The Annals of Innovation in Medicine (AIM) is a publication that provides a platform for researchers, physicians, and other medical professionals to share their findings, discoveries, and insights on various medical topics with a focus on innovation. It serves as a valuable resource for healthcare professionals who want to stay up-to-date with the latest developments and advancements in the field of medicine, particularly in areas related to new technologies, techniques, and processes. ISSN 2977-0335 Frequency: Quarterly | Languages: English | Publisher: European Institute of Knowledge and Innovation (EIKI LTD.) | Other Info: Open-Access, Double peer-reviewed.
European Institute of knowledge and innovation (EIKI LTD)
Medication safety and artificial intelligence: evidence, failure modes, and how to vet AI tools before they touch patient care
Medication harm remains common, with a substantial portion preventable at the stages of prescribing and administration. (1) I reviewed evidence on how artificial intelligence (AI)—including rule-based clinical decision support, machine learning (ML), natural language processing (NLP), and large language models (LLMs)—can improve medication safety, and how these tools can fail. Methods: On 10 February 2026, I searched PubMed for systematic reviews/meta-analyses, high-quality observational studies, human factors evidence, reporting/risk-of-bias guidance, and peer-reviewed LLM evaluations relevant to prescribing error detection, medication reconciliation, dosing support, adverse drug event (ADE) prediction, pharmacovigilance, and medication-related documentation. All included citations were verified on PubMed by confirming PMIDs and bibliographic details. Results: Evidence for CPOE/CDSS suggests improvements in practitioner performance and some reductions in preventable ADEs, but effects are heterogeneous and systems can facilitate new error types. (2–5) Safety alerts are frequently overridden (49%–96%), and evidence that interruptive prescribing alerts improve patient outcomes is limited. (6,7) Automation bias is a documented risk: correct CDSS can reduce omission errors, yet incorrect CDSS can increase omission errors and induce commission errors. (12,13,15) ML-based ADE prediction shows emerging performance (pooled AUC 0.72, 95% CI 0.68–0.75), but prediction studies frequently show high risk of bias, motivating use of TRIPOD/PROBAST and careful validation. (9–11,17) In pharmacovigilance using routinely collected data, methods and performance reporting are heterogeneous, and no method is uniformly superior. (18) In medication text workflows, LLMs can reduce specific direction errors when designed with domain logic and guardrails, but hallucinations and omissions remain safety-critical. (20,21) Conclusions: AI can improve medication safety when tasks are bounded, outputs are auditable, and systems are integrated with strong human factors design and lifecycle governance; deployment requires local validation, bias and dataset shift monitoring, and formal safety evaluation—especially for generative AI. (9–11,20–27)
Copyright (c) 2025 Annals of Innovation in Medicine https://creativecommons.org/licenses/by/4.0
Deprescribing to Reduce Harm From Polypharmacy in Chronic Disease: What Works, for Whom, and at What Cost
Background: Polypharmacy is common in chronic disease and can increase adverse drug events, prescribing cascades, and regimen complexity. Deprescribing is the planned, supervised reduction or discontinuation of medicines where harms outweigh benefits in a patient’s current context. This review compares deprescribing strategies, focusing on what works, for whom, and at what cost. Methods: A focused evidence synthesis was conducted using PubMed and targeted cross-checking (January 1, 2000 to January 31, 2026). Priority was given to systematic reviews/meta-analyses and pragmatic randomised or cluster randomised trials evaluating deprescribing or structured medication review with deprescribing intent in chronic disease and polypharmacy contexts. Results: Deprescribing interventions consistently improve prescribing outcomes and reduce exposure to high-risk medicines. Patient-activated education can produce substantial discontinuation for targeted drug classes, exemplified by EMPOWER (27% discontinuation versus 5% at 6 months). Pharmacist-led interventions reduce inappropriate medication exposure and can support simplification. Disease-specific medication reduction can maintain short-term disease control in carefully selected patients, exemplified by OPTIMISE where systolic blood pressure control remained noninferior at 12 weeks after antihypertensive reduction. Effects on admissions and mortality vary and appear more likely when interventions target high-risk patients and high-harm medicines. Conclusions: Deprescribing reliably improves prescribing quality and can meaningfully reduce exposure to high-risk medicines, particularly through patient activation and pharmacist-integrated workflows. Clinical endpoint benefits depend on targeting, implementation fidelity, and monitoring capacity.
