Annals of African Medicine最新文献

{"title":"Practices of Evidence-based Mathematics Interventions for Children with Autism Spectrum Disorder: A Cross-sectional Study.","authors":"Faisal Amjad, Nizar H Bagadood, Sofia Ahmed Sait, P V Vijesh","doi":"10.4103/aam.aam_447_26","DOIUrl":"10.4103/aam.aam_447_26","url":null,"abstract":"<p><strong>Aims: </strong>This study investigates the practices and perceptions of educators regarding evidence-based mathematics interventions for children with autism spectrum disorder (ASD).</p><p><strong>Methods: </strong>A quantitative survey design was employed, collecting data from 250 teachers in special and inclusive education settings.</p><p><strong>Results: </strong>Findings revealed strong educator awareness and positive perceptions of the effectiveness of strategies such as explicit instruction, the concrete-representational-abstract sequence, task analysis, and technology-assisted learning like video modeling. Despite high implementation rates and recognition of these practices' benefits for conceptual understanding and skill generalization, significant barriers impeded consistent application. Primary challenges included insufficient training, time constraints, limited resources, and a lack of institutional support.</p><p><strong>Conclusions: </strong>The study concludes that a critical research-to-practice gap persists, underscoring the necessity for enhanced professional development, systemic resource allocation, and stronger administrative support to translate evidence-based knowledge into sustained, high-fidelity classroom practice for improved mathematics outcomes in students with ASD.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1454-1463"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454236","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":"Objective Evidence for Mind-body Interventions: Selective Modulation of Meridian-wise Bioelectrical Conductance by Yogic Practices.","authors":"Rekha Jiwane, Varun Malhotra, Santosh Wakode, Naina Bhargava, Jyoti Keswani, Danish Javed, Francisco J Cidral-Filho, Patrick Porter, Gaurav Chanderprakash Mittal","doi":"10.4103/aam.aam_455_26","DOIUrl":"10.4103/aam.aam_455_26","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Traditional Chinese Medicine (TCM) describes meridians as channels through which vital energy (Qi) flows, with disturbances in this flow associated with disease. Contemporary research has demonstrated that classical meridian points possess distinctive electrical properties that vary with autonomic and metabolic states. This study investigated the effects of different yogic practices, meditation, and exercise on meridian energy measured through electrical conductance at classical acupuncture points.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Healthy adults participated in various intervention groups (n = 14-30 per intervention). Meridian energy was assessed by measuring electrical conductance at the 12 classical meridian acupoints before and immediately after interventions including Kriya Yoga, Bhramari Pranayama, Anulom Vilom, Chandra Nadi, Surya Nadi, cooling pranayamas (Shitali, Seetkari, Ujjayi), Kapalbhati, and exercise. Pre- and post-intervention meridian energy values were compared using appropriate statistical analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Slow meditative practices produced marked increases in meridian energy across all meridians. Kriya Yoga (n = 30) and Bhramari Pranayama (n = 14) significantly increased mean meridian energy from approximately 45-50 to 90-99 units (P &lt; 0.0001), indicating widespread parasympathetic activation. Anulom Vilom (n = 30) produced balanced increases across all meridians (P &lt; 0.0001), whereas Chandra Nadi (n = 20) preferentially enhanced Kidney, Lung, and Bladder meridians, and Surya Nadi (n = 20) predominantly increased Stomach, Spleen, and Liver meridians. Cooling pranayamas achieved near-maximal meridian energy (~99 units), particularly in the Liver, Gallbladder, and Lung meridians. In contrast, exercise (n = 30) and Kapalbhati (n = 30) significantly reduced meridian energy (P &lt; 0.01), with the greatest reductions observed in the Heart and Small Intestine meridians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The observed changes suggest that different yogic practices exert distinct physiological effects on meridian energy that parallel shifts in autonomic nervous system activity. Meditative and slow breathing techniques enhanced meridian conductance, consistent with parasympathetic predominance, whereas vigorous exercise and Kapalbhati reduced meridian energy, reflecting sympathetic activation. These findings provide physiological support for the TCM concept of dynamic meridian regulation and establish a potential