Annals of African Medicine最新文献

{"title":"A Randomised Trial Comparing the Outcome of Expert Tibia Nailing and Plating for Distal Tibial Fractures.","authors":"Vinay Prabhat, Allen Kujur, Rohit Topno, Sabyasachi Kundu, Govind Kumar Gupta, Verma Dipak Kumar Prakash Prasad","doi":"10.4103/aam.aam_197_24","DOIUrl":"10.4103/aam.aam_197_24","url":null,"abstract":"<p><strong>Background: </strong>Management of distal tibial fracture is challenging as it has precarious blood supply and its subcutaneous location. It is frequently complicated by contusion, infection, delayed union, and nonunion and may lead to revision surgeries. Distal tibial fracture needs a stable fixation with minimum damage to the soft tissues by the surgical dissection and implants. The optimal method of fixation remains debatable. Traditional methods like open reduction and rigid internal fixation have been associated with infections and devitalization of soft tissues and hence have poor results.</p><p><strong>Aims and objectives: </strong>The aim of our study is to compare the functional and radiological outcome of the distal tibial fractures treated by expert tibia nailing (ETN) and tibial plating.</p><p><strong>Methodology: </strong>This study was carried out in Rajendra Institute of Medical Sciences, Ranchi. This is a prospective study, period from November 2021 to October 2022. Patients were randomized using computer-generated random numbers. Patients fulfilling the inclusion criteria were included and underwent operative intervention. 30 patients underwent surgery with ETN and 30 patients with locking compression plate. All patients were examined preoperatively, postoperatively and in follow-up period. Data regarding different parameters including, timing of surgery after trauma, operating time, intraoperative blood loss, any postoperative complications, and radiological and functional outcomes were recorded and analyzed.</p><p><strong>Results: </strong>In the ETN group, 21 (70.0%) patients had excellent range of motion (ROM) with the American Orthopedic Foot and Ankle Society (AOFAS) score ranging from 90 to 100, 4 (13.3%) patients had good ROM with AOFAS score ranging from 80 to 90, and 5 (16.7%) patients had fair ROM with AOFAS score ranging from 70 to 80. In plating, 20 (66.7%) patients had excellent ROM with AOFAS score ranging from 90 to 100, 2 (6.7%) patients had good ROM with AOFAS score ranging from 80 to 90, and 8 (26.7%) patients had fair ROM with AOFAS score ranging from 70 to 80. In the ETN group, the mean union time (mean ± standard deviation [SD]) of patients was 5.0333 ± 1.0981 months. In the plating group, the mean union time (mean ± SD) of patients was 5.5000 ± 1.6135 months. There is no significant difference in terms of fracture union, delayed union, malunion, nonunion, and deep infection in both groups; however, in the expert tibial nailing group, there is lesser operating time, blood loss, and lesser chances of superficial infection as compared to plating.</p><p><strong>Conclusion: </strong>Both ETN and plating offer no significant advantage over each other in terms of fracture union, delayed union, malunion, nonunion, and deep infection; but superficial infection, blood loss, and operating time are significantly less ( P < 0.05) in patients treated with expert tibial nail. The choice of implant should be con","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"384-390"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466391","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":"Placement of Postgraduate Medical Residents at Peripheral Hospitals during their Training: An Assessment of Residents' Experiences.","authors":"Padmakumar Krishnankutty Nair, Praveenlal Kuttichira","doi":"10.4103/aam.aam_184_24","DOIUrl":"10.4103/aam.aam_184_24","url":null,"abstract":"<p><strong>Context: </strong>The district residency program (DRP) was introduced by the National Medical Commission to enhance practical training for postgraduate medical residents in India. Irrespective of their specialty, residents have to undergo 3 months DRP program and is a critical component of the postgraduate curriculum.</p><p><strong>Aim: </strong>This study evaluates the effectiveness of the DRP in Kerala, focusing on knowledge improvement, implementation of national health programs, challenges faced, and satisfaction levels.