Annals of African Medicine最新文献

{"title":"Synchronous Leiomyomas of the Sigmoid Colon and Ileocecal Valve Presenting as Colonic Polyps in a Young Male.","authors":"Ajay Pranami, Anukalp Prakash, Vedanti Newaskar, Richa Joshi","doi":"10.4103/aam.aam_766_26","DOIUrl":"https://doi.org/10.4103/aam.aam_766_26","url":null,"abstract":"<p><strong>Abstract: </strong>Gastrointestinal (GI) leiomyomas are rare benign smooth muscle tumors, most commonly arising in the esophagus and stomach. Their occurrence in the colon is uncommon, and synchronous involvement of multiple colonic sites is exceedingly rare. We report a case of a young male who underwent colonoscopic evaluation for GI symptoms, which revealed polypoidal lesions in the sigmoid colon and at the ileocecal valve. Both lesions were endoscopically resected. Histopathology with immunohistochemistry is essential for accurate diagnosis and to differentiate these lesions from GI stromal tumors. Recognition of this entity is important to guide appropriate management and avoid overtreatment.</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":"149236665","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":"Assessment of Heavy Metal Exposure in Adult Patients with Minimal Change Disease: A Cross-sectional Case-Control Study.","authors":"Vetha Palani Chellakkannu, Mallikarjun Shivaputrappa Karishetti Khanpet","doi":"10.4103/aam.aam_825_26","DOIUrl":"https://doi.org/10.4103/aam.aam_825_26","url":null,"abstract":"<p><strong>Background: </strong>Minimal change disease (MCD) is a major cause of nephrotic syndrome and is traditionally considered an immune-mediated podocytopathy. Environmental heavy metals have emerged as potential nephrotoxic factors that may contribute to glomerular injury and disease susceptibility.</p><p><strong>Objectives: </strong>The objectives of this study were to determine serum concentrations of selected heavy metals and evaluate their association with MCD in adults.</p><p><strong>Materials and methods: </strong>This cross-sectional case-control study was conducted in the Department of Nephrology at a tertiary care teaching hospital between October 2024 and December 2025. Twenty adults with biopsy-proven MCD and 20 age- and sex-matched healthy controls were enrolled. Clinical, environmental, and occupational exposure histories were recorded. Serum concentrations of chromium, cadmium, arsenic, lead, and mercury were measured using inductively coupled plasma mass spectrometry. Heavy metal levels were compared between cases and controls and correlated with clinical parameters including serum albumin, urine protein-creatinine ratio, and acute kidney injury (AKI).</p><p><strong>Results: </strong>The mean age of MCD patients was 31.6 ± 12.4 years, with males constituting 70% of cases. Severe albuminuria and nephrotic-range proteinuria were present in 85% of patients, while severe hypoalbuminemia was observed in 75%. AKI occurred in 35% of cases. Mean serum chromium (3.80 ± 1.42 vs. 1.80 ± 0.52 μg/L; P < 0.001) and cadmium levels (0.58 ± 0.56 vs. 0.00 ± 0.00 μg/L; P < 0.001) were significantly higher among MCD patients compared with controls. Elevated chromium levels were detected in 95% of cases, arsenic in 75%, cadmium in 20%, and lead in 10%, whereas mercury was undetectable in all participants. No significant associations were observed between heavy metal concentrations and serum albumin levels, proteinuria severity, or AKI (P > 0.05). Steroid sensitivity and complete remission were achieved in 90% of patients.</p><p><strong>Conclusions: </strong>Adult patients with MCD demonstrated significantly higher serum chromium and cadmium concentrations compared with healthy controls. However, heavy metal exposure was not associated with disease severity or renal outcomes. These findings suggest that environmental heavy metals may act as contributory factors rather than direct determinants of disease expression. Larger prospective studies are required to clarify the role of environmental nephrotoxins in the pathogenesis of MCD.</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":"149236646","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":"Association between Neuropsychological Impairments and Adaptive Functioning in Stroke Survivors: A Cross-sectional Study.","authors":"S Aravind Kumar, M Ardhanaari, Ashwathi Janakiram, N R Nappinnai","doi":"10.4103/aam.aam_900_26","DOIUrl":"https://doi.org/10.4103/aam.aam_900_26","url":null,"abstract":"<p><strong>Background: </strong>Poststroke neuropsychological deficits are common and often impact cognition, adaptive functioning, and functional independence, which can hinder successful community re-entry.</p><p><strong>Objectives: </strong>To assess the relationship between neuropsychological impairments and adaptive functioning in stroke survivors and to determine independent predictors of adaptive functioning.</p><p><strong>Materials and methods: </strong>This cross-sectional study was conducted with 122 stroke survivors aged 30-60 years from July 2025 to March 2026. Neuropsychological functioning was evaluated with the Bender-Gestalt Test and Montreal Cognitive Assessment (MoCA); the Vineland Social Maturity Scale (VSMS) was used to assess adaptive functioning; the Functional Independence Measure (FIM) was used to assess functional independence; and the National Institutes of Health Stroke Scale (NIHSS) was used to assess neurological severity.