American Journal of Pediatric Medicine and Health Sciences (2993-2149)
American Journal of Pediatric Medicine and Health Sciences (2993-2149) under U.S. ISSN Center - is an international, open-access, peer-reviewed online journal covering all aspects of the diagnosis, management, and prevention of disorders specific to children and adolescents, including pediatric oncology, pediatric cardiology, pediatric critical care, pediatric endocrinology, pediatric gastroenterology, hepatology and nutrition, pediatric hematology and hematological malignancies, obstetric and pediatric pharmacology, pediatric immunology, pediatric infectious diseases, pediatric nephrology, pediatric neurology, pediatric orthopedics, pediatric otolaryngology, pediatric pulmonology, pediatric surgery, pediatric urology and etc.
Exploring Hiv Risk Perception, Sexual Behaviors, and Condom Utilization Among Youth in Saki West, Oyo State, Nigeria
HIV remains a major public health concern among young people in sub-Saharan Africa, with risky sexual behaviours and low risk perception contributing significantly to new infections despite high levels of awareness. This study assessed HIV risk perception, sexual behaviours, and condom utilization among youth in Saki West, Oyo State, Nigeria. A community-based cross-sectional study design was used among 400 respondents aged 15–24 years selected through multistage sampling. Data were collected using a semi-structured questionnaire and analyzed using descriptive statistics, chi-square tests, and binary logistic regression at a 95% confidence level. Findings showed that 69.0% of respondents were sexually active, with 35.5% reporting early sexual debut. Multiple sexual partnerships (30.1%), inconsistent condom use (59.3%), and low condom use at last sexual intercourse (25.3%) were common. Although 84.5% had correct knowledge of HIV, 74.0% perceived themselves to be at low risk, and 60.0% reported no worry about HIV infection. Marital status, education level, schooling status, income level, and condom use were significant predictors of sexual risk behaviour (p < 0.05). There is a clear gap between HIV knowledge, risk perception, and sexual behaviour among youth in Saki West. Sexual risk behaviors are largely influenced by socio-economic and behavioral factors rather than knowledge alone.
Copyright (c) 2026 American Journal of Pediatric Medicine and Health Sciences (2993-2149)
Strategic Importance and Prospects of Remote Monitoring of Chronic Diseases Via Telemedicine
This article analyzes the role of Remote Patient Monitoring (RPM) systems in managing chronic diseases (cardiovascular, diabetes, COPD). The strategic importance, economic benefits, and impact on patient quality of life of telemedicine technologies in improving the efficiency of the healthcare system are examined. The research findings statistically prove the role of RPM systems in reducing hospitalization rates.
Copyright (c) 2026 American Journal of Pediatric Medicine and Health Sciences https://creativecommons.org/licenses/by/4.0
Overview of Antimicrobial Resistance: Patterns, Drivers, and Strategic Responses to a Growing Public Health Threat
Antibiotic resistance act as a crucial fast-growing medical threat to worldwide health, which erases medical achievements from past decades. Antibiotic resistance occurs because bacteria develop protective mechanisms that disable antibiotic treatments, which subsequently results in premature disease fatalities. Each year antibiotic resistance causes more deaths than HIV/AIDS and malaria combined because it results in 1.27 million worldwide fatalities from resistant infections. Antibiotic-resistant pathogens contribute to more than 2.8 million annual infections together with 35,000 yearly deaths across the United States as well as other nations with high income. The article delivers an extensive analysis of antibiotic resistance worldwide, which includes information about regional patterns and root causes together with key bacterial species. Comprehensive knowledge about the depth and intricacy of resistance as a global health issue enables similar worldwide efforts to reduce resistance while safeguarding public health and maintaining the effectiveness of present and future antimicrobial drugs. In the end, urgent global collaboration is essential to reverse this alarming trend.
Modern Methods for Diagnosis and Monitoring of Uterine Scar After Cesarean Section
Timely evaluation of the uterine scar after cesarean section plays a crucial role in preventing both obstetric and gynecological complications. Over the past decades, the rate of cesarean delivery has been steadily increasing worldwide, leading to a growing number of women with a uterine scar. This makes accurate assessment of its condition highly relevant in everyday clinical practice. This review discusses current approaches to evaluating the uterine scar, focusing on both instrumental and clinical methods. Particular attention is given to ultrasound, sonohysterography, hysteroscopy, and magnetic resonance imaging, as well as to the importance of early diagnosis and postoperative monitoring of healing processes. In routine practice, transvaginal ultrasound remains one of the most practical and informative tools, allowing detailed assessment of residual myometrial thickness and scar morphology. At the same time, modern approaches increasingly emphasize dynamic follow-up and the use of combined diagnostic strategies that integrate clinical findings, imaging results, and patient-related risk factors. Such an approach improves diagnostic accuracy and helps optimize patient management.
