British Journal of Healthcare and Medical Research
BJHR is an international, peer-reviewed, open-access journal that publishes high-quality original research and reviews across healthcare, medicine, and allied health sciences. The journal welcomes contributions in clinical medicine, dentistry, public health, nursing, diagnostics, therapeutics, prevention, rehabilitation, mental health, midwifery and obstetrics, healthcare systems, medical technologies, psychology, physiotherapy, and related interdisciplinary fields. It also encourages innovative scholarship on data-driven methods and artificial intelligence to improve diagnosis, treatment, care delivery, and health outcomes. In addition, BJHR provides a platform for research relevant to public health practitioners, community health workers, assistive personnel, and other professionals involved in preventive, curative, and rehabilitative care at individual and population levels.
Systemic Bactericidal Complement in Human Cardiomyopathies: Revisiting Approach
Cardiac diseases are of common prevalence among age human beings. In a clinical setting, the cardiologist of working team at Hilla Mergan Teaching Hospital, diagnose 23 cardiomyopathy test patients whom complained inflammatory-infectious manifestations in continuum with ageing processes. Five normal aged and five normal adulthood were the controls. The test and control groups were enrolled in blood collection with heparin for bactericidal assay. The heparinized one in tenth diluted blood samples were inoculated with fresh diluted E coli culture suspensions. The inoculated blood samples were incubated for 10,20 and 40 minutes at 37C.Then streaked onto nutrient agar plates and incubated for an overnight period in 37C.To score bactericidal activity onto the streak line; confluent growth means no action, weak growth means hypoactive and no growth means active bactericidal complement. Complement bactericidal activity patterns in cardiomyopathy patients were as; inactive ,hypoactive and active. The nature of this bactericidal activity was found to be dependent on the initial blood-bacteria interaction time at 37C as the time passed from 10 to 40 min. Nine out of the 23(39.13%) test patient have shown inactivity up to 40 min incubation. Fourteen out of the 23(60.7%) were expressing various grades of bactericidal activity. Complement inactivity can be attributed to; consumption of complement in immune-pathogenesis of the cardiac disease, ageing and/ or infection induced complement suppressive effects. Complement hypoactivity may be due to the cardiomyopathy and /or ageing.
Copyright (c) 2026 Ibrahim M S Shnawa, Mohamed M Abdurazak, Baha H H Alameidi http://creativecommons.org/licenses/by/4.0
Biophysical Mechanisms of Cognitive Erosion: Alpha-Emitting Nanoparticulates and the Topography of Global IQ (A Paper written with Gemini)
This paper explores the correlation between regional variations in average IQ and environmental contamination by alpha-emitting nanoparticulates. Drawing on the axonal transport mechanisms identified by Tournier et al. (2009) and the quantum biophysical models of Pirot, we hypothesize that internal contamination via the olfactory and optic pathways leads to chronic neuroinflammation and synaptic interference. We examine the 'Shuriken' versus 'Round' geometry of isotopes and propose a three-stage remediation protocol involving neutron moderation via CO2, metabolic excretion, and controlled neurogenesis.
Copyright (c) 2026 Florent Pirot http://creativecommons.org/licenses/by/4.0
Human Physiology Education through Pedagogy, Andragogy, and Heutagogy to Improve Nursing Practice towards Ensuring Patient Safety
A strong grasp of human physiology is crucial for safe and effective nursing practice because it facilitates clinical reasoning, decision-making, and timely patient interventions. Traditional teaching methods, however, might not be sufficient to meet the various learning requirements of practicing nurses and nursing students at various phases of their careers. In order to improve patient safety, this study investigates the integration of pedagogy, andragogy, and heutagogy as complementary educational frameworks for teaching physiology in nursing education. Pedagogical approaches use instructor-led instruction and structured guidance to help new learners acquire foundational knowledge. Adult learners can apply physiological concepts to real-world clinical contexts thanks to andragogical strategies that emphasize self-directed, experience-based learning. By encouraging nurses to recognize their own learning needs, reflect on their practice, and participate in ongoing professional development, heutagogical approaches further foster learner autonomy, critical thinking, and adaptability. Nursing educators can promote greater comprehension, clinical competency, and lifelong learning abilities by integrating physiology instruction with these progressive learning paradigms. By strengthening nurses' physiological knowledge and enhancing their clinical judgment, the integration of these frameworks may help to improve patient safety and care quality by lowering errors.
Copyright (c) 2026 Albert Opoku, Asafo, T. A. Adjei, Jones Afriyie-Anto, Mustapha Bin Usman http://creativecommons.org/licenses/by/4.0
Acute Pancreatitis Evolved to a New Treatment
Introduction: Acute pancreatitis is an inflammatory disease of the pancreas that is characterized by a wide spectrum of clinical severity, from mild and self-limiting episodes to severe necrotizing disease with high morbidity and mortality. Objective: To describe the experience of the results obtained from patients with acute pancreatitis with a statistical, deductive, critical, logical and impartial analysis. Method: A retrospective, longitudinal, observational and descriptive study was conducted; presenting results by descriptive statistics, patients present with acute pancreatitis of probable biliary and/or pancreatic pathology. Results: 81 patients (19.75 %) men and 65 women (80.25 %), with a mean age of 39 years, with acute pancreatitis due to acute lithiasis cholecystitis (77.7 %). Once in remission, laparoscopic cholecystectomy was performed in 71 patients (91.02%). Morbidity was 19.75% and adjusted to 4.93%. With a residual choledocholithiasis of 7.4%. No mortality was reported. Discussion: The etiology of acute pancreatitis is a mystery to date, since there is no proven genesis that causes it, it is a potentially fatal inflammatory disease with well-known etiologies; however, in up to 30% of cases no identifiable cause is found, resulting in the diagnosis of acute pancreatitis. The Atlanta classification for acute pancreatitis is currently the most reliable that focuses on baseline behavior/behavior/prognosis, organ failure, and protective measures as central issues for developing or not developing acute respiratory distress syndrome and increasing mortality rates. Conclusion: acute pancreatitis is a pathology that for centuries has caused fear, brutal health sequelae/limitations to survivors, which has plagued humanity due to such high rates of morbidity and mortality; that in view of this background, overdiagnosis and excessive treatment have been exercised with an increase in the costs of human resources, material and economic, with precarious results. It is concluded that therapeutic management of mild acute pancreatitis, so basic and unorthodox, is beneficial for medical practice that does benefit the patient and the permanently worn-out impoverished health sector.