</p><p><strong>Materials and methods: </strong>A descriptive cross-sectional study was conducted among 59 postgraduate medical students in Kerala. Data were collected using a structured questionnaire and analyzed.</p><p><strong>Statistical analysis used: </strong>Data was analyzed using SPSS version 25.</p><p><strong>Results: </strong>Fifty-nine responses gathered. The mean age was 29.64 years (standard deviation = 2.148). The majority were females (61.0%) and enrolled in 2022 (54.2%). Thirty-seven (62.7%) performed general clinical duties, 44 (74.6%) outpatient and inpatient services by 40 (67.8%). Fifty-seven (96.6%) reported logbook maintenance and supportive supervision. 17 (28.8%) received hands-on surgical training. Forty-seven (79.7%) suggested continuing DRP is useful, though 22 (37.3%) opined is of excess duration. Adequate lodging and food arrangement were reported by (35%-59.3%) and 42 (71.2%), respectively.</p><p><strong>Conclusions: </strong>DRP enhances the practical experience, understanding health services, and secondary-level care delivery. Improvements in surgical training and lodging are required. Duty allocation during night and emergency is needed.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"281-285"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466540","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":"Anatomical Study and Clinical Significance of Atlanto-occipital and Atlantoaxial Assimilation Anomaly in Asian Population.","authors":"Kosuri Kalyan Chakravarthi, Venumadhav Nelluri, Raju Sugavasi, Deepthynadh Reghunadhan","doi":"10.4103/aam.aam_291_24","DOIUrl":"10.4103/aam.aam_291_24","url":null,"abstract":"<p><strong>Background: </strong>Atlanto-occipital and atlantoaxial assimilation are rare congenital abnormalities characterized by abnormal fusion of the atlas vertebra with the occipital bone or the axis vertebra, respectively, within the craniovertebral junction. These anomalies can significantly alter the biomechanics and structural integrity of the cervical spine, leading to diverse clinical presentations ranging from restricted neck mobility to neurological deficits. Accordingly, this study aims to investigate the prevalence, anatomical abnormalities, and clinical significance of atlanto-occipital and atlantoaxial assimilation in the Asian population.</p><p><strong>Materials and methods: </strong>A total of 82 human dry skulls and 82 sets of dry cervical vertebrae were examined for the presence of atlanto-occipital and atlantoaxial assimilation. Detailed morphometric analysis was performed to document the fusion patterns and variations in anatomical structures. The data were analyzed to determine the prevalence of these congenital anomalies and their implications for craniovertebral stability and neurological function.</p><p><strong>Results: </strong>Among the 82 skulls and 82 cervical vertebrae examined, atlanto-occipital assimilation was identified in 3 skulls (3.65%), whereas atlantoaxial assimilation was observed in 2 cases (2.43%). Combined occurrences of both anomalies were found in 2 skulls (2.43%) of the sample.</p><p><strong>Conclusion: </strong>A thorough understanding of atlanto-occipital and atlantoaxial assimilation is clinically crucial due to its potential impact on the structural and functional dynamics of the craniovertebral junction. These congenital anomalies, though infrequent, can pose considerable clinical challenges, including compromised craniovertebral stability and an increased risk of neurological symptoms. Early diagnosis and careful clinical evaluation are crucial for managing potential complications associated with these conditions.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"415-420"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555478","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":"Prevalence and Various Risk Factors Associated with Suicidal Ideation Thoughts in Medical Students from a Medical College in Northern India.","authors":"Visesh Kumar, Azfar Mateen, Tarique Aziz, Ajay Kumar Singh, Abhas Kumar Singh, Mala Mahto, Reetesh Kumar Rai","doi":"10.4103/aam.aam_28_25","DOIUrl":"10.4103/aam.aam_28_25","url":null,"abstract":"<p><strong>Introduction: </strong>In medical school, suicide ideation is an important issue that has garnered increasing attention in recent years. Students in the medical field have an environment full of stress. Medical students are subjected to dealing with problems that produce lots of mental distress due to the surrounding environment, dealing with patients' deaths, issues related to different ethical backgrounds, and witnessing death and human agony.