Asian Journal of Research in Medical and Pharmaceutical Sciences

Environmental Genotoxins and Human Health Risks: Exposure Pathways, Mechanisms, Biomarkers and Challenges for Causal Risk Assessment

2026-08-13T07:50:09+00:00

Environmental genotoxins are exogenous chemical agents or complex particulate mixtures capable of damaging DNA, chromosomes or genome-maintenance systems. Their public-health importance extends beyond cancer because persistent or poorly repaired lesions may contribute to reproductive impairment, developmental disturbance, haematological toxicity and other chronic disease pathways. This critical narrative review integrates evidence on major environmental genotoxin classes, exposure routes, molecular mechanisms, human biomonitoring, disease associations and risk-assessment practice. Literature published from 1 January 2000 to 31 May 2026 was examined through accessible scholarly indexes and authoritative sources, with earlier foundational studies retained where necessary. The evidence is strongest when exposure characterisation, mechanistic plausibility, internal-dose biomarkers and prospective health outcomes converge. Such convergence is clearest for aflatoxin B1 and hepatocellular carcinoma, benzene and haematological malignancy, inorganic arsenic and several cancers, inhaled hexavalent chromium and respiratory cancer, and ambient particulate pollution and lung cancer. For many pesticides, drinking-water by-products, metals and emerging particulate contaminants, genotoxic signals are credible but heterogeneous because exposure mixtures, assay protocols, tissue choice, confounding and dose relevance differ markedly. Comet, micronucleus, chromosome-aberration and DNA-adduct assays provide complementary information, yet none independently quantifies disease risk. Mutational signatures and adductomics offer stronger source attribution, but translation from experimental systems to population-level causation remains incomplete. Current single-chemical regulation also underrepresents cumulative exposure, susceptibility, co-exposures and environmental inequity. More defensible risk assessment requires harmonised longitudinal biomonitoring, repeated personal exposure measurement, mechanistically anchored dose-response analysis, transparent mixture methods and explicit separation of hazard identification from exposure-specific risk. Prevention should prioritise source control for well-established hazards while uncertainty is reduced for less mature evidence domains.

Scoliosis in Adults Aged 50 Years and Older: Prevalence, Patterns, Associated Factors, and Evidence Gaps with Special Emphasis on Enugu Metropolis, Nigeria

2026-09-11T11:10:20+00:00

Scoliosis identified in later adulthood is increasingly recognised as an age-related spinal health problem, but its epidemiology remains difficult to quantify because adult scoliosis combines different aetiologies and because prevalence estimates are highly sensitive to sampling and imaging methods. This critical narrative review synthesises evidence on the prevalence, radiographic patterns, associated factors, natural history, and clinical relevance of scoliosis in adults aged 50 years and older, with particular attention to the evidence needed for Enugu Metropolis, Nigeria. Literature published from 1 January 1980 to 8 July 2026 was considered, with emphasis on population-based and community-oriented imaging studies, longitudinal cohorts, systematic reviews, and studies that clarify age, sex, bone health, degenerative change, muscle status, alignment, and symptoms. Reported prevalence varies markedly across studies, from single-digit estimates in broad adult samples to more than one-third in several elderly cohorts, while a small volunteer study reported a substantially higher estimate. This dispersion reflects genuine age effects but also differences in case definitions, age structure, recruitment, curve ascertainment, prior-scoliosis exclusion, and imaging modality. Age is the most consistent associated factor. Female predominance is supported in several datasets and a meta-analysis but is not universal. Evidence linking osteoporosis, body mass index, and sarcopenia to scoliosis remains inconsistent or largely cross-sectional. Longitudinal studies more strongly implicate asymmetric disc degeneration, vertebral rotation, lateral translation, and related segmental instability in de novo curve development or progression. Cobb angle alone incompletely captures clinical impact; sagittal imbalance, loss of lordosis, lateral listhesis, stenosis, and neural compression often better explain pain and disability. No verified population-based prevalence study specifically addressing adults aged 50 years and older in Enugu Metropolis was identified. The principal regional priority is therefore a representative, standardised radiographic epidemiological study that separates prevalence from clinic-based case frequency and couples coronal curvature with sagittal alignment, degenerative features, symptoms, function, and relevant exposures.

System-Level Responses and Outcomes of Medical Emergencies: A Systematic Review

2026-05-28T11:43:05+00:00

Background: Medical emergencies are highly time-sensitive events in which delays in recognition, dispatch, transport, triage, escalation, and definitive treatment can alter survival, complications, and length of stay.

Aim: This systematic review synthesised contemporary evidence on how emergency response processes and emergency-system interventions influence outcomes across prehospital and hospital settings, with deliberate attention to Nigeria and other African countries.

Methods: A PRISMA 2020-aligned systematic review with narrative synthesis was undertaken. PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar were searched for peer-reviewed studies published between January 2014 and March 2026, while seminal older reviews were used selectively in the background, where they remained conceptually important. Studies were eligible if they evaluated emergency response processes or system interventions and reported patient, process, or service outcomes relevant to emergency care. Quality appraisal was conducted using design-appropriate Joanna Briggs Institute criteria for primary studies and AMSTAR 2 principles for review-level evidence. Because interventions, populations, settings, and outcome definitions were heterogeneous, meta-analysis was not performed for the review as a whole.

