Annals of African Medicine最新文献

{"title":"To Correlate the Relationship between Diabetic Retinopathy, Diabetic Peripheral Neuropathy, and Its Association with Glycemic Control in Rural Population of South India.","authors":"Sri Archana, T R Manjula, Chethan B Shetty, Sangeetha Jeganathan, Keerthan Rao","doi":"10.4103/aam.aam_433_25","DOIUrl":"10.4103/aam.aam_433_25","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) and diabetic peripheral neuropathy (DPN) are among the most prevalent complications of diabetes mellitus (DM), both of which stem from microvascular complications and are believed to have a shared underlying pathophysiology. A notable challenge is that patients may go unnoticed for either condition by their treating physician, given that these complications typically fall under different medical specialties. Consequently, this study aimed to investigate the clinical correlation between the severity of DR and DPN and explore their associations with glycemic variability and the levels of glycated hemoglobin (HbA1c).</p><p><strong>Methodology: </strong>This is a hospital-based cross-sectional observational study involving 156 patients attending the ophthalmology outpatient department and the inpatient department at a tertiary care hospital in rural South India over a period of 2 years.</p><p><strong>Results: </strong>There was an increase in the severity of DR with increasing duration of DM among patients ( P < 0.001). The proportion of patients with DPN notably increased with increasing severity of DR among the patients ( P < 0.001). Notably, the number of patients with DR and DPN changes increased with increasing glycemic values. These findings suggest a statistically significant association between DR and DPN and glycemic control.</p><p><strong>Conclusion: </strong>This study revealed a positive correlation between the severity of DR and the presence of DPN, along with an association with HbA1c variability. This underscores the importance of interdisciplinary collaboration for comprehensive evaluation and management.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1491-1496"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and Emotional Modulation through Vipassana Meditation: A Pre-experimental Study.","authors":"Tilottama Wankhade, Sujata R Lavangare, Akanksha P Dani","doi":"10.4103/aam.aam_426_25","DOIUrl":"10.4103/aam.aam_426_25","url":null,"abstract":"<p><strong>Context: </strong>Vipassana meditation (VM), a mindfulness-based practice, has been known to promote good health all the way. Global chronic diseases such as cardiovascular diseases, diabetes, and hypertension often bring physical and mental pain together. Through developing emotional regulation and helping to reduce stress, VM can be used as an alternative medicine in combination with the conventional therapies now used for treating this condition.</p><p><strong>Objective: </strong>The aim of the study was to evaluate how VM alters key health measures, including body weight, blood pressure and sugar levels, pulse rate, body mass index (BMI), and emotional state. It also sought to identify changes in emotional spectrum of reactions, such as fear, expectations, and concern before/after the 10-day VM camp.</p><p><strong>Materials and methods: </strong>A pre-experimental study was done at Khadavli Vipassana Center, from which time it admitted 156 first-time participants. After excluding four participants, the final sample size was 152. Health indices were assessed before and after the meditation using standard tools, while the emotional spectrum was ascertained with a unstructured questionnaire. Paired samples t -tests and analysis of the content of emotional responses were conducted on the data.</p><p><strong>Results: </strong>There were significant improvements in physical health: the participants' mean weight decreased by 0.8 kg, BMI dropped 0.3 kg/m², and their systolic and diastolic readings were slightly reduced. This was accompanied with reduced random blood sugar (by 8.8 mg/dl). Oxygen saturation (SpO₂) increased by 0.92%. Emotional responses demonstrated a marked reduction in fear and a corresponding increase in positive affect, including enhanced feelings of peace and well-being, observed upon completion of the 10-day intervention period. People said that they had found peace of mind and taken away stress.</p><p><strong>Conclusion: </strong>VM has a significant impact on the physical health system and psychological health, which suggests that it may be not only useful in relieving chronic illness but also could become an adjunct to standard medical treatment. Randomized controlled trials are needed to confirm these findings.