</p><p><strong>Objective: </strong>In this study, we evaluated various risk factors that can cause suicidal thoughts.</p><p><strong>Materials and methods: </strong>A cross sectional study was conducted on medical students of a medical college in eastern Uttar Pradesh. A total of 423 study participants responded. The participants were asked to respond questionnaire on sociodemographic variables and risk factors and a Patient Health Questionnaire 9 (PHQ 9) through Google Forms.</p><p><strong>Results: </strong>A total of 18 (4.2%) respondents reported having suicidal ideation thoughts in the last 1 year and 12 students reported a cutoff score >9 in the PHQ 9 questionnaire. Depression, academic stress, use of alcohol, and abuse by physical or sexual means were the risk variables significantly linked to greater suicidal ideation thoughts. The prevalence of suicidal ideation among medical students is worrisome.</p><p><strong>Conclusions: </strong>The data suggests that the initial steps in preventing suicidal ideation are that students should get proactive student counseling and early treatment if needed.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"468-473"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596113","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":"Exploring the Intersections between Triglyceride-rich Lipoproteins and Acute Coronary Syndrome: A Cross-sectional Study.","authors":"Priya Baluni, Sandesh Sadanand Raut, Prasad Chandrakant Bagare, Saurabh Ashok Sujanyal, Sachin Shivnitwar","doi":"10.4103/aam.aam_256_24","DOIUrl":"10.4103/aam.aam_256_24","url":null,"abstract":"<p><strong>Background: </strong>Within 20 years, cardiovascular disease (CVD), which is currently the main cause of death in the Indian subcontinent, is expected to overtake all other causes of death in South Asia. Acute coronary syndrome (ACS), a critical form of CVD, is associated with multiple risk factors including hyperlipidemia. While triglyceride-rich lipoproteins (TRLs) and their remnants are well-studied traditional markers such as low-density lipoprotein (LDL-C) and high-density lipoprotein-cholesterol (HDL-C), new research indicates that they may possibly be important in ACS risk. Delayed removal of CM and very LDL remnants has been linked to increased cardiovascular risk. This study aims to explore the association between TRL-C, a surrogate marker for these atherogenic lipoproteins, and ACS.</p><p><strong>Materials and methods: </strong>Between November 2018 and March 2020, a cross-sectional study was carried out in hospitals at Smt. Sucheta Kriplani Hospital and Lady Hardinge Medical College in New Delhi. The study included 200 patients aged 18 or older, diagnosed with ACS. Data were collected on lipid profiles and cardiac biomarkers from venous blood samples. TRL-C was computed by subtracting LDL-C and HDL-C from total cholesterol. Patients were divided into three groups according to the type of ACS they had ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina (UA). Statistical analyses, including ANOVA and Kruskal-Wallis tests, were used to examine associations between TRL-C levels and ACS types.</p><p><strong>Results: </strong>The average TRL-C was significantly higher in STEMI patients (43.68 mg/dL) compared to NSTEMI (31.27 mg/dL) and UA (25.31 mg/dL) (P < 0.0001). The study found no significant associations between TRL-C levels and the use of statins or between previous ACS events and the spectrum of current ACS.</p><p><strong>Conclusion: </strong>TRL-C is significantly associated with the severity of ACS, with higher levels correlating with more severe forms of the condition. Despite the use of statins, TRL-C levels remained a significant predictor of ACS severity, suggesting that TRL-C could be a valuable marker for assessing cardiovascular risk beyond traditional lipid profiles. Further research is needed to explore the role of TRL-C in recurrent ACS and its potential utility in refining treatment strategies.