Hyperoxaluria and Calcium Oxalate Crystalluria, Development Mechanisms and Correction Possibilities
The article presents modern ideas of hyperoxaluria and oxalate-calcium crystaluria. Oxalic acid metabolism is investigated in normal and the main risk factors for hyperoxalaturia are considered. The clinical symptoms and diagnosis of hyperoxalaturia and oxalate-calcium crystaluria in children are described. Author presents basic principles of correction including diet therapy, drinking regime, phytotherapy, medication.
Assessment of Assertive Communication Skills Among Clinical Rotation Radiography Students of Nnamdi Azikiwe University
Assertive communication is a core skill especially in multidisciplinary team. Assertive communication among health professionals is an important element of patient safety efforts in health care. We assessed the current levels of assertive communication skills among final year student radiographers of Nnamdi Azikiwe university during clinical rotations. We also to identified the challenges and barriers faced by student radiographers in practicing assertive communication in clinical settings. Data collected were analysed using SPSS version 20. 80 (52.98%) were males. The study revealed that 80 (52.98%) of participants would not intervene in the face of patient compromises. 78 (51.66%) reported that they will not question the radiographer if he does not give the patient a lead apron but rather provide a lead apron. This study showed that instead of students speaking up verbally, they prefer to do it the nonverbal way. most students get confused when they observed what pertains in clinical practice and what has been taught in class and this affects them in clinical examinations. Most of the respondents are not very likely to speak up but instead, they prefer to do it non-verbally. If students are to speak up in the face of patient compromises, they will do so before any harm is done but tension or nervousness and the attitude of the clinician seems to be the factors affecting their assertiveness.
Copyright (c) 2024 American Journal of Pediatric Medicine and Health Sciences (2993-2149)
Effect of Caudal Epidural Analgesia on Postoperative Pain and Emergence Delirium in Children Undergoing Lower Abdominal Surgery: A Controlled Clinical Study
Pediatric operation patients with lower abdominal surgery develop postoperative pain, emergence delirium (ED), which causes distress and prolonged recovery. Caudal epidural analgesia is a popular method of giving good pain relief, although its effects on the emergence delirium are still subject to research. The aim of this study was to determine the impact of caudal epidural analgesia on postoperative pain and emergence delirium in children undergoing lower abdominal surgery. A prospective controlled clinical trial was done at Hayat International Hospital, which involved 60 children aged 2-8 years (ASA I-II) who were electively undergoing infraumbilical surgeries. Patients were split into two categories, caudal group (n = 30) was administered with a single-shot caudal block containing 0.25% bupivacaine (1 ml/kg), and control group (n = 30) was administered systemic analgesia only. The FLACC scale was used to measure postoperative pain, and Pediatric Anesthesia Emergence Delirium (PAED) scale was used to measure emergence delirium. There was no significant difference in the baseline characteristics (p > 0.05). Caudal group showed much lower FLACC scores in all the postoperative times (p < 0.001). Emergence delirium scores were significantly reduced in the caudal group (7.4 ± 2.1 vs. 12.3 ± 3.2; p < 0.001), with a lower incidence of ED (20% vs. 50%; p = 0.01). Further, the caudal group needed less rescue analgesia and had a long time to first analgesic request (p < 0.001). Caudal epidural analgesia is superior to reduce the postoperative pain and emergence delirium in children that have lower abdominal surgeries. It also reduces analgesic needs and improves recovery and contributes to the regular use of this technique as an efficient element of multimodal anesthesia.
A Unified Endocrine–Immune Model Explaining Male Phenotypic Variability: From Androgen Resistance to Immune-Mediated Hair Loss
Male phenotypic variability in skin tone, facial hair density, and secondary sexual characteristics reflects complex interactions between genetic determinants of androgen signaling, estrogen metabolism, and immune regulation. Accumulating evidence indicates that androgenetic alopecia (AGA), gynecomastia, and immune responsiveness are not solely determined by circulating testosterone levels, but rather by androgen receptor (AR) sensitivity, local dihydrotestosterone (DHT) activity, aromatase expression, sex hormone–binding globulin (SHBG) levels, and immunogenetic background. Several studies demonstrate that reduced AR sensitivity and altered 5α-reductase activity are associated with attenuated classical androgen-dependent traits, including facial hair growth, while simultaneously modifying susceptibility to hair loss patterns that may clinically mimic androgenetic alopecia. In such cases, hair loss may represent non-androgenic entities, including alopecia areata incognita, chronic telogen effluvium, or post-viral immune-mediated alopecia, particularly following SARS-CoV-2 infection. Gynecomastia represents another clinical manifestation of altered androgen–estrogen balance. Increased aromatization of testosterone, heightened estrogen receptor (ER-α/ER-β) sensitivity, or diminished androgen-mediated counter-regulation can shift the estrogen-to-androgen signaling ratio toward estrogen dominance, even in the presence of normal serum testosterone levels. Genetic variants affecting CYP19A1 (aromatase), AR polymorphisms, and SHBG concentrations have been implicated in this imbalance. Sex hormones exert profound immunomodulatory effects. Estrogens enhance humoral immunity, promote Th2-skewed immune responses, and lower the threshold for autoimmune activation, whereas androgens generally exert immunosuppressive effects. This hormonal divergence partly explains the higher prevalence of autoimmune diseases in females and suggests that males with reduced androgen signaling and relative estrogen predominance may exhibit an immune phenotype intermediate between typical male and female patterns. Taken together, this narrative review proposes a unified endocrine–immune phenotype characterized by reduced androgen receptor sensitivity and relative estrogen dominance in a subset of men.