link between meridian bioelectrical activity and autonomic function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Yogic practices produce characteristic and measurable alterations in meridian energy, with the direction and magnitude of change depending on the type of practice. Electrical meridian mapping may serve as a rapid, non-invasive biomarker of mind-body interventions, offering potential applications in personalized stress management, autonomic assessment, and me","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1464-1472"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688593","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":"Knowledge, Perceptions, and Career Interest in Anesthesiology among MBBS Students: Impact of an Operation Theater-only Elective.","authors":"Sethulaxmi Rajan, Jibina Susan Issac, Silpa Annedath Radhakrishnan, Shaji Kizhakkevilayil Rarappan","doi":"10.4103/aam.aam_459_25","DOIUrl":"10.4103/aam.aam_459_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Undergraduate exposure to anesthesiology is brief, and not all students have an option to take a 2-week, operation theatre (OT)-only elective in the Indian undergraduate medical curriculum. We aimed to find out whether taking this elective led to improved knowledge, more positive perceptions of the specialty, and a greater interest in choosing anesthesiology as a career among MBBS students.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey using a validated 25-item questionnaire. It produced a knowledge score (0-9), a perception score (10-50), and a yes/no measure of definite or likely career intention. We compared students who had completed anesthesia elective with those who had not.</p><p><strong>Results: </strong>Response rate was 70% ( n = 105). Most respondents (80%) were in the 3 rd year, and 20% had completed the elective, who were the 4 th -year students. The overall mean knowledge score was 5.1 ± 1.8. Students who completed the elective scored higher for knowledge (6.2 ± 1.4 vs. 4.1 ± 1.6; P < 0.001) and for perceptions (34 ± 5 vs. 28 ± 6; P < 0.001). The biggest gains were recognizing that anesthesiologists lead preanesthetic evaluation and also work in pain clinics. Words students used shifted positively (\"patient-centred,\" \"team-oriented\"), and interest in simulation was strong. Definite or likely career intention was 18% among elective-exposed students and 11% among those without elective ( P = 0.04). Elective completion and prior observership predicted higher perception, and perception ≥ 35 predicted career intention.</p><p><strong>Conclusion: </strong>Completing OT-only anesthesia elective was associated with better knowledge, more positive perceptions, and a modest increase in career interest.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1569-1575"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627668","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":"Bioactivity of Ethanolic Extract of Borassus flabellifer Sprout Peel and Its Phytochemical Analysis: An In vitro Study.","authors":"S Abirami, Antony V Samrot, K Yamuna Devi, Wilson Samraj, M Mahesh, S Kalpana Shree, A M Alabsi","doi":"10.4103/aam.aam_231_25","DOIUrl":"10.4103/aam.aam_231_25","url":null,"abstract":"<p><strong>Abstract: </strong>Palmyra palm sprout skin was extracted using ethanol to test its antibacterial activity against isolated urinary tract infection (UTI) pathogenic bacteria. The extract demonstrated excellent inhibitory activity at the concentration of 500 µl/well. It was observed that all the isolated UTI-causing bacteria were highly resistant to selected commercially available antibiotics. The ethanol extract of the palmyra palm sprout skin showed excellent antioxidant, anti-inflammatory, antidiabetic, and antiproliferative activities. Before boiling the Panam kilangu, the sprout skin is usually peeled from it and thrown away as it is considered of no use. However, our study demonstrates a waste-to-wealth based alternative use for the palmyra palm sprout skin. Based on studies, these by-products could be used as a source of valuable bioactive compounds. It showed excellent inhibitory activity at the concentration of 500 µg/well against UTI bacteria. It also showed to possess various secondary metabolites, such as flavonoids, saponins, etc. Gas chromatography-mass spectrometer analysis revealed the presence of various bioactive metabolites.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1642-1649"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802878","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":"Immunohistochemical Analysis of MUC1 and MUC4 Co-expression in Oral Leukoplakia and Oral Squamous Cell Carcinoma.","authors":"Mohammed Abidullah","doi":"10.4103/aam.aam_235_25","DOIUrl":"10.4103/aam.aam_235_25","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the immunohistochemical co-expression of MUC1 and MUC4 in oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) and assess their potential as biomarkers for diagnosing and prognosticating oral malignancies.