Annals of African Medicine最新文献

{"title":"Radiographic Performance of Direct, Indirect, and Combined Reduction Techniques in AO A3/A4 Thoracolumbar Burst Fractures: A Computed Tomography-based Secondary Analysis.","authors":"Sagar Gurnani, Navendu Gadhia, Goli Sudheer","doi":"10.4103/aam.aam_757_26","DOIUrl":"https://doi.org/10.4103/aam.aam_757_26","url":null,"abstract":"<p><strong>Background: </strong>Optimal reduction of retropulsed canal fragments in thoracolumbar burst fractures remains debated. This secondary analysis compared computed tomography (CT)-based canal restoration after indirect ligamentotaxis, direct fragment impaction, and combined reduction.</p><p><strong>Materials and methods: </strong>Anonymized patient-level and aggregate data from an open-access cohort of 34 single-level AO A3/A4 thoracic or lumbar burst fractures were analyzed. Patients underwent bisegmental posterior stabilization using indirect, direct, or combined reduction. Preoperative spinal canal area (SCA) stenosis and midsagittal diameter (MSD) stenosis were available at the patient level, whereas postoperative SCA and MSD were available as group means.</p><p><strong>Results: </strong>Thirteen patients underwent indirect reduction, 13 underwent direct reduction, and eight underwent combined reduction. Mean age was 36.4 ± 14.1 years; 23 patients were male. Mean SCA stenosis decreased from 43.7% to 16.6% after indirect reduction, 63.0% to 12.7% after direct reduction, and 48.0% to 11.6% after combined reduction. Direct reduction cases had higher preoperative SCA stenosis than indirect reduction cases (Mann-Whitney U-test P = 0.014).</p><p><strong>Conclusion: </strong>All three techniques achieved substantial radiographic canal restoration. Direct reduction was preferentially used for more severe canal compromise, supporting morphology- and stenosis-guided reduction selection. Prospective local validation with patient-level postoperative CT and functional outcomes is required.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236694","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":"Parental Psychological Distress Associated with Pediatric Type 1 Diabetes: A Cross-sectional Study.","authors":"Laila A Albishi, Nagwa Hanafi, Tariq Alrasheed, Saleh F Alqifari, Rana F Alblwi, Razan S Makki","doi":"10.4103/aam.aam_866_26","DOIUrl":"https://doi.org/10.4103/aam.aam_866_26","url":null,"abstract":"<p><strong>Background: </strong>Parenting a child with type 1 diabetes (T1D) represents an ongoing psychological burden necessitating continuous management of the disease. Although this issue has been recognized, few studies in Saudi Arabia have evaluated the disease-related anxiety and distress among parents of T1D children and adolescents. Therefore, this study was designed to assess levels of diabetes-related distress and anxiety among the parents of children and adolescents with T1D.</p><p><strong>Methods: </strong>This cross-sectional study surveyed 87 parents of children with T1D who attended the Pediatric Diabetes Clinic at King Fahd Specialist Hospital. Two validated instruments, namely the Parent Diabetes Distress Scale (PDDS) and the Spielberger State-Trait Anxiety Inventory, were used. To assess the reliability of both tools, Cronbach's α was calculated. Associations among parental distress, anxiety, and child or parent sociodemographic and clinical characteristics were determined using bivariate statistical techniques.</p><p><strong>Results: </strong>Parents exhibited moderate-related diabetes distress, with a mean PDDS score of 3.06 ± 0.85 on the 5-point scale. Furthermore, they demonstrated mild-to-moderate anxiety with a mean STAI score of 2.62 ± 0.39 on the 4-point scale. The highest PDDS subscale scores were observed on the parent-teen relationship and teen management subscales. Parents of children aged ≥10 years showed higher distress and anxiety compared with younger age groups (P < 0.05). The same higher distress was observed with longer disease duration.</p><p><strong>Conclusion: </strong>Our findings highlight the need for appropriate psychosocial support for Saudi parents of children and adolescents with T1D, especially for those caring for adolescents and those with longer disease duration.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236649","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":"Status of Labor Analgesia as a Felt Need - A Questionnaire-based Survey in Antenatal Women at a Tertiary Care Center in North India.","authors":"Vidisha Khanna, Anjoo Agarwal, Smriti Agrawal, Rachael Cherubin","doi":"10.4103/aam.aam_882_26","DOIUrl":"https://doi.org/10.4103/aam.aam_882_26","url":null,"abstract":"<p><strong>Background: </strong>Labor analgesia is recognized worldwide as the right of every laboring woman and the duty of the obstetrician. Although multiple modalities are available, demand for these services remainslow in government hospitals in India. With increasing emphasis on respectful maternity care, this is alarming. Pain relief in labor directly influences maternal satisfaction, choice of mode of delivery, and perceptions of maternity services.