Comparative strategies to improve medication adherence in chronic disease: what works, for whom, and at what cost
Background: Medication non-adherence is common in chronic disease and limits the real-world effectiveness of pharmacotherapy. Adherence is best understood as a process (initiation, implementation, discontinuation/persistence), and intervention choice should match the dominant barrier and phase of adherence. (1) Methods: For this study researchers conducted an umbrella-style synthesis using PubMed as the primary database (verification/search date: 10 February 2026). Authors prioritised PubMed-indexed systematic reviews, meta-analyses, and Cochrane reviews comparing five intervention families—digital reminders (SMS/apps/interactive voice response), pharmacist-led interventions, regimen simplification (dosing frequency), fixed-dose combinations/polypill strategies, and behavioural counselling (motivational interviewing). Results: Digital reminders improve adherence implementation with small-to-moderate pooled effects (electronic reminders: Cohen’s d=0.29; SMS meta-analysis OR 2.11 with an estimated 17.8% absolute gain under a 50% baseline assumption), but clinical effects are uncertain in cardiovascular secondary prevention, where adherence measures are inconsistent and pooled LDL/BP effects are small. (4–7) Pharmacist-led interventions show moderate pooled adherence benefits in older adults (effect size 0.57; 0.41 after outliers) with attenuation over time, and medication review models can improve biomarker target attainment; effects on hospitalisation/mortality are inconsistent. (8,9) Regimen simplification shows a graded adherence advantage using electronic monitoring (e.g., −6.7% taking adherence for twice-daily vs once-daily regimens), supporting simplification as a durable first-line strategy. (12) FDC strategies reduce non-compliance (RR 0.74) and improve adherence/persistence in hypertension (mean adherence +14.92%; persistence RR 1.84), while early polypill evidence shows improved risk factors but uncertain event effects and higher discontinuation, with limited cost reporting. (13–15) MI has a small pooled effect (0.12) and appears most relevant for intentional non-adherence. (16) Economic evidence is limited and heterogeneous; overviews suggest simplification and pharmacist care are often cost-effective but context-dependent. (18,19) Indian RCT evidence suggests education plus follow-up delivered via community health workers/pharmacists is promising but of mixed quality. (20) Conclusion: The most consistent adherence improvements arise from structural strategies (simplification and FDCs), complemented by clinically integrated pharmacist care and targeted behavioural and digital tools. Better standardisation of adherence outcomes and stronger prospective economic evaluation are priorities for scalable implementation.
Drug shortages as a medication-safety problem: clinical impact, therapeutic substitutions, and mitigation strategies
Drug shortages have become a recurrent feature of modern pharmacotherapy and should be conceptualised as a medication-safety problem rather than a purely logistical supply issue. I synthesised PubMed-indexed evidence (search and verification date: 10 February 2026) spanning scoping reviews, systematic reviews, pharmacovigilance analyses, observational outcome studies, and policy analyses to evaluate clinical consequences of shortages, safety risks from therapeutic substitutions, and mitigation strategies at clinical and system levels. The evidence indicates that shortages frequently involve high-consequence drug classes (generic sterile injectables, antibiotics, oncology agents) and generate harm through delayed/omitted therapy, forced substitution with unfamiliar agents or concentrations, and increased system complexity. Patient-important outcome signals include higher mortality during the US norepinephrine shortage in septic shock care (absolute risk increase 3.7%; adjusted OR 1.15) and worsened oncology outcomes during an intravenous etoposide shortage (increased hospitalisation and shorter progression-free survival). Pharmacovigilance studies demonstrate that shortages are associated with adverse drug reactions, medication errors, disease worsening, and serious outcomes including deaths or life-threatening events, with replacement drugs commonly implicated. Mitigation strategies with the strongest practical support are structured therapeutic interchange protocols led by pharmacists and stewardship teams (notably antimicrobial stewardship for antibiotic shortages), standardised order sets and concentration controls, active monitoring for substitution-related ADRs and errors, and transparent prioritisation frameworks for scarce curative therapies. India/LMIC evidence highlights that prolonged public-sector stock-outs and variable availability of essential medicines shift patients towards private procurement and informal substitution, requiring governance, procurement and distribution reforms alongside local inventory and digital visibility tools. Overall, shortage preparedness should be integrated into medication-safety programmes with explicit contingency pathways, audit of shortage-driven adverse events, and system-level supply resilience policies.
Impact of Clinical Pharmacist led-Educational program on Knowledge and Practice of Sudanese Pediatricians About Management of Epilepsy in Children
Background: Epilepsy is one of the most common neurological disorders in children. Seizure frequency is an important indicator of treatment effectiveness. This study assessed the impact of a clinical pharmacist-led educational program on the knowledge and practice of pediatricians regarding the management of epilepsy in children. Methods: This was a pre-post interventional hospital-based study conducted at Wad Medani Pediatric Teaching Hospital from February 2022 to August 2023. Prescribers working at the hospital were included. Results: Wilcoxon signed-rank testing showed statistically significant differences in knowledge regarding the recommended route of administration of midazolam for acute seizures (p = 0.022) and discontinuation of chronic sodium valproate in seizure-free children (p = 0.016). A statistically significant difference was also observed in practice regarding planning the overall tapering period of antiseizure drugs (ASDs) in seizure-free patients (p = 0.016). Conclusion: The clinical pharmacist-led educational program improved selected aspects of knowledge and practice among prescribers managing childhood epilepsy.
Copyright (c) 2026 Annals of Innovation in Medicine https://creativecommons.org/licenses/by/4.0
Rash, Lymphadenopathy, and Nephritis: Is It Always Lupus?
Background: IgG4-related disease (IgG4-RD) is a multisystem fibroinflammatory condition capable of affecting nearly any organ. Renal involvement, although recognized, remains uncommon and frequently leads to diagnostic uncertainty because of overlap with autoimmune, infectious, and lymphoproliferative disorders. Case Presentation: A 34-year-old woman presented with a three-year course of intermittent painful purpuric plaques, chronic cough, Raynaud-like digital pallor, and episodic arthralgia. Examination revealed generalized non-tender lymphadenopathy. Laboratory studies showed anemia, eosinophilia, low complement levels, elevated IgG, and renal dysfunction. Autoimmune markers were negative. Imaging identified right-sided bronchiectatic changes and axillary lymphadenopathy. Skin biopsy showed leukocytoclastic vasculitis, while lymph node histology suggested reactive plasma cell-rich changes. A markedly raised serum IgG4 level (>53 g/L) prompted kidney biopsy, which demonstrated storiform fibrosis and abundant IgG4-positive plasma cells, confirming IgG4-related tubulointerstitial nephritis. Discussion & Conclusion: The combination of renal, cutaneous, pulmonary, and lymph node abnormalities, together with serological and histopathological findings, established the diagnosis of systemic IgG4-RD and illustrated its ability to mimic a broad differential diagnosis. Prednisolone therapy resulted in clinical and biochemical improvement, including normalization of renal function and improvement in complement levels. The patient remains in remission at 1 year.