Copyright (c) 2026 Brenda Lizeth Herrera Gómez Tagle, María de los Ángeles Carmona Alva, Jaime Ricardo López Sixtos, José de Jesús Macedo Garduño, Rubén Omar Gress Tovar, Gabriel Cervera Rodríguez, Aldair Cruz Gallardo, Alexis Nevid Fuentes Otero, Indra Lucía Badillo Campuzano, Morelos Adolfo García Sánchez http://creativecommons.org/licenses/by/4.0
Evaluating Pharmaceutical Compounding Practices and Quality Management Gaps in Nigeria
In Nigeria, compounding practices have historically been confined mainly to hospital and institutional pharmacies and remain relatively under-documented despite their clinical significance. This study assessed the current practices, challenges, and future directions of pharmaceutical compounding in Nigeria, with the aim of identifying gaps in training, regulation, infrastructure and quality assurance that influence the safety and effectiveness of compounded medications. A descriptive cross-sectional mixed-methods design was employed. The quantitative component involved a structured questionnaire administered to registered pharmacists engaged in compounding activities, while the qualitative component consisted of Key Informant Interviews (KIIs) with experienced pharmacists from hospital, institutional, and regulatory settings. Quantitative data were analyzed using descriptive and inferential statistics in SPSS, while qualitative data were examined through thematic analysis to identify recurring professional and institutional themes. Integration of both datasets enabled triangulation and a comprehensive interpretation of findings. A total of 69 valid survey responses were analyzed. Results indicated that most pharmacists possessed at least a Bachelor of Pharmacy or Pharm. D qualification and reported moderate to high familiarity with compounding practices. However, only about one-third had received formal or specialized compounding training beyond undergraduate education. Non-sterile compounding—such as oral suspensions, creams, and capsules—was the predominant practice, with sterile compounding performed by fewer than 10% of respondents due to inadequate facilities. Key challenges identified included limited access to quality raw materials, insufficient infrastructure, regulatory ambiguity, and the absence of standardized operating procedures and validated stability data. Qualitative findings further highlighted reliance on informal learning, gaps in regulatory enforcement, and concerns regarding quality assurance and patient safety. Overall, the study demonstrates that while pharmaceutical compounding remains an essential component of healthcare delivery in Nigeria, systemic limitations hinder its optimal practice. Strengthening regulatory frameworks, expanding professional training, improving infrastructure, and developing national compounding guidelines are essential to enhance quality, safety, and sustainability in pharmaceutical compounding practice
Copyright (c) 2026 John Alpha, Abraham Amlogu, Qazeem Abdulganiyu, Ibrahim Lawal http://creativecommons.org/licenses/by/4.0
Identification of Brugada Syndrome as a Quality Control Test for EMF Danger for Affected Individuals with and without Implanted Devices or Unaware of their Condition
We report three cases of workers with Brugada syndrome (BrS) who were fitted with an active implantable medical device (AIMD) with a defibrillator effect. In these individuals, abnormalities in sodium ion channels are the cause of acute ventricular fibrillation attacks. While the fundamental role of ICD therapy in preventing fatal arrhythmias in Brugada syndrome is obvious, device-related complications cannot be ruled out, especially in younger, working-age patients, even in cases where thoracoscopic epicardial ablation was performed in addition to the ICD with a positive outcome. However, while it is obvious in these individuals, limiting or excluding excess exposure to electromagnetic field (EMF) sources or other incompatibilities with the routine performance of certain tasks is necessary, based on necessary precautions. However, it appears difficult to diagnose Brugada syndrome or other channelopathies in subjects without device use and with an unresolved medical history, or to rule out the effect of exposure to (EMF) in those with unrecognized Brugada syndrome. The goal of this study is to clarify which specific measures could be adopted, whether they are sufficient in the most severe conditions, and whether precautionary procedures allow for continued work. Finally, it is also important to clarify a larger clinical study in the preventive phases.
Copyright (c) 2026 Mauro Mazzotta, Manuel Fernandez, Alessandro Dario Mazzotta, Rocco Giuseppe Cazzato http://creativecommons.org/licenses/by/4.0
In-hospital Outcomes and Long-term Survival after Off-Pump and On-Pump Redo Coronary Artery Bypass Grafting: A Propensity Matched Analysis
Background: Redo coronary artery bypass grafting (redo-CABG) carries substantial perioperative risk, and comparative evidence between on-pump and off-pump approaches remains limited. This study evaluates short-term outcomes and long-term survival in patients undergoing redo-CABG with (on-pump) or without cardiopulmonary bypass (off-pump). Methods: We retrospectively analyzed 191 patients undergoing redo-CABG (off-pump: n=143; on-pump: n=48) from 2006–2019. Primary endpoints included 30-day mortality, re-exploration, re-intubation/tracheostomy, and hemofiltration; secondary endpoint was long-term survival. Propensity score matching (1:1, caliper 0.20) yielded 40 well-balanced pairs. Kaplan–Meier analysis and Cox regression assessed survival and predictors of mortality. Results: In the unmatched cohort, 30-day mortality was similar (8.4% off-pump vs 6.3% on-pump, p=0.76). Off-pump patients required fewer transfusions (22.4% vs 43.8%, p=0.01), received fewer grafts (median 2 vs 3, p<0.001), and had lower index of completeness of revascularization scores (0.87±0.39 vs 1.03±0.25, p=0.001). In matched cohorts, 30-day and in-hospital mortality did not differ (12.5% vs 2.5%, p=0.20), but all on-pump patients required transfusion versus none off-pump (p<0.001). Long-term survival was comparable (10-year: 63.5% vs 73.7% unmatched; 68.7% vs 74.3% matched; log-rank p=0.20 and p=0.52, respectively). Independent predictors of long-term mortality included peripheral vascular disease (HR 2.44, p=0.006), operative urgency (HR 2.20, p=0.005), and age (HR 1.04, p=0.021). Conclusions: Off-pump redo-CABG offers similar short- and long-term outcomes to on-pump surgery, with reduced transfusion needs. Both techniques remain viable, with selection guided by patient factors, anatomy, and surgical expertise.
