Annals of African Medicine最新文献

{"title":"Port Site Infection in Laparoscopic Cholecystectomy: A Prospective Observational Study at a Tertiary Care Hospital in India.","authors":"Dharmendra Kumar Pipal, Ravi Prakash, Prahlad Kalwan, Sudha Sudha, Vibha Rani Pipal, Seema Yadav","doi":"10.4103/aam.aam_33_25","DOIUrl":"https://doi.org/10.4103/aam.aam_33_25","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic surgery, a minimally invasive technique, is preferred due to its rapid recovery and minimal incisions. However, postsurgery port site infection (PSI) is a rare complication that can increase patient morbidity and damage the surgeon's reputation. The effectiveness of laparoscopic surgery depends on advancements in sterilization and surgical techniques. This current study aimed to evaluate the port site infections after laparoscopic cholecystectomy, identify contributing variables, and ascertain which factors are amenable to modification to avoid infections and optimize the benefits of laparoscopic surgery, thereby improving patient outcomes.</p><p><strong>Methodology: </strong>This prospective observational study, including 138 participants having elective laparoscopic cholecystectomy, was done over 1 year, from January 1 to December 31, 2021, at a tertiary care hospital.</p><p><strong>Results: </strong>We observed the port site infection rate in 6 of 138 participants (4.3%). Male patients showed increased rates, with infections occurring in three of 13 (23%, χ² =0.218; P = 0.641) cases when bile, stones, or pus spilled, and in 4 of 6 (66.7%, χ² =012.105; P = 0.001, a significant association) cases at the epigastric port. The majority of the port site infection (PSI) were superficial, accounting for 83.3%, with nonspecific bacteria identified in 5 out of 6 cases (83.3%).</p><p><strong>Conclusion: </strong>The majority of PSIs were superficial and more common in males; one participant experienced a mycobacterial infection; there is a significant association between port site infection and pus, stones, or bile spilling through the port used for gallbladder extraction. Chronic deep surgical site infections require special consideration because Mycobacterium tuberculosis may be the cause.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526192","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":"Understanding the Acceptability of Depot Medroxyprogesterone Acetate (ANTARA) among Women of Reproductive Age from the Lens of Grassroot Level Providers in Rural and Urban Areas of Nagpur, India.","authors":"N R Aiswarya Lakshmi, Akanksha Dani, Nidhi J Vithalani, Nishaant Ramasamy, Amol Rambhau Dongre, Mathavaswami Vijayageetha","doi":"10.4103/aam.aam_116_25","DOIUrl":"https://doi.org/10.4103/aam.aam_116_25","url":null,"abstract":"<p><strong>Context: </strong>Depot medroxyprogesterone acetate (DMPA), marketed as ANTARA, is a long-acting contraceptive with minimal daily interference. Despite its availability, its uptake remains low in India, with only 0.4% of women using injectables (NFHS-5). This study explores the acceptability of DMPA among women in rural and urban Nagpur.</p><p><strong>Objective: </strong>The objective of the study was to examine the acceptability of DMPA among women of reproductive age in Nagpur.</p><p><strong>Methods: </strong>A constructivist paradigm and descriptive design were employed at the Urban Health Centre (PHC), Nandanvan and Rural Health Training Center, Bela Nagpur, India. Data were collected from 21 Accredited Social Health Activists (ASHAs) using free listing, pile sorting, and focus group discussions. Analysis included Smith's salience score, cognitive mapping, and thematic categorization.</p><p><strong>Results: </strong>Pile sorting identified three major clusters: Menstrual-related concerns, general perceptions, and service delivery barriers. ASHA interviews revealed five key barriers: menstrual and physical side effects, social and cultural factors, health concerns, misunderstandings, and preference for alternative methods.</p><p><strong>Conclusion: </strong>Findings indicate the need for pre-administration counseling, enhanced ASHA training for community education, and sharing positive user experiences to improve DMPA uptake.