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1530-1537"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Autonomy: Enhancing Accuracy in Medical Decision-making Capacity Assessment.","authors":"Mohammad Ajaz Alam, Ayushi Garg, Srishty Agarwal, Amishi Singla, Baltej Singh, Brian Mcgillen, Rohit Jain","doi":"10.4103/aam.aam_415_25","DOIUrl":"10.4103/aam.aam_415_25","url":null,"abstract":"<p><strong>Abstract: </strong>Evaluating medical decision-making capability (DMC) is critical for maintaining patient autonomy and informed consent in health care. DMC refers to a patient's ability to comprehend information about their treatment, recognize its implications, reason through the options, and articulate their decision. Several assessment techniques, including the Aid to Capacity Evaluation, the Hopkins Capacity Assessment Test (HCAT), Understanding Treatment Disclosure (UTD), and the MacArthur Competence Assessment Tool, have been discussed in this review. The legal distinction between decisional ability and competence is stressed, with courts making legal decisions based on expert testimony and healthcare providers conducting clinical assessments. The review also underlines the responsibility of physicians in assessing DMC and the need for continued monitoring in cases of shifting states such as delirium. This review emphasizes the importance of standardized training and robust tools for improving the accuracy and consistency of DMC assessments, ensuring that patient decisions are informed and autonomous.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1393-1399"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Analysis of the Efficacy of CD117 and Special Stains as Indicators of Mechanical Asphyxial Deaths.","authors":"Raghvendra Singh Shekhawat, Rahul Panwar, Meenakshi Rao, Vikas Premlal Meshram, Meena Suresh Kumar, Sridevi Gnanasekaran, Mohini Rathore, Tanuj Kanchan","doi":"10.4103/aam.aam_377_25","DOIUrl":"10.4103/aam.aam_377_25","url":null,"abstract":"<p><strong>Background: </strong>Determining the cause of death in suspected asphyxia is often difficult when external findings are absent. Mast cells (MCs) may provide objective histological evidence of hypoxia.</p><p><strong>Objective: </strong>To compare the efficacy of immunohistochemistry (IHC) using CD117 with Toluidine Blue (TB) and Giemsa (GM) stains in detecting mast cells in asphyxial and non-asphyxial lung tissues.</p><p><strong>Materials and methods: </strong>Lung samples from 164 medicolegal autopsies at AIIMS Jodhpur were studied, 57 asphyxial and 107 non-asphyxial deaths. Peribronchial and perialveolar regions were examined using TB, GM, and IHC (CD117). Mean mast cell counts were compared using Mann-Whitney U and Kruskal-Wallis tests.</p><p><strong>Results: </strong>Mast cell counts were significantly higher in asphyxial cases. Peribronchial counts: IHC 2.27 ± 1.02, TB 2.29 ± 1.19, GM 0.84 ± 0.59. Perialveolar counts: IHC 0.74 ± 0.12, TB 0.10 ± 0.19, GM 0.01 ± 0.51. IHC was more sensitive than GM (P < 0.001), while TB showed comparable efficacy to IHC.</p><p><strong>Conclusion: </strong>CD117-based IHC is the most sensitive method for identifying mast cells in asphyxial lungs, though TB remains a valuable low-cost option. Mast cell analysis can serve as an adjunct marker in diagnosing mechanical asphyxia.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1699-1706"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of the Nuclear Factor Kappa-light-chain-enhancer of Activated B-cells Pathway Induces a Pro-inflammatory Network in Patients with Pulmonary Tuberculosis.","authors":"Vanitha Gnanasoundran, Suganya Kannan, Jeyakumar Balakrishnan","doi":"10.4103/aam.aam_133_26","DOIUrl":"10.4103/aam.aam_133_26","url":null,"abstract":"<p><strong>Background: </strong>Leukocyte-stimulating inflammatory cytokines, including interleukin (IL)-27, IL-1β, and IL-10, in conjunction with the transcription factor nuclear factor kappa-light-chain-enhancer of activated B-cells (NF-κB), are essential in limiting Mycobacterium tuberculosis infections; however, it remains uncertain if these indicators are a reliable indicator of the severity of TB illness.</p><p><strong>Materials and methods: </strong>Using real-time polymerase chain reaction (PCR), we examined the mRNA expression of IL-27, IL-1β, IL-10, and NF-κB in peripheral blood mononuclear cell responses in patients with tuberculosis (TB) ( n = 25).