Annals of African Medicine最新文献

{"title":"Evaluation of Intraoperative Findings and the Role of Biliary Mapping Using Methylene Blue in Laparoscopic Cholecystectomy: A Cross-sectional Study.","authors":"Ravendra Kumar, Faraz Ahmad, Sanjeev Kumar, Akshay Anand, Surender Kumar","doi":"10.4103/aam.aam_307_24","DOIUrl":"https://doi.org/10.4103/aam.aam_307_24","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is the most effective treatment for gallstones. Anomalies in the biliary tree provide a risk and increase the probability of bile duct injury. The use of methylene blue for bile duct mapping may enhance intraoperative visibility; nevertheless, its efficacy and feasibility remain uncertain.</p><p><strong>Aim: </strong>The aim of this study was to evaluate intraoperative findings during LC and assess the role of biliary mapping using methylene blue in identifying biliary anatomy and reducing complications.</p><p><strong>Materials and methods: </strong>A total of 84 gallstone patients scheduled for LC were included. After obtaining informed consent from the patients, methylene blue was injected into the gallbladder to visualize the architecture of the bile ducts. The intraoperative results, anatomical changes, and complications were analyzed.</p><p><strong>Results: </strong>The majority of intraoperative findings consisted of short cystic ducts (55.95%), followed by normal ducts (13.10%) and elongated ducts (8.33%). Uncommon observations included intrahepatic gallbladder (4.76%), colonic adherent gallbladder (2.38%), and twisted common bile duct. No significant adverse effects of methylene blue were noted. Methylene blue bile mapping enhanced the visibility of the bile duct architecture, particularly in cases with anatomical anomalies, and reduced the likelihood of bile duct injury.</p><p><strong>Conclusion: </strong>Methylene blue bile mapping is a cost-effective and practical tool for LC that identifies bile duct architecture and reduces problems. This study suggests that it may be safer than intraoperative cholangiography in resource-limited situations.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697366","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":"Type 2 Diabetes in Morocco: Toward a Precision Diabetology, from Pathogenesis to Treatment.","authors":"Ahmed Anas Guerboub, Jade Issouani, Ikhlass Lakssir, Hajar Srifi, Malak Riznat, Mohamed Malad, Mustapha Asfour, Abderrahaman Tadlaoui, Yassine Errahali","doi":"10.4103/aam.aam_87_25","DOIUrl":"https://doi.org/10.4103/aam.aam_87_25","url":null,"abstract":"<p><strong>Background: </strong>The traditional classification of diabetes into types 1 and 2 does not reflect its heterogeneity in presentation, progression, treatment response, and complications.</p><p><strong>Methods: </strong>This study explores a new classification based on five distinct subgroups to enhance understanding and management. Its applicability was tested in 1002 newly diagnosed Moroccan type 2 diabetes patients and compared with the Indian \"WellGen\" and Swedish \"ANDIS\" cohorts.</p><p><strong>Results: </strong>Newly diagnosed Moroccan type 2 diabetics were mainly classified into four subgroups designated as: severe insulin deficiency diabetes (SIDD), severe insulin resistance diabetes (SIRD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD). One thousand and two patients were included in our study with a sex ratio of 1. Patients were classified into the subgroups of MARD (42%), MOD (21%), and SIDD (19%), while SIRD was 14%. In our study, retinopathy and neuropathy were more prevalent in the SIDD subgroup, while nephropathy in the SIRD, while patients in the MARD group had a higher prevalence of cardiovascular complications.</p><p><strong>Conclusions: </strong>Our results provide useful clues as to the pathophysiological mechanisms and susceptibility to complications of type 2 diabetes in the Moroccan population, and suggest a need to review management strategies. Our results confirm the new diabetic subgroups proposed by similar studies, suggesting a possible generalization of this diabetes classification to Africa and the MENA region.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697442","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 and Angiographic Profile of Acute Coronary Syndrome in Adults Under 40 Years: A Cross-sectional Observational Study.","authors":"Tushar Pancholi, Pradnya Diggikar, Madineni Madhukar, Yammanuru Bhavya Sri, Sreevidya Yekkaluru, Shivraj Patil, Priyanka Aher, Prashansa Gupta","doi":"10.4103/aam.aam_129_25","DOIUrl":"https://doi.org/10.4103/aam.aam_129_25","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) in young adults presents unique clinical and diagnostic challenges, with limited data from the Indian subcontinent.</p><p><strong>Aim: </strong>This study aims to assess the clinical profile, risk factors, and diagnostic findings of ACS in adults aged ≤40 years.