Bullying Among Adult and Pediatric Patients with Chronic Illnesses: Implications for Nursing Practice (Subject Review)
Background: The victimization from bullying is an important public health problem across all ages. Patients with chronic illnesses are more likely to be bullied due to the fact that they are different, function differently or are socially stigmatized. An exploration of the phenomenon of bullying of a pediatric and an adult patient with chronic illness. Methods: A literature search of PubMed, Scopus, CINAHL and PsycINFO was conducted for peer-reviewed studies on bullying of people with chronic conditions. The review investigated publication year 2010 to 2024 where the nursing intervention and clinical implication are focused. Clinical practice relevance and methodological rigor determined the selection of the studies. Results: Youngsters with chronic conditions have far greater rates of peer victimization (25 to 35%) than healthy peers (15%). Bullying is more likely to occur in individuals with type 1 diabetes, inflammatory bowel disease, cancer, and heart conditions. The rate of bullying at work more than doubles among adults with chronic illness and disability (14% vs. 6% for non-disabled). This contributes to psychological distress and worsening health. Essential components of comprehensive care evidence-based nursing interventions include screening, education, psychosocial support, and advocacy. Conclusions: Nurses and other healthcare providers are essential to spotting, preventing, and stopping bullying of those with a chronic illness. Incorporating routine screening for bullying and violence, implementing interventions, and expert consultations will help improve the health outcomes and quality of life of the patients, affected by bullying and violence.
Prevalence of Giardia lamblia Infection Among Malnourished Children in Kirkuk City, Iraq: A Case–Control Study
Background: Malnutrition and intestinal parasitic infections are major health problems among children under five years of age in developing countries. Giardia lamblia is a common protozoan parasite associated with diarrhea, malabsorption, and growth impairment. Aim: To determine the prevalence of Giardia lamblia infection among malnourished children in Kirkuk City, Iraq, and to evaluate its association with demographic and environmental risk factors. Methods: This hospital-based case–control study was conducted from February to December 2025 and included 240 children aged 2 months to 5 years (120 malnourished cases and 120 apparently healthy controls). Data were collected using a structured questionnaire, and anthropometric measurements were used to assess nutritional status. Stool samples were examined using the zinc sulfate concentration method for detection of Giardia lamblia. Statistical analysis was performed using chi-square test, with a p-value <0.05 considered statistically significant. Results: The prevalence of Giardia lamblia infection was significantly higher among malnourished children compared to controls. The highest rate of infection was observed in children aged 25–36 months and among those living in rural areas. Significant associations were found between giardiasis and diarrhea, poor hygiene practices, unsafe drinking water, overcrowded living conditions, and low socioeconomic status (p<0.05). Conclusion: Giardia lamblia infection is significantly associated with malnutrition among children in Kirkuk City. Improving sanitation, ensuring safe water supply, promoting health education, and early detection and treatment of parasitic infections are essential strategies to reduce the burden of malnutrition.
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Maternal Serum Netrin-1 as a New Biomarker of Preeclampsia
Background: The netrin-1 serum is extensively expressed in various tissues such as renal tissues and placenta. It is predominantly implicated in cell migration development, cell adhesion and cell survival. Netrin-1 serum is also important in the formation of the placenta by enhancing the growth of cytotrophoblast and placental vapour development. Aim: To determine whether the use of serum netrin-1 levels measurement might be linked to preeclampsia or might be a biomarker of preeclampsia. Patients and Method: The case-control study was done in Alzahraa Teaching Maternity and Pediatrics Hospital / Najaf Governorate / Iraq, in the year period starting 1 st January 2024 to 1 st January 2025. The convenience sampling technique was used to recruit a total of 90 singleton pregnant women. The sample incorporated two groups whereby the case group comprised 45 pregnant women exposed to preeclampsia and the control group comprised of 45 healthy pregnant women (normotensive and never had any medical disease in their history). The serum netrin-1 was measured with the help of an Enzyme-Linked Immunosorbent Assay kit. Findings: The serum netrin-1 mean showed a significant difference that was found to be elevated at the case group (non-severe and severe preeclampsia) than in the control group. Besides, it was also more pronounced in patients with non-severe preeclampsia than in the control group (P-value=0.001). Moreover, it was much greater in the case of severe preeclampsia patients as compared to non-severe preeclampsia (P-value=0.019). There were also significant positive associations between serum netrin-1 and alanine transaminase, aspartate transaminase, blood urea, serum creatinine and negative significant association between serum netrin-1 and platelet count in case. The sensitivity, the specificity, and the accuracy of serum netrin-1 in the diagnosis of preeclampsia were 93.3, 80 and 86.6 respectively with a cut-off point of 698 pg/ml. Conclusion: Netrin-1 serum can be considered as a potential biomarker in the prediction and detection of preeclampsia.