Copyright (c) 2026 Muhammad Saad Asif MBBS, Muhammad Talha Wajid MBBS, Nandor Marczin PhD, Sunil K. Bhudia FRCS(CTh), Shahzad G. Raja FRCS(CTh) http://creativecommons.org/licenses/by/4.0
A Note on Medical Sciences, Good Death and Good Dying
This Note explores the distinction between “good death” and “good dying” in relation to advancement of medical sciences. Although advances in medical science have extended life expectancy, living longer does not necessarily ensure dignity, comfort, and/or psychological well-being at the end of life. We take a position that death is an event, whereas dying is a process shaped by symptom management, communication, family presence, psycho-social support, and ethical care. It further highlights the paradox that medical progress may prolong life while simultaneously widening the gap between longevity and quality of life, particularly among socially isolated older population. Accordingly, this paper calls for attention to palliative care, end-of-life, and dignity-based practice to reduce suffering in the final stage of life.
Copyright (c) 2026 Ik-Whan G. Kwon, Sung-Ho Kim http://creativecommons.org/licenses/by/4.0
Human ageing influence immunity and modify microbiome. Ageing scientific workers have made three questions as; why ageing, why do we age, and how do we age. They evolve theories in trying to answer them. The concepts of; ageing, immunity and microbiome were elucidated. Ageing affect immunity , ageing affect microbiome. Mutual communications between these elements were bidirectional. The objective of the present opinion paper was to suggest and prove for an” Ageing-immunity-microbiome axis” through review current relevant publications and showcase analysis for an age human population. This suggested axis pathway starts as low grade inflammation, chronic low grade inflammation, inflamm-ageing , inflamma-immuno-ageing, immune senescence then microbiome modifications. Each of the tripartite elements of the axis affect and affected by the other via multiple bidirectional cross-talk communications.
Copyright (c) 2026 Ibrahim M S Shnawa http://creativecommons.org/licenses/by/4.0
Poor Eating Habits are the Primary Factor in Obesity -Induced NCD Vulnerability in Young Gabonese Adults
We previously reported obesity as an important behavioural risk factor for chronic non-communicable diseases (NCDs), which are increasingly prevalent among young, active populations in Gabon (Ongali et al., 2020). However, which one among lifestyle and diet remains the most responsible for the development of obesity is still debated. Herein, we investigate the relative impact of sedentary lifestyles versus poor dietary habits on obesity development within a university setting. Our findings reveal obesity rates of 18% among male students and 27% among female students. The data highlight that while physical inactivity contributes to weight gain, poor dietary habits, characterized by high consumption of fast food and sugary beverages, alongside irregular meal patterns, are the predominant drivers. These results suggest that dietary choices are the primary factor increasing NCD vulnerability among young Gabonese adults. This study calls on public health authorities to carry out awareness campaigns and take steps to combat obesity among young people to prevent NCD.
Copyright (c) 2026 Brice Ongali, Marie-Yvonne Akoume, Serge Christian Mayani Okolongo, Alain Moutsinga, Guy Joseph Lemamy http://creativecommons.org/licenses/by/4.0
Prevalence of Cryptococcal Infection among HIV Infected Patients Attending a Tertiary Hospital in South-west Nigeria
Background: Cryptococcal infection is a fungal infection often found in immunocompromised patients like HIV – AIDS. The infection is found in 2-7 cases per 100,000 of HIV – AIDS patients with a 12% fatality in USA. Approximately 625,000 deaths globally are reported yearly from cryptococcal infection. Sub – Saharan Africa has been reported to have the highest Cryptococcal infection mortality in HIV – AIDS patients annually. Aim: This study was conducted to determine the prevalence of Cryptococcal infection among HIV infected patients attending a tertiary Hospital in Nigeria to serve as a template for the necessary interventions required to combat the menace of the high morbidity and mortality associated with Cryptococcal infection in people living with HIV-AIDS. Materials and Method: This is a retrospective cross- sectional review of a 5 years (2021-2025) hospital records. A pro forma was used in collecting data from the hospital records. Analysis was done using descriptive statistical tool of the statistical package of social sciences version 27 to obtain frequency, percentages and bar chart while T- test was used to obtain P values for incidence of Cryptococcal infection and gender distribution among the study population. The level of statistical significance was set at a predetermined P< 0.05. Results: The prevalence of cryptococcal infection among the HIV infected patients in this study was 11.8% which indicates that more than one in ten patients in this cohort had evidence of Cryptococcal infection, reflecting a considerable burden in the population. A statistically significant difference (P= 0.017) of Cryptococcal infection was found by gender with higher seroprevalence of 16.7 in female compared to 4.8% in males suggesting a gender based disparity in infection risk within the cohort. Conclusion: Cryptococcal infection is a very relevant opportunistic infection among HIV –infected patients in Nigeria with overall prevalence of 11.8 percent with statistically significant association with gender, females having higher prevalence.
Copyright (c) 2026 Ajayi Adeleke Ibijola (FMCpath), Kolawole Asimiyu Fasakin (PhD), Oluwafemi Johnson Adegbamigbe (FMCpath), Ayodele Jacob Esan (PhD), Chinecherem Gloria Ugwueze (BMLS), Oluwatoyin Temitope Bamiteko (MB.B.S), Babatunde Sunday Awoyinka (FWACS), Wasiu Adegbenga Ajetunmobi (FWACP), Adewumi Bakare (FMCOG), Olanrewaju Sola Bamisaye (MB.ChB) http://creativecommons.org/licenses/by/4.0
Innate Immune Memory IIM is a twist functional mode of innate immune cells. In the present opinion paper, It is being; conceptualized, immune mechanism explored and potentials explained. IIM is of central and peripheral nature, impart specific long term adaptation for innate immune cells in bone marrow and in peripheral organ tissue microenvironment with marked immune functional plasticity. The IIM stimulants are; infection, microbial macromolecules, vaccination and inflammogen. Mechanisms behind which are; Noncoding RNA, gene circuit regulation, epigenetic reprogramming, circadian rhythm regulation and metabolic shift from oxidative to glycolytic pathways in the innate immune cells. IIM have both protective and pathogenic potentials. The spectrum its functional activities ensembles; Vaccine confer shared immune protection against heterologous infections, an add on immune effect to past infection and past vaccination responses. Though in an unexposed population to second pathogen exposure, it can be synergistic with adaptive immune responses. IIM resilient respiratory and urinary bacterial infections in immune compromised patients. Its role in autoimmune diseases is context dependent. In some AD it promotes pathogenesis and in others its protective. Showcase analysis for human microgial cell, ageing mice and human BCG vaccination models for elucidation of IIM and suggestion for an IIM project for human typhoid. IIM stands as an encouraging scientific base for vaccine production programs and immunotherapeutic targets.