</p><p><strong>Results: </strong>PCR amplification of 16S specific to mycobacterium DNA showed 84% positivity rate among the 25 samples. Sputum patients with active TB showed higher activation NF-κB mRNA expression when compared to healthy controls. Furthermore, the multidimensional IL-27 secretion in TB patients showed statistically significant mRNA expression as compared to healthy controls. Similarly, TB patients had drastically changed pro-inflammatory cytokine IL-1β mRNA expression. In addition, TB patients' anti-inflammatory cytokine IL-10 mRNA expression was substantially lower than that of healthy controls.</p><p><strong>Conclusion: </strong>Our findings highlight significant alterations in cytokine expression (IL-27, IL-1β, and IL-10) and NF-κB activation in active TB patients, indicating their potential roles in TB pathogenesis. However, further research is required to confirm their value as biomarkers for disease severity.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1449-1453"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Mitochondrial DNA Copy Number and Redox/Inflammatory States in Diabetic and Nondiabetic Chronic Kidney Disease: A Study in a South Indian Cohort.","authors":"Vasagam Shomnath M Chellam, Rajendran Babu, Jeyakumar Balakrishnan, T Rajendran, Suganya Kannan","doi":"10.4103/aam.aam_319_25","DOIUrl":"10.4103/aam.aam_319_25","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a global health challenge, with diabetic kidney disease being a major cause in India. Mitochondrial dysfunction is central to kidney injury, and mitochondrial DNA copy number (mtDNA-CN) reflects mitochondrial health. This study compared mtDNA-CN in urine cell pellets from diabetic CKD (DCKD), non-DCKD (NDCKD), and healthy controls (HC) in a South Indian cohort.</p><p><strong>Materials and methods: </strong>This prospective, cross-sectional study included 75 participants (25 DCKD, 25 NDCKD, 25 HC). Urine cell pellet mtDNA-CN was measured by qPCR. Statistical analysis used ANOVA/Kruskal-Wallis tests ( P < 0.05 significant).</p><p><strong>Results: </strong>Participants averaged 55.08 ± 13.24 years old. DM patients showed significantly higher mtDNA-CN than non-DM patients (93.96 ± 14.01 vs. 49.04 ± 22.28; P = 0.0001). While no difference existed between CKD Stage III and IV, overall mtDNA-CN varied significantly across No CKD, Stage III, and Stage IV groups ( P = 0.0001). A progressive increase in mtDNA-CN was observed from HC (31.84 ± 13.41) to NDCKD (66.24 ± 14.74) and then to DCKD (93.96 ± 14.01), with highly significant differences among these groups ( P = 0.0001).</p><p><strong>Conclusion: </strong>Our findings indicate a progressive increase in urine cell pellet mtDNA-CN across healthy individuals, NDCKD, and DCKD. This pattern, particularly in DCKD, may reflect a compensatory mitochondrial response to metabolic stress, suggesting mtDNA-CN as a promising noninvasive biomarker for disease monitoring.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1670-1677"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical and Functional Outcome of Extra-articular Distal Humerus Fracture Treated with Locking Compression Plate.","authors":"Ketan Kulkarni, Rahul Salunkhe, Amit Kale, Kishan Mahida, Urva Dholu","doi":"10.4103/aam.aam_432_25","DOIUrl":"10.4103/aam.aam_432_25","url":null,"abstract":"<p><strong>Background: </strong>Extra-articular distal humerus fractures account for approximately 16% of all humerus fractures and 3% of adult fractures. These injuries pose significant treatment challenges due to the complex three-dimensional anatomy and the biomechanical demands placed on the distal humerus.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the clinical and functional outcomes of extra-articular distal humerus fractures treated with locking compression plates.</p><p><strong>Materials and methods: </strong>A prospective study was conducted on 90 patients with extra-articular distal humerus fractures who underwent open reduction and internal fixation using an extra-articular distal humerus plate (EADHP) between June 2020 and March 2023. Patients were followed for an average of 7 months. Functional outcomes were assessed using the Mayo elbow performance score (MEPS), Anderson criteria, and disabilities of the arm, shoulder, and hand (DASH) score.</p><p><strong>Results: </strong>The mean patient age was 45.2 years, with a male predominance (71.7%). Road traffic accidents were the most common cause (81.3%). The average time to fracture union was 10 weeks. The mean MEPS was 84, and the mean DASH score was 15.6. According to the Anderson criteria, 84.4% achieved excellent results and 15.6% achieved good results. Complications included elbow stiffness (12.5%), hardware prominence (6.2%), ulnar neuropraxia (6.2%), infection (3.1%), and heterotopic ossification (3.1%).