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526196","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":"Bardet-Biedl Syndrome: Report of a Classical Case from North India.","authors":"Dhruv Kapoor, Shyam Chand Chaudhary, Akash Khandelwal, Chitranshu Pancholi, Shambhavi Sinha, Tarun Pal","doi":"10.4103/aam.aam_47_25","DOIUrl":"https://doi.org/10.4103/aam.aam_47_25","url":null,"abstract":"<p><strong>Abstract: </strong>Bardet-Biedl syndrome (BBS) is a genetic disorder affecting cilia and its functions and manifests floridly in late childhood as a multisystem disorder with the classical triad being polydactyly, atypical retinal dystrophy, and central obesity. So far, very few case reports have been reported from India and even fewer from North India. We are reporting a classic case of a 14-year-old boy presenting to the medicine outpatient department with features of lower respiratory tract infection, who, on work-up, was diagnosed as a case of BBS on clinical grounds. He underwent conservative treatment and, over the next 7 days of treatment with parenteral antibiotics and fluids, resumed in the state of normalcy. Obese children or adolescents with polydactyly must raise a suspicion in the minds of a physician and must warrant further investigations, so as to prognosticate the guardians well before complications set in.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504698","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 Association between Reproductive Hormones and Semen Parameters: A Cross-sectional Comparative Study of Prediabetics in Southeast Nigeria.","authors":"Chijioke Stanley Anyigor-Ogah, Ozoemena S Oboke, Albert E Okorocha, Okechukwu Anyigor-Ogah, Hope U Oboke, Agatha N Ekechi, Idakari Chinedu Nweke, Idika M Idika","doi":"10.4103/aam.aam_34_25","DOIUrl":"https://doi.org/10.4103/aam.aam_34_25","url":null,"abstract":"<p><strong>Background: </strong>An inverse relationship exists between insulin resistance and testosterone levels in nondiabetic men. The association between changes in reproductive hormones and prediabetes (PD) in men and the impact of these hormonal changes on the semen parameters are unclear. This study aimed to elucidate the association between reproductive hormones and semen parameters among prediabetics and compare the same with diabetics.</p><p><strong>Materials and methods: </strong>This was a cross-sectional comparative study of 75 adult males with PD, and 58 with diabetes based on screening who presented within the study period and selected by systematic random sampling through face-to-face interviewer-administered structured questionnaire. Comparison between numerical variables was done using Fisher's test, while in the categorical variables, Chi-square test was used. Logistic regression analysis was used to find the association between the dependent and independent variables. Odds ratio at 95% confidence interval was used for the test of strength. The association was considered statistically significant at P < 0.05.</p><p><strong>Results: </strong>All semen parameters were independently associated with PD, while semen volume, liquefaction, viscosity, and total count independently predicted diabetes mellitus (DM). Among prediabetics, low semen volume and concentration were associated with significantly lower mean total testosterone (TT). Semen histology in the two groups studied showed effects in semen integrity but more effects in subjects with DM.</p><p><strong>Conclusion: </strong>Mean TT level was significantly associated with poor semen volume in diabetics. Respondents with PD and diabetes had higher odds of having abnormal semen parameters at various points. Therefore, PD poses a serious reproductive health challenge the same way that DM does.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504723","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":"Postoperative Urinary Retention in Patients Undergoing Orthopedic Procedures: Unilateral versus Bilateral Spinal Anesthesia.","authors":"Sharika Sriramanan, Padmanabha Kaimar, M Kavya Prabhu","doi":"10.4103/aam.aam_93_25","DOIUrl":"https://doi.org/10.4103/aam.aam_93_25","url":null,"abstract":"<p><strong>Background: </strong>The incidence of postoperative urinary retention (POUR) may also vary based on the type of anesthesia provided to the patient. This study aims to evaluate the occurrence of POUR developing following unilateral and bilateral spinal anesthesia.</p><p><strong>Methods: </strong>The analysis was summarized by frequency, percentage, mean, and standard deviation. The demographic data and the contributing factors between the two groups were analyzed by Student's t-test. The symptoms of retention were compared using the Chi-square test, and the rescue intervention used between the two groups was studied using the Fisher's exact test. Statistical significance was established with P < 0.05.