</p><p><strong>Results: </strong>The mean MoCA, VSMS composite, and FIM scores were 25.1 ± 2.8, 90.6 ± 8.4, and 94.2 ± 12.7, respectively. MoCA scores were significantly positively correlated with VSMS composite (r = 0.53) and FIM (r = 0.62), while NIHSS scores were significantly negatively correlated with all neuropsychological and functional measures (all P < 0.05). Of the factors considered, MoCA score was the best independent predictor of adaptive functioning, followed by FIM score. Cognitive, adaptive, and functional outcomes were significantly better for participants with ischemic stroke.</p><p><strong>Conclusion: </strong>Adaptive functioning is strongly linked with neuropsychological functioning following stroke, and global cognitive performance and functional independence are the main predictors of adaptive functioning. A thorough evaluation of skills could help in the development of a tailored rehabilitation plan and enhance long-term outcomes.</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":"149236635","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":"Partial Internal Biliary Diversion for Progressive Familial Intrahepatic Cholestasis: Clinical Outcomes in Three Cases.","authors":"Sanjeev Kumar Verma, Kishore G S Bharathy, Prerna Priyadarshini","doi":"10.4103/aam.aam_786_26","DOIUrl":"https://doi.org/10.4103/aam.aam_786_26","url":null,"abstract":"<p><strong>Abstract: </strong>Internal biliary diversion surgery is a promising treatment modality for relieving pruritus in patients with progressive familial intrahepatic cholestasis (PFIC). Other treatment modalities include medical management and liver transplantation. We report three children with PFIC and preserved synthetic liver function who underwent successful partial internal biliary diversion surgery at a tertiary care centre in North India. All three children had a good postoperative recovery with significant improvement in pruritus, as documented by the 5-D itch scale, associated with a reduction in serum bile acid levels over a median follow-up of 23 months. Therefore, in appropriately selected patients with PFIC, partial internal biliary diversion can result in favourable clinical outcomes, and potentially avoid or delay the need for liver transplantation.</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":"149236636","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 Estimation of Prevalence of Cognitive Impairment in Epileptic Patients.","authors":"Batchu Akhilesh, Sukanya Swapankumar Dasgupta, Chaitra Kannadka, Rizul Gupta, Samyak Jitendra Nagar, Lavalik Boppana","doi":"10.4103/aam.aam_808_26","DOIUrl":"https://doi.org/10.4103/aam.aam_808_26","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment is a frequent, but frequently overlooked, complication of epilepsy that has a negative impact on patients' quality of life and functioning. Recurrent seizures and neurological factors can have a deleterious effect on multiple cognitive domains such as memory, attention, and executive function. The Montreal Cognitive Assessment (MoCA) scale was used to assess cognitive impairment in patients with epilepsy in this study.</p><p><strong>Objectives: </strong>The objectives of this study were to estimate the prevalence of cognitive impairment in patients with diagnosed epilepsy for more than 2 years using the MoCA scale, assess cognitive function using the MoCA score in epilepsy patients, and determine the prevalence of cognitive impairment.</p><p><strong>Materials and methods: </strong>A hospital-based prospective observational study was conducted among 97 patients with epilepsy for 18 months. A MoCA scale (0-30) was used to evaluate cognitive function. Means and standard deviations were given for numerical variables, and frequencies and percentages were reported for categorical variables. The Fisher's exact test or Chi-square test was used for the analysis of categorical variables as appropriate.</p><p><strong>Results: </strong>The prevalence of cognitive impairment was significantly higher in the group with hypertension (45, 95.7%) than in the group without hypertension (40, 80.0%) (χ2 = 5.54, P = 0.02). The association between cognitive impairment and diabetes mellitus was not statistically significant. The associations with hypothyroidism, cerebrovascular accident, and ischemic heart disease were not statistically significant, as per Fisher's exact test (P = 0.99, 0.07, and 0.99, respectively).</p><p><strong>Conclusion: </strong>Based on these findings, it is concluded that there is a need to consider cognitive impairment as an important and often unrecognized comorbidity with the overall disease burden of patients with epilepsy. The authors emphasize that it is crucial to include routine cognitive assessments in daily clinical practice.