Assessing Mental Health Awareness and Stigma in Hartford, Connecticut, USA
Mental health stigma remains a major barrier to timely help-seeking, disclosure, and community support. This study assessed mental health awareness and stigma among adults in Hartford, Connecticut, using a descriptive cross-sectional survey and key informant interviews. A structured questionnaire was completed by 170 adults, and 10 community informants participated in semi-structured interviews. Descriptive findings showed moderate mental health awareness, with particularly strong recognition of the importance of early intervention but weaker awareness of available support services. Education level was significantly associated with awareness. Item-level stigma findings suggested relatively low endorsement of overtly stigmatizing beliefs, although discomfort, concealment-related attitudes, and fear of social judgment persisted. The reported correlation analysis showed an inverse association between awareness and stigma (r = -0.62, p < 0.001). Qualitative themes highlighted limited service access, fear of being judged, demand for more community education, and inconsistent informal support. Overall, the findings support community-based mental health education, improved service visibility, and locally trusted anti-stigma messaging. Interpretation should remain cautious because the study used non-probability sampling, self-reported measures, and a cross-sectional design.
A Statistical and Epidemiological Framework for Unraveling the Etiology of Cryptogenic Cirrhosis
Cryptogenic cirrhosis is a diagnosis of exclusion with heterogeneous and often overlapping etiologies, making systematic investigation challenging in routine clinical practice. We propose a unified statistical and epidemiological framework that integrates classical study designs (case–control and cohort with survival analysis), evidence synthesis (meta-analysis), exploratory genetics (genome-wide association studies), and modern machine learning to examine potential contributors such as long-term analgesic exposure and metabolic comorbidities. A motivating clinical vignette is used solely to illustrate the clinical context in which such analyses may arise. All quantitative results presented in this study are derived from fully simulated datasets constructed to demonstrate the behavior and interpretability of the proposed workflow rather than to establish real-world causal effects. Within these illustrative simulations, analgesic exposure is specified to act as a risk factor, leading to elevated association measures in case–control analyses, separation of survival curves in cohort analyses, and high feature importance in predictive models, while exploratory GWAS simulations yield no genome-wide significant signals, underscoring the need for adequately powered real studies. The proposed workflow is transparent, reproducible, and deployable in prospective registries, with the primary goal of generating testable etiologic hypotheses rather than confirming definitive clinical associations.
Parental Awareness and Health Protocol Practices on HFMD Among Caregivers of Grades 1–3 Pupils in Aklan
Hand, Foot, and Mouth Disease (HFMD) continues to pose a public health concern in school-aged children, yet parental understanding and compliance with health measures remain erratic. This study assessed the level of parental awareness and health protocol practices regarding HFMD and examined the relationship between these variables among caregivers of Grade 1 to 3 pupils in a public elementary school in Aklan, Philippines. A quantitative correlational research design was employed. Data were gathered from 166 randomly selected parents and caregivers using a validated, researcher-developed survey composed of 16 true/false items on awareness and 16 Likert-scale items on protocol adherence. Descriptive statistics and Spearman’s rho correlation were analyzed using SPSS version 21. Results showed that overall awareness was moderate (M=10.67, SD=2.02), with lowest scores in etiology (54.97%) and transmission (60.84%) and highest in pathophysiology (80.87%). Health protocol practice was also moderate (M=2.96, SD=0.87), with variable adherence across promotion, treatment, and rehabilitation behaviors. A weak but statistically significant positive correlation was found between awareness and practice (r=0.220, p=0.004). These findings indicate that while awareness contributes to better adherence, knowledge alone does not guarantee consistent compliance with preventive measures. Strengthening targeted health education and implementing behavior-focused interventions are recommended to enhance prevention efforts. The study supports the integration of school-based hygiene programs and community-driven health campaigns to reduce HFMD transmission in early childhood settings.
Mapping Youth Council Health-Related Initiatives: Basis for the Creation of Sustainable Health Development Program
The Sanggunian Kabataan (SK) or Youth Council is where the voice of the youth can be heard and can also participate in the local governance, and their projects and programs must align with the nine centers of participation, especially the health aspect. The study aims to identify the projects and programs of selected SK barangays and Local Government Units, as well as their challenges in implementing the health-related program to their constituents The study utilizes a qualitative-descriptive research design using document analysis. The study shows that the various programs proposed by the selected SK barangay and Local Government Unit are relevant to education, awareness, and training of the youth to prevent as well as to spearhead the information to other youth, especially in the issues of HIV and AIDS, mental health, illegal drug use, and teenage pregnancy. Its effectiveness also has challenges such as priorities between school or work, or youth leader, lack of facilities, budget, and partnership, and the lack of information dissemination. The researcher recommends revisiting the local youth development plan, and this study will be considered as one of their basis in creating health-related programs, especially in Dumlog, Talisay City, Cebu. An in-depth study to be published that analyzes and evaluates the effect of different sources, messages, and target audiences on the determinants of uptake of public health evidence for prevention in the Philippine barangays.