Design Principles and Human Factors in Modern Operating Rooms: Impact of Layout, Robotic Integration and Work-Related Stress
The operating room (OR) is a high-risk clinical environment in which spatial configuration, technological integration, and human performance interact to influence surgical safety. The rapid expansion of robotic-assisted surgery (RAS) has significantly transformed traditional OR design requirements, introducing increased equipment density, altered team positioning, and modified communication patterns. Empirical evidence indicates that suboptimal layout, inefficient zoning, and workspace constraints contribute to flow disruptions, cognitive workload, and work-related stress. Robotic systems amplify these vulnerabilities by increasing technological footprint and docking complexity. Flow disruptions, particularly within transitional zones, represent persistent latent conditions affecting workflow continuity. Stress in surgical settings has been associated with impaired communication and performance, suggesting that environmental inefficiencies may indirectly influence safety outcomes. This review synthesizes current evidence on OR spatial configuration, equipment integration, workflow interruptions, and stress in robotic surgery. The findings support a systems-based, human-centered approach to operating room design to optimize efficiency, resilience, and team performance in technologically advanced surgical environments.
Copyright (c) 2026 Laura Cormio, Luigi Cormio, Cristian Cannella http://creativecommons.org/licenses/by/4.0
Biophilic Design in Hospitals: A Narrative Review of Its Impact on Users’ Well-being and Healing Environments
The design of healthcare facilities can influence patients’ emotional state, comfort, and overall hospital experience. In recent years, growing attention has been directed toward architectural strategies that incorporate natural elements to create more supportive clinical environments. Among these approaches, biophilic design has been increasingly explored as a way to reconnect built spaces with nature and promote healthier indoor environments. This narrative review discusses current evidence on the application of biophilic design principles in hospital settings. The literature indicates that integrating elements such as natural light, vegetation, nature-inspired materials, and improved environmental conditions may contribute to the development of more supportive and restorative healthcare environments. These features have been linked to lower stress levels, improved psychological well-being, and more positive patient experiences during hospitalization. Nature-oriented design strategies appear, therefore, to offer valuable opportunities for improving the quality of healthcare spaces and supporting both patient recovery and staff well-being.
Copyright (c) 2026 Laura Cormio, Cristian Cannella, Luigi Cormio http://creativecommons.org/licenses/by/4.0
Homeopathy and Diabetes: Current Evidence and Future Prospects
Scientific research into the treatment of diabetes mellitus represents one of the major healthcare challenges and, today, is very broad and in-depth, so much so that it also focuses on potential homeopathic treatments. We examined the scientific literature and realized that, in recent years, highly significant clinical and preclinical studies have been conducted that could reveal new therapeutic opportunities and interesting homeopathic perspectives. Today, the possibility of managing diabetes homeopathically is being carefully evaluated; in fact, thanks to in vitro and in vivo studies, and clinical trials, the scientific literature continues to grow and provide encouraging information: clinical and preclinical evidence, although limited, suggests the role of homeopathy in the treatment of prediabetes, diabetes, diabetic neuropathy, diabetic ulcers, and any comorbidities. It is undeniable that the currently available results need to be consolidated with further scientific evidence, but it is also undeniable that they represent the building blocks of a small but solid foundation of knowledge that can support future responsible, serious, and rigorous research. We therefore believe that further investigation is necessary to fully understand the role homeopathic medicine could play in the field of diabetes, but we also believe that the knowledge currently available is already very interesting and can significantly encourage studies on homeopathic remedies that can be used to treat prediabetes, diabetes, and any comorbidities.
Copyright (c) 2026 Giulio Tarro, Giovanni De Giorgio http://creativecommons.org/licenses/by/4.0
Colchicine as an Anti-Inflammatory Agent in Atherosclerosis-Mediated Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): A Systematic Review
Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) represents 5–15% of all acute myocardial infarctions (AMI) and disproportionately affects younger patients and women. Atherosclerosis-driven inflammation via the NLRP3 inflammasome pathway is increasingly recognized as a pivotal mechanism. Colchicine, an ancient alkaloid with potent anti-inflammatory properties, has emerged as a promising therapeutic agent in this setting. Objective: To systematically evaluate the evidence for colchicine as an anti-inflammatory agent in atherosclerosis-mediated MINOCA, including its mechanisms of action, clinical efficacy, and safety profile. Methods: A comprehensive search of PubMed/MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov was conducted from inception through December 2023. Studies examining colchicine in MINOCA, acute coronary syndromes, and atherosclerotic cardiovascular disease were included. PRISMA guidelines were followed throughout. Results: Thirteen studies (5 RCTs, 4 prospective cohort studies, 4 retrospective studies) comprising 15,428 patients met inclusion criteria. Colchicine significantly reduced major adverse cardiovascular events (MACE) by 23–31%, with reduction in high-sensitivity C-reactive protein (hs-CRP) by 38–56%. In MINOCA-specific analyses, colchicine attenuated the NLRP3 inflammasome cascade, reduced IL-1β and IL-18 levels, and suppressed neutrophil-mediated endothelial injury. Adverse effects were predominantly gastrointestinal, occurring in 7.1–10.5% of patients. Conclusion: Colchicine demonstrates consistent anti-inflammatory efficacy in atherosclerosis-mediated MINOCA. Its favorable safety profile at low doses (0.5 mg/day) and compelling mechanistic rationale support its incorporation into MINOCA management guidelines. Dedicated randomized trials in MINOCA populations are warranted.