</p><p><strong>Conclusion: </strong>The EADHP locking compression plate provides excellent stability for extra-articular distal humerus fractures, enabling early mobilization and favorable functional recovery. Its stable construct reduces the risk of implant failure and nonunion, making it a reliable option for these challenging fractures.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1518-1521"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Patterns and Academic Performance among Undergraduate Medical Students: A Cross-sectional Study at a Tertiary Care Teaching Hospital in Chennai, South India.","authors":"Vanathy Karunamoorthy, Nivetha Rajaraman, Aarthi Saravanan, Keerthana Arunagirinathan","doi":"10.4103/aam.aam_195_26","DOIUrl":"10.4103/aam.aam_195_26","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances are common among college students and may adversely affect mood, physical health, and academic performance. Medical undergraduates are particularly vulnerable due to academic stress and demanding schedules. This study aimed to assess and determine the association between sleep quality and academic performance among medical students. Understanding the relationship between sleep quality and academic achievement may help promote healthier sleep behaviors among students.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted from October 2025 to January 2026 among 3 rd -year undergraduate medical students at a tertiary care teaching hospital in Chennai, South India. A total of 100 eligible students were recruited based on the predefined inclusion and exclusion criteria. Data were collected using self-administered, standardized, validated semi-structured questionnaires. Sleep quality and academic performance were assessed and Fisher's exact test was performed through the SPSS software version 25 to determine the association between the variables.</p><p><strong>Results: </strong>Among 100 undergraduate medical students (mean age 21.31 ± 1.10 years), the mean internal assessment score was 41.09 ± 13.93 and the mean global Pittsburgh Sleep Quality Index score was 4.16 ± 1.86. Sleep quality was significantly associated with academic performance (Fisher's exact test = 15.679, P = 0.001); 65.9% of students with poor academic performance were poor sleepers, whereas the majority of students with fair or good performance were good sleepers, demonstrating a clear link between healthier sleep patterns and better academic outcomes.</p><p><strong>Conclusion: </strong>Good sleep quality is significantly associated with better academic performance among medical undergraduates. These findings highlight the importance of promoting healthy sleep habits as a potential strategy to improve the academic outcomes in medical students.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1429-1434"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Skin Speaks the Mind: Two Unusual Cases of Dermatitis Artefacta Managed by Dermatology-psychiatry Collaboration.","authors":"Manjaree Morgaonkar, Nishtha Mishra, Sathwik Ramesh, Gauri Sharma","doi":"10.4103/aam.aam_490_25","DOIUrl":"10.4103/aam.aam_490_25","url":null,"abstract":"","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1745-1746"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Family Resilience in Autism Spectrum Disorder: An Integrative Review of Models, Interventions, and Future Directions.","authors":"Leena Pravil John, R Hemalatha","doi":"10.4103/aam.aam_434_25","DOIUrl":"10.4103/aam.aam_434_25","url":null,"abstract":"<p><strong>Abstract: </strong>Families caring for children with autism spectrum disorder (ASD) often encounter persistent stress, stigma, and limited support systems. Despite these challenges, many demonstrate resilience-the capacity to adapt and sustain well-being under adversity. This integrative review synthesizes conceptual frameworks and interventions designed to strengthen family resilience in ASD caregiving. A systematic search across PubMed, Scopus, CINAHL, and Google Scholar (2000-2025) yielded 55 eligible studies. Seven resilience models were identified: protective factors, transactional, ecological systems, CARE, mindfulness-based stress reduction, Triple-A, and strengths-based approaches. Interventions informed by these models produced measurable benefits, including reductions in parental stress and caregiver burden, alongside gains in family cohesion, psychological health, and quality of life. The review underscores the importance of culturally adapted, multidisciplinary, and scalable resilience-building strategies, while calling for standardized evaluation tools and policy integration to ensure sustainable support for families raising children with ASD.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1377-1383"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}