Nigerian medical journal : journal of the Nigeria Medical Association最新文献

{"title":"Hidden in Plain Sight: Diagnostic Challenges of Extraoral Sinus Tracts of Dental Origin: A Literature Review with Case Reports.","authors":"Vijay Yadav, Krishna P Biswas, Pranitha Vallala, Sakshi Katyal, Anurag Negi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Extraoral cutaneous lesions of odontogenic origin are frequently misdiagnosed due to their asymptomatic dental causes and innocuous presentation. This literature review included 42 articles that highlight the diagnostic challenges of odontogenic cutaneous sinus tracts (OCSTs), which are often mistaken for skin infections, cysts, or neoplasms. As a result, patients typically consult dermatologists, general practitioners, or surgeons before reaching a dental specialist, with a diagnostic delay (Median = 12 months). Misdiagnosis can lead to unnecessary investigations, increasing patient distress and healthcare costs. IOPA radiographs with sinus-tract tracing OR cone-beam computed tomography (CBCT) are the investigation of choice to reach a correct diagnosis in such cases. A multidisciplinary approach involving timely referral to an endodontist/oral surgeon is essential for effective management. This paper presents two clinical cases from our institution that demonstrate successful diagnosis and resolution of OSCTs through appropriate dental intervention, emphasizing the importance of clinical awareness and interdisciplinary collaboration.</p><p><strong>Key messages: </strong>Odontogenic cutaneous sinus tracts often mimic dermatologic lesions, leading to misdiagnosis. Early recognition, proper diagnosis, and timely referral to dental specialists are essential for effective management. Interdisciplinary collaboration is crucial to prevent unnecessary treatments and ensure complete healing.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"867-874"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764212","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":"Predictors of nephropathy in sickle cell disease: A cross-sectional analysis across age and clinical phenotypes in Zaria, Nigeria.","authors":"M M Abdulrasheed, R M Akuse, S Awwalu, A Ibrahim, M A Bugaje, I B Bosan, I N Ibrahim, Faruk Ja, A Yakubu, H R Ahmad, R Yusuf, H M Suleiman, S B Lawal, A U Ibrahim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) is associated with significant complications, including nephropathy, which can progress to end-stage renal disease. While risks for SCD nephropathy have been identified globally, their specific prevalence and predictors in Nigerian, especially across age and clinical phenotypes, are less well understood. This study assessed the prevalence and predictors of nephropathy among Nigerian SCD patients.</p><p><strong>Methods: </strong>This was a cross-sectional study among paediatrics, adolescent, and adult patients with SCD attending hematology clinics of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Interviewer-administered questionnaires were utilised to collect demographic and clinical data. Nephropathy was defined by the presence of proteinuria, haematuria, or eGFR <60 ml/min. Patients were classified into hyper-haemolytic and vaso-occlusive sub-phenotypes. Statistical analyses involved Mann-Whitney U tests, chi-square tests, and logistic regression, with a significance level set at p < 0.05.</p><p><strong>Results: </strong>A total of 311 SCD patients were enrolled, with a median age of 17 (IQR 9-25) years and 65% female. Nephropathy was present in 13.8% of patients, with significantly higher prevalence among adults (23.7%) compared to adolescents (9.1%) and paediatrics patients (3.8%) respectively (X²= 19.27, p < 0.001). The odds of nephropathy were significantly higher in adults (OR 5.57, 95% CI: -0.53-3.96) and females (OR 2.05, 95% CI: 1.72-3.16). Patients with hyper-haemolytic complications had higher odds of nephropathy than those with a vaso-occlusive phenotype (P = 0.366).</p><p><strong>Conclusion: </strong>The prevalence of nephropathy in Nigerian SCD patients increases with age and is more common in females, with hyper-hemolytic sub-phenotypes showing a higher risk profile.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"1150-1155"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764306","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":"Unraveling the Hepatorenal Connection: Intrarenal Resistive Index as a Sentinel Diagnostic Tool in Chronic Liver Disease.","authors":"Khurram Khaliq Bhinder, Suraya Bano, Amna Mehboob, Amaima Gulzar, Raana Amer, Zunera Asghar, Zenab Farooq","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The early identification of renal dysfunction in cirrhotic individuals is pivotal, as renal vasoconstriction may manifest months before traditional biomarkers show significant alterations. Advanced diagnostic approaches are imperative for the detection of hepatorenal syndrome (HRS) during its early stages, enabling prompt clinical intervention and enhancing patient outcomes.