Results: Twenty-four studies were included in the final synthesis: ten systematic reviews/meta-analyses and fourteen primary studies. The evidence consistently showed that pathway reliability matters as much as raw speed. Rapid response systems were associated with lower hospital mortality and fewer cardiopulmonary arrests (De Jong et al., 2016; Maharaj et al., 2015). Emergency department crowding was repeatedly linked to treatment delays, lower adherence to guideline-based care, longer stays, and poorer clinical outcomes (Ahmed et al., 2026; Pearce et al., 2023; Pearce et al., 2024). Sepsis alert systems and earlier antibiotic delivery improved adherence and were associated with lower mortality in several analyses (Kim et al., 2024; Leung et al., 2024). African studies added critical contextual insight: Nigerian hospitals demonstrated moderate but uneven emergency-care capacity (Umoga et al., 2026); EMS awareness in Abuja exceeded actual utilisation (Nto et al., 2024); trauma treatment delay in Sokoto was associated with worse outcomes (Nuradeen et al., 2025); Lagos sepsis mortality remained high with low compliance to key diagnostics (Akase et al., 2023); and studies from Uganda, Rwanda, Tanzania, Malawi, Ethiopia, Ghana, and South Africa highlighted the importance of workforce supervision, training, critical care readiness, referral pathways, and context-appropriate transport systems.

Conclusion: The review concludes that emergency outcomes are shaped by the quality of the whole pathway rather than by a single time target alone. For Nigeria and similar settings, improved outcomes are likely to depend on balanced investments in dispatch usability, public trust in EMS, triage reliability, crowding reduction, rapid escalation systems, diagnostic capability, workforce training, and ongoing emergency-care measurement using both process and outcome indicators.

The Efficacy of Resilience Training Interventions in Mitigating Burnout among Nursing Staff: A Systematic Review and Meta-Analysis

2026-06-02T11:36:38+00:00

Background: Burnout is a major occupational problem among nurses, characterised by emotional exhaustion, depersonalisation, and reduced personal accomplishment, with negative consequences for both healthcare workers and patient care.

Aims: This systematic review and meta-analysis aimed to synthesise evidence on the effectiveness of resilience-training interventions in reducing burnout among nursing staff.

Study Design: Systematic review and meta-analysis.

Methodology: A comprehensive search was conducted in PubMed, ScienceDirect, and Google Scholar. Eligible studies included randomised controlled trials and quasi-experimental studies involving registered nurses in clinical settings that reported sufficient data to estimate effect sizes. The risk of bias was assessed using the RoB 2 and JBI tools. Data were pooled using a random-effects meta-analysis.

Results: Eight studies (496 nurses) met the inclusion criteria. Resilience training significantly reduced total burnout (mean difference = −6.53, 95% CI: −11.43 to −1.64, P=.008) with substantial heterogeneity (I² = 69.2%). Emotional exhaustion also significantly improved (standardised mean difference = −0.48, 95% CI: −0.73 to −0.24, P=.001) with low heterogeneity (I² = 20.7%). Effects on depersonalisation (SMD = −0.17, 95% CI: −0.63 to 0.30, P=.47) and personal accomplishment (SMD = −0.08, 95% CI: −0.61 to 0.46, P=.77) were not statistically significant, with high heterogeneity (I² = 78.6% and 82.1%, respectively). Egger’s test showed no publication bias (P=.13).

Conclusion: Resilience training effectively reduces total burnout and emotional exhaustion among nursing staff but does not significantly improve depersonalisation or personal accomplishment. Healthcare administrators should consider integrating these interventions into workplace wellness initiatives, particularly for nurses in high-acuity settings.

Intimate Partner Violence and Women's HIV Risk: A Scoping Review of Pathways Across the HIV Care Continuum

2026-06-12T11:31:51+00:00

Background: Women are among the most vulnerable populations affected by the Human Immunodeficiency Virus. A Joint United Nations Programme on HIV/AIDS report revealed that women accounted for 53% of all people living with HIV globally as of 2024. And one of the structural factors identified to predispose women to HIV risk is intimate partner violence. This scoping review aimed to synthesize evidence on the mechanistic pathways linking intimate partner violence to HIV infection, treatment engagement, and clinical outcomes among women globally.

Method: This scoping review followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and was guided by the Arksey and O’Malley framework. The Population, Concept, and Context framework was used to define eligibility. A thorough search in PubMed, Web of Science, and Google Scholar identified articles that were published between January 2015 and March 2026. Studies that examined intimate partner violence and HIV outcomes among women were eligible.

Result: There were 1,847 studies that were obtained in the database search. Following the selection process, 29 studies were found eligible and included in the final synthesis. The most assessed forms of intimate partner violence were physical and sexual. Across studies, intimate partner violence was associated with decreased condom negotiation, less autonomy, as well as poor treatment outcomes, including antiretroviral therapy adherence, interruption in treatment, reduced viral suppression, and poor mental health outcomes.

Conclusion: Intimate partner violence operates through mechanistic pathways to influence HIV outcomes among women globally. The findings underscore the urgent need for integrated, trauma-informed, and gender-responsive approaches to HIV prevention and treatment. Addressing intimate partner violence is not peripheral to HIV programming, it is key to achieving equitable outcomes for women globally.