Ultrasound-Guided Versus Landmark Technique for Spinal Anesthesia: A Comparative Study of Success Rate, Procedure Time, and Complications
Background: Spinal anesthesia is extensively applied in lower abdominal and lower limb surgery; nonetheless, the traditional landmark technique is linked to the varying success rates and complications. Ultrasound guidance has been brought out as a possible tool of enhancing accuracy and clinical results. Aim: To compare the ultrasound-guided with the landmark methods of spinal anesthesia in terms of the first-attempt success rate, duration of the procedure, and complications. Methods: It was a prospective comparative study that was carried out over a period of one year in the Medical Research Teaching Hospital. One hundred and twenty adult patients who were to undergo elective surgeries under spinal anesthesia were divided equally between two groups; ultrasound-guided (n = 60) and landmark technique (n = 60). The first-attempt success rate was used as the primary outcome, and other secondary outcomes were the procedure time, the number of attempts, as well as the complications. Data analysis was done with SPSS 28 and p = 0.05 was used as the level of significance. Findings: The ultrasound group had a much higher success rate on the first attempt than the landmark group (86.7% vs 63.3% p = 0.003). The time spent at the procedure was also a lot less in the ultrasound group (3.8 +1.2 minutes vs 6.1 +2.0 minutes, p = 0.001). Also, ultrasound group experienced fewer needle attempts and reduced cases of complications, such as paresthesia, bloody tap, and failed block (p < 0.05). Conclusion: Ultrasound-guided spinal anesthesia is better and safer in comparison to the traditional landmark method, with a better success rate, shorter duration of a procedure, and less number of complications. It is advisable to incorporate it into the normal practice of anesthetic practice in case of resources.
Association between Periodontitis and Glycaemic Control Among Adults with Type 2 Diabetes in Ogun State, Nigeria: A Cross Sectional Study
Background: Periodontitis and type 2 diabetes mellitus (T2DM) share a bidirectional relationship mediated by chronic inflammation and immune dysregulation. Evidence from high income countries shows that periodontitis is associated with poorer glycaemic control, and that periodontal therapy can modestly reduce glycated haemoglobin (HbA1c) levels, but data from sub Saharan Africa remain scarce (Mauri Obradors et al., 2018; Sanz et al., 2018; Tsobgny Tsague et al., 2018; Simpson et al., 2022). This study assessed the association between periodontal status and glycaemic control among adults with T2DM attending public hospitals in Ogun State, Nigeria. Methods: A hospital based cross sectional study was conducted among adults with T2DM attending teaching and general hospitals in Ogun State. Sociodemographic, behavioural and clinical information was collected using interviewer administered questionnaires and medical records. Periodontal status was assessed using the 2018 case definition for periodontitis. Glycaemic control was determined using HbA1c, with poor control defined as HbA1c ≥ 7.0%. Multivariable logistic regression was used to examine the association between periodontitis and poor glycaemic control, adjusting for age, sex, body mass index (BMI), and duration of diabetes, smoking and oral hygiene practices. Results: A total of 234 participants were included; 142 (60.7%) had periodontitis. Poor glycaemic control was observed in 64.8% of participants with periodontitis compared with 41.3% of those without periodontitis. After adjustment for potential confounders, periodontitis remained significantly associated with poor glycaemic control (adjusted odds ratio [AOR] ≈ 2–3, 95% confidence interval not including 1). Conclusion: Periodontitis was independently associated with poor glycaemic control among adults with T2DM in Ogun State. Integrating periodontal screening, prevention and basic periodontal therapy into routine diabetes care in Nigerian public hospitals may improve metabolic outcomes and support holistic non communicable disease management.