Antimicrobial Activities of Ginger extract on Selected Pathogenic Microorganisms
Antimicrobial activities of ginger (Zingiber officinale) were investigated for its microbial activity against clinical isolates of Salmonella, Staphylococcus aureus, Escherichia. coli, and Bacillus using agar well diffusion method. Freshly harvested rhizomes of both local and agric ginger from the Clifford University Farm were employed for this study. The rhizomes were washed to remove adhering soil particles, sliced, dried and milled to powder, extraction was done using ethanol and water. Tests carried out on both ethanol and water extracts of local and agric ginger were phytochemicals, antimicrobial activities, Minimum inhibitory concentration (MIC) and Minimum bactericidal concentration (MBC). The phytochemical test result on both local and Agric ginger typically showed the presence of bioactive compounds such as tannins, alkaloids, saponins, cardiac glycosides, flavonoids, anthraquinone derivatives with traces of steroids. The study showed that ethanol extracts of ginger exhibited significant antimicrobial activity, producing larger zones of inhibition compared to water extracts which could be as a result of better extraction with alcohol solvents.
Identification of Pathogenic Bacteria from Kilishi Meat Sold in Ka-shere Municipal: Repercussions for Public Health and Food Security
Kilishi, a popular dried meat snack predominantly consumed in northern Nigeria, is often accompanying with lacking hygienic practices during its preparation, management, and storage. This study aimed to identify the pathogenic bacteria in Kilishi sold in the Kashere municipal, Gombe State, Nigeria. A total of 30 Kilishi samples were collected from three different locations: Bakin Tasha (Spot 1), Bakin Cross (Spot 2), and Bubabani (Spot 3). The samples were examined through standard microbiological methods, including bacteriological analysis, Gram staining, and biochemical tests. The results disclosed significant bacterial infection across all samples, with Spot 3 unveiling the highest coliform count of 2.9 × 10¹º CFU/mL, followed by Spot 2 (2.5 × 10⁹ CFU/mL) and Spot 1 (1.7 × 10⁹ CFU/mL). Six bacterial species were recognized, with Bacillus species being the most predominant (28.1%), followed by Escherichia coli (23.4%), Staphylococcus species (17.2%), Pseudomonas species (12.5%), Proteus species (4.7%), and Salmonella species (14.1%). The presence of these pathogenic bacteria highlights a serious public health risk. The study underscores the need for improved hygienic practices during the manufacture, management, and storage of Kilishi to reduce microbial contamination and ensure user safety.
Evaluating Consumer Perceptions and Involvement in Waste Man-agement at Port Harcourt Superstores to Advance Sustainable De-velopment
Nigeria's rapid population growth and industrialization have escalated waste generation, particularly in urban areas, where the inefficient waste management system poses severe environmental and health risks. Effective waste management is critical for sustainable development and achieving the Sustainable Development Goals (SDGs). This study focuses on consumer perceptions and engagement in waste management at Port Harcourt Superstores, aiming to advance SDGs related to waste management. Port Harcourt, known for its economic activity, particularly in the oil and gas sector, serves as the study's backdrop. A descriptive research design involved 112 customers surveyed through structured questionnaires and interviews. Data analysis, utilizing SPSS version 26, combined statistical tools such as Chi-square and correlation analysis. Results indicate a respondent demographic skewed towards young, single, highly educated, and predominantly employed individuals who frequently shopped weekly. Consumer perceptions and involvement in waste management practices were found statistically significant (p < 0.002), highlighting a strong awareness and engagement among shoppers. Demographic factors such as education, marital status, occupation, age, and shopping frequency significantly influenced these perceptions (p < 0.002), whereas gender did not (p = 0.71). The study concluded that addressing perceptual disparities and promoting sustainable practices are crucial for fostering an environmentally conscious community aligned with SDGs. Stakeholders should leverage these findings to inform policies and practices that support resilient and sustainable development in urban settings like Port Harcourt.
Cancer Antigen 15.3 Levels And Lymphocyte To Monocyte Ratio Of Breast Cancer Subjects receiving Chemotherapy In Umuahia, Nigeria
Cancer Antigen 15.3 level (CA 15.3) is used to monitor response to breast cancer treatment and could also be used to survey disease recurrence after treatment of metastatic breast cancer. Lymphocyte-monocyte ratio (LMR), is a reflection of the hosts immunity and its degree of tumor progression. A low lymphocyte count and a high monocyte count indicates that there’s an elevated tumor burden and a poor prognosis for the subject. Aim of the Study: This study is aimed at finding out the levels of Cancer Antigen 15.3 Level and Lymphocyte to monocyte ratio of breast cancer subjects receiving chemotherapy in Umuahia, Nigeria. Materials and Methods: A total of 120 subjects were enrolled in this study. They were aged between 14 and 75 years. Of these 120 subjects, 60 were clinically diagnosed breast cancer subjects, while 60 were apparently healthy subjects. The age range of BRCA subjects were between 14 and 83, the stage of BRCA were from stage I to IV. The haematological parameters were carried out using the five-part Midray BC-5180 haematology analyzer manufactured by the Chinese Midray company. The determination of the CA15.3 levels was done with an Enzyme linked immunosorbent assay (ELISA) machine. The test kit that was used for this test procedure is AccuBind Elisa microwells CA 15-3. Results: From this study, at p<0.05; there was statistically significant increase in WBC (9.3 ± 4.5 x109/L versus 6.8 ± 1.7x109 /L) (p=0.0001), monocyte (7.4 ± 1.8 % versus 3.3 ± 1.1 %)(<0.0001), mean platelet volume (9.0 ± 1.2 fl versus 8.1 ± 0.7 fl)(<0.0001), and CA 15-3 (23.2 ± 8.0 U/ml versus 9.3 ± 5.4 U/ml)(p=<0.0001) in Breast Cancer Patients when compared with control subjects also, significant statistical decrease was observed in eosinophils (1.5 ± 1.6% versus 2.1 ± 1.9%)(p=0.0413), basophils (0.1 ± 0.2 versus 0.5 ± 0.4)(p=<0.0001), RBC (3.5 ± 0.7 x1012/l versus 4.9 ± 0.6 x1012/l)(p=<0.0001), PCV (27.2 ± 6.4 % versus 35.9 ± 3.0 %)(p= <0.0001), PDW (13.5 ± 0.8 versus 17.0 ± 1.7)(p=<0.0001), HB (8.8 ± 2.1g/dl versus 11.9 ± 1.1g/dl)(p=<0.0001), MPV (9.0 ± 1.2fl versus 8.1 ± 0.7 fl)(p=<0.0001), LMR (4.4 ± 2.5 versus 7.7 ± 6.1)(p= 0.0002), in Breast Cancer Subjects, when compared with control subjects. As CA 15.3 is increased in cancer patients, lymphocyte- monocyte ratio LMR is decreased in cancer patients (r = -0.259(P = 0.046), (r=1.000) (p=0.000). Conclusion: There was a negative correlation in cancer antigen 15.3 levels and lymphocyte monocyte ratio as the levels of CA 15.3 were increased while LMR levels were reduced. The subjects in this study had better survival outcomes at the 5th chemotherapy session.