</p><p><strong>Objectives: </strong>The aim of this study antenatal women's understanding of labor analgesia in North India, particularly regarding their knowledge of labor analgesia and epidural anesthesia. It also investigated the relationship between the willingness to seek labor analgesia and several sociodemographic factors, including age, education, occupation, parity, and past delivery experiences.</p><p><strong>Methodology: </strong>Following ethical clearance, a crosssectional questionnairebased survey was conducted among consenting antenatal women attending the outpatient department of a tertiary care government hospital in North India. The validated questionnaire comprised three sections: one each for demographic details, obstetric history, and awareness and intentions regarding labor analgesia in the current pregnancy.</p><p><strong>Results: </strong>Of 477 enrolled women, more than half (50.9%) were aged 25-31 years, a majority were graduates, and over 80% were homemakers. Most participants (81.1%) expressed willingness for vaginal delivery, whereas 17.8% were unwilling, primarily due to previous difficult experiences (51.8%) or fear of pain (12.9%). Awareness of labor analgesia was extremely low: only 41 women (8.64%) had heard of epidural anesthesia, and just 42 expressed willingness to consider it.</p><p><strong>Conclusion: </strong>Labor analgesia awareness and demand in India are low and vary by education and occupation, highlighting the need for targeted awareness initiatives and culturally sensitive interventions to improve patient education and integrate labor pain management into respectful maternity care.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236660","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":"Intellectual Functioning and Cognitive Outcomes in Poststroke Individuals: A Cross-sectional Study.","authors":"S Aravind Kumar, M Ardhanaari, V Vivian Kapil, V Smitharuckmani","doi":"10.4103/aam.aam_899_26","DOIUrl":"https://doi.org/10.4103/aam.aam_899_26","url":null,"abstract":"<p><strong>Background: </strong>Poststroke cognitive impairment is a frequent complication and has a significant impact on functional recovery and quality of life. Evidence from Indian populations is limited, but intellectual functioning as a measure of cognitive reserve might impact cognitive and functional outcomes following stroke.</p><p><strong>Aim: </strong>This study aimed to assess the relationship between intellectual functioning and neuropsychological outcomes in poststroke patients.</p><p><strong>Materials and methods: </strong>This study is a hospital-based cross-sectional correlational design conducted from July 2025 to March 2026 with 122 stroke survivors aged 30-60 years. Intellectual functioning was evaluated by the Binet-Kamat Test of Intelligence (BKT), global cognition by the Montreal Cognitive Assessment (MoCA), visuomotor integration by the Bender-Gestalt Test (BGT), functional independence by the Barthel Index (BI), and depressive symptoms by the 17-item Hamilton Depression Rating Scale-17 (HAMD-17).</p><p><strong>Results: </strong>The mean Binet-Kamat test intelligence quotient (BKT IQ) and MoCA scores were 100.3 ± 6.9 and 25.4 ± 2.7, respectively. BKT IQ showed a significant positive correlation with MoCA (r = 0.52), BI (r = 0.41) and BGT score (r = 0.28), and a negative correlation with HAMD score (r = -0.35) (all P < 0.05). Multiple linear regression showed that BKT IQ was the best independent predictor of cognitive performance (β = 0.38; P < 0.001), followed by education level, BI, HAMD score, and age. The MoCA, BGT and BI scores were significantly higher in ischemic stroke participants compared to hemorrhagic stroke.</p><p><strong>Conclusion: </strong>Intellectual functioning was significantly related to cognitive functioning, functional independence, visuomotor functioning, and depressive symptoms after stroke. Intellectual functioning assessment can help in the prediction of prognosis and in the planning of individual neurorehabilitation in patients after stroke.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Uterine Artery Doppler Indices in Predicting Endometrial Pathology in Perimenopausal and Postmenopausal Women Presenting with Abnormal Uterine Bleeding.","authors":"Aashi Sarvesh, Shraddha Shetty Kandavar, Santosh Rai","doi":"10.4103/aam.aam_926_26","DOIUrl":"https://doi.org/10.4103/aam.aam_926_26","url":null,"abstract":"<p><strong>Context: </strong>Abnormal uterine bleeding (AUB) in perimenopausal and postmenopausal women requires evaluation to exclude premalignant and malignant endometrial pathology. Uterine artery Doppler may improve diagnostic accuracy when combined with transvaginal ultrasonography (TVS).