Stigma and Discrimination Experienced by Individuals Living with Sickle Cell Disease in Lagos Metropolis, Nigeria
Introduction: Sickle cell disease (SCD) is a common inherited blood disorder in Nigeria, often accompanied by social stigma and discrimination. Misconceptions about its causes, inheritance, and management affect the psychosocial well-being of affected individuals. Objectives: This study assessed stigma and discrimination experienced by individuals living with SCD in Lagos Metropolis, Nigeria. Method of Analysis: A cross-sectional community-based survey was conducted among 600 adults using multistage cluster sampling. Data were collected with a semi-structured interviewer-administered questionnaire covering socio-demographics, knowledge and beliefs about SCD, attitudes, genotype awareness, personal contact with individuals with SCD, and stigmatizing behaviors. Descriptive statistics summarized the data, while chi-square tests assessed associations between variables. Results: Awareness of SCD was universal, with friends/relatives and radio/TV as primary information sources. Knowledge and genotype awareness were moderate, with only 55% knowing their genotype. Attitudes were generally positive, but 28% reported high social distance behaviors. Higher knowledge and favorable attitudes were significantly associated with lower social distance (χ² = 18.6, p < 0.001), while low personal contact and lack of genotype awareness predicted higher stigma (χ² = 15.4, p = 0.002). Conclusion: Despite high awareness, stigma and discriminatory behaviors toward individuals with SCD persist. Community education, genetic counseling, and promoting positive interactions are essential to reduce stigma and improve social inclusion.
Radiomonitoring at the Meat-Oriented Farm “Soatov Otabek” in the Amudarya District of the Republic of Karakalpakstan
This article presents the results of radiometric monitoring conducted at the meat-oriented agro-farm “Soatov Otabek,” located in the Amudarya district of the Republic of Karakalpakstan. Samples of soil, alfalfa, water bodies, and hay collected from the farm territory were analyzed under laboratory conditions. The levels of ionizing radiation and the presence of radioactive substances were determined. Based on the obtained results, the radiation status of the farm environment was evaluated and compared with established regulatory standards. The findings confirm the importance of radiomonitoring in ensuring environmental safety and the quality of livestock products.
Surgical Techniques and Treatment Results of Skin Graft Reconstruction in Post-Burn Elbow Contractures
Post-burn scar deformities and contractures affecting joint regions, particularly the elbow, represent a significant clinical problem due to their impact on both functional capacity and aesthetic appearance. These pathological changes often result in restricted range of motion, discomfort, and a noticeable decline in patients’ quality of life and daily activity levels. Among the available reconstructive methods, skin grafting remains one of the most reliable and widely used techniques for correcting such deformities. This study focuses on the surgical principles and technical nuances of skin grafting in the management of post-burn elbow deformities. Special attention is given to preoperative evaluation, including assessment of scar characteristics and tissue condition, as well as to the selection of appropriate grafting techniques. In addition, key aspects of postoperative care, rehabilitation, and complication prevention are discussed. The findings indicate that properly planned and executed skin grafting significantly improves joint mobility, restores functional performance, and enhances cosmetic outcomes. Furthermore, the integration of adjunctive methods, including physiotherapy and laser therapy, contributes to better long-term results and reduces the risk of recurrence.
Healthcare Financing Options for Under-Five Child Care and Their Implications for Primary Healthcare Utilization in Oyo State, Nigeria
Under-five morbidity and mortality remain major public health challenges in Nigeria. Timely utilization of primary healthcare (PHC) is essential for preventing and managing common childhood illnesses. Caregivers’ socio-demographic characteristics, education, and household income strongly influence PHC utilization. Out-of-pocket payments dominate healthcare financing, limiting timely utilization of PHC services, while enrolment in health insurance schemes remains low, particularly among informal and low-income households. Understanding how caregiver factors interact with financing methods is critical for improving PHC access and child health outcomes. This study assessed the relationship between caregivers’ healthcare financing options and PHC utilization for under-five children in Oyo State, Nigeria. A cross-sectional survey was conducted among caregivers of under-five children, collecting data on socio-demographics, income, health-seeking patterns, and financing options. Descriptive statistics and chi-square tests were employed to examine associations between variables. The mean age of caregivers was 31.0 years (SD ± 8.5), with 91.7% female and 77.5% married. Informal employment was predominant (56.2%), and the majority earned below ₦100,000 per month. Out-of-pocket payment was the most common financing method (44.5%). PHC utilization was suboptimal, with only 22.7% of caregivers seeking care from PHC facilities during child illness and 53.1% delaying care by more than five days. Socio-demographic characteristics, particularly age, education, and income, significantly influenced financing choices and uptake of PHC. (p<0.001). Expanding affordable insurance coverage, promoting caregiver-targeted health education, and strengthening PHC service delivery and governance are essential to enhance timely utilization and equitable access, contributing to improved child health and progress toward universal health coverage in Nigeria.
Presently Frequent Occurrence Of Cervical Pathologies And Their Causes.
Cervical pathologies are a group of diseases that are widespread among women of reproductive age. In recent years, the incidence of inflammatory diseases, dysplasia and cervical cancer has been increasing. This article analyzes the types, etiological factors, pathogenesis, risk factors and causes of their spread of cervical pathologies. The main etiological factors are human papillomavirus (HPV), early sexual life, polysexual intercourse, decreased immunity and lack of screening. Early diagnosis and preventive measures are important in reducing the incidence.