</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":"149236614","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":"Association of Intrinsic Capacity Decline with Frailty, Polypharmacy, Nutritional Status, and Fall Risk among Older Adults: A Cross-sectional Study from a Tertiary Care Center.","authors":"Harishchandra Chaudhari, Swapnil Suresh Patil, Yashodeep Baburao Gaikwad","doi":"10.4103/aam.aam_662_26","DOIUrl":"https://doi.org/10.4103/aam.aam_662_26","url":null,"abstract":"<p><strong>Background: </strong>Intrinsic capacity reflects an individual's physical and mental abilities and influencing healthy aging; its decline often precedes disability and is linked with frailty, malnutrition, polypharmacy, and falls.</p><p><strong>Materials and methods: </strong>This cross-sectional observational study was conducted at a tertiary care center in Western Maharashtra, India, among 165 adults aged 60 years and above. Participants were enrolled by consecutive sampling. Sociodemographic details, comorbidities, medication use, fall history, and functional parameters were recorded. Intrinsic capacity was assessed across cognition, locomotion, vitality/nutrition, vision, hearing, and psychological domains. Frailty was assessed using the Clinical Frailty Scale, nutritional status using the Mini Nutritional Assessment-Short Form (MNA-SF), and data were analyzed using IBM SPSS Statistics version 27.0.</p><p><strong>Results: </strong>The mean age was 72.77 ± 9.14 years. Intrinsic capacity decline was present in 147 (89.1%) participants, with severe decline in 76 (46.1%). Locomotion was the most commonly impaired domain (106, 64.2%), followed by vitality/nutrition (74, 44.8%) and psychological domain (61, 37.0%). The mean BMI was 22.49 ± 3.83 kg/m2, the mean number of current medications was 4.32 ± 2.09, the mean Timed Up and Go duration was 12.98 ± 3.26 s, the mean MNA-SF score was 11.58 ± 2.01, the mean Clinical Frailty Scale score was 4.27 ± 1.57, and the mean number of impaired intrinsic capacity domains was 2.29 ± 1.34. Intrinsic capacity decline was significantly associated with frailty, nutritional status, polypharmacy, and fall risk.</p><p><strong>Conclusion: </strong>Intrinsic capacity decline was highly prevalent among older adults. Routine multidomain geriatric assessment may help identify vulnerable individuals and guide early preventive interventions.</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":"149236687","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":"Incidence and Outcomes of Incidental Dural Tears Following Open Lumbar Spine Surgery: A Three-and-a-Half-Year Experience from Benin City, Nigeria.","authors":"Ali Elijah Usiholo, George Aighobahi Akpede, Hanson Osazuwa Idehen","doi":"10.4103/aam.aam_581_26","DOIUrl":"https://doi.org/10.4103/aam.aam_581_26","url":null,"abstract":"<p><strong>Background: </strong>Incidental durotomy is a recognized complication of lumbar spine surgery and may lead to cerebrospinal fluid (CSF) leakage, pseudomeningocele, meningitis, and prolonged hospitalization if not promptly recognized and adequately repaired. There is limited information on its incidence and management from sub-Saharan Africa. This study evaluated the incidence, risk factors, management, and early outcomes of incidental dural tears following open lumbar spine surgery in a Nigerian private neurosurgical practice.</p><p><strong>Methods: </strong>We conducted a retrospective review of 68 consecutive patients who underwent open lumbar spine surgery between July 2022 and December 2025. Patient demographics, operative characteristics, occurrence of incidental dural tears, methods of repair, and postoperative outcomes were analyzed. Comparisons between patients with and without dural tears were performed using the Mann-Whitney U-test and Fisher's exact test, with statistical significance set at P < 0.05.</p><p><strong>Results: </strong>Incidental dural tears occurred in 9 of 68 (13.2%) patients. Thirty-five (51.5%) patients underwent single-level decompression, while 33 (48.5%) underwent multilevel decompression. Dural tears occurred in 4 of 35 (11.4%) patients undergoing single-level decompression and in 5 of 33 (15.2%) patients undergoing multilevel decompression, with no significant association between multilevel surgery and incidental durotomy (P = 0.65). Both patients with previous lumbar surgery sustained incidental dural tears, and previous surgery was significantly associated with durotomy (P = 0.016). All dural tears were recognized intraoperatively and repaired immediately using primary suture closure with selective adjunctive use of autologous fascial grafts and cyanoacrylate sealant. No patient developed persistent CSF leakage or meningitis, and one patient developed a pseudomeningocele that resolved with conservative management.</p><p><strong>Conclusion: </strong>Incidental durotomy occurred in 13.2% of patients undergoing open lumbar spine surgery in this series. Prompt intraoperative recognition and layered repair resulted in favorable early outcomes. Although previous lumbar surgery was significantly associated with incidental durotomy, this finding should be interpreted cautiously because of the small number of revision procedures. Larger prospective multicenter studies are required to better define risk factors and optimize management in similar resource-limited settings.