beam Computed Tomography Evaluation of Skeletal and Dentoalveolar Alteration Following Twin Block versus Fixed Functional Appliance in Mandibular Advancement.","authors":"Omar Khalfan Saeed Alkindi Alsuwaidi, Anuj Lavania, Sujit Panda, P C Ramesh Kumar, Nikita Mishra, Pallavi Chandrashekhar, Pallavi Nanaiah, Murali Patla Shivarama Bhat","doi":"10.4103/aam.aam_719_26","DOIUrl":"https://doi.org/10.4103/aam.aam_719_26","url":null,"abstract":"<p><strong>Introduction: </strong>Mandibular retrognathism is commonly managed during growth modification using functional appliances. Cone-beam computed tomography (CBCT) allows accurate evaluation of skeletal and dentoalveolar changes. This study compared the skeletal, dentoalveolar, and temporomandibular joint (TMJ) alterations in growing patients after receiving twin block and fixed functional appliance therapy.</p><p><strong>Materials and methods: </strong>Thirty participants, aged 11-15 years, diagnosed with Class II malocclusion due to mandibular retrognathism were included in this comparative clinical investigation. Two groups of patients were split equally as twin block and fixed functional appliance therapy groups. CBCT evaluations were performed at baseline (T0) and posttreatment (T1). Skeletal, dentoalveolar, and TMJ parameters were assessed and compared between the groups.</p><p><strong>Results: </strong>Skeletal analysis showed significantly greater mandibular advancement in the twin block group, with increased SNB and Co-Gn measurements. There was a greater reduction in ANB angle compared to the fixed functional group, indicating superior orthopedic effects. Dentoalveolar changes revealed controlled maxillary incisor retroclination in both the groups. However, mandibular incisor proclination (IMPA) was significantly higher in the fixed functional group. TMJ evaluation demonstrated adaptive remodeling in both the groups, with the twin block appliance showing more favorable anterior and posterior joint space changes.</p><p><strong>Conclusion: </strong>Both twin block and fixed functional appliances are efficient in treating Class II malocclusion in growing patients. Twin block therapy produces more favorable skeletal advancement and TMJ remodeling, whereas fixed functional appliances rely more on dentoalveolar corrections.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163899","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":"From Rare to Rising: A Story of Enterobacter-associated Pneumonia Evolving in the Community.","authors":"Soma Bose, Debarati Banerjee, Swashria Bain, Abhijit Datta, Dibyendu Banerjee","doi":"10.4103/aam.aam_693_26","DOIUrl":"https://doi.org/10.4103/aam.aam_693_26","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumonia is a common cause of mortality and morbidity worldwide and is the fifth leading cause of death. It is generally caused by Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, and some atypical microorganisms. Interestingly, a member of ESKAPE pathogens, mainly Enterobacter cloacae complex, is increasingly showing its presence in the samples of lower respiratory tract specimens. Emergence of multidrug resistance (MDR) in these bacteria, including resistance to last-resort carbapenems, has led to an increased interest in this organism causing pneumonia.</p><p><strong>Aims and objectives: </strong>(1) Prevalence of E. cloacae complex among community-acquired pneumonia (CAP) patients and (2) antibiotic resistance pattern of these pathogens.</p><p><strong>Materials and methods: </strong>Respiratory samples from adult patients were processed according to standard microbiological techniques, including direct smear examination, incubation in blood, MacConkey and chocolate agar plates, and Gram staining. Identification of E. cloacae complex and antibiotic susceptibility testing, along with resistance patterns, was performed by automated ID/AST instrument.</p><p><strong>Results: </strong>About 15.7% of E. cloacae complex-associated CAP patients were found over a 1-year study period. Antimicrobial susceptibility tests indicated a MDR profile in 58.3% of isolates. Resistance was mostly to carbapenems (72.73%), followed by aztreonam (69.7%), piperacillin-tazobactam (68%), and fluoroquinolones (63.6%).</p><p><strong>Conclusion: </strong>E. cloacae complex is an emerging and clinically significant pathogen causing CAP. Its MDR profile contributes to an increased tendency to intensive care unit admission and the development of sepsis. Hence, detecting this pathogen in lower respiratory tract specimens should be treated as a high alert and should prompt treatment at the earliest.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163516","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}