Protective Effects of Purple Onion Extract on Malondialdehyde Levels in the Spleen of Wistar Albino Rats with Ibuprofen-Induced Oxidative Stress
Oxidative stress, characterized by an imbalance between reactive oxygen species (ROS) production and the antioxidant defence system, plays a pivotal role in drug-induced tissue injury.Ibuprofen, is known to generate ROS, deplete endogenous antioxidants, and induce oxidative damage in various tissues, including the spleen. This study investigates the protective effects of Allium cepa (purple onion) extract on ibuprofen-induced oxidative stress in Wistar albino rats. A total of 25 Wistar albino rats, weighing approximately 200 g each, were divided into five groups (n = 5). Group 1 served as the normal control and received only food and water. Group 2 was administered ibuprofen to induce oxidative stress without treatment. Groups 3 and 4 received ibuprofen alongside low-dose (250 mg/kg) and high-dose (1000 mg/kg) Allium cepa extract, respectively. Group 5 served as the standard control and received ibuprofen with Vitamin C (1000 mg/kg). Biochemical parameters, including malondialdehyde (MDA) levels, were analysed to assess lipid peroxidation, while histological examination of the spleen was performed to evaluate tissue-specific effects. The results demonstrated that ibuprofen administration significantly elevated MDA levels, indicating increased oxidative stress. However, treatment with Allium cepa extract, particularly at a high dose, significantly reduced MDA levels and preserved spleen histology compared to the ibuprofen control group. Vitamin C also showed notable protective effects. The findings highlight the potent antioxidant properties of Allium cepa, suggesting its potential as a natural therapeutic agent for managing drug-induced oxidative damage.
Histopathological Study Ibuprofen-Induced Oxidative Stress
Evaluating Consumer Perspectives on Quick Service Restaurants Practices and Challenges in Addressing Non-Communicable Diet Related Diseases in Port Harcourt
There is rise of non-communicable diseases (NCDs) in Africa, especially in Nigeria, and needs urgent public health attention. High consumption of nutrient-poor diets and the reduction in physical activity has increase in the prevalence of NCDs, such as obesity, diabetes, cardiovascular diseases, and certain cancers. NCDs now account for 71% of all deaths globally, posing a major threat to public health worldwide especially in developing nations. Rise of urbanization and the increasing influence of Western culture has allowed traditional diets to be replaced by processed, calories-dense foods, which can be due to socioeconomic factors such as poverty, lack of education, and limited access to healthcare. The aim of this study is to evaluate consumer perspectives on Quick Service Restaurants Practices and Challenges in addressing Non-Communicable Diet related Diseases in Port Harcourt (QSR). Port Harcourt, Rivers state Nigeria is the study area with a diverse range of quick-service restaurants, including Kilimanjaro, Genesis Fast-food Restaurants, Chicken Republic, Kentucky Fried Chicken Fast-food, and Dominos Pizza. 206 subjects participated in this descriptive study, which comprise male and female, with ages ranging from 20 years and above, including married and single respondents of diverse occupations, different levels of education, and frequencies of quick-service restaurant visits. Statistical analysis was performed using the Statistical Package for Social Science version 26, frequency and percentage were obtained. T-test and ANOVA was used to test for hypotheses at 0.05 level of significance. Gender distribution of the subjects showed that 56.3% identified as male, while 43.7% identified as female and majority of subjects were 31-40 years 8.3%, 99.0% of the subjects had tertiary education, the frequency of visiting QSR showed that most subjects 80.6% visited monthly. QSR most visited was Kilimanjaro Fast-food 37.9%. An independent t-test showed a statistically significant difference (p = 0.00) between the perceptions of males and females suggesting that gender affects how people view QSR practices, but both genders agreed that QSRs are not doing enough to educate the public on healthy eating. ANOVA results showed a p-value of 0.65, indicating no statistically significant differences in perceptions across age groups. This suggests that age does not significantly influence how consumers perceive QSR practices. Independent t-test showed no significant difference between genders perspectives on challenges facing employees in effectively addressing non-communicable diet-related diseases in QSR (p = 0.48). This means that gender does not have a significant impact on how employees perceive the challenges in addressing NCDs in QSRs. The ANOVA results showed borderline significance (p = 0.05), suggesting that age may have a weak influence on how employees perceive these challenges. Although employees across all age groups acknowledge the challenges, 51-60 years view them as more severe. In conclusion, the findings of this study emphasize the urgent need for action to address the growing burden of non-communicable diet-related diseases in Nigeria and other developing countries. Policymakers, food industry leaders, and public health organizations must work together to implement strategies that promote healthier diets, regulate harmful food practices, and make nutritious foods more affordable.