Late-Onset Multiple Acyl-CoA Dehydrogenase Deficiency (MADD / Glutaric Acidemia Type IIC) Presenting as Chronic Sensory Ataxic Ganglionopathy, Bilateral Sensorineural Hearing Loss, and Vocal Cord Dysfunction Associated with a Novel ETFDH Variant

2026-09-11T10:23:28+00:00

Background: Multiple acyl-CoA dehydrogenase deficiency (MADD), also known as glutaric acidaemia type II (GA II), is a rare inherited autosomal recessive disorder involving the metabolic pathways of fatty acid and amino acid oxidation. Catastrophic metabolic crises are observed in the typical neonatal presentation of MADD, whereas variable lipid storage myopathy is a common characteristic of late-onset type IIC. Sensory ataxic ganglionopathy, cranial neuropathies and vocal cord paralysis are relatively atypical presentations of late-onset MADD, and diagnosis is often difficult.

Case Presentation: A 39-year-old woman had a 5-year history of insidiously progressive symmetrical paraesthesia, with functionally disabling sensory ataxia requiring ambulatory/mobility aid use, progressively debilitating bilateral hearing loss and dysphonia. On examination, she had diffuse hypotonia, moderate (4/5) proximal lower-limb weakness, atrophy of the distal intrinsic interphalangeal muscles, diffuse hyporeflexia, absent knee and ankle jerks, absent plantar responses bilaterally, a positive Romberg sign, bilateral mixed/sensorineural hearing loss (CN VIII, R>L), and a voice abnormality due to vocal cord paresis with a wide phonatory gap (CN IX/X). Microscopic analysis of the sural nerve biopsy revealed marked loss of myelinated fibres without clusters of regenerating nerve fibres; the histology was definitive for sensory ganglionopathy. Initial serology was positive for anti-beta-2 glycoprotein 1 and anti-cardiolipin IgM, suggesting an immune/antiphospholipid-mediated process. Exome sequencing revealed a novel homozygous missense variant in ETFDH exon 13, c.1826G>A, p.Gly609Glu. Classified as a VUS, this had clinical associations with early-onset GA IIC. Following pulse steroid immunotherapy with the addition of metabolic support (riboflavin, L-carnitine, CoQ10), there was subjective sensory recovery and resolution of voice problems, with regained independence in day-to-day tasks; attribution to individual treatments remains problematic.

Conclusion: This study emphasises the phenotypic variability of MADD presenting with features mimicking autoimmune sensory neuronopathy. Exome sequencing is important in resolving diagnostically confusing cases of adult-onset cranial neuropathies and sensory ataxia. Novel ETFDH variants underscore the need for careful clinical and histopathological correlation, while early treatment with riboflavin and metabolic cofactors may contribute to clinical stabilisation.

Association between Diet, Sleep Pattern, and Menstrual Cycle among Female Medical Students

2026-06-03T11:52:21+00:00

Background: Female medical students are exposed to high academic stress, irregular sleep, and variable dietary habits, which may affect hormonal balance and menstrual health. This study examines the relationship between diet, sleep patterns, and menstrual cycle characteristics in this population.

Aims: The present study reveals the interconnectedness between diet, sleep pattern and menstrual cycle among female medical students

Study Design: A simple cross-sectional study using a structured questionnaire regarding demographic information, diets, sleep pattern, menstrual cycle and also the history of initial menarche.

Place and Duration of Study: Study conducted in the Faculty of Medicine, Universitas Kristen Indonesia, Jakarta-Indonesia. from October 2025 until April 2026.

Methodology: Using simple random sampling methods, sampling technique will be related to the determination of the number of sample using the Slovin formula to estimate population proportion, where population size=112 and acceptable margin error (e)= 5% and the number of respondents using Slovin's formula is calculated as 87.5, rounded into 88. All data obtained from electronic structured questionnaire consist of demographic, diet pattern, sleep pattern and menstrual cycle pattern. All instrument has been tested for validity and reliability. Electronic data then collected and analyzed further using Chi-square (p= 0.05).

Results: Most respondents had good diets, good sleep patterns, and regular menstrual cycles. Bivariate analysis showed no association between age at menarche and menstrual cycle (p=0.250), diet and menstrual cycle (p=0.391), or sleep patterns and menstrual cycle (p=0.391).

Conclusion: Age of menarche, diet, and sleep patterns are not related to the menstrual cycle, so other factors likely play a greater role in influencing the menstrual cycle.