</p><p><strong>Materials and methods: </strong>A retrospective observational study was conducted on formalin-fixed, paraffin-embedded tissue specimens from the archives of the Department of Oral Pathology and Microbiology. A total of 80 histopathologically confirmed cases, consisting of 40 OL and 40 OSCC cases, were selected. Immunohistochemical staining for MUC1 and MUC4 was performed using specific monoclonal antibodies, and the expression was evaluated based on localization, intensity, and extent of staining. Statistical analysis was performed using SPSS, with P < 0.05 considered statistically significant.</p><p><strong>Results: </strong>The study found that MUC1 and MUC4 expression were significantly higher in OSCC compared to OL. High MUC1 expression was observed in 82.5% of OSCC cases versus 30% in OL cases ( P < 0.001), and high MUC4 expression was found in 70% of OSCC cases versus 30% in OL ( P = 0.002). Co-expression of MUC1 and MUC4 was seen in 90% of OSCC cases and 65% of OL cases ( P = 0.027). Logistic regression analysis confirmed that OSCC diagnosis was a strong predictor of high MUC1 and MUC4 expression ( P < 0.001).</p><p><strong>Conclusion: </strong>The findings suggest that MUC1 and MUC4 are significantly overexpressed in OSCC compared to OL, and their co-expression may serve as a valuable biomarker combination for early diagnosis and prognosis. Elevated expression of both mucins is associated with poor prognosis, indicating their potential for use in clinical practice for risk stratification and personalized treatment in OSCC patients.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1556-1562"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050028","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":"Efficacy of Intraoperative Intravenous Dexmedetomidine on Postoperative Analgesia among Patients following Gynecological Surgeries - A Comparative Observational Study.","authors":"N Gary Renil, Shaila S Kamath, Rashmi R Aithal, Shodhan Rao Pejavar","doi":"10.4103/aam.aam_116_26","DOIUrl":"10.4103/aam.aam_116_26","url":null,"abstract":"<p><strong>Context: </strong>Dexmedetomidine has been used as an adjuvant to minimize the adverse effects associated with opioids, either in the form of intravenous injection or intravenous infusion.</p><p><strong>Aim: </strong>The present study aimed to compare the efficacy of dexmedetomidine when administered via intravenous infusion and intravenous bolus injection.</p><p><strong>Materials and methods: </strong>A comparative observational study was conducted among 1000 participants aged 35-65 years with American Society of Anesthesiologists physical status I/II, scheduled to undergo elective gynecological surgeries. Participants were divided into Group D (received a loading dose of bolus 0.5 µg/kg, followed by 0.3 µg/kg/h intravenous infusion of dexmedetomidine) and Group C (control group) 15 min before the induction of anesthesia. Hemodynamic variables, recovery time, rescue analgesia, pain scores, and any adverse events were recorded.</p><p><strong>Results: </strong>Participants in Group D had lower hemodynamic parameters (after 1 h till the end of surgery) ( P < 0.05). Participants in Group D took fewer rescue analgesics compared to Group C ( P = 0.001), and recovery time was prolonged in Group D ( P = 0.001). Pain scores were lower in Group D compared to Group C ( P = 0.001).</p><p><strong>Conclusion: </strong>A loading dose of intravenous bolus followed by intravenous infusion of dexmedetomidine is a valuable adjunct in the perioperative management of such patients, offering potential benefits in enhancing recovery and reducing the need for postsurgical analgesia.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1441-1448"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203715","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":"Ultrasound-based Evaluation of Postoperative Scrotal Swelling following Jaboulay's Procedure: A Prospective Observational Study.","authors":"NoelAdarsh Srivaram, Vignesh Thiyagu, Balasubramanian Sankararaman, Jeyakumar Balakrishnan, Nishanth Chandrasekaran, Arafath Natchiar","doi":"10.4103/aam.aam_197_26","DOIUrl":"10.4103/aam.aam_197_26","url":null,"abstract":"<p><strong>Background: </strong>Postoperative scrotal swelling is a common occurrence following hydrocelectomy and may raise concern regarding complications, such as hematoma, infection, or recurrence. Differentiating physiological postoperative changes from pathological findings based on clinical examination alone can be challenging in the early postoperative period. Ultrasonography provides an objective and noninvasive method for postoperative evaluation; however, prospective data on serial ultrasound-based assessment following Jaboulay's procedure remain limited.