Assessment of Attitudes and Perceptions toward COVID-19 Vaccination among Community Health Workers in Training at Agency Schools, University College Hospital, Ibadan, Nigeria
Background: Community health workers play a critical role in the promotion of public health interventions, including vaccination. Their attitudes and perceptions toward COVID 19 vaccination can influence both personal uptake and advocacy within the wider community. This study assessed the awareness, attitudes, perceptions, and factors associated with COVID 19 vaccine acceptance among community health workers in training at Agency Schools, University College Hospital (UCH), Ibadan, Nigeria. Methods: A descriptive cross-sectional study was conducted among 200 trainees enrolled in the Primary Health Care Tutors and Community Health Officers Training Programmes. Data were collected using a structured self-administered questionnaire, capturing socio-demographic characteristics, knowledge, perception, attitude, vaccination status, and factors influencing vaccine acceptance. Descriptive statistics, frequencies, percentages, and chi-square tests were used to analyze associations between perception, attitude, and vaccine uptake. Results: The mean age of respondents was 32.1 ± 8.4 years, with a majority being female (65%) and of Yoruba ethnicity (80%). Awareness of COVID 19 and preventive measures, including vaccination, was high, with 98% demonstrating knowledge of transmission routes and 95% aware of vaccine side effects. Eighty-five percent had received at least one dose of the COVID 19 vaccine, and 83% completed the full vaccination schedule. Positive attitudes toward vaccination, including encouragement of peers, were observed in 95% of respondents. Misconceptions regarding vaccine safety and efficacy were minimal but present. Chi-square analysis indicated significant associations between both attitude and perception with vaccine acceptance (p < 0.05). Perceived factors influencing vaccine uptake included personal health considerations, peer influence, and access to vaccination information. Conclusion: Community health worker trainees at UCH Ibadan demonstrated high awareness and generally positive attitudes toward COVID 19 vaccination, which were strongly associated with uptake. Residual misconceptions highlight the need for continued educational interventions, peer advocacy, and transparent communication to sustain vaccine confidence. Strengthening these strategies within training programs can enhance both personal uptake and broader public health promotion.
Risk Factors Associated with Severe Dehydration in Children with Acute Diarrhea in Emergency Settings
Background: Acute diarrhea is a leading cause of emergency care to children hospital globally and it still makes a significant contribution to the under-five morbidity and mortality. The most life-threatening complication is severe dehydration that has to be identified and treated immediately. Knowledge of clinical and socioeconomic predictors in the emergency situation plays a crucial role in selecting prevention initiatives. Aim: To identify the prevalence and independent predictors of severe dehydration in children that report to emergency departments with acute diarrhea. Methods: It was a hospital-based analytical cross-sectional study that was done in three tertiary emergency departments that were based in pediatric units with a 12 months period. Four hundred and twenty children aged between 1-59 months old diagnosed with acute diarrhea underwent enrolment in consecutive sampling. The level of dehydration was categorized by the WHO. The sociodemographic and nutrition, clinical, and home-management variables were obtained by interviewing caregivers and examining these factors by the doctor. The logistic regression analysis showed the multivariate predictors of severe dehydration with adjusted odds ratio (AOR), and 95% confidence interval (CI) being evaluated. Aim: 128 children were found to have severe dehydration (30.5%). Independent predictors were lack of oral rehydration therapy (AOR = 3.82; 95% CI: 2.156788), later presentation >48 hours (AOR = 3.12; 95% CI: 1.885.16), stool frequency>8/day (AOR = 2.91; 95% CI: 1.704.98), moderate/severe malnutrition (AOR = 2.74; 95) Conclusion: In emergency departments in almost a third of cases of children with acute diarrhea, severe dehydration was found. The clinical severity indicators as well as modifiable home-care practices both posed a significant risk. Rehydration therapy at an early stage, breastfeeding and timely treatment are significant measures to decrease emergency complications and avoid death.
Pediatric Nutrition Determinants, Health Outcomes, and Public Health Implications
The importance of pediatric nutrition, however, is its impact on a child growth and development as well as subsequent immune health and long-term outcomes. Adequate consumption of macronutrients and micronutrients in early childhood is critical for healthy physical and cognitive development. Yet there are global disparities, with undernutrition and micronutrient deficiencies continuing to be major public health challenges alongside emerging childhood obesity. The latest epidemiological evidence shows malnutrition is a direct contributory factor in over 45% of all deaths among under-fives worldwide. Rapid dietary transitions and urbanization have simultaneously resulted in increasing prevalence of overweight and metabolic disorders in children. Both extremes of malnutrition undernutrition and overnutrition have long-term consequences such as compromised immunity, poorer education achievement and greater risk for non-communicable diseases in adulthood. This article summarizes current evidence on the determinants of nutritional status in children and adolescents, describes health outcomes associated with nutritional imbalance, and outlines preventive approaches at familial/community/policy levels. As we work to improve sustainable child health outcomes worldwide, reinforcing early-life nutritional interventions continues to be a critical factor.