Evaluation of the Anti Ulcer Effect of Extract of Chromolaena odorata Leaves on Ethanol and Indomethacin Induced Ulcer Models

2026-06-04T10:23:34+00:00

Public health is greatly impacted by peptic ulcer disease, a chronic illness marked by sores in the lower oesophagus, duodenum, or stomach. In ethnomedicine, Chromolaena odorata has long been used to treat ulcers. The study evaluated the anti-ulcer properties of the methanol extract and fractions of C. odorata leaves. The methanol extract and its n-hexane, ethyl-acetate, and n-butanol fractions were subjected to anti-ulcer screening using the in vivo ulcer models in ethanol and indomethacin-induced experimental rats. Important parameters, such as the pH, total acidity, free acidity, and ulcer index, were measured from the rats treated with extract and fractions (200 and 400 mg/kg doses) and standard omeprazole. The extract (4.67 %w/w yield) and its fractions contained different amounts of flavonoids, steroids, terpenoids, saponins, phenol, tannins, alkaloids, and cardiac glycosides. Statistical analysis was performed using one-way ANOVA followed by Dunnett’s t-test, with p < 0.05 considered statistically significant. The ethyl acetate (400 mg/kg) exhibited a 56.7% gastroprotective effect with an ulcer index of 1.30 ± 0.20, while the crude (400 mg/kg) showed an inhibition rate of 50.0% with an ulcer index of 1.50 ± 0.25, lower than omeprazole (63.3%) in the ethanol-induced model. In the indomethacin-induced ulcer model, the 400 mg/kg extract (400 mg/kg) and ethyl acetate fraction (400 mg/kg) elicited 77.6% and 63.5% ulcer inhibition compared with the omeprazole standard (83.11%). All the fractions significantly decreased stomach acidity by elevating pH. Significant anti-ulcer efficacy is demonstrated by C. odorata, with the most effective portion being ethyl acetate, which could provide anti-ulcer lead compounds. The gastroprotective properties are probably aided by the presence of bioactive substances, including flavonoids and tannins.

Serum Urea and Creatinine Profiles among Hypertensive Patients in Enugu, Nigeria: A Hospital-based Cross-sectional Study

2026-06-17T10:17:07+00:00

Background: Hypertension is associated with renal morbidity, and serum urea and creatinine remain commonly used biochemical markers for routine assessment of renal function, particularly in settings where advanced renal investigations may be limited. This study assessed demographic and clinical variations in serum urea and creatinine levels among hypertensive patients attending a tertiary hospital in Enugu, Nigeria.

Methods: A hospital-based cross-sectional study was conducted among 100 hypertensive patients receiving care at the University of Nigeria Teaching Hospital, Enugu. Participants with chronic kidney disease, diabetes, cardiovascular conditions other than hypertension, pregnancy, use of smedications known to affect kidney function, or other chronic illnesses that could influence blood urea and creatinine levels were excluded. Sociodemographic and clinical variables, including age, sex, duration of hypertension, and blood pressure control status, were recorded. Venous blood samples were collected, and serum creatinine was determined using the modified Jaffe kinetic method, while serum urea was analysed using the Diacetyl Monoxime method. Data were analysed using GraphPad Prism version 8.0. Continuous variables were summarised as mean ± standard deviation, and group comparisons were performed using Student’s t-test and one-way analysis of variance, with statistical significance set at p < 0.05.

Results: Serum urea and creatinine levels differed significantly across demographic and clinical categories. Mean urea and creatinine increased across age groups from 6.25 ± 1.74 mmol/L and 1.01 ± 0.27 mg/100 ml in participants aged 40 years to 8.77 ± 1.82 mmol/L and 1.33 ± 0.16 mg/100 ml in those aged 51–60 years. Males had higher mean urea and creatinine levels than females. Patients with hypertension for more than 10 years had higher mean values than those with shorter disease duration. Uncontrolled blood pressure was associated with higher urea and creatinine levels than controlled blood pressure.

Conclusion: Age, sex, duration of hypertension, and blood pressure control status were associated with variations in serum urea and creatinine among hypertensive patients in this hospital-based study.

Modulatory Effects of Telfairia occidentalis Ethanolic Leaf Extract on Monosodium Glutamate–Induced Multi-Organ Toxicity in Experimental Rats

2026-07-03T06:59:32+00:00

Background: Monosodium glutamate (MSG) is a commonly used flavour enhancer associated experimentally with oxidative stress and organ injury at high doses. This study evaluated the modulatory effects of an ethanolic leaf extract of Telfairia occidentalis on MSG-induced biochemical, oxidative, and histological alterations in selected organs of Wistar rats. Methods: Adult male Wistar rats were allocated into control, MSG-treated (200 mg/kg), extract-only (500 mg/kg), and four extract-intervention groups exposed orally for 28 days. The intervention regimens evaluated pre-/co-treatment (500 mg/kg extract), co-administration (500 mg/kg extract), or post-treatment at low (100 mg/kg) or high (500 mg/kg) extract doses against MSG. Serum indices of hepatic and renal function, oxidative stress markers, and histological sections of the liver, kidneys, and spleen were assessed. Results: MSG administration significantly elevated serum liver enzymes (ALT, AST, ALP), renal biomarkers (urea, creatinine), malondialdehyde, and superoxide dismutase activity compared with controls. Histological evaluation revealed hepatocellular degeneration, sinusoidal congestion, renal tubular injury, glomerular congestion, splenic haemorrhage, and lymphoid disruption in MSG-treated rats. Administration of Telfairia occidentalis extract reduced the severity of these biochemical disturbances and improved tissue architecture across the treated groups. However, residual hepatic, renal, and splenic lesions persisted, including mild congestion, fatty change, and focal haemorrhage, regardless of the intervention regimen.