</p><p><strong>Materials and methods: </strong>This prospective observational study included 75 adult patients with vaginal hydrocele who underwent Jaboulay's procedure at a tertiary care teaching hospital over 18 months. All patients underwent standardized ultrasonographic evaluation on postoperative day 2 (POD 2), POD 10, and at 2 months after surgery. Parameters assessed included scrotal wall thickness and epididymal head, body, and tail dimensions. Continuous variables were expressed as mean ± standard deviation and analyzed using repeated measures analysis of variance, whereas categorical variables were compared using the McNemar test.</p><p><strong>Results: </strong>The mean age of patients was 52.4 ± 16.8 years. On POD 2, 48.0% of patients demonstrated moderate swelling, and 36.0% had mild swelling. By POD 10, a significant reduction in swelling was observed, with 60.0% of patients showing minimal swelling and 40.0% demonstrating complete resolution ( P < 0.001). The mean scrotal wall thickness decreased significantly from 6.6 ± 1.9 mm on POD 2 to 4.6 ± 1.3 mm at 2 months ( P < 0.001). Significant reductions were also observed in epididymal dimensions across follow-up intervals ( P < 0.001). Postoperative hematoma occurred in 5.3% of patients and was managed conservatively.</p><p><strong>Conclusion: </strong>Postoperative scrotal swelling following Jaboulay's procedure is predominantly physiological and resolves progressively over time. Serial ultrasonography plays an important role in differentiating normal postoperative changes from complications.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1435-1440"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947631","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":"Adverse Gastrointestinal Effects of Alendronate Versus Risedronate in Osteoporosis: A Systematic Review and Meta-analysis.","authors":"Mahmoud Ismail Nouh, Hala Albuti, Mohammed Hasosah, Hani Raka Karrar, Rwid Enzar Ashgar, Yousef Ismail Nouh, Rehab Salah Aldin Alhendi, Tariq Mohammed Omaish, Hanin Ali Aseeri, Sarah Abdulhadi Alanazi, Ahmed Hayazi Albariqi, Abdulrahman Eid Alqarzi, Abdulrahman Faisal Baomar, Waad Hassan Bahabri","doi":"10.4103/aam.aam_216_25","DOIUrl":"10.4103/aam.aam_216_25","url":null,"abstract":"<p><strong>Abstract: </strong>Bisphosphonates (BPs; alendronate and risedronate) have been approved as a therapy for osteoporosis. While the efficacy of these drugs appears similar, differences in safety and gastrointestinal tract (GIT) adverse effects are lacking. Consequently, a systematic review and a meta-analysis were carried out reporting on the incidence rate of GIT adverse effects and the safety of alendronate versus risedronate. In this study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. This study collected articles from Embase, PubMed, Cochrane library, and Web of Science. Only RCTs that focused on the comparison between alendronate and risedronate in treating patients with osteoporosis were included. Risk ratios (RRs), 95% confidence intervals (CIs), and random-effects model were calculated. This meta-analysis identified 2202 studies including 4151 participants. There were six eligible RCTs. The incidence rate of GIT adverse effects in patients who received alendronate was 20.19%, while the incidence rate in patients who received risedronate was 18.30%. The rate of GIT adverse effects was not significantly different with alendronate compared to risedronate (RR: 1.11; 95% CI: 0.86-1.42; P < 0.44). In this review, the incidence rate of alendronate-associated gastrointestinal (GI) adverse effects was slightly higher than the incidence rate of risedronate-associated GI adverse effects. Although the finding is not statistically significant, switching the patient from alendronate to risedronate may nevertheless lower the incidence rate of GI side effects.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1371-1376"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947566","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":"Cognitive Impairment and Postoperative Outcomes in Patients Undergoing Primary Total Hip Arthroplasty and Primary Total Knee Arthroplasty: A Systematic Review and Meta-analysis.","authors":"Ravi S Jatti, Nikhil Manvi, Shubham Agarwal","doi":"10.4103/aam.aam_465_26","DOIUrl":"10.4103/aam.aam_465_26","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are commonly performed procedures in older adults. Preoperative cognitive impairment, including mild cognitive impairment, dementia, and frailty-related cognitive decline, may adversely affect postoperative recovery and outcomes. However, the magnitude of this association in arthroplasty patients remains incompletely defined.