</p><p><strong>Materials and methods: </strong>This hospital-based, cross-sectional study included 60 patients aged 18-40 with confirmed ACS. Clinical symptoms, laboratory investigations, Electrocardiography (ECG), echocardiography, and coronary angiography were analyzed. Associations were tested using the Chi-square test, with P < 0.05 considered statistically significant.</p><p><strong>Results: </strong>The median age was 35.5 years; 96.7% were males. Breathlessness and palpitations were reported in all cases, while chest pain was present in 81.7%. Hypertension (40%), diabetes (31.7%), smoking (28.3%), and drug use (55%) were common risk factors. Single-vessel disease was the predominant angiographic finding (61.7%). Smoking correlated significantly with ECG abnormalities (P = 0.0382), and diabetes with severe coronary involvement (P = 0.0429).</p><p><strong>Conclusions: </strong>ACS in young adults is more prevalent in males and often presents with nonclassical symptoms. Diabetes and smoking are significantly associated with diagnostic severity. Early risk identification and preventive strategies are essential in this population.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697362","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":"Role of Thoracic Epidural Anesthesia in Providing Adequate Intraoperative and Postoperative Opioid-free Analgesia for Breast Cancer Surgeries.","authors":"Nitu Puthenveettil, Sunil Rajan, Jerry Paul","doi":"10.4103/aam.aam_130_25","DOIUrl":"https://doi.org/10.4103/aam.aam_130_25","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most common malignancy in women. Postoperative pain and opioid analgesics are suspected to influence cancer recurrence. In this study, we try to assess the feasibility of providing complete opioid-free surgical anesthesia and postoperative analgesia for breast cancer surgeries.</p><p><strong>Methodology: </strong>This prospective observational study was performed on 30 patients posted for breast cancer surgery under thoracic epidural anesthesia. The epidural catheter was placed in the upper thoracic space. A titrated bolus of 10-12 mL of 2% lignocaine with adrenaline followed by an infusion of 0.2% ropivacaine at 5-10 mL/hour was used. Time taken from epidural bolus to skin incision, the total dose of local anesthetic and propofol required, postoperative pain score, the patient and surgeon satisfaction score, and adverse events were noted.</p><p><strong>Results: </strong>Opioid-free epidural anesthesia was successful in all patients. The average time required to start the surgery after placement of the epidural catheter was 17.8 ± 2.5 min. The average total dose of local anesthetic and propofol supplemented was 6.9 ± 4.5 mL and 18.9 ± 11.8 mg, respectively. Postoperative pain scores were <4 at all time points. The average surgeon and patient satisfaction scores were 9.1 ± 0.2 and 9.1 ± 0.2, respectively. Thirteen percent of patients required treatment for hypotension. There were no episodes of bradycardia or airway compromise.</p><p><strong>Conclusions: </strong>Based on our data, it appears to be safe to perform opioid-free breast cancer surgeries under thoracic epidural anesthesia with complimentary sedation and local infiltration. Epidural infusion of local anesthetic provides excellent intra- and postoperative analgesia, which helps avoid the use of opioids.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697439","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":"Traditional Aqueous and Ethanol Maceration of Hamelia patens Leaves: A Phytochemical and Pharmacological Exploration.","authors":"Anita Devi Krishnan Thantry, Kosuri Kalyan Chakravarthi, Ashwathy Varadarajan Thundakattil, Kalidasan Vasodavan","doi":"10.4103/aam.aam_152_25","DOIUrl":"https://doi.org/10.4103/aam.aam_152_25","url":null,"abstract":"<p><strong>Background: </strong>Hamelia patens Jacq., commonly referred to as firebush, is a tropical shrub belonging to the Rubiaceae family. It has been traditionally employed in various ethnomedical practices to address ailments such as dermatological infections, inflammatory conditions, and gastrointestinal disturbances. These therapeutic applications are attributed to its diverse array of bioactive phytoconstituents, including alkaloids, flavonoids, and phenolic compounds. Despite extensive studies on organic solvent extracts, there remains a paucity of data concerning the efficacy and phytochemical composition of traditional aqueous extracts.</p><p><strong>Objective: </strong>This investigation aims to delineate the maceration-based extraction methodologies utilizing aqueous and ethanol solvents for H. patens leaves and to underscore the significance of each method in isolating pharmacologically active compounds.