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"370-377"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603471","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":"Maternal Serum Neuropilin a Prognostic Marker in Fetal Growth Restriction: A Tertiary Center Experience.","authors":"Rekha Sachan, Pushpalata Sachan, Shalini Yadav, Munna Lal Patel, Wahid Ali","doi":"10.4103/aam.aam_289_24","DOIUrl":"10.4103/aam.aam_289_24","url":null,"abstract":"<p><strong>Introduction: </strong>Fetal growth restriction (FGR) is defined as a pathological decrease in the rate of fetal growth. Neuropilin-1 (NRP1) is a transmembrane glycoprotein, involved in the regulation of angiogenesis, and has emerged as a potential biomarker for various pregnancy-related complications. A recent study showed that NRP1 is downregulated in the placenta of FGR pregnancies. This study aimed to evaluate the role of NRP1 as a prognostic marker in FGR.</p><p><strong>Methods: </strong>This was a case-control study, carried out in the department of obstetrics and gynecology in collaboration with pathology over a period of 1 year. After informed consent and ethical clearance, a total of 200 pregnant women were enrolled. FGR was defined as per Delphi criteria 2016. 100 women who had FGR, were classified into two groups, 37 had severe FGR, 63 had mild FGR, and 100 women who had appropriate for gestational age fetuses were considered controls. 2 ml venous blood sample was withdrawn and maternal serum NRP1 (sNRP1) level was measured by ELISA technique using (Elabscience) ELISA kit as per producer protocol.</p><p><strong>Results: </strong>Severe FGR was found in 18.5% and mild FGR in 31%. On umbilical artery Doppler, mean pulsatility index (PI) and resistive index (RI) were increased in severe FGR fetuses as compared to mild FGR (PI 2.170 vs. 1.462 and RI 0.723 vs. 0.725). Mean sNRP1 level was high in severe FGR as compared to mild FGR, (1970.84 pg/ml vs. 1708.31 pg/ml) while a significant low level of sNRP1 (1080.75 pg/ml) was found in fetuses of appropriate for gestation age ( P ≤ 0.001). At the cutoff value of sNRP1 >1493 had a sensitivity of 100% and specificity of 96% for prediction of FGR ( P < 0.001).</p><p><strong>Conclusions: </strong>Maternal serum sNRP1 has good diagnostic and prognostic value in FGR.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"438-442"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603548","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":"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":"https://doi.org/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 χ2 = 24.69 for IL-6 (P = 0.00), χ2 = 11.91 for S100B (P = 0.008), and χ2 = 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":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","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":"A Cross-sectional Study for the Correlation of Vitamin D Level and Severity of Early Rheumatoid Arthritis.","authors":"Sudipto Chakraborty, Mohidur Rahaman, Pradip Dey, Shreya Choudhury, Rajeswar Samanta, Swagatam Sengupta, Parineeta Singhal, Siktha Purkait, Sakshi Puri, Insha Aleena, Dhiman Sen","doi":"10.4103/aam.aam_205_24","DOIUrl":"10.4103/aam.aam_205_24","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic inflammatory multisystemic disorder that can cause significant deformity and disability. Vitamin D has a role in Th1-medicated autoimmune diseases like RA. Furthermore, some observational studies have concluded that Vitamin D supplementation reduces the severity of RA.</p><p><strong>Aims: </strong>This study aimed to find out any correlation between Vitamin D levels and severity of early RA.</p><p><strong>Settings and design: </strong>This study settings and design were a cross-sectional single-center observational study.</p><p><strong>Materials and methods: </strong>This was an observational study. All patients with early RA were screened and evaluated as per protocol. No extra tests were done.</p><p><strong>Statistical analysis used: </strong>Pearson's Chi-square test for independence of attributes/Fisher's exact test was used to find the association between the categorical variables as appropriate.</p><p><strong>Results and conclusion: </strong>We found that all patients of early RA had moderate-tosevere disease activity without any relation with their Vitamin D level ( P > 0.05).</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"298-303"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466386","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":"Absolute Eosinophil Counts as a Prognostic Marker in Patients with Sepsis.","authors":"S Shravani, Ashwin Kulkarni, Shaikh Mohammed Aslam, K Mohammed Suhail, Rafi Mohammed Shaji","doi":"10.4103/aam.aam_203_24","DOIUrl":"10.4103/aam.aam_203_24","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a leading cause of mortality and morbidity in critically ill patients. It is necessary to have markers of severity that are easily accessible and useful to guide treatment in a timely manner. Eosinophil count could be a potential biomarker in sepsis, and it is routinely checked in clinical practice.