</p><p><strong>Aim: </strong>The aim of this study is to evaluate the diagnostic utility of uterine artery Doppler indices in predicting endometrial pathology among perimenopausal and postmenopausal women presenting with AUB.</p><p><strong>Settings and design: </strong>This was a prospective, observational study conducted at a tertiary care hospital.</p><p><strong>Subjects and methods: </strong>A total of 175 perimenopausal and postmenopausal women with AUB underwent TVS with assessment of endometrial thickness (ET), uterine artery pulsatility index (PI), and resistance index (RI). Endometrial tissue samples obtained by Pipelle biopsy or dilatation and curettage underwent histopathological examination. Histopathological diagnoses were established using standard diagnostic criteria and correlated with the PALM-COEIN classification.</p><p><strong>Statistical analysis used: </strong>Receiver operating characteristic curve analysis was used to assess the cutoff point and diagnostic performance․.</p><p><strong>Results: </strong>Among 175 women, 157 (89.7%) had benign pathology and 18 (10.3%) had premalignant/malignant lesions. PI and RI were significantly lower in premalignant/malignant lesions. In perimenopausal women, PI and RI showed excellent diagnostic accuracy (area under the curve [AUC]: 0.946 and 0.973, respectively). In postmenopausal women, AUCs were 0.798 and 0.674, respectively. Optimal cutoffs were PI ≤1.12 and RI ≤0.425 for perimenopausal women and PI ≤1.77 and RI ≤0.575 for postmenopausal women. Combined assessment of ET, PI, and RI achieved the highest diagnostic performance (AUC 0.851).</p><p><strong>Conclusions: </strong>Uterine artery Doppler indices improve the ability of TVS to distinguish benign from premalignant/malignant endometrial pathology and may serve as a useful noninvasive risk stratification tool in women with AUB.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236699","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":"Cystatin C, Neutrophil Gelatinase-associated Lipocalin, and Pro-atrial Natriuretic Peptide as Biomarkers in the Assessment of Diabetic Nephropathy Patients.","authors":"Nhetan Navin Acharya, Koushik Biswas, S Sri Sahasarajitha, Dharmendra Kumar, Maharudra S Shekhanawar, Naren V Nimbal","doi":"10.4103/aam.aam_998_26","DOIUrl":"https://doi.org/10.4103/aam.aam_998_26","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) is a significant microvascular complication linked with diabetes mellitus which leads to chronic kidney disease worldwide. Conventional biomarkers, namely, serum creatinine and albuminuria often fail to detect early renal impairment.</p><p><strong>Aim: </strong>The study aimed to compare the utility of serum cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), and pro-atrial natriuretic peptide (ANP) for assessing the severity of DN.</p><p><strong>Materials and methods: </strong>This prospective, observational study was conducted on 52 DN cases and 52 controls. Clinical and laboratory parameters of all were assessed at baseline. Serum creatinine, cystatin C, NGAL, and pro-ANP of cases were measured at baseline, 6 months and 12 months. Statistical analysis, including group comparison, correlation and regression analysis, receiver operating characteristic (ROC) analysis, and longitudinal analysis, was done on IBM SPSSv26.</p><p><strong>Results: </strong>At baseline, cases had significantly higher serum creatinine, cystatin C, and NGAL than controls. Pro-ANP was higher in cases but not significant. A significant Pearson's correlation appeared between cystatin C (r = -0.852), creatinine (r = -0.833), pro-ANP (r = -0.553), and estimated glomerular filtration rate (eGFR) (all P < 0.001). No significant correlation was observed between NGAL and eGFR. ROC analysis showed that cystatin C had the highest diagnostic accuracy (area under the curve = 0.995, P < 0.001). Time trend analysis highlighted a significant increase of cystatin C, pro-ANP, and serum creatinine (P < 0.001), but not for NGAL (P = 0.093), with increasing renal impairment over 12 months.</p><p><strong>Conclusion: </strong>Cystatin C demonstrated strongest correlation with eGFR and highest diagnostic accuracy. Time trend analysis revealed significant increase in cystatin C level over 12 months, highlighting its potential role as biomarker for monitoring DN patients.