Comparison between Traditional Surgery and Laparoscopic Surgery in the Treatment of Hernias in the Elderly
Hernia repair in older patients typically involves a number of complexities related to the effects of aging on the body as well as underlying medical issues. This research has compared and contrasted open term with laparoscopically performed hernia repairs while evaluating operative outcomes, short-term recovery periods, complication rates, and long-term results. The terminal ambit of surgical evaluations showed that laparoscopy took about 10 minutes longer on average (95 ± 20 min) than open procedures (85 ± 15 min) during the course of surgery; however, the amount of blood lost during laparoscopic repair was much less (60 ± 20 ml versus 120 ± 30 ml). Regarding early recovery from surgery, patients undergoing a laparoscopic repair were able to ambulate sooner (1.5 ± 0.4 days post-op) when compared with patients undergoing an open repair (2.5 ± 0.5 days post-op), and exhibited fewer pain complaints (VAS 3 ± 1 versus VAS 6 ± 1), and stayed in the hospital for less time (3 ± 0.8 days versus 5 ± 1 days). The incidence of postoperative complications was higher in patients who had an open repair; for example, there were greater instances of wound-related morbidity due to wound infections (8% vs 3%) and seromas (10% vs 4%) in the open repair group when compared with the laparoscopic group. Incidence rates of cardiopulmonary events were somewhat higher during the immediate post-operative period in the laparoscopic group (6% vs 5%), however, all cardiopulmonary events were associated with an early post-operative period only. Recurrence rates of hernia at longterm follow-up were similar (4% laparoscopic vs 5% open), but laparoscopic repair patients exhibited more optimal functional status and greater patient satisfaction (90% vs 75%). Patients who had laparoscopic repairs also experienced significantly less chronic pain than patients who had open repairs (5% vs 12%). In conclusion, laparoscopic hernia repair provided numerous advantages to elderly patients over open procedure including shorter recovery time, lower complication rates and better long-term quality of life while presenting comparable rates of hernia recurrence.
Antibiotic Resistance in Uzbekistan And Germany: A Comparative Investigation into Public Health Implications
This study sets out to investigate and contrast the prevalence of and health burden associated with antibiotic resistance in Uzbekistan and Germany, with a special emphasis on the public health implications in both countries. Comparing healthcare systems, antibiotic use and resistance rates, the study helps to identify that contribute to development of resistance. Data were from health authorities, hospital reports and literature with comparison of differences and similarities between the 2 countries. The results of the work offer valuable input to the worldwide problem of antibiotic resistance underlining that purpose-oriented measures and international collaboration for containment are urgently needed.
Obesity Prevalence and its Health Implications: A Cross-National Analysis of Uzbekistan and Germany
Obesity has become an increasing worldwide health problem associated with chronic diseases including cardiovascular disease, type 2 diabetes as well as several cancers. The current study aims to compare the prevalence of obesity and related health consequences between a low-middle income country (Uzbekistan) and a high-income nation (Germany). Germany: Germany has an established obesity epidemic, with more than 50% of adults overweight Uzbekistan: Rapid urbanization and changes in diet have led to an emerging obesity crisis in the country The analysis describes underlying factors such as SES, diet, PA, and urbanization. It assesses the impact of public health interventions in each country, too. Results It seems that in Germany many public health programs were launched but had only some—primarily among the socially challenged groups—success. In contrast, Uzbekistan is at an early phase of the obesity epidemic and needs focused prevention plans. This study recommends country-specific public health interventions in both countries to address the escalating obesity epidemic and its consequential health effects.
Clinical Features of Bronchial Asthma in Children
Identification of clinical forms of bronchial asthma in children in the presence of causally significant allergens and concomitant allergic diseases associated with rhinoconjunctival symptoms, seizures develop rapidly, often acquiring a severe course of the disease.When bronchial asthma was combined with rhinoconjunctival symptoms, seizures developed intensively, the disease was severe and serious complications were observed.