</p><p><strong>Methodology: </strong>A prospective observational cross-sectional study was conducted in the Radiology Department at Shifa International Hospital. The study included patients aged 18-75 years who presented with documented ascites and were scheduled for abdominal ultrasound. A comparison was also performed with normal subjects. Exclusion criteria encompassed patients with ascites attributable to non-cirrhotic causes, a history of acute renal failure or renal impairment due to conditions such as diabetic nephropathy or glomerulonephritis. Data was collected using a structured proforma and subsequently analyzed using SPSS version 25.</p><p><strong>Results: </strong>The mean portal vein diameter (± standard deviation) in millimeters was: in normal subjects, 7.6 ± 1.59; in cirrhosis without ascites, 9.8 ± 3.24; in cirrhosis with mild ascites, 10.3 ± 1.51; in cirrhosis with moderate ascites, 12.5 ± 1.55; and in cir rhosis with gross ascites, 16.3 ± 2.33.</p><p><strong>Conclusions: </strong>Early detection of renal impairment in cirrhotic patients can be effectively facilitated by measuring the Intrarenal Resistive Index (RRI) using renal duplex ultrasound. This non-invasive diagnostic method allows for the evaluation of intrarenal hemodynamics and has been shown to exhibit a positive correlation between RRI values and the degree of liver decompensation.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"1004-1013"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765808","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":"Behavioral and Socioeconomic Determinants of Medication Adherence among Adults with Chronic Diseases in Osun State, Nigeria.","authors":"Oluwateniola A Adeyemi-Benson, Oluwafikayo S Adeyemi-Benson, Peter Olaniyi, Anifat O Oladele, Adeola Dorcas Aderinwale","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic non-communicable diseases (NCDs) are major contributors to morbidity and mortality in Nigeria, with behavioural and socioeconomic factors influencing treatment outcomes. Medication adherence remains suboptimal in many low-resource settings. This study assessed the behavioural and socioeconomic determinants of medication adherence among adults with chronic diseases in Osun State, Nigeria.</p><p><strong>Methods: </strong>A descriptive cross-sectional survey was conducted among adults with chronic diseases during community medical outreaches in 2025. Data on socio-demographics, clinical characteristics, lifestyle behaviours, healthcare access, and medication adherence (using a 4-item self-reported questionnaire) were collected and analysed using descriptive statistics, Chi-square tests, and logistic regression.</p><p><strong>Results: </strong>Among 277 respondents, the mean age was 54.7±14.7 years, and 76.5% were female. Overall adherence was low, with only 38% classified as adherent. Socio-demographic factors were not significantly associated with adherence. Elevated blood sugar was associated with higher adherence (AOR = 5.363, 95% CI: 1.778-16.178), while lower meal frequency was associated with poorer adherence (AOR = 0.389, 95% CI: 0.181-0.837). Physical activity was also significantly associated with adherence. Cost was the most commonly reported barrier to healthcare access.</p><p><strong>Conclusion: </strong>Medication adherence among adults with chronic diseases in Osun State is low and is influenced mainly by behavioural and clinical factors rather than socio-demographic characteristics. Interventions should focus on lifestyle modification, patient education, and reducing financial barriers to care.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"943-954"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766340","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":"In Vitro Activity of Ceftazidime/Avibactam Against Multidrug-Resistant Gram-Negative Bacilli in Niger.","authors":"Massir Issoufou Noma, Abdourahamane Yacouba, Ounoussa Tapha, Harouna Moussa, Abdoulaye Ousmane, Souleymane Brah, Mahamadou Doutchi, Maman Laminou Ibrahim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The rise of multidrug-resistant Gram-negative bacilli (MDR-GNB) necessitates the evaluation of new antibiotics such as ceftazidime-avibactam (CZA). Data on its efficacy in Niger is scarce. This study assessed the in vitro activity of CZA against clinical MDR-GNB isolates.