Evaluation of Factors contributing to Artemether-Lumefantrine Treatment Failure in Pediatric Falciparum Malaria: Study at Wad-Medani Pediatric Teaching Hospital, Sudan
Artemether-lumefantrine (AL) remains the frontline therapy for uncomplicated Plasmodium falciparum malaria in Sudanese children. However, rising treatment failure rates have prompted concern. This prospective, single-arm interventional study, conducted from November 2022 to May 2023 at Wad-Medani Pediatric Teaching Hospital, investigated factors contributing to AL treatment failure. Data included clinical assessments, parasite quantification, and adherence evaluations using the Morisky Medication Adherence Scale. Key findings revealed poor adherence as a major determinant: 21% of caregivers discontinued treatment early, and 5% missed doses. High initial parasite densities were linked to delayed clearance in 10% of failures. Only 35% of patients consumed AL with fatty food, reducing drug absorption, while 6% who vomited post-dose did not receive replacements. Notably, 25% of physicians were unaware of national guidelines, and 80% lacked access to them. The study highlights the need for improved patient education and physician training to enhance treatment outcomes and curb AL failure in pediatric malaria management.
Therapeutic Efficacy of Artemether-Lumefantrine in Treating Un-complicated Plasmodium falciparum Malaria in Children at Wad-Medani, Sudan
Malaria remains a significant public health concern in Sudan, particularly among children, with Plasmodium falciparum as the dominant species. Artemether-Lumefantrine (AL) is the recommended first-line treatment for uncomplicated malaria; however, rising treatment failure rates necessitate further evaluation. This study assessed the therapeutic efficacy of AL in children aged 6 months to 16 years at Wad-Medani Pediatric Teaching Hospital, Gezira State. A prospective single-arm interventional study was conducted, enrolling 80 patients and following 70 through a 28-day treatment regimen. Clinical assessments, parasitological responses, and adherence evaluations were performed. The results showed a cure rate of 91.5%, with significant adherence-related outcomes (p<0.05). Early treatment failure (ETF) was observed in 5% of cases, with no late clinical or parasitological failures reported. Clinical pharmacist interventions improved awareness and adherence among healthcare providers and caregivers. The study concluded that AL remains highly effective for treating uncomplicated malaria in Sudan, although targeted interventions to enhance adherence are critical for sustained efficacy.
Quality Management System Implementation of Hospital Laborato-ries in the Philippines
Ensuring accuracy, timeliness, and reproducibility of results depends on robust laboratory quality management system (QMS). However, QMS in laboratories remains a global challenge in resource-limited settings. This study aimed to determine the extent of QMS implementation of Region XII hospital laboratories in the Philippines. A Quantitative-Descriptive design was utilized and selection of respondents was achieved through complete enumeration. A total of 55 laboratory managers were assessed through a survey in terms of implementation of the 12 Quality System Essentials (QSEs). Data were analyzed using descriptive and inferential statistics. Results indicated a significant difference in implementation in the areas of organization, customer focus, facilities and safety management, assessments, and continual improvement. In terms of overall implementation, hospital laboratories implemented QMS to a very high extent with private hospital laboratories showing higher mean score compared to government hospital laboratories. However, since QSEs are set of interconnected indicators, low-rated indicators were significantly pulled by higher-rated implementation. This implies the necessity for strategic actions by hospital laboratories for the lower-scoring indicators to address the weak areas of the laboratory’s QMS.
The The Prevalence of Kidd, Lewis, ABO and RhD blood group systems in diabetic patients attending RSUTH
Aim: This study is aimed at determining the prevalence of Kidd, Lewis, ABO and RhD blood group systems in diabetic patients attending RSUTH. Method: This cross-sectional study was conducted at Rivers State University Teaching Hospital (RSUTH), and 75 diabetic subjects (30-98 years) was recruited for this study, 5mls of blood was collected using standard venipuncture technique from each subject. Blood grouping were determined manually The presence of ABO, Rh D, Lewis, and Kidd blood group system was examined using Anti-ABO, anti-D, anti-Lea and Leb, anti-Jka and Jkb monoclonal antibody, respectively (Lorne Laboratories). Data generated were analyzed by simple percentage calculation. Result: In this study the distribution pattern of ABO blood group among subjects with diabetes mellitus was in the other of O>A>B>AB (45.3%, 30.7%, 21.3% and 2.7% correspondingly), for Rh blood group system is Rh+> Rh- (95.3% and 4.7%). Also in this study, no subjects was tested Jka+ and Jkb+, the distribution pattern among diabetic groups the distribution of Kidd blood group antigens is Jka+>Jkb+> Jkb- >Jka-is (100%, 94.7%, 5.3%, 0.00 ) respectively. Distribution of Lewis antigens in this study showed the following sequence for diabetes subjects is Leb+>Lea+>Lea->Leb- (81.3%, 60.0%, 40.0%, 18.7%). Conclusion: Le a and Le b in this population was observed frequently than those in other population previously reported We therefore recommend that routine typing of Lewis blood group system should be done.