</p><p><strong>Results: </strong>The patients were sorted into two groups: Unilateral and bilateral spinal anesthesia groups. Two patients who underwent orthopedic procedures under unilateral spinal anesthesia and eight patients under bilateral spinal anesthesia developed POUR. The mean age, duration of surgery, the intravenous fluids administered, symptoms of retention, need for rescue intervention, and the presentation of symptoms of retention were nil significant between the two groups. The presentation of symptoms of retention was significant with respect to the time taken to void in both the groups.</p><p><strong>Conclusion: </strong>There is a similar proportion of occurrence of POUR between unilateral and bilateral spinal anesthesia in patients undergoing orthopedic procedures.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504706","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 Outcome of Laser Ablation Hemorrhoidoplasty versus Conventional Hemorrhoidectomy.","authors":"Mohammed Yousef Alessa, Loai Saleh Albinsaad, Arshadullah Khan, Laila Zamil Alzamil, Raghad Mabrouk Alanazi, Najd Mabrouk Alanazi, Abeer Mabrouk Alanazi","doi":"10.4103/aam.aam_226_24","DOIUrl":"https://doi.org/10.4103/aam.aam_226_24","url":null,"abstract":"<p><strong>Context: </strong>Hemorrhoids affect a significant proportion of the population, and the choice between laser hemorrhoidoplasty and conventional hemorrhoidectomy remains a crucial clinical decision.</p><p><strong>Aims: </strong>The aim of this study was to compare the outcomes of piles management with laser hemorrhoidoplasty versus conventional surgical hemorrhoidectomy.</p><p><strong>Settings and design: </strong>A retrospective data collection from hospital registry about 50 patients who underwent laser hemorrhoidoplasty and another 50 patients who underwent conventional hemorrhoidectomy.</p><p><strong>Subjects and methods: </strong>Demographic and clinical data were analyzed using descriptive and inferential statistics. Data were meticulously collected and analyzed, employing SPSS statistical software.</p><p><strong>Statistical analysis used: </strong>SPSS statistical software was used for statistical analysis.</p><p><strong>Results: </strong>The mean age was 40.45 years, with a balanced gender distribution. While no significant difference in age was observed between treatment groups, notable variations in gender and hemorrhoid degree distribution were evident. Laser hemorrhoidoplasty exhibited a higher percentage of patients with second-degree hemorrhoids, while conventional hemorrhoidectomy had a higher prevalence of more severe hemorrhoids (degree 3 or 4). Clinical outcomes revealed that laser hemorrhoidoplasty was associated with less postoperative pain and bleeding. Notably, all laser patients reported mild pain (1-3), while the conventional group exhibited a broader spectrum, including severe pain (7-9) in 96% of cases. Furthermore, bleeding outcomes were more favorable in the laser group, with 100% experiencing minor bleeding compared to the conventional group, which showed a higher incidence of both minor and moderate bleeding.</p><p><strong>Conclusions: </strong>The observed advantages of laser hemorrhoidoplasty in terms of reduced postoperative pain and bleeding suggest its potential as a favorable alternative, particularly in less severe cases.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504724","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":"Tracheoesophageal Fistula as a Rare Cause of Persistent Pulmonary Tuberculosis Symptoms.","authors":"Yasir V Abdullah, Shashank Shastry, I V Prem Narasimharao, Mughal Tariq Mustafa","doi":"10.4103/aam.aam_105_25","DOIUrl":"https://doi.org/10.4103/aam.aam_105_25","url":null,"abstract":"<p><strong>Abstract: </strong>Tracheoesophageal fistula (TEF) is a rare yet severe complication of tuberculosis (TB), often leading to persistent symptoms, recurrent infections, and treatment failure. Its early recognition and appropriate management are crucial to improving patient outcomes. We report the case of a 24-year-old woman with pulmonary TB who presented with persistent fever, copious expectoration, and progressive weight loss despite receiving anti-tubercular therapy (ATT) for 3 months. She developed a right pneumothorax, requiring Malecot catheter insertion, and was referred to our institute due to poor treatment response. Differential