</p><p><strong>Methodology: </strong>This prospective cross-sectional study was carried out on 306 non-duplicate MDR-GNB isolates from a National Reference Laboratory from December 2023 to November 2024. Antimicrobial susceptibility testing was performed, and CZA resistance rates were determined. Statistical analysis identified factors associated with resistance.</p><p><strong>Results: </strong>Overall, 23.4% of MDR isolates were resistant to CZA. However, resistance varied dramatically by phenotype: 7.6% in ESBL-producing Enterobacterales (ESBL-E), 33.3% in carbapenem-resistant <i>Pseudomonas aeruginosa</i> (CRPA), 61.7% in carbapenem-resistant Enterobacterales (CRE), and 100% in carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB). Multivariate analysis confirmed that carbapenem resistance was the strongest predictor of CZA resistance (OR=19.00, 95% CI: 9.96-38.27, p<0.001).</p><p><strong>Conclusion: </strong>CZA demonstrates potent activity against ESBL-E in Niger, supporting its role as a carbapenem-sparing agent. However, the high resistance rates in CRE and CRAB preclude its empirical use for suspected infections with these pathogens. These findings underscore the critical need for routine CZA susceptibility testing and enhanced stewardship to preserve its utility.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"887-897"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763013","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 Gaps in Antimicrobial Resistance and Stewardship among Clinical Students in a Nigerian College of Health Sciences: A Cross-Sectional Study.","authors":"Solomon Olubodunrin Ariyibi, Taiwo Rasheedat Bakare, Abiodun Olajuwon Bada, Feyisola Oluwakemi Bamijoko, Luqman Opeoluwa Ogunjimi, Akintunde Blessing Akinpelu, Samson Gbenga Oluwayomi, Sule Ajibola Saka, Muheenat Abolanle Aliyu, Bisola Folusho Olubiyi, Samuel Busayo Ogunlade","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a major global public health threat, disproportionately affecting low- and middle-income countries such as Nigeria. Clinical healthcare students represent a critical target for antimicrobial stewardship (AMS), as prescribing behaviours developed during training often persist into practice. However, evidence on AMR and AMS knowledge across multiple health disciplines in Nigerian clinical training settings is limited. This study aimed at assessing AMR and AMS knowledge among clinical students and identify factors associated with poor knowledge.</p><p><strong>Methodology: </strong>A descriptive cross-sectional study was conducted among 422 clinical students in Medicine, Pharmacy, and Nursing at a Nigerian College of Health Sciences. Data were collected using a structured questionnaire adapted from the WHO AMR awareness tool. Knowledge was assessed using a 13-item score and categorized as good (≥70%), fair (50-69%), or poor (<50%). Associations were tested using chi-square, while independent predictors were identified using multivariate logistic regression.</p><p><strong>Results: </strong>Most participants were aged 21-25 years (68.0%) and female (62.1%). Although 96.9% recognised AMR as a global health problem and 92.4% correctly identified the purpose of stewardship, important gaps were identified. Only 47.2% correctly defined AMR, 36.0% recognized poor infection prevention and control as a driver, and misconceptions persisted regarding antibiotic use in viral infections (40.8%) and uncomplicated malaria (41.7%). Overall, 5.0% had good knowledge, 73.0% fair, and 22.0% poor. On bivariate analysis, level of study (χ²=15.358, p<0.001), department (χ²=7.981, p=0.018), and awareness of Nigeria's National AMR Action Plan (χ²=6.496, p=0.011) were significantly associated with knowledge. Higher level of study (AOR=0.438; p=0.001) and awareness of the national AMR action plan (AOR=0.497; p=0.012) were independently associated with better knowledge.</p><p><strong>Conclusion: </strong>Despite high awareness of the AMR threat, significant knowledge gaps and misconceptions persist among clinical students. Strengthening AMR education through integrated curricula, active learning approaches, and improved dissemination of national policies is essential.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"875-886"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763619","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":"A Cross-Sectional Study to Evaluate the Economic Impact on Caregivers of Patients Undergoing Treatment for Cerebral Palsy and Disabilities at AIIMS Deoghar.","authors":"Vasanth Chellamuthu, S Sharanabasappa, Amisha Chowdhury, Anasua Paria, Teena Khuriwal, Patade Vidula Rajesh, Raj Nandani Sah, Khimchali Hasnu, Manisha Meena, Anjali Rao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cerebral Palsy (CP) is a non-progressive neurodevelopmental disorder characterized by impairments in movement and posture resulting from early brain injury. In India, the estimated incidence is approximately 3 per 1,000 live births, accounting for 15-20% of childhood physical disabilities. The condition imposes substantial psychosocial and economic burdens on families, highlighting the need for effective support systems.