Copyright (c) 2026 Pushpraj Patel, Anjeney Mishra, Akhilesh Patel, Kaveri Shaw Patel, Darnule Rahul Ashok, Sachin Gawande http://creativecommons.org/licenses/by/4.0
Identifying Prognostic Factors for Drug-Resistant Epilepsy in Children with Cerebral Palsy
Background and purpose: Drug-resistant epilepsy is a common and disabling complication in children with cerebral palsy (CP). This study aimed to analyze the relationship between neurological, functional, and perinatal factors and the development of drug-resistant epilepsy in pediatric patients with CP to determine prognostic factors and improve medical management. Methods: We compared three groups of patients with cerebral palsy: those with drug-resistant epilepsy, those with drug-sensitive epilepsy, and those without epilepsy. Clinical variables, perinatal history, characteristics of seizure onset, neuroimaging findings, functional scales (GMFCS, MACS), and comorbidities were collected. Associations were evaluated using appropriate statistical tests, including Fisher's exact test, multiple logistic regression, and inferential statistics in Epi Info™ version 7.2. Results: We studied 80 patients. Drug-resistant epilepsy was present in 49 (61%) of the participants. It was significantly associated with quadriplegic motor involvement (p=0.04), early seizure onset (p=0.03), and corticosubcortical atrophy on neuroimaging (20%, n=16). The need for gastrostomy (p=0.03) and the use of dual therapy (p=0.06) or polytherapy (p=0.008) were also strongly related to drug resistance. Conclusions: Drug-resistant epilepsy in children with CP is strongly linked to markers of severe neurological compromise and early epileptic manifestations, rather than to isolated perinatal complications. Early identification of high-risk profiles may guide timely diagnostic and therapeutic strategies to improve clinical outcomes.
Copyright (c) 2026 Cinthya Carolina Avalos Román, Sofía Lucila Rodríguez Rivera http://creativecommons.org/licenses/by/4.0
Nurses’ Compliance with Principles of Documentation: A Descriptive, Short Observational Study from Oman
Background: Nursing documentation is a critical component of patient care, communication, and legal accountability. Inadequate documentation compromises patient safety and quality of care. Objective: To assess nurses’ compliance with principles of nursing documentation. To correlate the demographic characteristics with the quality of nursing documentation. Methods: A descriptive, quantitative observational study was conducted using patient records documented by nurses over a defined period in multicenter at primary health care institution, South Sharqyiah. Documentation was assessed using a structured audit checklist based on established documentation principles. Descriptive and inferential statistics were used for analysis. Results: A total of 273 nurses were observed for their documentation post care delivery for a defined period. Overall compliance with documentation principles was moderate (71.3%). The study findings indicated varying levels of compliance with documentation principles. High compliance was observed in general structure and quality of documentation such as’’ Document is entered by staff who delivered the care’’ (mean=1.99, SD=0.12); Document is stated in specific, concise, accurate manner (mean=1.96, SD=0.20), while The lowest scores in the entire audit were found in documenting pain assessment (mean=1.26). Low scores in nursing documentation were also found in nursing process, psychological support, procedural notes contain details of intervention (mean=1.38) for each one. Providing health education, and communication with clients/ family were also got low scores (1.39, 1.46) respectively. In regards to documentation of vital signs, the highest scores of documentation was blood pressure (1.81), whereas the lowest was documenting respiratory rate (1.53) and documenting consciousness level of the patient (1.01) . The quantitative data also illustrates that only 98 (36%) of nurses had in service training related to nursing documentation. Significant associations were found between quality of documentation and demographic characteristics include nationality, education, institution category (p < 0.05). Conclusion: Nurses’ compliance with documentation principles was suboptimal in several areas. This study found a critical gap in nursing documentation related to documenting psychological care, health education and nurse/patient communication, which recommend to re-assess the current policies and protocols and modify them accordingly. Strengthening training, supervision, and standardized documentation tools are also recommended to improve documentation quality and patient safety.
Copyright (c) 2026 Amira AL Nasri, Ahmed AL Balushi, Salma AL Hakmani, Muna AL Bahlooli, Raya AL Senaidi, Nassra AL Zarai, Abayada AL Wahaibi, Tahani AL Kitani, Alya AL Araimi, Azmi AL Humaidi http://creativecommons.org/licenses/by/4.0
Assessment of the Quality of Hand-dug Well Water in Lubumbashi, DR Congo: Bacteriological, pH and Temperature Characteristics
Background: Access to safe drinking water remains a critical challenge in Lubumbashi, Democratic Republic of the Congo (DR Congo), where a significant proportion of the population relies on hand-dug wells for domestic water supply. This study assessed the bacteriological quality, pH, and temperature characteristics of hand-dug well water in Lubumbashi to determine its suitability for human consumption. Methods: A cross-sectional study was conducted across two neighbourhoods in Lubumbashi from April to June 2024. Eighty-nine water samples were collected from hand-dug wells. Physical parameters (pH, and temperature) were measured in situ using portable instruments. Bacteriological analysis was performed using selective culture media to detect total coliforms, faecal coliforms, Escherichia coli, Salmonella typhi, and Clostridium perfringens. Results were compared with World Health Organization (WHO) and DR Congo national drinking water standards. Results: The median water temperature was 23°C (range: 18-28°C). Waters were predominantly acidic with pH values below 6.5. Overall bacteriological contamination was detected in 38% of samples. Faecal indicators organisms were not identified among the bacterial contaminants of which: Enterobacter agglomerans, Klebsiella ozanae, Klebsiella pneumoniae, and Proteus mirabilis. These signify a potential risk for opportunistic infections and may lead to gastrointestinal disturbances. Conclusion: Hand-dug well water in Lubumbashi exhibits substantial bacteriological contamination, rendering just under two fifths of the samples unsuitable for direct human consumption according to WHO standards. Although the identified pathogens present health risks, their presence may suggest an alternate pathways of contamination—potentially environmental or opportunistic in nature—rather than direct faecal contamination.