</p><p><strong>Aims and objectives: </strong>To assess absolute eosinophil count (AEC) as prognostic marker in patients with sepsis.</p><p><strong>Methodology: </strong>This observational study was conducted in a tertiary care hospital in South India. A total of 100 patients admitted with sepsis were included. AEC and Sequential Organ Failure Assessment (SOFA) score were calculated at admission and after 72 h. AEC was correlated with the SOFA score. These patients were clinically followed up during their hospital stay. A receiver operating characteristic curve was developed to determine the optimum AEC cutoff point for predicting mortality.</p><p><strong>Results: </strong>Decreasing trend of AEC during the course of hospital stay (after 72 h) of admission was found to have a strong negative correlation with SOFA score. AEC cutoff <50 cells/mm 3 after 72 h of admission was associated with increased mortality. Low AEC after 72 h of admission and decreasing trend of AEC were associated with increased risk of requirement of ionotropic support, dialysis, ventilator, and mortality.</p><p><strong>Conclusion: </strong>A decline in AEC after 72 h of admission was linked to increased mortality. Therefore, eosinophil count can be used as a cost-effective marker for assessing severity and prognosis in patients with sepsis.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"332-336"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555544","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":"Assessing Autonomic Dysfunction in Diabetes: A Hospital-based Study in a Developing Country.","authors":"Khalid A Dafalla, Azza O Alawad, Tarig Hakim Merghani, Fathelrahman M Ahmed, Ahmed Alsiddig Ebraheem","doi":"10.4103/aam.aam_202_24","DOIUrl":"10.4103/aam.aam_202_24","url":null,"abstract":"<p><strong>Background: </strong>Autonomic nervous system (ANS) dysfunction is a common complication in patients with diabetes mellitus, potentially affecting the various organ systems leading to significant morbidity. This study aimed to evaluate ANS dysfunction in diabetic patients attending Wad Madani Teaching Hospital, Sudan.</p><p><strong>Materials and methods: </strong>A cross-sectional and hospital-based study was conducted on a sample of 100 patients in Wad Madani Teaching Hospital in Sudan. For each participant, a data collection form was utilized to record the sociodemographic details, previous medical history, and patient assessment results including heart rate (HR), blood pressure (BP), weight, and height. Patients were assessed for the signs of autonomic dysfunction using the clinical examinations and standardized autonomic function tests. HR variability (HRV), BP response to standing, and deep breathing tests were the primary methods used to assess ANS function. The results were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 26. 0.</p><p><strong>Results: </strong>The mean age of the participants was 63.4 ± 9.9 years, with males comprising 75% of the sample. Of the participants, 48% were overweight and 22% were obese, with 77% demonstrating poor glycemic control (hemoglobin A1c ≥ 7.0%). Only 11% of participants had normal HRV during deep breathing, while 56% showed abnormal values. For the HR response to standing, 27% of participants had abnormal results. Regarding BP response to standing, 19% had abnormal readings. Autonomic dysfunction was prevalent, with 89% of participants exhibiting some degree of dysfunction, including early parasympathetic (16%) and combined parasympathetic and sympathetic dysfunction (19%).</p><p><strong>Conclusion: </strong>Autonomic dysfunction is highly prevalent among diabetic patients in Wad Madani, with most exhibiting parasympathetic and sympathetic dysfunctions. This underscores the need for the early diagnosis and management of autonomic complications in diabetic patients to improve the outcomes and quality of life.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"356-360"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575613","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}