</p><p><strong>Methodology: </strong>A quantitative, cross-sectional study was conducted at All India Institute of Medical Sciences, Deoghar. A total of 250 caregivers were selected using a purposive sampling technique. Data were collected using structured tools assessing socio-demographic characteristics, medical expenditure, and non-medical expenditure.</p><p><strong>Results: </strong>The findings revealed a considerable financial burden among caregivers, with median medical and non-medical expenditures indicating substantial out-of-pocket costs. Individuals from lower socio-economic groups constituted the largest proportion of the sample (32%). Statistically significant associations were observed between age and non-medical expenditure (p = 0.01); caregiver education and medical (p = 0.01) as well as total expenditure (p = 0.02); occupation and total expenditure (p = 0.01); type of CP and medical expenditure (p = 0.04); and distance from healthcare facility and non-medical expenditure (p = 0.03).</p><p><strong>Conclusions: </strong>The study highlights the significant economic burden experienced by caregivers of children with Cerebral Palsy, particularly in rural and low-income settings. The most common clinical type identified was spastic CP. The mean medical and non-medical expenditures were ₹8,339.4 and ₹6,776.4, respectively. Key caregiver and contextual factors were significantly associated with these costs. The findings underscore the need for subsidized rehabilitation services, caregiver education, and improved accessibility to healthcare in order to reduce financial strain and enhance the quality of disability care.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"955-973"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763961","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":"A Comparative Study of Prevalence and Pattern of Abnormal Papanicolaou Smear Amongst Pregnant and Non-Pregnant Women in Keffi, North Central Nigeria.","authors":"Oluwasegun Ajala Akanni, Idris Muhammad Yakubu, Yahaya Bawa Ubam, Olubunmi Abidemi Tunde-Olatunji, Amaechi Peter Achara, Amos A'aron, Odunayo Akanni, Olamide Ishola, Nandi Tokkit Ishaya, Arisegi Sarafadeen Adeniyi, Musa Ali-Gombe, Waziri Usman Muhammad","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>To determine and compare the prevalence of epithelial cell abnormalities and associated sociodemographic and behavioral factors in pregnant and non-pregnant women attending clinics at Federal Medical Center (FMC), Keffi, Nasarawa State, Nigeria.</p><p><strong>Methodology: </strong>This comparative cross-sectional study initially enrolled 71 pregnant women (Group A) and 71 non-pregnant women (Group B), frequency-matched for age and parity, attending antenatal, gynecological, and family planning clinics at FMC Keffi. Ayre's spatula-collected cervical smears were interpreted by two consultant cytopathologists blinded to pregnancy status. Abnormal results were classified according to the Bethesda 2014 system. Data were analyzed with SPSS version 26; chi-square and independent t-tests were used at p≤0.05.</p><p><strong>Results: </strong>The prevalence of epithelial cell abnormalities was 9.9% (95% CI: 4.1%-19.3%) in pregnant women and 10.4% (95% CI: 4.3%-20.3%) in non-pregnant women (p=0.909). Inflammatory/reactive changes were more common in pregnant women (31.0% vs 17.9%, p=0.048). Low-grade squamous intraepithelial lesion was the most frequent abnormality (8.5% vs 6.0%), followed by Atypical squamous cells of undetermined significance (1.4% vs 3.0%). HPV vaccine awareness was 7% in both groups, and vaccination coverage was 0%. Gravidity (p=0.043) and age at first sexual intercourse (p=0.001) were significantly associated with epithelial cell abnormality findings in both groups. No independent predictors were found in the logistic regression model.</p><p><strong>Conclusion: </strong>The prevalence of epithelial cell abnormalities was comparable between the groups, suggesting that antepartum screening may be feasible and yield comparable findings. The 93% HPV vaccine unawareness and 0% vaccination coverage highlight the urgent need for national vaccination programs and the integration of opportunistic screening into antenatal care to scale up progress toward WHO's 90-70-90 cervical cancer elimination targets in Nigeria.