Conclusion: The findings indicate that Telfairia occidentalis ethanolic leaf extract attenuated, but did not completely reverse, MSG-induced multi-organ toxicity under the tested pre-, co-, and post-treatment regimens. Further studies are required to clarify long-term dose-response relationships and the duration required for full structural recovery.

Preliminary in vitro Antibacterial Screening of Nanochitosan-functionalized PLA Monofilament Sutures for Potential Intraoral Wound-closure Applications

2026-07-08T11:10:34+00:00

Aims: The study aims to compare the antibacterial performance of nanochitosan-functionalised polylactic acid (PLA) monofilament suture formulations and to determine whether surface coating provides a more favourable preliminary profile than bulk blending for potential intraoral wound-closure applications.

Study Design: Preliminary in vitro comparative formulation-screening study.

Place and Duration of Study: Laboratory-based biomaterials screening conducted at Universitas Sumatera Utara and collaborating laboratories in Indonesia.

Methodology: The experimental sample comprised six distinct formulation groups (n_formulations = 6): PLA dip-coated with commercial nanochitosan and sodium tripolyphosphate (TPP) (A1), PLA dip-coated with naturally derived nanochitosan and TPP (A2), an uncoated PLA control (A3), PLA blended with commercial nanochitosan (B1), PLA blended with naturally derived nanochitosan (B2), and a blended-branch PLA control (B3). Antibacterial activity against Staphylococcus aureus was the primary endpoint and was assessed by inhibition-zone diameter. Mucosal-cell viability and tensile properties were retained as supporting indicators. Results were reported descriptively as mean ± standard deviation; no inferential significance was claimed.

Results: A1 produced the numerically largest inhibition zone (16.8 ± 1.2 mm), followed by A2 (14.2 ± 1.0 mm), B1 (10.5 ± 0.9 mm), and B2 (9.2 ± 0.8 mm); A3 and B3 produced no inhibition. All formulations remained above the 70% preliminary non-cytotoxicity threshold, with A1 showing 92.5 ± 3.1% viability. A1 retained tensile strength of 34.84 kgf/mm² and had the greatest elongation at break (22.20%) among the formulations.

Conclusion: Within this preliminary formulation-level screening, surface-localised nanochitosan—particularly the commercial nanochitosan/TPP coating—showed the most favourable numerical balance of antibacterial activity, cytocompatibility, and mechanical adequacy. The findings identify A1 as a lead formulation for powered antibacterial testing, oral polymicrobial biofilm models, simulated saliva degradation, knot-security assessment, and in vivo wound-healing validation.

Effects of Ethanolic Leaves Extract of Azadirachta indica Linn on Gene Expression of Streptozotocin-induced Hyperglycemic Wistar Rats (Rattus norvegicus Albinus)

2026-07-16T11:32:12+00:00

This study evaluated the effects of Azadirachta indica leaf extract on body weight and pancreatic insulin and glucagon gene expression in streptozotocin-induced hyperglycaemic male Wistar rats. Thirty-five adult male Wistar rats were assigned to five groups of seven animals each: a non-diabetic control group, an untreated diabetic control group, a diabetic group treated with metformin, and diabetic groups treated with A. indica leaf extract at 250 or 500 mg/kg body weight. Hyperglycaemia was induced using a single intraperitoneal dose of streptozotocin, and treatments were administered orally for six weeks. The extract was assessed for phytochemical and proximate composition, while body weight and blood glucose levels were monitored weekly. Pancreatic tissues were collected after treatment for molecular analysis of insulin and glucagon gene expression using RT-qPCR, with β-actin as the reference gene. Phytochemical analysis showed the presence of flavonoids, saponins, alkaloids, phenols, tannins, terpenoids, glycosides, steroids, oxalate, carbohydrates, monosaccharides, proteins, and amino acids, with steroids having the highest measured concentration (18.22 mg/g). Crude fibre was the most abundant proximate component. Untreated diabetic rats showed progressive body weight loss, whereas the treated groups showed improved body weight and reduced blood glucose levels compared with the untreated diabetic group; these differences were statistically significant (P < 0.05). The group treated with 500 mg/kg extract showed a higher percentage of insulin expression and a lower percentage of glucagon expression than the untreated diabetic group. These findings suggest that A. indica leaf extract may influence pancreatic gene-expression patterns in this experimental model.

Development and Expert Content Validation of a Pop-up Laser-assisted Cone-positioning Device for Periapical Radiography