</p><p><strong>Materials and methods: </strong>Freshly harvested H. patens leaves underwent thorough washing and were subsequently dried either by air in a shaded, well-ventilated environment or using an oven maintained at 40°C-50°C to preserve thermolabile constituents. The desiccated leaves were then pulverized into a coarse powder. For extraction, 5 g of the coarsely powdered material were subjected to maceration with 100 mL of distilled water and 50 mL of ethanol (70%-95%) for a duration of 24-72 h at ambient temperature, with intermittent agitation to facilitate solvent penetration. Postmaceration, the mixtures were filtered to obtain the respective aqueous and ethanol extracts. Comprehensive phytochemical screening was conducted to detect the presence of alkaloids, flavonoids, tannins, saponins, phenolics, glycosides, triterpenoids, phytosterols, and carbohydrates.</p><p><strong>Results: </strong>Phytochemical analyses revealed that the aqueous extract evaluated positive for alkaloids, saponins, phytosterols, phenols, flavonoids, carbohydrates, glycosides, and triterpenoids, while tannins were absent. Conversely, the ethanol extract demonstrated the presence of phytosterols, phenols, flavonoids, carbohydrates, glycosides, and triterpenoids but evaluated negative for tannins, alkaloids, and saponins. These findings suggest that solvent polarity plays a pivotal role in the selective extraction of phytochemicals, with aqueous extraction favoring polar compounds and ethanol extraction being more efficacious for semi-polar constituents.</p><p><strong>Conclusion: </strong>Maceration employing aqueous and ethanol solvents effectively isolates distinct profiles of bioactive compounds from H. patens leaves. The aqueous extract, enriched with polar phytochemicals, aligns with traditional medicinal preparations, whereas the ethanol extract, containing a broader spectrum of semi-polar compounds, holds considerable promise for pharmaceutical applications.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697440","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 Role of Antidotes in Managing Toxicological Emergencies: Historical Evolution, Categorization, and the Importance of Antidote Banking - A Review of Literature.","authors":"Venkatesh Janarthanan, Ninad Nagrale, M Senthil Kumaran, Arijit Dey, O Gambhir Singh","doi":"10.4103/aam.aam_149_24","DOIUrl":"10.4103/aam.aam_149_24","url":null,"abstract":"<p><p>Poisoning represents a significant and growing public health concern, as evidenced by the data from the National Crime Records Bureau indicating that poisoning accounted for 25.1% of the 164,033 reported suicides in 2021, with an additional 0.4% related to the ingestion of sleeping pills. This highlights the urgent need for effective antidotes in the management of toxicological emergencies. Antidotes, defined as therapeutic agents that counteract the effects of poisons, drugs, or toxins, play a critical role in toxicology. Their mechanisms of action include altering toxicokinetics, halting absorption, neutralizing toxins, or inhibiting harmful metabolic conversions. This review delves into the historical development of antidotes, their categorization, recommended dosages, indications, contraindications, and potential side effects. It also explores the concept of antidote banking, a strategic approach to ensure the availability of antidotes during emergencies. Understanding these aspects is vital for healthcare professionals in managing acute, unintentional, or self-poisoning cases effectively, especially among young adults. The historical evolution from Mithridatism, the first known antidote, to modern, evidence-based antidotes demonstrates significant advancements in medical science. Antidotes are categorized based on their mechanisms, including toxic effect bypass, inert complex formation, accelerated detoxification, reduced toxic conversion, receptor site blockade, and receptor site competition. In addition, they are classified by their site of action: serological, pharmacological, mechanical, physical, and chemical. Antidote banking, endorsed by the World Health Organization, emphasizes the need for a reliable supply of critical, emergency, and urgent antidotes to manage poisoning incidents efficiently. This comprehensive review provides valuable insights into antidote development and application, contributing to enhanced public health responses to toxicological emergencies.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"515-521"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186307","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 of Motor Evoked Potential on Intraoperative Neurophysiological Monitoring Cases of Neurosurgeries.","authors":"Deepshikha, Manish Bajpai, B K Ojha, Dileep Kumar Verma, Afreen Saif, Akhilesh Kumar Verma","doi":"10.4103/aam.aam_133_24","DOIUrl":"10.4103/aam.aam_133_24","url":null,"abstract":"<p><strong>Background: </strong>Motor evoked potential (MEP) monitoring is crucial in intraoperative neurophysiological monitoring (IONM) during neurosurgeries, but its effectiveness is influenced by factors such as anesthesia type, patient condition, and surgical technique. Interpreting MEP changes requires expertise due to technical issues and neural injury. Clinical studies show MEPs reduce permanent motor deficits, improving surgical outcomes and patient safety. This study aims to evaluate the efficacy and outcomes of MEP monitoring in IONM during neurosurgeries.