Copyright (c) 2026 Tsheko Manya, Manu F. Manun’Ebo, Esther Imvar Khang, Choudelle Nkulu-wa-Ngoie http://creativecommons.org/licenses/by/4.0
Emergence of Artificial Intelligence in Multiple Domains of Neurology: A Review
Artificial Intelligence (AI) has emerged as a transformative force across multiple domains of neurology, reshaping traditional paradigms in diagnosis, therapeutics, research, and patient care. This review explores the breadth and depth of AI applications within neurological sciences, emphasizing clinical innovations, translational potential, and ethical implications. In diagnostics, AI has significantly enhanced neuroimaging interpretation, disease classification, and multimodal data integration—enabling earlier and more accurate detection of conditions such as Alzheimer’s disease, stroke, and Parkinson’s disease. Therapeutically, AI-driven adaptive deep brain stimulation (aDBS) and closed-loop neuromodulation systems are setting new standards for personalized treatment, offering dynamic feedback-based modulation of neural activity. The review also addresses AI’s critical role in drug discovery and development, where deep learning and generative models have accelerated target identification, virtual screening, and molecule generation. Assistive technologies, particularly brain–computer interfaces (BCIs), have advanced rapidly, enabling communication and mobility for individuals with profound neurological disabilities. These innovations include speech prostheses, silent-speech decoding, and robotic sensory feedback systems. Despite these advancements, the integration of AI in neurology faces challenges including data bias, explainability, and privacy concerns. The future of AI-driven neurology will depend on interdisciplinary collaboration, ethical governance, and the continued development of interpretable, equitable, and human-centered technologies. This review synthesizes current progress while mapping trajectories for future research and clinical implementation.
Copyright (c) 2026 Alok K Bandyopadhyay PhD RAC http://creativecommons.org/licenses/by/4.0
Ankyloglossia in the Gambia; A Cause for Concern?
Background: Ankyloglossia (AG) is the presence of a short lingual frenum that interferes with normal tongue movement. Prevalence has been estimated to be from less than 1% to 10%. This significant wide range can be attributable to the lack of diagnostic criteria for AG. It is believed that there has been no published study done on the prevalence of Ankyloglossia in the EFSTH or in the Gambia which anecdotical appears to be unusually common and this has informed this prospective study. Objective: To determine the prevalence of tongue tie amongst patients attending the oral and maxillofacial clinics in Edward Francis Small Teaching Hospital (EFSTH) from January 2018 to January 2019. Methods: This is a retrospective descriptive study which was conducted at the oral and maxillofacial clinic of EFSTH from January 2018 to January 2019. The inclusion criterion is all the patients who presented with Ankyloglossia at the oral and maxillofacial clinic and exclusion criteria include those with incomplete records. Results: The study revealed that a total of 44 children with ankyloglossia were seen within the period of study. Which is 10.1% of all the patients seen at the oral and maxillofacial surgery clinic within the study period. 66% of the patients were males. Children between 0-12 months of age accounting for 50%, 13-36 months of age were 25%, while those of ≥109 months accounted for 11.4%, followed by 37-72 months and 73-108 months each accounting to 6.8% respectfully. The study also revealed that majority of those with AG was residing in Kanifing municipal counsel and Brikama area counsel accounting 48% and 45% respectively. The others were residing in Banjul municipal counsel and other areas accounting 6% and 2% respectively. The study has shown that most of those with Ankyloglossia were born by parents of younger age group, ranging 25-35 years. Our study also shows that only 2% of those with ankyloglossia presented with other associated birth defects while 89% presented with difficulty in breastfeeding. Conclusion: Tongue-tie affects a considerable number of infants and children in the Gambia. However, it is important that accurate information and guidance is given to parents with regard to the indications and potential benefits of awareness of the presence tongue-tie and the need for early surgical treatment to prevent malnutrition and possible speech defect.
Copyright (c) 2026 Victoria Nwebuni Okoje, Demba Sey, Akindayo Olufunto Akinyamoju, Kelvin Uchenna Omeje, Cyril Adegbulugbe http://creativecommons.org/licenses/by/4.0
ESR1-Mediated Regulation of Slc2a4 Gene Expression by Estrogen: Demonstration of a Potential Estrogen Responsive Element (ERE) in the Slc2a4 Gene Promoter
This study investigated the transcriptional activity (gene reporter assay) of some putative estrogen responsive elements (EREs) in the Slc2a4 gene promoter region, which could contribute to understanding the estrogen receptor 1 (ESR1) mediated enhancer role of estradiol (E2). In 3T3L1 adipocytes, E2 and ESR1-selective agonist (PPT) increased (by 35%, p<0.01) the expression of Slc2a4 mRNA; ESR1-selective antagonist (MPP) abrogated the E2 effect. In transiently transfected HEK293-FT cells, the basal Slc2a4-Luciferase activity of 5’-500, 5’-250 and 5’-149 bp segments of the promoter revealed that the loss of the -500/-250 bp segment reduces the unstimulated Slc2a4-Luc activity (60%, p<0.001), a response attributed to the loss of seven known binding-sites of enhancer transcription factors. Besides, E2/PPT increased (~150%, p<0.001) the relative Slc2a4-Luc activity of all constructs, revealing that the ESR1-mediated E2-induced transcriptional activity is preserved in all constructs, and that the putative ERE half-sites, encompassed in -250/-149 bp segment, do not display transcriptional activity. Finally, 5’-500 bp and 5’-149 bp constructs, containing four mutated nucleotides in the putative complete Slc2a4 ERE, lost their responsiveness to E2. In conclusion, this study reveals an imperfect complete Slc2a4 ERE site (-59/-46 bp), which is involved in the ESR1-mediated E2-induced enhancing of the Slc2a4 gene expression.
Copyright (c) 2026 Caroline Pancera Laurindo, Karen Cristina Rego Gregorio, Helayne Soares de Freitas, Camila Nogueira Alves Bezerra, Maristela Mitiko Okamoto, Patricia Monteiro Seraphim, William Tadeu Festuccia, Ubiratan Fabres Machado http://creativecommons.org/licenses/by/4.0
A Standardized Postoperative Care Pathway Eliminates Emergency Department Utilization After Hemorrhoidectomy
Background: Excisional hemorrhoidectomy is associated with significant postoperative morbidity, including pain, bleeding, urinary retention, and patient anxiety, frequently resulting in unplanned emergency department (ED) visits. We describe a standardized perioperative and postoperative care pathway designed to minimize complications and eliminate ED utilization. Methods: A retrospective review was conducted of consecutive patients undergoing excisional hemorrhoidectomy at a large regional hospital–affiliated practice. The protocol emphasized meticulous intraoperative hemostasis, structured patient education, early postoperative communication, and risk stratification for urinary retention. Primary outcome was ED utilization within 30 days. Secondary outcomes included postoperative bleeding, urinary retention, and wound-related concerns. Results: Approximately 100 patients were included. There were zero ED visits within 30 days postoperatively. No patients experienced major postoperative hemorrhage requiring intervention. Urinary retention was anticipated and managed in the outpatient setting without ED referral. All patients demonstrated appropriate wound healing. Conclusion: A structured, education-driven postoperative care pathway can eliminate ED utilization following hemorrhoidectomy while maintaining excellent clinical outcomes. This model is reproducible and scalable across healthcare systems.