2026-07-18T04:49:42+00:00

Positioning errors in periapical radiography, particularly cone cut and beam misalignment, remain recurrent technical problems that may compromise image adequacy, increase repeat exposure, and reduce the reliability of radiographic interpretation. Although operator training and conventional positioning aids may reduce selected errors, alignment control remains challenging in the bisecting-angle technique because of anatomical variation, restricted intraoral access, and sensitivity to vertical and horizontal angulation. This study aimed to develop a pop-up laser-assisted intraoral X-ray cone-positioning device and to establish its early-stage expert content validation before usability or clinical performance testing. A research and development design was employed in two sequential stages: prototype design and fabrication, followed by expert content validation. The prototype consisted of three principal modules: a remote motor, a controller box, and a laser module configured with dot/cross projection to support pre-exposure cone alignment. A multidisciplinary technical panel representing physics, optical-electronic engineering, and manufacturing/metrology conducted content validation using a structured five-point rating instrument covering structural quality, usage qualities, management qualities, and generic environmental qualities. The validation profile was consistently favourable, with all indicator scores ranging from 4.00 to 5.00. The overall mean score across all indicators was 4.62/5.00, and the complementary Content Validity Index analysis showed I-CVI = 1.00 for all indicators, with S-CVI/Ave = 1.00. Structural quality achieved the highest domain score, while lower but still favourable scores in understandability, learnability, maintainability, accountability, and autonomy identified specific refinement priorities. The findings indicate that the prototype achieved an acceptable level of design readiness and technical-content validity. The findings support further usability testing and controlled radiographic evaluation; no claim of clinical effectiveness is made at this stage.

Oral Health-related Quality of Life among Rural Adults with Untreated Dental Caries and Symptoms Suggestive of Pulpal or Periapical Disease in North Sumatra: A Pilot Study

2026-07-23T06:30:46+00:00

Background: Untreated dental caries can progress to pulpal inflammation, necrosis, and periapical disease, but its patient-reported consequences remain poorly documented in rural Indonesian communities.

Objective: To describe dental caries experience and oral health-related quality of life (OHRQoL) among rural adults attending community screening with untreated caries and symptoms or clinical findings suggestive of pulpal or periapical involvement.

Methods: This community-based cross-sectional descriptive pilot study included a non-probability sample of 100 adults aged 18-81 years. A precision-based adequacy calculation for a single proportion (95% confidence, expected proportion 0.50, absolute precision 0.10) yielded a minimum of 96 participants; the achieved sample was 100. Dental status was summarised using decayed, missing, and filled teeth (DMF-T) counts. OHRQoL was assessed with a locally adapted 14-item OHIP-derived questionnaire covering functional, physical, and social domains on a three-point frequency scale. Because radiography and standardised pulpal/periapical testing were unavailable, no definitive diagnosis of apical periodontitis was assigned. Analyses were descriptive.

Results: Women comprised 80% of participants, and 56% were younger than 45 years. The mean DMF-T score was 5.49; decayed teeth accounted for 65.0% of the index, missing teeth for 33.2%, and filled teeth for 1.8%. Frequent impacts included food impaction (45%), perceived bad breath (45%), difficulty smiling (29%), difficulty eating preferred foods (25%), and oral pain (20%). Mean item scores were highest for functional limitation (1.83), followed by physical (1.77) and social impacts (1.57); the aggregate mean total score was 23.37 out of 42.

Conclusion: This convenience pilot cohort showed a predominantly untreated disease profile accompanied by recurrent functional and physical burdens. The findings support earlier caries detection, accessible restorative care, and structured referral for confirmatory pulpal and periapical assessment. They should not be interpreted as prevalence estimates or causal evidence, and require confirmation with probability-based recruitment, radiographic diagnosis, and a validated Indonesian OHRQoL instrument.

Tuberculosis Treatment Outcomes at a Referral Center in Dakar, Senegal: A Retrospective Study

2026-07-28T09:07:36+00:00

Background: Tuberculosis remains a major public health concern in Senegal, and evaluation of treatment outcomes is necessary to assess programme performance. This study evaluated first-line anti-tuberculosis treatment outcomes at the Infectious and Tropical Diseases Department of Fann University Hospital in Dakar.

Methods: A retrospective descriptive study was conducted using records of patients registered for tuberculosis treatment between 1 January 2022 and 31 December 2023. Sociodemographic, clinical, bacteriological, and therapeutic data were extracted from medical records and treatment registers. Data were entered using Microsoft Excel 2016 and analysed using SPSS version 20.0.

Results: Overall, 102 patients were included. The median age was 33 years, and 63.7% were male. Most patients (59.8%) were from Dakar. Pulmonary tuberculosis accounted for 51% of cases, and 38% of patients were HIV-positive. Tuberculosis was bacteriologically confirmed in 46.1% of patients; among confirmed cases, GeneXpert was used in 76.6%. The standard six-month regimen was administered to 86.3% of patients. Treatment was completed by 63.7%, and 12.7% were cured, giving a treatment success rate of 76.5%. Six deaths, one treatment failure, one loss to follow-up, and 16 unevaluated outcomes were recorded.

Conclusion: Treatment success was achieved in approximately three-quarters of patients. Improved completeness of treatment registers, timely diagnostic confirmation, and strengthened follow-up are needed to reduce unevaluated outcomes and support continuity of tuberculosis care.