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at King George's Medical University, Lucknow, involving 132 patients undergoing elective surgery and above 2 years of age. The study excluded trauma patients, severely ill patients, morbidly ill patients, and those under 2 years old patients. The study involved subjects from the Department of Neurosurgery at King George's Medical University, Lucknow. Intraoperative neuromonitoring was performed using the Medtronic Nim-Eclipse System. MEP was used to monitor the functional integrity of corticospinal tracts by stimulating the patient's motor cortex transcranially and recording the activity in selected muscles.</p><p><strong>Results: </strong>Out of 132, a total of 75 (59.09%) patients were male and 57 (40.91%) patients were female. Patient distribution is based on age group, with ≤20 years being the most common age group, followed by 21-30 years, 31-40 years, 41-50 years, 51-60 years, and >60 years, respectively. The neurological impairments observed after surgery in the form of MEP waveforms. Of the 39 patients, 2 individuals (5.13%) had neurological impairment at the end of the procedure.</p><p><strong>Conclusion: </strong>The study suggests that monitoring evoked potentials can detect and address neurological issues, improve postoperation function, and enhance patient safety and surgical outcomes in neurosurgery. It emphasizes the importance of MEP monitoring for assessing motor pathway integrity and recommends further studies with larger cohorts.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"617-620"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186327","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 and Radiological Evaluation of Severity of Acute Ischemic Stroke with Special Reference to Neuroinflammatory Biomarkers.","authors":"K C Shashidhara, Ashika Reddy Padamati, M Manthappa, M C Prasad","doi":"10.4103/aam.aam_78_24","DOIUrl":"10.4103/aam.aam_78_24","url":null,"abstract":"<p><strong>Background: </strong>Given the complexity of stroke, diverse mechanisms are known to be involved in its pathophysiology among which inflammation is one of the major culprits. Poor clinical outcomes are seen in those stroke patients with significant systemic inflammation. Therapeutic options to fight stroke are still limited and the only approved drug is tissue-plasminogen activator and/or mechanical thrombectomy. As inflammation highly influences susceptibility of stroke patients to overcome the disease, there is an increasing need to develop new diagnostic, prognostic, and therapeutic strategies for poststroke inflammation.</p><p><strong>Subjects and methods: </strong>This study was conducted over a period of 18 months. Seventy-five patients who were diagnosed with acute ischemic stroke based on patient's clinical history, neurological signs, and radioimaging were included. Patients underwent computed tomography scan/magnetic resonance imaging scan within 24 h of admission to exclude stroke mimics and primary intracerebral hemorrhage. National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of stroke clinically. Inflammatory biomarkers such as plasma MMP-9, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and S100B were measured using the ELISA kits.</p><p><strong>Results: </strong>We observed that plasma concentration of MMP-9, IL-6, and S100B showed statistical significant association with severity of stroke as assessed by NIHSS, with Chi-square test values of χ 2 = 24.69 for IL-6 ( P = 0.00), χ 2 = 11.91 for S100B ( P = 0.008), and χ 2 = 19.5 for MMP-9 ( P = 0.00). The mean values of MMP-9, IL-6, S100B levels, and hs-CRP levels were significantly elevated in severe, moderately to severe stroke groups as related with mild stroke group as evaluated by NIHSS.</p><p><strong>Conclusion: </strong>Neuroinflammatory markers such as MMP-9, IL-6, S100B, and hs-CRP are the promising tool as inflammatory biomarkers with other indicators of acute ischemic injury to diagnose acute ischemic stroke and facilitate a better clinical assessment of patients during the acute phase of the disease. More importantly, this study showed that these biomarkers have strong independent prediction values for stroke outcome. We propose that some of those biomarkers might turn out to be targets to be therapeutically altered overcoming the urgent need for the identification of potent drugs to modulate stroke-associated inflammation.