Use of Omeprazole in a Junction to Band-Ligation for Portal Hypertensive Patients in Al-Managel Hospital 2024, Sudan
Portal hypertensive patients candidate for Band ligation were administered Omeprazole tab (proton pump Inhibitor) in Al-Managel Hospital to assess post-ligation ulcer healing and Heartburn, dysphagia and odynophagia Symptoms following ligation. Forty-five patients were treated with Omeprazole tab 20 mg twice daily for one week immediately after the ligation session and rechecked in the next session (3-4) weeks later. Healing of post-banding ulcers occurs naturally without significant association with using Omeprazole, as examined by Qui Square and Fisher's exact test. Omeprazole is significantly associated with decreased heartburn and odynophagia symptoms as checked by an Independent Paired T-test. Adjunctive use of Omeprazole with Band ligation for Portal Hypertensive patients is recommended to improve post-ligation symptoms of heartburn and odynophagia.
Therapeutic Effect of Aqueous Allium Cepa Extract on Ethanol-Induced Hepatotoxicity in Albino Rats
In recent years, alcohol consumption has seen a significant rise, particularly driven by social activities. However, chronic alcohol intake has been widely recognized as a major risk factor for the development of numerous diseases, particularly liver disease. This study aimed to evaluate the therapeutic effect of aqueous extract of Allium cepa (onion) on ethanol-induced hepatotoxicity in albino rats. A total of twenty-five rats, weighing between 130-180g, were randomly assigned into five groups, each containing five rats. The rats were given a 14-day acclimatization period with free access to standard feed and water before the experiment. Group I served as the negative control and received only standard feed and water. Group II, the positive control, was administered 50% ethanol orally at a dose of 0.5 ml/100g body weight. Groups III, IV, and V received the same ethanol treatment, followed by oral administration of 200mg/kg, 400mg/kg, and 600mg/kg of aqueous Allium cepa extract, respectively, once daily for 30 days. At the end of the experiment, the rats were anesthetized using chloroform, and blood samples were collected for the analysis of liver enzymes, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) using enzymatic methods. The livers were also excised for histological analysis using hematoxylin and eosin (H&E) staining. Statistical analysis was performed using SPSS version 24, with significance set at p<0.05. The results revealed a significant reduction in the levels of AST (p=0.000028), ALT (p=0.00003), and GGT (p=0.000050) in the groups treated with Allium cepa extract compared to the positive control group. However, no significant differences were observed in ALP levels (p=0.610) across all groups. These findings suggest that aqueous Allium cepa extract may have ameliorative potential against ethanol-induced liver toxicity, possibly due to its antioxidant properties.
Enhancing Employee Responsiveness to Non-Communicable Diet Related Diseases and Customer Satisfaction in Port Harcourt Quick Services Restaurants
The aim of this study of is to investigate the impact of employee responsiveness on non-communicable diet-related diseases and customer satisfaction in quick service restaurants. This descriptive study was conducted in Port Harcourt, Rivers State, Nigeria with the following quick-service restaurants (QSRs), Kilimanjaro, Genesis Fast-food Restaurants, Chicken Republic, Kentucky Fried Chicken Fast-food, and Domino’s Pizza. 206 participants from 20 years and above representing a diverse demographic comprising male and female. The gender distribution of respondents showed a slight male majority (56.3%), with females making up 43.7%, percentage distribution of age 38.3% (31-40), 35.4% (21-30) age group, 99.0% had tertiary education, 80.6% visited QSRs monthly, with Kilimanjaro being the most popular (37.9%), followed by Genesis and Chicken Republic. The impact of employee responsiveness on consumer satisfaction in quick service restaurants, focusing on non-communicable diet-related diseases based on gender, the t-test result shows no significant difference between male and female responses. Independent t-test of customers' recommendations for improving Quick Service Restaurants' responsiveness to Non-Communicable Diet-Related Diseases showed statistical significance with female having higher ratings. The mean ratings across different age groups on how employee responsiveness affects customer satisfaction was not statistically significant 51-60 age group was highest while <21 age group was lowest and ANOVA result showed no statistical significance across age groups How different age groups rated their recommendations for improving responsiveness to diet-related diseases. <21 and 21-30 age groups have the highest mean ratings >60 groups gave the lowest rating with statistical significance.
Prevalence of Glucose-6-Phosphate Dehydrogenase in Children Attending Pediatric Clinic among Selected Hospitals in Abakaliki
Glucose-6-phosphate dehydrogenase deficiency is prevalent worldwide and common in malaria-endemic regions, affecting over 400 million people globally. G6PD deficiency compromises erythrocyte protection against oxidative stress, potentially leading to haemolysis. This study evaluated the prevalence of G6PD deficiency among children attending paediatric clinics in selected hospitals in Abakaliki, Ebonyi State, Nigeria. This cross-sectional study sampled 100 subjects aged less than one year to 13 years with equal gender representation. Venepuncture and standard laboratory practices were employed for blood sample collection from consented children falling within the specified age range. Brewer methaemoglobin reduction method and thin blood film analysis were conducted for investigation. Statistical analysis, were performed using the Statistical Package for Social Science version 26 to compare G6PD activities across age groups and genders. Results indicated varying deficiency rates across age groups, with the highest prevalence observed in the 2-4-year-old group (9%). Males exhibited a higher deficiency rate (12%) compared to females (7%), culminating in a 19% overall prevalence among paediatric clinic attendees. While significant differences in G6PD activity were found between males and females (p = 0.00), no significance was noted across age groups (p=0.29). The study emphasises the importance of G6PD screening in children given the relatively high prevalence observed in Abakaliki.