Molecular Characterisation of the Diego and Wright Blood Group Systems of Blood Donors in Malta: A PCR-RFLP Study

2026-08-19T06:37:57+00:00

The Diego and Wright blood group systems are clinically important because antibodies directed against their antigens may cause haemolytic transfusion reactions (HTRs) and haemolytic disease of the foetus and newborn (HDFN). Despite their relevance in transfusion medicine, limited information is available regarding the prevalence of Diego and Wright blood group alleles in Malta. Molecular genotyping provides a reliable alternative to conventional serological methods, particularly for rare antigens for which suitable antisera may be unavailable or difficult to obtain. This study aimed to establish a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay for the molecular detection of the Diego and Wright blood group alleles in blood donors in Malta and to determine the distribution of these alleles within the donor population. A total of 403 randomly selected blood donor samples were collected between February and July 2024. Genomic DNA was extracted and amplified using polymerase chain reaction (PCR). Restriction fragment length polymorphism analysis was performed using NaeI and Hpy188I restriction enzymes to differentiate the DI*A/DI*B and DI*02.03/DI*02.04 alleles, respectively. A subset of samples underwent Sanger sequencing to validate the genotyping results. Donor demographic information relating to parental ancestry was also collected to assess population diversity. The donor cohort was composed predominantly of individuals with Maltese ancestry, although 11.7% of participants reported at least one parent of foreign origin. PCR-RFLP analysis demonstrated the complete absence of the DI*A allele encoding the Dia antigen and the DI*02.03 allele encoding the Wra antigen. All successfully genotyped samples (403) carried the DI*B and DI*02.04 alleles, corresponding to the high-frequency Dib and Wrb antigens, respectively. Sequencing results showed complete concordance with PCR-RFLP findings and confirmed the presence of the DI*B and DI*02.04 alleles in all samples analysed. The study provides the first molecular data describing the distribution of Diego and Wright blood group alleles in blood donors in Malta. The exclusive detection of DI*B and DI*02.04 alleles is consistent with findings reported in other predominantly Caucasian and Middle Eastern populations. PCR-RFLP proved to be a reliable and cost-effective genotyping method and may serve as a useful tool for rare blood group screening and future implementation of molecular transfusion medicine strategies in Malta.

Histomorphological Evaluation of Azadirachta indica Linn Ethanolic Leaves Extract on Visceral Organs of Streptozotocin-induced Hyperglycemic Wistar Rats (Rattus norvegicus Albinus)

2026-08-19T12:49:01+00:00

Changes in tissue and organ morphology can occur with the use of herbs for prophylactic and chemotherapy purposes and are mainly detected using expensive biochemical markers. This study therefore examined the histomorphological effects of Azadirachta indica leaves extract on the visceral organs of streptozotocin-induced hyperglycaemic Wistar rats using special histological stains. Thirty-five streptozotocin-induced hyperglycaemic male Wistar rats were grouped into five groups (n=7): diabetes not induced–control; diabetic not treated–control; diabetic treated with Metformin–control; and diabetic treated with 250mg/kg and 500mg/kg per body weight. All groups were treated for 42 days. Fasting blood glucose was measured every week. The rats were sacrificed on day 42, and blood collected through cardiac puncture was used for liver and kidney function tests, while the harvested liver, kidney and pancreas were used for oxidative stress and inflammatory tests, histologically processed and stained with special histological stains for microscopic examination. Data were subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) version 20.0, and P<0.05 was considered significant.

Fasting blood glucose levels significantly decreased every week in Wistar rats treated with 250mg/kg and 500mg/kg (P<0.05). The liver and kidney enzymatic activities, superoxide dismutase, Malondialdehyde, interleukin 6, caspase and tumour necrotic factor in diabetic groups treated with 250 mg/kg and 500 mg/kg increased tremendously (P<0.05). In untreated diabetic Wistar rats, the kidney, liver and pancreas tissues showed gross inflammation, atrophic glomeruli, degenerated epithelial cells, thickened basement membranes, collagen fibre deposition, glycogen accumulation, fibrosis, weakened reticulin fibres and degenerated islets of Langerhan’s, whereas all these features were absent in Wistar rats treated with 500 mg/kg ethanolic leaves extract of Azdirachta indica.

Histological special stains revealed that Azadirachta indica ethanolic leaves extract preserved and repaired the tissue architecture of the liver, kidney and pancreas against diabetes-associated abnormalities in these visceral organs.

Proximate Analysis and Antioxidant Activity Studies on Santalaceae (Viscum album) Leaf Extract

2026-08-29T14:00:55+00:00

This study characterised the methanolic leaf extract of mistletoe (Viscum album) parasitic on Moringa oleifera by assessing its phytochemical constituents, trace elements, extract yield, and in vitro DPPH radical-scavenging activity. Leaves collected in Nasarawa State, Nigeria, were air-dried, powdered, extracted with 80% methanol, and analysed using standard phytochemical procedures and atomic absorption spectrophotometry. Antioxidant activity was assessed by the 2,2-diphenyl-1-picrylhydrazyl method using extract concentrations ranging from 10 to 100 ppm, with vitamin C as the reference standard and a 30-minute reaction time. The extract yield was 16.25%. Qualitative phytochemical screening detected alkaloids, tannins, saponins, flavonoids, and steroids, whereas anthraquinones were absent. Trace element analysis detected copper (46.5 mg/kg), iron (231.6 mg/kg), lead (0.2 mg/kg), and zinc (75.2 mg/kg), while cadmium was not detected. The reported values for the detected metals were within the WHO/FAO maximum permissible values presented in the manuscript. DPPH inhibition increased with extract concentration, from 9.20% at 10 ppm to 52.02% at 100 ppm. These findings show that the analysed mistletoe leaf extract contains several phytochemical classes, selected trace elements, and concentration-dependent radical-scavenging activity under the conditions of the DPPH assay. The results are specific to the analysed sample and provide a basis for further quantitative characterisation of its constituents and antioxidant properties.