</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":"149230916","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":"Intraoperative New-onset Atrial Fibrillation during Endoscopic Retrograde Cholangiopancreatography: A Peri-anesthetic Challenge.","authors":"Aparna Bagle, Shivraj Dinesh Gadhvi, Sakhshi Gupta","doi":"10.4103/aam.aam_739_26","DOIUrl":"https://doi.org/10.4103/aam.aam_739_26","url":null,"abstract":"","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":"149236708","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":"Osteonecrosis in Antiphospholipid Syndrome: An Evidence Map and Diagnostic Attribution Framework for a Noncriteria Manifestation.","authors":"Veeramreddy Kavya, Nemani Sai Manasa, G Akshaya Kamalashree, Hariharan Murugadoss, Aneesh Basheer","doi":"10.4103/aam.aam_746_26","DOIUrl":"https://doi.org/10.4103/aam.aam_746_26","url":null,"abstract":"<p><strong>Abstract: </strong>Osteonecrosis has been reported in antiphospholipid syndrome (APS) and antiphospholipid antibodies (aPL) positivity, but because it also follows glucocorticoid exposure, systemic lupus erythematosus (SLE), alcohol use, trauma, pregnancy, transplantation, and thrombophilia, its status as an APS-related manifestation is uncertain, and clinicians lack a structured way to decide whether it is APS-attributable or coincidental. We conducted a structured narrative review with evidence mapping, searching PubMed/MEDLINE, Embase, and Scopus from inception to May 2026 with citation chasing; eligible reports described osteonecrosis, avascular necrosis, aseptic necrosis, or bone infarction in confirmed APS or documented aPL positivity. Twenty-two publications were charted for design, phenotype, osteonecrosis site, diagnostic modality, competing etiologies, and attribution, and synthesized narratively. Reported frequencies ranged from 3.75% and 4.5% for clinically ascertained disease to 20% for asymptomatic magnetic resonance imaging screen-detected disease in steroid-naïve primary APS-estimates that are not directly comparable. Femoral-head disease predominated, but multifocal, bilateral, and atypical-site lesions were repeatedly described. Attribution was strongest in young patients with persistent high-risk aPL, minimal traditional risk factors, and concurrent thrombotic, obstetric, or microvascular features, yet competing causes, especially glucocorticoids and SLE-frequently coexisted. We propose the APSO framework, stratifying attribution into four tiers (high-confidence, probable, uncertain/mixed, and aPL-positive osteonecrosis without classifiable APS) by APS certainty, aPL risk, osteonecrosis phenotype, and competing-cause burden. Osteonecrosis is a candidate noncriteria skeletal manifestation of APS, but aPL positivity alone is insufficient for causal attribution; prospective validation 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":"149236667","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":"Immunohistochemical Evaluation of S100 and CD163 in Leprosy with Emphasis on Polar Leprosy.","authors":"Anvita L Joshi, Shrinivas Bheemrao Somalwar, Shailaja Prabhala, Deepthi Konda","doi":"10.4103/aam.aam_889_26","DOIUrl":"https://doi.org/10.4103/aam.aam_889_26","url":null,"abstract":"<p><strong>Background: </strong>Leprosy (Hansen's disease), caused by Mycobacterium leprae, manifests as an immunopathologic spectrum from tuberculoid (TT) to lepromatous (LL) leprosy. Histopathological diagnosis is essential for accurate classification. S100 immunostaining highlights nerve fibers within granulomas and CD163 identifies M2 macrophages, both offering diagnostic and pathogenetic insights beyond routine hematoxylin-eosin (H and E) staining.</p><p><strong>Aims: </strong>The aim of the study was to evaluate the pattern of S100 immunostaining and CD163 expression across different histopathological types of leprosy and correlate these with clinicopathological features.</p><p><strong>Materials and methods: </strong>This hospital-based, cross-sectional study (August 2022-August 2024) included 33 adults, treatment-naïve, biopsy-proven leprosy cases. Skin biopsies were stained with H and E, Fite-Faraco, S100 (EP32), and CD163 (EP324) immunostains. S100 nerve patterns and CD163 grading were correlated with histopathological type.</p><p><strong>Results: </strong>Mean age was 40.2 years (male: female = 3.1:1). Lepromatous leprosy was the most common (33.3%). Fragmented S100 pattern (51.5%) predominated. S100 positive nerves were within the infiltrate in 83.3% of paucibacillary cases versus outside in 66.6% of multibacillary cases (P = 0.009). CD163 was significantly associated with histopathological type (P = 0.01), with Grade 4 positivity in 63.6% of LL cases. S100 enabled nerve visualization in 18% of cases where nerve fibers were difficult to identify on H and E alone.</p><p><strong>Conclusions: </strong>S100 immunostaining is a valuable adjunct in diagnosing and subtyping leprosy. CD163 correlates significantly with the lepromatous pole, reflecting M2 macrophage predominance, with future therapeutic implications.</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":"149236680","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}