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236685","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":"Pharmacogenetic Determinants of Chemotherapy Response in Breast Cancer: A Comprehensive Review of Chemotherapeutic Agents.","authors":"Prajakta Reur, Ganesh S Bose, Richa Kumari, Smriti P K Mittal, Abhijeet P Kulkarni, Rashmi A Gudur, Anand K Gudur, Kailas D Datkhile","doi":"10.4103/aam.aam_589_26","DOIUrl":"https://doi.org/10.4103/aam.aam_589_26","url":null,"abstract":"<p><strong>Background: </strong>Tumor organoids and pharmacogenetic profiling represent two rapidly advancing tools in precision oncology. Organoids provide physiologically relevant three-dimensional models that retain the genomic, architectural and functional features of patient tumors, enabling high-fidelity drug testing. In parallel, germline pharmacogenetic variation significantly influences chemotherapy metabolism, efficacy and toxicity, particularly in breast cancer. Integrating these approaches offers a powerful framework for individualized therapy selection.</p><p><strong>Methodology: </strong>A narrative review methodology was used to synthesize recent evidence (2006-2025) from PubMed, Scopus, Web of Science and ScienceDirect. Eligible studies included original research on tumor organoid engineering, microenvironmental modelling, drug-response profiling, vascular and immune co-culture systems, and pharmacogenetic determinants of chemotherapy response. Findings were organized thematically across domains of organoid fidelity, microenvironment reconstruction, drug-response prediction, and clinically relevant pharmacogenetic variants.</p><p><strong>Results: </strong>Organoid studies demonstrated high establishment rates, preservation of tumor heterogeneity and improved modeling of stromal, vascular and immune components. Drug-response patterns in organoids correlated strongly with patient outcomes, supporting their role in personalized therapeutic stratification. Parallel evidence shows that key pharmacogenetic variants, including ABCB1, ABCG2 and CBR3 for anthracyclines; CYP2B6 and ALDH1A1 for cyclophosphamide; CYP2C8, CYP3A4 and TUBB2A for taxanes; DPYD and TYMS for fluoropyrimidines; ERCC1 and XRCC1 for platinum agents; and CYP2D6 for tamoxifen, significantly influence treatment toxicity and efficacy. Together, organoid phenotyping and genotype profiling provide complementary insights for clinical decision-making.</p><p><strong>Conclusion: </strong>Advances in biomaterials, microengineering and multi-omic integration are rapidly enhancing organoid reliability, while robust pharmacogenetic markers continue to inform safe and effective chemotherapy use. Combining organoid-based functional testing with pharmacogenetic data offers a strong platform for next-generation precision oncology, enabling more accurate prediction of therapy response and toxicity in breast cancer.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236640","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":"Determinants of Low Birth Weight among Children Born at a Tertiary Care Hospital in Jharkhand, India.","authors":"Chandramani Kumar, Sweta Lal, Chhitiz Anand","doi":"10.4103/aam.aam_699_26","DOIUrl":"https://doi.org/10.4103/aam.aam_699_26","url":null,"abstract":"<p><strong>Background: </strong>Low birth weight (LBW) is a major determinant of infant morbidity and mortality in India and globally. It is associated with poor neurological development, increased childhood morbidity, and growth impairment later in life. To support improved policy guidance and implementation, this study aimed to identify the common risk factors and determinants of LBW among babies delivered in a tertiary healthcare setting in Jharkhand.</p><p><strong>Methodology: </strong>We conducted a hospital-based case-control study including 400 mothers who delivered LBW babies as cases and 400 mothers who delivered normal birth weight babies as control. Data were collected through interviews and review of prior medical records of the mothers included. Descriptive and analytical analyses, including frequency distribution, t-test, odds ratio (OR) estimation, and regression were performed using JAMOVI software.</p><p><strong>Results: </strong>Higher socioeconomic status (OR = 2.278) of pregnant women and the presence of complications during pregnancy (OR = 4.665) were found to be significantly associated with LBW among newborns. Sanitary practices were comparable in both groups and majority of women in both groups had fewer than four antenatal care visits. More than 85% of women in both groups were anemic during pregnancy. Maternal anemia, birth order, and gestational age at delivery were not significantly associated with the birth weight of newborns.</p><p><strong>Conclusion: </strong>The presence of pregnancy-related complications and higher socioeconomic status was identified to be important determinants of LBW among newborns. The latter finding, contrary to previous studies, requires further investigation.