Copyright (c) 2026 Ali Mahmood, MD, FACS, FASCRS, Michael Yaakovian, MD, FACS, Aman Barkat Ali, MD, FACS, Aiva Mariam Mahmood, Emaan Anya Mahmood http://creativecommons.org/licenses/by/4.0
Clinical Research on the Combination of Unaccompanied and Family-Based Care Models for Premature Infants
Objective: To explore the application effect of the combination of unaccompanied care and family-based care in preterm infants and to provide clinical evidence for optimizing the care program for preterm infants. Methods: A total of 120 preterm infants admitted to the neonatal Intensive Care Unit (NICU) of our hospital from January 2021 to January 2024 were selected as the research subjects and randomly divided into the observation group and the control group, with 60 cases in each group using the random number table method. The observation group adopted a combined model of "unaccompanied basic care + staged family participation". The control group adopted the traditional simple unaccompanied care model. The length of hospital stay, rate of weight gain, incidence of complications (necrotizing enterocolitis, bronchopulmonary dysplasia, etc.), success rate of breastfeeding, score of parental care ability and score of parent-child attachment relationship of the two groups of children were retrospectively analyzed and compared, and growth and development after discharge were evaluated in combination with 3-year follow-up data. Statistical analysis was performed using SPSS 22.0 software, and measurement data were expressed as (x youdaoplaceholder3 ±s) for t-test; Count data were expressed as [n (%)] and analyzed by x-test2. A P value <0.05 was considered statistically significant. Results: The average length of hospital stay in the observation group was (29.8±5.6) days, significantly shorter than that in the control group [(36.5±6.2) days] (t=6.324, P<0.001); The rate of weekly weight gain in the observation group was (19.5±3.1) g/d, significantly higher than that in the control group, which was (14.2±2.8) g/d (t=9.751, P<0.001). The total complication rate in the observation group was 11.6% (7/60), significantly lower than 28.3% (17/60) in the control group (X2=5.792, P=0.016); The success rate of breastfeeding in the observation group was 81.6% (49/60), significantly higher than 56.7% (34/60) in the control group (X2=9.072, P=0.003). The scores of parental care ability (85.6±6.3) and parent-child attachment relationship (88.4±5.7) in the observation group were significantly higher than those in the control group (62.3±7.5) and (65.2±6.8) (t values were 18.963 and 20.154, respectively; P <0.001). The 3-year follow-up showed that 91.6% (55/60) of preterm infants in the observation group had growth and development indicators within the normal range of children of the same age, significantly higher than 73.3% (44/60) in the control group (X2=7.023, P=0.008). Conclusion: The combination of unaccompanied and family-based care model can not only ensure the safety of acute phase treatment for preterm infants, but also promote their growth and development and the improvement of family care ability through family participation, and at the same time strengthen the emotional bond between parents and children, and is suitable for the whole-course care of preterm infants.
Copyright (c) 2026 Gao Diaoyan, Fan Taotao, Yan Chunmei, Tian Yuanyuan, Liu Xiaoyan, Zhang Li http://creativecommons.org/licenses/by/4.0
Simulation-Based Education in Undergraduate Nursing Pharmacology: A Systematic Review of Modalities, Effectiveness, and Design Quality
Simulation-based learning is increasingly used in healthcare education; however, limited evidence exists on how it is specifically applied to support undergraduate nursing students in pharmacology. This systematic review aimed to examine the types of simulation modalities used to enhance pharmacology education, evaluate their effectiveness in improving students’ medication management, and assess the quality of existing studies. Systematic searches were conducted across seven databases, including Embase, CINAHL, Web of Science, PubMed, and Medline. Of the 3,060 records identified, 127 full-text articles were assessed for eligibility, and 51 studies met the inclusion criteria. Simulation modalities consistently improved pharmacology-related learning outcomes. Studies that incorporated structured pre-briefing, validated assessment instruments, and comprehensive debriefing protocols demonstrated the strongest statistical effects. However, students’ perceived self-efficacy in pharmacology was rarely examined, indicating an important gap in the current literature. Overall, effectiveness appeared to be influenced less by the level of simulation fidelity and more by the alignment between the simulation modality, learning objectives, student needs, and educational context. Adherence to best-practice standards recommended by the International Nursing Association for Clinical Simulation and Learning also appeared to strengthen learning outcomes. Simulation-based pharmacology education shows promise for improving medication competence among undergraduate nursing students, although further research is needed to evaluate self-efficacy outcomes and strengthen methodological rigour.
Copyright (c) 2026 Maria Massoud, Clare McKeaveney, Samirh Said Alqhtani, Oonagh McCloy, Katherine MA Rogers http://creativecommons.org/licenses/by/4.0
Malaria Prevention Strategies and Associated Challenges among College Students in Anambra State, Nigeria
Malaria is an endemic disease in Nigeria with high cost of treatment and economic burden with its prevention better than cure. This is a descriptive study that determined the malaria preventive strategies and associated challenges among College students in Anambra State, Nigeria. A Sample of 365 respondents was proportionately and randomly drawn from a population 4,135 College students for the study. A 29-item structured questionnaire that was tested for internal consistency with 0.87 reliable index via Spearman-Brown Coefficient Correlation was used for data collection. Data were collected through face-to-face administration and presented in tables. Descriptive and inferential statistics were applied in data analysis using SPSS Version 23 IBM. Chi-square was used to test the hypothesis at 0.95 alpha. Results from the study revealed poor implementation of preventive strategies against malaria among the College students. Students that implement the strategies go by sewage disposal (80.1%), environmental sanitation (71.5%), and keeping windows and doors closed at night (51.3%). The major challenges faced by the students in the implementation of the strategies are: sweating too much while sleeping under ITN (80.1%) and allergic reactions to insecticide sprays (67.3%). The study also revealed that year of study, gender, and course of study are associated with practice of malaria prevention strategies among the college students as students at higher level do not implement the prevention strategies.