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"567-572"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762846","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":"Pathogenesis and Current Treatment Strategies in Rheumatoid Arthritis: A Systematic Review Article.","authors":"Debajani Deka","doi":"10.4103/aam.aam_11_24","DOIUrl":"10.4103/aam.aam_11_24","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic, symmetrical, and inflammatory autoimmune disease that initially affects small joints, progressing to larger joints, and eventually the skin, eyes, heart, kidneys, and lungs. It has been recorded that RA affects 0.5%-1% of the adult population of developed regions. It initially affects small joints, progressing to larger joints, and eventually the skin, eyes, heart, kidneys, and lungs. Often, the bone and cartilage of joints are destroyed, and tendons and ligaments weaken. All this damage to the joints causes deformities and bone erosion, usually very painful for a patient. RA by producing inflammatory cytokines and proteinases, such as matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases that perpetuate joint destruction by abnormal proliferation of synovium. Under the influence of synovial cells, cytokines such as - Interleukin (IL)-1 and IL-17 chondrocytes are destroyed by apoptosis. Again the extracellular matrix secretes a proteinase called MMPs that damages the type 2 collagen fibers of the cartilage matrix causing biomechanical changes to the joint movements. This way with destruction of articular cartilage of the joint surface by hyperplastic synovium leads to a reduction of joint space. The difference between the hyaline cartilage of the articular surface and other hyaline cartilage is that articular hyaline cartilage never undergoes regeneration. With limited membrane permeability and poor gastrointestinal stability, monoclonal antibodies (mABs) do not have good oral bioavailability (<1%). For this reason, they are usually not administered orally, and parenteral administration is mostly by intravenous, subcutaneous (SC), and intramuscular (IM) injections. When mABs are injected IM or SC, the absorption process from the site of injection is through the interstitial space and into the lymphatic system, with subsequent draining into the systemic circulation. Although IM and SC routes of administration offer lower bioavailability because of proteolytic degradation in the interstitial fluid or the lymphatic system, the SC route is the most widely used due to convenience and the possibility of patient self-administration. For these last two routes of administration, the peak plasma concentration after a single dose is achieved 3-7 days after administration, due to the slow absorption into the systemic circulation. Other potential routes of administration include intravitreal, intraperitoneal, and pulmonary. CRD NUMBER-42024601637.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"532-539"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967553","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":"Role of Micro RNA Expression as Biomarker in Breast Cancer.","authors":"Gitika Nanda Singh, Nijarth Shahi, Parijat Suryavanshi, Krishna Kant Singh, Neetu Nigam","doi":"10.4103/aam.aam_78_23","DOIUrl":"https://doi.org/10.4103/aam.aam_78_23","url":null,"abstract":"<p><strong>Background: </strong>The most common cancer in women is breast cancer (BC). MicroRNA-21 was one of the first oncomiRs to be found at elevated levels in a number of malignancies, including gliomas, BC, and colorectal cancer (miR-21). MiRNA is associated with processes such as apoptosis, invasion, metastasis, and proliferation, which are known features of cancer. This study aimed to investigate the molecular basis and clinical significance of miR-21 in BC, as microRNAs play a critical role in this disease.</p><p><strong>Materials and methods: </strong>MiR 21 was then analyzed by the quantitative polymerase chain reaction (qPCR) using the Taq-Man probe. The thermal profile included 5 min of denaturation at 95°C, then 40 cycles of denaturation at 95°C for 20 s, annealing at 52°C for 20 s, and extension at 72°C for 30 s. Two separate runs of real-time polymerase chain reaction and reverse transcription (RT) were then performed. Relative quantification of the gene expression levels (fold change) based on computed tomography values was used to examine the data from RT-qPCR for miR-21 and Glyceraldehyde-3-phosphate dehydrogenase (Livak and Schmittgen).</p><p><strong>Results: </strong>The mean fold change in serum miR-21 levels was significantly higher in cases (8.17 ± 2.49) than in controls (1.02 ± 0.23). The mean fold change in serum miR-21 levels in Stages III, IV and lymph nodes were significantly higher than in Stages I and II. The mean fold change in serum miR-21 gene expression was significant with the changes in different Ki67 levels.</p><p><strong>Conclusions: </strong>Our results demonstrate the importance of miR-21 plasma level as a diagnostic and prognostic biomarker for BC.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"24 3","pages":"549-554"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697443","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}