Neuroprotective Effects of Eleveted Dose Vitamin A on the Hippocampus of Adult Male Wistar Rats Exposed to Toxic Doses of Methamphetamine

2026-09-04T06:30:31+00:00

Methamphetamine overstimulates brain regions such as the striatum and hippocampus by increasing neurotransmitter activity, thereby causing neurotoxicity, whereas vitamin A may help protect neurons through anti-inflammatory and neuroprotective effects. This study investigated the neuroprotective effects of an elevated dose of vitamin A on the hippocampus of adult male Wistar rats exposed to toxic doses of methamphetamine (METH). Twenty adult male rats were randomly divided into four groups (n = 5): Group A (control) received feed and water only; Group B received METH at 5 mg/kg at 3-hour intervals within 12 hours; Group C received vitamin A only (2.5 mg/kg); and Group D received the combined treatment of METH (5 mg/kg at 3-hour intervals within 12 hours) and vitamin A (2.5 mg/kg) for 28 days. After the final administration, the animals were sedated and sacrificed; their brains were harvested, fixed in 10% neutral formol saline, and processed for histological examination using haematoxylin and eosin (H&E) staining. Body-weight analysis revealed weight loss in methamphetamine-intoxicated Wistar rats. Methamphetamine increased MDA levels and reduced GSH and SOD levels, indicating oxidative stress. Hippocampus-dependent cognitive performance assessed using the Morris water maze indicated impaired learning after methamphetamine exposure, whereas vitamin A improved cognition and antioxidant status. Histological analysis revealed better-preserved hippocampal architecture in the vitamin A-treated groups than in the METH-only group. Overall, vitamin A provided partial neuroprotection against METH-induced hippocampal toxicity but did not completely reverse the damage.

Bioactive Evaluation and Antimicrobial Activities of Nigerian Mistletoe (Phragmanthera incana) Leaf Extracts

2026-09-04T11:03:16+00:00

Mistletoe is a hemiparasitic medicinal plant traditionally used for several human and animal ailments. This study evaluated the phytochemical constituents and antibacterial activity of aqueous and methanolic leaf extracts of Nigerian mistletoe parasitic on Stereospermum kunthianum. The leaves were air-dried, powdered, and extracted using 80% methanol or de-ionised distilled water. Qualitative and quantitative phytochemical analyses were performed, and antibacterial activity was assessed against Bacillus subtilis, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa using the agar diffusion method. Both extracts contained alkaloids, saponins, tannins, flavonoids, and steroids, whereas anthraquinones were absent. The extraction yields of the methanolic and aqueous extracts were 16.12% and 15.62%, respectively. The methanolic extract showed higher measured values for the assessed phytochemicals than the aqueous extract. Antibacterial activity varied with extract concentration and test organism. The highest inhibition zone, 27 mm, was recorded for the methanolic extract at 10,000 µg/ml against Staphylococcus aureus, whereas the smallest inhibition zone, 9 mm, was recorded for the aqueous extract at 1,000 µg/ml against Pseudomonas aeruginosa. Overall, the methanolic extract demonstrated greater antibacterial activity than the aqueous extract under the experimental conditions. The findings indicate that the aqueous and methanolic extracts differed in their measured phytochemical composition and antibacterial activity. These results provide a comparative assessment of the two extraction solvents under the study conditions.

Knowledge and Utilization of the WHO Surgical Safety Checklist among Perioperative Nurses in Two Nigerian Teaching Hospitals: A Comparative Cross-Sectional Study

2026-09-12T07:32:02+00:00

Background and Objective: The World Health Organization Surgical Safety Checklist (WHO SSC) reduces preventable perioperative harm when implemented with fidelity, yet knowledge may not translate into consistent use. This study compared knowledge and utilisation of the WHO SSC among perioperative nurses in two Nigerian teaching hospitals.

Materials and Methods: A comparative cross-sectional study included 56 perioperative nurses from two Nigerian teaching hospitals. A structured questionnaire assessed knowledge and self-reported utilisation, while a WHO-adapted checklist assessed observed practice. Descriptive statistics and independent-samples t tests were used; p<0.05 was considered significant.

Results: No participant had poor knowledge. Mean knowledge was higher at Hospital A than Hospital B (13.44±1.67 vs 12.43±1.26; mean difference 1.01, 95% CI 0.19-1.83; p=0.01; Hedges g=0.72). Good self-reported utilisation was 75.0% and 85.0%, respectively, but mean utilisation scores did not differ significantly (23.88±4.86 vs 25.18±2.18; p=0.31). No checklist event was observed at Hospital A during the observation period. Among 17 Hospital B procedures, utilisation was poor in 17.6%, moderate in 70.6%, and good in 11.8%. Frequently omitted activities included major blood-loss planning, specimen-label read-back, equipment-problem discussion, and recovery planning.

Conclusions: Knowledge and reported utilisation were generally favourable, but observed practice showed incomplete implementation and a substantial knowledge-practice gap. Hospitals should integrate checklist execution into mandatory workflow, designate coordinators, and use direct observation, audit, and feedback to monitor fidelity.