Copyright (c) 2026 Anieche, John Emenike, Orji, Chinenye Nwatoka, Okonkwo, Oluchukwu Ginika, Chude, Jane Ifediba, Ezekiel, Rosemary, Okonkwo, Oluchukwu Ginika http://creativecommons.org/licenses/by/4.0
Brachy in Tricky Situations: A Trans Perineal Interstitial Implant in a Case of Carcinoma Cervix Co-occurring with Uterine Didelphys
A 43 year old lady with an uterine anomaly was diagnosed to have FIGO stage II B -HPV associated poorly differentiated cervix adenocarcinoma. She has a bicornuate unicolis uterus -class U3b, subclass C0, subclass V0 as per ESHRE/ESGE classification system of female genital anomalies.Post 50 Gy of chemo radiotherapy to the pelvis, her peculiar anatomical configuration posed a challenge for delivering HDR brachytherapy boost. We decided to proceed with a transperineal interstitial implant & achieved a total EqD2 of 80 Gy to HRCTV. The target coverage was achieved with 11 needles held up by Syed Neblett template guided by transrectal ultrasound [TRUS]. Interstitial implant using TRUS is a safe technique in a resource limited setting allowing an image guided approach for brachytherapy. Patient is on follow up since 2 years with no evidence of disease.
Copyright (c) 2026 Tasneem Rushdi, N V N Madhusudhana Sresty, T. Subramanyeshwar Rao, Srilatha Sreera, Niharika Aaduru http://creativecommons.org/licenses/by/4.0
Conceptual Frameworks for Understanding Postnatal Mothers’ Satisfaction with the Birthing Experience: A Narrative Review
Modern healthcare is increasingly emphasizing maternal satisfaction as the most important qualitative outcome of the childbirth experience. This narrative review aimed to categorize and evaluate the conceptual frameworks used to define and measure maternal satisfaction. A comprehensive search was conducted across electronic databases, including PubMed, EMBASE, and the Cochrane Library, supplemented by Google Scholar and Semantic Scholar. The AI tool Elicit was utilized to assist in screening scientific papers for thematic relevance. Search terms included satisfaction, conceptual frameworks, birthing experience, and postnatal mothers. This narrative review identifies a spectrum of frameworks varying in scope, focus, and theoretical origin. The Donabedian framework remains the foundational model for quality, while the WHO quality of care framework for maternal and neonatal health provides a holistic policy perspective by elevating respectful maternity care to a core dimension. The Hulton framework emphasizes institutional assessment. In contrast, the Hollins Martin and Dencker models are patient-driven, prioritizing internal, subjective experiences and patient-reported factors. The findings suggest a divide between the top-down quality assurance models (Donabedian, Hulton, WHO) and bottom-up, experience-based models (Hollins Martin, Dencker). No single framework provides a comprehensive multidimensional understanding of maternal satisfaction. This review suggests that researchers should consider integrating structural quality indicators with subjective patient-reported dimensions to fully capture the complexity of the birthing experience.
Copyright (c) 2026 Mutinke Zulu, Bellington Vwalika, Kaorolin Maeland, Concepta Kwaleyela http://creativecommons.org/licenses/by/4.0
Spatial Autocorrelation of Pancreatic Cancer Incidence Across ZIP Codes in Hillsborough County, Florida
Pancreatic cancer is one of the most lethal malignancies in the United States, with survival outcomes strongly influenced by early detection and underlying social determinants of health. This study examines the spatial distribution of pancreatic cancer incidence across ZIP codes in Hillsborough County and evaluates the relationship between geographic clustering and sociodemographic characteristics. Using spatial analytical techniques, we tested for geographical autocorrelation and identified statistically significant hotspots and cold spots of pancreatic cancer incidence. Global spatial autocorrelation was assessed using Moran’s I to determine whether incidence rates were spatially clustered across ZIP codes. Local cluster detection was then performed with Getis–Ord Gi* statistic to identify areas with significantly higher or lower incidence relative to neighboring locations. To explore potential drivers of these spatial patterns, regression analyses were conducted using the ZIP code–level sociodemographic variables. Independent variables included racial composition, poverty rate, educational attainment, and indicators of socioeconomic disadvantages. These variables were evaluated for their association with pancreatic cancer incidence rates to determine whether disparities in disease burden corresponded with specific demographic and socioeconomic characteristics. Regression findings indicated that several sociodemographic variables, particularly income and racial composition, were significantly correlated with increased incidence rates. These findings highlight the importance of integrating spatial epidemiology with sociodemographic analysis to identify communities experiencing disproportionate disease burden. Targeted public health interventions, improved screening awareness, and resource allocation in identified hot spot areas may help address disparities in pancreatic cancer outcomes within Hillsborough County.
Copyright (c) 2026 Arshita Singh, Aarya Satardekar, Anusha Parajuli, Spuritha Bhandaru, Namit Choudhari, Rishil Shah, Salah Komrojki, Benjamin G. Jacob http://creativecommons.org/licenses/by/4.0
Evaluation of the Clinical Pattern of Limb Amputations in Patients with Electrical Burns During the Pandemic COVID-19
Burns caused by electricity, are devastating injuries, can cause loss of life, The epidemiological pattern of this type of injury increased during the covid-19 pandemic. The objective of this study was to evaluate the clinical pattern of limb amputation in patients with electrical burns treated at CENIAQ from March 2020 to February 2023 This is a prospective study of routine medical practice with convenience sampling, for 36 months. One of the epidemiological and social phenomena during the COVID-19 pandemic was the incorporation of personnel without adequate preparation for high-risk tasks, conditioning devastating injuries that required amputation of one or more limbs
Copyright (c) 2026 Alan Guillermo Zavaleta Avila, Paul Robledo Madrid, Mario Velez Palafox http://creativecommons.org/licenses/by/4.0