diagnoses, including drug-resistant TB and malabsorption, were ruled out. Clinical suspicion of TEF arose due to worsening cough on swallowing. Bronchoscopy confirmed a TEF, five tracheal rings above the carina, measuring 7-8 mm in diameter. A computed tomography scan delineated its extent, and bronchoalveolar lavage analysis confirmed Mycobacterium TB. The patient was managed with nasogastric feeding, intravenous antibiotics, and ATT continuation. Her condition improved significantly within 10 days. TEF is a rare but serious complication of pulmonary TB that can significantly impact treatment success. Early recognition, nutritional support, and ATT continuation are crucial for improved outcomes and preventing complications this case underscores the importance of considering TEF in patients with persistent symptoms despite standard TB treatment.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504725","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":"Diabetic Peripheral Neuropathy: A Clinical Study Correlating Peripheral Neuropathy with Dyslipidemia and Nerve Conduction Velocity Study in Diabetics.","authors":"Vikram Vikhe, Vivek Lapsiwala, Tejas Kore, Sarthak Mangal","doi":"10.4103/aam.aam_103_25","DOIUrl":"https://doi.org/10.4103/aam.aam_103_25","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic peripheral neuropathy (DPN) is one of the most common and debilitating complications of diabetes mellitus, affecting approximately 50% of patients with long-standing disease. While hyperglycemia is the primary driver of nerve damage, emerging evidence suggests that dyslipidemia may also contribute significantly to the development and progression of neuropathy. This study aimed to evaluate the clinical profile, lipid abnormalities, and nerve conduction patterns in patients with DPN and to explore the potential correlations between these parameters.</p><p><strong>Methodology: </strong>This cross-sectional study included 100 diabetic patients with clinical evidence of peripheral neuropathy. Comprehensive assessment included demographic data, diabetes history, clinical examination, metabolic parameters (fasting and postprandial blood glucose, glycated hemoglobin [HbA1c], and complete lipid profile), and nerve conduction studies of upper and lower limb nerves. Neuropathy was classified as motor, sensory, or sensorimotor based on clinical and electrophysiological findings, and severity was assessed using the Toronto Clinical Neuropathy Scale.</p><p><strong>Results: </strong>The study population had a slight female predominance (54%) and uniform distribution across age groups. Type 2 diabetes constituted 88% of cases, with diabetes duration ranging from <5 to 20 years. Metabolic assessment revealed poor glycemic control in most patients (99% with fasting blood sugar >126 mg/dL, 100% with postprandial blood sugar >180 mg/dL, and 84% with HbA1c >7%) and high prevalence of lipid abnormalities (88% with hypertriglyceridemia and 90% with elevated low-density lipoprotein-cholesterol). Sensory symptoms (numbness 71% and tingling 62%) predominated over motor symptoms. Sensory neuropathy was the most common type (45%), followed by sensorimotor (32%) and motor neuropathy (23%). Nerve conduction studies showed greater involvement of sensory nerves, with upper limb nerves (median and ulnar) being more frequently affected than lower limb nerves. No statistically significant associations were found between lipid parameters and neuropathy types or severity, although trends were observed.</p><p><strong>Conclusion: </strong>This study demonstrates a high prevalence of dyslipidemia and poor glycemic control in patients with DPN, with sensory neuropathy being the predominant type. While statistical associations between specific lipid abnormalities and neuropathy characteristics were not established, the remarkably high prevalence of lipid derangements suggests that they may contribute to the pathogenesis. A multifactorial approach to neuropathy management, addressing both glycemic control and lipid abnormalities, may be beneficial in reducing the burden of this complication.