</p><p><strong>Objective: </strong>To evaluate the association between preoperative cognitive impairment and postoperative outcomes in older adults undergoing primary THA or TKA.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed and Scopus were searched for studies evaluating preoperative cognitive status and postoperative outcomes in patients aged ≥60 years undergoing THA or TKA. Eligible studies assessed cognition using validated tools or clinical diagnoses and reported postoperative neurocognitive or clinical outcomes. A random-effects meta-analysis using the Restricted Maximum Likelihood estimator was performed. Pooled effect estimates were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Findings: </strong>Ten studies involving 10,573 patients were included. Preoperative cognitive impairment was consistently associated with adverse postoperative outcomes, including postoperative delirium, postoperative cognitive dysfunction, long-term cognitive decline, nonhome discharge, and mortality. The pooled analysis demonstrated a significant association between preoperative cognitive impairment and adverse postoperative outcomes (OR 2.38; 95% CI 1.78-2.98; P < 0.001). Although substantial heterogeneity was observed (I² = 76.7%), the direction of effect was consistent across studies.</p><p><strong>Conclusion: </strong>Preoperative cognitive impairment more than doubles the risk of adverse postoperative outcomes following THA and TKA. Routine cognitive screening should be incorporated into preoperative assessment to identify high-risk patients and support perioperative brain health strategies aimed at improving surgical outcomes.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1384-1392"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395718","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":"Comparison of Postoperative Pain Following Modified Radical Mastectomy under Thoracic Epidural Anesthesia versus General Anesthesia: A Randomized Control Trial.","authors":"Nitu Puthenveettil, Sundeep Vijayaraghavan, Sunil Rajan, Jerry Paul","doi":"10.4103/aam.aam_441_25","DOIUrl":"10.4103/aam.aam_441_25","url":null,"abstract":"<p><strong>Background: </strong>Breast surgeries are commonly performed under general anesthesia. The aim of the study was to compare postoperative pain following modified radical mastectomy under thoracic epidural anesthesia versus general anesthesia with the use of laryngeal mask airway.</p><p><strong>Materials and methods: </strong>This randomized controlled study was performed on hundred patients undergoing unilateral modified radical mastectomy. The patients were assigned into two equal groups, E and G. Group E patients received thoracic epidural anaesthesia, and group G received general anesthesia. The primary objective was to compare postoperative pain scores between the two groups. Secondary objectives included incidence of postoperative sore throat, hoarseness of voice, cough, nausea and vomiting, perioperative analgesic requirement, patient and surgeon satisfaction, duration of hospital and intensive care unit (ICU) stay, and any associated anesthesia complications.</p><p><strong>Results: </strong>Both groups were similar with respect to demographics. Postoperative pain score was significantly lower in Group E at all time points. The perioperative analgesic requirement was significantly higher in Group G than in Group E, and this was statistically significant with P < 0.001. Duration of hospital stay and intraoperative hemodynamics were comparable between the two groups. Patient satisfaction was significantly higher in Group G; however, surgeons were satisfied with both methods. Sore throat, cough, hoarseness of voice, nausea and vomiting, and duration of ICU stay were significantly higher in group G. Infiltration of local anesthetic in the axilla was required in 10% of the patients in the epidural group.</p><p><strong>Conclusions: </strong>Although patients found general anesthesia more satisfying, thoracic epidural anesthesia provided significantly better postoperative analgesia compared with general anesthesia with laryngeal mask airway inpatients undergoing modified radical mastectomy and was associated with significantly lower ICU stay, comparable surgeon satisfaction with lower incidence of postoperative sore throat, nausea and vomiting, hoarseness of voice, and cough.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"25 6","pages":"1694-1698"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975475","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}