Mechanisms of Brain Adaptation in Post-Stroke Motor Recovery
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Exercise-Based Cardiac Rehabilitation: Impact on Myocardial Function measured by Global Longitudinal Strain
Measures of cardiovascular (CV) health and function are improved by exercise. However, it might be challenging to determine the short-term efficacy of an exercise intervention when conventional metrics steadily improve. Reductions in left ventricular global longitudinal strain (LVGLS) are a powerful predictor of future cardiac dysfunction and death. LVGLS is a very sensitive cardiac imaging tool that can identify myocardial dysfunction before more conventional assessments. Because of its sensitivity, LVGLS may provide a practical way to monitor the short-term impact of an exercise intervention on CV function, giving practitioners valuable data to enhance patient care in exercise environments. It's unknown, nevertheless, how exercise affects LVGLS. This systematic review and meta-analysis aimed to determine the effect exercise has on LVGLS across a range of populations. Included studies assessed LVGLS pre–post an exercise intervention (minimum 2 weeks) in adults 18 years and over, and were published in English from 2000 onwards. Study-level random-effects meta-analyses were performed using Stata (v16.1) to calculate summary standardized mean differences (SMD) and 95% confidence intervals (CI). 39 studies met selection criteria, with 35 included in meta-analyses (1765 participants). In primary analyses, a significant improvement in LVGLS was observed in populations with CV disease (SMD=0.59; 95% CI 0.16–1.02; p=0.01), however, no significant effect of exercise was observed in CV risk factor and healthy populations. In populations with CV disease, LVGLS could be used as an early biomarker to determine the effectiveness of an exercise regime before changes in other clinical measures are observed.
Utilizing Global Longitudinal Strain (GLS) to Guide Safe Exercise Prescription and Physical Rehabilitation in Pediatric BAV Patients
Bicuspid aortic valve (BAV) is one of the most common congenital heart defects in children and is frequently associated with progressive valvular dysfunction and aortopathy. Conventional assessment using left ventricular ejection fraction (LVEF) may fail to detect early myocardial impairment. Despite increasing clinical application of speckle tracking echocardiography (STE), limited pediatric evidence exists regarding the prognostic value of global longitudinal strain (GLS) for identifying subclinical left ventricular dysfunction and guiding early clinical decision-making in BAV patients. This study provides an analytical evaluation of recent pilot evidence assessing GLS in pediatric BAV patients, with emphasis on segmental strain abnormalities and phenotype-specific risk stratification through STE-derived measurements. The evidence indicates that GLS is more sensitive than LVEF in detecting subtle myocardial dysfunction even when global systolic performance appears preserved. Segmental strain reductions, particularly in inferior, anterior, and apical regions, were identified as early indicators of myocardial alteration. Integration of GLS into routine pediatric BAV assessment may enhance early risk stratification, support safe exercise prescription, and enable personalized monitoring strategies. Nevertheless, larger multi-center longitudinal investigations are necessary to validate GLS as a standardized prognostic marker in pediatric cardiology practice.
Cholesteatoma of the Pineal Region of the Brain
Pineal region cholesteatoma (intracranial epidermoid cyst) is a rare benign congenital lesion characterized by accumulation of keratinized epithelium. Due to its slow growth, the tumor may remain asymptomatic for a long period and becomes clinically evident after compression of surrounding brain structures and ventricular system. This article presents a clinical case diagnosed using MRI and treated surgically. Neuroimaging revealed a large cystic formation in the pineal region. Microsurgical removal of the lesion was performed successfully, and the postoperative period was without complications. Early radiological diagnosis and timely surgical intervention are essential for favorable outcomes. Long-term follow-up is recommended because recurrence may occur.
Health Risk Analysis and Source Apportionment of Polyaromatic Hydrocarbons in Water and Sediment in Aluu River
This study focuses on the health risk analysis and source apportionment of polyaromatic hydrocarbons in water and sediment in Aluu River. The objectives were to quantify and characterize PAH concentrations, determine the sources of these contaminants and the health risks associated with exposure to polycyclic aromatic hydrocarbons. Surface water and sediment samples were collected from multiple locations along the Aluu River using standard sampling protocols. PAHs were extracted and quantified using Gas Chromatography-Mass Spectrometry (GC-MS) methods. Source apportionment was conducted using principal component analysis (PCA), while ecological and human health risk assessments were performed using hazard quotient (HQ) and cancer risk (CR) models. PAHs were detected in both water and sediment, with total concentrations ranging from 3.33 to 6.41 µg/L in water and 22.33 to 31.00 µg/kg in sediments. High molecular weight PAHs (HPAHs) predominated, suggesting pyrogenic sources. Health risk assessments indicated elevated HQs for several carcinogenic PAHs such as chrysene, benzo[a]pyrene, and benzo[ghi]perylene. The total cancer risk from PAHs in surface water ranged from 0.039 to 0.090, significantly above the acceptable threshold (1.0 × 10⁻⁶), indicating potential long-term health concerns. Principal component analysis (PCA) identified distinct pollution sources for PAHs, including industrial discharge, combustion activities, and urban runoff. The findings demonstrate significant contamination of the Aluu River by PAHs, with sediment acting as a major sink for these pollutants. The dominance of high-risk carcinogenic PAHs, coupled with elevated health risk indices, indicates potential long-term ecological degradation and serious public health concerns for populations dependent on the river. Establishment of a long-term environmental monitoring program to track PAHs trends and evaluate effectiveness of mitigation strategies is recommended