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504699","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":"Five-year Experience of Using Single Port Rigid Thoracoscopy in Patients of Undiagnosed Exudative Pleural Effusion at Tertiary Center in North India.","authors":"Hemant Kumar, Ved Prakash, Mohammad Arif, Chanchal Rana, Saumya Shukla, Anurag Tripathi, Mrityunjaya Singh, Sachin Kumar, Deepak Sharma, Shubhra Srivastava","doi":"10.4103/aam.aam_70_25","DOIUrl":"https://doi.org/10.4103/aam.aam_70_25","url":null,"abstract":"<p><strong>Background: </strong>Pleural effusion is one of the common pleural diseases encountered by pulmonologists worldwide. Malignancy and tuberculosis are the two most common etiologies in such patients, who have completely different prognoses. Pleural biopsy is the gold standard investigation to diagnose various causes of pleural effusion. Rigid Medical Thoracoscopy is a semi-invasive tool to evaluate the pleura morphologically and take an image-guided biopsy from the pleura for a definitive diagnosis.</p><p><strong>Materials and methods: </strong>This was a single-center, retrospective data-based study. Data were collected between January 1st, 2020, and December 31st, 2024. Patients with undiagnosed exudative pleural effusion, defined as negative cartridge based nucleic acid amplification for tuberculosis and twice negative pleural fluid cytology for malignancy, underwent rigid thoracoscopy to confirm their diagnosis.</p><p><strong>Results: </strong>A total of 376 patients underwent thoracoscopy. The mean age of the patients was 58.8 years, and male-to-female ratio was 1.3:1. The most common etiology observed was malignancy, seen in 275 patients (73.1%), followed by tuberculosis in 66 patients (17.5%) and nonspecific inflammation in 25 patients (6.7%). A final diagnosis could be made in 369 patients, giving a diagnostic yield of 98.1%. It was also used to break septations, which ultimately led to the expansion of their lung in 10 patients. Fifteen patients (4%) had major complications, whereas 31 patients (8.2%) had procedure-related minor complications.</p><p><strong>Conclusion: </strong>Rigid medical thoracoscopy has a very high diagnostic yield with few complications in the diagnosis of exudative pleural effusion. Therefore, tissue-based biopsy with thoracoscopy can be easily performed to make a correct diagnosis with huge future implication in such patients.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504702","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":"Mind Over Matter: Cognitive Decline in Hemodialysis Patients: A Cross-sectional Analysis.","authors":"Vidya Sagar Ram, Anita Anita, Aaditya Shivhare, Amit Varshney","doi":"10.4103/aam.aam_298_24","DOIUrl":"https://doi.org/10.4103/aam.aam_298_24","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) affects up to 15% of the global population, with cognitive impairment frequently reported in patients, particularly those undergoing hemodialysis (HD). The study aims to analyze cognitive performance differences between patients receiving conservative management and those on HD in India.</p><p><strong>Materials and methods: </strong>This observational cross-sectional study was conducted between September 2021 and April 2023, involving 1214 end-stage CKD patients - 604 on conservative therapy and 610 on HD. Neurocognitive assessment tools included the abbreviated mini-mental state examination (MMSE), Addenbrooke's cognitive examination III (ACE-III), Grober and Buschke Test, Trail Making Tests, Stroop Test, and Boston Naming Test. Statistical analysis utilized the Wilcoxon and Chi-square tests for group comparisons.</p><p><strong>Results: </strong>The HD group demonstrated significantly lower scores in the ACE-III visuospatial domain (P = 0.00685) and verbal inhibitory control (P = 0.011) assessed by the INECO frontal screening test. No significant differences were observed in global cognitive performance based on MMSE or other ACE-III domains. In addition, 16.7% of HD patients had deficient Stroop test scores, and 33.3% were unable to complete it due to visual difficulties.</p><p><strong>Discussion: </strong>The findings highlight selective deficits in frontal-executive functions among HD patients, potentially reflecting subcortical and vascular pathophysiology due to hemodynamic stress and cerebral hypoperfusion. These results underscore the need for routine cognitive screening in CKD patients to guide treatment strategies.</p><p><strong>Conclusion: </strong>Patients with end-stage CKD on HD exhibited significant impairments in executive function compared to those under conservative management. Incorporating neurocognitive evaluations into clinical practice can enhance treatment decision-making and improve patient outcomes.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504705","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}