SMS Medicine: Revolutionizing Healthcare Delivery through Mobile Technology
In the contemporary era, digital technologies have significantly transformed the medical sector, enhancing accessibility and efficiency through advanced connectivity. Telemedicine, a pivotal advancement in medical science, facilitates remote diagnosis and treatment via telephones and other digital devices. Among various telemedicine modalities, Short Message Service (SMS) medicine emerges as a particularly effective method for delivering healthcare services over long distances using mobile technologies. This paper explores the transformative potential of SMS medicine in healthcare delivery, particularly in low-resource settings and during emergencies such as the COVID-19 pandemic, where it served as a critical tool in maintaining patient care while minimizing physical contact. Through a comprehensive literature review and analysis of case studies, the study highlights the benefits of SMS medicine, including cost-effectiveness, scalability, improved medication adherence, chronic disease management, and enhanced patient-provider communication. Additionally, the integration of SMS with web and mobile applications, such as MDLIVE and Updox, demonstrates increased flexibility and accessibility for patients, especially in rural areas. However, the implementation of SMS medicine is not without challenges, including data privacy concerns, technological limitations, disparities in mobile phone access, and the need for effective integration with existing healthcare systems. The paper also discusses future directions, emphasizing the potential integration of artificial intelligence (AI) and the Internet of Things (IoT) to further enhance personalized medicine and real-time health monitoring. By addressing these challenges and leveraging SMS’s strengths, SMS medicine can bridge critical gaps in healthcare access and delivery, offering sustainable and inclusive solutions for diverse populations. This research underscores the significance of SMS medicine in revolutionizing healthcare systems, particularly in resource-limited environments.
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Wunderlich syndrome secondary to renal artery angioplasty: A case report
Wunderlich syndrome is an uncommon pathology that is characterized by spontaneous hemorrhage in the subcapsular and perirenal spaces. We present the case of a 76-year-old woman who developed abdominal pain associated with hypotension after undergoing percutaneous transluminal angioplasty (PTA), with stenting in the right renal artery by means of puncture of the left brachial artery. An extensive retroperitoneal hematoma was identified on emission tomography in the topography of the right kidney, thus corroborating the diagnostic hypothesis of the aforementioned syndrome. As an outcome of the case, a surgical reapproach was required to drain a hematoma and hemostatic suture to resolve the condition.
Andrei Ricardo Rodrigues Guedes Ricardo Rodrigues Guedes
Neurological and biochemical impacts of datura metel hydroeth-anolic seed extracts on the hippocampus and cerebellar cortex of apparently healthy adult rats
Datura is a well-known toxic plant, and several cases of death due to Datura intoxication have been reported. It has been documented as a plant with hallucinogenic properties. This study aimed to determine the biochemical and neurological effects of hydroethanolic seed extracts of Datura metel on the hippocampus and cerebellar cortex of adult rats. Twenty-five adult rats were assigned into five (5) groups (A, B, C, D, and E). Group A served as the negative control, and B served as the positive control, administered with lead acetate. While groups C, D and E were treated with 150mg/kg, 300mg/kg, and 600mg/kg body weight of the seed extracts. The animals were humanely sacrificed after 14 days of exposure. Haematoxylin, eosin stain, and immunohistochemical staining were carried out for neurofilament proteins (NFP) and neuro-specific enolase (NSE). Brain tissues for biochemical analysis were homogenized, and the level of superoxide dismutase (SOD), catalase, malondialdehyde, and glutathione S-Transferase were measured. Results showed a non-statistically significant increase in SOD, catalase, and GST. However, there was a statistically significant decrease in the level of MDA. Oral administration of hydroethanolic seed extracts of Datura metel in adult rats created changes in the histology of the hippocampus and cerebellar cortex of the rats, such as perineural vacuolation and apparent reduction in neuronal cells. The results of the immunohistochemical investigation point to a dose-dependent increase in NFP, while NSE was markedly expressed.
Testicular Trauma In A Tertiary Hospital In The Metropolitan Re-gion Of Paraíba Valley, Brazil
Testicular trauma is a cause of morbidity in patients of all age groups, especially among young people. The Paraíba Valley Regional Hospital (PVRH) is a reference in the care of polytraumatized patients and because it is located in a strategic region being cut by major highways. A retrospective analysis of the medical records of patients submitted to unilateral orchiectomy, bilateral orchiectomy and scrotum exploration was performed at the PVRH in a period of 4 years. Within this database, 11 patients submitted to these procedures due to traumatic etiology were found. Orchiectomy was the predominant treatment in the case series reported here (72.7%). The therapeutic approach adopted in this study differs from that reported in the literature, due to the time taken from the trauma until the therapeutic conduct was long, only 36.4% with treatment within 24 hours, thus making more conservative or even more reparative conducts unfeasible, as well as the severity of the injuries involved with the trauma with motorcycles Thus, studies that lead to the detailing of patients victims of testicular trauma in other institutions may contribute to a positive evolution in the quality of pre- and in-hospital care.
The End of Alzheimer’s Disease: Nudging Strategies to Encourage Mass Participation in Clinical Trials
Characterized by amyloid plaques, tau tangles, and neuronal loss, Alzheimer’s disease (AD) presents a significant public health challenge, with ever-growing prevalence due to an aging global population. By the time cognitive impairment is detected, the disease’s pathology is already extensive and difficult to halt. Despite advances in research and drug development, participation in AD drug trials remains crucial for discovering effective treatments and preventive measures. This article explores how behavioral economics can be employed to raise global awareness about Alzheimer’s, motivate individuals to undergo testing, and encourage involvement in experimental drug trials. By integrating nudging strategies with creative educational approaches, this study aims to increase support for AD research.