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236659","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":"When Erectile Dysfunction Therapy Clouds the Vision: Central Serous Chorioretinopathy after Sildenafil in a Healthy Male.","authors":"Archana Bhange, Siddhartha Gollamudi, Priyanka Sangram Aher, Sumit Navneeth Toshniwal, Harshita Sangram Kashyap","doi":"10.4103/aam.aam_960_26","DOIUrl":"https://doi.org/10.4103/aam.aam_960_26","url":null,"abstract":"<p><strong>Abstract: </strong>Central serous chorioretinopathy (CSCR) is a pachychoroid-spectrum disorder characterized by serous neurosensory retinal detachment secondary to choroidal vascular congestion and retinal pigment epithelial dysfunction. While corticosteroid use and psychological stress are well-established risk factors, phosphodiesterase type-5 inhibitors such as sildenafil citrate, widely used for erectile dysfunction, have been increasingly recognized as an under-reported pharmacological trigger, with proposed mechanisms involving acute choroidal vasodilation and hyperpermeability. A 39-year-old previously healthy male presented with sudden, painless diminution of vision in the right eye of 48 h, occurring shortly after ingestion of a single large recreational dose of sildenafil citrate. Best-corrected visual acuity was reduced to 6/18 in the right eye, with a normal left eye. Fundus examination revealed a well-demarcated serous macular elevation, and optical coherence tomography (OCT) confirmed a dome-shaped neurosensory detachment with a markedly elevated central subfield thickness. A comprehensive systemic and hematological workup, including thrombophilia screening and cardiac evaluation, was unremarkable, supporting a diagnosis of sildenafil-induced CSCR. The patient was managed conservatively with topical nepafenac, topical Flurbiprofen, and oral alcaftadine, along with cessation of further sildenafil use. Serial follow-up over approximately 2 months demonstrated progressive resolution of subretinal fluid, normalization of central subfield thickness, and preservation of visual acuity, with OCT angiography confirming adequate perfusion and no neovascular complication. This case reinforces sildenafil as a potential, dose-related precipitant of acute CSCR even after a single high dose in patients without conventional risk factors. Prompt recognition, drug cessation, and conservative management resulted in complete anatomical and visual recovery, highlighting the importance of a thorough medication history in young patients presenting with unexplained central visual disturbance.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236634","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":"Biochemical-sonographic Correlations in First-trimester Screening for Foetal Aneuploidy: A Cross-sectional Study from Eastern India.","authors":"Kirti Rani, Jiut Ram Keshari, Kumar Harsheet Raj, Rekha Kumari, Dipali Prasad, Pankaj Prabhakar","doi":"10.4103/aam.aam_887_26","DOIUrl":"https://doi.org/10.4103/aam.aam_887_26","url":null,"abstract":"<p><strong>Background: </strong>Aneuploidy screening constitutes an essential component of routine prenatal care worldwide, which is done by ultrasonography during the first trimester. Moreover, pregnancy-associated plasma protein-A (PAPP-A) and free β-human chorionic gonadotropin (β-hCG) reflect placental function, which serve as important biochemical markers for aneuploidy risk assessment.</p><p><strong>Aim: </strong>The present study investigated the correlation between maternal serum PAPP-A and free β-hCG levels with first-trimester ultrasound screening markers, i.e. nuchal translucency (NT) thickness and nasal bone (NB) for detecting fetal aneuploidy.</p><p><strong>Materials and methods: </strong>This was a cross-sectional observational study, which enrolled 139 women with singleton pregnancies at 11-14 weeks of gestation. First-trimester ultrasonography was performed by an experienced doctor, and maternal serum PAPP-A and free β-hCG were also measured. Correlation investigation was done by Spearman's correlation coefficient, while associations were done by Fisher's exact test.</p><p><strong>Results: </strong>A significant positive correlation was observed between PAPP-A gestational age and maternal body mass index. Further, there were a strong negative correlation of NT thickness with PAPP-A multiples of the median (MoM) (P < 0.001) and a strong positive correlation with β-hCG MoM (P < 0.001). The fetal NB was absent in seven (5.0%) pregnancies, of which three were confirmed to have chromosomal abnormalities by noninvasive prenatal testing. Absent NB demonstrated 42.9% sensitivity and 100% specificity, while β-hCG levels were significantly higher in NB-negative pregnancies (P < 0.01).</p><p><strong>Conclusions: </strong>The combined assessment of PAPP-A, free β-hCG, NT thickness, and fetal NB could improve the performance of first-trimester screening for fetal aneuploidy, enabling more accurate early prenatal risk stratification and facilitating timely clinical decision-making.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236644","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}