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"1116-1129"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760866","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":"Role of Haematological Inflammatory indices in the Occurrence of Coronary Artery Disease: A Preliminary Retrospective Case-Control Study.","authors":"Pritika Dutta, Thoushara Manmmadhan, Dhiren Punja, Vineetha K Ramdas Nayak","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is a paramount cardiovascular disease that significantly contributes to global mortality. Recent literature reports hematological inflammatory indices as promising surrogate markers for identifying CAD. This study aims to simultaneously investigate the potential of five inflammatory indices to assess the association with the occurrence of CAD in the Asian Indian population.</p><p><strong>Methodology: </strong>We conducted an age-matched retrospective case-control study among one hundred and thirty-one male cases and controls, and ninety-seven female cases and controls, based on the coronary angiogram performed in the Department of Cardiology in a tertiary referral hospital in southern India. From the Complete Blood Count reports, Neutrophil-to-lymphocyte ratio (NLR), Platelet-to-Lymphocyte ratio (PLR), and Lymphocyte-to-Monocyte ratio (LMR) were calculated for each subject. Erythrocyte Sedimentation Rate (ESR) and Mean Platelet Volume (MPV) values were collected from the laboratory reports. Student t-test and Mann-Whitney test were applied for analysing data that denoted Gaussian distribution and skewed distribution, respectively. To obtain diagnostic accuracy, receiver operating characteristic (ROC) curves were applied, designating the area under the curve (AUC), sensitivity, and specificity.</p><p><strong>Results: </strong>Among the five inflammatory biomarkers, ESR and NLR demonstrated comparatively better discriminatory ability in both males (AUC=0.717, 0.7397) and females (AUC=0.8042, 0.7397).</p><p><strong>Conclusion: </strong>The findings suggest that ESR and NLR are quick and cost-effective biomarkers and may serve as adjunctive markers of coronary artery disease in the Asian Indian population.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"933-942"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762924","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":"Evaluating the Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) on Craving Reduction and Relapse Prevention in Alcohol and Opioid Use Disorders: A Randomised Controlled Trial.","authors":"Abdullahi Abdulwahab Yakubu, Summayyah Muhammad Bashar, Audu Ishaq Aveka, Bashir Adam Yakasai","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>High relapse rates in alcohol use disorder (AUD) and opioid use disorder (OUD) remain a significant treatment challenge globally and within Nigeria. This randomised controlled trial evaluated the efficacy of repetitive transcranial magnetic stimulation (rTMS) as an adjunct to cognitive-behavioural therapy (CBT) for sustained craving reduction and relapse prevention in patients with AUD and OUD.</p><p><strong>Methodology: </strong>In this double-blind, sham-controlled trial, 300 participants with AUD or OUD were assigned to active or sham rTMS groups. All received standard cognitive-behavioural therapy. The active group underwent 20 sessions of 10 Hz rTMS over the left dorsolateral prefrontal cortex. Primary outcomes were changes in craving (measured by the Visual Analog Scale and the Obsessive Compulsive Drug Use Scale) and relapse rates at 3, 6, and 12-month follow-ups.</p><p><strong>Results: </strong>Active rTMS yielded significantly greater craving reduction versus sham at all assessment points (p<0.001). The 12-month cumulative relapse rate was markedly lower in the active group (31.7%, 45/142) compared to the sham (72.3%, 102/141; p<0.001). The number needed to treat was 2.5 (95% CI: 2.1-3.1), and the hazard ratio for relapse was 0.34 (95% CI: 0.24-0.48, p<0.001). These therapeutic effects were consistent at all time points and across both AUD and OUD subgroups.</p><p><strong>Conclusion: </strong>Adjunctive high-frequency rTMS is an effective intervention, demonstrating robust and sustained reductions in craving and relapse over 12 months for patients with AUD and OUD. These findings support its integration into standard treatment protocols in Nigeria and similar settings.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":"67 3","pages":"1173-1185"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764514","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}